ABSTRACT
We reported the case of a patient presenting a rectal cancer of the upper part with a BMI at 59 which was previously considered as a contraindication to surgery. To perform the operation we had to make as first step of the procedure a panniculectomy. The technique made possible the rectal resection under good conditions, without blood transfusion. The post-operative course was uneventful except a pulmonary embolism controlled with medical treatment. This procedure is feasible in colorectal surgery.
Subject(s)
Colorectal Neoplasms/complications , Colorectal Neoplasms/surgery , Obesity, Morbid/complications , Obesity, Morbid/surgery , Subcutaneous Fat, Abdominal/surgery , Female , Humans , Middle AgedABSTRACT
Because of the lack of specificity of gastrointestinal tract symptoms and of imaging studies findings in one hand, and because of a presumed high risk of complications in the other hand, surgical management of acute abdomen in neutropenic patients remains very controversial. The purpose of the study is to review our experience with management of acute abdomen. The records of 21 neutropenic patients admitted in the intensive care unit for postoperative management or for evaluation and diagnosis of abdominal symptoms were reviewed. Thirteen patients underwent surgery, 8 did not. Peritoneal signs on physical examination were correlated with positive laparotomies, the sensitivity was 71% and the specificity was 50%. Seven of the 13 operated patients survived the surgical procedure (54%); while 37,5% of the non operative group survived. The surgical treatment may be safely carried out in neutropenic patients with an acute abdomen and represent sometimes the only way to assure proper treatment.
Subject(s)
Abdomen, Acute/surgery , Neoplasms/surgery , Neutropenia/surgery , Abdomen, Acute/etiology , Abdomen, Acute/mortality , Adult , Aged , Diagnosis, Differential , Female , Humans , Laparoscopy , Male , Middle Aged , Neoplasms/mortality , Neutropenia/etiology , Neutropenia/mortality , Peritoneal Lavage , Retrospective Studies , Risk Factors , Survival RateABSTRACT
Identification of parathyroid tissue during surgery of the thyroid gland usually reduces the risk of post-operative hypoparathyroidism. The reliability of methylene blue by intravenous infusion as a means of recognizing the parathyroid glands was tested in 59 consecutive patients (including 23 with carcinoma) undergoing thyroid gland surgery. Precise localization of the glands was possible in 87%. The side-effects being mild, the authors suggest that this method should be used systematically in all cases of bilateral thyroid surgery, in cancers of the thyroid glands and in reoperations.