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Can Gonen - One of the best experts on this subject based on the ideXlab platform.
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The Histological Quality and Adequacy of Diminutive Colorectal Polyps Resected Using Jumbo Versus Hot Biopsy Forceps
Digestive Diseases and Sciences, 2015Co-Authors: Bulent Yasar, Huseyin Kayadibi, Evren Abut, Dilek Benek, Koray Kochan, Can GonenAbstract:Background Polypectomy with jumbo Forceps (JF) and polypectomy with Hot Biopsy Forceps (HBF) are still widely used techniques for removal of diminutive colorectal polyps (DCPs). JF may be more effective for the removal of DCPs because of their larger size. Aim To evaluate the histological quality and adequacy of DCPs resected using JF compared with HBF. Methods One hundred and seventy-nine patients with 237 DCPs were included in this study. DCPs were removed using either JP or HBF. Results The tissue architecture was good in 29.9 % of the HBF group, in comparison with 90 % of the JF group ( p
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the histological quality and adequacy of diminutive colorectal polyps resected using jumbo versus Hot Biopsy Forceps
Digestive Diseases and Sciences, 2015Co-Authors: Bulent Yasar, Huseyin Kayadibi, Evren Abut, Dilek Benek, Koray Kochan, Can GonenAbstract:Polypectomy with jumbo Forceps (JF) and polypectomy with Hot Biopsy Forceps (HBF) are still widely used techniques for removal of diminutive colorectal polyps (DCPs). JF may be more effective for the removal of DCPs because of their larger size. To evaluate the histological quality and adequacy of DCPs resected using JF compared with HBF. One hundred and seventy-nine patients with 237 DCPs were included in this study. DCPs were removed using either JP or HBF. The tissue architecture was good in 29.9 % of the HBF group, in comparison with 90 % of the JF group (p < 0.001). No cautery damage or crash artifact was observed in 93.3 % of JF group and in 8.5 % of HBF group (p < 0.001). Moreover, there were statistically significant differences between the groups with regard to the high level of cautery damage or crush artifact (p < 0.001). The overall diagnostic quality of the specimens removed using JF was significantly better than that of the specimens removed by HBF (96 vs. 80 %, respectively, p < 0.001). There were statistically significant inverse associations between cautery damage or crush artifact and overall diagnostic quality of HBF and JF (r = −0.373, p < 0.001; r = −0.382, p < 0.001, respectively). Surgical margins were determined as negative in 87.5 % of the JF group and in 76.1 % of the HBF group (p = 0.022). A total of 80.8 % of the JF specimens and 30.8 % of the HBF specimens were well evaluated for two lateral and deep surgical margins (p < 0.001). JF was superior to HBF for histopathological interpretation and eradication of DCPs.
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The Histological Quality and Adequacy of Diminutive Colorectal Polyps Resected Using Jumbo Versus Hot Biopsy Forceps
Digestive diseases and sciences, 2014Co-Authors: Bulent Yasar, Huseyin Kayadibi, Evren Abut, Dilek Benek, Koray Kochan, Can GonenAbstract:Polypectomy with jumbo Forceps (JF) and polypectomy with Hot Biopsy Forceps (HBF) are still widely used techniques for removal of diminutive colorectal polyps (DCPs). JF may be more effective for the removal of DCPs because of their larger size. To evaluate the histological quality and adequacy of DCPs resected using JF compared with HBF. One hundred and seventy-nine patients with 237 DCPs were included in this study. DCPs were removed using either JP or HBF. The tissue architecture was good in 29.9 % of the HBF group, in comparison with 90 % of the JF group (p
Wei-sheng Chen - One of the best experts on this subject based on the ideXlab platform.
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One-year follow-up period after transumbilical thoracic sympathectomy for hyperhidrosis: Outcomes and consequences
The Journal of thoracic and cardiovascular surgery, 2013Co-Authors: Li-huan Zhu, Sheng-sheng Yang, Long Chen, Shengping Chen, Wei-sheng ChenAbstract:Objectives Thoracic sympathectomy is considered the most effective method to treat palmar hyperhidrosis. We developed a novel approach for thoracic sympathectomy in patients with palmar hyperhidrosis through the umbilicus, using an ultrathin gastroscope. The aim of this study was to evaluate the continuing efficacy and patient satisfaction of this innovative surgery. Methods All procedures were performed under general anesthesia and the patients were intubated with a dual-lumen endotracheal tube. After a 5-mm umbilical incision, the muscular parts of the diaphragmatic dome were incised with a needle-knife and the nasal gastroscope was advanced into the thoracic cavity. The sympathetic chain was identified at the desired thoracic level and ablated with Hot Biopsy Forceps. All patients were followed up for at least 1 year after the procedure through clinic visits or telephone/e-mail interviews. Results From April 2010 to August 2011, a total of 35 patients underwent a transumbilical thoracic sympathectomy. Fifty-seven percent were male patients, with a mean age of 21.2 years (range, 16-33 years). The success rate after 12 months was 97.1% (34 of 35) for isolated palmar hyperhidrosis and 72.2% (13 of 18) for axillary hyperhidrosis. Compensatory sweating was reported in 28.6% of patients at the 1-year follow-up evaluation. There was no mortality, no diaphragmatic hernia, and no Horner syndrome was observed. Quality of life related to hyperhidrosis improved substantially in 27 (77.1%) patients, and improved in 4 (11.4%) patients at 12 months after surgery. A total of 94.3% of patients were satisfied with the excellent cosmetic results of the surgical incision. Conclusions Transumbilical thoracic sympathectomy is an efficacious alternative to the conventional approach. This technique avoided the chronic pain and chest wall paresthesia associated with the chest incision. In addition, this novel procedure afforded maximum cosmetic benefits.
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Feasibility of endoscopic transumbilical thoracic sympathectomy in a porcine model
Interactive cardiovascular and thoracic surgery, 2013Co-Authors: Jixue Zhang, Sheng-sheng Yang, Li-huan Zhu, Long Chen, Heping Zheng, Wei-sheng ChenAbstract:OBJECTIVES: Thoracoscopic sympathectomy is an effective treatment for palmar hyperhidrosis. Current methods are associated with risks of chronic neuropathic pain and a visible chest scar. We developed a novel surgical technique for the performance of sympathectomy by embryonic natural orifice transumbilical endoscopic surgery with a flexible endoscope in a porcine model. METHODS: Transumbilical flexible endoscopic thoracic sympathectomies were performed in seven farm pigs (three acute and four 4-week survivals). Under general anaesthesia, animals were intubated and mechanically ventilated with a dual lumen endotracheal tube through tracheostomy. A newly developed long transabdominal trocar was placed through the umbilicus. After insertion of a gastroscope through this trocar, a small incision was created on both sides of the diaphragm by a needle-knife. Then the gastroscope was inserted into the thoracic cavity, and the sympathetic chain was identified at the desired thoracic level and ablated. Operation time, safety and feasibility were recorded in all animals. RESULTS: The transumbilical thoracic sympathectomies were successfully completed in all pigs with a mean operation time of 66.7 ± 9.4 min. Intraoperative bleeding occurred in one pig during the electrosurgical incision of diaphragm tissue, which was successfully controlled by Hot Biopsy Forceps. No other acute intraoperative complications were observed in any cases. In the acute group, the length of the diaphragm incision ranged from 4 to 5 mm in three pigs. In the survival group, the animals recovered promptly from surgery. In three pigs, a small pneumothorax was found in the postoperative chest X-ray, but all of them were completely resolved with conservative treatment. Autopsy showed all bilateral T3 sympathetic chains were successfully ablated and no evidence of vital structure injury or diaphragmatic hernia. CONCLUSIONS: Transumbilical flexible endoscopic thoracic sympathectomy is technically feasible, simple and safe in a porcine model. This technique can be used as a novel experimental platform for studies of natural orifice transluminal endoscopic surgery (NOTES) for intrathoracic surgery.
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The investigation of endoscopic transumbilical thoracic sympathectomy in experimental models
Chinese Journal of Thoracic and Cardiovaescular Surgery, 2013Co-Authors: Sheng-sheng Yang, Wei-sheng ChenAbstract:Objective To evaluate the safety and feasibility of endoscopic transumbilical thoracic sympathectomy.Methods The technique was performed in 4 swine models.Under general anesthesia,a newly developed long abdominal trocar (60 cm in lengths) was placed through the umbilicus,which was also used to establish pneumoperitoneum.After insertion of gastroscope through this trocar,two small incisions of diagrams were created by needle-knife,through which the gastroscope was sent into the thoracic cavity to ablate the T3 ganglia by Hot Biopsy Forceps under One-lung ventilation.The animals were killed at the completion of the procedure.Results This procedure was completed in four pigs.The sympathetic chain was successfully ablated in all swine,as confirmed by gross surgical pathology and histology,the mean operative time was (81.7 ±15.4) minutes.There was no major bleeding.All bilateral T3 sympathetic chains were successfully ablated in the 4 swines as confirmed by gross surgical pathology and histology.There was no severe bleeding and damage to peripheral organs during the operation in any of the cases,and no prominent pneumothorax was revealed by postoperative chest X-ray radiography.Conclusion Endoscopic transumbilical thoracic sympathectomy is safe,feasible and effective with good cosmetic result. Key words: Endoscopiy; Swine; Sympathectomy
Bulent Yasar - One of the best experts on this subject based on the ideXlab platform.
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The Histological Quality and Adequacy of Diminutive Colorectal Polyps Resected Using Jumbo Versus Hot Biopsy Forceps
Digestive Diseases and Sciences, 2015Co-Authors: Bulent Yasar, Huseyin Kayadibi, Evren Abut, Dilek Benek, Koray Kochan, Can GonenAbstract:Background Polypectomy with jumbo Forceps (JF) and polypectomy with Hot Biopsy Forceps (HBF) are still widely used techniques for removal of diminutive colorectal polyps (DCPs). JF may be more effective for the removal of DCPs because of their larger size. Aim To evaluate the histological quality and adequacy of DCPs resected using JF compared with HBF. Methods One hundred and seventy-nine patients with 237 DCPs were included in this study. DCPs were removed using either JP or HBF. Results The tissue architecture was good in 29.9 % of the HBF group, in comparison with 90 % of the JF group ( p
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the histological quality and adequacy of diminutive colorectal polyps resected using jumbo versus Hot Biopsy Forceps
Digestive Diseases and Sciences, 2015Co-Authors: Bulent Yasar, Huseyin Kayadibi, Evren Abut, Dilek Benek, Koray Kochan, Can GonenAbstract:Polypectomy with jumbo Forceps (JF) and polypectomy with Hot Biopsy Forceps (HBF) are still widely used techniques for removal of diminutive colorectal polyps (DCPs). JF may be more effective for the removal of DCPs because of their larger size. To evaluate the histological quality and adequacy of DCPs resected using JF compared with HBF. One hundred and seventy-nine patients with 237 DCPs were included in this study. DCPs were removed using either JP or HBF. The tissue architecture was good in 29.9 % of the HBF group, in comparison with 90 % of the JF group (p < 0.001). No cautery damage or crash artifact was observed in 93.3 % of JF group and in 8.5 % of HBF group (p < 0.001). Moreover, there were statistically significant differences between the groups with regard to the high level of cautery damage or crush artifact (p < 0.001). The overall diagnostic quality of the specimens removed using JF was significantly better than that of the specimens removed by HBF (96 vs. 80 %, respectively, p < 0.001). There were statistically significant inverse associations between cautery damage or crush artifact and overall diagnostic quality of HBF and JF (r = −0.373, p < 0.001; r = −0.382, p < 0.001, respectively). Surgical margins were determined as negative in 87.5 % of the JF group and in 76.1 % of the HBF group (p = 0.022). A total of 80.8 % of the JF specimens and 30.8 % of the HBF specimens were well evaluated for two lateral and deep surgical margins (p < 0.001). JF was superior to HBF for histopathological interpretation and eradication of DCPs.
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The Histological Quality and Adequacy of Diminutive Colorectal Polyps Resected Using Jumbo Versus Hot Biopsy Forceps
Digestive diseases and sciences, 2014Co-Authors: Bulent Yasar, Huseyin Kayadibi, Evren Abut, Dilek Benek, Koray Kochan, Can GonenAbstract:Polypectomy with jumbo Forceps (JF) and polypectomy with Hot Biopsy Forceps (HBF) are still widely used techniques for removal of diminutive colorectal polyps (DCPs). JF may be more effective for the removal of DCPs because of their larger size. To evaluate the histological quality and adequacy of DCPs resected using JF compared with HBF. One hundred and seventy-nine patients with 237 DCPs were included in this study. DCPs were removed using either JP or HBF. The tissue architecture was good in 29.9 % of the HBF group, in comparison with 90 % of the JF group (p
Ken Hirabayashi - One of the best experts on this subject based on the ideXlab platform.
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Randomized controlled study of injury in the canine right colon from simultaneous Biopsy and coagulation with different Hot Biopsy Forceps
Gastrointestinal endoscopy, 1995Co-Authors: Thomas J. Savides, Dennis M. Jensen, Jacques A. See, Rome Jutabha, Gustavo A. Machicado, Ken HirabayashiAbstract:Monopolar Hot Biopsy Forceps (HBF), bipolar HBF, and cold Biopsy Forceps (CBF) followed by bipolar electrocoagulation are used clinically to simultaneously perform a Biopsy and coagulate diminutive colon polyps and angiomata. Our purpose was to conduct a randomized, controlled study to evaluate the safety of these different techniques in the canine right colon. After right colotomy in 8 mongrel dogs, colonic mucosa was grasped en face, tented, and Biopsy performed in randomized order. The dogs were sacrificed after nine days and the Biopsy sites were identified and histologically examined. Monopolar HBF caused an overall mean rate of acute serosal whitening of 29% compared with 0% for bipolar HBF and CBF and 6% for CBF/bipolar probe. Histologically confirmed transmural injury 9 days after Biopsy occurred in 44% of monopolar HBF compared with 5% of bipolar HBF, 0% of CBF, and 50% of CBF/bipolar probe. Monopolar HBF had significantly higher rates of acute serosal whitening and histologic transmural damage than bipolar HBF or cold Biopsy alone. On the basis of these results, monopolar HBF should be avoided for coagulation of small or flat right colon lesions such as diminutive polyps or angiomata.
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Randomized controlled study of injury in the canine right colon from simultaneous Biopsy and coagulation with different Hot Biopsy Forceps
Gastrointestinal endoscopy, 1995Co-Authors: Thomas J. Savides, Dennis M. Jensen, Jacques A. See, Rome Jutabha, Gustavo A. Machicado, Ken HirabayashiAbstract:Abstract Background: Monopolar Hot Biopsy Forceps (HBF), bipolar HBF, and cold Biopsy Forceps (CBF) followed by bipolar electrocoagulation are used clinically to simultaneously perform a Biopsy and coagulate diminutive colon polyps and angiomata. Our purpose was to conduct a randomized, controlled study to evaluate the safety of these different techniques in the canine right colon. Methods: After right colotomy in 8 mongrel dogs, colonic mucosa was grasped en face, tented, and Biopsy performed in randomized order. The dogs were sacrificed after nine days and the Biopsy sites were identified and histologically examined. Results: Monopolar HBF caused an overall mean rate of acute serosal whitening of 29% compared with 0% for bipolar HBF and CBF and 6% for CBF/bipolar probe. Histologically confirmed transmural injury 9 days after Biopsy occurred in 44% of monopolar HBF compared with 5% of bipolar HBF, 0% of CBF, and 50% of CBF/bipolar probe. Conclusions: Monopolar HBF had significantly higher rates of acute serosal whitening and histologic transmural damage than bipolar HBF or cold Biopsy alone. On the basis of these results, monopolar HBF should be avoided for coagulation of small or flat right colon lesions such as diminutive polyps or angiomata. (Gastrointest Endosc 1995;42:573-8.)
Enayat Safavi - One of the best experts on this subject based on the ideXlab platform.
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comparison of Hot versus cold Biopsy Forceps in the diagnosis of endobronchial lesions
Archivos De Bronconeumologia, 2011Co-Authors: Shahram Firoozbakhsh, Soroush Seifirad, Enayat Safavi, Reza Dinparast, Shervin Taslimi, Gholamreza DerakhshandeilamiAbstract:Introduction Traditionally cold Biopsy Forceps were used for endobronchial Biopsy, and recently electrocautery (Hot) bronchoscopy Biopsy Forceps are introduced. It is hypothesized that Hot Biopsy Forceps may decrease procedure related bleeding and also may decrease the quality of obtained samples. Patients and methods Patients with different indications for endobronchial Biopsy during fiberoptic bronchoscopy underwent three Hot and three cold biopsies with a random fashion. All biopsies were obtained with a single Biopsy Forceps with and without the application of an electrocoagulation current, set on soft coagulation mode (40W). A four point scale was used for quantification of bleeding. A single pathologist blinded to the patients' history was requested to review all samples. A three point scale was used to assess electrocoagulation damage. Results A total of 240 biopsies were obtained from 40 patients. Frequency of positive concordance between the two methods was 85%. The degree of electrocoagulation damage of the samples was as follows: grade 1=52.5%, grade 2=32.5%, and grade 3=15%. The average bleeding score following Hot Biopsy was significantly lower compared to the cold Biopsy (P=.006). The concordance between diagnostic yield of Hot and cold biopsies was 85%. There was no significant difference between the diagnostic yields of two Biopsy methods (P=.687). Conclusions Hot Biopsy Forceps significantly decreased the procedure related bleeding. The quality of samples was not impaired significantly. Regarding low prevalence of bleeding following endobronchial Biopsy, routine use of Hot bronchoscopy Forceps is not reasonable. However, familiarity of bronchoscopists with this method may improve bronchoscopy safety.
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Comparison of Hot Versus Cold Biopsy Forceps in the Diagnosis of Endobronchial Lesions
Archivos de bronconeumologia, 2011Co-Authors: Shahram Firoozbakhsh, Soroush Seifirad, Enayat Safavi, Reza Dinparast, Shervin Taslimi, Gholamreza DerakhshandeilamiAbstract:Traditionally cold Biopsy Forceps were used for endobronchial Biopsy, and recently electrocautery (Hot) bronchoscopy Biopsy Forceps are introduced. It is hypothesized that Hot Biopsy Forceps may decrease procedure related bleeding and also may decrease the quality of obtained samples. Patients with different indications for endobronchial Biopsy during fiberoptic bronchoscopy underwent three Hot and three cold biopsies with a random fashion. All biopsies were obtained with a single Biopsy Forceps with and without the application of an electrocoagulation current, set on soft coagulation mode (40W). A four point scale was used for quantification of bleeding. A single pathologist blinded to the patients' history was requested to review all samples. A three point scale was used to assess electrocoagulation damage. A total of 240 biopsies were obtained from 40 patients. Frequency of positive concordance between the two methods was 85%. The degree of electrocoagulation damage of the samples was as follows: grade 1=52.5%, grade 2=32.5%, and grade 3=15%. The average bleeding score following Hot Biopsy was significantly lower compared to the cold Biopsy (P=.006). The concordance between diagnostic yield of Hot and cold biopsies was 85%. There was no significant difference between the diagnostic yields of two Biopsy methods (P=.687). Hot Biopsy Forceps significantly decreased the procedure related bleeding. The quality of samples was not impaired significantly. Regarding low prevalence of bleeding following endobronchial Biopsy, routine use of Hot bronchoscopy Forceps is not reasonable. However, familiarity of bronchoscopists with this method may improve bronchoscopy safety. Copyright © 2011 SEPAR. Published by Elsevier Espana. All rights reserved.
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Comparison of Hot versus cold Biopsy Forceps in the diagnosis of endobronchial lesions
European Respiratory Journal, 2011Co-Authors: S H Firouzbakhsh, Soroush Seifirad, Reza Dinparast, Shervin Taslimi, Saeideh Azari, Enayat SafaviAbstract:Background: Traditionally cold Biopsy Forceps were used for endobronchial Biopsy; recently electrocautery (Hot) bronchoscopy Biopsy Forceps are introduced. It is hypothesized that Hot Biopsy Forceps may decrease procedure related bleeding and also may decrease the quality of obtained samples. Methods: Patients with different indications for endobronchial Biopsy underwent three Hot and three cold endobronchial biopsies with a random fashion. All biopsies were obtained with a single Biopsy Forceps with and without the application of an electrocoagulation current, set on soft coagulation mode (120W). A four point scale was used for quantification of bleeding. A single pathologist blinded to the patients9 history was requested to review all samples. A three point scale was used to assess electrocoagulation damage. Results: A total of 240 biopsies were obtained from 40 patients. Frequency of positive concordance between the two methods was 85%. The degree of electrocoagulation damage of the samples was as follows: grade1=52.5%, grade 2=32.5%, and grade3=15%. The average bleeding score following Hot Biopsy was significantly lower compared to the cold Biopsy (p=0.006). The concordance between diagnostic yield of Hot and cold biopsies was 85%. There was no significant difference between the diagnostic yields of two Biopsy methods (p=0.687). Conclusions: In this study, Hot Biopsy Forceps significantly decreased the procedure related bleeding and minimally impaired the quality of samples. Regarding low prevalence of bleeding following endobronchial Biopsy, routine use of Hot bronchoscopy Forceps is not reasonable. However, familiarity of bronchoscopists with this method may improve bronchoscopy safety.