sodium-morrhuate and Postoperative-Complications

Foam sclerotherapy is a widely used treatment for varicose veins. However, complications caused by poor foam stability still remain. Most studies ignore multiple influencing factors and only study a single factor. Furthermore, a stable foam preparation using different preparation conditions has not been developed. This study aimed to explore the changing laws of foam stability under multifactorial conditions, and to determine the influence of various factors and optimal preparation conditions on the half-life of foam. A two-level orthogonal test was conducted using four factors (syringe size, surfactant, preparation temperature, and pump speed). Classifications were established as follows: syringe sizes, 2.5 mL and 5 mL; surfactant concentrations, 6% and 0%; preparation temperatures, 20 °C and 10 °C; and pump speeds, 250 mm/s and 125 mm/s, respectively. Eight experimental group (EG) multi-factor combinations were tested. Half-life and drainage time were recorded for analysis. The initial drainage time was within 200 s, but the difference between the groups was also about 200 s. The drainage rate curves of all EGs gradually increased over time. Conversely, the foam half-life extended by about 10 times for the four factors. In addition, the analyses revealed that the order of influence was surfactant >temperature >pump speed >syringe size. The most stable foam preparation was determined. Syringe size, surfactant, temperature, and pump speed had markedly observable influences on foam half-life. A combination of multiple factors can be used to prepare a more stable foam in clinical scenarios and to suitably superimpose favorable conditions to avoid unfavorable conditions.

Topics: Carbon Dioxide; Drug Stability; Half-Life; Humans; Models, Chemical; Poloxamer; Postoperative Complications; Sclerosing Solutions; Sclerotherapy; Sodium Morrhuate; Surface-Active Agents; Syringes; Temperature; Varicose Veins; Video Recording

Endoscopic sclerotherapy using sodium morrhuate has been used to treat patients with weight regain after Roux-en-Y gastric bypass whose presumed etiology is loss of restriction due to gastrojejunostomy dilation. Weight loss and stability have been demonstrated in several studies with short-term follow-up evaluation.. This retrospective review evaluated all the patients who underwent sclerotherapy for a dilated gastrojejunostomy between 2007 and 2012.. The study identified 48 patients with a mean follow-up period of 22 months (range 12-60 months). The mean age of these patients was 47.5 ± 10.5 years, and 92 % were women. The average weight loss from the primary procedure was 132.5 ± 54.82 lb, and the average weight regain from the lowest weight to the maximum weight before sclerotherapy was 46 ± 40.32 lb. The median number of sclerotherapy sessions was two (range 1-4). The pre-procedure mean gastrojejunostomy diameter was 20 ± 3.6 mm, and the mean volume of sodium morrhuate injected per session was 12.8 ± 3.7 ml. The average weight loss from sclerotherapy to the final documented weight was 3.17 ± 19.70 lb, which was not statistically significant. The following variables in the multivariate analysis were not associated with statistically significant weight loss: volume of sodium morrhuate, patient age, gastrojejunostomy diameter, number of sclerotherapy sessions, decrease in gastrojejunostomy diameter between the first and second sessions, and number of follow-up years. Weight stabilization or loss was achieved by 58 % of our cohort, with a mean weight loss of 15.9 ± 14.6 lb in this subgroup.. The long-term follow-up evaluation of patients undergoing sclerotherapy of the gastrojejunostomy for weight regain after gastric bypass showed only a marginal weight loss, which was not statistically significant in our study population, although more than 50 % of the patients achieved weight loss or stabilization.

Topics: Dilatation, Pathologic; Endoscopy, Gastrointestinal; Female; Follow-Up Studies; Gastric Bypass; Humans; Male; Middle Aged; Postoperative Care; Postoperative Complications; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Sodium Morrhuate; Time Factors; Treatment Outcome; Weight Gain