1.The research advances on patients with lymphorrhea and lymphocele after urological pelvic lymph node dissection
Chinese Journal of Urology 2021;42(3):237-240
Lymphorrhea and lymphocele are the common complications after urological pelvic lymph node dissection, which are difficult to diagnose and treat. Up to now, a few studies of lymphorrhea and lymphocele were reported, and there is no relevant diagnosis and treatment guideline. The pathogenesis, treatment and prevention of lymphorrhea and lymphocele formation after urological pelvic lymphadenectomy were reviewed in this article.The mechanism of occurrence includes leakage and exudation of lymph-vessels. The high risk factors are old age, open surgery and perioperative use of anticoagulants. Most patients can be cured by nutrition management and percutaneous catheter sclerotherapy. Closing lymph-vessels and stumps may paly an important role in prevetion of lymphorrhea and lymphocele.
2.Umbilical vascular catheter rupture: a case report and literature review
Nanhui XIE ; Fangting LI ; Jihua CHEN ; Baoying TAN ; Chenzhou LIU
Chinese Journal of Neonatology 2023;38(5):267-271
Objective:To study the clinical characteristics of neonatal umbilical vascular catheter (UVC) rupture.Methods:A neonate with UVC rupture admitted to Neonatology Department of our hospital was retrospectively reviewed. Literature on this subject were searched in the following databases: Chinese Medical Journal full-text Database, CNKI, Wanfang Database, CQVIP database, PubMed, Web of Science, Embase and Cochrane Library (up until March 15 2022). The causes, treatment and prognosis of neonatal UVC rupture were analyzed.Results:In our case, the UVC was accidentally damaged during the removal of the ligature suture. The UVC was ruptured after a slight force was applied to remove the catheter, resulting in approximately 7 cm of UVC remaining in the body. Trans-umbilical vein intervention was performed and the catheter was successfully removed with a lasso under X-ray guidance. A total of 33 UVC rupture cases were included from 15 articles (no case report in China before). In 16 cases (47.1%), the UVCs were accidentally cut off by knife or scissors when removing the catheter. In 3 cases (8.8%), the UVCs were broken during insertion. The UVC was broken in 1 case (2.9%) during flushing the catheter. The causes of the other 14 cases (41.2%) were unknown. 9 cases (26.5%) had clinical manifestations, including respiratory distress, prominent heart murmur, sepsis and limb ischemia. 20 cases (58.8%) showed no clinical features. No data on the other 5 cases (14.7%). 21 cases (61.8%) received vascular intervention removal, 11 cases (32.4%) received surgical removal, 1 case (2.9%) was removed with tweezers, and 1 case (2.9%) died before UVC was removed. Among the neonates receiving surgical treatment, 1 case died of sepsis on the second day after surgery and 1 case had sequela of limb ischemia. 2 cases had postoperative vasospasm and embolism after vascular intervention with overall good prognosis.Conclusions:The rupture of UVC in neonates is rare and mainly related with knife and scissors injury.