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At least 235 records · Page 13Linked to original sources
PubMed1995

Heater probe thermocoagulation and multipolar electrocoagulation for arrest of peptic ulcer bleeding. A prospective, randomized comparative trial.

Both heater probe thermocoagulation (HPT) and multipolar electrocoagulation (MPEC) are promising techniques to control peptic ulcer bleeding. However, their hemostatic effects are still not proven conclusively in controlled trials. Here we have tried to do that. Patients with a bleeding ulcer or a nonbleeding visible vessel at the ulcer base received either HPT or MPEC randomly. We compared hemostatic rates, rebleeding rates, hospital stay, volume of blood transfusion, number of operations, and mortality between both groups. A total of 80 patients entered this trial. Patients of both groups had similar ultimate hemostatic rates (HPT 92.5%, MPEC 85%), days in hospital (HPT 5.4, MPEC 5.0), volume of blood transfusion (mean values: HPT 1,774 ml, MPEC 1,974 ml), number of operations (HPT 3, MPEC 3), and mortality (HPT 2, MPEC 3). Both therapeutic approaches are safe and effective for peptic ulcer bleeding.

Aged↗
PubMed1999

The fate of intracranial microaneurysms treated with bipolar electrocoagulation and parent vessel reinforcement.

OBJECTIVE: Although direct clipping remains the treatment of choice for intracranial aneurysms, not all aneurysms can be clipped. This report reviews the results of bipolar coagulation followed by parent vessel reinforcement for the treatment of intracranial microaneurysms (maximal diameter of < or =3 mm), with immediate and delayed postoperative angiographic evaluation in all cases. METHODS: During a 1-year period, 20 intracranial microaneurysms in 12 patients were treated with bipolar electrocoagulation followed by reinforcement of the parent artery with muslin gauze. All patients underwent intraoperative or immediate postoperative angiographic evaluation, and all underwent follow-up angiographic evaluation approximately 1 year later. No patient was lost to follow-up monitoring. RESULTS: Microaneurysms involved the middle cerebral artery (eight cases), internal carotid artery (six cases), anterior cerebral/anterior communicating artery (five cases), and superior cerebellar artery (one case). In all cases, the patient was undergoing a craniotomy for clipping of a larger aneurysm, and the microaneurysms were treated concurrently. At the time of the immediate angiographic examinations, 19 of 20 (95%) microaneurysms were no longer visible and 1 was substantially smaller (< 1-mm irregularity on the parent vessel). No patient experienced an adverse event related to microaneurysm treatment. In the 1-year follow-up examinations, there was no angiographic evidence of recurrence in the 19 cases with complete obliteration; the one residual aneurysm remained stable. CONCLUSION: At 1 year, direct coagulation followed by parent vessel reinforcement seems to provide a satisfactory treatment option for intracranial microaneurysms.

Cerebral Angiography↗
PubMed1979

Electrocoagulation diathermy treatment of cervical intraepithelial neoplasia.

Although there are other physical methods of destruction which may be effective for small areas of dysplastic change, the author believes that D&C and electrocoagulation diathermy under general anesthesia is a more reliable and more effective method of destruction of abnormal T-Zone. It has the distinct advantage of being able to eliminate large areas, and in particular, changes of major atypia extending into the gland crypts. To date, no patient treated in this fashion has developed invasive carcinoma of the cervix.

Electrocoagulation↗
PubMed1989

The efficacy of electrocoagulation diathermy performed under local anaesthesia for the eradication of precancerous lesions of the cervix.

This study demonstrates the feasibility of performing electrocoagulation diathermy with intracervical infiltration of local anaesthetic for precancerous lesions of the cervix. A technique suitable for office procedure without need of any supplementary analgesia is described; 200 patients were treated in this fashion with results indicating the ability to obtain high primary cure rates with low morbidity similar to those previously obtained with general anaesthesia.

Adolescent↗
PubMed1984

Electrocoagulation in a sterile surgical field.

A useful technique for the electrocoagulation of bleeders while maintaining a sterile surgical field is outlined. The method is fast and efficient, and no special equipment is required.

Dermatologic Surgical Procedures↗
PubMed1980

Controlled destruction and temperature distributions in biological tissues subjected to monoactive electrocoagulation.

An analysis of the temperature fields developed in a biological tissue undergoing a monoactive electrical coagulating process is presented, including thermal recovery following prolonged heating. The analysis is performed for the passage of alternating current and assumes a homogeneous and isotropic tissue model which is uniformly perfused by blood at arterial temperature. Solution for the one-dimensional spherical geometry is obtained by a Laplace transform and numerical integrations. Results obtained indicate the major role which blood perfusion plays in determining the effects of the coagulating process; tissue temperatures and depth of destruction are drastically reduced as blood perfusion increases. Metabolic heat generation rate is found to have negligible effects on tissue temperatures whereas electrode thermal inertia affects temperature levels appreciably. However, electrodes employed in practice would have a low thermal inertia which might be regarded as zero for all practical purposes. It is also found that the depth of tissue destruction is almost directly proportional to the electrical power and duration of application. To avoid excessively high temperatures and charring, it would be advantageous to reduce power and increase the time of application. Results of this study should be regarded as a first approximation to the rather complex phenomena associated with electrocoagulation. They may, nevertheless, serve as preliminary guidelines to practicing surgeons applying this technique.

Blood Circulation↗
PubMed2006

A randomised controlled trial of ablation of Barrett's oesophagus with multipolar electrocoagulation versus argon plasma coagulation in combination with acid suppression: long term results.

BACKGROUND: Many modalities have been used to ablate Barrett's oesophagus (BO). However, long term results and comparative effectiveness are unknown. AIMS: Our aim was to compare the long term efficacy of achieving complete reversal (endoscopic and histological) between multipolar electrocoagulation (MPEC) and argon plasma coagulation (APC) in BO patients and assess factors influencing successful ablation. METHODS: Patients with BO, 2-6 cm long, underwent 24 hour pH testing on proton pump inhibitor (PPI) therapy. Patients were then randomised by BO length to undergo ablation with MPEC or APC every 4-8 weeks until endoscopic reversal or maximal of six treatment sessions. RESULTS: Thirty five BO patients have been followed for at least two years following endoscopic ablation, 16 treated with MPEC and 19 with APC. There was complete reversal of BO in 24 patients (69%); 75% with MPEC and 63% with APC (p = 0.49). There was no difference in the number of sessions required in the two groups. There was no difference in age, pH results, BO length, PPI dose, or hiatal hernia size between patients with and without complete reversal. One patient developed an oesophageal stricture but there were no major complications such as bleeding or perforation. CONCLUSIONS: In BO patients treated with MPEC or APC in combination with acid suppression, at long term follow up, complete reversal of BO can be maintained in approximately 70% of patients, irrespective of the technique. There are no predictors associated with achieving complete reversal of BO. Continued surveillance is still indicated in the post ablative setting. As yet, these techniques are not ready for clinical application (other than for high grade dysplasia or early oesophageal adenocarcinoma) and cannot be offered outside the research arena.

Adult↗
PubMed1984

Which electrode? A comparison of four endoscopic methods of electrocoagulation in experimental bleeding ulcers.

Several inexpensive endoscopic methods of electrocoagulation have been advocated for treatment of gastrointestinal haemorrhage. We compared four types of electrode: dry monopolar - Cameron Miller (M), liquid monopolar - Storz (L), bipolar - Bicap ACMI (B), and heater probe - Seattle (H). The electrical and thermal properties of these probes were studied using computerised monitoring of energy deposition and their efficacy and safety was tested in a randomised study in 140 experimental canine gastric ulcers. At optimal pulse settings 20J (M), 70J (L), 17J (B), 15J (H), effective haemostasis was achieved in all ulcers, the mean number of pulses being M5, L6, H6 and B11, the first three requiring significantly (p less than 0.01) less pulse than B. Relative safety of the electrodes was assessed by comparing the incidence of full thickness damage at histology: B24%, H20%, L58% and M69%; B and H proving significantly (p less than 0.01) safer than L and M. Sticking was assessed as H greater than B greater than M much greater than L. Insensitivity to extreme angulation and force of application was assessed as L greater than B greater than M (H is preset). Of the two safer electrodes the heater probe was more effective than the bipolar probe. Despite its greater tendency to stick than the other devices, the heater probe appeared the most promising of the endoscopic electrodes tested.

Animals↗
PubMed1999

Comparison of adrenaline injection and bipolar electrocoagulation for the arrest of peptic ulcer bleeding.

BACKGROUND: Peptic ulcers with active bleeding or a non-bleeding visible vessel require aggressive endoscopic treatment. AIMS: To determine whether endoscopic adrenaline injection alone or contact probe therapy following injection is a suitable treatment for peptic ulcer bleeding. METHODS: A total of 96 patients with active bleeding or non-bleeding visible vessels received adrenaline alone, bipolar electrocoagulation alone, or combined treatment (n=32 in each group). RESULTS: Initial haemostasis was not achieved in one patient in the adrenaline group, two in the gold probe group, and two in the injection gold probe group (p>0.1). Rebleeding episodes were fewer in the injection gold probe group (2/30, 6.7%) than in the gold probe group (9/30, 30%, p=0.04) and in the adrenaline group (11/31, 35.5%, p=0.01). Treatment failure (other therapy required) was rarer in the injection gold probe group (4/32, 12.5%) than in the adrenaline group (12/32, 37.5%, p=0.04). The volume of blood transfused after entry of the study was less in the injection gold probe group (mean 491 ml) than in the adrenaline group (1548 ml, p<0. 0001) and the gold probe group (1105 ml, p<0.01). Duration of hospital stay, numbers of patients requiring urgent surgery, and death rate were not statistically different among the three groups. CONCLUSIONS: For patients with peptic ulcer bleeding, combined adrenaline injection and gold probe treatment offers an advantage in preventing rebleeding and decreasing the need for blood transfusion.

Adolescent↗
PubMed1978

Clinical use of transcatheter electrocoagulation.

Transcatheter electrocoagulation is an effective method of experimental vessel occlusion even in the presence of thrombocytopenia and heparinization. This technique was used to occlude 13 arteries in 3 patients. In vitro testing suggests that intra-arterial bipolar platinum electrodes may achieve the therapeutic objectives more rapidly and with less risk, but more investigative work is required.

Arteries↗
PubMed1979

Vessel occlusion with transcatheter electrocoagulation: initial clinical experience.

Transcatheter electrocoagulation (TCEC) was used for vessel occlusion in combination with embolization by Gelfoam and/or Ivalon in six patients in whom other interventional or surgical techniques were considered dangerous or unfeasible. The technique was effective in decreasing or obliterating the blood supply to variously located lesions in all cases. The only complications were small skin burns in one patient and a small ulceration of the upper lip in another.

Adult↗
PubMed1988

Long-term occlusion of the porcine cystic duct by means of endoluminal radio-frequency electrocoagulation.

Recurrent cholelithiasis must be expected after gallstone removal without cholecystectomy. Chemical gallbladder ablation may offer prevention but requires preliminary cystic duct occlusion. Radio-frequency (RF) electrocoagulation of the cystic duct was performed in 15 pigs to induce occlusion by a controlled thermal epithelial injury. A flexible coagulation catheter was placed into the cystic duct lumen under fluoroscopic control by means of either subhepatic cholecystostomy or direct, percutaneous transhepatic gallbladder puncture. Complete cystic duct occlusion was proved in 14 animals. Follow-up ranged from 1 to 17 weeks (mean, 11 weeks). Histologically, the RF technique induced an intense chronic inflammatory and fibroblastic reaction, which eventually obliterated the coagulated cystic duct segments. There was no epithelial regeneration or recanalization of the fibrotic cystic duct segments. The adjacent structures, particularly the cystic artery, were intact in all specimens.

Animals↗
PubMed1989

Catheter for endoluminal bipolar electrocoagulation.

An interventional catheter was designed that can induce controlled endoluminal tissue lesions by means of bipolar radio-frequency (RF) electrocoagulation under fluoroscopic guidance. The technique was used to obtain safe and reproducible percutaneous occlusion of the porcine cystic duct by reactive endoluminal scar formation. The new triple-lumen, 7-F, polyethylene catheter contains two insulated active wires and accommodates a 0.038-inch steerable guide wire, which facilitates insertion and placement of the active catheter tip under fluoroscopic control. The coagulation technique is relatively simple and requires only a small, portable bipolar RF generator and ammeter.

Animals↗
PubMed2000

Electrocoagulation of perianal warts: a word of caution.

BACKGROUND: Perianal warts are common, and may be extensive. Electrocoagulation is a recognised management option. METHOD: A 20-year-old male underwent electrocautery of extensive perianal warts. He presented 3 months postoperatively with constipation and inability to defecate. Examination revealed severe perianal stricture, which necessitated a defunctioning colostomy. RESULT: A gradual and spontaneous resolution of the stricture was observed over the following 18 months. Closure of the colostomy was followed by satisfactory anal function. CONCLUSION: Electrocautery of extensive perianal warts should be used with caution. Preservation of healthy skin bridges between lesions is essential if perianal stricture is to be avoided, and may best be achieved by sharp scissors dissection.

Adult↗