Percutaneous treatment for symptomatic pancreatic pseudocysts: Long-term results in a single center
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Background This research compares the outcomes of percutaneous technique and open surgical peritoneal dialysis catheter placement in children.In this randomized controlled trial, between 2010 and 2011,a total of 35 pediatric uremic patients were enrolled and randomized into two study groups. Follow up data included duration of operation (minute), duration of hospitalization (days) and onset time of peritoneal dialysis. Complications were considered as mechanical and infectious.The percutaneous procedure was significantly faster than the open surgical technique (9.5 ± 1.81 versus 27.00 ± 2.61 minutes, p= 0.0001). The onset of dialysis was earlier in percutaneous insertion. There were no cases of hollow viscous perforation, early peritonitis and exit site infection at the 3rd, 7th, and 14th day in both groups. Complications in open surgical group were include wrapped omentum in 4 (23.5%), catheter malposition in 3 (17.6%),delayed exit site infection in 2 (11.7%), Incisional hernia in 1 (5.8%)and hemoperitoneum in 2 (11.7%)cases. Complications in percutaneous insertion group were include catheter malposition and wrapped omentum each in one case.Percutaneous method with secure insertion of the catheter reduced the rate of some complications. Although they were not statistically significant, this technique reduces the time of hospitalization and operation without need to general anesthesia. The onset of dialysis was earlier significantly. Trial registry code: IRCT2013091514670N1.
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The role of totally implantable central venous port (TICVP) system is increasing. Implantation performed by radiologist with ultrasound-guided access of vein and fluoroscope-guided positioning of catheter is widely accepted nowadays. In this article, we summarized our experience of TICVP system by surgeon and present the success and complication rate of this surgical method.Between March 2009 and December 2010, 245 ports were implanted in 242 patients by surgeon. These procedures were performed with one small skin incision and subcutaneous puncture of subclavian vein. Patient's profiles, indications of port system, early and delayed complications, and implanted period were evaluated.There were 82 men and 160 women with mean age of 55.74. Port system was implanted on right chest in 203, and left chest in 42 patients. There was no intraoperative complication. Early complications occurred in 11 patients (4.49%) including malposition of catheter tip in 6, malfunction of catheter in 3, and port site infection in 2. Late complication occurred in 12 patients (4.90%).Surgical insertion of TICVP system with percutaneous subclavian venous access is safe procedures with lower complications. Careful insertion of system and skilled management would decrease complication incidence.
Subclavian vein
Port (circuit theory)
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Endovascular aneurysm repair
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Objective:To investigate the the pros and cons of the clinical-commonly used Paracentetic suprapubic cystostomy method of fistula and its points requiring attention. Methods:Paracentetic suprapubic cystostomy was operated in local anesthesia in 44 cases, 16 patients used bladder puncture outfit made of three parts, 19 patients used disposable puncture outfit, 9 patients used percutaneous renal puncture outfit. Then the difference in operation time, cost price and complication were analyzed between cases. Results:All cases’operation were successfully completed. Complications occurred in 15 cases times, with only one case of serious complications. After due treatment all complication cases were cured or improved. The average time of surgery in group with three sets was (10 ±2.3) min, slightly higher than that in one-time group (6 ±1.4) min, but the cost of the former was significantly lower than the latter (P0.05); whereas the average surgery time in group of percutaneous renal surgery was the longest, but the complications were significantly less than the other groups (P0.05). Conclusions: The opration used with bladder puncture outfit made of three parts cost the shortest time and least money, and cause less complication. It is most safe to use the percutaneous renal puncture outfit. And Paracentetic suprapubic cystostomy method is a safe and effective treatment when it accompanied with full preoperative preparation, standardized operation, close postoperative follow-up.
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Objective To investigate the cause, prevention and the treatment of postoperative complication of the placement of percutaneous portcatheter system Methods Retrospective analysis of 18 cases with different postoperative complications of the placement of percutaneous portcatheter system. Results 18 patients developed different postoperative complications, including skin necrosis in 2 cases(discard to use 2 cases), incision infection in 3 cases(discard to use 2 cases), incision split in 3 cases(discard to use 1 case), pipe obstruction in 4 cases(discard to use 1 case), pipe moving in 3 cases, incision hemorrhage in 2 cases, pump inversion in 1 case. After all, 12 cases of complicafions were cured. Conclusions Skin necrosis and incision infection are serious postoperative complication of the placement of percutaneous portcatheter system that lead to discard the percutaneous portcatheter system discard to use.
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Percutaneous insertion of central venous catheter (CVC) is a valuable procedure in managing critically ill patients. However, placement of CVC is not without its complications. The author reports a case in which a CVC was inserted into the right pleural cavity which was not detected by the usual clinical methods of confirming catheter placement and an antero-posterior (A-P) chest x-ray.
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Totally implantable venous devices (TIVDs) are usually utilized for venous access for chemotherapy of cancers. Fracture and migration into the left pulmonary artery of catheter fragment are a potentially severe and rare complication. We present a case of an asymptomatic patient who had this complication. Percutaneous retrieval is now the standard of care. We discuss, through this observation, the usefulness of this technique used an intravascular snare to capture and secure the catheter fragment and we concluded that it is generally advisable to retrieve this foreign body even in asymptomatic patients.
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Central venous catheters (CVCs) are important for maintenance of childhood leukemia treatment but CVCs may develop complications. The aim of this study was to retrospectively evaluate the CVC-related complication rate, complication types, and outcome in children with acute leukemia. Complications developing in 310 CVCs (ports n=250, Hickman catheters n=60) inserted in 262 patients were evaluated. A total of 225,296 catheter days were screened. Median (range) CVC in-dwelling time was 661.5 (1 to 2636) days. In total, 157 complications developed of which 91 (58%) were infectious complications, 35 (22.3%) were vascular, 19 (12.1%) were surgical, and 12 (7.6%) were mechanical. Hickman catheters had a higher complication rate and were more prone to mechanical complications ( P <0.01) but there was no difference for other complications. A lower absolute neutrophil count at insertion was observed in children with infectious complications ( P <0.01). Seventy-eight of 136 catheters (57.3%) had to be removed prematurely. The overall complication rate was 0.65 per 1000 catheter days. In multivariate analysis, relapse leukemia, Hickman catheter and low absolute neutrophil count increased complication risk by 4.00, 1.97, and 1.92 times, respectively. Five (1.9%) deaths occurred because of catheter complications. Safe use of CVCs can be improved by early detection of complications and an experienced catheter care team.
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