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PubMed1975

Electrocoagulation of bleeding in the upper part of the gastrointestinal tract: a preliminary experimental clinical report.

Electrocoagulation of gastric or esophageal bleeding sites was evaluated in dogs using a flexible suction coagulator electrode passed through the endoscope using an electrocautery unit (Cameron-Miller model 80-7910). Acute and chronic coagulation studies in 25 dogs showed that electrocoagulation of both the esophageal and gastric mucosa was safe at an electrocautery unit setting of 5 for three to five seconds. This level of coagulation was successful in stopping bleeding created from actively bleeding esophageal and gastric mucosal defects by taking multiple large biopsy specimens. Based on these data, six patients with active bleeding gastric lesions have undergone mucosal coagulation. This successfully stopped the bleeding initially in all six patients; two patients rebled and required operative intervention within 48 hours. Further clinical evaluation is being implemented to determine its clinical role in the treatment of bleeding in the upper part of the gastrointestinal tract.

Adult↗

PubMed1981

Electrocoagulation for skin cancer: an old oncologic tool revisited.

Two-hundred-sixty-two squamous cell and basal cell carcinomas were treated by electrocoagulation over a six-year period. Eighty-four percent of these lesions were basal cell carcinomas. The overall recurrence rate was 3% in a personal 2--9-year follow-up. Those lesions measuring 2--5 cm had a 4% recurrence rate. All operations were done on an ambulatory basis. One-third of the patients were 70 years of age or older. This method has been found to be effective in the treatment of postradiation recurrences of skin cancer. Up to now such recurrences have defied attempts at cure. The technique is simple, safe, convenient, economical, and highly effective. It is believed that electrocoagulation and curettage should be considered the ideal therapy for those skin cancers in all locations in which surgical excision and primary closure cannot be done without plastic surgical intervention.

Age Factors↗

PubMed1984

A new device for electrocoagulation of small vessels.

The importance of sealing small vessels by electrocoagulation in microsurgery is well known. In practice, the reliability of both short and long time results obtained with common and bipolar forceps with radiofrequency application is variable, particularly when encrusted coagulations adhere to the forceps tips and there is danger of damaging the vessel when the forceps are withdrawn. The coagulation process involves a sudden change in tissue characteristics, that occurs within a narrow temperature range, closely following the pattern of the applied current and is only modified by heat dissipation to the cooler parts, such as the forceps tips. Keeping these principles in mind, we developed an improved device which provides: A well-balanced current flow between the tips, which is unaffected by wiring, distributed capacitance and current leakage of the electrocoagulator ; a time-dependent heating pattern that coagulates only the core of the clamped tissue.

Electrocoagulation↗

PubMedDate not supplied

Electrocoagulation for adenocarcinoma of the low rectum.

Cancers of the distal rectum (less than 7.5 cm from the anal verge) that are freely mobile, moderately well or well differentiated, less than 4 cm in size, limited to the bowel wall, and without evidence of metastasis should be considered candidates for treatment with electrocoagulation for cure. Tumor cell ploidy and evaluation with intrarectal ultrasound may in the future add additional useful information with regard to patient selection. Electrocoagulation and laser ablation of tumors may also be useful modalities for palliation of patients with metastatic disease or who are not candidates for curative surgery.

Adenocarcinoma↗

PubMed1998

Gastric antral vascular ectasia successfully treated by endoscopic electrocoagulation.

We report two cirrhotic patients with gastric antral vascular ectasia (GAVE) in whom chronic blood loss presented a major problem. Case 1, a 69-year-old man, had alcoholic liver cirrhosis, and case 2, a 75-year-old woman, had liver cirrhosis associated with hepatitis C virus. The patients required repeated blood transfusions but still exhibited persistent anemia. On upper gastrointestinal endoscopy, both patients showed esophageal varices without stigmata of bleeding or red color signs and presented with a characteristic antral appearance so distinctive as to be diagnostic; diffuse erythemas consisting of ectatic and tortuous capillaries throughout the antrum. Endoscopic electrocoagulation treatment with a monopolar probe was effective for controlling blood loss from GAVE. The patients tolerated the procedure well and there were no resultant complications. Several sessions of the treatment resulted in eradication of almost all the vascular lesions, negative fecal occult blood test results, and marked alleviation of their anemia without further treatment. Endoscopic electrocoagulation is suggested to be a safe, non-invasive, and effective treatment for blood loss from GAVE, especially in patients with liver cirrhosis in whom surgery carries an increased risk.

Aged↗

PubMed1978

Risk of cervical cancer among an electrocoagulated population.

In Finland an organized mass screening program covers the total female population. Based on the material (429,832) from a nationwide mass screening registry it was estimated that the female population not subjected to electrocoagulation of the uterine cervix (362,511) had a sixfold risk of frankly invasive carcinoma, a fourfold risk of carcinoma in situ or dysplasia of high degree, and a twofold risk of dysplasia of low degree as compared with the female population subjected to electrocoagulation of the uterine cervix (67,321). The relative risk of cervical lesion varied by cytologic diagnosis, marital status, and Trichomonas vaginalis.

Adult↗

PubMed1981

Deaths associated with laparoscopic sterilization by unipolar electrocoagulating devices, 1978 and 1979.

In 1978 and 1979, two women in the United States were reported to have died from electrical complications following sterilization with unipolar coagulating devices. Both deaths followed apparent bowel injuries occurring at the time of sterilization. Numerous reports have documented the electrical accidents associated with unipolar electrocoagulation. Because unipolar electrocoagulation has greater risk for these complications than alternative sterilization techniques, without proved greater benefits, we question the need for continuing its use in female sterilization.

Adult↗

PubMed1976

Electrocoagulation as primary therapy for rectal carcinoma.

The survival of forty-seven patients with cancer of the rectum treated by electrocoagulation is compared with thirty-seven patients treated by abdominoperineal resection. The one to ten year survival for the electrocoagulationgroup was 48 per cent and the one to eight year survival for the abdominoperineal resection group was 46 per cent. We believe that electrocoagulation when selectively applied has a place in the management of cancer of the rectum.

Adenocarcinoma↗

PubMed1990

Long-term follow-up of laparoscopic sterilizations by electrocoagulation, the Hulka clip and the tubal ring.

A follow-up study of 499 women who underwent sterilization between August 1973 and May 1976 at the Siriraj Hospital in Bangkok, Thailand, and had long-term (4-12 years post-surgery) follow-up is described. Women were sterilized through participation in one of three studies conducted at this hospital. In the first study, 124 underwent sterilization using the Hulka clip via laparoscopy; 67.7% of these women returned for a long-term follow-up visit. In the second study, 300 women were randomly allocated to the Hulka clip or to unipolar electrocoagulation (cautery) via laparoscopy; 70.7% of the women from this study returned for a long-term follow-up visit. The final study was a randomized trial comparing the tubal ring and unipolar electrocoagulation occlusion techniques in 300 cases. Long-term follow-up visits were recorded for 207 women (69.0%) from this study. Five technical failures (procedures not performed or completed as planned) and six non-interval cases were excluded from follow-up analyses. A total of 713 interval patients were eligible for follow-up. Long-term follow-up was initiated in 1978 and continued through 1986. Late sequelae of sterilization, including pregnancies and pelvic surgery, are discussed with regard to type and time of tubal occlusion. One intrauterine and two ectopic pregnancies were reported among women who were sterilized with cautery; one ectopic pregnancy was reported by a woman sterilized with the Hulka clip. Pelvic or abdominal surgeries were reported in 27 cases. Most (greater than 98%) women indicated that they were satisfied with their sterilization procedure.

Adult↗

PubMed1984

Restoration of the hamster tracheal wall following injury by electrocoagulation.

The trachea of Syrian golden hamsters was injured by electrocoagulation. The lesions induced as well as the repair process were studied by light and scanning electron microscopy. The changes observed were considered to create the proper conditions for studying the significance of severe focal damage to the respiratory tract for the formation of tumors at the site of injury. Electrocoagulation caused deep crater-like injuries measuring 2 to 3 mm in diameter. Not only the mucosa, but also the submucosal tissues and cartilage rings were damaged. The repair process of the epithelium followed the pattern of covering the defect by squamous epithelium, hyperplasia, and stratified squamous metaplasia and finally differentiation into normal tracheal epithelium. The recovery of the epithelium was strikingly slow; even after a recovery period of 10 weeks regeneration of the epithelium was still incomplete in some animals. This relatively slow process of repair was ascribed to the depth and severity of the injuries involving a large mass of damaged tissues other than epithelium. Regeneration of the cartilage rings comprised three processes, viz removal of necrotic cartilage, growth of fibroblasts into the necrotic cartilage, and deposition of new cartilage along the necrotic rings.

Animals↗

PubMed1991

Determination of the optimal technique for bipolar electrocoagulation treatment. An experimental evaluation of the BICAP and Gold probes.

The optimal technique for use of bipolar electrocoagulation has not been established despite its widespread clinical use. This study of the BICAP (Circon-ACMI, Stamford, CT) and Gold (Microvasive, Watertown, MA) probes evaluates the maximal force that can be applied through an endoscope and quantifies the depths of coagulation and sticking at varying parameters in a beef liver model. Maximal forces of application were determined with 3.2- and 2.3-mm probes extended 3 and 6 cm outside the endoscope at 90 degrees and 45 degrees. Depths of coagulation and sticking were measured at 90 combinations of varying forces of application (0, 50, and 100 g), watt settings (1, 3, 5, 7, and 9), and durations (2, 6, 10, and 14 seconds; 3 x 2 seconds, 7 x 2 seconds) for the 3.2-mm BICAP and Gold probes. Mean maximal force of application decreased with greater extension or angulation of the probe outside the scope (3.2-mm BICAP--90 degrees: 3 cm, 110 g; 6 cm, 56 g; 45 degrees: 3 cm, 50 g; 6 cm, 30 g; P less than 0.001; 3.2-mm Gold--90 degrees: 3 cm, 130 g; 6 cm, 105 g; 45 degrees: 3 cm, 62 g; 6 cm, 48 g; P less than 0.001). The maximal force was significantly greater with the Gold probe than with the BICAP in seven of eight comparisons. Significant variations among the mean depths of coagulation (in millimeters) for pooled data of each parameter were observed with force of application (BICAP: 0 g, 0.8; 50 g, 1.4; 100 g, 1.7), watt settings (BICAP: 1, 0.6; 3, 1.7; 5, 1.4; 7, 1.4; 9, 1.3), and duration of treatment (BICAP: 2 seconds, 0.8; 6 seconds, 1.1; 10 seconds, 1.4; 14 seconds, 1.5; values for the Gold probe were comparable). The greatest depths of coagulation were observed at 100 g force, watt setting 3, and 14 seconds or 7 x 2 seconds duration. Sticking paralleled depth of coagulation, increasing with force and duration of application. In conclusion, optimal treatment of bleeding gastroduodenal lesions with bipolar electrocoagulation includes (a) placing the tip of the endoscope en face as close as possible to the bleeding lesion, (b) applying the maximal force possible, (c) using a low-watt setting (approximately 3), and (d) treating with prolonged periods of coagulation.

Electrocoagulation↗

PubMed1996

A computer based, temperature controlled bipolar electrocoagulation system.

OBJECTIVE: To reduce complications during electrocoagulation particularly injury of other organs, a computer based, temperature controlled bipolar coagulation system has been developed. Under this system temperature in the tissue is kept between 60 degrees C and 95 degrees C during coagulation. A real time graphic display provides the surgeon with an actual temperature at the tip of the forceps during coagulation. STUDY DESIGN: Rabbit uterine horns were coagulated at 90 degrees C and were examined histologically and histochemically at 6 weeks after coagulation. RESULTS: Electrocoagulation at 90 degrees C induced a total loss of LDH activity in the tissue. Lumen of the uterus was completely occluded when examined 6 weeks later. CONCLUSION: This system with low temperature is sufficient for homogenous coagulation of the tissue.

Animals↗

PubMed2004

Removal of arsenic from water by electrocoagulation.

In the present study electrocoagulation (EC) has been evaluated as a treatment technology for arsenite [As(III)] and arsenate [As(V)] removal from water. Laboratory scale experiments were conducted with three electrode materials namely, iron, aluminum and titanium to assess their efficiency. Arsenic removal obtained was highest with iron electrodes. EC was able to bring down aqueous phase arsenic concentration to less than 10 microgl(-1) with iron electrodes. Current density was varied from 0.65 to 1.53 mAcm(-2) and it was observed that higher current density achieved rapid arsenic removal. Experimental results at different current densities indicated that arsenic removal was normalized with respect to total charge passed and therefore charge density has been used to compare the results. Effect of pH on arsenic removal was not significant in the pH range 6-8. Comparative evaluation of As(III) and As(V) removal by chemical coagulation (with ferric chloride) and electrocoagulation has been done. The comparison revealed that EC has better removal efficiency for As(III), whereas As(V) removal by both processes was nearly same. The removal mechanism of As(III) by EC seems to be oxidation of As(III) to As(V) and subsequent removal by adsorption/complexation with metal hydroxides generated in the process.

Aluminum↗

PubMed1975

Tubal electrocoagulation under hysteroscopic control (three hundred and fifty cases).

Three hundred and fifty patients of the Family Planning Service of the Hospital De Gineco Obstetricia of the Medical Center at the Mexican Social Security Institute were treated by tubal electrocoagulation under hysteroscopic control. Our results in these patients are presented, with a follow-up period of between nine and 30 months after electrocoagulation.

Adult↗

PubMed1987

Neodymium-YAG laser photocoagulation versus multipolar electrocoagulation for the treatment of severely bleeding ulcers: a randomized comparison.

A randomized trial comparing the efficacy of BICAP electrocoagulation and YAG laser photocoagulation was carried out in 100 patients presenting at endoscopy with peptic ulcer and a spurting or oozing vessel or a nonbleeding vessel. Fifty patients were enrolled in each treatment group. All lesions were pretreated with injection of epinephrine 1:10,000. Subsequently, 1-sec pulses of 80 watt YAG laser power were applied to the vessel or 1- to 2-sec pulses of electrocoagulation of 25 watt BICAP at a setting of 10. The 10 F BICAP probe was always used. Definitive hemostasis after one treatment amounted to 72% in both the laser and in the BICAP group. After two sessions the cumulative success rate was 88% in the laser group and 86% in the BICAP group. Emergency surgery and mortality were also comparable. One perforation occurred in each treatment group and both patients were operated upon without complications. It is concluded that both YAG laser and BICAP are highly and equally effective in the treatment of severe bleeding from peptic ulcers. This study stresses the importance of repeated treatment sessions in order to obtain optimal results.

Adult↗

PubMedDate not supplied

Prospective randomized comparative study of bipolar versus direct current electrocoagulation for treatment of bleeding internal hemorrhoids.

Internal hemorrhoids are the most common cause of lower gastrointestinal bleeding. Although new anoscopic therapies are available, few comparative randomized studies have evaluated them in regard to long-term efficacy, recurrence rates, and safety. Our purpose was to compare the treatment of internal hemorrhoids with direct current (Ultroid, Cabot Medical, Langhorn, Pa.) and bipolar (BICAP, Circon ACMI, Stamford, Conn.) hemorrhoid probes. One hundred patients with symptomatic internal hemorrhoids were randomized: 50 to direct current electrocoagulation and 50 to bipolar electrocoagulation. Follow-up and treatment were at 3- to 4-weekly intervals; two to three hemorrhoid segments were treated at each session until relief of symptoms (bleeding, prolapse, and discharge) and a reduction in hemorrhoid size to grade 1 or 0 were noted. The hemorrhoids of 98% of all patients studied were grade 2 or 3; 2% of patients had grade 1 hemorrhoids and none had grade 4 hemorrhoids. At 1 year after treatment, most patients had no (69%) or only mild (23%) recurrence, and a few had severe, symptomatic (8%) hemorrhoid recurrence. A greater recurrence rate was noted after direct current treatment (34%) than bipolar treatment (29%). In contrast, rebleeding at 1 year occurred less frequently after direct current treatment (5%) than after bipolar treatment (20%). Our conclusions were as follows: (1) Both direct current and bipolar probes were effective for control of chronic bleeding from grade 1 to 3 internal hemorrhoids. (2) Bipolar probe was significantly faster than direct current probe. (3) Direct current treatment produced fewer complications than bipolar treatment (12% versus 14%). (4) Recurrence rates were low after 1 year with either device (8%).(ABSTRACT TRUNCATED AT 250 WORDS)

Electrocoagulation↗

PubMed1994

Use of electrocoagulation in the treatment of vesicovaginal fistulas.

The role of electrocoagulation for the treatment of vesicovaginal fistulas has not been clearly defined. To determine the use of this therapeutic modality, 15 cases of fistulas treated with electrocoagulation were retrospectively reviewed. Fulguration represented the primary treatment in 12 patients and the secondary treatment in 3 after an initial attempt at open surgical closure failed. In all instances fistula size was estimated to be 3.5 mm. or less. A Bugbee electrode, which was inserted into the fistula either cystoscopically or vaginally, was used to destroy the epithelial lining of the fistula tract. Following the procedure the bladder was decompressed with a large indwelling Foley catheter for at least 2 weeks. Fulguration was successful as the sole treatment modality in 9 of 12 patients (75%) and as an alternative intervention after failure of an open surgical repair in 2 of 3 (66%). Therefore, 11 of the 15 women (73%) had complete resolution of the fistulas with this technique. We conclude that fulguration is usually effective in managing patients with vesicovaginal fistulas a few millimeters in size or less. This technique should be used as an initial treatment for appropriately selected patients and in women with small residual fistulas after open surgical failure.

Electrocoagulation↗

PubMed1999

Pregnancy after tubal sterilization with bipolar electrocoagulation. U.S. Collaborative Review of Sterilization Working Group.

OBJECTIVE: To determine risk factors for pregnancy after tubal sterilization with bipolar electrocoagulation. METHODS: A total of 2267 women who had bipolar electrocoagulation were followed for up to 8 to 14 years as part of a multicenter, prospective, cohort study conducted in medical centers in nine United States cities. We used proportional hazards analysis and cumulative life-table probabilities to assess pregnancy risk in these women. RESULTS: The 5-year cumulative probability of pregnancy for women sterilized in 1978-1982 was 19.5 per 1000 procedures (95% confidence interval [CI], 12.2, 26.9); the comparable probability for women sterilized in 1985-1987 was significantly lower, 6.3 per 1000 procedures (95% CI, 0.0, 13.5) (one-tailed P = .01). Women enrolled in 1985-1987 who had fewer than three sites of coagulation had a probability of failure of 12.9 per 1000 procedures (95% CI, 0.0, 38.0); by contrast, women who had three or more sites coagulated had a probability of failure of 3.2 per 1000 procedures (95% CI, 0.0, 9.6) (one-tailed P = .01). CONCLUSION: The long-term probability of pregnancy after tubal sterilization with bipolar coagulation was very low when three or more sites of the fallopian tube were coagulated. Bipolar coagulating systems can be highly effective for sterilization when the fallopian tube is coagulated adequately.

Adolescent↗