Malignancies of the pancreatobiliary system are usually unresectable at the time of diagnosis. As a consequence, a majority of these cases are candidates for palliative care. With advances in chemotherapeutic agents and multidisciplinary care, the survival rate in pancreatobiliary malignancies has improved. Therefore, there is a need to provide an effective and long-lasting palliative care for these patients. Endoscopic palliation is preferred to surgery as the former is associated with equal efficacy and reduced morbidity. The main role of endoscopic palliation in the vast majority of pancreatobiliary malignancies includes biliary and enteral stenting for malignant obstructive jaundice and gastric outlet obstruction, respectively. Recent advances in endoscopic palliation appear promising in imparting long-lasting relief of symptoms. Use of radiofrequency ablation and photodynamic therapy in malignant biliary obstruction has been shown to improve the survival rates as well as the patency of biliary stents. The emergence of endoscopic ultrasound (EUS) as a therapeutic tool has enhanced the capability of minimally invasive palliation in pancreatobiliary cancers. EUS is a valuable alternative to endoscopic retrograde cholangiopancreatography for the palliation of obstructive jaundice. More recently, EUS is emerging as an effective primary modality for biliary and gastric bypass.
Catheter Ablation ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Gastric Bypass ; Gastric Outlet Obstruction ; Humans ; Jaundice, Obstructive ; Palliative Care ; Pancreatic Neoplasms ; Photochemotherapy ; Stents ; Survival Rate ; Ultrasonography

ObjectiveTo evaluate the effectiveness and safety of low-concentration hydrogen peroxide solution (HPS) for continuous bladder irrigation after transurethral resection of the prostate (TURP).

METHODSWe retrospectively analyzed the clinical data about 148 cases of benign prostatic hyperplasia (BPH) treated by TURP from January 2013 to January 2016. Seventy-six of the patients received postoperative continuous bladder irrigation with 0.15% HPS (group A) and the other 72 with normal saline (group B). We compared the two groups of patients in their postoperative hemoglobin (Hb) levels, duration of bladder irrigation, frequency of catheter blockage, time of catheterization, and length of hospital stay.

RESULTSThere were no statistically significant differences between the two groups of patients preoperatively in the prostate volume, International Prostate Symptoms Score, maximum urinary flow rate, postvoid residual urine, or levels of serum PSA and Hb (P > 0.05). At 48 hours after operation, a significantly less reduction was observed in the Hb level in group A than in group B (［3.38 ± 2.56］ vs ［7.29 ± 6.58］ g/L, P < 0.01). The patients of group A, in comparison with those of group B, also showed remarkably shorter duration of postoperative bladder irrigation (［32.57 ± 5.99］ vs ［46.10 ± 8.79］ h, P < 0.01), lower rate of catheter blockage (3.3% vs 11.8%, P < 0.01), shorter time of catheterization (［3.74 ± 0.79］ vs ［4.79 ± 0.93］ d, P < 0.01), and fewer days of postoperative hospital stay (［4.22 ± 0.81］ vs ［4.67 ± 0.88］ d, P < 0.01).

CONCLUSIONSLow-concentration HPS for continuous bladder irrigation after TURP can reduce blood loss, catheter blockage, bladder irrigation duration, catheterization time, and hospital stay, and therefore deserves a wide clinical application.

Anti-Infective Agents, Local ; administration & dosage ; Catheter Obstruction ; Humans ; Hydrogen Peroxide ; administration & dosage ; Length of Stay ; Male ; Postoperative Hemorrhage ; prevention & control ; Postoperative Period ; Prostatic Hyperplasia ; blood ; surgery ; Quality of Life ; Retrospective Studies ; Therapeutic Irrigation ; methods ; statistics & numerical data ; Transurethral Resection of Prostate ; Treatment Outcome ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; prevention & control ; Urinary Retention

PURPOSE: This study was a retrospective cohort study to evaluate the effect of evidence-based guidelines for catheter dysfunction among hemodialysis patients, Success rate and bleeding complications in catheterization were examined. METHODS: We performed a retrospective cohort study, including 94 patients with catheter dysfunction who were receiving hemodialysis at a university hospital; 55 in the control group and 39 in the protocol group. This protocol was composed of the catheter dysfunction assessment, conservative management of catheter dysfunction, drug management of catheter dysfunction, catheter function test and maintenance management. Data were analyzed with a Chi-square test and t-test using SPSS/WIN 23.0 program. RESULTS: The patency rate of the protocol group was significantly higher than that of the control group. The rate of bleeding complications was not statistically significant for either the control group or the protocol group before or after application. CONCLUSION: The application of the guidelines effectively increased the patency rate of the catheter without bleeding complications. It is hoped that this guideline can be disseminated to nurses nationwide to improve the efficiency of catheter function for hemodialysis patients.
Catheter Obstruction ; Catheterization ; Catheters ; Cohort Studies ; Evidence-Based Practice ; Hemorrhage ; Hope ; Humans ; Renal Dialysis ; Retrospective Studies

OBJECTIVE: The thromboembolic events during neuroendovascular therapy (NET) are the major complications of concern that can be occasionally fatal. The thrombotic occlusion of the guide catheter for NET is thought to be the risk of the thromboembolic events. We have developed an idea for inventing the monitoring system of the continuous irrigation through the guide catheter. We herein present a unique invention of the guide catheter irrigation monitoring device. METHODS: We have developed ideas for preventing the thrombotic occlusion of the guide catheter. In order to design a convenient device working in the practical use, we have consulted and shared the ideas with the electrical engineers about putting the invention. RESULTS: The guide catheter irrigation monitoring device (GCIMD) consisted of three parts of optical sensor, main body and electric adapter. In brief, the basic principles of working of the GCIMD are as follows. The optical sensor is attached to the dripping chamber of the line to irrigation solution. The main body had the small light and speaker to make an alarm sounds. The sensor monitors the dripping of flush solution. If the dripping stops more than three seconds, a warning alarm has been activated. So, the operating physicians can concentrate and check the guide catheter irrigation. After the use of the GCIMD, there was no major thromboembolic complication in conjunction with the thrombotic occlusion of the guide catheter in our institute. CONCLUSION: We have developed a brilliant invention of the GCIMD for NET.
Angiography ; Catheter Obstruction ; Catheters* ; Endovascular Procedures ; Infarction ; Inventions* ; Ischemia

PURPOSE: Parenteral nutrition (PN) not only provides nutritional support but also plays a crucial role in the treatment of children with intestinal failure. The aim of this study was to evaluate the clinical significance and clinical outcomes of long-term PN. METHODS: Retrospective cohort study was conducted using the medical records of patients treated at Seoul National University Children's Hospital. This study included 19 patients who received PN for over six months. Most patients received home PN. RESULTS: The indications for PN included short bowel syndrome, chronic intestinal pseudo-obstruction, and intractable diarrhea of infancy. The median age of PN initiation was 1.3 years, and the median treatment duration was 2.9 years. Two patients were weaned from PN; 14 continued to receive PN with enteral feedings; and 3 patients died. The overall survival rates at 2 and 5 years were 93.3% and 84.0%, respectively. The incidence of catheter-related bloodstream infections was 2.7/1,000 catheter-days and was associated with younger age at PN initiation and lower initial height Z-score. Six patients developed catheter-related central vein thrombosis, with an incidence of 0.25/1,000 catheter-days. Eleven patients experienced PN-associated liver disease (PNALD), and one patient underwent multi-visceral transplant. The patients with PNALD exhibited lower final heights and body weight Z-scores. All patients experienced micronutrient deficiencies transiently while receiving PN. CONCLUSION: PN is an important and safe treatment for pediatric intestinal failure. PNALD was linked to final anthropometric poor outcomes. Micronutrient deficiencies were common. Anthropometric measurements and micronutrient levels must be monitored for successful PN completion.
Body Weight ; Catheter-Related Infections ; Child ; Cholestasis ; Cohort Studies ; Diarrhea ; Humans ; Incidence ; Intestinal Pseudo-Obstruction ; Liver Diseases ; Medical Records ; Micronutrients ; Nutritional Support ; Parenteral Nutrition ; Retrospective Studies ; Seoul ; Short Bowel Syndrome ; Survival Rate ; Thrombosis ; Veins

OBJECTIVE: To describe and analyze the clinical characteristics of nasopharyngeal teratoma in infants and improve the levels of diagnosis and treatment to reduce misdiagnosis. METHOD: The clinical data of 11 cases of nasopharyngeal teratoma in infants were reviewed retrospectively and summarized the clinical features. After the preoperative examination of nasopharyngeal endoscopy and imaging (CT or MRI), all patients were under general anesthesia of nasopharyngeal teratoma surgical resection. Of them, 8 cases were used radiofrequency ablation, 3 cases used conventional power systems. RESULT: Eleven cases with neoformation were completely removed, the operation time was 5-15 min, blood loss was 1-5 ml, patients had no significant nasal obstruction, bleeding, eating nasopharyngeal regurgitation, breathing difficulties or other complications. No recurrence was found after 10 months to 9 years followed up. CONCLUSION The nasopharyngeal mass must be kept in mind in the differential diagnosis of breathing difficulties in infants, especially when it exists together with upper airway obstruction symptoms; The low-temperature radiofrequency ablation with endoscopic had the advantages of short time, precise control, less bleeding, clear operative field, little injury and pain, low recurrence, providing a new clinical treatments.
Catheter Ablation ; Child ; Child, Preschool ; Endoscopy ; Humans ; Infant ; Nasal Obstruction ; Nasopharyngeal Neoplasms ; surgery ; Nasopharynx ; pathology ; Neoplasm Recurrence, Local ; Retrospective Studies ; Teratoma ; surgery

OBJECTIVE: To investigate the therapeutic effects of 894 coblation-assisted treatment in adult with obstructive sleep apnea-hypopnea syndrome. METHOD: A review of 894 coblation-assisted treatment in adult with obstructive sleep apnea-hypopnea syndrome was presented with respect to the sleep monitoring results, SF-36 health questionnaire survey, therapeutic effects and complications. RESULT: After operation for 6 months, the patients' sleep Monitoring results were improved remarkably (P<0. 01) and their symptoms of snore or choke got improved. SF-36 health questionnaire survey showed that social function, energy and mental health dimension scores were significantly higher than the preoperative (P<0. 05). There were 18 patients suffered Secondarily bleeding within 2 weeks and 23 patients recrudesced within 1 year. CONCLUSION Radio frequency coblation is an applicable method of therapy for patients with obstructive sleep apnea-hypopnea. The treatments differ with the obstructive location and character of upper airway.
Adult ; Airway Obstruction ; Catheter Ablation ; Humans ; Recurrence ; Retrospective Studies ; Sleep Apnea, Obstructive ; therapy ; Snoring ; Surveys and Questionnaires

A rubber tip disconnection of Arrow-Trerotola percutaneous thrombolytic device (PTD) may occur occasionally. We experienced 5 cases of a rubber tip disconnection among 453 mechanical thrombectomy sessions with the use of PTD. We present a report about these five cases and suggest possible causes for the occurrences.
Aged ; Catheter Obstruction/*etiology ; Equipment Failure Analysis/*methods ; Female ; Humans ; Male ; Middle Aged ; Renal Dialysis/*instrumentation ; Rubber ; Thrombectomy/*instrumentation ; Treatment Outcome

PURPOSE: Laparoscopy is being widely utilized beyond the field of surgery. We report on the early experience of laparoscopic CAPD catheter placement in adult ESRD patients. In addition, we investigate the question of whether laparoscopic CAPD catheter insertion can be used as a feasible long-term procedure. METHODS: Laparoscopic CAPD catheter placement was performed in 28 patients by one surgeon, between June, 2010 and October, 2013, and observed. A retrospective outcome study was conducted based on review of medical records. RESULTS: A total of 28 laparoscopic procedures were performed. The mean age of patients who underwent laparoscopic placement of a catheter was 60.3 years old. The most common cause of ESRD was uncontrolled hypertension combined with diabetes. The procedure took 45.7 minutes. Peritoneal dialysis was introduced on postoperative day eight, after one week of daily washing and no dialysate leaks were observed. Two incidences of catheter-related complications were observed: one incidence of catheter obstruction (due to its m igration and omental w rapping, w hich was m anaged with surgical removal) and one incidence of peritonitis (which was controlled with antibiotics). CONCLUSION: Laparoscopic CAPD catheter placement using tw o ports is a simple procedure with minimal complication. Laparoscopic CAPD catheter placement will gain greater acceptance as an alternative to the traditional method of CAPD catheter placement.
Adult* ; Catheter Obstruction ; Catheters* ; Humans ; Hypertension ; Incidence ; Kidney Failure, Chronic* ; Laparoscopy ; Medical Records ; Outcome Assessment (Health Care) ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Retrospective Studies

Autonomic dysreflexia is a clinical emergency syndrome of uncontrolled sympathetic output that can occur in patients who have a history of spinal cord injury. Despite its frequency in spinal cord injury patients, central nervous system complications are very rare. We report a man with traumatic high level incomplete spinal cord injury who suffered hypertensive right thalamic hemorrhage secondary to an episode of autonomic dysreflexia. Prompt recognition and removal of the triggering factor, the suprapubic catheter obstruction which led to hypertensive attack, the patient had a favorable functional outcome after the resorption of the hematoma and effective rehabilitation programme.
Autonomic Dysreflexia* ; Catheter Obstruction ; Central Nervous System ; Cerebral Hemorrhage* ; Emergencies ; Hematoma ; Hemorrhage ; Humans ; Rehabilitation ; Spinal Cord Injuries