Computer tomography-guided negative pressure drainage treatment of intrathoracic esophagojejunal anastomotic leakage:A case report

BACKGROUND Esophagojejunal anastomotic leakage(EJAL)is a serious and potentially crucial complication of total gastrectomy and represents the major cause of postoperative death,with a mortality rate of up to 50%.However,treatment remains challenging and controversial.We report here the case of a patient whose intrathoracic EJAL was successfully treated with computer tomography(CT)-guided negative pressure drainage treatment.CASE SUMMARY A 69-year-old male patient complained of difficulty swallowing within the last six months.He was diagnosed with esophagogastric junction carcinoma,Siewert II,cT3N0M0 stage II.Total gastrectomy and Roux-en-Y esophagojejunostomy were performed.High fever,left chest pain and dyspnea appeared on postoperative day 5,and EJAL was confirmed by CT,gastroscopy and oral blue-dimethylene tests.Conservative treatment measures were applied immediately,including antibiotics,nasojejunal tubes,and repeated thoracic puncture and drainage under ultrasound guidance.However,without sufficient and effective drainage,the thoracic infection and systemic condition continued to deteriorate.With the cooperation of multiple departments,percutaneous CT-guided drainage(24 Fr 7 mm)in the thoracic cavity was successfully placed near the anastomotic leakage.Because of continuous negative pressure suction,the infection symptoms were effectively controlled and the general situation gradually recovered.Subsequent follow-up examination showed that the patient was in good condition.CONCLUSION Negative pressure drainage via CT may represent an effective minimally invasive approach to treating intrathoracic EJAL.

Choice and management of negative pressure drainage in anterior cervical surgery

BACKGROUND Postoperative unobstructed drainage is an important measure for avoiding hematoma formation and preventing complications from anterior cervical surgery.AIM To discuss the characteristics and key points of clinical management of two types of commonly used negative pressure drainage systems in clinical settings.METHODS Two types of commonly used silica gel negative pressure drainage balls and a type of gastrointestinal decompression apparatus were fully emptied and then injected with different amounts of water and air.Following this,the negative pressure values of the three devices were measured.Meanwhile,we undertook a retrospective analysis of the clinical data of 1328 patients who had been treated with different negative pressure drainage apparatuses during their anterior cervical surgery in our department between January 2007 and January 2018.RESULTS As the amount of injected air or water increased,the negative pressure of the silica gel negative pressure drainage ball decreased rapidly,dropping to zero when 150 mL of water or air was injected.In contrast,the negative pressure of gastrointestinal decompression apparatus decreased slowly,maintaining an ideal value even when 300 mL of water or air was injected.And statistical analysis demonstrated that patients who had been treated with the gastrointestinal decompression apparatus were less likely to develop severe complications than those who had been treated with the silica gel negative pressure drainage ball(P<0.05).CONCLUSION This study showed that the gastrointestinal decompression apparatus has the advantages of large suction capacity,long duration of continuous negative pressure,and good drainage effect,all of which are the favorable factors for the use of this apparatus for negative pressure drainage in anterior cervical surgery.

Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures

BACKGROUND Gustilo III fractures have a high incidence and are difficult to treat.Patients often experience difficulty in wound healing.Negative pressure drainage technology can help shorten wound healing time and has positive value in improving patient prognosis.AIM To explore the clinical value of the negative pressure sealing drainage technique in wound healing of Gustilo IIIB and IIIC open fractures.METHODS Eighty patients with Gustilo IIIB and IIIC open fractures with skin and soft tissue injuries who were treated in the Second People’s Hospital of Dalian from March 2019 to December 2021 were selected as the research subjects.They were divided into a study group(n=40,healed with negative pressure closed drainage)and a control group(n=40,healed with conventional dressing changes)according to the variation in the healing they received.The efficacy of the clinical interventions,the variations in the regression indicators(time to wound healing,time to fracture healing,time to hospitalization),and the conversion and healing of bacterial wounds were compared 1-3 mo after the intervention.RESULTS The total effective rate of patients among the study group was 95.00%(38/40),which was notably higher than 75.00%(30/40)among the control group(P<0.05).The wound healing time,fracture healing time,and hospital stay of the patients in the study group was shorter than the control group(P<0.05).After the intervention,the negative bacterial culture at the wound site rate and wound healing rate of the patients among the study group increased compared to the control group(P<0.05).CONCLUSION Negative pressure sealing and drainage technology has a good therapeutic effect on patients with Gustilo IIIB and IIIC open fracture wounds with skin and soft tissue injury.It can notably enhance the wound healing rate and the negative rate of bacteria on the wound surface and help to speed up the recovery process of patients.

Principle and engineering application of pressure relief gas drainage in low permeability outburst coal seam

With the increase in mining depth, the danger of coal and gas outbursts increases.In order to drain coal gas effectively and to eliminate the risk of coal and gas outbursts, we used a specific number of penetration boreholes for draining of pressure relief gas.Based on the principle of overlying strata movement, deformation and pressure relief, a good effect of gas drainage was obtained.The practice in the Panyi coal mine has shown that, after mining the C11coal seam as the protective layer, the relative expansion deformation value of the protected layer C13 reached 2.63%, The permeability coefficient increased 2880 times, the gas drainage rate of the C13 coal seam increased to more than 60%, the amount of gas was reduced from 13.0 to 5.2 m3/t and the gas pressure declined from 4.4 to 0.4 MPa, which caused the danger the outbursts in the coal seams to be eliminated.The result was that we achieved a safe and highly efficient mining operation of the C13 coal seam.

Predicting air pressure in drainage stack of high-rise building

It is necessary to understand the features of air pressure in a drainage stack of a high-rise building for properly designing and operating a drainage system. This paper presents a mathematical model for predicting the stack performance. A step function is used to describe the effect of the air entrainment caused by the water discharged from branch pipes. An additional source term is introduced to reflect the gas-liquid interphase interaction （GLII） and stack base effect. The drainage stack is divided into upper and base parts. The air pressure in the upper part is predicted by a total variation diminishing （TVD） scheme, while in the base part, it is predicted by a characteristic line method （CLM）. The predicted results are compared with the data measured in a real-scale high- rise test building. It is found that the additional source term in the present model is effective. It intensively influences the air pressure distribution in the stack. The air pressure is also sensitive to the velocity-adjusting parameter （VAP）, the branch pipe air entrainment, and the conditions on the stack bottom.

Gas Drainage Technology in Fully Mechanized Caving Face with Horizontal Sublevel Mining in Steep and Extra-Thick Coal Seam

This paper analyzes the gas source of the horizontally sectioned fully mechanized caving face in the steeply inclined and extra-thick seam of Adaohai Coal Mine, and numerically simulates the stress distribution and pressure relief of the lower section coal after the upper section working face is mined. It theoretically analyzed the reasonable layout of the drainage boreholes, and designed the drainage borehole layout accordingly. In the upper and lower section of the working face, the actual drainage effect of the boreholes was inspected, and the air exhaust gas volume in the working face was statistically analyzed. It was confirmed that the layout of boreholes was reasonable, the gas control effect of working face was greatly improved and fully met the needs of safe mining. The control effect was greatly improved and the need for safe mining was fully met, and thus a gas drainage technology suitable for the coal seam storage conditions and mining technology of the Adaohai Coal Mine was found. That is to say: the gas emission from the working face of the section mining mainly comes from its lower coal body. Pre-draining the lower coal body of the section and depressurizing gas interception and drainage are the key to effectively solve the problem of gas emission from the working face. Drainage boreholes in the working face of the section should be arranged at high and low positions. The high-level boreholes are located about 2 m from the top of the working face, and the high-level boreholes are about 9 m away from the top of the working face. Through the pre drainage of high and low-level boreholes in advance and the interception and pressure relief drainage, the gas control in the horizontal sublevel fully mechanized caving mining face in steep and extra thick coal seam can realize a virtuous cycle.

A New Technique for The Therapy of Complicated Deep Tissue Infection(with 4 Cases)

Objective: The objective of this study was to discuss the effect of double perfusion cannula accompanied with low negative pressure drainage in the treatment of complexity of abdominopelvic and perineal infections. Methods: The technology of the double perfusion cannula accompanied with low negative pressure drainage was used to treat complexity of abdominopelvic and perineal infections. Results: Double perfusion cannula accompanied with low negative pressure drainage can be applied to the treatment of complexity of abdominopelvic and perineal infections. It has an obvious effect on infection control and reduces recovery time. Conclusion: Double perfusion cannula accompanied with low negative pressure drainage has a good effect on complexity of abdominopelvic and perineal infections; it can be used in wider surgical fields to prevent infections.