localization of 42 pulmonary nodules (mean size, 7.3 mm; range, 4-18 mm). A 7 cm platinum micro coil was inserted into pulmonary nodules under CT guidance using a 21-gauge chiba needle. The technical details, surgical and pathologic findings associated with micro coil localizations were retrospectively evaluated. Result(s): All nodules were localized by CT guided micro coil with 100% technical success with mean time 13.4 minutes (range 8-26 minutes). 6 patients developed Mild parenchyma lung hemorrhage along with needle tract and 7 patient developed mild pneumothorax all are asymptomatic and no intervention needed. 3 patients developed moderate pneumothorax for which needle aspiration was performed but not chest tube was inserted. No other complication occurred. All micro coils were identified during the surgery except one which was dislodged and attached to chest wall (41 out of 42 micro coils) 97.6 % clinical success and all nodule were surgically resected. Pathology revealed 28 metastatic pulmonary nodules, 1 primary adenocarcinoma-in-situ and 13 benign pulmonary nodules. Micro coils did not affect the histopathology examination. Conclusion(s): CT-guided micro coil localization is an effective and safe pre-operative localization procedure prior to VATS, enabling accurate resection and diagnosis of pulmonary nodules.
were referred late 20 days plus postsurgery), six of which had re-surgery and one patient who had residual tubular cutaneousanastomosis fistula had track coiling with cessation of leakage. Conclusion: Fluoroscopic-guided esophageal stenting might be effective in bypassing anastomotic leakages following bariatric surgeries; however, it should be considered as soon as significant leakage is diagnosed and should be considered before resurgery. Placement of the stents was feasible without major procedurerelated complications.
Background The burden of uterine fibroids is substantial in sub-Saharan Africa (SSA), with up to 80% of black women harboring them in their lifetime. While uterine artery embolization (UAE) has emerged as an effective alternative to surgery to manage this condition, the procedure is not available to the vast majority of women living in SSA due to limited access to interventional radiology (IR) in the region. One of the few countries in SSA now offering UAE in a public hospital setting is Tanzania. This study aims to assess the safety and effectiveness of UAE in this new environment.Methods From June 2019 to July 2022, a single-center, retrospective cohort study was conducted at Tanzania’s first IR service on all patients who underwent UAE for the management of symptomatic fibroids or adenomyosis. Patients were selected for the procedure based on symptom severity, imaging findings, and medical management failure. Procedural technical success and adverse events were recorded for all UAEs. Self-reported symptom severity and volumetric response on imaging were compared between baseline and six-months post-procedure using paired sample t-tests.Results During the study period, 92.1% (n = 35/38) of patients underwent UAE for the management of symptomatic fibroids and 7.9% (n = 3/38) for adenomyosis. 97.3% (n = 37/38) were considered technically successful and one minor adverse event occurred (2.7%). Self-reported symptom-severity scores at six-months post-procedure decreased in all categories: abnormal uterine bleeding from 8.8 to 3.1 (-5.7), pain from 6.7 to 3.2 (-3.5), and bulk symptoms from 2.8 to 1 (-1.8) (p < 0.01). 100% of patients reported satisfaction with outcomes. Among the nine patients with follow-up imaging, there was a mean volumetric decrease of 35.5% (p = 0.109).Conclusions UAE for fibroids and adenomyosis can be performed with high technical success and low complication rates in a low-resource setting like Tanzania, resulting in significant symptom relief for patients. Building capacity for UAE has major public health implications not only for fibroids and adenomyosis, but can help address the region’s leading cause of maternal mortality, postpartum hemorrhage.
Background Transthoracic core needle biopsy (TTCNB) became a routinely offered procedure in Tanzania in October 2018. This study evaluates the safety and effectiveness of establishing a TTCNB program in a resource-limited setting.
Methodology A single center, prospective, observational cohort study was conducted at Muhimbili National Hospital on 90 patients who underwent computed tomography-guided TTCNB from October 2018 to May 2021. Patient and procedural data, including demographic information, complications, pathology results, and clinical outcomes, were stored in a Research Electronic Data Capture (REDCap) database. Follow-up was conducted at 4 weeks postprocedure by phone. Descriptive analysis was performed using Statistical Package for Social Sciences.
Results A total of 90 patients underwent TTCNB. Seven samples were lost or never processed. In total, 68/83 (81.9%) of processed samples were diagnostic, with 89.7% (n = 61) classified as malignant and 10.3% (n = 7) classified as benign. Overall, 82.4% (n = 56) were classified as primary malignancies, 7.4% (n = 5) as metastatic malignancies, 5.9% (n = 4) as benign tumors, and 4.4% (n = 3) as infectious. Reasons for nondiagnostic samples were crashed/insufficient samples in 53.3% (n = 8) and nonspecific chronic inflammation in 46.7% (n = 7). Minor (Society of Interventional Radiology [SIR] class A and B) complications occurred in 8 cases (8.9%), while there was 1 (1.1%) major complication (SIR class F). A total of 44/90 (48.9%) patients could be reached for follow-up at 4 weeks postprocedure. In addition, 31/44 (70.5%) of these patients had a diagnosis of malignancy. Of these, 20 received chemotherapy, 8 died prior to receiving any treatment, 2 declined any further medical or surgical intervention, and 1 was treated with surgical excision and adjuvant chemotherapy.
Conclusion Although recently introduced in Tanzania, TTCNB has been performed with 81.9% diagnostic accuracy and a complication rate comparable to existing literature.
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