Retrospective review of all gastric cancer surgeries from 2005 to 2009 ( = 2,588) revealed 53 patients (2.0%) who developed anastomotic leakage and were treated conservatively. EN was performed via a nasointestinal tube inserted using a guidewire under X-ray
fluoroscopy. Clinical outcomes and complications following EN were compared with those in patients treated with PN (historical control group). The severity of complications was evaluated according to the Clavien-Dindo classification.
Fifty patients were included in the final this website analysis (three patients died): 29 patients managed by EN and 21 managed by PN. There were no significant differences in clinical outcomes and the frequency of total complications between the two groups; however, there were fewer tube/catheter-related complications in the EN compared with the PN group (1 vs. 7, respectively; < 0.01). There was one epistaxis (3.4%; grade I) in the EN group and seven catheter infections (33.3%; grade II) in the PN group. The risk of grade II or higher complications was greater in the PN than the EN group (11 vs. 4, respectively; < 0.01), with the greatest difference seen in the incidence of catheter infections. On days 7, 10, and 15 after diagnosis of leakage, the white Mdivi1 blood cell count and C-reactive protein levels were higher in the PN than in the EN group. The PN group required prolonged intravenous antibiotic infusion ( < 0.01).
tube insertion with EN can be performed safely for patients with anastomotic leakage. A major advantage of EN is fewer infectious complications. Because EN was not inferior to PN in terms of clinical outcome, we recommended that it is used in patients with anastomotic leakage after gastric cancer surgery.”
“OBJECTIVES: Laser lead extraction is a challenging procedure, especially in patients with old or multiple pacemaker (PM) or implantable cardioverter defibrillator (ICD) leads. The mechanical force is a leading cause of
complications during the extraction procedure. Use of new laser sheaths, which deliver a rate of 80 pulses per second, may probably reduce intraoperative adverse events by reduction of extraction force.
METHODS: selleck chemicals llc Between January 2012 and April 2013, 76 PM and ICD leads were treated in 38 patients using GlideLight 80 Hz laser sheaths. Indications for lead removals were pocket infection (42.1%), septicaemia or endocarditis (23.7%), lead dysfunction (31.6%) and upgrade from PM to ICD (2.6%). Data on procedural success rates, intra-and postoperative outcomes, as well as 30-day mortality were collected into a database and analysed retrospectively.
RESULTS: The mean patient age was 62.0 +/- 17.7 years (range 18-83), and 73.7% were male. The mean time from initial lead implantation was 96.0 +/- 58.3 months (range 24-288). Thirty-seven (48.7%) PM and 39 (51.3%) ICD leads had to be extracted. The mean procedural time was 68.3 +/- 27.3 min (range 35-115).