World journal of surgery
-
World journal of surgery · Dec 2003
Early escharotomy as a measure to reduce intraabdominal hypertension in full-thickness burns of the thoracic and abdominal area.
Intraabdominal hypertension (IAH) can occur in critically ill patients who have undergone surgery, who have required fluid resuscitation after intraabdominal operations, or whose abdominal surgical wound closure was under tension. If IAH remains unrelieved, it can lead to development of the abdominal compartment syndrome (ACS). The latter presents with severe cardiorespiratory and urinary symptoms such as hypotension, hypoventilation, and oliguria, and it can become fatal if it is not diagnosed early and treated properly. ⋯ These results were indicative of significant relief of the elevated intraabdominal pressure in all patients after escharotomy, as well as the efficacy of the procedure. It is thus demonstrated that full-thickness burns of the thoracic and abdominal areas can cause a significant early increase in intraabdominal pressure that, if left untreated, can lead to the development of ACS. However, the application of simple decompression techniques can offer remarkable, immediate, and often lifesaving results and is absolutely indicated for this reason, as well as for its well-known beneficial effects on respiratory function.
-
World journal of surgery · Dec 2003
Comparative StudySubareolar subcutaneous injection of blue dye versus peritumoral injection of technetium-labeled human albumin to identify sentinel lymph nodes in breast cancer patients.
Lymphatic mapping in breast cancer patients is a widely used technique for axillary staging, though the optimal technique is not yet established. The purpose of this study was to show that subareolar and subcutaneous injection of blue dye drains to the same sentinel lymph node (SLN) in the axillary basin as does peritumoral injection of technetium (Tc)-labeled albumin. Two injection methods were compared in 154 consecutive patients with newly diagnosed pT1 or pT2 breast cancers (tumor size 5-45 mm). ⋯ Our results support the hypothesis that the lymphatic drainage of the breast parenchyma and the subareolar plexus leads to the same sentinel lymph node. It is a rapid, reliable method for identifying SLNs in breast cancer patients. It is easy to perform, especially in nonpalpable tumors, and it does not disturb surgery by discoloring peritumoral tissue.