• 제목/요약/키워드: Balloon dilation

검색결과 25건 처리시간 0.02초

Retrograde balloon dilation as a therapeutic option for post-gynecologic surgery ureteral stricture followed by ureteroureterostomy: a comparative study regarding stricture length

  • Lim, Geon Woo;Yu, Young Dong;Choi, Kyung Hwa;Rhee, Seung Ryeol;Park, Dong Soo;Hong, Young Kwon
    • Journal of Yeungnam Medical Science
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    • 제35권2호
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    • pp.179-186
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    • 2018
  • Background: To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries. Methods: A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Among them, 102 patients received balloon dilation, and their medical records were retrospectively reviewed. Success of balloon dilation was defined as the condition that requires no further clinical interventions after 6 months from balloon dilation. Results: The ureter injury rate of women treated with open radical abdominal hysterectomy was highest (32 cases, 31.4%). 60 patients (60.8%) showed successful outcomes regarding dilation. All patients underwent technically successful dilation with a full expansion of balloon during the procedure, but 40 patients (39.2%) were clinically unsuccessful as they showed a recurrence of ureteral stricture on the previous balloon dilation site after the first dilation procedure. Univariate logistic regression analyses showed that stricture length >2 cm was a significant predictor of successful dilation (odds ratio, 0.751; 95% confidence interval, 0.634-0.901; p-value, 0.030), but it failed to achieve independent predictor status in multivariate analysis. Conclusion: Balloon dilation can an effective alternative treatment option for strictured portion of the primary UUS in post-gynecologic surgery patients when its length is <2 cm.

Risk factors for recurrent stenosis after balloon dilation for benign hepaticojejunostomy anastomotic stricture

  • Takafumi Mie;Takashi Sasaki;Takeshi Okamoto;Tsuyoshi Takeda;Chinatsu Mori;Yuto Yamada;Takaaki Furukawa;Akiyoshi Kasuga;Masato Matsuyama;Masato Ozaka;Naoki Sasahira
    • Clinical Endoscopy
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    • 제57권2호
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    • pp.253-262
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    • 2024
  • Background/Aims: Hepaticojejunostomy anastomotic stricture (HJAS) is a feared adverse event associated with hepatopancreatobiliary surgery. Although balloon dilation for benign HJAS during endoscopic retrograde cholangiopancreatography with balloon-assisted enteroscopy has been reported to be useful, the treatment strategy remains controversial. Therefore, we evaluated the outcomes and risk factors of recurrent stenosis after balloon dilation alone for benign HJAS. Methods: We retrospectively analyzed consecutive patients who underwent balloon-assisted enteroscopy-endoscopic retrograde cholangiopancreatography for benign HJAS at our institution between July 2014 and December 2020. Results: Forty-six patients were included, 16 of whom had recurrent HJAS after balloon dilation. The patency rates at 1 and 2 years after balloon dilation were 76.8% and 64.2%, respectively. Presence of a residual balloon notch during balloon dilation was an independent predictor of recurrence (hazard ratio, 2.80; 95% confidence interval, 1.01-7.78; p=0.048), whereas HJAS within postoperative 1 year tended to be associated with recurrence (hazard ratio, 2.43; 95% confidence interval, 0.85-6.89; p=0.096). The patency rates in patients without a residual balloon notch were 82.1% and 73.1% after 1 and 2 years, respectively. Conclusions: Balloon dilation alone may be a viable option for patients with benign HJAS without residual balloon notches on fluoroscopy.

비혈관성 관강 장기의 양성 협착 질환의 방사성동위원소 치료 (Radioisotope Treatment for Benign Strictures of Non-vascular Luminal Organs)

  • 신지훈
    • Nuclear Medicine and Molecular Imaging
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    • 제40권2호
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    • pp.106-112
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    • 2006
  • Tissue hyperplasia is one of the most frequently encountered complications when self-expanding metallic stents are placed in benign non-vascular luminal organ strictures, thus causing restenosis of the lumen. The investigators postulated that ionizing irradiation could be applied to prevent restenosis caused by tissue hyperplasia in non-vascular luminal organs as it reduced coronary or peripheral arterial narrowing successfully. The authors combined $\beta$-irradiation using $^{188}Re-MAG_3$ solution with balloon dilation for animal and clinical studies because this new treatment approach had the advantages such as low penetration depth of $\beta$-ray, self-centering irradiation, and mechanical effect of balloon dilation over using $\gamma$-irradiation with afterloading devices in this article, the concept and mechanism of radioisotope balloon dilation, and animal and clinical studies using radioisotope balloon dilation are reviewed.

Balloon dilation with triamcinolone intralesional injection successfully treated rectal stricture in a three-month kitten

  • Lee, Hee-Ryung;Adam, Gareeballah Osman;Lee, Sei-Jin;Kim, Shang-Jin
    • 대한수의학회지
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    • 제60권1호
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    • pp.39-42
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    • 2020
  • This report describes a three-month-old Korean domestic kitten presented with dehydration and poor body condition. Physical examination revealed abdominal distension. Rectal diagnosis was unachievable due to the small rectum diameter. X-ray radiography and endoscopy confirmed presence of abdominal distension and indicated a stricture located 1.5 cm from the anus. A balloon was gently inserted into the rectum and inflated several times followed by triamcinolone injection. Four months later, same procedures were repeated. This report is the first to describe the use of balloon dilation of a rectal stricture followed by intralesional triamcinolone injection in a small cat with poor condition.

우심실 양분증 이환견에 대한 풍선확장술 시술 증례 (Balloon dilation of double chambered right ventricle in a dog)

  • 김진욱;윤병국;박준석;김정국;이기호;박형진;허찬;서경원;송근호
    • 한국동물위생학회지
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    • 제40권1호
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    • pp.67-70
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    • 2017
  • A 4 months old, intact male Shih-tzu was referred to the Veterinary Medical Teaching Hospital of Chungnam National University for evaluation of the cause of cardiac murmur and syncope. Thoracic radiography revealed right-sided cardiomegaly. Echocardiography showed marked hypertrophy of right ventricular free wall and obstruction of right ventricular outflow tract, indicating double chambered right ventricle (DCRV). The dog was medicated with atenolol and sildenafil for DCRV, however, clinical signs did not control by medication. Balloon dilation for DCRV was performed to ameliorate patient's clinical signs. The peak systolic pressure gradient across the obstruction region was decreased and clinical signs was improved by balloon dilation procedure. This is the first case report of balloon dilation for the treatment of canine DCRV in South Korea.

양성 소장협착의 내시경적 진단과 치료 (Endoscopic Diagnosis and Treatment of Benign Small Bowel Stricture)

  • 김진수
    • The Korean Journal of Medicine
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    • 제99권4호
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    • pp.199-205
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    • 2024
  • Benign small bowel strictures can occur in association with various conditions, including small bowel Crohn's disease, nonsteroidal anti-inflammatory drug-induced enteritis, ischemic enteritis, intestinal tuberculosis, radiation enteritis, postoperative adhesions, and anastomotic strictures. Benign small bowel strictures are classified into two categories, low-grade and high-grade. Low-grade small bowel strictures involve a partial reduction of the internal diameter of the small intestine, causing slight obstruction of the passage of food and digestive fluids without significant bowel obstruction symptoms. By contrast, high-grade small bowel strictures involve a severe narrowing of the intestinal lumen, leading to marked obstruction of the passage of food and digestive fluids and pronounced bowel obstruction symptoms. Small bowel strictures can be diagnosed using various methods, including abdominal plain radiography, abdominal computed tomography, computed tomography enterography, magnetic resonance enterography, balloon-assisted enteroscopy, and abdominal ultrasound. Each diagnostic method has unique advantages and disadvantages as well as differences in diagnostic specificity and sensitivity. Therefore, even if small bowel strictures are not observed using a single imaging technique, their presence cannot be completely excluded. A comprehensive diagnosis that combines clinical information from multiple diagnostic modalities is necessary. Therapeutic approaches for managing small bowel strictures include medical therapy, endoscopic balloon dilation using balloon-assisted enteroscopy, and surgical methods such as strictureplasty and segmental resection. Endoscopic balloon dilation, in particular, can help reduce complications associated with repeated surgeries for strictures.

소아의 선천성 및 후천성 식도 질환에서 내시경적 풍선 확장술 (Endoscopic Balloon Dilatation in Children with Congenital and Acquired Esophageal Anomalies)

  • 곽주영;박재홍
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제8권2호
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    • pp.137-142
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    • 2005
  • 목 적: 소아의 선천성 및 후천성 식도 질환의 치료에 있어 내시경적 풍선 확장술의 안전성, 효과 그리고 기술적인 문제들을 평가하였다. 방 법: 1993년부터 10년 동안 선천성 및 후천성 식도 질환의 치료로 부산대학교병원 소아과에서 내시경적 풍선 확장술을 시행한 8명을 대상으로 이들의 의무 기록을 후향적으로 분석하였다. 시술은 풍선 카테터를 내시경 겸자구를 통해 삽입하여 내시경 직시 하에서 시행되었으며 최초로 사용되는 풍선의 크기는 식도의 내경과 협착 부위의 직경에 기초하여 결정하였다. 협착이 아주 심한 경우에는 먼저 유도 철선을 통과시킨 후, 유도 철선을 따라 풍선 카테터를 삽입시켰다. 풍선을 협착 부위에 위치시키고 서서히 확장하면서 목표하는 크기로 풍선이 팽창되면 1분 동안 확장된 상태를 유지하였다가 감압하여 1분 이상의 휴식을 가졌다. 확장 후 합병증이 없으면 풍선의 직경을 1 mm 간격으로 늘리면서 추가 확장하였다. 결 과: 남아가 3명, 여아가 5명이었고, 평균 연령은 4.2세였다. 8명의 환자에서 27회(환자 당 평균 3.2회)의 확장이 시행되었다. 기저 질환의 종류는 선천 성 식도 폐쇄에 대한 수술 후 발생한 식도 협착이 3예, 식도윤이 2예, 그 외 식도 무이완증, 빙초산에의한 부식성 식도염 그리고 고압성 식도 하부 괄약근이 각각 1예였다. 6~15 mm 직경의 풍선을 사용하였고, 최초 풍선의 크기는 협착의 형태와 정도에 따라 결정되었다. 합병증으로는 식도 천공과 심한 호흡 곤란이 각각 1예 있었다. 6예(75%)에서 시술 후 정상적인 음식 섭취를 보였다. 결 론: 내시경적 풍선 확장술은 소아의 선천성 및 후천성 식도 질환을 치료하는데 있어 안전하고 효과적인 방법이다.

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Pulmonic stenosis corrected by balloon valvuloplasty in a Maltese dog

  • Lee, Seung-Gon;Moon, Hyeong-Sun;Hyun, Changbaig
    • 대한수의학회지
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    • 제47권3호
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    • pp.333-336
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    • 2007
  • A 6-month-old intact male Maltese dog (2.5 kg of body weight) was presented with the primary complaint of heart murmur and exercise intolerance. Diagnostic studies revealed severe pulmonic stenosis. Since the pressure gradient in stenotic pulmonic valve area was higher than 200 mmHg (maximum flow velocity = 7.1 m/s), the dog was underwent balloon valvuloplasty. With this procedure, the peak pulmonic velocity was reduced to 3.0 m/s (PG = 36 mmHg). Periodic re-evaluations performed in monthly interval revealed no further deterioration even after 4 month of procedure. This is the first case report of pulmonic stenosis fixed by non-surgical balloon valvuloplasty in Korea.

Endoscopic Balloon Dilation for Treatment of Congenital Antral Web

  • Peck, Jacquelin;Khalaf, Racha;Marth, Ryan;Phen, Claudia;Sosa, Roberto;Cordero, Francisco Balsells;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권4호
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    • pp.351-354
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    • 2018
  • Congenital antral webs are a rare but relevant cause of gastric outlet obstruction in infants and children. The condition may lead to feeding refusal, vomiting, and poor growth. Due to the relative rarity of the disease, cases of congenital antral web are frequently misdiagnosed or diagnosed with significant delay as physicians favorably pursue diagnoses of pyloric stenosis and gastric ulcer disease, which are more prevalent. We report a case of an eight-month-old female who presented with persistent non-bilious emesis, feeding difficulties, and failure to thrive and was discovered to have an antral web. The web was successfully treated with endoscopic balloon dilation, which resolved her symptoms. Two years later, the patient remains asymptomatic and is thriving with weight at the 75th percentile for her age.