Edward B. Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin St., Suite 470, Houston, TX, 77030, USA.
Department of Radiology, Jackson Memorial Hospital, University of Miami Miller School of Medicine, 1611 NW 12th Ave West Wing, Rm 279, Miami, FL, 33136, USA.
Skeletal Radiol. 2021 Jun;50(6):1169-1175. doi: 10.1007/s00256-020-03662-y. Epub 2020 Nov 6.
To evaluate our pediatric experience with percutaneous ultrasound-guided fenestration of ganglia (PUGG).
Retrospective study of pediatric patients who underwent PUGG from June 2016 to October 2018 at a free-standing tertiary referral academic children's hospital with a minimum of 6 months follow-up. Electronic medical records, picture archiving system, and post-procedural calls were utilized for patient demographics, lesion characteristics, procedure details, and recurrence. The procedure itself consisted of assessment by Child Life, application of topical anesthetic cream, sterile preparation and draping, and intra-procedural ultrasound guidance for local anesthetic instillation, ganglion aspiration, fenestration, and intra-remnant steroid instillation. Post-procedure care included an ice pack, compression dressing for 48 h, and 4 weeks of brace wear and activity restriction.
Forty-five patients met the inclusion criteria, ages 3-18 years, mean 13.5 years, and female to male ratio of 2:1. Ganglion locations consisted of 80% (36/45) in the wrist and 20% (9/45) in other locations (elbow, ankle, and foot). Ninety-eight percent (44/45) of procedures were performed non-sedated, including 20% (9/44) between ages 7 and 11 years. 28.9% (13/45) of ganglia recurred, the earliest at 3 weeks, the latest at 10 months, and an average of 3 months' time. No complication occurred and no patients required post-procedural narcotics or Emergency Department visitation for pain control.
Percutaneous ultrasound-guided fenestration of ganglia (PUGG) is a safe, minimally invasive alternative to surgical excision in the pediatric population, which can be performed without sedation and does not leave a scar.
评估我们在小儿经皮超声引导神经节开窗术（PUGG）方面的经验。
回顾性研究 2016 年 6 月至 2018 年 10 月期间在一家独立的三级转诊学术儿童医院接受 PUGG 的儿科患者，这些患者的随访时间至少为 6 个月。利用电子病历、影像归档系统和术后电话随访获取患者的人口统计学资料、病变特征、手术细节和复发情况。该手术包括儿童生活评估、局部麻醉乳膏的应用、无菌准备和铺巾，以及术中超声引导下局部麻醉剂的注射、神经节抽吸、开窗和腔内残余物类固醇的注射。术后护理包括冰袋、48 小时的压缩包扎，以及 4 周的支具佩戴和活动限制。
45 名患者符合纳入标准，年龄 3-18 岁，平均年龄 13.5 岁，男女比例为 2:1。神经节的位置包括 80%（36/45）在手腕，20%（9/45）在其他位置（肘部、脚踝和足部）。98%（44/45）的手术是在非镇静状态下进行的，包括 20%（9/44）的患者年龄在 7-11 岁之间。28.9%（13/45）的神经节复发，最早在 3 周，最晚在 10 个月，平均复发时间为 3 个月。没有发生并发症，也没有患者需要术后使用阿片类药物或因疼痛控制而到急诊就诊。
经皮超声引导神经节开窗术（PUGG）是小儿人群中一种安全、微创的手术切除替代方法，可在不镇静的情况下进行，且不会留下疤痕。
