Sodium hydroxide-induced esophageal stricture via an endoscopic injection needle: a novel rabbit model of corrosive injury

Purpose: Benign strictures of the esophagus are commonly encountered in clinical practice and are difficult to manage conservatively. This study aimed to establish a novel animal model of benign esophageal stricture by using corrosive-induced injury in rabbits with an injection of sodium hydroxide(NaOH) via a self-made endoscopic injection needle. Materials and Methods: Corrosive injury of the esophagus was induced in 10 rabbits by administration of 1 mL of 1.5% NaOH using a laryngoscope with a self-made endoscopic injection needle. The self-made injection needle was fabricated by modification of the core of an endoscopic injection needle. The laryngoscope examination was performed at 2 weeks and 4 weeks after induction of corrosive injury; esophagography was also performed at 4 weeks to assesse sophageals tricture.A lla nimalsw eree uthanizedat th een dof the fourth week; the esophagus was removed, and stained sectionsw eree xaminedm icroscopically. Results: Laryngoscope examination at 2 weeks showed ulceration. At the end of fo urth we e k,laryngosco py,r a diolo gical, and gross exa m inations showed successful in ductionof e s ophagea l stric turein a llanimal s,without any c omp licatio n.The m eanst r ic t ure inde x at the en dof fourth week wa s49.54±3. 61%; the mean le ngth of stricture w as18.0± 2.5mm.Micros copicexa mina tionrevea ledf ocalulceratio nand subm ucosalth i cke ning secondary to fibrosis. Conclusion:Rab bit esop hageal stri ctu re induced us ing lary ngosc opy with endosco pic injec tion of a sm all am ount of lowcon centration s odium hyd roxid e is a t echn ica lly simp le,safe,and re produ cible meth od for cre atio n of an animal m odel of esophageal stricture.This model can be useful for developing new treatment methods for esop hageal s tricture.

Efficacy and safety of computed tomography-guided microwave ablation with fine needle-assisted puncture positioning technique for hepatocellular carcinoma

BACKGROUND In microwave ablation(MWA), although computed tomography(CT) scanning can overcome gas interference, it cannot achieve real-time localization. Therefore, the puncture technique is more important in CT-guided ablation.AIM To compare the fine needle-assisted puncture(FNP) positioning technique and the conventional puncture(CP) technique for the safety and efficacy of CT-guided MWA in treating hepatocellular carcinoma(HCC).METHODS This retrospective study included 124 patients with 166 tumor nodules from February 2018 and June 2021. Seventy patients received CT-guided MWA under the FNP technique(FNP group), and 54 patients received MWA under the CP technique(CP group). Intergroup comparisons were made regarding local tumor progression(LTP), recurrence-free survival(RFS), overall survival(OS), and complications. The influencing variables of LTP and RFS were analyzed through univariate and multivariate regressions.RESULTS The 1-, 2-, and 3-year cumulative incidences of LTP in the FNP group were significantly lower than those in the CP group(7.4%, 12.7%, 21.3% vs 13.7%, 32.9%, 36.4%;P = 0.038). The 1-, 2-, and 3-year RFS rates in the FNP group were significantly higher than those in the CP group(80.6%, 73.3%, 64.0% vs 83.3%,39.4%, and 32.5%, respectively;P = 0.008). The FNP technique independently predicted LTP and RFS. Minor complications in the FNP group were lower than those in the CP group(P < 0.001). The difference in median OS was insignificant between the FNP and CP groups(P = 0.229).CONCLUSION The FNP technique used in CT-guided MWA may improve outcomes in terms of LTP, RFS, and procedure-related complications for HCC.