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Hepatocellular carcinoma and liver metastases: clinical data on a new dual-lumen catheter kit for surgical sealant infusion to prevent perihepatic bleeding and dissemination of cancer cells following biopsy and loco-regional treatments.

Izzo F, Palaia R, Albino V, Amore A, di Giacomo R, Piccirillo M, Leongito M, Nasto A, Granata V, Petrillo A, Lastoria S - Infect. Agents Cancer (2015)

Bottom Line: RFA is a safe and effective procedure for treating unresectable primary or secondary liver malignancies, but it is not without complications.No statistical significance was observed between bleeding and age (p = 0.840), gender (p = 0.607) and histological diagnosis (p = 0,571), respectively.This study demonstrated that fibrin sealant or other surgical sealant injection, after any locoregional procedure such as biopsy or ablation, could make adverse events even more rare.

View Article: PubMed Central - PubMed

Affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.

ABSTRACT

Background: RFA is a safe and effective procedure for treating unresectable primary or secondary liver malignancies, but it is not without complications. The most common reported complications include abdominal hemorrhage, bile leakage, biloma formation, hepatic abscesses, and neoplastic seeding. The aim of this study is to evaluate the feasibility of percutaneous use of surgical sealant with a new coaxial bilumen catheter, to prevent the perihepatic bleeding and dissemination of cancer cells through the needle-electrode (neoplastic seeding) or along the needle track.

Methods: We designed a novel dual-lumen catheter to facilitate the optimal application of fibrin sealant after diagnostic and therapeutic percutaneous procedures. Percutaneous RFA has been performed using mask ventilation or neuroleptanalgesia. The main aims of this study, after the ablation procedure, in the treatment of unresectable liver cancer were to prevent major adverse events: a) the perihepatic bleeding; b) dissemination of cancer cells through the needle-electrode and or needle track.

Results: A total of 181 patients were evaluated for this study at National Cancer Institute of Naples from January 2012 to January 2014. The association of blood loss (≤1 g/dl; ≥1 g/dl) with age, gender, histological diagnosis were analyzed. No statistical significance was observed between bleeding and age (p = 0.840), gender (p = 0.607) and histological diagnosis (p = 0,571), respectively.

Conclusions: This study demonstrated that fibrin sealant or other surgical sealant injection, after any locoregional procedure such as biopsy or ablation, could make adverse events even more rare.

No MeSH data available.


Related in: MedlinePlus

Dual-lumen catheter. (a) Design of dual-lumen catheter. (b) Detail of the superior Luer-Lock attachment with evidence of the coaxial dual-lumen. (c) Internal section of the catheter.
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Fig1: Dual-lumen catheter. (a) Design of dual-lumen catheter. (b) Detail of the superior Luer-Lock attachment with evidence of the coaxial dual-lumen. (c) Internal section of the catheter.

Mentions: The kit used in the present study consisted of a 14G introducer, a 15G coaxial dual-lumen catheter, and a needle (Figure 1a,b,c). The introducer (Grimalind® L25) and catheter (20 cm long) were graduated, of the same length (200 mm) and made of radiopaque material (30% barium sulfate). The catheter had a steel core, a sharp and removable tip that was slightly longer than the introducer (210 mm) and a Luer-Lock connection. The needle had an oblique tip to allow easy penetration of the tissue. The catheter composed of Grilfex® ELG 6260 (PEBA) — a radiopaque and semi-rigid material — has two chambers one for each sealant component (Figure 2) and an inner spiral shape in which two components of the sealant are mixed before the injection (Figure 3).Figure 1


Hepatocellular carcinoma and liver metastases: clinical data on a new dual-lumen catheter kit for surgical sealant infusion to prevent perihepatic bleeding and dissemination of cancer cells following biopsy and loco-regional treatments.

Izzo F, Palaia R, Albino V, Amore A, di Giacomo R, Piccirillo M, Leongito M, Nasto A, Granata V, Petrillo A, Lastoria S - Infect. Agents Cancer (2015)

Dual-lumen catheter. (a) Design of dual-lumen catheter. (b) Detail of the superior Luer-Lock attachment with evidence of the coaxial dual-lumen. (c) Internal section of the catheter.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4403704&req=5

Fig1: Dual-lumen catheter. (a) Design of dual-lumen catheter. (b) Detail of the superior Luer-Lock attachment with evidence of the coaxial dual-lumen. (c) Internal section of the catheter.
Mentions: The kit used in the present study consisted of a 14G introducer, a 15G coaxial dual-lumen catheter, and a needle (Figure 1a,b,c). The introducer (Grimalind® L25) and catheter (20 cm long) were graduated, of the same length (200 mm) and made of radiopaque material (30% barium sulfate). The catheter had a steel core, a sharp and removable tip that was slightly longer than the introducer (210 mm) and a Luer-Lock connection. The needle had an oblique tip to allow easy penetration of the tissue. The catheter composed of Grilfex® ELG 6260 (PEBA) — a radiopaque and semi-rigid material — has two chambers one for each sealant component (Figure 2) and an inner spiral shape in which two components of the sealant are mixed before the injection (Figure 3).Figure 1

Bottom Line: RFA is a safe and effective procedure for treating unresectable primary or secondary liver malignancies, but it is not without complications.No statistical significance was observed between bleeding and age (p = 0.840), gender (p = 0.607) and histological diagnosis (p = 0,571), respectively.This study demonstrated that fibrin sealant or other surgical sealant injection, after any locoregional procedure such as biopsy or ablation, could make adverse events even more rare.

View Article: PubMed Central - PubMed

Affiliation: Abdominal Surgical Oncology and Hepatobiliary Unit, Istituto Nazionale Tumori, IRCCS Fondazione "G. Pascale", Via M.Semmola, 80131 Naples, Italy.

ABSTRACT

Background: RFA is a safe and effective procedure for treating unresectable primary or secondary liver malignancies, but it is not without complications. The most common reported complications include abdominal hemorrhage, bile leakage, biloma formation, hepatic abscesses, and neoplastic seeding. The aim of this study is to evaluate the feasibility of percutaneous use of surgical sealant with a new coaxial bilumen catheter, to prevent the perihepatic bleeding and dissemination of cancer cells through the needle-electrode (neoplastic seeding) or along the needle track.

Methods: We designed a novel dual-lumen catheter to facilitate the optimal application of fibrin sealant after diagnostic and therapeutic percutaneous procedures. Percutaneous RFA has been performed using mask ventilation or neuroleptanalgesia. The main aims of this study, after the ablation procedure, in the treatment of unresectable liver cancer were to prevent major adverse events: a) the perihepatic bleeding; b) dissemination of cancer cells through the needle-electrode and or needle track.

Results: A total of 181 patients were evaluated for this study at National Cancer Institute of Naples from January 2012 to January 2014. The association of blood loss (≤1 g/dl; ≥1 g/dl) with age, gender, histological diagnosis were analyzed. No statistical significance was observed between bleeding and age (p = 0.840), gender (p = 0.607) and histological diagnosis (p = 0,571), respectively.

Conclusions: This study demonstrated that fibrin sealant or other surgical sealant injection, after any locoregional procedure such as biopsy or ablation, could make adverse events even more rare.

No MeSH data available.


Related in: MedlinePlus