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[PMID]: 29524857
[Au] Autor:Hazir B; Haberal HB; Akinci D; Akdogan B
[Ad] Address:Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey. Electronic address: berkhazir@hacettepe.edu.tr.
[Ti] Title:An unusual localization of seven months delayed pelvic lymphocele following radical retropubic prostatectomy: Case report and literature review.
[So] Source:Int J Surg Case Rep;44:181-184, 2018 Mar 06.
[Is] ISSN:2210-2612
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: A pelvic lymphocele is a collection of lymphatic fluid that develops after extensive lymphadenectomies in surgeries such as urological malignancies or renal transplantation. Pelvic lymphoceles may cause complications such as fever, abdominal pain, leg swelling, genital swelling and flank pain. This report summarizes the management of a pelvic lymphocele after open radical retropubic prostatectomy with bilateral lymphadenectomy. PRESENTATION OF CASE: Herein, we present a case in which a pelvic lymphocele developed seven months post-radical open retropubic prostatectomy and through this patient we discussed the lymphocele following radical prostatectomy. The pelvic lymphocele occurred along the sciatic nerve from the sciatica foramen to the intergluteal muscles. The patient was treated with three drainage catheters. This localization is an atypical and unusual for lymphocele after radical retropubic prostatectomy. DISCUSSION: Lymphocele formation that leads to major complications after radical prostatectomy is rare. Lymphocele formation is most commonly seen in the early postoperative period, but it should be considered in patients with fever, abdominal pain or leg swelling during the late postoperative period. Lymphocele formation was the most common cause of hospital readmission after radical prostatectomy. CONCLUSION: Lymphocele formation can be seen in atypical regions and can lead to unexpected complications after radical prostatectomy. Therefore, it should be brought to mind when complaints such as fever and lower extremity swelling occurred in patients underwent extensive lymph node dissection. Surgical treatment options are available, but percutaneous interventions can also be used.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 108004 MEDLINE  
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[PMID]: 29524703
[Au] Autor:Liu JKC
[Ad] Address:Department of Neuro-Oncology, Moffitt Cancer Center. Electronic address: james.liu@moffitt.org.
[Ti] Title:Neurological Deterioration Due to Brain Sag Following Bilateral Craniotomy for Subdural Hematoma Evacuation.
[So] Source:World Neurosurg;, 2018 Mar 07.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Intracranial hypotension from cerebrospinal fluid hypovolemia resulting in cerebral herniation is a rare but known complication that can occur following neurosurgical procedures, usually encountered in correlation with perioperative placement of a lumbar subarachnoid drain. Decrease in CSF volume resulting in loss of buoyancy results in downward herniation of the brain without contributing mass effect, causing a phenomenon known as 'brain sag.' Unreported previously is brain sag occurring without concomitant occult CSF leak or lumbar drainage. CASE DESCRIPTION: This case report describes a patient who underwent bilateral craniotomies for subacute on chronic subdural hematomas with successful decompression, but suffered from an acute neurological deterioration secondary to brain sag. Despite an initial improvement in neurological exam, he subsequently exhibited a progressive neurologic deterioration with evidence of cerebral herniation on neuroimaging, without evidence of continued mass effect on the brain parenchyma. After a diagnosis of 'brain sag' was determined based on imaging criteria, the patient was placed in a flat position which resulted in a rapid improvement in neurological exam without any further intervention. CONCLUSIONS: This case is unique from previous reports of intracranial hypotension following craniotomy in that the symptoms were completely reversed with positioning alone, without any evidence of active or occult CSF drainage. This report emphasizes that the diagnosis of brain sag should be taken into consideration when there is an unknown reason for neurologic decline after craniotomy, particularly bilateral craniotomies, if the imaging indicates herniation with imaging findings consistent with intracranial hypotension, without evidence of overlying mass effect.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  3 / 108004 MEDLINE  
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[PMID]: 29520387
[Au] Autor:Kang HW; Cho KS; Ham WS; Kang DH; Jung HD; Kwon JK; Choi YD; Lee JY
[Ad] Address:Department of Urology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
[Ti] Title:Predictive factors and treatment outcomes of Steinstrasse following shock wave lithotripsy for ureteral calculi: A Bayesian regression model analysis.
[So] Source:Investig Clin Urol;59(2):112-118, 2018 Mar.
[Is] ISSN:2466-054X
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Purpose: This study aims to assess the predictive factors and treatment outcomes of Steinstrasse formation following shock wave lithotripsy (SWL) for ureter stone. Materials and Methods: The medical records of 1,418 ureter stone patients who underwent one-session SWL from November 2005 to May 2013 at our medical institute were retrospectively reviewed. Finally, 551 patients met inclusion criteria. Maximal length and location of stone, stone attenuation (Hounsfield units), and skin-to-stone distance (SSD) were determined on pretreatment non-contrast computed tomography. Results: Of 551 patients, 12 patients (2.2% of total cohort) developed Steinstrasse after one-session SWL. The Steinstrasse incidence was significantly associated with stone size, stone attenuation value, and SSD. Prophylactic ureter stenting was not a statistically significant predictor of Steinstrasse formation. After propensity-score matching, Steinstrasse group showed a significant shorter SSD compare to non-Steinstrasse group. Multivariate logistic regression and Bayesian analysis revealed that stone size, stone attenuation and SSD were significant predictor of Steinstrasse formation following SWL for ureter stone. The Steinstrasse resolved spontaneously in six patients and remaining six patients were treated by additional SWL. None of patients with Steinstrasse required ureteral stenting, percutaneous drainage, or consequent surgical intervention. Conclusions: Steinstrasse formation following SWL for ureter stone was rare event but nonnegligible. Large stone size, high stone attenuation and short SSD were significant predictors of Steinstrasse formation following SWL for ureter stone. Majority of patients with Steinstrasse formation could be treated conservatively in this clinical scenario.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.4111/icu.2018.59.2.112

  4 / 108004 MEDLINE  
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[PMID]: 29520383
[Au] Autor:Sivaraman A; Benfante N; Touijer K; Coleman J; Scardino P; Laudone V; Eastham J
[Ad] Address:Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, NY, USA.
[Ti] Title:Can pelvic node dissection at radical prostatectomy influence the nodal recurrence at salvage lymphadenectomy for prostate cancer?
[So] Source:Investig Clin Urol;59(2):83-90, 2018 Mar.
[Is] ISSN:2466-054X
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Purpose: To verify the quality of pelvic lymph node dissection (PLND) performed at radical prostatectomy (RP) and its impact on nodal recurrence in patients undergoing salvage lymph node dissection (sLND). Materials and Methods: Retrospective review of 48 patients who underwent sLND for presumed nodal recurrence, to describe the PLND characteristics at RP and correlate the anatomical sites and number of suspicious nodes reported in radiological imaging and final pathology of sLND. Results: Overall, at RP, 8 (16.7%) did not undergo PLND, 32 (66.7%) and 8 (16.7%) received a "limited" (between external iliac vein and obturator nerve) and an "extended" (external iliac, hypogastric, and obturator) dissection, respectively. Median nodes removed during limited and extended dissection were 2 and 24, respectively. At sLND, the mean age was 61.3 years and median prostate specific antigen (PSA) was 1.07 ng/mL. Median nodes removed at sLND were 17 with a median of 2 positive nodes. Recurrent nodes were identified within the template of an extended PLND in 62.5%, 50.0% and 12.5% patients, respectively, following prior no, limited and extended dissection at RP. Recurrence outside the expected lymphatic drainage pathway was noted in 37.5% patients with prior extended dissection at RP. There was a correlation between imaging and pathology specimen in 83% for node location and 58.3% for number of anatomical sites involved. Conclusions: In prostate cancer patients undergoing sLND, most had inadequate PLND at the original RP. Pattern of nodal recurrence may be influenced by the prior dissection and pre sLND imaging appears to underestimate the nodal recurrence.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.4111/icu.2018.59.2.83

  5 / 108004 MEDLINE  
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[PMID]: 29520180
[Au] Autor:Gwon DI; Ko GY; Kim JW; Ko HK; Yoon HK; Sung KB
[Ad] Address:Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.
[Ti] Title:Double-Stent System with Long Duodenal Extension for Palliative Treatment of Malignant Extrahepatic Biliary Obstructions: A Prospective Study.
[So] Source:Korean J Radiol;19(2):230-236, 2018 Mar-Apr.
[Is] ISSN:2005-8330
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Objective: To investigate the technical safety and clinical efficacy of a double-stent system with long duodenal extension in patients with malignant extrahepatic biliary obstruction. Materials and Methods: This prospective study enrolled 48 consecutive patients (31 men, 17 women; mean age, 61 years; age range, 31-77 years) with malignant extrahepatic biliary obstructions from May 2013 to December 2015. All patients were treated with a double-stent system with long duodenal covered extension (16 cm or 21 cm). Results: The stents were successfully placed in all 48 patients. There were five (10.4%) procedure-related complications. Minor complications were self-limiting hemobilia (n = 2). Major complications included acute pancreatitis (n = 1) and acute cholecystitis (n = 2). Successful internal drainage was achieved in 42 (87.5%) patients. Median patient survival and stent patency times were 92 days (95% confidence interval [CI], 61-123 days) and 83 days (95% CI, 46-120 days), respectively. Ten (23.8%) of the 42 patients presented with stent occlusion due to food impaction with biliary sludge, and required repeat intervention. Stent occlusion was more frequent in metastatic gastric cancer patients with pervious gastrectomy, but did not reach statistical significance ( = 0.069). Conclusion: Percutaneous placement of a double-stent system with long duodenal extension is feasible and safe. However, this stent system does not completely prevent stent occlusion caused by food reflux.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.3348/kjr.2018.19.2.230

  6 / 108004 MEDLINE  
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[PMID]: 29462737
[Au] Autor:Ma T; Bai X; Chen W; Li G; Lao M; Liang T
[Ad] Address:Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Provincial Key Laboratory of Pancreatic Disease, 88 Jiefang Road, Hangzhou 310009, China.
[Ti] Title:Pancreas-preserving management of grade-C pancreatic fistula and a novel bridging technique for repeat pancreaticojejunostomy: An observational study.
[So] Source:Int J Surg;52:243-247, 2018 Feb 17.
[Is] ISSN:1743-9159
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:PURPOSE: Optimal surgical strategy for grade-C postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is not justified. External wirsungostomy is feasible. However, the subsequent repeat pancreaticojejunostomy (PJ) is challenging. This study aims to introduce our experience of external wirsungostomy for grade-C POPF and a novel technique to do the repeat PJ (re-PJ). MATERIALS AND METHODS: From January 1, 2012 to December 31, 2016, all consecutive patients who underwent pancreaticoduodenectomy (PD) with PJ were identified. The clinical data were retrospectively collected and analyzed. RESULTS: Out of 325 patients, 11 patients (3.38%) underwent salvage re-laparotomy for grade-C POPF. External wirsungostomy was performed in 10 patients (3.08%). Four patients died of severe complications within 90 days postoperatively or tumor progression before the scheduled re-PJ was performed. Three patients got their external pancreatic drainage tube pulled out accidentally without causing severe consequences. Three patients underwent planned re-PJ after external wirsungostomy, including one with duct-to-mucosa PJ and two with the novel bridging technique. The operative times of the two patients undergoing the novel bridging technique were 120 min, 135 min, respectively, and the length of post-operative hospital stay (LPHS) were 7 d, 5 d, respectively. The operative time and the LPHS of whom underwent duct-to-mucosa PJ were 315 min, 24 d, respectively. There was no major post-operative complication. CONCLUSION: External wirsungostomy may be a safe way to preserve the pancreas remnant in grade-C POPF patients. The novel bridging technique may be a simpler alternative to traditional PJ.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  7 / 108004 MEDLINE  
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[PMID]: 29455048
[Au] Autor:Ban MJ; Jung JY; Kim JW; Park KN; Lee SW; Koh YW; Park JH
[Ad] Address:Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea; Department of Medicine, Graduate School, Yonsei University, Seoul, Republic of Korea.
[Ti] Title:A clinical prediction score to determine surgical drainage of deep neck infection: A retrospective case-control study.
[So] Source:Int J Surg;52:131-135, 2018 Feb 15.
[Is] ISSN:1743-9159
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The objective of this retrospective study was to identify predictors of an abscess guaranteed to be surgically drained successfully in patients with deep neck infection (DNI). MATERIALS AND METHODS: We divided 97 consecutive patients with DNI into a drained group and a non-drained group. We then developed a clinical prediction score and validated it in 32 further patients. RESULTS: Significant predictors of successful surgical drainage (i.e., positive for pus) were rim enhancement on computed tomography, C-reactive protein, erythrocyte sedimentation rate, and the neutrophil to lymphocyte ratio. The estimated cut-off values (excluding rim enhancement, which is a yes/no parameter) were 41.25, 56.5, and 8.02, respectively, and the clinical prediction score for each of the four other factors was determined to be 2, 2, 3, and 3 points, respectively. The cut-off score for the sum of these points was 6.5 and the scoring system had an accuracy of 87.5% in the validation group. CONCLUSION: Our clinical prediction scoring system can predict whether drainage is successful in patients with DNI.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  8 / 108004 MEDLINE  
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[PMID]: 29273999
[Au] Autor:Hofker TO; Kaijser MA; Nieuwenhuijs VB; Lange JFM; Hofker HS
[Ad] Address:Department of Surgery, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
[Ti] Title:Distal Duodenogastrostomy or Proximal Jejunogastrostomy in the Management of Ultra-Short Bowel.
[So] Source:J Gastrointest Surg;22(3):538-543, 2018 Mar.
[Is] ISSN:1873-4626
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Inflammatory bowel disease, vascular disease, volvulus, adhesions, or abdominal trauma may necessitate extensive small-bowel resection resulting in an ultra-short distal duodenal or jejunal stump. If this distal duodenal or short jejunal stump is too short for stoma creation and bowel continuity restoration is hazardous or not possible at all, a distal duodenogastrostomy or proximal jejunogastrostomy in combination with drainage of the stomach is an option to prevent stump leakage. Although successful, this distal duodenogastrostomy has been described only in very few patients and in older records. We reintroduced this technique and describe a recent series of patients that confirms its usefulness in certain conditions. The technique of the distal duodenogastrostomy or proximal jejunogastrostomy with gastric drainage was used for the management of the difficult distal duodenum stump in five critically ill patients undergoing extensive bowel resection. Four patients with small-bowel ischemia and one patient suffering from perforating Crohn's disease and small-bowel volvulus were treated successfully. The gastrostomies were subsequently converted to a duodenotransversostomy (in two patients) or the patients underwent small-bowel transplantation (two patients). One patient still has a jejunogastrostomy just after the duodenal-jejunal transition. In all five patients, the distal duodenogastrostomy or proximal jejunogastrostomy in combination with gastric drainage functioned well up to restoration of bowel continuity. In one patient, distal duodenogastrostomy and transabdominal gastric drainage functioned well for 5years. No anastomotic leakage occurred. This procedure provides a feasible solution for an ultra-short bowel at emergency laparotomy. It enhances the surgical armamentarium and provides treatment options for these patients that were perhaps previously deemed unsalvageable.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.1007/s11605-017-3654-0

  9 / 108004 MEDLINE  
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[PMID]: 29524185
[Au] Autor:Donatelli G; Guerriero L; Cereatti F; Arapis K; Dammaro C; Dumont JL; Fuks D; Perretta S
[Ad] Address:Unit d'Endoscopie Interventionnelle, Ramsay Gnrale de Sant, Hpital Priv des Peupliers, 8 Place de l'Abb G. Hnocque, 75013, Paris, France. donatelligianfranco@gmail.com.
[Ti] Title:Endoscopic Fistula-jejunostomy for Chronic Gastro-jejunal Fistula After Sleeve Gastrectomy.
[So] Source:Obes Surg;, 2018 Mar 09.
[Is] ISSN:1708-0428
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Proximal gastric leak is one of the most common complications after laparoscopic sleeve gastrectomy (LSG). Endoscopy is the gold standard treatment for acute staple-line leaks. Surgery is the most effective treatment modality in case of chronic fistula. MATERIAL AND METHODS: A 55-year- old man presented an acute leak after LSG. The leak was treated with metal stent deployment with temporary closure. After 6months, he presented leak recurrence with general sepsis, perigastric-infected collection, and gastro-jejunal fistula. RESULTS: Endoscopic internal drainage (EID) was performed; however, due to fistula persistence, a surgical procedure was proposed. The patient refused revisional surgery; therefore, endoscopic salvage procedure was decided. A fully covered metal stent was deployed in order to bypass the perigastric collection creating an endoscopic gastro-jejunal anastomosis. CONCLUSION: Revisional surgery is the gold standard treatment for chronic fistula after SG. Endoscopic treatment with SEMS deployment may be a sound option in selected cases especially after failure of other endoscopic techniques or refusal of revisional surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1007/s11695-018-3193-0

  10 / 108004 MEDLINE  
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[PMID]: 29523464
[Au] Autor:Ben Saad S; Melki B; Douik El Gharbi L; Soraya F; Chaouch N; Aouina H; Cherif J; Hamzaoui A; Merghli A; Daghfous H; Tritar F
[Ad] Address:Service de pneumologie C, hpital Abderrahmne Mami, Tunis, Tunisie; Universit el Manar, Tunis, Tunisie. Electronic address: soumayalabizertine@yahoo.fr.
[Ti] Title:Pneumothorax tuberculeux: prise en charge diagnostique et thrapeutique. [Tuberculous pneumothorax: Diagnosis and treatment].
[So] Source:Rev Pneumol Clin;, 2018 Mar 06.
[Is] ISSN:0761-8417
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:BACKGROUND: Pneumothorax is a serious complication of cavitary pulmonary tuberculosis. The aim of this study was to describe clinical futures, to highlight challenges of its management. METHODS: A retrospective multicentric and descriptive study including 65patients treated for PT (1999-2015) was conducted to figure out clinical futures and its work-up. RESULTS: The mean age was 37.8years. The sex ratio was 3.6. Smoking history and incarceration were noted respectively in 67.6 and 15.3% of cases. Acute respiratory failure and cachexia were reported in 26.1 and 10.7% of cases. The PT was inaugural in 41.5% of cases. Pyo-pneumothorax was noted in 69.2% of cases. The duration of antituberculous treatment ranged from 6 to 15months for susceptible TB and was at least 12months for resistant TB (4cases). Thoracic drainage was performed in 90.7% patients. Its average length was 47days. The drain drop was noted in 20% of cases. Bronchopleural fistula was diagnosed in 6cases and pleural infection in 5 of cases. Surgery treatment was necessary in 6cases. Mean time to surgery was 171days. Six patients had pleural decortication associated with pulmonary resection in 4cases. Persistent chronic PT was noted in 12.6% and chronic respiratory failure in 3% of cases and death in 15.3% of cases. CONCLUSION: The diagnosis of the PT is often easy. Its treatment encounters multiples difficulties. Duration of thoracic drainage and anti-TB treatment are usually long. Surgery is proposed lately.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher


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