Distribution of descending necrotizing mediastinitis and efficacy of distribution-specific drainage
| Autor: | Chihiro Furuta, Takashi Akiyama, Rumiko Taguchi, Tetsuya Ogawa, Motoki Yano, Daisuke Inukai, Masayuki Haniuda, Mayuko Kishimoto, Hiroki Okamoto, Hiroki Numanami |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Clinical pathology business.industry Mediastinum Exact distribution medicine.disease Mediastinitis Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis medicine Distribution (pharmacology) Original Article 030212 general & internal medicine Drainage Abscess business Anterior thoracic wall |
| Zdroj: | J Thorac Dis |
| Popis: | Background Descending necrotizing mediastinitis (DNM) resulting from oropharyngeal and cervical abscess is a life-threatening condition. This study attempted to improve our recognition of the extension and distribution of the abscess for ideal thoracic drainage. Methods We performed a retrospective clinical analysis of seven patients who underwent thoracic drainage for DNM with available clinical data. For mapping and classification of the distribution of the abscess, computed tomography and intraoperative findings were utilized. Results To cure patients, cervical drainage and thoracic drainage were performed 14 and 11 times, respectively. The operation time for thoracic drainage and intraoperative blood loss were 141±77 min and 103±103 g, respectively. The mean hospital stay was 66±41 days. All patients are alive without recurrence. We divided the abscess distribution into nine categories including the anterior thoracic wall, according to the computed tomography and intraoperative findings. The rate of abscess descended gradually toward the lower mediastinum. Abscesses were not necessarily continuous, and skipped lesions were occasionally noted. Conclusions We were able to cure all seven patients with DNM. It might be helpful to recognize the exact distribution of the abscess and distribution-specific drainage using a new map and classification of thoracic abscess. |
| Databáze: | OpenAIRE |
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