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General surgery
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Other less common options. Bile salts (however 50% recurrence of gallstones).Extracorporeal shock wave lithotripsy (ESWL).
Critical care, neurology and analgesia
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Extracorporeal membrane oxygenation (ECMO) is a complex life support technique for severe pulmonary or cardiopulmonary failure, developed through modification of the heart lung bypass machine [1]. The technique of ECMO involves oxygenating blood outside the body and, thus, obviates the need for gas exchange in the lungs. The technique is categorised as either veno-venous (VV) or veno-arterial (VA), depending on the type of cannulation. In VV ECMO, deoxygenated blood is drained and oxygenated blood re-infused via venous sites. In neonates, this is achieved by placing a double lumen cannula in the right internal jugular vein (Figure 1). In VA ECMO, deoxygenated blood drawn from the right internal jugular vein is returned oxygenated via the right common carotid artery. While VV ECMO provides support purely with gas exchange, VA ECMO also supports the heart.
Sialendoscopy for the Management of Obstructive Salivary Gland Disease: A Systematic Review and Meta-Analysis
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
Iro et al. published a multicentred prospective observational study of extracorporeal shockwave lithotripsy alone or in combination with sialendoscopy (chapter 33). Their reported success rate in the 4,691 patients was 97% and the incidence of sialadenectomy was 2.9%.5 These are cases where sialendoscopy was used as an adjunct for stone removal.
Novel elbow basket mechanical lithotripter for large common bile duct stone removal
Published in Postgraduate Medicine, 2022
Huahui Zhang, Ying Fang, Jian Huang, Fengdong Li, Xiangrong Qin, Jin Huang
Many techniques can be used for fragmenting stones, for example, digital cholangioscopy-guided laser lithotripsy, surgery treatment, and extracorporeal shock wave lithotripsy [11–13]. With the development of endoscopic techniques, cholangioscopy-guided lithotripsy for stone removal has been widely used in recent years [7]. A multicenter study showed that the success rate of cholangioscopy-guided lithotripsy for CBD stones was 80% in a single procedure [14]. In contrast to ERCP, cholangioscopy is a complex therapeutic endoscopic procedure that will require a longer time to complete the operation. Moreover, the treatment of CBD stones by cholangioscopy is expensive because cholangioscopy-guided laser lithotripsy requires highly skilled providers and expensive equipment [15]. Extracorporeal shock wave lithotripsy is a complex and technically demanding procedure with a low success rate. It is used when conventional techniques have failed to fragment CBD stones or cannot be used [4]. Laparoscopic CBD exploration is traumatic and requires T-tube drainage after surgery, which is generally applied for patients with a suspected bile duct malignancy or ERCP that has failed to remove stones [16].
Grooved vs smooth ureteric stent before extracorporeal shockwave lithotripsy: Single-blind randomised clinical trial
Published in Arab Journal of Urology, 2022
Abdulqadir Alobaidy, Tarek Ibrahim, Walid El Ansari, Hosam Tawfik, Abdulla Al-Naimi, Salam Hussain, Abdulla Al-Ansari
Urolithiasis is a common disease with increasing prevalence especially in the Middle East [1]. Despite the technological advances in surgical management, extracorporeal shockwave lithotripsy (ESWL) remains a viable treatment option for renal and proximal ureteric stones [2]. Due to its low invasiveness, cost, and complications as well as high efficiency, ESWL provides a stone-free rate (SFR) of up to 95% [3–5]. The American Ureteral Stones Guidelines panel recommended ESWL as the first-line treatment for ureteric stones of ≤1 cm and optional for those >1 cm [6]. Likewise, the European and Asian Associations of Urology recommend ESWL as the first option in the treatment of renal stones of <2 cm [2,7]. However, despite its popularity, ESWL has limitations that might discourage some surgeons from the procedure, preferring to use other treatment modalities.
New nonchemotherapy treatment options for cutaneous T-cell lymphomas
Published in Expert Review of Anticancer Therapy, 2021
Extracorporeal photopheresis (ECP) has been FDA approved as a first line treatment of MF/SS with blood involvement or advanced erythrodermic involvement since 1988[7]. Leucocytes are separated from the patient’s whole blood, mixed with photosensitizing agent 8-methoxypsoralen, and exposed to ultraviolet A light before being reinfused into the patient[56]. In addition to decreasing the viability of irradiated cells, ECP is also thought to have an immunomodulatory effect by normalizing the Th1/Th2 imbalance found in patients with MF/SS[57]. In an initial multi-center study of 37 patients with resistant MF/SS, 73% (27/37) responded to ECP treatment[58]. To date, there are no randomized controlled trials comparing ECP to other standard therapies for MF/SS[59]. Reported adverse events included post-reinfusion temperature elevations and erythema accentuation. ECP may be administered with other therapies such as interferon alfa, vorinostat, and bexarotene[59].