Document Detail


Endoscopic ultrasound-guided celiac ganglia neurolysis vs. celiac plexus neurolysis: a randomized multicenter trial.
MedLine Citation:
PMID:  23616126     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND STUDY AIMS: No prospective comparison of endoscopic ultrasonography-guided direct celiac ganglia neurolysis (EUS - CGN) vs. EUS-guided celiac plexus neurolysis (EUS - CPN) has been reported. The aim of the current study was to compare the effectiveness of EUS - CGN and EUS - CPN in providing pain relief from upper abdominal cancer pain in a multicenter randomized controlled trial.
PATIENTS AND METHODS: Patients with upper abdominal cancer pain were randomly assigned to treatment using either EUS - CGN or EUS - CPN. Evaluation was performed at Day 7 postoperatively using a pain scale of 0 to 10. Patients for whom pain decreased to ≤ 3 were considered to have a positive response, and those experiencing a decrease in pain to ≤ 1 were considered to be completely responsive. Comparison between the two groups was performed using intention-to-treat analysis. The primary endpoint was the difference in treatment response rates between EUS - CGN and EUS - CPN at postoperative Day 7. Secondary endpoints included differences in complete response rates, pain scores, duration of pain relief, and incidence of adverse effects.
RESULTS: A total of 34 patients were assigned to each group. Visualization of ganglia was possible in 30 cases (88 %) in the EUS - CGN group. The positive response rate was significantly higher in the EUS - CGN group (73.5 %) than in the EUS - CPN group (45.5 %; P = 0.026). The complete response rate was also significantly higher in the EUS - CGN group (50.0 %) than in the EUS - CPN group (18.2 %; P = 0.010). There was no difference in adverse events or duration of pain relief between the two groups.
CONCLUSIONS: EUS - CGN is significantly superior to conventional EUS - CPN in cancer pain relief.
CLINICAL TRIAL REGISTRATION: http://www.umin.ac.jp/ctr/index.htm (ID: UMIN-000002536).
Authors:
S Doi; I Yasuda; H Kawakami; T Hayashi; H Hisai; A Irisawa; T Mukai; A Katanuma; K Kubota; T Ohnishi; S Ryozawa; K Hara; T Itoi; K Hanada; K Yamao
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Publication Detail:
Type:  Clinical Trial, Phase II; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Video-Audio Media     Date:  2013-04-24
Journal Detail:
Title:  Endoscopy     Volume:  45     ISSN:  1438-8812     ISO Abbreviation:  Endoscopy     Publication Date:  2013  
Date Detail:
Created Date:  2013-04-25     Completed Date:  2014-01-03     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  362-9     Citation Subset:  IM    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / etiology,  therapy*
Aged
Aged, 80 and over
Anesthetics, Local
Autonomic Nerve Block / methods*
Bupivacaine
Celiac Plexus*
Endosonography
Ethanol / therapeutic use
Female
Ganglia, Sympathetic*
Humans
Intention to Treat Analysis
Male
Middle Aged
Pain Management / methods*
Pancreatic Neoplasms / complications*
Ultrasonography, Interventional
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 3K9958V90M/Ethanol; Y8335394RO/Bupivacaine
Comments/Corrections
Comment In:
Endoscopy. 2013 Oct;45(10):854   [PMID:  24068591 ]
Endoscopy. 2013 Oct;45(10):854   [PMID:  24068592 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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