Case report: the first case of laparoscopic ureteric re-implantation in a solitary urinary system
2014
s / International Journal of Surgery 12 (2014) S13eS117 S21 patients can exhibit thoracic pathologies, which require surgical intervention. We evaluated the outcomes and complications of these thoracic procedures. Methods: Retrospective analysis of clinical variables for consecutive patients undergoing ECMO treatment during a 4 year period. Results: 70 patients underwent ECMO with an age range of 18-74 (median 54 years). 54.6% had at least one complication relating to ECMO.11 patients (15.7%) required thoracic surgical intervention whilst on ECMO, their duration of ECMO ranging 2-28 days (median 16 days). The mean ICU stay was 41.4 days (range 13-61 days). A total of 10 isolated intercostal chestdrains were inserted, with a bleeding rate of 10% (significant haemothorax). Three patients underwent thoracotomy/VATs for evacuation of empyema/haemothorax. Two of these 3 patients (66.7%) developed significant bleeding requiring re-exploration/ packing, however none died. In-hospital mortality in the 11 patients was 27.3%, similar to the total ECMO group (p1⁄40.28). Conclusions: A small but significant proportion of ECMO patients require thoracic surgical intervention, which carries the risk of major bleeding, especially with interventions such as thoracotomy/ VATs. However, in-hospital mortality rates are acceptable for this high-risk patient population, and are not related to thoracic surgical intervention.
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