Treatment of stellate ganglion block in diseases:Its role and application prospect

The stellate ganglion(SG),as a type of sympathetic ganglion,consists of the sixth and seventh cervical vertebrae and the first thoracic sympathetic ganglia.SG block(SGB)is a minimally invasive injection that aims to inject low-concentration local anesthetics to induce a broad sympathetic blocking effect near the SG.There have been no changes and progress in the clinical application of SGB since the 1830s due to several potential risks,including hematoma from blood vessel injury,hoarseness from recurrent laryngeal nerve injury,and cardiopulmonary arrest.The feasibility and safety of SGB have greatly improved since the appearance of ultrasound-guided SGB.In recent years,SGB has been widely applied in the field of non-anesthesiology sedation,with significant therapeutic effects on pain,immunological diseases,somnipathy,psychological disorders,arrhythmias,and endocrine diseases.The present study reviews the present application of SGB in clinical practice.

Irreversible Electroporation for Hepatocellular Carcinoma Abutting the Diaphragm:A Prospective Single-center Study

Background and Aims:Irreversible electroporation(IRE)is an emerging local ablation therapy which may be effective for unresectable tumors.This study aimed to evaluate the safety and efficacy of percutaneous IRE in the treatment of hepatocellular carcinoma(HCC)abutting the diaphragm.Methods:A total of 26 participants with 39 tumors abutting the diaphragm were prospectively evaluated between July 2015 and September 2018.Complications associated with IRE were recorded,and the survival benefit of IRE was analyzed.The factors associated with time to local tumor progression(LTP)were analyzed using univariate and multivariate Cox regression models.Results:No major complications or treatmentrelated deaths occurred.The technical success rate was 96.2%(25/26)and complete ablation rate was 92.3%(36/39).The median followup period was 16.7 months(range:3.0-43.0 months),the LTP occurred in 15.2%of tumors and median time to LTP was 20.4 months.Overall,tumor size(hazard ratio:1.24[95%confidence interval:0.38,3.81],p=0.03)was the only factor associated with time to LTP.Conclusions:This study shows for the first time that percutaneous IRE is a safe and effective ablation technology for HCC abutting the diaphragm.