141 results on '"Gelatin Sponge, Absorbable adverse effects"'
Search Results
2. Symptomatic epidural hematoma caused by absorbable gelatin sponge implantation: A case report.
- Author
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Gao WS, Ren B, An J, and Zhou XZ
- Subjects
- Humans, Postoperative Complications, Hematoma diagnostic imaging, Hematoma etiology, Gelatin Sponge, Absorbable adverse effects, Gelatin
- Published
- 2023
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3. Comparison of blood loss between tranexamic acid-soaked absorbable Gelfoam and topical retrograde injection via drainage catheter plus clamping in cervical laminoplasty surgery.
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Chen C, Ye YY, Chen YF, Yang XX, Liang JQ, Liang GY, Zheng XQ, and Chang YB
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- Blood Loss, Surgical prevention & control, Catheters, Constriction, Drainage, Gelatin Sponge, Absorbable adverse effects, Humans, Postoperative Hemorrhage etiology, Postoperative Hemorrhage prevention & control, Antifibrinolytic Agents adverse effects, Laminoplasty adverse effects, Tranexamic Acid adverse effects
- Abstract
Background: To compare the safety and efficacy of tranexamic acid (TXA)-soaked absorbable Gelfoam and the retrograde injection of TXA through a drain with drain-clamping in degenerative cervical laminoplasty patients., Methods: Patients were assigned into either TXA retrograde injection (TXA-RI), TXA-soaked absorbable Gelfoam (TXA-Gel), or control groups. The demographics, operative measurements, volume and length of drainage, length of hospital stay, complete blood cell count, coagulopathy, postoperative complications, and blood transfusion were recorded., Results: We enrolled 133 patients, with 44, 44, and 45 in the TXA-RI, TXA-Gel, and control groups, respectively. The baseline characteristics did not differ significantly among the three groups. The TXA-RI group exhibited a lower volume and length of postoperative drainage compared to the TXA-Gel and control groups (126.60 ± 31.27 vs. 156.60 ± 38.63 and 275.45 ± 75.27 mL; 49.45 ± 9.70 vs 58.70 ± 10.46 and 89.31 ± 8.50 hours, all P < 0.01). The TXA-RI group also had significantly shorter hospital stays compared to the control group (5.31 ± 1.18 vs 7.50 ± 1.25 days, P < 0.05) and higher hemoglobin and hematocrit levels (12.58 ± 1.67 vs 11.28 ± 1.76 g/dL; 36.62 ± 3.66% vs 33.82 ± 3.57%, both P < 0.05) at hospital discharge. In the TXA-RI and TXA-Gel groups, the D-dimmer (DD) and fibrinogen (FIB) were significantly lower than those in the control group after surgery (P < 0.05). None of the patients required blood transfusion. No complications, including thromboembolic events, were reported., Conclusion: Topical retrograde injection of TXA through a drain with drain-clamping at the conclusion of unilateral posterior cervical expansive open-door laminoplasty may effectively reduce postoperative blood loss and the length of hospital stays without increasing postoperative complications., (© 2022. The Author(s).)
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- 2022
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4. Diaphragmatic weakness after transcatheter arterial chemoembolization of the right inferior phrenic artery for treatment of hepatocellular carcinoma: a comparison of outcomes after N-butyl cyanoacrylate versus gelatin sponge embolization.
- Author
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Noh SY, Gwon DI, Park S, Yang WJ, Chu HH, and Kim JW
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- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Retrospective Studies, Carcinoma, Hepatocellular therapy, Chemoembolization, Therapeutic adverse effects, Diaphragm blood supply, Diaphragm physiopathology, Enbucrilate adverse effects, Gelatin Sponge, Absorbable adverse effects, Liver Neoplasms therapy
- Abstract
Background: The inferior phrenic artery (IPA) is the most common extrahepatic feeder for hepatocellular carcinoma (HCC) during transhepatic arterial chemoembolization (TACE)., Purpose: To compare the incidence of diaphragmatic weakness in patients with HCC after TACE of the right IPA conducted using either N-butyl cyanoacrylate (NBCA) or gelatin sponge particles., Material and Methods: Medical records of 111 patients who underwent TACE of the right IPA using NBCA were retrospectively reviewed and compared with data from 135 patients with IPA embolization using gelatin sponge particles., Results: The incidence of diaphragmatic weakness after the initial TACE procedure did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 20.7%; P = 0.458). Five patients in the NBCA group and 11 in the gelatin sponge group showed spontaneous resolution of diaphragmatic weakness after a mean period of 3.5 months. Diaphragmatic weakness developed after the initial follow-up visit in 17 patients from the gelatin sponge group due to repeated TACE of the right IPA (mean 2.4 sessions; range 2-4 sessions), while it spontaneously developed without additional TACE procedures in one patient from the NBCA group. Permanent diaphragmatic weakness was less common in the NBCA than in the gelatin sponge group (12.6% and 25.2%, respectively; P = 0.017). The complete response rate did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 25.9%; P = 0.065)., Conclusion: Use of NBCA rather than gelatin sponge particles for TACE of the right IPA resulted in a lower incidence of permanent diaphragmatic weakness.
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- 2022
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5. Multicenter phase III trial of regenerative treatment for chronic tympanic membrane perforation.
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Kanemaru SI, Kanai R, Omori K, Yamamoto N, Okano T, Kishimoto I, Ogawa K, Kanzaki S, Fujioka M, Oishi N, Naito Y, Kakehata S, Nakamura H, Yamada S, Omae K, Kawamoto A, and Fukushima M
- Subjects
- Aged, Female, Fibroblast Growth Factor 2 adverse effects, Gelatin Sponge, Absorbable adverse effects, Humans, Male, Middle Aged, Treatment Outcome, Fibrin Tissue Adhesive, Fibroblast Growth Factor 2 therapeutic use, Gelatin Sponge, Absorbable therapeutic use, Tympanic Membrane Perforation therapy
- Abstract
Objective: To evaluate the efficacy and safety of regenerative treatment for tympanic membrane perforation (TMP) using gelatin sponge, basic fibroblast growth factor (bFGF), and fibrin glue., Methods: This was a multicenter, non-randomized, single-arm study conducted at tertiary referral centers. Twenty patients with chronic TMP (age 23-78 years, 6 males, 14 females) were registered from three institutions. All treated patients were included in the safety analysis population. The edges of the TMP were disrupted mechanically by myringotomy and several pieces of gelatin sponge immersed in bFGF were placed and fixed with fibrin glue to cover the perforation. The TMP was examined 4 ± 1 weeks later. The protocol was repeated up to four times until closure was complete. The main outcome measures were closure or a decrease in size of the TMP, hearing improvement, and air-bone gap evaluated 16 weeks after the final regenerative procedure (FRP). Adverse events (AEs) were monitored throughout the study., Results: Total closure of the TMP at 16 weeks was achieved in 15 out of 20 patients (75.0%, 95% confidence interval [CI]: 50.9%-91.3%) and the mean decrease in size was 92.2% (95%CI: 82.9%-100.0%). The ratio of hearing improvement and the air-bone gap at 16 weeks after FRP were 100% (20/20; 95%CI: 83.2%-100%) and 5.3 ± 4.2 dB (p <0.0001), respectively. Thirteen out of 20 patients (65.0%) experienced at least one AE, but no serious AEs occurred., Conclusion: The results indicate that the current regenerative treatment for TMP using gelatin sponge, bFGF, and fibrin glue is safe and effective., Competing Interests: Declaration of Competing Interest This study was supported by Nobelpharma Co., Ltd., Tokyo, Japan. S. Kanemaru received patent royalties/licensing fees from Nobelpharma Co., Ltd. S.Yamada is a former employee of Nobelpharma Co., Ltd. All the other authors disclose no conflicts of interest., (Copyright © 2021. Published by Elsevier B.V.)
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- 2021
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6. Efficacy and Safety of a Thrombin-Containing Collagen-Based Hemostatic Agent in Spinal Surgery: A Randomized Clinical Trial.
- Author
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Park SM, Kang DR, Lee JH, Jeong YH, Shin DA, Yi S, Ha Y, and Kim KN
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- Adult, Aged, Collagen adverse effects, Drainage, Female, Gelatin Sponge, Absorbable adverse effects, Gelatin Sponge, Absorbable therapeutic use, Hemostasis, Hemostatic Techniques, Hemostatics adverse effects, Humans, Length of Stay, Male, Middle Aged, Neurosurgical Procedures, Prospective Studies, Thrombin adverse effects, Treatment Outcome, Blood Loss, Surgical prevention & control, Collagen therapeutic use, Hemostatics therapeutic use, Spine surgery, Thrombin therapeutic use
- Abstract
Objective: When common hemostatic methods, such as suturing, cautery, and compression, fail to arrest bleeding during surgery, various local hemostatic agents are used. We aimed to evaluate the hemostatic efficacy and safety of CollaStat (Dalim Tissen Co. Ltd., Seoul, Korea), a novel thrombin-containing, collagen-based topical haemostatic agent used in spinal surgery, by comparing it with Floseal (Baxter Healthcare, Deerfield, Illinois, USA)., Methods: We performed a randomized controlled trial in 78 patients who underwent spinal surgery. The participants were randomly assigned to either an intervention group (use of CollaStat) or a control group (use of Floseal). We compared successful haemostasis rate, time to hemostasis, length of hospital stay, amount of fluid drainage, and rate of adverse events between the 2 groups., Results: The hemostasis success rate was 94.87% in the intervention group and 97.44% in the control group. The hemostatic efficacy and safety of CollaStat were found to be noninferior to those of Floseal since the higher limit (11.09%) of the confidence interval (CI) for the difference with Floseal was greater than the prespecified noninferiority margin of -13%. There were no statistically significant differences at the 5% level in hemostasis time, number of hemostatic agents used, hospitalization period, and amount of drainage between the 2 groups. Also, there was no incidence of medical device-related serious adverse events or adverse events in both groups., Conclusions: The hemostatic efficacy and safety of CollaStat were found to be noninferior to those of Floseal. Therefore CollaStat can be safely and effectively used in spinal surgery., (Copyright © 2021 Elsevier Inc. All rights reserved.)
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- 2021
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7. Review of topical gelatin-based haemostatic agents; an insidious culprit of intraoperative anaphylaxis?
- Author
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White RZ, Kerr L, White TJ, and Sampson MJ
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- Animals, Cattle, Collagen, Gelatin adverse effects, Gelatin Sponge, Absorbable adverse effects, Humans, Swine, Anaphylaxis chemically induced, Hemostatics adverse effects
- Abstract
Background: An under-recognized complication of gelatin-based haemostatic agents is their potential to cause anaphylactic reactions. This review aims to collate and analyse case in the literature of intraoperative anaphylaxis secondary to locally applied haemostatic agents., Methods: An electronic search was performed on databases Medline, Embase, Pubmed and ProQuest. A total of 7671 articles were reviewed from title and abstract. After exclusion criteria and duplicates removed, 19 articles with 21 cases were included for analysis. Data extracted from each of the articles included patient demographics, haemostatic agent used, surgery type, known allergies and any objective evidence of hypersensitivity post anaphylactic episode, that is tryptase levels, IgE levels, skin prick testing., Results: Fifty-seven percent of cases involved patients <18 years of age; 57% of cases involved spinal surgery; 100% of cases displayed objective evidence of hypersensitivity (tryptase levels, bovine or porcine IgE levels, or skin prick testing). Thirty-three percent of patients had exposure preoperatively to a known agent causing anaphylaxis or allergy which would preclude the use of a gelatin-based haemostat. These products included vaccines, spam meats, red meat, Jell-O and CollaPlug. Gelatin-based haemostat agents included Floseal, Gelfoam, Surgiflo, fibrin glue, Avitene, haemofibrine sponge, topical bovine thrombin and thrombin-soaked gelatin., Conclusion: Increased awareness of allergy to gelatin-based haemostats for surgical and anaesthetic is imperative, with 33% of cases having a known contraindication to gelatin-based haemostat. This review highlights important aspects in the pre-operative patient history and post-event patient investigation that could assist anaesthetists and surgeons in the prevention of future events., (© 2021 Royal Australasian College of Surgeons.)
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- 2021
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8. Two Cases of Cerebral Infarcts Caused by Topical Hemostatic Agent Embolism.
- Author
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Coss DJ, Tlomak W, and Cochran E
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- Administration, Topical, Adult, Cerebral Infarction diagnostic imaging, Computed Tomography Angiography, Fatal Outcome, Female, Gelatin Sponge, Absorbable administration & dosage, Gelatin Sponge, Absorbable adverse effects, Hemostatics administration & dosage, Humans, Intracranial Embolism etiology, Male, Middle Aged, Vertebrobasilar Insufficiency etiology, Vertebrobasilar Insufficiency pathology, Cerebral Infarction pathology, Hemostatics adverse effects, Intracranial Embolism pathology
- Abstract
Abstract: Resorbable topical hemostatic agents are widely used in surgical procedures to control intraoperative bleeding. There have been multiple reports of complications from use of these agents, including pulmonary vasculature thromboembolism, cerebral venous sinus occlusion, and postoperative inflammatory mass lesions each containing the hemostatic agent. We report 2 cases of inadvertent intra-arterial embolization of hemostatic agent. Both cases followed elective surgical cervical spinal procedures, during which gelatin-based local hemostatic agents were used to control unanticipated bleeding. Postoperatively, both patients exhibited neurologic defects and were found to have infarcts of the brain. At autopsy, vertebrobasilar thromboemboli containing foreign material grossly and microscopically consistent with hemostatic matrix material were found in both cases. These are the first reports of hemostatic agent embolization resulting in cerebral infarcts and leading to death., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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9. Gelfoam Migration: A Potential Cause of Recurrent Hydrocephalus.
- Author
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Ktari O, Frassanito P, Gessi M, Bianchi F, Tamburrini G, and Massimi L
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- Child, Female, Foreign-Body Migration diagnostic imaging, Humans, Hydrocephalus diagnostic imaging, Infant, Male, Recurrence, Ventriculostomy adverse effects, Foreign-Body Migration etiology, Foreign-Body Migration surgery, Gelatin Sponge, Absorbable adverse effects, Hydrocephalus etiology, Hydrocephalus surgery
- Abstract
Background: Gelfoam is a simple and effective hemostatic agent that is used to seal brain corticotomies or skull burr holes. Owing to its low cost, it is one of the most widely used tools in neurosurgical daily practice. However, migration of Gelfoam fragments can cause occlusion of endoscopic third ventriculostomy (ETV) or shunt, leading to hydrocephalus recurrence., Case Description: Two cases of Gelfoam migration causing recurrent hydrocephalus are presented: a 12-year-old girl who underwent surgery for posterior fossa tumor removal and ETV for associated hydrocephalus, where a portion of Gelfoam (used to seal the burr hole) migrated up to close the ETV, and a preterm 8-month-old boy who was treated by neuroendoscopic brain lavage and afterward by ventriculoperitoneal shunt for posthemorrhagic hydrocephalus, where all the Gelfoam used to close the corticotomy migrated into the lateral ventricle, thus reopening the corticotomy and releasing small fragments that ultimately obstructed the shunt. A new endoscopic procedure was required in both patients (the second patient also required a shunt revision)., Conclusions: Review of the pertinent literature discloses other complications of Gelfoam migration (e.g., mass effect, granulomatous reaction) as well as other causes of uncommon ETV/shunt obstruction. Nonetheless, Gelfoam will remain an indispensable tool for neurosurgeons. The present report emphasizes the importance of its correct use to avoid complications., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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10. A Rare Case of Fatal Pulmonary Embolism in a Pediatric Spine Surgery.
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Ji P, Jiang Y, Hou W, Li Q, and Kang Y
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- Child, Echocardiography, Transesophageal, Fatal Outcome, Female, Foreign-Body Migration pathology, Hemostasis, Surgical, Humans, Intraoperative Complications diagnostic imaging, Intraoperative Complications pathology, Pulmonary Embolism diagnostic imaging, Pulmonary Embolism pathology, Blood Loss, Surgical, Foreign-Body Migration complications, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Intraoperative Complications etiology, Pulmonary Embolism etiology, Scoliosis surgery, Spinal Fusion
- Abstract
Background: An 11-year-old girl had undergone posterior spinal fusion surgery for scoliosis. The surgery was complicated by intraoperative bleeding, and hemostasis was achieved by topically applying gelatin sponges., Case Description: She developed acute pulmonary embolism and cardiac arrest during the surgery, which was confirmed by transesophageal echocardiography., Conclusions: Autopsy shortly after revealed that her death was associated with unintended intravascular entry of gelatin sponge fragments, resulting in an embolic event and secondary cardiopulmonary collapse., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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11. Endo-sponge Assisted Early Surgical Closure of Ileal Pouch-anal Anastomotic Leakage Preserves Long-term Function: A Cohort Study.
- Author
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Wasmann KA, Reijntjes MA, Stellingwerf ME, Ponsioen CY, Buskens CJ, Hompes R, Tanis PJ, and Bemelman WA
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- Adult, Female, Gelatin Sponge, Absorbable administration & dosage, Gelatin Sponge, Absorbable adverse effects, Humans, Long Term Adverse Effects etiology, Long Term Adverse Effects prevention & control, Male, Netherlands, Outcome and Process Assessment, Health Care, Retrospective Studies, Wound Closure Techniques instrumentation, Anastomotic Leak etiology, Anastomotic Leak prevention & control, Colitis, Ulcerative surgery, Colonic Pouches adverse effects, Postoperative Complications etiology, Postoperative Complications prevention & control, Proctocolectomy, Restorative adverse effects, Proctocolectomy, Restorative methods, Sepsis etiology, Sepsis prevention & control
- Abstract
Background and Aims: Endo-sponge [Braun Medical] assisted early surgical closure [ESC] is an effective treatment to control pelvic sepsis after ileal pouch-anal anastomosis [IPAA] leakage, and became standard treatment in our centre from 2010 onwards. The aim of this cohort study was to assess the long-term pouch function of ulcerative colitis [UC] patients treated with ESC or conventional management [CM] for anastomotic leakage after IPAA., Methods: Consecutive patients who underwent an IPAA for UC between 2002 and 2017 were included. Patients treated with ESC [2010-2017] or CM [2002-2009] for anastomotic leakage were compared with control patients without anastomotic leakage of the corresponding time period. Main endpoints were long-term pouch function on a 3-point scale and pouch failure, as measured with the validated pouch dysfunction score questionnaire., Results: Some 280 of 334 patients [84%] returned the pouch dysfunction questionnaire, of whom 18 were treated with ESC and 22 with CM for anastomotic leakage. Control cohorts included 133 [2010-2017] and 107 patients [2002-2009]. Between ESC-treated patients and control patients, pouch function [p = 0.647] and pouch failure rates [0/18 versus 5/133, p >0.99] were similar. CM resulted in worse pouch function [p = 0.016] and a higher pouch failure rate [5/22 versus 5/107, p = 0.013] compared with control patients., Conclusions: ESC, in contrast to CM, for IPAA leakage in UC patients is associated with preservation of pouch function and preclusion of pouch failure, probably due to early and effective treatment of pelvic sepsis., (Copyright © 2019 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
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12. Uterine Artery Embolization with Gelfoam for Acquired Symptomatic Uterine Arteriovenous Shunting.
- Author
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Camacho A, Ahn EH, Appel E, Boos J, Nguyen Q, Justaniah AI, Faintuch S, Ahmed M, and Brook OR
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- Abortion, Induced adverse effects, Adult, Dilatation and Curettage, Female, Fertility, Gelatin Sponge, Absorbable adverse effects, Humans, Middle Aged, Postpartum Hemorrhage diagnostic imaging, Postpartum Hemorrhage etiology, Pregnancy, Retrospective Studies, Risk Factors, Time Factors, Time-to-Pregnancy, Treatment Outcome, Uterine Artery Embolization adverse effects, Uterine Hemorrhage diagnostic imaging, Uterine Hemorrhage etiology, Young Adult, Gelatin Sponge, Absorbable administration & dosage, Postpartum Hemorrhage therapy, Uterine Artery Embolization methods, Uterine Hemorrhage therapy
- Abstract
Purpose: To evaluate the technical and clinical success rates and safety of bilateral gelfoam uterine artery embolization (UAE) for symptomatic acquired uterine arteriovenous shunting due to prior obstetric or gynecologic event., Materials and Methods: This was a retrospective study of consecutive patients of reproductive age who presented with abnormal uterine bleeding after recent gynecologic procedures or obstetric events between January 2013 and February 2018. Bilateral UAE was performed in all patients using gelfoam slurry. Technical success was defined as angiographic resolution of arteriovenous shunting. Clinical success was defined as cessation of symptomatic bleeding, resolution on follow-up imaging, or minimal estimated blood loss (EBL) (<50 ml) on subsequent elective dilation and curettage (D&C) procedure., Results: Eighteen patients (mean age, 32.8 ± 7.1 years) were included. Technical success and clinical success were experienced by 17/18 (94.4%) and 16/17 (94.1%) patients, respectively. Angiography demonstrated arteriovenous shunting in 18/18 (100%) patients, with early venous drainage. Seven of 18 (38.9%) patients underwent subsequent scheduled D&C due to remaining retained products of conception, with an EBL of 17.9 ± 15.6 ml. There was 1 minor complication of a self-limited vascular access groin hematoma (1/18, 5.6%) and 1 major complication (1/18, 5.6%) of a pulmonary embolism detected 3 days after UAE. The length of clinical follow-up was 19.3 ± 15.5 months, in which 41.2% (7/17) of the patients became pregnant., Conclusions: UAE with gelfoam alone for symptomatic uterine arteriovenous shunting is a feasible treatment option that has a high technical and clinical success rate with a low rate of complications., (Copyright © 2019 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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13. Experience with Compressed Gelfoam Plugs in Children during Liver Biopsies and Other IR Procedures: A Retrospective Single-Center Case Series.
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McDonald J, Amirabadi A, Farhat Z, Temple M, Parra D, Amaral J, and Connolly B
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- Adolescent, Age Factors, Anaphylaxis chemically induced, Biopsy, Large-Core Needle, Child, Child, Preschool, Female, Gelatin Sponge, Absorbable adverse effects, Hemorrhage etiology, Humans, Infant, Infant, Newborn, Male, Ontario, Retrospective Studies, Risk Assessment, Risk Factors, Treatment Outcome, Gelatin Sponge, Absorbable administration & dosage, Hemorrhage prevention & control, Image-Guided Biopsy adverse effects, Liver Diseases pathology, Radiography, Interventional adverse effects
- Abstract
Purpose: To analyze the experience using compressed gelfoam plugs (CGPs) in children during liver biopsies and other interventional procedures., Materials and Methods: This was a single-center, retrospective, consecutive case series of 477 various pediatric interventional radiology procedures using CGPs (January 2012 to December 2016) performed on 397 children (209 males, 188 females; median age, 7 years [range, 9 days-17.8 years]; median weight, 18 kg [range, 2.7-141 kg]). Of 477 procedures, most (n = 371) were liver biopsies, 98 were biopsies of other organs, and 8 were non-biopsy procedures. Analysis focused on liver biopsies., Results: Of liver biopsies, a median of 2 CGPs were used per procedure, and the mean drop in hemoglobin was -0.36 g/dl (-3.0% change). Thirty-seven mild, 8 moderate, 2 severe, and 1 life-threatening (an anaphylaxis to CGP) adverse events (AEs) occurred. Analysis of liver biopsies with AEs showed significant association between number of passes, cores, and focal-type lesions (unadjusted logistic regression: P = .007, P = .022, P = .028, respectively) and age, weight, and number of passes (adjusted multiple logistic regression: P = .006, P = .032, P = .046, respectively). Technical problems relating to CGP deployment were noted in 5 (1%), without any AEs., Conclusions: CGPs were used in a wide variety of procedures and organs in children. There was 1 life-threatening AE resulting from the rare risk of anaphylaxis caused by the gelfoam-containing plug. After liver biopsies, transfusion was required in 2/371 (0.5%) procedures, 1 related to pre-biopsy anemia (0.25%)., (Copyright © 2019 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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14. Hemostatic Thrombin-Gelatin Matrix-Related Intracranial Cyst Formation.
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Ho MY, Yang SH, Chen CM, and Huang AP
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- Aged, 80 and over, Female, Gelatin adverse effects, Hemostatic Techniques instrumentation, Humans, Thrombin adverse effects, Brain Neoplasms etiology, Cysts etiology, Gelatin Sponge, Absorbable adverse effects, Hemostatic Techniques adverse effects
- Abstract
Background: Local hemostatic agents have been used in the neurosurgical field for many years; it is safe and efficient with no fatal complication reported in the literature. We routinely used a gelatin-thrombin hemostatic agent (FloSeal Hemostatic Matrix) for hemostasis in minimally invasive endoscopic-assisted surgery for more than 500 patients with intracerebral hemorrhage. However, 2 cases with sterile cyst formation were encountered., Case Description: We reported 2 cases with sterile cyst formation after the use of a gelatin-thrombin hemostatic agent. Both of them had intracerebral hemorrhage. One received endoscopic hematoma evacuation, and the other had traditional craniotomy. They all received drainage of the cyst due to progressive enlargement and the mass effect they exert., Conclusions: These sterile cysts were very close to the ventricle wall on images. We hypothesized that cyst wall may be formed not only by hemostatic agent-related fibrosis and inflammation according to the previous literature review but also by the presence of the check valve mechanism between the cyst and the ventricle, which caused further dilation of the cyst., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2019
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15. Single-Center Retrospective Study of Preoperative Prostatic Artery Embolization with the Use of Gelatin Sponge: Initial Experience and Influence for Blood Loss in Prostate Surgery.
- Author
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Shin MG, Kim KY, Han YM, Kim KM, and Shin YS
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- Aged, Aged, 80 and over, Blood Loss, Surgical prevention & control, Blood Transfusion, Gelatin Sponge, Absorbable adverse effects, Humans, Length of Stay, Male, Middle Aged, Postoperative Hemorrhage prevention & control, Preoperative Care adverse effects, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Arteries, Embolization, Therapeutic adverse effects, Gelatin Sponge, Absorbable administration & dosage, Laser Therapy adverse effects, Preoperative Care methods, Prostate blood supply, Prostate surgery, Prostatectomy adverse effects
- Abstract
Purpose: To investigate the safety and effectiveness of preoperative prostatic artery embolization (PAE) in relation to decrease in hemoglobin level, requirement for blood transfusion, length of hospitalization, and procedure-related complications., Materials and Methods: Ten consecutive patients who underwent surgery after preoperative PAE were identified from May 2017 to October 2018 (embolization group: holmium-laser enucleation of the prostate [HoLEP] in 6 patients and robotic simple prostatectomy in 4 patients, mean age 72.9 ± 8.7 years, mean prostatic volume 106.5 ± 22.0 mL). For comparison, consecutive patients with a large prostatic volume (≥70 mL) who underwent surgery without preoperative PAE during the same period were enrolled (nonembolization group: HoLEP in 9 patients and robotic simple prostatectomy in 1 patients, mean age 71.2 ± 5.7 years, mean prostatic volume 87.8 ± 26.7 mL)., Results: PAE was technically successful in 90% of patients (9/10). The median interval between PAE and surgery was 2 days. The mean hemoglobin reduction was lower (1.40 ± 0.92 g/dL vs 3.07 ± 1.50 g/dL; P = .008) and the median length of hospitalization was shorter (8.5 days vs 11 days; P = .039) in the embolization group than the nonembolization group. The operating time (mean for HoLEP 146 ± 38 min vs 179 ± 59 min [P = .248], mean for robotic simple prostatectomy 223 ± 32 min vs 354 min) and number of blood transfusion (1 patient vs 2 patients; P = .392) were not significantly different between the 2 groups. None of the patients developed any complications except bleeding requiring transfusion., Conclusions: Preoperative PAE is safe and may reduce blood loss during prostate surgery., (Copyright © 2019 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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16. Bronchial Artery Embolization for Hemoptysis in Primary Lung Cancer: A Retrospective Review of 84 Patients.
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Han K, Yoon KW, Kim JH, and Kim GM
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- Aged, Carcinoma, Non-Small-Cell Lung diagnostic imaging, Carcinoma, Non-Small-Cell Lung pathology, Embolization, Therapeutic adverse effects, Female, Gelatin Sponge, Absorbable adverse effects, Hemoptysis etiology, Humans, Lung Neoplasms diagnostic imaging, Lung Neoplasms pathology, Male, Middle Aged, Neoplasm Staging, Polyvinyl Alcohol adverse effects, Progression-Free Survival, Recurrence, Republic of Korea, Retrospective Studies, Small Cell Lung Carcinoma diagnostic imaging, Small Cell Lung Carcinoma pathology, Time Factors, Tomography, X-Ray Computed, Bronchial Arteries, Carcinoma, Non-Small-Cell Lung complications, Embolization, Therapeutic methods, Gelatin Sponge, Absorbable administration & dosage, Hemoptysis therapy, Lung Neoplasms complications, Polyvinyl Alcohol administration & dosage, Small Cell Lung Carcinoma complications
- Abstract
Purpose: To evaluate the safety and efficacy of bronchial artery embolization (BAE) in patients with primary lung cancer-related hemoptysis and to identify factors associated with hemoptysis-free survival., Methods: Data from 84 patients with primary lung cancer (non-small cell [n = 74] and small cell [n = 10]) who underwent BAE from 1997 to 2018 for the management of hemoptysis were retrospectively reviewed. Of these, 53 patients had stage IV lung cancer. The hemoptysis volume prior to initial BAE was trivial (blood-tinged sputum) in 21 patients, moderate (< 300 mL per 24 hours) in 34 patients, and massive (> 300 mL per 24 hours) in 29 patients., Results: Technical success, defined as the ability to selectively embolize the abnormal vessel, was achieved in 83 patients (98.8%), and clinical success was achieved in 69 (82.1%) patients. Polyvinyl alcohol particles were used to embolize in 51 patients, gelfoam in 15 patients, and gelfoam plus microcoils in 17 patients. Hemoptysis recurred in 20 patients (23.8%) during follow-up. The median hemoptysis-free survival and overall survival periods were both 61 days. In the clinical-success and clinical-failure groups, the median overall survival period was 99 and 9 days, respectively (P < .001). In multivariable analysis, massive hemoptysis (P = .012) and cavitary lung mass (P = .019) were predictive factors for shortened hemoptysis-free survival., Conclusions: BAE is a safe and effective approach to control hemoptysis, although the prognosis in primary lung cancer patients presenting with hemoptysis is generally poor. Massive hemoptysis and cavitary lung mass are significant predictors of shortened hemoptysis-free survival., (Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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17. The Relationship Between Gelatin Sponge Preparation Methods and the Incidence of Intrauterine Synechia Following Uterine Artery Embolization for Postpartum Hemorrhage.
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Saiga A, Yokota H, Higashide T, Takishima H, Omoto A, Kubota Y, Horikoshi T, and Uno T
- Subjects
- Adult, Equipment Design, Female, Humans, Pregnancy, Retrospective Studies, Treatment Outcome, Uterine Artery Embolization methods, Gelatin Sponge, Absorbable adverse effects, Gynatresia etiology, Postpartum Hemorrhage therapy, Uterine Artery Embolization adverse effects, Uterine Artery Embolization instrumentation
- Abstract
Purpose: To evaluate the relationship between gelatin sponge preparation methods and the incidence of intrauterine synechia following uterine artery embolization (UAE) for postpartum hemorrhage (PPH)., Materials and Methods: In a retrospective monocentric study, we used data from 20 consecutive UAE procedures (19 patients) for PPH, performed in 2007-2016, in which gelatin sponge had been used. The gelatin sponge was processed either into a slurry by pumping it back and forth about 10 times through two syringes connected to a three-way stopcock or into pledgets using a scalpel and small scissors to obtain pieces approximately 2 × 2 × 2 mm in size. Patient information was obtained from medical records, and the data were compared between patients treated with the slurry (n = 7) or pledgets (n = 13) forms. Due to the lack of follow-up data and hysterectomy after UAE, the sample size was 6 and 12 because 1 patient with 2 procedures was excluded., Results: The rate of intrauterine synechia was significantly higher in the slurry group (5/6, 83.3%) than that in the pledgets group (0/12, 0%; P < 0.001). In contrast, there were no significant differences in population characteristics, such as the incidence of placenta accreta, non-placental diseases, and severity of shock (DIC score, shock index, or blood loss) between the groups., Conclusions: Although non-randomization and small sample size were the two main limitations, our observations suggest that UAE using gelatin sponge slurry may be associated with a high incidence of intrauterine synechia compared to UAE using pledgets.
- Published
- 2019
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18. Comparison of Local Injection of Fresh Frozen Plasma to Traditional Methods of Hemostasis in Minimally Invasive Procedures.
- Author
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Haaga J, Rahim S, Kondray V, Davidson J, Patel I, and Nakamoto D
- Subjects
- Blood Coagulation Disorders complications, Cohort Studies, Female, Gelatin Sponge, Absorbable adverse effects, Hemostasis, Hemostasis, Surgical adverse effects, Humans, International Normalized Ratio, Male, Middle Aged, Minimally Invasive Surgical Procedures adverse effects, Platelet Transfusion, Retrospective Studies, Surgery, Computer-Assisted, Blood Loss, Surgical prevention & control, Embolization, Therapeutic adverse effects, Gelatin Sponge, Absorbable therapeutic use, Hemostasis, Surgical methods, Plasma, Postoperative Hemorrhage prevention & control
- Abstract
Rationale and Objectives: To evaluate different techniques for reducing hemorrhagic complications in coagulopathic patients with elevated international normalized ratio having an image-guided percutaneous invasive procedure; techniques included systemic transfusion of fresh frozen plasma (FFP), local injection of FFP, percutaneous injection of gelatin sponge, and percutaneous placements of angiographic coils., Materials and Methods: Retrospective review of 232 consecutive patients with known coagulopathy undergoing image-guided minimally invasive procedures were selected. Ninety-one patients had local FFP injected, 40 patients underwent local synthetic gelatin injection, 16 patients had percutaneous coil embolization, and 85 patients received systemic FFP. The number of bleeds, complications related to bleeds, and systemic complications were recorded. A 30 cc threshold was used to delineate significant bleeding., Results: No patients experienced clinically significant or insignificant bleeding with local FFP injection (P value <.05). Other local hemostatic methods (Gelfoam, systemic FFP, and coil embolization) were associated with higher levels of bleeding (12.5%, 17.1%, 37.5%, respectively) and complications (7.5%, 31.4%, 37.5%, respectively). Systemic FFP infusion was associated with respiratory, infectious, and mortal complications., Conclusions: Local injection of blood products provides a safe and efficacious hemostatic agent to reduce the incidence of postprocedural bleeding. The technique is associated with lower rates of bleeding and systemic complications when compared to other local and systemic techniques. Further randomized prospective studies with a larger patient cohort need to be performed to corroborate these initial findings., (Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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19. Comparison the efficacy of hemorrhage control of Surgiflo Haemostatic Matrix and absorbable gelatin sponge in posterior lumbar surgery: A randomized controlled study.
- Author
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Ma L, Dai L, Yang Y, and Liu H
- Subjects
- Blood Transfusion, Female, Gelatin adverse effects, Gelatin Sponge, Absorbable adverse effects, Hemostasis drug effects, Hemostatics adverse effects, Humans, Male, Middle Aged, Operative Time, Thrombin adverse effects, Blood Loss, Surgical prevention & control, Gelatin therapeutic use, Gelatin Sponge, Absorbable therapeutic use, Hemostatics therapeutic use, Lumbar Vertebrae surgery, Thrombin therapeutic use
- Abstract
Objective: To compare the hemostatic effect of hematostatic agent Surgiflo and absorbable gelatin sponge (AGS) in posterior lumbar surgery., Methods: A total of 60 cases were recruited during August 2016 and June 2017 according to the inclusion and exclusion criteria. Patients were randomly allocated to the Surgiflo Haemostatic Matrix (SHM) group or the AGS group (AGS) by computer-generated randomization codes. The success rates of hemostasis for 3 minutes and 5 minutes, the time of operation, the amount of intraoperative bleeding, the volume of autogenously blood transfusion, the amount of blood during hemostasis, the amount of blood transfusion, and BP, RBC, HCT, HB of preoperative, 2 to 3 days, and 5 to 7 days following operation were recorded to compare. Daily drainage and all adverse events after operation were also compared., Results: All the patients were followed up for at least 1 month. The RBC and HCT of the AGS group before operation were lower than those in the control group (P = .039, P = .029), but there was no difference after operation (P >.05). In the control group, 19 cases were successfully hemostatic in 3 minutes, 4 cases were successful in 5 minutes, and 7 cases were combined with hemostasis. In the SHM group, it was 22, 3, and 5 cases respectively. There was significant difference in blood loss during hemostatic process between the 2 groups (P <.001). There was no difference in the amount of blood loss and autologous blood transfusion between the 2 groups, and there was no difference in the operation time between the 2 groups. In the AGS group, allogeneic blood was infused in 1 case during operation, and no allogeneic blood was infused in the other patients. The drainage volume on the 1st day and the 2nd to 4th day after operation in the AGS group was less than that in the control group (P = .015, P = .010)., Conclusion: Compared with AGS, SHM could decrease the blood loss during hemostatic process and the postoperative drainage volume in posterior operation of lumbar degenerative disease. SHM is a safe and effective hemostatic agent in lumbar posterior surgery.
- Published
- 2018
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20. Iatrogenic obstructive hydrocephalus resulting from Gelfoam accumulation within the cerebral aqueduct: a case report.
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Hazama A, Driver J, Grannan B, Dasenbrock H, and Goumnerova L
- Subjects
- Child, Humans, Male, Seizures surgery, Gelatin Sponge, Absorbable adverse effects, Hydrocephalus etiology, Iatrogenic Disease, Neurosurgical Procedures adverse effects, Postoperative Complications etiology
- Abstract
The authors present the case of a previously healthy 12-year-old male with intractable seizures localized to a right frontal area of encephalomalacia and porencephalic cyst who underwent resection of the seizure focus. The surgical resection cavity extended into the right lateral ventricle, and due to encountered hemorrhage, Gelfoam was used for optimal hemostasis. The patient did well following the procedure, but presented 5 months later with headaches and emesis and was discovered to have obstructive hydrocephalus on imaging studies. Endoscopic third ventriculostomy (ETV) was performed, where Gelfoam was encountered in the third ventricle, obstructing the cerebral aqueduct. After the completion of the ETV, the patient did well and continues to be asymptomatic 1 year following the procedure.
- Published
- 2018
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21. Intracranial foreign material granulomas after cranial surgery.
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Al-Afif S, Hatipoglu Majernik G, Hermann EJ, Esmaeilzadeh M, Hartmann C, and Krauss JK
- Subjects
- Adolescent, Adult, Aged, Child, Diagnosis, Differential, Female, Gelatin Sponge, Absorbable adverse effects, Humans, Male, Middle Aged, Sutures adverse effects, Brain surgery, Granuloma, Foreign-Body etiology, Neurosurgical Procedures adverse effects, Postoperative Complications etiology
- Abstract
Background: Various synthetic materials are used in neurosurgery and left in place intentionally during surgery for several purposes such as hemostasis, dural closure, or cranioplasty. Although leaving such substances in surgical sites is considered safe, in general, foreign body granuloma may occur months or years after intracranial surgery. Thus, far relatively little is known about treatment and outcome of such lesions., Methods: A systematic review of 3466 histopathological examinations after cranial surgeries achieved over a 13-year period was performed. After excluding patients with Teflon granulomas or infection, a total of 12 patients with foreign body granulomas induced by synthetic material used in a prior surgery were identified. Patient records, imaging studies, and histopathological data were analyzed. Furthermore, postoperative outcome was assessed., Results: Mean age at the second surgery was 51 years (range, 11-68 years). The median time between the primary and the secondary surgery was 13 months (range, 1-545 months). Eight patients (75%) presented with signs and symptoms related to the foreign body granulomas. Total resection of the foreign body granulomas was performed in all patients. The granulomas were induced by oxidized cellulose polymer (n = 6), suture material (n = 3), Gelfoam (n = 1), methylmethacrylate (n = 1), and bone wax (n = 1). The mean postoperative follow-up time was 54 months (range 1-137 months). There was symptomatic improvement in all instances. Imaging studies did not demonstrate any recurrence., Conclusion: Despite its rarity, foreign body granuloma should be taken into consideration in the differential diagnosis of intracranial mass lesions especially in cases of suspected tumor recurrence after prior surgery. The pathogenesis of foreign body granuloma still needs further clarification. Our study demonstrates that they have good prognosis after surgical removal.
- Published
- 2018
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22. Transarterial chemoembolization for unresectable hepatocellular carcinoma: A comparison of the efficacy and safety of 2 embolic agents.
- Author
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Chen S, Yu W, Zhang K, Liu W, and Chen Q
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Agents administration & dosage, Antineoplastic Agents adverse effects, Antineoplastic Agents therapeutic use, Carcinoma, Hepatocellular blood, Carcinoma, Hepatocellular diagnostic imaging, Chemoembolization, Therapeutic adverse effects, Ethiodized Oil administration & dosage, Ethiodized Oil adverse effects, Ethiodized Oil therapeutic use, Female, Gelatin Sponge, Absorbable administration & dosage, Gelatin Sponge, Absorbable adverse effects, Gelatin Sponge, Absorbable therapeutic use, Hemostatics administration & dosage, Hemostatics adverse effects, Hemostatics therapeutic use, Humans, Liver Neoplasms blood, Liver Neoplasms diagnostic imaging, Magnetic Resonance Imaging, Male, Middle Aged, Retrospective Studies, Tomography Scanners, X-Ray Computed, Treatment Outcome, alpha-Fetoproteins analysis, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular therapy, Chemoembolization, Therapeutic methods, Liver Neoplasms pathology, Liver Neoplasms therapy
- Abstract
The aim of this study was to compare the efficacy and safety of 2 different embolic agents, namely gelatin sponge particle (GSP) and Lipiodol, for transarterial chemoembolization (TACE) of unresectable hepatocellular carcinoma (HCC).We retrospectively reviewed 87 consecutive patients with unresectable HCC who underwent Lipiodol TACE with lobaplatin and 87 consecutive patients with unresectable HCC who underwent GSP TACE with lobaplatin between January 2013 and June 2017 in our institution as the initial treatment. Both groups were compared considering the clinical and laboratory outcomes and imaging findings before and after TACE. Tumor response and adverse events were also evaluated.There was significant difference in the rate of complete and overall response between the groups (P = .029 and .001, respectively), specifically when the tumor size was >5 cm (P = .001). The disease control rate was significantly better in the GSP group than in the Lipiodol group (94.3% vs. 86.4%, P = .011). The response differences in higher stages were significant between the 2 groups (P = .035 and .007, respectively). The grades of adverse events were also significantly different between the groups (P = .000).GSP-as an embolic agent in TACE for HCC-could significantly increase the rate of tumor response 1 month after treatment, especially in large tumors, without any significant increase in severe adverse events, when compared to Lipiodol.
- Published
- 2018
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23. Anterosuperior anchoring myringoplasty using cyanoacrylate glue can prevent packing gelfoam in the middle ear cavity.
- Author
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Li Y, Liang J, Cheng Y, Zhang Q, Ren X, and Sheng Y
- Subjects
- Adolescent, Adult, Female, Follow-Up Studies, Gelatin Sponge, Absorbable administration & dosage, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome, Cyanoacrylates administration & dosage, Gelatin Sponge, Absorbable adverse effects, Hearing Loss prevention & control, Myringoplasty methods, Tissue Adhesives administration & dosage, Tympanic Membrane Perforation surgery
- Abstract
Objectives: Although a number of methods have been attempted to improve securing the graft, packing gelfoam in the middle ear cavity cannot be avoided, which could obstruct the tympanic ostium of the Eustachian tube and affect inner ear function. Myringoplasty using tissue adhesive has gained traction because tissue adhesives can effectively stabilise the graft and act as scaffolding to improve the graft uptake. The aim of this prospective study was to explore myringoplasty using cyanoacrylate glue with no packing in the middle ear cavity for the repair of subtotal tympanic membrane (TM) perforations., Methods: Between March 2014 and November 2015, 71 patients with subtotal TM perforations were randomly and prospectively divided into a glue group and a control group. Two securing techniques were performed using only cyanoacrylate glue or using only filling gelfoam in the middle ear cavity, respectively, during an anterosuperior anchoring myringoplasty operated by a single surgeon., Results: At a 6-month follow-up, the graft uptake rate was 87% in the glue group and 89% in the control group. A significant hearing improvement was found in both groups postoperatively when compared to the preoperative values (P<0.05 for both). There was no significant difference in the graft uptake rate and hearing improvement between the 2 groups (P>0.05). Similar complications were found in each group., Conclusion: Cyanoacrylate glue is a helpful material for graft stabilisation and can substitute for filling gelfoam in the middle ear cavity during anterosuperior anchoring myringoplasty for subtotal TM perforation., (Copyright © 2017. Published by Elsevier Masson SAS.)
- Published
- 2018
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24. Control of major pulmonary artery bleeding with a gelatin matrix-thrombin solution: a retrospective analysis.
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Cardillo G, Carleo F, DI Martino M, Ciamberlano B, Ialongo P, Cusumano G, Denitza Tinti M, Ricci A, and Cafarotti S
- Subjects
- Aged, Blood Transfusion, Female, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Humans, Male, Middle Aged, Postoperative Hemorrhage etiology, Postoperative Hemorrhage prevention & control, Pulmonary Artery injuries, Pulmonary Artery surgery, Retrospective Studies, Suture Techniques, Time Factors, Treatment Outcome, Vascular System Injuries diagnosis, Vascular System Injuries etiology, Vascular System Injuries surgery, Blood Loss, Surgical prevention & control, Gelatin Sponge, Absorbable therapeutic use, Hemostatic Techniques, Hemostatics therapeutic use, Pneumonectomy adverse effects, Pulmonary Artery drug effects, Vascular System Injuries drug therapy
- Abstract
Background: Intraoperative pulmonary artery (PA) bleeding is common during thoracic surgery. We investigated the efficacy of the gelatin matrix-thrombin solution FloSeal (Baxter International, Deerfield, IL, USA) for control of major PA bleeding., Methods: Retrospective data were collected on all intraoperative PA injuries during open or minimally invasive lobectomy or pneumonectomy between January 2000 and January 2014. Patients received either 4/0 prolene sutures (Standard) or the gelatin matrix-thrombin solution, plus sutures as needed (Matrix), with at least 6-month follow-up. Endpoints included time to hemostasis, total blood loss, transfusion and complications., Results: Of 2809 procedures, 39 (1.4%) had intraoperative PA injury, of which 21 received standard care and 18 the gelatin matrix-thrombin solution. Hemostasis was achieved in all Standard group patients after 2 minutes, and after 5 minutes in Matrix patients. Additional sutures were required in 4 (19.0%) Standard group patients. Three (16.7%) Matrix patients had a second solution application, while 17 (77.8%) received precautionary sutures. Mean blood loss on postoperative day 1 was 836.1±186.1 mL and 957.1±163.0 mL in the Matrix and Standard groups, respectively (P=0.003). Four (22.2%) Matrix patients received postoperative transfusions versus eight (38.0%) Standard patients (P=0.02). Two Standard and no Matrix patients underwent surgical revision. There were no complications and no mortalities., Conclusions: Our analysis suggests that the gelatin matrix-thrombin solution is safe and effective for the control of major bleeding following intraoperative PA injury, and may improve outcomes. Further prospective studies are required to confirm our findings.
- Published
- 2017
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25. Does topical hemostatic agent (Floseal ® ) have a long-term adverse effect on erectile function recovery after nerve-sparing robot-assisted radical prostatectomy?
- Author
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Martorana E, Rocco B, Kaleci S, Pirola GM, Bevilacqua L, Bonetti LR, Puliatti S, Micali S, and Bianchi G
- Subjects
- Administration, Topical, Adult, Aged, Follow-Up Studies, Gelatin Sponge, Absorbable administration & dosage, Hemostatics administration & dosage, Humans, Male, Middle Aged, Organ Sparing Treatments, Peripheral Nerves, Prostatectomy adverse effects, Retrospective Studies, Robotic Surgical Procedures adverse effects, Severity of Illness Index, Surveys and Questionnaires, Erectile Dysfunction etiology, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Penile Erection drug effects, Recovery of Function drug effects
- Abstract
Objectives: To investigate the long-term effects of Floseal
® on erectile function recovery (EFR) after nerve-sparing robot-assisted radical prostatectomy (RALP)., Methods: We prospectively collected results of the self-administered International Index Erectile Function Questionnaire 1-5 and 15 (IIEF 1-5 and 15) of 532 consecutive patients who underwent RALP for prostate cancer in our institution between October 2007 and December 2015. Patients were divided into two groups according to Floseal® application after prostatectomy. They were enrolled according to the following criteria: (a) bilateral nerve-sparing procedure; (b) preoperative IIEF ≥ 17; adherence to our erectile rehabilitation protocol; (c) 1-year follow-up. Outcomes were measured as mean IIEF score, EFR (IIEF < 17 or ≥17), grade of ED: severe (IIEF < 17), moderate (17-21), mild (22-25) and no ED (>25)., Results: A total of 120 patients were enrolled. Group A included 40 consecutive patients who received traditional hemostasis, and Group B included 80 consecutive patients in which Floseal® was additionally used. No differences were observed in terms of preoperative mean IIEF score (p = 0.65). Group B patients showed a trend toward a higher mean IIEF score 3 months after surgery (p = 0.06) but no differences in terms of EFR (p = 1.000). Long-term results (6, 9, 12 months after surgery) showed a significantly and progressively higher mean IIEF score (p = 0.04, 0.003, 0.003) and EFR (p = 0.043, 0.027, 0.004) in Group A patients. Comparison between the groups in terms of severe, moderate, mild and no ED becomes significant at 9 and 12 months (p = 0.002, 0.006)., Conclusion: The results of our study suggest that local use of Floseal® worsens the long-term erectile function recovery in patients selected for nerve-sparing RALP.- Published
- 2017
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26. Gelatin Anaphylaxis During Surgery: A Rare Cause of Perioperative Anaphylaxis.
- Author
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Raveendran R and Khan DA
- Subjects
- Adrenergic Agonists administration & dosage, Anaphylaxis diagnosis, Anaphylaxis drug therapy, Anaphylaxis immunology, Child, Epinephrine administration & dosage, Female, Humans, Treatment Outcome, Anaphylaxis chemically induced, Gelatin Sponge, Absorbable adverse effects, Spinal Fusion
- Published
- 2017
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27. Chitosan Dextran gel as an anti adhesion agent in a postlaminectomy spinal sheep model.
- Author
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Rajiv S, Drilling A, Bassiouni A, Harding M, James C, Robinson S, Moratti S, and Wormald PJ
- Subjects
- Animals, Chitosan therapeutic use, Dextrans chemistry, Gelatin Sponge, Absorbable adverse effects, Gelatin Sponge, Absorbable chemistry, Hemostatic Techniques, Postoperative Complications therapy, Sheep, Spinal Cord pathology, Tissue Adhesions, Chitosan analogs & derivatives, Gelatin Sponge, Absorbable therapeutic use, Laminectomy methods, Postoperative Complications prevention & control, Spinal Cord surgery
- Abstract
Introduction: Post-operative peridural adhesions increase morbidity after neurosurgical procedures. Aim of this study is to assess safety and efficacy of Chitosan-Dextran (CD) gel as an anti-adhesion agent in a spinal laminectomy sheep model., Methods: Eighteen sheep were used in this study with 6 animals in each treatment arm (namely, CD gel, Gelfoam paste and normal saline control). Posterior lumbar laminectomy was performed in all animals and the dura was exposed intact. Test agents were applied over the exposed dura and the wound was closed in layers. Sheep were euthanized at the end of three months. MRI spine was performed after euthanasia to assess epidural fibrosis. Adhesion in the spinal specimen was assessed by Peel test and histopathology was used to assess safety of the agents., Results: Average scores for the Peel test for CD gel, Gelfoam and normal saline control groups were 1.16 (95% CI, 0.5-1.7), 1.5 (95% CI, 0.6-2.3) and 3 (95% CI, 2.1-3.8) respectively. There was significant reduction in adhesions between treatment and normal saline treated groups (p=0.0292), with no difference between Gelfoam and CD gel groups (p=0.56). Average scores on MRI for CD gel, Gelfoam and normal saline groups were 1.4 (95% CI, 0.9-1.8), 1.5 (95% CI, 1.2-1.8) and 1.6 (95% CI, 1.3-1.8) respectively, with no significant difference in fibrosis amongst (p=0.2992). Histopathology did not show any adverse effects., Conclusion: CD gel is an effective agent to reduce epidural adhesions with a good safety profile in neural tissue., (Copyright © 2017 Elsevier Ltd. All rights reserved.)
- Published
- 2017
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28. The Safety and Efficacy of Adjuvant Hemostatic Agents During Laparoscopic Nephron-Sparing Surgery: Comparison of Tachosil and Floseal Versus No Hemostatic Agents.
- Author
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Tonyali S, Koni A, Yazici S, and Bilen CY
- Subjects
- Drug Combinations, Female, Fibrinogen adverse effects, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Humans, Male, Middle Aged, Postoperative Complications prevention & control, Retrospective Studies, Thrombin adverse effects, Treatment Outcome, Fibrinogen therapeutic use, Gelatin Sponge, Absorbable therapeutic use, Hemostatics therapeutic use, Kidney Neoplasms surgery, Laparoscopy, Nephrectomy methods, Nephrons, Organ Sparing Treatments, Thrombin therapeutic use
- Abstract
Purpose: To compare the effectiveness of TachoSil and Floseal during laparoscopic nephron-sparing surgery (LNSS), and to evaluate postoperative complications, especially hemorrhage and urinary leakage., Materials and Methods: The medical records of all patients that underwent LNSS for a small renal mass (SRM) performed by the same experienced surgeon were retrospectively analyzed. The patients were divided into the following 3 groups, based on hemostatic agent: group 1: no adjuvant hemostatic agent (no AHA); group 2: TachoSil; group 3: Floseal., Results: The study included 79 patients; no AHA group: n = 18; TachoSil group: n = 25; Floseal group: n = 36. The 3 groups were similar in terms of diameter [29.6 ± 11.5 mm, 26.4 ± 13.4 mm and 30.4 ± 9.6 mm, respectively (P = .218)] and PADUA scores [6.9 ± 0.9, 6.7 ± 1 and 6.9 ± 0.9, respectively (P =.540)]. Mean duration of surgery was significantly shorter in the Floseal group (120.9 ± 23.1 minutes) than in the no AHA group (156.6 ± 34.4 minutes). Mean ischemia time was longest in the no AHA group (24.3 ± 4 minutes) and shortest in the Floseal group(21.3 ± 4.3 minutes). Intra-abdominal (IA) catheter drainage on postoperative day 1 was significantly higher in the no AHA group thanin the TachoSil and Floseal groups [156.9 ±78.3 mL vs. 72.6 ± 64.5 and 60.8 ± 30.2 mL, respectively (P < .05)]. Mean duration of hospitalization was 3.2 ± 0.5 days in the no AHA group that was significantly longer than in the Floseal group (2.8 ± 0.7 days) (P = .043). There were not any differences in intraoperative complications, the transfusion rate, surgical margin positivity, or postoperative complications between the 3 groups (P = .596, P =.403, P = 1.0, P = .876, respectively). However, pseudoaneurism as a late term complication occurred in 27.7% patients in the no AHA group., Conclusion: TachoSil and Floseal are safe and effective adjuvant treatments for patients undergoing LNSS. They might be useful especially in preventing pseudo aneurisms, shortening intraoperative ischemia time and hospital stay and decreasing postoperative drainage. Shortened operation and warm ischemia time may also be attributed to long learning curve of LNSS.
- Published
- 2017
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29. Cytologic findings following intraoperative use of Floseal R hemostatic matrix: A potential diagnostic pitfall in fluid aspiration cytology.
- Author
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Barroeta JE, Lhospital E, Smith E, and Ko EM
- Subjects
- Carcinoma, Endometrioid surgery, Endometrial Neoplasms surgery, Female, Humans, Lymph Node Excision, Middle Aged, Carcinoma, Endometrioid pathology, Diagnostic Errors, Endometrial Neoplasms pathology, Gelatin Sponge, Absorbable adverse effects
- Abstract
We report the case of a 62-year-old woman who underwent laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection for endometrial endometrioid carcinoma FIGO grade 1. Cytologic examination of the pelvic washing specimen showed an acellular matrix with frayed edges and cracking artifact. Upon investigation, it became apparent that this could represent hemostatic matrix Floseal
R that had been used intraoperatively at the lymphadenectomy site. Laboratory replication of the cytologic findings with a FlosealR sample confirmed it. This is the first reported case of FlosealR in pelvic washing cytology and represents a potential diagnostic pitfall. Diagn. Cytopathol. 2016;44:1117-1119. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)- Published
- 2016
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30. Appendicitis caused by gelatin-based haemostatic agent.
- Author
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Teloken PE, Bowles T, and Sparrow S
- Subjects
- Appendectomy methods, Appendicitis diagnosis, Appendicitis surgery, Appendix diagnostic imaging, Appendix drug effects, Appendix surgery, Child, Female, Humans, Laparoscopy, Reoperation, Ultrasonography, Appendicitis chemically induced, Gelatin Sponge, Absorbable adverse effects, Gynecologic Surgical Procedures adverse effects, Hemostatics adverse effects, Ovarian Cysts surgery, Postoperative Hemorrhage therapy
- Published
- 2016
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31. Sporadic versus Tuberous Sclerosis Complex-Associated Angiomyolipomas: Predictors for Long-Term Outcomes following Transcatheter Embolization.
- Author
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Sheth RA, Feldman AS, Paul E, Thiele EA, and Walker TG
- Subjects
- Acrylic Resins adverse effects, Adolescent, Adult, Age Factors, Aged, Angiomyolipoma diagnostic imaging, Angiomyolipoma etiology, Child, Embolization, Therapeutic adverse effects, Female, Gelatin adverse effects, Gelatin Sponge, Absorbable adverse effects, Humans, Kidney Neoplasms diagnostic imaging, Kidney Neoplasms etiology, Magnetic Resonance Imaging, Male, Middle Aged, Particle Size, Retrospective Studies, Risk Factors, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Tuberous Sclerosis diagnosis, Tumor Burden, Young Adult, Acrylic Resins administration & dosage, Angiomyolipoma therapy, Embolization, Therapeutic methods, Gelatin administration & dosage, Gelatin Sponge, Absorbable administration & dosage, Kidney Neoplasms therapy, Tuberous Sclerosis complications
- Abstract
Purpose: To evaluate risk factors for long-term outcomes following embolization of sporadic versus tuberous sclerosis complex (TSC)-associated angiomyolipomas (AMLs)., Materials and Methods: A retrospective review of consecutive transcatheter embolizations of renal AMLs between 2002 and 2014 was performed. Tumor volumetrics including density analysis were obtained. Treatment outcomes were assessed at 1 year after embolization using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 and volumetric RECIST criteria. A total of 56 patients, 70% (39/56) of whom had TSC, underwent embolization of 72 renal AMLs. Embolization was most commonly performed (70/72, 97%) using microspheres (300-500 μm or 500-700 μm Embosphere)., Results: Between the sporadic and TSC-associated populations, there was no difference in follow-up time (648 d vs 583 d, P = .78), initial tumor diameter (6.68 cm vs 5.71 cm, P = .09), or percent tumoral fat content (39.5% vs 8.6%, P = .35). Progressive disease was noted in 9 TSC-associated AMLs by volume and 3 TSC-associated AMLs by diameter but in no sporadic AMLs. Growth suppression curves were remarkable for rebound growth in TSC patients, particularly in TSC patients younger than 18 years. Patient age (P = .007) and tumor volume (P = .03) were found to correlate with tumor regrowth within the TSC population. No difference was found in median change in total volume after embolization based on fat content (-57.9% vs -54.2%, P = .68)., Conclusions: TSC, patient age, and tumoral volume before embolization are risk factors for AML growth following embolization. Intratumoral fat content was not found to predict response to embolization., (Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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32. Superselective Conventional Transarterial Chemoembolization for Hepatocellular Carcinoma: Rationale, Technique, and Outcome.
- Author
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Miyayama S and Matsui O
- Subjects
- Antineoplastic Agents adverse effects, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular pathology, Chemoembolization, Therapeutic adverse effects, Computed Tomography Angiography, Ethiodized Oil adverse effects, Gelatin Sponge, Absorbable adverse effects, Humans, Liver Neoplasms diagnostic imaging, Liver Neoplasms mortality, Liver Neoplasms pathology, Patient Selection, Risk Factors, Time Factors, Treatment Outcome, Tumor Burden, Antineoplastic Agents administration & dosage, Carcinoma, Hepatocellular therapy, Chemoembolization, Therapeutic methods, Ethiodized Oil administration & dosage, Gelatin Sponge, Absorbable administration & dosage, Liver Neoplasms therapy
- Abstract
Conventional transarterial chemoembolization with ethiodized oil and gelatin sponge (GS) particles is a standard technique for hepatocellular carcinoma. Ethiodized oil can temporarily block tumor sinusoids, portal venules, hepatic sinusoids, and arterial microcommunications. By adding GS embolization, strong ischemic effects not only on the tumor but also on the surrounding liver parenchyma can be achieved. Superselective conventional transarterial chemoembolization is mainly indicated for patients with Child-Pugh scores of 5-8, tumors ≤ 7 cm, and ≤ 5 lesions. According to a Japanese nationwide survey, the 5-year survival rate of patients with Child-Pugh class A and a single tumor was 52%., (Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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33. Portal Vein Embolization via Percutaneous Transsplenic Access prior to Major Hepatectomy for Patients with Insufficient Future Liver Remnant.
- Author
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Ko HK, Ko GY, Sung KB, Gwon DI, and Yoon HK
- Subjects
- Aged, Computed Tomography Angiography, Embolization, Therapeutic adverse effects, Embolization, Therapeutic instrumentation, Enbucrilate adverse effects, Feasibility Studies, Female, Gelatin Sponge, Absorbable adverse effects, Humans, Liver diagnostic imaging, Liver physiopathology, Male, Middle Aged, Phlebography methods, Punctures, Retrospective Studies, Time Factors, Treatment Outcome, Ultrasonography, Cell Proliferation, Embolization, Therapeutic methods, Enbucrilate administration & dosage, Gelatin Sponge, Absorbable administration & dosage, Hepatectomy, Liver blood supply, Liver surgery, Liver Regeneration, Portal Vein diagnostic imaging, Splenic Vein diagnostic imaging
- Abstract
Purpose: To evaluate the feasibility and safety of percutaneous transsplenic portal vein embolization (PVE) before major hepatectomy for patients with insufficient future liver remnant., Materials and Methods: From May 2014 to June 2015, 27 transsplenic PVEs were attempted in 26 patients. In 16 patients, transsplenic PVE was indicated because of huge or multiple tumors in the trajectory of the puncture (n = 15) or a high-positioned liver (n = 1), which prevented safe ipsilateral transhepatic access. In the remaining 10 patients, transsplenic access was planned. A perihilar splenic vein was punctured using a 21-gauge Chiba needle under ultrasound and fluoroscopic guidance. Embolization of portal venous branches was performed using gelatin sponge particles followed by application of coils, an AMPLATZER Vascular Plug (AGA Medical Corporation, Golden Valley, Minnesota), or glue to prevent recanalization. Embolization of transsplenic routes was performed using coils followed by glue., Results: Transsplenic PVE was successful in 24 (88.9%) of 27 sessions; 3 procedures failed because of splenic vein dissection (n = 1) and failed splenic vein puncture (n = 2). Major complications occurred in 1 patient (3.8%) with splenic vein dissection. Minor complications occurred in 2 patients: a small amount of fluid collection in the splenic hilar area in 1 patient and glue migration along the splenic vein in 1 patient. Planned liver resection was performed in 24 of 26 patients at 4.9 weeks ± 3.5 after PVE., Conclusions: Transsplenic PVE is safe and feasible and can be an effective alternative treatment for patients with a challenging ipsilateral, transhepatic route., (Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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34. Adverse Hemodynamic Event Due to Floseal Hemostatic Matrix Application.
- Author
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Chakrabarti D, N GK, and Masapu D
- Subjects
- Adrenergic alpha-1 Receptor Agonists therapeutic use, Adult, Embolism, Air complications, Embolism, Air therapy, Female, Fluid Therapy, Head-Down Tilt, Hemostasis drug effects, Humans, Hypotension complications, Hypotension therapy, Mephentermine therapeutic use, Embolism, Air etiology, Gelatin Sponge, Absorbable adverse effects, Hemodynamics drug effects, Hemostatics adverse effects
- Published
- 2016
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35. Comparative analysis of Cutanplast and Spongostan nasal packing after endoscopic sinus surgery: a prospective, randomized, multicenter study.
- Author
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Cho KS, Park CH, Hong SL, Kim MJ, Kim JY, Kim YW, Koo SK, and Roh HJ
- Subjects
- Chronic Disease, Cost-Benefit Analysis, Female, Fibrin Foam adverse effects, Gelatin Sponge, Absorbable adverse effects, Hemostatics administration & dosage, Hemostatics adverse effects, Humans, Male, Middle Aged, Nasal Cavity, Paranasal Sinuses surgery, Patient Preference, Pilot Projects, Prospective Studies, Treatment Outcome, Wound Healing drug effects, Endoscopy adverse effects, Endoscopy methods, Fibrin Foam administration & dosage, Gelatin Sponge, Absorbable administration & dosage, Hemostasis, Surgical adverse effects, Hemostasis, Surgical methods, Hemostasis, Surgical psychology, Otorhinolaryngologic Surgical Procedures adverse effects, Otorhinolaryngologic Surgical Procedures methods, Postoperative Hemorrhage economics, Postoperative Hemorrhage therapy, Sinusitis surgery
- Abstract
Commercial gelatin-based packing materials are available under different names and compositions to be used after endoscopic sinus surgery (ESS). The purpose of this study was to investigate the efficacy of Spongostan and Cutanplast nasal packing on patients' subjective symptoms, hemostasis, and wound healing following ESS. One hundred adult patients with chronic sinusitis requiring the same extent of ESS were included. Following surgery, one nasal cavity was packed with Cutanplast and the other one with Spongostan. Patients' subjective symptoms while the packing was in situ, hemostatic properties, degree of remaining amount of packing materials, postoperative wound healing, and the cost of the pack were evaluated. Cutanplast and Spongostan are equally effective in the control of postoperative bleeding following ESS. However, Cutanplast packing was significantly more comfortable than Spongostan for nasal obstruction, postnasal drip, rhinorrhea, and headache. Furthermore, the Cutanplast packing was significantly less painful at all time points. The remaining amount of the pack was significantly lower in the Cutanplast than Spongostan packing. Spongostan packing appears to impair wound healing within the sinus cavities up to 3 months postoperatively. Cutanplast was less expensive than Spongostan as used in this study. Cutanplast may be more useful gelatin-based packing material than Spongostan in terms of efficacy and cost-benefit after ESS.
- Published
- 2015
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36. Intraoperative anaphylaxis likely due to Gelfoam in a pediatric patient undergoing liver biopsy.
- Author
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Robbins KA and Keet CA
- Subjects
- Biopsy adverse effects, Child, Collagen adverse effects, Edema immunology, Epiglottis immunology, Epiglottis pathology, Female, Gelatin adverse effects, Gelatin immunology, Heart Transplantation adverse effects, Humans, Liver surgery, Lymphoproliferative Disorders complications, Pharynx immunology, Pharynx pathology, Anaphylaxis diagnosis, Anaphylaxis etiology, Anaphylaxis genetics, Collagen immunology, Gelatin Sponge, Absorbable adverse effects, Intraoperative Complications diagnosis, Intraoperative Complications etiology
- Published
- 2015
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37. Suspected intraoperative anaphylaxis to gelatin absorbable hemostatic sponge.
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Ji J and Barrett EJ
- Subjects
- Anti-Allergic Agents therapeutic use, Anti-Inflammatory Agents therapeutic use, Child, Preschool, Dental Care for Chronically Ill, Diphenhydramine therapeutic use, Female, Humans, Hydrocortisone therapeutic use, Hypotension chemically induced, Skin Tests, Tooth Extraction methods, Tooth Socket drug effects, Tooth Socket surgery, Williams Syndrome complications, Anaphylaxis chemically induced, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Intraoperative Complications
- Abstract
Anaphylaxis under anesthesia is a life-threatening medical emergency that requires rapid identification and treatment. Allergies to agents with which the general population are likely to come into contact are usually identified, but patients are exposed to uncommon agents during anesthesia and surgery. Here, we describe a case of anaphylaxis under anesthesia implicating Gelfoam sponges.
- Published
- 2015
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38. Thrombin hemostatic matrix leading to acute cerebral edema and sterile fluid collection formation post-tumor resection: two cases.
- Author
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Zeiler FA, Kaufmann AM, and Silvaggio J
- Subjects
- Adult, Humans, Male, Middle Aged, Brain Edema etiology, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Thrombin adverse effects
- Published
- 2015
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39. Observational evaluation of outcomes and resource utilization from hemostatic matrices in spine surgery.
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Price JS, Tackett S, and Patel V
- Subjects
- Blood Loss, Surgical statistics & numerical data, Databases, Factual, Female, Gelatin Sponge, Absorbable adverse effects, Gelatin Sponge, Absorbable therapeutic use, Hemostatics adverse effects, Humans, Length of Stay statistics & numerical data, Male, Middle Aged, Operative Time, Outcome and Process Assessment, Health Care statistics & numerical data, Patient Discharge economics, Patient Discharge statistics & numerical data, Regression Analysis, Retrospective Studies, Risk Assessment, Thrombin adverse effects, United States epidemiology, Blood Loss, Surgical prevention & control, Blood Transfusion statistics & numerical data, Hemostatics therapeutic use, Spine surgery
- Abstract
Objective: Studies have indicated that outcomes may differ by choice of flowable hemostat, but there is limited evidence in spine surgery. The objective of this study was to conduct a comparison of outcomes following use of advanced flowable hemostatic matrices in a large spine surgery population., Methods: This is an observational retrospective cohort analysis using Premier's US Perspective Hospital Database. Two commonly-used hemostatic matrices (Floseal and Surgiflo kitted with thrombin) were compared in cases categorized as either major or severe spine surgery. Outcomes included complications, blood product administration, hospital length of stay (LOS), surgery time, and amount of matrix used in surgery., Results: Major spine surgery patients treated with Surgiflo were associated with increased risk of blood product transfusion (OR = 2.56, 95% CI = 1.79-3.65, p < 0.001), longer surgery time (+8.84 min, p < 0.0001), and increased product usage (+3.34 mL, p < 0.001), compared to Floseal; however, risk of complications and LOS did not differ by choice of matrix in this patient group. Severe spine surgery patients treated with Surgiflo were associated with longer surgical time (+26.9 min, p < 0.001) and increased product usage (+1.52 mL, p < 0.01), compared to Floseal; however, risk of complications, transfusion and LOS did not differ by choice of matrix in this patient group., Limitations: Inherent to limitations associated with database analysis, this study did not evaluate potential physician differences such as skill and experience, assess long-term outcomes, nor include cases with missing data., Conclusion: The results from this analysis indicated that surgery time, risk of blood transfusion, and amount of matrix used are greater with Surgiflo patients, compared to Floseal patients. Choice of matrix did not appear to impact hospital LOS or risk of surgical complications. Future research should evaluate the cost consequences of increased clinical and resource utilization by choice of hemostatic matrix in spine surgery.
- Published
- 2015
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40. Life-threatening intraoperative anaphylaxis to gelatin in Floseal during pediatric spinal surgery.
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Agarwal NS, Spalding C, and Nassef M
- Subjects
- Albuterol therapeutic use, Anaphylaxis drug therapy, Atropine therapeutic use, Bronchodilator Agents therapeutic use, Child, Epinephrine therapeutic use, Humans, Intraoperative Complications drug therapy, Male, Terbutaline therapeutic use, Anaphylaxis chemically induced, Gelatin adverse effects, Gelatin Sponge, Absorbable adverse effects, Intraoperative Complications chemically induced, Spine surgery
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- 2015
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41. The efficacy of a thrombin-based hemostatic agent in primary total knee arthroplasty: a meta-analysis.
- Author
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Wang C, Han Z, Zhang T, Ma JX, Jiang X, Wang Y, and Ma XL
- Subjects
- Arthroplasty, Replacement, Knee adverse effects, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Humans, Treatment Outcome, Arthroplasty, Replacement, Knee methods, Blood Loss, Surgical prevention & control, Gelatin Sponge, Absorbable therapeutic use, Hemostatics therapeutic use, Postoperative Hemorrhage prevention & control
- Abstract
Purpose: Total knee arthroplasty (TKA) is a popular procedure in severe osteoarthritis. But perioperative bleeding remains a problem. Floseal® is a mixture of thrombin and bovine gelatin which can benefit a lot on reducing intraoperative and postoperative bleeding. However, there is no enough evidence judging its safety and efficiency. So a meta-analysis is conducted by us to evaluate the efficacy and safety of a thrombin-based hemostatic agent compared with conventional methods in TKA., Method: Two independent reviewers selected literatures published before August 2014 from MEDLINE, Embase, and The Cochrane Central Register of Controlled Trials. Other internet databases were also performed to identify trials according to the Cochrane Collaboration guidelines. High-quality randomized controlled trials (RCTs), prospective control trials (PCTs), and case controlled trials (CCTs) were selected. The meta-analysis was undertaken using RevMan 5.1 for Windows., Results: Three RCTs, one PCT, and one CCT met the inclusion criteria. There were significant differences in hemoglobin decline and calculated total blood loss between the Floseal® group and control group. There were no significant differences in postoperative drainage volume, rate of transfusion requirement, incidence of wound infection, deep vein thrombosis (DVT), and pulmonary embolism (PE) between treatment and control groups., Conclusions: The present meta-analysis indicates that a thrombin-based hemostatic agent can reduce hemoglobin decline and calculated total blood loss after TKA and is not related to adverse reactions or complications such as wound infection, DVT, and PE.
- Published
- 2014
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42. Response to: microsurgical principles should be considered in studies addressing adhesion prevention: Çağlar et al. (2014).
- Author
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Cağlar M
- Subjects
- Animals, Female, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Uterus surgery
- Published
- 2014
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43. Microsurgical principles should be considered in studies addressing adhesion prevention: Cağlar et al. (2014).
- Author
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Mynbaev OA, Eliseeva MY, Mazitova MI, Malvasi A, and Tinelli A
- Subjects
- Animals, Female, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Uterus surgery
- Published
- 2014
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- View/download PDF
44. Increased adhesion formation after gelatin-thrombin matrix application in a rat model.
- Author
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Cağlar M, Yavuzcan A, Yıldız E, Yılmaz B, Dilbaz S, and Kumru S
- Subjects
- Animals, Female, Fibrosis, Glutathione Transferase metabolism, Inflammation pathology, Models, Animal, Rats, Wistar, Superoxide Dismutase metabolism, Tissue Adhesions pathology, Uterine Diseases pathology, Uterus metabolism, Uterus pathology, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Uterus surgery
- Abstract
Purpose: To evaluate the effects of gelatin matrix and thrombin-based hemostatic sealant agents (gelatin-thrombin matrix) on postoperative adhesion formation in the rat uterine horn model., Methods: A total of fourteen female Wistar-Albino rats were used in our postoperative adhesion formation model. Both uterine horns were exposed by midline incision with sterile technique and each uterine horn was traumatized by bipolar electrocautery. Before closure of the abdomen, 0.9 % NaCl solution was administered intraperitoneally in the control group and the gelatin-thrombin matrix was applied on the traumatized areas on the uterine horns of the rats in the study group. At day 21 after the first surgery, the intraperitoneal macroscopic adhesion scores and the extent of fibrosis, inflammation scores, inflammatory cell activities, inflammation types of adhesion tissues, and the level of free oxygen radicals [malondialdehyde (MDA)] and antioxidant enzyme activity [superoxide dismutase (SOD) and glutathione S-transferase (GST)] in the uterine horn tissue were measured., Results: There was no statistically significant difference between the two groups in terms of macroscopic adhesion scores (p = 0.064), MDA levels (p = 0.121), and GST activity (p = 0.360). However, there was statistically significant difference between the two groups in terms of the extent of fibrosis (p < 0.001), inflammation score (p = 0.001), inflammatory cell activity (p = 0.002), and SOD activity (p < 0.001)., Conclusions: Gelatin-thrombin matrix was found to have increased the extent of fibrosis, inflammatory cell activity, and inflammation score, and reduced the activity of SOD, which acts to prevent cell damage.
- Published
- 2014
- Full Text
- View/download PDF
45. Additional benefit of hemostatic sealant in preservation of ovarian reserve during laparoscopic ovarian cystectomy: a multi-center, randomized controlled trial.
- Author
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Song T, Lee SH, and Kim WY
- Subjects
- Adult, Anti-Mullerian Hormone blood, Female, Gelatin Sponge, Absorbable adverse effects, Gynecologic Surgical Procedures adverse effects, Gynecologic Surgical Procedures methods, Hemostasis, Surgical adverse effects, Hemostatics adverse effects, Humans, Laparoscopy methods, Treatment Outcome, Gelatin Sponge, Absorbable therapeutic use, Hemostasis, Surgical methods, Hemostatics therapeutic use, Ovarian Cysts surgery, Ovarian Reserve
- Abstract
Study Question: Is hemostasis by hemostatic sealant superior to that achieved by bipolar coagulation in preserving ovarian reserve in patients undergoing laparoscopic ovarian cystectomy?, Summary Answer: Post-operative ovarian reserve, determined by serial serum anti-Müllerian hormone (AMH) levels, was significantly less diminished after ovarian hemostasis when hemostatic sealant was used rather than bipolar coagulation., What Is Known Already: Hemostasis achieved with bipolar coagulation at ovarian bleeding site results in damage to the ovarian reserve., Study Design, Size, Duration: A prospective, multi-center randomized trial was conducted on 100 participants with benign ovarian cysts, between December 2012 and October 2013., Participant/materials, Setting, Methods: Participants were randomized to undergo hemostasis by use of either hemostatic sealant (FloSeal™) or bipolar coagulation during laparoendoscopic single-site (LESS) ovarian cystectomy. The primary end-point was the rate of decline of ovarian reserve calculated by measuring serum AMH levels preoperatively and 3 months post-operatively., Main Results and the Role of Chance: Age, parity, socio-demographic variables, preoperative AMH levels, procedures performed and histologic findings were similar between the two groups of patients. There were also no differences in operative outcomes, such as conversion to other surgical approaches, operative time, estimated blood loss, or perioperative complications between the two groups. In both study groups, post-operative AMH levels were lower than preoperative AMH levels (all P < 0.001). The rate of decline of AMH levels was significantly greater in the bipolar coagulation group than the hemostatic sealant group (41.2% [IQR, 17.2-54.5%] and 16.1% [IQR, 8.3-44.7%], respectively, P = 0.004)., Limitations, Reasons for Caution: Some caution is warranted because other ovarian reserve markers such as serum markers (basal FSH and inhibin-B) or sonographic markers were not assessed., Wider Implications of the Findings: The present study shows that the use of a hemostatic sealant during laparoscopic ovarian cystectomy should be considered, as hemostatic sealant provides the additional benefit of preservation of ovarian reserve., Study Funding/completing of Interests: This study was supported by the Medical Research Funds from Kangbuk Samsung Hospital. No conflict of interest is declared., Trial Registration Number: www.clinicaltrials.gov, no. NCT01857466., (© The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2014
- Full Text
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46. Guidelines on the use of gelatin sponge particles in embolotherapy.
- Author
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Miyayama S, Yamakado K, Anai H, Abo D, Minami T, Takaki H, Kodama T, Yamanaka T, Nishiofuku H, Morimoto K, Soyama T, Hasegawa Y, Nakamura K, Yamanishi T, Sato M, and Nakajima Y
- Subjects
- Anaphylaxis chemically induced, Animals, Embolization, Therapeutic adverse effects, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Humans, Japan, Pain etiology, Embolization, Therapeutic methods, Gelatin Sponge, Absorbable therapeutic use, Hemorrhage therapy, Hemostatics therapeutic use, Neoplasms therapy, Practice Guidelines as Topic
- Abstract
Gelatin sponge (GS) is one of the most widely used embolic agents in interventional procedures. There are four commercially available GS products in Japan; however, the endovascular use of Gelfoam and Spongel is off-label, and Gelpart can only be used for hepatic artery embolization and Serescue can only be used for hemostasis of arterial bleeding. GS has been used for a variety of clinical indications, mainly tumor embolization and stopping massive arterial bleeding. The optimal size and preparation procedure of GS particles differs slightly for each clinical indication. In addition, there is a risk of ischemic and/or infectious complications associated with GS embolization in various situations. Therefore, radiologists should be familiar with not only the preparation and handling of GS particles, but also the disadvantages and potential risks, in order to perform GS embolization safely and effectively.
- Published
- 2014
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47. Permanent cortical blindness after bronchial artery embolization.
- Author
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van Doorn CS, De Boo DW, Weersink EJM, van Delden OM, Reekers JA, and van Lienden KP
- Subjects
- Adult, Blindness, Cortical diagnostic imaging, Bronchial Arteries abnormalities, Contrast Media, Female, Gelatin Sponge, Absorbable adverse effects, Hemoptysis etiology, Hemoptysis therapy, Humans, Radiographic Image Enhancement methods, Subclavian Artery abnormalities, Subclavian Artery diagnostic imaging, Tomography, X-Ray Computed methods, Treatment Outcome, Blindness, Cortical etiology, Bronchial Arteries diagnostic imaging, Cystic Fibrosis complications, Embolization, Therapeutic adverse effects
- Abstract
A 35-year-old female with a known medical history of cystic fibrosis was admitted to our institution for massive hemoptysis. CTA depicted a hypertrophied bronchial artery to the right upper lobe and showed signs of recent bleeding at that location. Bronchial artery embolization (BAE) was performed with gelfoam slurry, because pronounced shunting to the pulmonary artery was present. Immediately after BAE, the patient developed bilateral cortical blindness. Control angiography showed an initially not opacified anastomosis between the embolized bronchial artery and the right subclavian artery, near to the origin of the right vertebral artery. Cessation of outflow in the bronchial circulation reversed the flow through the anastomosis and allowed for spill of embolization material into the posterior circulation. Unfortunately the cortical blindness presented was permanent.
- Published
- 2013
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48. Intraoperative anaphylaxis secondary to intraosseous gelatin administration.
- Author
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Luhmann SJ, Sucato DJ, Bacharier L, Ellis A, and Woerz C
- Subjects
- Animals, Blood Loss, Surgical prevention & control, Bone Screws, Cattle, Child, Female, Gelatin Sponge, Absorbable administration & dosage, Hemostatics administration & dosage, Humans, Intraoperative Complications etiology, Spinal Fusion methods, Swine, Anaphylaxis etiology, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects, Scoliosis surgery
- Abstract
Background: FloSeal and SurgiFlo Hemostatic Matrices are commonly used in surgical procedures to promote coagulation and minimize blood loss. They are composed of bovine and porcine gelatin matrix, respectively, that can be injected into pedicles to stop osseous bleeding during pedicle screw insertion., Methods: This report details 2 pediatric spinal deformity reconstructive surgery patients who experienced intraoperative cardiovascular events after the intraosseous administration of animal-derived gelatin., Results: Case #1 is an 11-year-old female with adolescent idiopathic scoliosis who was undergoing routine posterior spinal instrumentation and fusion. During placement of the fourth pedicle screw, the patient developed profound hypotension, tachycardia, and elevated airway pressures requiring intravenous epinephrine and phenylephrine for hemodynamic support. Surgery was aborted. Postoperative work-up demonstrated a positive ImmunoCAP study for bovine gelatin. Surgery was repeated 1 week later, without the use of FloSeal, and no episodes of hemodynamic instability. Case #2 was a 9-year-old female with juvenile idiopathic scoliosis who was undergoing a growing spine construct. As in Case #1, SurgiFlo was placed into 2 pedicle tracts after which there was profound hypotension, tachycardia, and elevated airway pressures. Resuscitative efforts included intravenous atropine and epinephrine with resolution. Surgery was aborted. Surgery was repeated 2 weeks later, without the use of SurgiFlo, with no episodes of hemodynamic instability., Conclusions: Given that the patient's symptoms were classic for anaphylaxis, and that the timing of the anaphylaxis immediately followed the administration of FloSeal and SurgiFlo we believe that FloSeal and SurgiFlo were the causes of the reactions. These are the first known reported cases of intraoperative anaphylaxis associated with FloSeal and SurgiFlo. On the basis of our experience, in order to avoid intraoperative cardiovascular events, we obtain preoperative ImmunoCAP testing and eliciting a thorough preoperative history about bovine-derived and porcine-derived gelatin products.
- Published
- 2013
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49. Prospective study of transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma: an Asian cooperative study between Japan and Korea.
- Author
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Ikeda M, Arai Y, Park SJ, Takeuchi Y, Anai H, Kim JK, Inaba Y, Aramaki T, Kwon SH, Yamamoto S, and Okusaka T
- Subjects
- Aged, Aged, 80 and over, Anthracyclines adverse effects, Antibiotics, Antineoplastic adverse effects, Carcinoma, Hepatocellular blood supply, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular pathology, Disease Progression, Disease-Free Survival, Ethiodized Oil adverse effects, Female, Gelatin Sponge, Absorbable adverse effects, Humans, Japan, Liver Neoplasms blood supply, Liver Neoplasms mortality, Liver Neoplasms pathology, Male, Middle Aged, Prospective Studies, Republic of Korea, Survival Analysis, Survival Rate, Time Factors, Treatment Outcome, Anthracyclines administration & dosage, Antibiotics, Antineoplastic administration & dosage, Carcinoma, Hepatocellular therapy, Chemoembolization, Therapeutic adverse effects, Chemoembolization, Therapeutic mortality, Ethiodized Oil administration & dosage, Gelatin Sponge, Absorbable therapeutic use, Liver Neoplasms therapy
- Abstract
Purpose: To evaluate the safety and efficacy of transcatheter arterial chemoembolization used for the treatment of unresectable hepatocellular carcinoma (HCC) with an Asian cooperative prospective study between Japan and Korea., Materials and Methods: Patients with unresectable HCC unsuitable for curative treatment or with no prior therapy for HCC were enrolled. The patients underwent transcatheter arterial chemoembolization with emulsion of Lipiodol and anthracycline agent, followed by embolization with gelatin sponge particles, which was repeated on an as-needed basis. The primary endpoint was 2-year survival rate, and the secondary endpoints were adverse events and response rate., Results: The 2-year survival rate of 99 patients was 75.0% (95% confidence interval, 65.2%-82.8%). The median time-to-progression was 7.8 months, and the median overall survival period was 3.1 years. Of 99 patients, 42 (42%) achieved a complete response, and 31 (31%) had a partial response. The response rate was 73% using modified Response Evaluation Criteria in Solid Tumors. The grade 3-4 toxicities included increased alanine aminotransferase level in 36%, increased aspartate aminotransferase level in 35%, thrombocytopenia in 12%, and abdominal pain in 4% of patients. All other toxicities were generally transient., Conclusions: Asian transcatheter arterial chemoembolization demonstrated sufficient safety and reasonable efficacy as a standard treatment for unresectable HCC. These results could be useful as reference data for future trials of transcatheter arterial chemoembolization., (Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.)
- Published
- 2013
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50. Granular hemostat deposits mimicking disseminated malignancy.
- Author
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Wood SJ, Kelsey A, Brennan B, Bruce J, and Craigie RJ
- Subjects
- Abdominal Neoplasms pathology, Abdominal Neoplasms surgery, Child, Preschool, Diagnosis, Differential, Humans, Infant, Newborn, Male, Neoplasm Metastasis diagnosis, Gelatin Sponge, Absorbable adverse effects, Hemostatics adverse effects
- Abstract
Hemostatic matrices are a part of the surgeon's armamentarium against profuse intraoperative bleeding. Granular deposits may form after the use of a liquid hemostat which can be mistaken for tumor recurrence or metastatic disease in the setting of neoplasia. We present two cases that highlight the importance of full knowledge of product usage during previous operations and the need for histological examination of these lesions., (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
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