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脊柱手术中引流管留置患者的长期后遗症

Long-term sequelae of patients with retained drains in spine surgery.

作者信息

Gausden Elizabeth B, Sama Andrew A, Taher Fadi, Pumberger Matthias, Cammisa Frank P, Hughes Alexander P

机构信息

*Weill Cornell Medical College †Spine Surgery Service, Hospital for Special Surgery, New York, NY ‡Centrum fur Muskuloskeletale Chirurgie, Charite, Berlin, Germany.

出版信息

J Spinal Disord Tech. 2015 Feb;28(1):37-9. doi: 10.1097/BSD.0b013e31826983ad.

Abstract

STUDY DESIGN

Case series.

OBJECTIVE

To assess sequelae of retained surgical drains in patients undergoing spine surgery.

SUMMARY OF BACKGROUND DATA

Although a rare event, surgical drains may break either before or during removal attempts. In cases of retained surgical drains, the patient and surgeon are left with a decision of either surgically removing the drain fragment, or leaving it in situ. There is a paucity of literature that pertains to this unusual complication of spine surgery and its effect on long-term outcome.

METHODS

Cases of retained drain fragments that occurred at the spine service of a single institution between January 1, 1990 and December 31, 2008 were identified using the institutional electronic billing system, International Classification of Diseases and Related Health Problems-9 codes, and surgeons' records.

RESULTS

Seven cases of retained drains were identified to have occurred during the study period. Five of the patients underwent a subsequent operation for drain removal without complications, whereas 2 patients elected to leave the drain in situ. At a minimum of 2-year follow-up, neither of the patients in which the drain fragment had been left in situ reported complications or sequelae related to the drain fragment, and radiographic imaging showed no distinct migration of the fragment within the soft tissue.

CONCLUSIONS

The 2 reported cases with a retained drain fragment left in situ support published and anecdotal opinions on retained soft-tissue drains not adversely affecting long-term patient outcome. In cases of asymptomatic patients with retained drains within soft tissue, leaving the fragment in situ is a treatment option that deserves consideration.

摘要

研究设计

病例系列。

目的

评估脊柱手术患者中手术引流管残留的后遗症。

背景资料总结

尽管手术引流管断裂是罕见事件,但在拔除尝试之前或过程中都可能发生。对于引流管残留的情况,患者和外科医生需要决定是通过手术取出引流管碎片,还是将其留在原位。关于脊柱手术这一不寻常并发症及其对长期预后影响的文献较少。

方法

利用机构电子计费系统、国际疾病分类及相关健康问题-9编码以及外科医生记录,确定1990年1月1日至2008年12月31日期间在单一机构脊柱科发生的引流管碎片残留病例。

结果

在研究期间共确定7例引流管残留病例。其中5例患者随后接受了取出引流管的手术,未出现并发症,而2例患者选择将引流管留在原位。至少随访2年时,将引流管碎片留在原位的2例患者均未报告与引流管碎片相关的并发症或后遗症,影像学检查也未显示碎片在软组织内有明显移位。

结论

报告的2例将引流管碎片留在原位的病例支持了已发表的及传闻中的观点,即软组织引流管残留不会对患者长期预后产生不利影响。对于软组织内引流管残留且无症状的患者,将碎片留在原位是一个值得考虑的治疗选择。

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