A CASE OF APPENDICEAL CANCER WITH FISTULA FORMATION TO THE SKIN AND ASCENDING COLON

Retained foreign bodies have become very rare in countries where the safety rules in the operating theatre are very rigorous and follow precise guidelines. There are low-income countries where hospital structures are precarious, in which the implementation of surgical safety rules has only been effective recently. Surgical teams in these countries are not yet well trained in the observance of the guidelines concerning swab count, meaning that textilomas are not uncommon. Abdominal textiloma may be asymptomatic, or present serious gastrointestinal complications such as bowel obstruction, perforation, or fistula formation because of misdiagnosis. It may mimic abscess formation in the early stage or soft tissue masses in the chronic stage. This case report presents a 27-year-old female who underwent an emergency laparotomy in a rural surgical centre for an ectopic pregnancy. Two months later, a swelling had appeared on the left side of her abdomen, gradually increasing in size, which was not very painful but caused digestive discomfort and asthenia. Intermittent fever was described and treated with antibiotics. The patient was referred to a better equipped centre to benefit from a CT scan. A textiloma was strongly suspected on the CT but a left colic mass was not excluded. Laparotomy confirmed the diagnosis of textiloma and the postoperative course was uneventful. Prevention rules must be strengthened in these countries where patients can hardly bear the costs of iterative surgeries for complications that are avoidable.

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Treatment of Malignant Esophageal Fistulas: Fluoroscopic Placement of Esophageal SEMS, Endoscopically-assisted through Surgical Gastrostomy. A Case Report

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.252.mlg ◽

2016 ◽

Vol 25 (2) ◽

pp. 249-252 ◽

Cited By ~ 3

Author(s):

Gabriel Constantinescu ◽

Vasile Şandru ◽

Mădălina Ilie ◽

Cristian Nedelcu ◽

Radu Tincu ◽

...

Keyword(s):

Esophageal Carcinoma ◽

Guide Wire ◽

Subsequent Development ◽

Covered Stent ◽

Metallic Stents ◽

Fistula Formation ◽

Life Threatening ◽

Endoscopic Placement ◽

Surgical Gastrostomy ◽

Methods Of Treatment

Progressive esophageal carcinoma can infiltrate the surrounding tissues with subsequent development of a fistula, most commonly between the esophagus and the respiratory tract. The endoscopic placement of covered self-expanding metallic stents (SEMS) is the treatment of choice for malignant esophageal fistulas and should be performed immediately, as a fistula formation represents a potential life-threatening complication. We report the case of a 64-year-old male diagnosed with esophageal carcinoma, who had a 20Fr surgical gastrostomy tube inserted before chemo- and radiotherapy and was referred to our department for complete dysphagia, cough after swallowing and fever. The attempt to insert a SEMS using the classic endoscopic procedure failed. Then, a fully covered stent was inserted, as the 0.035” guide wire was passed through stenosis retrogradely by using an Olympus Exera II GIF-N180 (4.9 mm in diameter endoscope) via surgical gastrostomy, with a good outcome for the patient. The retrograde approach via gastrostomy under endoscopic/fluoroscopic guidance with the placement of a fully covered SEMS proved to be the technique of choice, in a patient with malignant esophageal fistula in whom other methods of treatment were not feasible. Abbreviations: ERCP: endoscopic retrograde cholangio-pancreatography; GI: gastrointestinal; SEMS: self-expandable metallic stents.

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Retroflexion In The Ascending Colon Is A Costless Endoscopic Maneuver Increasing Adenoma Detection Rate

Case Medical Research ◽

10.31525/ct1-nct04086706 ◽

2019 ◽

Author(s):

Keyword(s):

Detection Rate ◽

Adenoma Detection Rate ◽

Ascending Colon ◽

Adenoma Detection

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Neutrophil/lymphocyte Ratio after Flow Citometry Periferic Blood Cell Detection - Predictive Marker of Anastomotic Fistula in Colorectal Cancer Surgery

Revista de Chimie ◽

10.37358/rc.20.6.8195 ◽

2020 ◽

Vol 71 (6) ◽

pp. 295-306

Author(s):

Dumitru Radulescu ◽

Vlad Dumitru Baleanu ◽

Andrei Nicolaescu ◽

Marius Lazar ◽

Marius Bica ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Rectal Surgery ◽

Predictive Marker ◽

Fistula Formation ◽

Cell Detection ◽

Colon And Rectal Surgery ◽

Optimal Value ◽

Anastomotic Fistula ◽

Colorectal Cancer Patients

Anastomotic fistula is a dreadful complication of colon and rectal surgery that can put life into danger, being common after colorectal surgery. The preoperative lymphocyte neutrophil ratio (NLR) is known as a prognostic marker for colorectal cancer patients. The existence of a predictive marker of anastomotic fistula in colorectal cancer patients is not fully undestood, so we proposed to investigate the utility of preoperative NLR as a predictor of anastomotic fistula formation. This study the Neutrophils and lymphocytes were detected from periferic blood using flow citometry. We retrospectively evaluated 161 patients with colorectal cancer, who were treated curatively, in which at least one anastomosis was performed, comparing NLR values between patients who had fistula and those with normal healing, then comparing the group with low NLR, with the group with increased NLR, after finding the optimal value of NLR using the ROC curve.The optimal value of the NLR after establishing the cutoff value was 3.07. Between the low NLR group (n=134) and the high NLR group (n=27), were observed statistically significant differences in fistula (p [0.001) and death (p=0.001). The odds ratio for failure in the group with increased NLR was 10.37, which means that patients with NLR]3.54 have a chance of developing anastomotic fistula greater than 10.37 comparable to patients with lower NLR. We suggest the preoperative use of NLR can be used as a predictive marker of anastomotic fistula than can increase the quality of preoperative preparation and therefore the establishment of the optimal surgical technique that can lead to anastomotic fistula risk decrease.

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Role of the urethral plate characters in the success of tubularized incised plate urethroplasty

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.138956 ◽

2014 ◽

Vol 47 (02) ◽

pp. 221-237 ◽

Cited By ~ 2

Author(s):

Hamdy Aboutaleb

Keyword(s):

Fistula Formation ◽

Success Rates ◽

Flat Plates ◽

Urethral Plate ◽

Tubularized Incised Plate ◽

Plate Shape ◽

Fistula Rate ◽

Universal Applicability ◽

Complications Rate ◽

Plate Width

ABSTRACT Background: Today, tubularized incised plate (TIP) urethroplasty is the most commonly performed operation for distal and mid-penile hypospadias. Reports from different centers worldwide confirm its nearly universal applicability and low complications rate. Aim: Evaluation of the urethral plate characters and its effect on the outcome of TIP urethroplasty. Materials and Methods: Between 2010 and 2013, 100 children with primary distal penile hypospadias underwent TIP urethroplasty. Urethral plates were categorized as flat, cleft, and deeply grooved. Postoperatively, patients were followed-up for evaluation of meatal stenosis, fistula formation, and glandular dehiscence at 1 st , 3 rd and 6 th months. Patients were followed-up for urethral calibration by urethral sound 8 Fr at 3 rd and 6 months follow-up. Data were statistically analysed using Epi info program to correlate between the width, plate shape, and complications. Results: Mean age at surgery was 4.3 years. Patients were followed-up for an average period of 6.4 months. Pre-operative location of the meatus was reported as coronal in 46, subcoronal in 50 and anterior penile in 4 cases. Urethral plate characters were flat in 26 cases, cleft in 52, and deeply grooved in 22. Urethral plate width was >8 mm in 74 cases and <8 mm in 26. Patients with urethral plate <8 mm had a statistically significant higher fistula rate (P = 0.004) and failed 8 Fr calibrations in 26.9% (P = 0.01) compared with the patients with urethral plate >8 mm. In addition, we also founds higher fistula rate and failed 8 Fr calibrations in flat urethral plate. Conclusions: An adequate urethral plate width (>8 mm) is essential for successful TIP repair. Lower success rates with flat plates may need buccal mucosal augmentation to improve the results.

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Nomograms predicting overall survival and cancer-specific survival for patients with appendiceal cancer after surgery

All Life ◽

10.1080/26895293.2021.1926342 ◽

2021 ◽

Vol 14 (1) ◽

pp. 428-440

Author(s):

Yuan Zhou ◽

Dan Wang ◽

Chongshun Liu ◽

Tingyu Yan ◽

Chenglong Li ◽

...

Keyword(s):

Overall Survival ◽

Appendiceal Cancer ◽

Cancer Specific Survival

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Administration of Single-Dose Antibiotic Does Not Decrease Oronasal Fistula Rates After Primary Palatoplasty

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665621992653 ◽

2021 ◽

pp. 105566562199265

Author(s):

Ishwarya Shradha Mamidi ◽

Esperanza Mantilla-Rivas ◽

Brynne A. Ichiuji ◽

Md Sohel Rana ◽

Karen I. Ramirez ◽

...

Keyword(s):

Single Dose ◽

Fistula Formation ◽

Readmission Rates ◽

Oronasal Fistula ◽

Inadequate Sample Size ◽

Perioperative Antibiotics ◽

The Difference ◽

Group 2 ◽

National Databases ◽

Group 1

Objective: Oronasal fistula (ONF) is a known complication after primary palatoplasty (PP). Studies investigating the effect of perioperative antibiotics on fistula rates after PP are limited by inadequate sample size or reliance on self-reporting through national databases. In this study, the authors evaluated the association between single-dose perioperative antibiotics and postoperative fistula rates after PP at a single institution. Design: A retrospective study. Participants: Children younger than 2 years who underwent PP from April 2009 to September 2019 were included. Interventions: Patients were divided into 2 categories: Group 1 received a single intraoperative dose of IV antibiotic, while group 2 did not. Main Outcome Measure(s): Outcome measures included ONF formation, length of stay (LOS), and 30-day readmission rates. Multivariable firth logistic regression, quantile regression, and χ2 tests were performed. Results: Of the 424 patients, 215 and 209 patients were in groups 1 and 2, respectively. The overall ONF rate was 1.9% among all patients. Patients in group 1 experienced an ONF rate of 3.3%, while patients in group 2 had an ONF rate of 0.5%. After correcting for confounding variables, the difference in ONF rates was not statistically different ( P = .68). Median LOS was 35.7 hours and 35.5 hours ( P = .17), while the rate of readmission within 30 days was 4.7% and 2.4% for group 1 and 2, respectively ( P = .96). Conclusions: Administration of a single-dose perioperative antibiotic did not decrease fistula formation after PP, nor did it affect the patient’s LOS or 30-day readmission rate.

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