scholarly journals The role of surgical management of BCG vaccine-induced regional suppurative lymphadenitis in children: a 7 years' experience from one medical center

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chen Liu ◽  
Minxiang Huang ◽  
Fang Liu ◽  
Xiaoliang Xu ◽  
Wenyu Feng ◽  
...  
Keyword(s):  
Lymph Node ◽  
Hospital Stay ◽  
Surgical Management ◽  
Surgical Excision ◽  
Postoperative Hospital Stay ◽  
Bcg Vaccine ◽  
Symptom Duration ◽  
Skin Involvement ◽  
Suppurative Lymphadenitis

Abstract Background The management strategy of Bacille Calmette-Guérin (BCG) vaccine-induced regional suppurative lymphadenitis in children is still controversial and more clinical studies are needed. We therefore present a surgical case series to explore the role of surgical management for this dilemma. Methods From January 2013 to June 2020, data from 65 patients diagnosed with BCG vaccine-induced regional suppurative lymphadenitis were retrospectively reviewed. Clinical characteristics, ultrasonographic findings, surgical procedures, perioperative management, and outcome were analyzed. The association between postoperative seroma and symptom duration, skin involvement, and postoperative hospital stay were compared using Yates's corrected Chi-square test and Student's t-test for statistical analysis. The follow-up period ranged from three to six months. Results Of the 65 cases, the median age at presentation was 3.4 months. All patients were full-term with normal range of birth weight and received a BCG vaccination in the first 24 h of life. All patients underwent surgical excision of the abscess with the involved lymph node(s). Postoperative seroma formation was found in 20 patients and fine needle aspiration was needed. There was no significant association between postoperative seroma formation with symptom duration, skin involvement, and postoperative hospital stay. No oral anti-tubercular agents were given postoperatively. The mean length of postoperative hospital stay was 6.02 ± 1.62 days. Sixty-four cases (98.46%) received only one procedure and recovered. One patient required a second procedure due to postoperative sinus. Conclusions The present study showed that surgical excision of the abscess with involved lymph node(s) is one of the choices for BCG vaccine-induced suppurative lymphadenitis, but special attention should be paid to controlling the surgical indications. Intraoperative meticulous manipulation and postoperative care are crucial to achieve a good outcome.

CORRELATION OF CYTOLOGY WITH THE HISTOPATHOLOGY IN BENIGN AND MALIGNANT LESIONS OF LYMPH NODES

2021 ◽  
pp. 42-45
Author(s):  
Aruna kumari ◽  
Prashanth Gunde ◽  
Manoj Gunde
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Wide Spectrum ◽  
Surgical Excision ◽  
Lymph Node Biopsy ◽  
The Body ◽  
Lymph Node Swelling ◽  
Malignant Lesions ◽  
Palpable Lymph Node

Background & Objectives: Lymph node swellings are one of the commonest clinical presentation of patients and it encompasses a wide spectrum ranging from benign lesions to a malignant lymphoma or a more obnoxious metastatic malignancy. The objective of the study was to study the role of FNAC in the evaluating lymph node swellings of cervical , axillary , supraclavicular in the body and to understand the various cytological patterns of FNAC in correlation with histopathology of lymph node swellings. Methods: Patients referred to the Department of Pathology, CAIMS ,karimnagar from cancer Hospital and its allied branches, for palpable lymph node swelling on whom FNAC procedure was performed were included in the study. FNAC diagnosis of patients was compared with histopathology in cases which underwent surgical excision and its diagnostic accuracy was studied. Results: Out of 280 cases which included in the study, lymph node biopsy was carried out in 150 cases, 4 cases were inconclusive. Most were in 31 to 40 years. Gender wise, there was female preponderance. Cervical group of lymph node were most affected. Benign /non neoplastic lymphadenopathies were diagnosed in 83 cases(55.5%) of cases. Metastatic deposits were diagnosed in 28 cases(18.6%) of cases. Lymphomas contributed to 39 cases(26%). On correlation of FNAC ndings with histopathology. The overall correlation rate was 97.33%. Interpretation & Conclusion: FNAC of lymph nodes is an excellent rst line method to investigate the nature of lesions as it is economical and an easy alternative to open biopsy

scholarly journals Role of Needle Aspiration in Diagnosis and Management of Suppurative Bacille Calmette–Guerin Adenitis: An Institutional Study of 30 Cases

2015 ◽  
Vol 7 (01) ◽  
pp. 021-025 ◽  
Author(s):  
Subrata Pal ◽  
Srabani Chakarabarti ◽  
Jyoti Prakash Phukan ◽  
Sudhanya Biswas ◽  
Anuradha Sinha ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Bacille Calmette Guerin ◽  
Bcg Vaccination ◽  
Suppurative Lymphadenitis

ABSTRACT Context: Regional lymphadenitis is the most common complication of bacille Calmette-Guerin (BCG) vaccination. Most of the BCG lymphadenitis cases are nonsuppurative, but some suppurate and follow abscess formation, rupture, ulceration and cicatrization. Needle aspiration is the rapid, safe and cost-effective method for diagnosis as well as management of suppurative BCG adenitis. Aims: The aims of the present study were to assess the clinical and cytological spectrum of BCG lymphadenitis and to evaluate the role of needle aspiration in the management of suppurative BCG lymphadenitis. Settings and Design: We have approached every cases of ipsilateral axillary lymphadenopathy having history of BCG vaccination. We designed to aspirate the suppurative axillary lymph nodes and follow-up of nonsuppurative cases. Subjects and Methods: 30 cases of BCG adenitis were studied during a period of 2 years. 12 cases of suppurative lymphadenitis were approached by needle aspiration and cytologically evaluated, and all the cases were followed-up for 12 weeks after diagnosis. Anti-tubercular drugs were not applied, and surgical excision was reserved for nonhealing lesions. Statistical Analysis Used: Data tables. Results: Ipsilateral axillary lymph nodes were commonest site and none had constitutional symptoms. Acid-fast bacilli were detected in 11 (91.67%) cases of suppurative BCG lymphadenitis. On follow-up all nonsuppurative adenitis were resolved spontaneously, and 8 suppurative lymphadenitis cases were resolved after 4 weeks of needle aspiration. Four cases needed repeat aspiration among which 3 resolved in 8 weeks, and one needed surgical excision. Conclusions: We recommend needle aspiration as a simple, safe, chief and effective modality, which helps in diagnosis as well as in management of suppurative BCG lymphadenitis.

Surgical Management for the Reduction of Postoperative Hospital Stay following Distal Pancreatectomy

2011 ◽  
Vol 58 (109) ◽  
pp. 1389-1393 ◽  
Author(s):  
Kiyoshi Yoshikawa ◽  
Masaru Konishi ◽  
Shinichiro Takahashi ◽  
Naoto Gotohda ◽  
Yuichiro Kato ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Distal Pancreatectomy ◽  
Surgical Management ◽  
Postoperative Hospital Stay

scholarly journals Surgical Management of Bacille Calmette-Guérin Vaccine-related Regional Lymphadenitis in Infants

2021 ◽  
Author(s):  
Chen Liu ◽  
Minxiang Huang ◽  
Lei Geng ◽  
Guojian Ding ◽  
Xijie Liu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Surgical Excision ◽  
Bcg Vaccine ◽  
Bacille Calmette Guerin ◽  
Regional Lymph Nodes ◽  
Normal Birth ◽  
One Year

Abstract BackgroundThe management of Bacille Calmette-Guérin (BCG) vaccine-related regional lymphadenitis in infants is still controversial. We present the results of surgical treatment for this condition.AimTo report our experience in the surgical management in infants with BCG vaccine-related regional lymphadenitis.ResultsFrom January 2013 to June 2020, 65 patients with BCG vaccine-related regional lymphadenitis were retrospectively reviewed. The patients included 55 boys and ten girls. Median age was 3.35 months (5.83±8.17, IQR 3.35-5.1). The infants were all full-term with normal birth weight and received vaccination in the first 24 h of life. All patients underwent surgical excision of the abscess and involved regional lymph nodes, and tolerated anesthesia and the surgical procedure well. Postoperative seroma occurred in 20 patients (20/65). The effusion was aspirated with a fine needle. Sixty-four patients recovered uneventfully. No anti-tuberculosis drugs were given postoperatively. Postoperative abscess recurred in one case and re-operation was required one year later. Postoperative follow-up of three to 12 months showed that all patients had a good outcome.ConclusionSurgical management of infantile BCG vaccine-related lymphadenitis is safe and effective with a low recurrence rate and few complications. Surgical intervention shortened the treatment period and avoided the use of anti-tuberculosis drugs. Surgeons should follow the natural course of this disease and be cautious in choosing surgical treatment.

scholarly journals The retrospective study of perioperative application of dexamethasone and furosemide for postoperative anti-inflammation in patients undergoing percutaneous nephrolithotomy

2021 ◽  
Author(s):  
Taiguo Qi ◽  
Xia Qi ◽  
Xiude Chen ◽  
Xunbo Jin
Keyword(s):  
Clinical Outcome ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Inflammatory Markers ◽  
Serum Levels ◽  
Postoperative Hospital Stay ◽  
Lower Serum ◽  
Combined Application ◽  
Furosemide Administration ◽  
Anti Inflammation

Abstract Objectives To investigate whether the perioperatively combined application of dexamethasone and furosemide could alleviate the inflammation in patients undergoing percutaneous nephrolithotomy (PCNL). Patients and methods 147 patients undergoing PCNL between November 2018 and October 2019 were enrolled in the study. 77 patients accepted a single dose of dexamethasone and furosemide administration (EXP group, n = 77), and 70 patients did not (CON group, n = 70). Demographic and perioperative data, inflammatory markers including interleukin-6 (IL-6) and procalcitonin (PCT), and clinical outcomes were compared between the two groups. Results Compared with the CON group, the incidence rate of urosepsis of the EXP group were significantly lower (11.69% vs. 24.29%, p = 0.046). 3 patients developed severe urosepsis in the EXP group, while 5 patients developed severe urosepsis in the CON group. Compared with those in the CON group, the patients with postoperative urosepsis in the EXP group showed lower serum levels of IL-6 at postoperative hour two (p = 0.045) and at postoperative day one (p = 0.031) and lower serum levels of PCT at postoperative day one (p = 0.015). There was a better clinical outcome of a shorter postoperative hospital stay (p = 0.015) in patients with postoperative urosepsis in the EXP group than in those in the CON group. Conclusion The perioperatively combined application of dexamethasone and furosemide was beneficial for alleviating postoperative inflammatory reaction and caused a better clinical outcome of a shorter postoperative hospital stay.

Cerebellopontine Angle Epidermoids: Comparative Results of Microscopic and Endoscopic Excision Using the Retromastoid Approach”

2021 ◽  
Author(s):  
Suyash Singh ◽  
Kuntal Kanti Das ◽  
Krishna Kumar ◽  
Kamlesh Rangari ◽  
Priyadarshi Dikshit ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Cranial Nerve ◽  
Cerebellopontine Angle ◽  
Surgical Excision ◽  
Csf Leak ◽  
Tumor Extension ◽  
Endoscopic Excision ◽  
Endoscopic Assistance ◽  
Comparative Results ◽  
Neurovascular Structures

Abstract Background Densely packed neurovascular structures, often times inseparable capsular adhesions and sometimes a multicompartmental tumor extension, make surgical excision of cerebellopontine angle epidermoids (CPEs) a challenging task. A simultaneous or an exclusive endoscopic visualization has added a new dimension to the classical microscopic approaches to these tumors recently. Method Eighty-six patients (age: 31.6 ± 11.7 years, M:F = 1:1) were included. Nineteen patients (22.1%) had a multicompartmental tumor. Tumor extension was classified into five subtypes. Sixty-two patients underwent a pure microscopic approach (72%) out of which 10 patients (16%) underwent an endoscope-assisted surgery (11.6%) and 24 patients (28%) underwent an endoscope-controlled excision. Surgical outcomes were retrospectively analyzed. Results Headache (53.4%), hearing loss (46.5%), and trigeminal neuralgia (41.8%) were the leading symptoms. Interestingly, 21% of the patients had at least one preexisting cranial nerve deficit. Endoscopic assistance helped in removing an unseen tumor lobule in 3 of 10 patients (30%). Pure endoscopic approach significantly reduced the hospital stay from 9.2 to 7.3 days (p = 0.012), and had a statistically insignificant yet a clearly noticeable lesser incidence of subtotal tumor excision (0 vs. 10%, p = 0.18) with comparable cranial nerve deficits but with a higher postoperative cerebrospinal fluid (CSF) leak rate (29% vs. 4.8%, p = 0.004). Conclusion Endoscope assistance in CPE surgery is a useful addition to conventional microscopic retromastoid approach. Pure endoscopic excision in CPE is feasible, associated with a lesser duration of hospital stay, better extent of excision in selected cases, and it has a comparable cranial nerve morbidity profile albeit with a higher rate of CSF leak.

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