Phenol-based endoscopic ultrasound-guided celiac plexus neurolysis for East Asian alcohol-intolerant upper gastrointestinal cancer patients:A pilot study
AIM:To investigate the effectiveness of phenol for the relief of cancer pain by endoscopic ultrasound-guided celiac plexus neurolysis(EUS-CPN).METHODS:Twenty-two patients referred to our hospital with cancer pain from August 2009 to July 2011for EUS-CPN were enrolled in this study.Phenol was used fo...
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Published in | World journal of gastroenterology : WJG Vol. 20; no. 30; pp. 10512 - 10517 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Baishideng Publishing Group Inc
14.08.2014
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Subjects | |
Online Access | Get full text |
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Summary: | AIM:To investigate the effectiveness of phenol for the relief of cancer pain by endoscopic ultrasound-guided celiac plexus neurolysis(EUS-CPN).METHODS:Twenty-two patients referred to our hospital with cancer pain from August 2009 to July 2011for EUS-CPN were enrolled in this study.Phenol was used for 6 patients with alcohol intolerance and ethanol was used for 16 patients without alcohol intolerance.The primary endpoint was the positive response rate(pain score decreased to≤3)on postoperative day 7.Secondary endpoints included the time to onset of pain relief,duration of pain relief,and complication rates.RESULTS:There was no significant difference in the positive response rate on day 7.The rates were 83%and 69%in the phenol and ethanol groups,respectively.Regarding the time to onset of pain relief,in the phenol group,the median pre-treatment pain score was 5,whereas the post-treatment scores decreased to 1.5,1.5,and 1.5 at 2,8,and 24 h,respectively(P<0.05).In the ethanol group,the median pre-treatment pain score was 5.5,whereas the post-treatment scores significantly decreased to 2.5,2.5,and 2.5 at 2,8,and24 h,respectively(P<0.01).There was no significant difference in the duration of pain relief between the phenol and ethanol groups.No significant difference was found in the rate of complications between the 2groups;however,burning pain and inebriation occurred only in the ethanol group.CONCLUSION:Phenol had similar pain-relieving effects to ethanol in EUS-CPN.Comparing the incidences of inebriation and burning pain,phenol may be superior to ethanol in EUS-CPN procedures. |
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Bibliography: | Hirotoshi Ishiwatari;Tsuyoshi Hayashi;Makoto Yoshida;Michihiro Ono;Hiroyuki Masuko;Tsutomu Sato;Koji Miyanishi;Yasushi Sato;Rishu Takimoto;Masayoshi Kobune;Atsushi Miyamoto;Tomoko Sonoda;Junji Kato;Department of Medical Oncology and Hematology,Sapporo Medical University School of Medicine,Sapporo 0600061,Japan;Department of Hospital Pharmacy,Sapporo Medical University School of Medicine,Sapporo 0600061,Japan;Department of Public Health,Sapporo Medical University School of Medicine,Sapporo 0600061,Japan Telephone: +81-11-6112111-3254 Fax: +81-11-6127987 Author contributions: Ishiwatari H designed the research; Ishiwatari H and Hayashi T performed the endoscopic procedure; Ishiwatari H, Hayahi T, Yoshida M, and Ono M collected the data and provided clinical advice; Masuko H and Miyamoto A prepared the neurolytic agent and provided clinical advice; Sato T, Miyanishi K, Sato Y, Takimoto R, Kobune M and Kato J provided clinical advise; Ishiwatari H and Sonoda T analyzed the data; Ishiwatari H wrote the paper; Hayashi T revised the paper; all authors approved the final manuscript for publication. Correspondence to: Hirotoshi Ishiwatari, MD, PhD, Assistant Professor, Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo 060-8543, Japan. ishihiro481019@gmail.com |
ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.v20.i30.10512 |