Gavrić Lovrec Vida, Cokan Andrej, Lukman Lara, Arko Darja, Takač Iztok
1 Division of Gynecology and Perinatology, University of Maribor Clinical Center, Maribor, Slovenia.
2 Department of Gynecology and Obstetrics, Faculty of Medicine, University of Maribor, Maribor, Slovenia.
J Int Med Res. 2018 Nov;46(11):4775-4780. doi: 10.1177/0300060518788247. Epub 2018 Sep 17.
Although the incidence of retained surgical items (RSIs) is low, it is nevertheless an important preventable cause of patient injury that can ultimately lead to the patient's death and to subsequent high medical and legal costs. Unintentional RSI is the cause of 70% of re-interventions, with a morbidity of 80% and mortality of 35%. The most common RSIs are sponges or gauze (gossypiboma or textiloma), while retained surgical instruments and needles are rare. Perioperative counting of equipment and materials is the most common method of screening for RSIs, while a diagnosis can later be confirmed by the clinical appearance and by imaging studies. We present a rare case of a 43-year-old patient who was admitted to our hospital because of two retained needles following a cesarean section, despite several subsequent laparotomies. One needle had been removed previously, but in addition to the remaining needle, we also removed a retained gauze. The diagnosis of RSIs is extremely important, and safe surgical practices including the addition of new imaging technologies should be encouraged to detect RSIs.
尽管手术物品遗留（RSIs）的发生率较低，但它仍是可预防的患者伤害的重要原因，最终可能导致患者死亡以及后续高昂的医疗和法律费用。非故意的手术物品遗留是70%再次手术的原因，发病率为80%，死亡率为35%。最常见的手术物品遗留是海绵或纱布（棉绒瘤或纺织瘤），而遗留手术器械和针则较为罕见。围手术期对设备和材料进行清点是筛查手术物品遗留最常用的方法，随后可通过临床表现和影像学检查来确诊。我们报告了一例罕见病例，一名43岁患者因剖宫产术后遗留两根针而入住我院，尽管随后进行了多次剖腹手术。之前已取出一根针，但除了剩余的那根针外，我们还取出了一块遗留的纱布。手术物品遗留的诊断极为重要，应鼓励包括采用新的成像技术在内的安全手术操作，以检测手术物品遗留情况。
