Assuntos
Doenças do Íleo , Febre Tifoide/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Gana/epidemiologia , Humanos , Doenças do Íleo/epidemiologia , Doenças do Íleo/etiologia , Doenças do Íleo/mortalidade , Doenças do Íleo/cirurgia , Incidência , Perfuração Intestinal/epidemiologia , Perfuração Intestinal/etiologia , Perfuração Intestinal/mortalidade , Perfuração Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
OBJECTIVES: To determine the optimum period for passive post-mastectomy drainage in Accra, Ghana, comparing early (day 4) to late (day 10) drain removal. DESIGN: Randomised prospective clinical study. SETTING: Surgical Department, Korle Bu Teaching Hospital, Accra, Ghana SUBJECTS: Patients with breast cancer scheduled for total mastectomy and level 11 axillary clearance. INTERVENTIONS: Patients were randomised to one of the two groups: early (day 4) and late (day 10) passive drainage. MAIN OUTCOME MEASURES: Duration of hospital stay, seroma formation and postoperative wound infection. RESULTS: Forty five patients had 4-day drainage and 42 had 10-day drainage. Late removal of drains (Day 10) was associated with a significantly higher drainage (1123ml) than those with early (4-day) drain removal (571 ml); p=0.0019. Late removal, however, had fewer seromas (28.6% vs. 46.7%; p=0.2), smaller aspirate volumes (435ml vs. 563ml) and fewer number of aspirations (2.1 vs. 3.2). Early removal had a shorter hospital stay of 6.2 (+/-1.52) days compared to 11.07 (+/- 0.76) days for late removal, and a lower wound infection rate (2.2% vs. 9.5%). There was a low incidence of seromas when drainage was <30 ml/day at the time of drain removal. CONCLUSIONS: Post-mastectomy passive drains may be removed when drainage is <30 ml in 24 hours. When there is a persistent large volume of axillary drainage, patients should be counselled about the relative risks of early and late drain removal. For patients who do not find seroma aspiration unacceptable, early (day 4) removal appears preferable to late (day 10) removal of drains.
Assuntos
Drenagem/métodos , Mastectomia , Cuidados Pós-Operatórios , Complicações Pós-Operatórias , Cicatrização , Adulto , Idoso , Líquidos Corporais , Gana , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Risco , Fatores de Risco , Seroma , Fatores de TempoRESUMO
A 74 year old patient presented with retention of urine as a result of an isolated right internal iliac artery aneurysm. The diagnostic difficulty leading to a delayed diagnosis resulted in rupture of the aneurysm. An endoaneurysmorrhaphy of the internal iliac artery was performed and the right common and external iliac arteries were anastomosed end to end. An early diagnosis and prompt therapy is recommended for this rare lesion.