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Abdreshov SN, Demchenko GA, Yeshmukhanbet AN, Yessenova MA, Mankibaeva SA, Atanbaeva GK, Kulbayeva MS. Morphofunctional Alteration of Mesenteric Lymph Nodes in the Inflammation of the Abdominal Cavity. Biology (Basel) 2024; 13:166. [PMID: 38534436 DOI: 10.3390/biology13030166] [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] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/02/2024] [Accepted: 02/29/2024] [Indexed: 03/28/2024]
Abstract
This paper provides data regarding the ratios of the functional structures of lymph nodes after inflammation in the abdominal organs. Lymph systems, including lymph nodes, function as filters of tissues and tissue fluids and are places of origin and lymphocyte production for normal physiological functions. They display specific morphological and functional responses in reaction to endogenous and exogenous substances. The morphological pattern of the mesenteric lymph node in experimental rat groups reflects a decrease in its immune function due to the processes of inflammation in the abdominal cavity. These processes work together with the associated organs and their involvement in the abdominal lymph nodes, in which there are discharges of the structure of the paracortical zone under conditions of reduced lymphogenic processes, according to the decrease in the size of the paracortex and the ratios of lymphoid nodes with and without germinal centers. Histological and morphometric analyses show changes in the mesenteric lymph node. These analyses are characterized by changes in the cortical and medullary substances, while the proportion of the cortical structure decreases. We also noted an increase in the number of macrophages in the lymphoid nodes and cerebral sinus, as well as a decrease in the number of mature plasmocytes, the paracortex, and the pulp strands. These changes indicate immunosuppressive effects on the lymph node. Under the conditions of inflammation, the formation of a mixed immune response occurs.
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Affiliation(s)
- Serik N Abdreshov
- Laboratory of Physiology Lymphatic System, Institute of Genetics and Physiology SC MSHE RK, Almaty 050060, Kazakhstan
- Faculty of Biology and Biotechnology, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
| | - Georgii A Demchenko
- Laboratory of Physiology Lymphatic System, Institute of Genetics and Physiology SC MSHE RK, Almaty 050060, Kazakhstan
| | - Anar N Yeshmukhanbet
- Laboratory of Physiology Lymphatic System, Institute of Genetics and Physiology SC MSHE RK, Almaty 050060, Kazakhstan
- Faculty of Biology and Biotechnology, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
| | - Makpal A Yessenova
- Laboratory of Physiology Lymphatic System, Institute of Genetics and Physiology SC MSHE RK, Almaty 050060, Kazakhstan
- Faculty of Biology and Biotechnology, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
| | - Sandugash A Mankibaeva
- Faculty of Biology and Biotechnology, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
| | - Gulshat K Atanbaeva
- Faculty of Biology and Biotechnology, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
| | - Marzhan S Kulbayeva
- Faculty of Biology and Biotechnology, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
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Nguyen YTH, Nguyen LAT, VAN Dong H, Duong HD, Yoshida A. Molecular identification of sparganum of Spirometra mansoni isolated from the abdominal cavity of a domestic cat in Vietnam. J Vet Med Sci 2024; 86:96-100. [PMID: 38030282 PMCID: PMC10849862 DOI: 10.1292/jvms.23-0236] [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: 06/09/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Cats normally play a role of the definitive host in which the plerocercoid (sparganum), the second larval form of Spirometra spp., develops into an adult in the intestines. However, some cases of cats with visceral or subcutaneous sparganosis were sporadically reported worldwide. We herein documented the discovery of a sparganum in abdominal cavity of a domestic cat during a surgery of dystocia. The larva was molecularly identified as Spirometra mansoni, belonging to Type I, that was recently misidentified to be S. erinaceieuropaei in several Asian countries. This is the first report for sparganum of S. mansoni in the cat. The future study is necessary to provide further insights into the species of Spirometra causing sparganosis and spirometrosis in humans and other animals.
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Affiliation(s)
- Yen Thi Hoang Nguyen
- Department of Parasitology, Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Ha Noi, Vietnam
- Department of Public Health, Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Ha Noi, Vietnam
| | - Lan Anh Thi Nguyen
- Department of Parasitology, Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Ha Noi, Vietnam
| | - Hieu VAN Dong
- Department of Public Health, Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Ha Noi, Vietnam
| | - Hieu Duc Duong
- Department of Parasitology, Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Ha Noi, Vietnam
| | - Ayako Yoshida
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan
- Centre for Animal Disease Control (CADIC), University of Miyazaki, Miyazaki, Japan
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Lima MMDS, Ximenes MAM, de Araújo DV, Barros LM, Galindo NM, Caetano JÁ. Abdominal compressions during cardiopulmonary resuscitation: a scoping review. Rev Bras Enferm 2023; 76:e20220400. [PMID: 38018609 PMCID: PMC10680381 DOI: 10.1590/0034-7167-2022-0400] [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: 07/11/2022] [Accepted: 06/14/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES to map the scientific evidence on the use of abdominal compressions during cardiopulmonary resuscitation in patients with cardiac arrest. METHODS this is a scoping review based on the question: "What is the evidence regarding the use of abdominal compressions during cardiopulmonary resuscitation in patients with cardiac arrest?". Publications up to August 2022 were collected from eight databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was used. RESULTS seventeen publications were included. The identified general population consisted of adults and elderly individuals. The primary outcome revealed significant rates of return of spontaneous circulation. Secondary outcomes indicated a significant improvement in heart rate, blood pressure, oxygen saturation, and other outcomes. CONCLUSIONS abdominal compressions have been shown to be beneficial. However, further clinical studies are needed to identify the best execution method and its impacts.
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Affiliation(s)
| | | | | | - Lívia Moreira Barros
- Universidade da Integração Internacional da Lusofonia, Afro-Brasileira. Redenção, Ceará, Brazil
| | - Nelson Miguel Galindo
- Instituto Federal de Educação, Ciência e Tecnologia de Pernambuco. Pernambuco, Ceará, Brazil
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Ciciriello S, Gerosa M, Ghezzi R, Sogni A, Incalza F, Guttadauro A, Maggioni D, Mari G. Transperitoneal laparoscopic retrievement of a migrated prosthetic head after total hip arthroplasty: a case report. Front Surg 2023; 10:1227026. [PMID: 37576923 PMCID: PMC10413258 DOI: 10.3389/fsurg.2023.1227026] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
The migration of a prosthetic head during total hip arthroplasty (THA) is a rare complication. Few cases are described in the literature, offering different solutions and surgical approaches for prosthetic head retrievement. Here, we present a case of successful laparoscopic transperitoneal retrieval of a prosthetic head migrated above the right iliac vein after THA with a posterolateral approach.
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Affiliation(s)
| | - Martino Gerosa
- Laparoscopic and Oncological General Surgery Department, Desio Hospital, ASST Brianza, Desio, Italy
| | - Riccardo Ghezzi
- Orthopaedic Department, Desio Hospital, ASST Brianza, Desio, Italy
| | - Angelo Sogni
- Department of Anesthesia and Intensive Care, Desio Hospital, ASST Brianza, Desio, Italy
| | | | - Angelo Guttadauro
- Department of Medicine and Surgery, School of Medicine and Surgery,University of Milano Bicocca, Milan, Italy
| | - Dario Maggioni
- Laparoscopic and Oncological General Surgery Department, Desio Hospital, ASST Brianza, Desio, Italy
| | - Giulio Mari
- Laparoscopic and Oncological General Surgery Department, Desio Hospital, ASST Brianza, Desio, Italy
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Sokolov SG, Yang P, Lebedeva DI. New record of Tylodelphys metacercariae (Diplostomidae) from Perccottus glenii (Odontobutidae) and their phylogenetic assessment. Acta Vet Hung 2022; 70:274-281. [PMID: 36227717 DOI: 10.1556/004.2022.00031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 05/26/2022] [Accepted: 09/15/2022] [Indexed: 01/29/2023]
Abstract
Metacercariae of Tylodelphys sp. were found in the abdominal cavity of the Chinese sleeper (Perccottus glenii) collected in Liaoning Province and Inner Mongolia Autonomous Region of China. The sequences of the mitochondrial cox1 gene and ribosomal ITS1-5.8S rDNA-ITS2 region were obtained and used for molecular identification and phylogenetic assessment of this parasite species. Results of phylogenetic analyses based on ITS and cox1 markers showed that the metacercariae of Tylodelphys sp. ex P. glenii from China were conspecific with specimens of Tylodelphys sp. collected by Sokolov et al. (2013) from the same fish-host species captured earlier in West Siberia, Russia. The examined Tylodelphys sp. ex. P. glenii is the only member of the genus whose metacercariae parasitise the abdominal cavity of fish in northern Eurasia. Tylodelphys sp. ex P. glenii clustered with T. darbyi, T. immer, T. podicipina, and Tylodelphys sp. of Soldánová et al., 2017 based on mitochondrial DNA markers, and with T. darbyi, T. immer, T. kuerepus, and T. schreuringi using nuclear DNA markers.
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Affiliation(s)
- Sergey G Sokolov
- 1A. N. Severtsov Institute of Ecology and Evolution, Russian Academy of Sciences, Moscow, Russia
| | - Peimin Yang
- 2Liaoning Institute of Freshwater Fisheries, Liaoyang, China
| | - Daria I Lebedeva
- 3Institute of Biology, Karelian Research Centre, Russian Academy of Sciences, Petrozavodsk, Russia
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Modrzejewski A, Kowalik K, Grochal I, Kaźmierczak K. Operative material left in the abdominal cavity during surgical procedures. Pol Przegl Chir 2022; 95:1-5. [PMID: 36805987 DOI: 10.5604/01.3001.0016.0661] [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] [Indexed: 01/27/2023]
Abstract
The authors present seven cases of surgical drape left in body cavities during surgical operations. The most common symptoms reported by these patients are analysed and the consequences of leaving a foreign body in the abdominal cavity are summarised. In the majority of cases, the time elapsed from the operation to the detection of the foreign body was an average of 17 months. In one case, the foreign body remained in the abdomen for 7 years. The most common symptom reported by patients was abdominal pain. Some patients also developed wound healing disorders with leakage of pus from the wound, fever, nausea and vomiting, weight loss or intermittent tarry stools. In most cases, the foreign body required reoperation to remove it. Major surgery with stoma creation or bowel resection was required. In one case described, the consequence of leaving a surgical drape was the death of the patient. In three cases, there was spontaneous expulsion of the surgical sling by the patient by natural means.
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Affiliation(s)
- Andrzej Modrzejewski
- Oddział Kliniczny Chirurgii Ogólnej Pomorskiego Uniwersytetu Medycznego w Szczecinie; Kierownik: prof. dr hab. n. med. Andrzej Modrzejewski
| | - Krzysztof Kowalik
- Klinika Urologii i Onkologii Urologicznej Pomorskiego Uniwersytetu Medycznego w Szczecinie Kierownik: prof. dr hab. n. med. Marcin Słojewski
| | - Inga Grochal
- Oddział Chirurgii Ogólnej Szpitala Specjalistycznego św. Łukasza w Końskich Kierownik: dr n. med. Zbigniew Sosnowski
| | - Konrad Kaźmierczak
- Zakład Medycyny Sądowej Pomorskiego Uniwersytetu Medycznego w Szczecinie Kierownik: prof. dr hab. n. med. Mirosław Parafiniuk
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Kızılet H, Cömert E, Taflan Ş, Doğan O, Beşir A, Kart C. Comparison of the effect of general anesthesia and spinal anesthesia technique combined with general anesthesia on intraabdominal volume during gynecological laparoscopy. J Obstet Gynaecol Res 2022; 48:3262-3268. [PMID: 36148979 DOI: 10.1111/jog.15435] [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: 06/22/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE We aimed to investigate the effect of spinal anesthesia which will be performed simultaneously with general anesthesia on the site of operation with the same pressure. MATERIAL AND METHOD This study was conducted as a randomized, prospective clinical study on 40 patients who were randomly divided into two groups. Twenty women underwent general anesthesia (Group GA) and 20 women underwent spinal anesthesia with general anesthesia (Group SGA). For all cases, preoperative height, weight, waist circumference, body mass index (kg/m2 ), the distance between both spina iliaca anterior superior, the distance of the intersection of both ribs with an imaginary line drawn over the anterior axillary line, suprapubic bone-umbilical, umbilical-xiphoid, and suprapubic bone-xiphoid distance from the midline of the abdomen were measured. Moreover, while the patient was lying in the neutral position on the operating table, the height of the highest point of the abdomen to the operating table was also measured. These measurements were repeated at intra-abdominal pressure (IAP) 14 and 25 mmHg. The amount of intra-abdominal insufflated CO2 was also recorded at IAP 14 and 25 mmHg. RESULTS When the intra-abdominal insufflation volumes of both groups were compared at 14 and 25 mmHg, respectively, there was no statistical difference (p: 0.54, p: 0.40). When 14 and 25 mmHg were compared in all cases, a statistically significant difference was observed in other measurements except in xiphoid-umbilical distance (p < 0.05). CONCLUSION We found that spinal anesthesia combined with GA had no effect on the abdominal volume and anthropometric measurements in laparoscopic procedures.
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Affiliation(s)
- Hakan Kızılet
- Department of Obstetrics and Gynecology, Adıyaman University Faculty of Medicine, Adiyaman, Turkey
| | - Ercan Cömert
- Department of Obstetrics and Gynecology, Adıyaman University Faculty of Medicine, Adiyaman, Turkey
| | - Şener Taflan
- Department of Obstetrics and Gynecology, Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Ozan Doğan
- Private Office, Clinic of Obstetrics and Gynecology Specialist, Istanbul, Turkey
| | - Ahmet Beşir
- Department of Obstetric and Gynecology, Karadeniz Teknik Universitesi, School of Medicine, Trabzon, Turkey
| | - Cavit Kart
- Department of Anesthesiology and Critical Care, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
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8
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Fischerova D, Pinto P, Burgetova A, Masek M, Slama J, Kocian R, Frühauf F, Zikan M, Dusek L, Dundr P, Cibula D. Preoperative staging of ovarian cancer: comparison between ultrasound, CT and whole-body diffusion-weighted MRI (ISAAC study). Ultrasound Obstet Gynecol 2022; 59:248-262. [PMID: 33871110 DOI: 10.1002/uog.23654] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/05/2021] [Accepted: 03/26/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To compare the performance of transvaginal and transabdominal ultrasound with that of the first-line staging method (contrast-enhanced computed tomography (CT)) and a novel technique, whole-body magnetic resonance imaging with diffusion-weighted sequence (WB-DWI/MRI), in the assessment of peritoneal involvement (carcinomatosis), lymph-node staging and prediction of non-resectability in patients with suspected ovarian cancer. METHODS Between March 2016 and October 2017, all consecutive patients with suspicion of ovarian cancer and surgery planned at a gynecological oncology center underwent preoperative staging and prediction of non-resectability with ultrasound, CT and WB-DWI/MRI. The evaluation followed a single, predefined protocol, assessing peritoneal spread at 19 sites and lymph-node metastasis at eight sites. The prediction of non-resectability was based on abdominal markers. Findings were compared to the reference standard (surgical findings and outcome and histopathological evaluation). RESULTS Sixty-seven patients with confirmed ovarian cancer were analyzed. Among them, 51 (76%) had advanced-stage and 16 (24%) had early-stage ovarian cancer. Diagnostic laparoscopy only was performed in 16% (11/67) of the cases and laparotomy in 84% (56/67), with no residual disease at the end of surgery in 68% (38/56), residual disease ≤ 1 cm in 16% (9/56) and residual disease > 1 cm in 16% (9/56). Ultrasound and WB-DWI/MRI performed better than did CT in the assessment of overall peritoneal carcinomatosis (area under the receiver-operating-characteristics curve (AUC), 0.87, 0.86 and 0.77, respectively). Ultrasound was not inferior to CT (P = 0.002). For assessment of retroperitoneal lymph-node staging (AUC, 0.72-0.76) and prediction of non-resectability in the abdomen (AUC, 0.74-0.80), all three methods performed similarly. In general, ultrasound had higher or identical specificity to WB-DWI/MRI and CT at each of the 19 peritoneal sites evaluated, but lower or equal sensitivity in the abdomen. Compared with WB-DWI/MRI and CT, transvaginal ultrasound had higher accuracy (94% vs 91% and 85%, respectively) and sensitivity (94% vs 91% and 89%, respectively) in the detection of carcinomatosis in the pelvis. Better accuracy and sensitivity of ultrasound (93% and 100%) than WB-DWI/MRI (83% and 75%) and CT (84% and 88%) in the evaluation of deep rectosigmoid wall infiltration, in particular, supports the potential role of ultrasound in planning rectosigmoid resection. In contrast, for the bowel serosal and mesenterial assessment, abdominal ultrasound had the lowest accuracy (70%, 78% and 79%, respectively) and sensitivity (42%, 65% and 65%, respectively). CONCLUSIONS This is the first prospective study to document that, in experienced hands, ultrasound may be an alternative to WB-DWI/MRI and CT in ovarian cancer staging, including peritoneal and lymph-node evaluation and prediction of non-resectability based on abdominal markers of non-resectability. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- D Fischerova
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - P Pinto
- Department of Obstetrics and Gynecology, Maternidade Alfredo da Costa, Centro Hospitalar Lisboa Central, Lisbon, Portugal
- First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - A Burgetova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - M Masek
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - J Slama
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - R Kocian
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - F Frühauf
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - M Zikan
- Department of Obstetrics and Gynecology, Bulovka Hospital, Prague, Czech Republic
| | - L Dusek
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - P Dundr
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - D Cibula
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Díaz-García J, Mesquida A, Gómez A, Machado M, Martín-Rabadán P, Alcalá L, Sánchez-Carrillo C, Reigadas E, Vicente T, Muñoz P, Escribano P, Guinea J. Antifungal Susceptibility Testing Identifies the Abdominal Cavity as a Source of Candida glabrata-Resistant Isolates. Antimicrob Agents Chemother 2021; 65:e0124921. [PMID: 34570649 DOI: 10.1128/AAC.01249-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
To identify unrecognized niches of resistant Candida isolates and compartmentalization, we retrospectively studied the antifungal susceptibility of 1,103 Candida spp. isolates from blood cultures, nonblood sterile samples, and nonsterile samples. Antifungal susceptibility was assessed by EUCAST E.Def 7.3.2; sequencing and genotyping of the fks1-2 and erg11 genes were carried out for non-wild-type isolates. Resistance compartmentalization (presence of resistant and susceptible isogenic isolates in different anatomical sites of a given patient) was studied. Clinical charts of patients carrying non-wild-type isolates were reviewed. Most isolates (63%) were Candida albicans, regardless the clinical source; Candida glabrata (27%) was the second most frequently found species in abdominal cavity samples. Fluconazole and echinocandin resistance rates were 1.5 and 1.3%, respectively, and were highest in C. glabrata. We found 22 genotypes among non-wild-type isolates, none of them widespread across the hospital. Fluconazole/echinocandin resistance rates of isolates from the abdominal cavity (3.2%/3.2%) tended to be higher than those from blood cultures (0.7%/1.3%). Overall, 15 patients with different forms of candidiasis were infected by resistant isolates, 80% of whom had received antifungals before or at the time of isolate collection; resistance compartmentalization was found in six patients, mainly due to C. glabrata. The highest antifungal resistance rate was detected in isolates from the abdominal cavity, mostly C. glabrata. Resistance was not caused by the spread of resistant clones but because of antifungal treatment. Resistance compartmentalization illustrates how resistance might be overlooked if susceptibility testing is restricted to bloodstream isolates.
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Nishimura MF, Nishimura Y, Nishikori A, Maekawa Y, Maehama K, Yoshino T, Sato Y. Clinical and Pathological Characteristics of Hyaline-Vascular Type Unicentric Castleman Disease: A 20-Year Retrospective Analysis. Diagnostics (Basel) 2021; 11:diagnostics11112008. [PMID: 34829355 PMCID: PMC8618395 DOI: 10.3390/diagnostics11112008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 09/20/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/11/2022] Open
Abstract
The first case of hyaline vascular type of unicentric Castleman disease (HV-UCD) was reported more than six decades ago. Since patients with HV-UCD are often asymptomatic and this condition is generally discovered incidentally on imaging tests, most of the previous reports were of mediastinal origin detected by chest radiography. In recent years, improved access to imaging modalities has provided new insights in the diagnosis of this condition. In this study, we reviewed the detailed clinical and pathological findings of 38 HV-UCD cases (20 males and 18 females, mean age: 42.8 years). The most common site involved was the abdominal cavity (34.2%), followed by mediastinum (23.7%) and retroperitoneum (15.8%). In the abdominal cavity, mesenteric origin was the most common. The mean size of masses was 4.8 cm. Pathologically, thick hyalinized collagen fibers surrounding large blood vessels and calcification were observed (81.6% and 23.7%, respectively). Multinucleated giant cells resembling Warthin–Finkeldey cell were also observed in occasional cases (23.7%). This is a unique paper that summarizes detailed clinical and pathological findings of a large series of a rare disease. The clinical information presented in this paper is more plausible than previous views and is useful for accurate diagnosis and understanding of the disease.
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Affiliation(s)
- Midori Filiz Nishimura
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan; (M.F.N.); (T.Y.)
| | - Yoshito Nishimura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan;
- Department of Medicine, John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
| | - Asami Nishikori
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan; (A.N.); (Y.M.); (K.M.)
| | - Yukina Maekawa
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan; (A.N.); (Y.M.); (K.M.)
| | - Kanna Maehama
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan; (A.N.); (Y.M.); (K.M.)
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan; (M.F.N.); (T.Y.)
| | - Yasuharu Sato
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan; (M.F.N.); (T.Y.)
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama 700-8558, Japan; (A.N.); (Y.M.); (K.M.)
- Correspondence: ; Tel.: +81-86-235-7150
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11
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Brown PJB, Gao Y, Clunie D. What is the abdomen? Rationalising clinical and anatomical perspectives using formal semantics. J Anat 2021; 238:1472-1491. [PMID: 33417250 PMCID: PMC8128770 DOI: 10.1111/joa.13384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022] Open
Abstract
The meaning of the term ‘abdomen’ has become increasingly ambiguous, as it has to satisfy the contemporary requirements of natural language discourse, literature, gross and radiological anatomy and its role in ontologies supporting electronic records and data modelling. It is critical that there is an agreed understanding of the semantics of the abdominopelvic cavity, its component volumes including the abdomen proper, true and false pelvic cavities, and its boundaries and regional contents. The expression of part–whole (meronymic) relationships is essential for inferences to be drawn by computer algorithms, but unless these are rigorously reviewed and tested incorrect assumptions are drawn. The SNOMED CT terminology descriptions and hierarchy of anatomical concepts relating to the trunk were scrutinised for ambiguity and sub‐optimal relationships using a panel of reference sources. Any identified errors were corrected and the impact of any changes reviewed iteratively by evaluating their effect on dependant hierarchies (modelled with the associated anatomical concepts). Anatomical concepts are generally structured according to a traditional gross standpoint, but in clinical practice covert complex regional notions are frequently used and during the evaluation process a new viewpoint relating to projectional (transmissive) or emissive radiological perspective was identified. The subtle but important differences in the boundaries, volumes and contents of these distinctive perspectives of the ‘abdomen’ are presented. Three significant complex variants have been identified which relate to the most common uses of the word ‘abdomen’. The merits and disadvantages of using ‘abdomen’ as common synonym to more than one concept (polysemy) are briefly discussed and the solution adopted by SNOMED International described. The review of existing ontologies and academic literature confirmed the frequent varied use of the word ‘abdomen’, which raises concerns when derived data are increasingly being used remotely from the point of clinical contact, potentially leading to incorrect inferences. The documented regional truncal volumes from an anatomical regional, segmental and cross‐sectional perspective have been integrated into a logical and comprehensive model suitable for computer processing. The robust modelling of meronymic hierarchies has to be rigorous to avoid systematic errors and it is thus timely that a proposed standard description of these subtly related volumes and structures is made available for discussion and comment.
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Chen J, Zhong R, Qiu L, Liang Q, Li H, Liu H, Yuan J. Abdominal cavity unidirectional shunt for refractory pericardial effusion 7 months after cardiac valve replacement: A case report. J Card Surg 2020; 36:329-332. [PMID: 33090578 DOI: 10.1111/jocs.15121] [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: 08/24/2020] [Revised: 09/23/2020] [Accepted: 10/02/2020] [Indexed: 11/27/2022]
Abstract
Refractory pericardial effusion after repeated pericardial drainage and drug therapy for nearly half a year after cardiac valve replacement is rare. We present the case of a 36-year-old female patient who underwent an abdominal cavity unidirectional shunt for refractory massive pericardial effusion through a subxiphoid mini-incision, 7 months after cardiac valve replacement. The head end of a prefabricated bovine pericardial short tube with double leaflets on the tail was sutured to the small incised hole of the diaphragm, whereas the body and the tail of the short tube were dissociated in the left anterior hepatic space. Three months later, the pericardial effusion completely disappeared, no peritoneal effusion occurred, and all symptoms vanished.
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Affiliation(s)
- Jingwei Chen
- Department of Cardiovascular Surgery, Maoming People's Hospital, Maoming, China
| | - Ruhe Zhong
- Department of Cardiovascular Surgery, Maoming People's Hospital, Maoming, China
| | - Longxing Qiu
- Department of Cardiovascular Surgery, Maoming People's Hospital, Maoming, China
| | - Qing Liang
- Department of Cardiovascular Surgery, Maoming People's Hospital, Maoming, China
| | - Hua Li
- Department of Cardiovascular Surgery, Maoming People's Hospital, Maoming, China
| | - Huajian Liu
- Department of Cardiovascular Surgery, Maoming People's Hospital, Maoming, China
| | - Jian Yuan
- Department of Cardiovascular Surgery, Maoming People's Hospital, Maoming, China
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13
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Akentyeva TN, Mukhamadiyarov RA, Krivkina EO, Luzgarev SV, Kudryavtseva YA. [Influence of unmodified and modified sutures on experimental abdominal adhesive process]. Khirurgiia (Mosk) 2020:29-34. [PMID: 32271734 DOI: 10.17116/hirurgia202003129] [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] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Experimental assessment of the effect of modified and unmodified surgical suture material on abdominal adhesive process. MATERIAL AND METHODS The study was performed on male rats of the Wistar subpopulation. There were 5 animals in each group. In all animals, midline abdominal incision was followed by suturing the parietal peritoneum with modified and unmodified suture material. All animals were euthanized with carbon dioxide vapors in 14 days after surgery. Macro- and microscopic assessment of severity of abdominal adhesive process was carried out. Two types of preparation of excised complexes 'peritoneum-suture material-adhesion' were applied for histological examination: paraffin sections and embedding in epoxy resin. Specimens were stained by Van Gieson and with methylene blue solution. Histological specimens were examined using Axio Imager A1 light microscope (Zeiss, Germany). RESULTS Polypropylene filaments result extensive adhesions occupying about 75% of the area. Adhesions have a dense structure with signs of vascularization. Modification of suture material with solution of polyhydroxybutyrate/hydroxyvalerate and heparin reduce severity of adhesions. The use of modified suture material was followed by adhesions with more loose structure, no signs of vascularization. Adhesions occupied less than 25% of the area. Histological examination of excised complexes 'peritoneum-suture material-adhesion' revealed accumulation of inflammatory cells around the unmodified suture material, while there were no signs of tissue inflammatory process around the modified sutures. CONCLUSION Application of polyhydroxybutyrate/hydroxyvalerate and heparin on the surface of surgical sutures is an effective method for prevention of abdominal adhesions.
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Affiliation(s)
- T N Akentyeva
- Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia
| | - R A Mukhamadiyarov
- Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia
| | - E O Krivkina
- Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia
| | - S V Luzgarev
- Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia
| | - Yu A Kudryavtseva
- Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo, Russia
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Suciu MD, Marica NA, Oniu T, Tomuta AI, Badea R. Embryonal carcinoma of an intraabdominal testicular tumor on an undescended testicle: a case report. Med Pharm Rep 2020; 93:213-218. [PMID: 32478330 PMCID: PMC7243893 DOI: 10.15386/mpr-1293] [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: 01/29/2019] [Revised: 02/14/2020] [Accepted: 03/13/2020] [Indexed: 12/05/2022] Open
Abstract
Cryptorchidism, as a singular pathology or associated with other dysgenesis syndromes, is one of the main factors of risk for the development of the testicular tumors. Although there are a great number of cases of undescended testicles that are diagnosed and treated during the first 6–12 months of life, there are rare cases of adults who are undiagnosed and untreated from this anomaly, which can present a high risk of malignancy. In this study we present the case of a 36-year-old patient, diagnosed at puberty with left cryptorchidism, untreated, who also hadevidenced a large intraabdominal tumoral mass associated with it. The tumoral mass had its origin in the undescended left testicle. Surgical excision of the tumor and retroperitoneal lymphadenectomy was performed. The histological result revealed embryonal carcinoma, without lymphnode metastasis. Adult patients with untreated cryptorchidism should be thoroughly investigated, as they have a high risk of developing testicular cancer.
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Affiliation(s)
- Mihai Domnutiu Suciu
- Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania.,Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Nucu Alexandru Marica
- Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania.,Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | | | - Radu Badea
- Department of Medical Imaging, Iuliu Hatieganu University of Medicine and Pharmacy, "Prof. Dr. Octavian Fodor", Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Romania
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de Vries FEE, Claessen JJM, Atema JJ, van Ruler O, Boermeester MA. Immediate Closure of Abdominal Cavity with Biologic Mesh versus Temporary Abdominal Closure of Open Abdomen in Non-Trauma Emergency Patients (CLOSE-UP Study). Surg Infect (Larchmt) 2020; 21:694-703. [PMID: 32097095 DOI: 10.1089/sur.2019.289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background: In more than 10% of emergency laparotomies in non-trauma patients, primary fascial closure is not achievable because of excessive visceral edema, which leaves the patient with an open abdomen (OA). An OA harbors an inherent high risk of serious complications, and temporary closure devices are used to achieve delayed fascial closure. A potential new strategy in preventing OA is immediate closure during the emergency procedure with a non-crosslinked biologic mesh. Methods: This is a prospective comparative cohort feasibility study in 13 teaching hospitals in the Netherlands. Non-trauma patients who underwent emergency laparotomy in which regular sutured primary fascial closure was not achievable because of excessive intra-abdominal edema were eligible. In one cohort, Biomesh (n = 20), the abdominal cavity was immediately closed at the emergency laparotomy with a non-crosslinked biologic mesh. In a parallel cohort, Control (n = 20), the resulting OA was managed by temporary abdominal closure (TAC; inlay polyglactin [Vicryl™] mesh [n = 7]) or commercial (ABTheraTM) abdominal negative pressure therapy device (n = 13)). The primary end point was the proportion of closed abdominal cavities at 90 days. Results: At 90 days, 65% (13/20) of the abdominal cavities were closed in the Biomesh cohort versus 45% (9/20) in Controls (p = 0.204). In the Biomesh cohort, seven of 20 (35%) patients had at least one major complication versus 15 of 20 (75%) patients in the Control cohort (p = 0.011). Both the median number of intensive care unit (ICU) and mechanical ventilation days were significantly lower in the Biomesh cohort; one versus 10 (p = 0.002) and 0 versus four (p = 0.003) days, respectively. The number of abdominal reoperations was significantly lower in the Biomesh cohort (median 0 vs. two, p < 0.001; total number five vs. 44). Conclusions: If primary fascial closure cannot be achieved at the emergency laparotomy in non-trauma patients, immediate abdominal closure by use of a non-crosslinked biologic mesh prevents OA management. This results in a non-significant higher proportion of closed abdominal cavities at 90 days compared with OA management with TAC techniques, and in a significant reduction of major complications and reoperations, and a shorter ICU stay.
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Affiliation(s)
- Fleur E E de Vries
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Jeroen J M Claessen
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Jasper J Atema
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Oddeke van Ruler
- Department of Surgery, IJsselland Hospital, Capelle aan den IJssel, the Netherlands
| | - Marja A Boermeester
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands
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Kaouk J, Aminsharifi A, Wilson CA, Sawczyn G, Garisto J, Francavilla S, Abern M, Crivellaro S. Extraperitoneal versus Transperitoneal Single Port Robotic Radical Prostatectomy: A Comparative Analysis of Perioperative Outcomes. J Urol 2020; 203:1135-40. [PMID: 31846392 DOI: 10.1097/JU.0000000000000700] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE We compared intraoperative and perioperative outcomes between extraperitoneal and transperitoneal radical prostatectomy performed using a "purpose-designed" single port robotic platform. MATERIALS AND METHODS A total of 98 patients underwent single port robotic prostatectomy using the da Vinci SP® robotic system with extraperitoneal (group I, 52) vs transperitoneal (group II, 46) approach. Demographics and perioperative data including postoperative recovery outcomes were recorded and compared between the 2 groups. RESULTS Groups were similar in terms of demographics and prostate cancer risk category. Mean operative time (201±37.5 vs 248.2±42.3 minutes, p <0.00001) as well as median postoperative hospital stay (4.3 vs 25.7 hours p <0.0001) was significantly shorter with the extraperitoneal approach. Overall need for pain medications or narcotics as well as the required amount of narcotics per patient (if administered) were significantly lower with the extraperitoneal approach. Extraprostatic extension was detected in 48.1% vs 41.3% of patients in groups I and II, respectively. Surgical margins were positive in 26.9% in group I vs 41.3% in group II (p=0.13). More than 80% of patients with positive surgical margins had high risk features on final surgical pathology. The 90-day continence rate was similar between the 2 groups (60% vs 62.5%, p=0.82). CONCLUSIONS Extraperitoneal and transperitoneal single port robotic radical prostatectomy are safe and feasible approaches. The extraperitoneal approach is associated with a significantly shorter postoperative hospital stay and decreased need for postoperative narcotics. Randomized trials with adequate sample size and postoperative followup are advisable for further evaluation of the outcomes to clarify patient selection criteria for each approach.
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17
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Ikeda N, Yoshida T, Seki A, Nakamura M, Tanaka T, Ichikawa R, Nakahara J, Orihara K, Kobayashi M, Yamashita R, Shibutani M, Ueda T. Extraskeletal chondrosarcoma in the abdominal cavity of a cow. J Vet Med Sci 2019; 81:1749-1752. [PMID: 31645509 PMCID: PMC6943319 DOI: 10.1292/jvms.19-0203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 11/22/2022] Open
Abstract
A 25-month-old female crossbred cow presented with astasia, emaciation, and stunted growth. Macroscopic examination revealed a large mass in the abdominal cavity, approximately 100 × 30 × 30 cm. Microscopic examination revealed that the mass consisted of multilobular mature and immature cartilaginous matrices with chondrocytic cells, surrounded by spindle to pleomorphic mesenchymal tumor cells. The cartilaginous matrices consisted of hyaline and elastic cartilages, as confirmed with Azan stain, and Victoria Blue and Van Gieson stain. Immunohistochemistry revealed that the chondrocytic and mesenchymal cells both expressed S-100. The tumor was diagnosed as an extraskeletal chondrosarcoma in the abdominal cavity of this cow.
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Affiliation(s)
- Nami Ikeda
- Shibaura Meat Sanitary Inspection Center, Tokyo Metropolitan Government, 2-7-19 Konan, Minato-ku, Tokyo 163-8001, Japan
| | - Toshinori Yoshida
- Laboratory of Veterinary Pathology, Veterinary Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509, Japan
| | - Airi Seki
- Shibaura Meat Sanitary Inspection Center, Tokyo Metropolitan Government, 2-7-19 Konan, Minato-ku, Tokyo 163-8001, Japan
| | - Misato Nakamura
- Laboratory of Veterinary Pathology, Veterinary Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509, Japan
| | - Takaharu Tanaka
- Laboratory of Veterinary Pathology, Veterinary Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509, Japan
| | - Ryo Ichikawa
- Laboratory of Veterinary Pathology, Veterinary Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509, Japan
| | - Junta Nakahara
- Laboratory of Veterinary Pathology, Veterinary Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509, Japan
| | - Kai Orihara
- Laboratory of Veterinary Pathology, Veterinary Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509, Japan
| | - Mio Kobayashi
- Laboratory of Veterinary Pathology, Veterinary Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509, Japan
| | - Risako Yamashita
- Laboratory of Veterinary Pathology, Veterinary Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509, Japan
| | - Makoto Shibutani
- Laboratory of Veterinary Pathology, Veterinary Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509, Japan
| | - Takayuki Ueda
- Shibaura Meat Sanitary Inspection Center, Tokyo Metropolitan Government, 2-7-19 Konan, Minato-ku, Tokyo 163-8001, Japan
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Fernandez LG, Sibaja Alvarez P, Kaplan MJ, Sanchez-Betancourt AA, Matthews MR, Cook A. Application of Negative Pressure Wound Therapy with Instillation and Dwell Time of the Open Abdomen: Initial Experience. Cureus 2019; 11:e5667. [PMID: 31720143 PMCID: PMC6823022 DOI: 10.7759/cureus.5667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Indexed: 12/16/2022] Open
Abstract
Recent therapeutic advances in the management of severe abdominal sepsis (SAS) have improved patient mortality and morbidity. However, SAS and its impact on multiple organ failure remain a serious, life-threatening condition with a high mortality rate. The open abdomen (OA) technique has become an effective alternative to repeat laparotomy. The use of OA negative pressure wound therapy (OA NPWT) has been a significant advancement in the management of the open abdomen. Similarly, negative pressure wound therapy (NPWT) with instillation and dwell time (NPWT-i) has been used in patients with multiple comorbidities, with an American Society of Anesthesiology Classification ≥ 2, severe traumatic wounds, diabetic foot infections, and wounds complicated by invasive infection or extensive biofilm. Controlled instillation of saline during NPWT-i may further enhance healing by facilitating automatic and contained volumetric wound irrigation and cleansing and diluting local levels of inflammatory cytokines, improving the local as well as the systemic response to infection. Although the soft tissue and intra-abdominal compartments differ anatomically, they share very similar biologic responses to infections. Therefore, from a biologic and physiologic aspect, intraperitoneal instillation therapy may play a role as an adjunctive treatment of abdominal compartment inflammation from trauma or infection. The addition of saline solution instillation to OA NPWT (OAI) in a programmed, controlled manner may offer the clinician an effective adjunctive therapy for the treatment of the complex septic abdomen. The technical aspects of instillation into the OA and a pooled multicenter case study cohort utilizing OAI with saline solution, bacitracin, or hypochlorous acid in the management of the septic abdomen is presented.
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Affiliation(s)
- Luis G Fernandez
- Surgery, Trauma Wound Care, University of Texas Health Science Center, Tyler, USA
| | | | | | | | | | - Alan Cook
- Epidemiology and Biostatistics, University of Texas Health Science Center, UT Health East Texas, Tyler, USA
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Yang BL, Chen KC, Wu CC. Preoperative computerized tomography-guided blue dye localization for metastatic lymphadenopathy and peritoneal tumor implants during laparoscopic surgery: Two case reports. Medicine (Baltimore) 2019; 98:e16159. [PMID: 31232973 PMCID: PMC6636921 DOI: 10.1097/md.0000000000016159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Computerized tomography (CT)-guided blue dye localization has been widely discussed for preoperative localization of pulmonary nodules. However, few studies have investigated this technique for intra-abdominal lesions. Although preoperative localization is not commonly required in laparotomy, it may assume importance with advancements in the field of laparoscopic surgery. PATIENT CONCERNS Herein, we report the cases of 2 patients diagnosed with colon cancer who underwent hemicolectomy with extended lymphadenectomy and subsequent chemotherapy. DIAGNOSES Follow-up CT scans showed newly developed metastatic lymphadenopathy and peritoneal tumor implants. INTERVENTIONS Considering the difficulty in identification of and access to the target lesions during laparoscopic surgery, preoperative CT-guided blue dye localization was performed in both cases. OUTCOMES All the target lesions were identified by the dye marker and removed successfully. The pathologic results revealed adenocarcinoma. LESSONS We established the following strategy for preoperative CT-guided dye localization of intra-abdominal lesions:Intra-abdominal lesions that are hard to identify due to their size or morphology, and difficult to approach due to their location or surrounding structures, maybe the candidates for this procedure, especially in cases of laparoscopic surgery.Operators should adjust their localization planning based on the surgery method, cutting path, and location of port sites. The target dye marker should be clearly visible in the presumed intra-operative field of view.A second dye marker should be made to ensure surgical success when the target dye marker is obscured by the surrounding structures in the presumed intra-operative field of view.
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Abstract
RATIONALE Intrauterine device (IUD) is commonly used in China. Its complications include uterine perforation, IUD ectopic migration, etc. However, a migrated IUD rarely leads to renal failure. PATIENT CONCERNS IUD insertion in the patient was followed by unexplained pain in the left renal area, without bladder irritation or dysuresia. DIAGNOSES Hydronephrosis, renal failure, migrated IUD. INTERVENTIONS The patient underwent laparoscopic and retroperitoneoscopic left nephrectomy, partial ureterectomy, and migrated IUD extraction. OUTCOMES No complications were found after 1 year of follow-up. LESSON An IUD should be placed by an experienced doctor. If conditions permit, it is best to perform the procedure under the guidance of ultrasound. The patients should be advised to undergo regular check-ups after the procedure. If necessary, abdominal color Doppler examination should be performed. Importantly, patients with IUD pregnancy must be reviewed.
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Affiliation(s)
- Xueyan Li
- Department of Obstetrics and Gynecology, People's Hospital of Zhengzhou University
| | - Hongran Li
- Department of Obstetrics and gynecology, Henan Provincial People's Hospital
| | - Chunmei Li
- Department of Obstetrics and gynecology, Henan Provincial People's Hospital
| | - Xiaohua Luo
- Department of Plastic surgery, People's Hospital of Zhengzhou University, Zhengzhou
| | - Yan Song
- Department of Obstetrics and gynecology, Xinxiang Medical University, Xinxiang, China
| | - Shanshan Li
- Department of Obstetrics and gynecology, Henan Provincial People's Hospital
| | - Suiyu Luo
- Department of Obstetrics and Gynecology, People's Hospital of Zhengzhou University
| | - Yu Wang
- Department of Obstetrics and Gynecology, People's Hospital of Zhengzhou University
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21
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Yang D, Wei Z, Fu H, Zhang X, Xu J, Hu Z, Cai Q. [Development of Abdominal Vacuum Extractor Characterized by Portability and Constant Negative Pressure Which Applying to Battlefield]. Zhongguo Yi Liao Qi Xie Za Zhi 2018; 42:339-340. [PMID: 30358346 DOI: 10.3969/j.issn.1671-7104.2018.05.008] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There are some problems such as difficulty of pressure control, inconvenience of use and carry, congested easily and dredged hardly in clinical application of vacuum extractor in common use. For solving the above problems, researchers have designed a new portable and pressure stabilized abdominal drainage system which was composed of integral double spherical aspirator and separated double cannula. The new apparatus has achieved good effects in drainage which is suitable for not only rescuing of abdominal trauma and war wound, but also abdominal surgery that manifested as sucking safe and effective, using easily and convenient, that was verified by testing.
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Affiliation(s)
- Dejun Yang
- Department Ⅱ of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003
| | - Ziran Wei
- Department Ⅱ of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003
| | - Hongbing Fu
- Department Ⅱ of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003
| | - Xin Zhang
- Department Ⅱ of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003
| | - Jiapeng Xu
- Department Ⅱ of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003
| | - Zunqi Hu
- Department Ⅱ of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003
| | - Qingping Cai
- Department Ⅱ of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003
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Salakhov EK, Vlasov AP, Bolotskyh VA. [Prognostic criteria of efficacy of programmed laparoscopic sanitation of the abdominal cavity in peritonitis]. Khirurgiia (Mosk) 2017:57-60. [PMID: 29076483 DOI: 10.17116/hirurgia20171057-60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To define prognostic criteria of efficacy of programmed laparoscopic sanitation of the abdominal cavity in peritonitis. MATERIAL AND METHODS There were 32 patients after programmed laparoscopic sanitation of abdominal cavity for peritonitis due to different acute surgical diseases. Subsequently 12 of them required relaparotomy due to poor effectiveness of laparoscopic sanitation. Comprehensive clinical examination and laboratory assessment of some indexes of homeostasis and oxidative status were conducted. RESULTS Prognostic clinical and laboratory criteria of efficacy of laparoscopic abdominal sanitation were suggested after analysis of intraoperative data during primary surgery and laboratory values in the 1st postoperative day. CONCLUSION The offered prognostic criteria allow to define further management of peritonitis patients after primary laparotomy.
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Affiliation(s)
- E K Salakhov
- Ogarev Mordovian State University, Saransk, Russia; Mendeleevsk Central State Hospital, Mendeleevsk, Russia
| | - A P Vlasov
- Ogarev Mordovian State University, Saransk, Russia
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23
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Nomura T, Sakakibara S, Moriwaki A, Kawamoto T, Suzuki S, Ishimura T, Hashikawa K, Terashi H. Low-Grade Myxofibrosarcoma of the Rectus Abdominus Muscle Infiltrating into Abdominal Cavity: A Case Report. Eplasty 2017; 17:e6. [PMID: 28293331 PMCID: PMC5329937] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Objective: Myxofibrosarcoma (MFS) is a relatively rare tumor that is histologically characterized by myxoid stroma and spindle cell proliferation. This tumor most commonly arises as a slow growing, enlarging painless mass in the extremities of elderly patients. Methods: We report a case of a primary, low-grade MFS in the rectus abdominis muscle infiltrating the abdominal cavity of a 75-year-old man. Results: The patient underwent a wide excision of the right abdominal wall mass with a 3-cm surgical margin from the scar due to a biopsy. The tumor infiltrated the urinary bladder, peritoneum, and external iliac vessels. Twenty-six months after the initial operation, he had recurrences in his abdominal wall, urinary bladder, and right iliac vessels. Conclusions: To our knowledge, primary MFS of the muscle in the abdomen has not been documented previously. Although this case was histopathologically classified as a low-grade tumor, it infiltrated the abdominal cavity. The tumor is suspected to have penetrated the abdominal cavity below the linea arcuata, which lacks the posterior sheath of the rectus abdominis muscle; from there, it could easily spread without being blocked by any biological barriers.
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Affiliation(s)
- Tadashi Nomura
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Shunsuke Sakakibara
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Aya Moriwaki
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Teruya Kawamoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Satoshi Suzuki
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Takeshi Ishimura
- Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Kazunobu Hashikawa
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Hiroto Terashi
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Nadimi ES, Blanes-Vidal V, Harslund JLF, Ramezani MH, Kjeldsen J, Johansen PM, Thiel D, Tarokh V. In vivo and in situ measurement and modelling of intra-body effective complex permittivity. Healthc Technol Lett 2015; 2:135-40. [PMID: 26713157 DOI: 10.1049/htl.2015.0024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 05/14/2015] [Revised: 06/26/2015] [Accepted: 07/01/2015] [Indexed: 11/19/2022] Open
Abstract
Radio frequency tracking of medical micro-robots in minimally invasive medicine is usually investigated upon the assumption that the human body is a homogeneous propagation medium. In this Letter, the authors conducted various trial programs to measure and model the effective complex permittivity ε in terms of refraction ε', absorption ε″ and their variations in gastrointestinal (GI) tract organs (i.e. oesophagus, stomach, small intestine and large intestine) and the porcine abdominal wall under in vivo and in situ conditions. They further investigated the effects of irregular and unsynchronised contractions and simulated peristaltic movements of the GI tract organs inside the abdominal cavity and in the presence of the abdominal wall on the measurements and variations of ε' and ε''. They advanced the previous models of effective complex permittivity of a multilayer inhomogeneous medium, by estimating an analytical model that accounts for reflections between the layers and calculates the attenuation that the wave encounters as it traverses the GI tract and the abdominal wall. They observed that deviation from the specified nominal layer thicknesses due to non-geometric boundaries of GI tract morphometric variables has an impact on the performance of the authors' model. Therefore, they derived statistical-based models for ε' and ε'' using their experimental measurements.
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Affiliation(s)
- Esmaeil S Nadimi
- Applied Statistical Signal Processing Group (πSeG), Faculty of Engineering , Maersk Mc-Kinney Moller Institute, University of Southern Denmark , Denmark
| | - Victoria Blanes-Vidal
- Department of Chemical Engineering, Biotechnology and Environmental Technology , University of Southern Denmark , Denmark
| | - Jakob L F Harslund
- Biomedical Laboratory , Institute of Molecular Medicine, Odense University Hospital , Denmark
| | - Mohammad H Ramezani
- Applied Statistical Signal Processing Group (πSeG), Faculty of Engineering , Maersk Mc-Kinney Moller Institute, University of Southern Denmark , Denmark
| | - Jens Kjeldsen
- Department for Gastroenterology , Institute of Clinical Research, Odense University Hospital , Denmark
| | | | - David Thiel
- Center for Wireless Monitoring and Applications, School of Engineering , Griffith University , Australia
| | - Vahid Tarokh
- School of Engineering and Applied Sciences , Harvard University , USA
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25
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Abstract
Follicular dendritic cell sarcoma (FDCS) is a rare malignant tumor recognized in recent years. It accounts for only 0.4% of soft-tissue sarcomas, and its underlying causes are largely unknown. A correct diagnosis can be difficult to make. Diagnosis of FDCS depends on the combined clinical examination, histopathologic features, electron microscopic examination and confirmation with immunohistochemical studies. Here, we report two rare cases of FDCS: one case involving multiple bones, and the other involving extensive abdominal and pelvic cavities. Clinical, histopathological, and immunohistochemical aspects, therapeutic options, and a related literature review of the two cases are discussed. As the prevalence of FDCS is increasing, the details of these rare cases may highlight the importance and facilitate treatment of similar diseases.
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Affiliation(s)
- Yuan Ma
- Department of Oncology, Shandong Cancer Hospital & Institute, School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Shandong Province, People's Republic of China
| | - Jujie Sun
- Department of Pathology, Shandong Cancer Hospital & Institute, Jinan, Shandong Province, People's Republic of China
| | - Cuicui Yang
- Department of Oncology, Shandong Cancer Hospital & Institute, School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Shandong Province, People's Republic of China
| | - Dandan Yuan
- Department of Oncology, Shandong Cancer Hospital & Institute, Jinan, Shandong Province, People's Republic of China
| | - Jie Liu
- Department of Oncology, Shandong Cancer Hospital & Institute, Jinan, Shandong Province, People's Republic of China
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26
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Wójcik G, Piskorz J, Bulikowski W. Massive peritoneal cavity calcification in the course of advanced ovarian cancer: a case report. Prz Menopauzalny 2015; 14:149-51. [PMID: 26327904 PMCID: PMC4498033 DOI: 10.5114/pm.2015.52156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 12/28/2014] [Accepted: 04/13/2015] [Indexed: 11/17/2022]
Abstract
Ovarian cancer usually does not give any clinical signs until it reaches a large size. This condition is often associated with the occurrence of metastases within the peritoneal cavity, pelvic and abdominal cavities. Ovarian cancer can spread by intraperitoneal implantation, by way of the lymphatic system, and also through the systemic circulation. Even when the tumor reaches a large size, the symptoms are not specific and may resemble other ailments. Therefore, ovarian cancer is detected in most cases only in the third and fourth level of advancement. Peritoneal calcification occurs in many diseases. The degree of calcium deposits is usually small and does not give clinical symptoms. In the reported case, computed tomography of the abdomen showed numerous scattered peritoneal calcifications of irregular shape as well as massive calcification in the uterus and appendages. In the detection of changes associated with calcification, multidetectory computed tomography shows a very high sensitivity. It makes the precise location and assessment of the extent of changes possible.
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Affiliation(s)
- Gustaw Wójcik
- Department of Diagnostic Imaging, Zofia Zamoyski Tarnowska Provincial Hospital in Tarnobrzeg, Tarnobrzeg, Poland
- Department of Rehabilitation, Physiotherapy and Balneotherapy, Medical University of Lublin, Lublin, Poland
| | - Jolanta Piskorz
- Department of Anesthesiology and Intensive Care, Zofia Zamoyski Tarnowska Provincial Hospital in Tarnobrzeg, Tarnobrzeg, Poland
| | - Włodzimierz Bulikowski
- Department of Rehabilitation, Physiotherapy and Balneotherapy, Medical University of Lublin, Lublin, Poland
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27
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Lee CH, Kim JH, Moon WS, Lee MR. Paragonimiasis in the abdominal cavity and subcutaneous tissue: report of 3 cases. Korean J Parasitol 2012; 50:345-7. [PMID: 23230333 PMCID: PMC3514427 DOI: 10.3347/kjp.2012.50.4.345] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Revised: 08/08/2012] [Accepted: 08/09/2012] [Indexed: 12/11/2022]
Abstract
Paragonimiasis is a parasitic disease caused by the lung fluke, Paragonimus spp. Lung flukes may be found in various organs, such as the brain, peritoneum, subcutaneous tissues, and retroperitoneum, other than the lungs. Abdominal paragonimiasis raises a considerable diagnostic challenge to clinicians, because it is uncommon and may be confused with other abdominopelvic inflammatory diseases, particularly peritoneal tuberculosis, and peritoneal carcinomatosis. Also, subcutaneous paragonimiasis does not easily bring up clinical suspicion, due to its rarity. We herein report 2 cases of abdominal paragonimiasis and 1 case of subcutaneous paragonimiasis in Korea.
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Affiliation(s)
- Chang Ho Lee
- Department of Surgery, Chonbuk National University Medical School, Jeonju 561-180, Korea
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28
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Benoit L, Cheynel N, Ortega-Deballon P, Giacomo GD, Chauffert B, Rat P. Closed hyperthermic intraperitoneal chemotherapy with open abdomen: a novel technique to reduce exposure of the surgical team to chemotherapy drugs. Ann Surg Oncol 2008; 15:542-6. [PMID: 17929098 PMCID: PMC2887654 DOI: 10.1245/s10434-007-9635-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [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: 08/01/2007] [Revised: 08/28/2007] [Accepted: 08/29/2007] [Indexed: 12/15/2022]
Abstract
BACKGROUND Exposure of the surgical team to toxic drugs during hyperthermic intraperitoneal chemotherapy (HIPEC) remains a matter of great concern. During closed-abdomen HIPEC, operating room staff are not exposed to drugs, but the distribution of the heated liquid within the abdomen is not optimal. With open-abdomen HIPEC, the opposite is true. Although the open-abdomen method is potentially more effective, it has not become a standard procedure because of the risk of exposure of members of the team to drugs. METHODS We present a new technique (closed HIPEC with open abdomen) which ensures protection against potentially contaminating exposure to liquids, vapours and aerosols, and allows permanent access to the whole abdominal cavity. Its principle is to extend the abdominal surgical wound upwards with a sort of "glove-box". The cutaneous edges of the laparotomy are stapled to a latex "wall expander". The expander is draped over a special L-section metal frame placed above the abdomen. A transparent cover containing a "hand-access" port, like those used in laparoscopic surgery, is fixed inside the frame. RESULTS In 10 patients, this device proved to be hermetic for both liquids and vapours. Intra-abdominal temperature was maintained between 42 and 43 degrees C during most of the procedure. The whole abdominal cavity was accessible to the surgeon, allowing optimal exposure of all peritoneal surfaces. CONCLUSION This technique allows optimal HIPEC, while limiting the potential toxic effects for the surgical, medical and paramedical teams.
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Affiliation(s)
- Laurent Benoit
- Service de Chirurgie digestive et Cancérologique - Chirurgie viscérale et Urgences
CHU DijonCentre Hospitalier Universitaire du Bocage, 1, Bd. Jeanne d'Arc, 21079 Dijon Cedex,FR
| | - Nicolas Cheynel
- Service de Chirurgie digestive et Cancérologique - Chirurgie viscérale et Urgences
CHU DijonCentre Hospitalier Universitaire du Bocage, 1, Bd. Jeanne d'Arc, 21079 Dijon Cedex,FR
| | - Pablo Ortega-Deballon
- Service de Chirurgie digestive et Cancérologique - Chirurgie viscérale et Urgences
CHU DijonCentre Hospitalier Universitaire du Bocage, 1, Bd. Jeanne d'Arc, 21079 Dijon Cedex,FR
| | - Giovanni Di Giacomo
- Service de Chirurgie digestive et Cancérologique - Chirurgie viscérale et Urgences
CHU DijonCentre Hospitalier Universitaire du Bocage, 1, Bd. Jeanne d'Arc, 21079 Dijon Cedex,FR
| | - Bruno Chauffert
- Service d'Oncologie Médicale
Centre Georges-François LeclercDijon,FR
| | - Patrick Rat
- Service de Chirurgie digestive et Cancérologique - Chirurgie viscérale et Urgences
CHU DijonCentre Hospitalier Universitaire du Bocage, 1, Bd. Jeanne d'Arc, 21079 Dijon Cedex,FR
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