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Taifour W, Youssef H, Ranjous Y, Deeb A, Moughdeb AKA. Uterine tube evisceration during drainage tube removal - A rare case report. Int J Surg Case Rep 2024; 119:109685. [PMID: 38701615 PMCID: PMC11078638 DOI: 10.1016/j.ijscr.2024.109685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/16/2024] [Accepted: 04/20/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Drainage tubes are commonly used to remove unwanted fluid after surgery. However, they are not indicated in all situations, and there is no evidence to support their common utilization. CASE PRESENTATION A 31-year-old woman at 38 weeks of gestation with a history of five cesarean sections presented with lower abdominal pain following a tonic-clonic epileptic seizure. Emergency surgery was performed due to fetal distress, and the uterus was found to be ruptured. After delivering the baby and closing the uterus, a drainage tube was inserted into the pouch of Douglas. Two days after surgery, the right ampulla and infundibulum were eviscerated from the drain site during the drainage tube removal. A second surgery was performed to reduce the herniated uterine tube. CLINICAL DISCUSSION Drainage tubes are typically easily removed without complications. Some reported complications related to drainage tube removal include herniation, anchoring and suctioning of the uterine tube to the drainage tube, knotting with the colonic epiploica, and fracturing and retraction of the drainage tube due to adhesions. To the best of our knowledge, this is the first reported case of uterine tube evisceration during drainage tube removal. CONCLUSION Evisceration after drainage tube removal is very rare. We believe that this is the first report of immediate evisceration after the removal process. Such complications can be avoided with more restricted instructions for the use of drainage tubes and more researches on the reasons for these complications.
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Affiliation(s)
- Wessam Taifour
- Obstetrics and Gynecology Hospital, Damascus University, Damascus, Syria.
| | - Hasan Youssef
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Yahia Ranjous
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Ali Deeb
- Obstetrics and Gynecology Hospital, Damascus University, Damascus, Syria
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Zhang Z, Liu Y, Xiong B. Trocar site incisional hernia caused by removal of drainage tube after laparoscopic appendectomy: A case report. Asian J Surg 2024:S1015-9584(24)00558-X. [PMID: 38522993 DOI: 10.1016/j.asjsur.2024.03.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Affiliation(s)
- Zhe Zhang
- General Surgery Department, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China; NO.1 School of Clinical Medicine, Kunming Medical University, Kunming, 650032, China.
| | - Yue Liu
- General Surgery Department, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China; NO.1 School of Clinical Medicine, Kunming Medical University, Kunming, 650032, China.
| | - Binghong Xiong
- General Surgery Department, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China; NO.1 School of Clinical Medicine, Kunming Medical University, Kunming, 650032, China.
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Nakamura S, Takahashi T, Minami M, Kanematsu R, Suda I, Hanakita J, Tokunaga S, Takeuchi S. Postoperative intractable leg pain caused by dislocation of drainage tube. Surg Neurol Int 2023; 14:177. [PMID: 37292411 PMCID: PMC10246310 DOI: 10.25259/sni_353_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 05/06/2023] [Indexed: 06/10/2023] Open
Abstract
Background A wide variety of conditions can cause recurrent postoperative lumbar radiculopathy. Case Description A 49-year-old female developed sudden recurrent postoperative right leg pain after a right-sided L5S1 microdiskectomy for a herniated disc. Emergent magnetic resonance and computed tomography studies demonstrated migration of the drainage tube into the right L5S1 lateral recess compromising the S1 nerve root. Following drain removal, the patient's right reg pain immediately resolved. Conclusion Migration of a lumbar wound drain into the operated lateral recess following a lumbar diskectomy may result in acute, recurrent/intractable radicular pain that was readily resolved with drain removal.
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Affiliation(s)
- Sho Nakamura
- Department of Neurosurgery, Higashiyamato Hospital, Higashiyamato
| | | | - Manabu Minami
- Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Japan
| | - Ryo Kanematsu
- Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Japan
| | - Izumi Suda
- Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Japan
| | - Junya Hanakita
- Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Japan
| | - Shinya Tokunaga
- Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Japan
| | - Shu Takeuchi
- Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Japan
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Hua Y, Gao X. Management of difficult extubation after breast cancer Surgery. Asian J Surg 2022; 45:3023. [PMID: 35811211 DOI: 10.1016/j.asjsur.2022.06.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/30/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Yitong Hua
- Department of Breast Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, 256603, PR China.
| | - Xiaoyuan Gao
- Department of Radiology, Binzhou Medical University Hospital, Binzhou, Shandong, 256603, PR China.
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Kong PF, Xu YH, Lai ZH, Ma MZ, Duan YT, Sun B, Xu DZ. Novel management indications for conservative treatment of chylous ascites after gastric cancer surgery. World J Gastroenterol 2022; 28:6056-6067. [PMID: 36405388 PMCID: PMC9669821 DOI: 10.3748/wjg.v28.i42.6056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/15/2022] [Accepted: 10/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chylous ascites (CA) presents a challenge as a relatively common postoperative complication in gastric cancer (GC). Primary conservative therapy involved total parenteral nutrition, continuous low-pressure drainage, somatostatin, and a low-fat diet. Drainage tube (DT) clamping has been presented as a potential alternative conservative treatment for GC patients with CA.
AIM To propose novel conservative treatment strategies for CA following GC surgery.
METHODS The data of patients with CA after GC surgery performed at the Fudan University Shanghai Cancer Center between 2006 and 2021 were evaluated retrospectively.
RESULTS 53 patients underwent surgery for GC and exhibited postoperative CA during the study period. Postoperative hospitalization and time of DT removal showed a significant positive association (R2 = 0.979, P < 0.001). We further observed that delayed DT removal significantly extended the total and postoperative hospitalization, antibiotic usage duration, and hospitalization cost (postoperative hospitalization: 25.8 d vs 15.5 d, P < 0.001; total hospitalization: 33.2 d vs 24.7 d, P < 0.01; antibiotic usage duration: 10.8 d vs 6.2 d, P < 0.01; hospitalization cost: ¥9.2 × 104vs ¥6.5 × 104, P < 0.01). Multivariate analysis demonstrated that postoperative infection and antibiotic usage were independent factors for delayed DT removal. Furthermore, DT removal times were shorter in seven patients who underwent DT clamping (clamped DT vs normal group, 11.8 d vs 13.6 d, P = 0.047; clamped DT vs delayed group, 13.6 d vs 27.4 d, P < 0.001). In addition, our results indicated that removal of the DT may be possible after three consecutive days of drainage volumes less than 300 mL in GC patients with CA.
CONCLUSION Infection and antibiotic usage were vital independent factors that influenced delayed DT removal in patients with CA. Appropriate standards for DT removal can significantly reduce the duration of hospitalization. Furthermore, DT clamping might be a recommended option for conservative treatment of postoperative CA.
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Affiliation(s)
- Peng-Fei Kong
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Yong-Hu Xu
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Zhi-Hua Lai
- Department of the General Surgery, Suzhou Industrial Park Xinghai Hospital, Suzhou 215124, Jiangsu Province, China
| | - Ming-Zhe Ma
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Yan-Tao Duan
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Bo Sun
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Da-Zhi Xu
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
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Li ZM, Jiao DC, Han XW, Lei QY, Zhou XL, Xu M. Preliminary application of brachytherapy with double-strand 125I seeds and biliary drainage for malignant obstructive jaundice. Surg Endosc 2021; 36:4932-4938. [PMID: 34845555 DOI: 10.1007/s00464-021-08848-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the efficacy and safety of brachytherapy with double-strand 125I seeds and biliary drainage for malignant obstructive jaundice. METHODS AND MATERIALS 42 patients with obstructive jaundice because of extrahepatic cholangiocarcinoma were enrolled. 22 patients (group A) received a biliary stent with common drainage tube implantation, and 20 patients (group B) received a biliary stent with double-strand 125I seeds radiotherapy drainage tube placement. The length, location and pathological stage of biliary stricture were recorded in the two groups. Total bilirubin (TBIL), direct bilirubin (DBIL), IgA, IgG, IgM, alanine aminotransferase and white blood cell (WBC) count were measured before and after percutaneous transhepatic cholangial drainage (PTCD). Tumor diameter was measured before and three months after PTCD, and the difference were calculated. Stent patency time, survival time, and complications were recorded. RESULTS There was no significant difference in the length, location and pathological stage of biliary stenosis between the two groups. There was no significant difference in TBIL, DBIL, IgA, IgG, IgM, alanine aminotransferase and WBC count between the two groups before or after PTCD (P > 0.05). Three months after PTCD, tumors growth in group A and tumors shrinkage in group B. The difference in tumor size between the two groups before and after PTCD was statistically significant (P < 0.05). The average stent patency times in groups A and B were 3.55 ± 0.76 months and 8.76 ± 1.85 months, respectively (P < 0.05). The average survival times in groups A and B were 133.5 ± 27.8 days and 252.5 ± 114.5 days, respectively (P < 0.05). There was no statistically significant difference in the incidence of complications between the two groups (P > 0.05). CONCLUSION Double-strand 125I seeds radiotherapy biliary drainage tubes can safely and effectively control tumors, prolong the patency of biliary stents, and prolong patient survival.
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Affiliation(s)
- Zong-Ming Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - De-Chao Jiao
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xin-Wei Han
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Qin-Yu Lei
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xue-Liang Zhou
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Miao Xu
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
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Fu R, Zhang J, Dong S, Chen Y, Zhang C, Tang W, Xia J, Nie Q, Zhong W. Drainage tube hole suture improvement: Removal-free stitches. Thorac Cancer 2019; 10:1827-1833. [PMID: 31368233 PMCID: PMC6718023 DOI: 10.1111/1759-7714.13157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 07/14/2019] [Accepted: 07/14/2019] [Indexed: 02/05/2023] Open
Abstract
Surgical method improvements aim to optimize the patient experience. The problem of healing of the drainage tube hole has not received attention and is of concern because it can plague patient recovery. In this article we report on how we have improved the method of suturing the drainage tube hole and explore the safety and effectiveness of this method. Between December 2017 to August 2018, 102 patients underwent thoracoscopic lung resection (single port or single utility port) using different methods of suturing drainage tube holes. The intervention group received improved methods with subcuticular and intradermal suture and removal-free stitches, whilst the control group received a conventional mattress suture and fixed chest tube. A preset line was left to tie knots and close the hole after the removal of the chest tube. The stitches were removed 7-12 days after surgery. The baseline clinical features of the patients were subsequently analyzed. The objective and subjective conditions of scars were evaluated using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS) at one month after surgery. The intervention group (n = 71) and control group (n = 31) had balanced baseline clinical characteristics. There were no significant differences between the two groups in terms of three-day postoperative pain and postoperative hospital stay. In the intervention group, three patients (4.23%) had wound splitting that required re-suturing, which was better than five patients (16.13%) in the control group (P < 0.05). The incidence of pleural fluid outflow, wound infection, post-removal pneumothorax, chest tube prolapse and incisional hernia were not different between the two groups. We conclude that the objective and subjective evaluation results of scars were significantly different between the two groups (P < 0.05), and the experimental group was superior to the control group. A balanced result between aesthetic appearance and safety as regards video-assisted thoracic surgery can be achieved through the chest tube hole improved suture method. This method also improves the patient's recovery experience.
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Affiliation(s)
- Rui Fu
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung CancerGuangdong Provincial People's Hospital & Guangdong Academy of Medical SciencesGuangzhouChina
- Shantou University Medical CollegeShantouChina
| | - Jia‐Tao Zhang
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung CancerGuangdong Provincial People's Hospital & Guangdong Academy of Medical SciencesGuangzhouChina
| | - Song Dong
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung CancerGuangdong Provincial People's Hospital & Guangdong Academy of Medical SciencesGuangzhouChina
| | - Ying Chen
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung CancerGuangdong Provincial People's Hospital & Guangdong Academy of Medical SciencesGuangzhouChina
| | - Chao Zhang
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung CancerGuangdong Provincial People's Hospital & Guangdong Academy of Medical SciencesGuangzhouChina
| | - Wen‐Fang Tang
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung CancerGuangdong Provincial People's Hospital & Guangdong Academy of Medical SciencesGuangzhouChina
| | - Jin Xia
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung CancerGuangdong Provincial People's Hospital & Guangdong Academy of Medical SciencesGuangzhouChina
| | - Qiang Nie
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung CancerGuangdong Provincial People's Hospital & Guangdong Academy of Medical SciencesGuangzhouChina
| | - Wen‐Zhao Zhong
- Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung CancerGuangdong Provincial People's Hospital & Guangdong Academy of Medical SciencesGuangzhouChina
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Abstract
Background Conventional cervical drainage tubes are placed crossing the suprasternal fossa during endoscopic thyroidectomy. In our clinical experience, some patients show shallow or absent suprasternal fossa, which affects the cosmetic outcome in the patient. Therefore, this study aimed to assess the feasibility and significance of restoring the suprasternal fossa by changing the position of neck drainage tubes. Methods and Materials A total of 117 female patients were enrolled and divided into 2 groups, including 59 and 58 individuals in the Conventional (conventional anterior neck region negative pressure drainage) and Improvement (improved method with a negative pressure drainage) groups. Then, restoration of the suprasternal fossa in all subjects was observed at 1 day postsurgery, the day of extubation, and 3 months postoperatively. In addition, drainage volume, the time to extubation, and abnormal neck sensations were compared between the groups. Results Compared with the Conventional group, the Improvement group showed improved restoration of the suprasternal fossa, with the patients more satisfied with the cosmetic outcome. However, operation time, postoperative drainage volume, and extubation time were not significantly different between the 2 groups. Conclusions In endoscopic thyroidectomy via the chest and breast approach, using the new drainage technique described here could yield improved restoration of the suprasternal fossa, ameliorating the cosmetic outcome and patient satisfaction.
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Affiliation(s)
- Gao-Xiang Chen
- Thyroid and Breast Surgery, Ningbo Medical Center Lihuili Eastern Hospital
| | - Cheng Li
- Thyroid and Breast Surgery, Ningbo Medical Center Lihuili Eastern Hospital
| | - Hai Zhang
- Thyroid and Breast Surgery, Ningbo Medical Center Lihuili Eastern Hospital
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Rosentreter A, Lappas A, Widder RA, Alnawaiseh M, Dietlein TS. Conjunctival repair after glaucoma drainage device exposure using collagen-glycosaminoglycane matrices. BMC Ophthalmol 2018; 18:60. [PMID: 29486746 PMCID: PMC5830326 DOI: 10.1186/s12886-018-0721-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 02/16/2018] [Indexed: 11/20/2022] Open
Abstract
Background To report the results of the repair of conjunctival erosions resulting from glaucoma drainage device surgery using collagen-glycosaminoglycane matrices (CGM). Methods Case series of 8 patients who underwent revision surgery due to conjunctival defects with exposed tubes through necrosis of the overlying scleral flap and conjunctiva after Baerveldt drainage device surgery. The defects were repaired by lateral displacement of the tube towards the sclera, with a slice of a CGM as a patch, covered by adjacent conjunctiva. Result Successful, lasting closure (follow-up of 12 to 42 months) of the conjunctival defects was achieved without any side-effects or complications in all eight cases. Conclusions Erosion of the drainage tube, creating buttonholes in the conjunctiva after implantation of glaucoma drainage devices, is a potentially serious problem. It can be managed successfully using a biodegradable CGM as a patch.
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Affiliation(s)
- André Rosentreter
- Department of Ophthalmology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
| | - Alexandra Lappas
- Center of Ophthalmology, University of Cologne, Cologne, Germany
| | | | - Maged Alnawaiseh
- Department Of Ophthalmology, University of Muenster Medical Center, Muenster, Germany
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Zhao Y, Hu W, Hou X, Zhou Q. Chylous Ascites After Laparoscopic Lymph Node Dissection in Gynecologic Malignancies. J Minim Invasive Gynecol 2014; 21:90-6. [DOI: 10.1016/j.jmig.2013.07.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/09/2013] [Accepted: 07/09/2013] [Indexed: 12/23/2022]
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