HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Repair of diaphragmatic injury and placement of tube thoracostomy during right upper quadrant peritonectomy.

AbstractOBJECTIVE:
Patients with advanced or recurrent ovarian cancer often have metastatic disease in the upper abdominal region, especially to the right hemidiaphragm, which requires diaphragmatic resection in order to achieve optimal cytoreduction. The aim of this surgical video is to demonstrate repair of a diaphragmatic injury and placement of tube thoracostomy during right upper quadrant peritonectomy in a patient with recurrent ovarian cancer.
METHODS:
This is the case of a 45-year-old woman presented with platinum sensitive recurrent ovarian cancer. Abdomen computed tomography also confirmed peritoneal carcinomatosis and pelvic recurrent mass. HIPEC was administered after complete cytoreduction including bilateral upper quadrant peritonectomy, during which diaphragmatic injury occurred near the central tendon and pleural cavity was entered. We inserted a chest tube through the 6th intercostal space in the anterior axillary line in order to prevent postoperative massive pleural effusion. Diaphragmatic defect was closed primarily after the tube placement. The chest tube was withdrawn on the third postoperative day and the patient was discharged on postoperative day 25 without any complications.
RESULTS:
The central tendon of diaphragm is the most vulnerable part for lacerations. Diaphragmatic repairs could be performed by various techniques; interrupted or continuous, locking or non-locking sutures, with either permanent or absorbable materials. In our view, all of the techniques provide similar results and surgeons can choose any of them as long as they are comfortable with the procedure.
CONCLUSION:
In most cases, these lacerations can be repaired primarily without necessitating tube thoracostomy. However, performance of HIPEC can cause massive pleural effusions which can lead to significant pulmonary morbidity. Therefore, retrograde placement of the chest tube under direct vision is quite straightforward when the diaphragm is opened.
AuthorsNejat Ozgul, Derman Basaran, Gokhan Boyraz, M Coskun Salman
JournalJournal of gynecologic oncology (J Gynecol Oncol) Vol. 27 Issue 1 Pg. e6 (Jan 2016) ISSN: 2005-0399 [Electronic] Korea (South)
PMID26463433 (Publication Type: Case Reports, Journal Article)
Topics
  • Chest Tubes
  • Cytoreduction Surgical Procedures (methods)
  • Diaphragm (injuries, surgery)
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local (surgery)
  • Ovarian Neoplasms (surgery)
  • Peritoneum (surgery)
  • Thoracostomy (methods)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: