Department of Pediatric Surgery, Gazi University, Faculty of Medicine, Ankara, Turkey.
Department of Pathology, Gazi University, Faculty of Medicine, Ankara, Turkey.
Acta Chir Belg. 2022 Aug;122(4):266-268. doi: 10.1080/00015458.2020.1846944. Epub 2021 Feb 14.
Surgicel is a hemostatic agent that consists of oxidized regenerated cellulose and used in surgical procedures as an aid to bleeding control. It is left in the operation site for hemostasis, could cause an operation by mimicking the recurrence of tumor, as in our patient.
A 3-year-old boy was operated by us at the age of 40 days and 2.5 years, respectively, due to pelvic neuroblastoma. He was re-operated for mimicking recurrence or residue tumor secondary to the prior placement of Surgicel within the peritoneal cavity.
Re-laparotomy was performed and the mass approximately 2.8 × 2×1 cm in size in front of the right ureter and iliac vessels and behind the bladder was removed by blunt and sharp dissection without damaging these organs. While gelatinous content was evacuated from this mass, there was no apparent tumor appearance. Pathology report was reported as fibrotic tissue characterized by foreign body and foreign body giant cells. The postoperative period was uneventful and he was discharged on the 2nd postoperative day.
In the light of our case, the use of hemostatic agents should be kept to a minimum and should not be left in the body unless it is difficult. Thus, unnecessary examination or recurrent surgery can be avoided.
Surgicel 是一种由氧化再生纤维素组成的止血剂,在手术中用作控制出血的辅助手段。它留在手术部位以止血,但可能会导致手术,因为它会模仿肿瘤的复发,就像我们的患者一样。
一名 3 岁男孩分别在 40 天和 2.5 岁时因骨盆神经母细胞瘤接受了我们的手术。由于先前在腹腔内放置 Surgicel,他因模拟复发或残留肿瘤而再次接受手术。
进行了再次剖腹手术,在右侧输尿管和髂血管前方以及膀胱后方,通过钝性和锐性分离切除了一个大约 2.8×2×1cm 大小的肿块,这些器官没有受损。从这个肿块中排出了胶状物质,但没有明显的肿瘤外观。病理报告报告为纤维组织,表现为异物和异物巨细胞。术后恢复顺利,他在术后第 2 天出院。
根据我们的病例,应尽量减少使用止血剂,除非难以止血,否则不应将其留在体内。因此,可以避免不必要的检查或再次手术。