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EN
Liver is common place where the cancer occurs primary as well as secondary. Liver resection as a potentially healing method can be performed only in about 20% of patients. Prognosis in group of patients treated non-invasively is bad. Using high frequency thermal ablation which damages the neoplastic tissue in liver may lead to prolongation of life expectancy.The aim of the study was to assess the early results of using the high frequency thermal ablation in patients with primary or secondary cancer.Material and methods. During years of 2001-2007 371 patients underwent the 520 procedures of percutaneous RF thermal ablation under US control. Mean age of patients was 62.47 (19-85 ± 11.63). 175 women and 196 men were treated using this method.Results. There were 10 early complications after thermal ablation (1.92% of procedures, 2.7% of patients). Two of them ended fatal (0.38% of procedures, 0.54% of patients). In seven cases absces formation were observed, one of them was the cause of death due to Clostridium perfingens infection. Cholerrhagia from damaged bile duct in cirrhotic liver caused the peritonitis and subsequent death of patient. Two patients suffered from sub-capsular hematoma of liver. 14 patients also suffered from long lasting pain (more than 14 days).Conclusions. Percutaneous thermal ablation in primary or secondary liver tumors is safe and efficient procedure. Long term follow up will give the knowledge about the real value of the procedure.
2
Content available remote A Prospective Comparison of Four Methods of Endovenous Thermal Ablation
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EN
The aim of the study was to compare clinical and duplex Doppler results of treatment of varicose veins with four methods of endovenous thermal ablation (EVTA).Material and methods. The results of treatment of varicose veins with 980 nm laser (EVLA980) in 67 extremities, with a radiofrequency ablation (RFA) in 43 extremities, with 810 nm laser (EVLA810) in 46 extremities and with 1470 nm laser (EVLA1470) in 15 extremities were prospectively analyzed. The data on patients' demographics, weight, stage of the venous disease, type of anesthesia, duration of the procedure, linear energy density (LED) applied, intra- and postoperative complications were collected. Thromboprophylaxis was not routinely administered. The patients were followed clinically and with duplex Doppler for 12 (1-24) months.Results. Technical success was achieved in 99% of limbs. The procedure was carried out under local anesthesia in 140 (91%) of patients. In 17 patients bilateral procedure was performed. There were one gastroenemius muscle vein thrombosis and one protruding thrombus from sapheno-femoral junction in EVLA810. No other serious complications were observed. A median LED was higher in EVLA810 than in EVLA980 and EVLA1470, 86.8 (82-94), 59.2 (45.4-74.4) and 58.8 (53-67.7) J/cm, respectively (p<0.001), though only in EVLA980 was below the intended range. Recanalization rates were 7% after EVLA980, 2% after EVLA810 and 0% after RFA and EVLA1470, p=0.14. The vein shrinking was fastest after EVLA1470. Neither neovascularization nor formation of arteriovenous fistulas was observed. Permanent saphenous nerve paresthesia occurred in two patients after RFA.Conclusions. All methods of ambulatory EVTA are safe and effective once the adequate linear energy density is applied.
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PL
Kostniak kostnawy jest nowotworem łagodnym o charakterystycznym ognisku (nidus) w badaniach radiologicznych. Najczęstszym objawem prowadzącym do jego rozpoznania jest silny, nocny ból, reagujący na niesteroidowe leki przeciwzapalne. Tomografia komputerowa jest metodą z wyboru w diagnostyce i lokalizacji zmiany. Kostniak kostnawy może wygoić się samoistnie, toteż leczenie zachowawcze jest jedną z metod postępowania. Resekcja otwarta była standardowym leczeniem kostniaka kostnawego do czasu wprowadzenia termoablacji prądem wysokiej częstotliwości (RFA) na początku lat 90. XX wieku. Obecnie istnieje kilka metod leczenia małoinwazyjnego. RFA pod kontrolą tomografii komputerowej jest aktualnie uważana za złoty standard terapeutyczny leczenia kostniaka kostnawego. W wielu przypadkach występuje znaczne opóźnienie pomiędzy początkiem charakterystycznych objawów a postawieniem prawidłowej diagnozy i skutecznym wyleczeniem. W związku z tym istotna jest znajomość obrazu klinicznego, prawidłowy dobór metod diagnostycznych i leczniczych.
EN
Osteoid osteoma (OO) is a benign bony lesion with a characteristic radiologic feature of x-ray focus (nidus). The most common symptom indicating diagnosis is strong nocturnal pain that eases with nonsteroidal anti-inflammatory drugs (NSAID). Computed tomography (CT) is a method of choice for diagnosing and localizing the tumor. Osteoid osteoma can regress spontaneously, thus conservative treatment is one of the methods of choice. In the past open resection surgery had been a standard management of osteoid osteoma until radiofrequency ablation (RFA) was discovered in the early 1990s. Nowadays, there are a few minimally invasive treatment techniques that are used. CT-guided radiofrequency ablation is considered a gold standard technique these days. Many cases occur with late diagnosis, and delayed treatment despite of characteristic symptoms. Therefore, it is crucial to be familiar with the clinical features of osteoid osteoma, proper diagnostic patterns, and treatment schemes.
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