OBJECTIVE: We evaluated the long-term results and response rates of celiac ganglia block to the level of tumor invasion of the celiac region. SUBJECTS AND METHODS. Forty-one patients each with an inoperable intraabdominal carcinoma who were referred to our department for celiac ganglia block were included in this study. Tumor invasion of the celiac ganglia region was graded on a four-point scale according to CT features (grade I = no invasion, grade II = invasion < 50%, grade III = invasion > 50%, and grade IV = complete invasion). Subjective pain levels (0 = no pain, 10 = worst pain) were obtained from the patients, and objective criteria (change in daily analgesic doses) were noted before the procedure and during the follow-up to determine effectiveness of the celiac ganglia block. RESULTS: Celiac ganglia block was successfully performed in all 41 patients (100%). In 39 (95%) of 41 patients, pain decreased significantly after the procedure, and the pain level did not change in the remaining two patients. Major complications were not encountered in any of the patients. Minor complications were observed in 35 patients (85%). Mean pain intensity and mean daily analgesic consumption significantly decreased after the procedure in all four groups. The amount of pain decrease for these two parameters was inversely related to degree of invasion. Responses of the patients were obtained at the end of the first week after the procedure and remained unchanged during long-term follow-up. CONCLUSION: Percutaneous celiac ganglia block, particularly when performed in earlier stages of ganglia invasion, is an effective, easy, and safe procedure with successful long-term results.
OBJECTIVE: We evaluated the long-term results and response rates of celiac ganglia block to the level of tumor invasion of the celiac region. SUBJECTS AND METHODS. Forty-one patients each with an inoperable intraabdominal carcinoma who were referred to our department for celiac ganglia block were included in this study. Tumor invasion of the celiac ganglia region was graded on a four-point scale according to CT features (grade I = no invasion, grade II = invasion < 50%, grade III = invasion > 50%, and grade IV = complete invasion). Subjective pain levels (0 = no pain, 10 = worst pain) were obtained from the patients, and objective criteria (change in daily analgesic doses) were noted before the procedure and during the follow-up to determine effectiveness of the celiac ganglia block. RESULTS: Celiac ganglia block was successfully performed in all 41 patients (100%). In 39 (95%) of 41 patients, pain decreased significantly after the procedure, and the pain level did not change in the remaining two patients. Major complications were not encountered in any of the patients. Minor complications were observed in 35 patients (85%). Mean pain intensity and mean daily analgesic consumption significantly decreased after the procedure in all four groups. The amount of pain decrease for these two parameters was inversely related to degree of invasion. Responses of the patients were obtained at the end of the first week after the procedure and remained unchanged during long-term follow-up. CONCLUSION: Percutaneous celiac ganglia block, particularly when performed in earlier stages of ganglia invasion, is an effective, easy, and safe procedure with successful long-term results.
Authors: Niek F Casteleijn; Folkert W Visser; Joost P H Drenth; Tom J G Gevers; Gerbrand J Groen; Marie C Hogan; Ron T Gansevoort Journal: Nephrol Dial Transplant Date: 2014-09 Impact factor: 5.992