PURPOSE: Perianal sepsis is traditionally treated by incision and drainage, wi th packing of the residual cavity until healing. This study was designed to show that perianal abscess may be safely treated by incision a...PURPOSE: Perianal sepsis is traditionally treated by incision and drainage, wi th packing of the residual cavity until healing. This study was designed to show that perianal abscess may be safely treated by incision and drainage alone. MET HODS: Healing times, analgesic requirements, pain scores, abscess recurrence, an d fistula rates were compared between two randomized groups treated with and wit hout packing of perianal abscess cavities. RESULTS: Fifty patients were recruite d (7 lost to follow-up): 20 in the packing and 23 in the nonpacking arm. The gr oups were comparable in terms of age and gender distribution, type and size of a bscess, and the presence of a fistula at operation. Mean healing times were simi lar (P = 0.214). The rate of abscess recurrence was similar (P = 0.61). Postoper ative fistula rates were similar (P = 0.38). Pain scores at the first dressing c hange were similar (P = 0.296). Although pain scores appeared much reduced in th e nonpacking arm, this did not attain statistical significance. CONCLUSIONS: Our pilot study indicates that perianal abscesses can be managed safely without con tinued packing of the cavity without any obvious complications.展开更多
Fistula between digestive tract and airway is one of the complications after esophagectomy with lymph node dissection. A case of esophagotracheal fistula secondary to esophagitis 9 years after esophagectomy and gastri...Fistula between digestive tract and airway is one of the complications after esophagectomy with lymph node dissection. A case of esophagotracheal fistula secondary to esophagitis 9 years after esophagectomy and gastric pull-up for treatment of esophageal carcinoma is described. It was successfully treated with transposition of a pedicled pectoralis major muscle flap.展开更多
Percutaneous radiofrequency thermal ablation （RFA） is an effective and safe therapeutic modality in the management of liver malignancies, performed with ultrasound guidance. Potential complications of RFA include li...Percutaneous radiofrequency thermal ablation （RFA） is an effective and safe therapeutic modality in the management of liver malignancies, performed with ultrasound guidance. Potential complications of RFA include liver abscess, ascites, pleural effusion, skin burn, hypoxemia, pneumothorax, subcapsular hematoma, hemoperitoneum, liver failure, tumour seeding, biliary lesions. Here we describe for the first time a case of biliary gastric fistula occurred in a 66-year old man with a Child＇s class A alcoholic liver cirrhosis as a complication of RFA of a large hepatocellular carcinoma lesion in the nl segment. In the light of this case, RFA with injection of saline between the liver and adjacent gastrointestinal tract, as well as laparoscopic RFA, ethanol injection （PEI）, or other techniques such as chemoembolization, appear to be more indicated than percutaneous RFA for large lesions close to the gastrointestinal tract.展开更多
文摘PURPOSE: Perianal sepsis is traditionally treated by incision and drainage, wi th packing of the residual cavity until healing. This study was designed to show that perianal abscess may be safely treated by incision and drainage alone. MET HODS: Healing times, analgesic requirements, pain scores, abscess recurrence, an d fistula rates were compared between two randomized groups treated with and wit hout packing of perianal abscess cavities. RESULTS: Fifty patients were recruite d (7 lost to follow-up): 20 in the packing and 23 in the nonpacking arm. The gr oups were comparable in terms of age and gender distribution, type and size of a bscess, and the presence of a fistula at operation. Mean healing times were simi lar (P = 0.214). The rate of abscess recurrence was similar (P = 0.61). Postoper ative fistula rates were similar (P = 0.38). Pain scores at the first dressing c hange were similar (P = 0.296). Although pain scores appeared much reduced in th e nonpacking arm, this did not attain statistical significance. CONCLUSIONS: Our pilot study indicates that perianal abscesses can be managed safely without con tinued packing of the cavity without any obvious complications.
文摘Fistula between digestive tract and airway is one of the complications after esophagectomy with lymph node dissection. A case of esophagotracheal fistula secondary to esophagitis 9 years after esophagectomy and gastric pull-up for treatment of esophageal carcinoma is described. It was successfully treated with transposition of a pedicled pectoralis major muscle flap.
文摘Percutaneous radiofrequency thermal ablation （RFA） is an effective and safe therapeutic modality in the management of liver malignancies, performed with ultrasound guidance. Potential complications of RFA include liver abscess, ascites, pleural effusion, skin burn, hypoxemia, pneumothorax, subcapsular hematoma, hemoperitoneum, liver failure, tumour seeding, biliary lesions. Here we describe for the first time a case of biliary gastric fistula occurred in a 66-year old man with a Child＇s class A alcoholic liver cirrhosis as a complication of RFA of a large hepatocellular carcinoma lesion in the nl segment. In the light of this case, RFA with injection of saline between the liver and adjacent gastrointestinal tract, as well as laparoscopic RFA, ethanol injection （PEI）, or other techniques such as chemoembolization, appear to be more indicated than percutaneous RFA for large lesions close to the gastrointestinal tract.
