Retained surgical sponge (gossypiboma) after intraabdominal or retroperitoneal surgery: 14 cases treated at a single center
Retained surgical sponge (gossypiboma) after intraabdominal or retroperitoneal surgery: 14 cases treated at a single center
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DOI：
10.1007/s00423-005-0581-4
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发表时间：
2006-08-01
影响因子：
2.3
通讯作者：
Haberal, Mehmet
中科院分区：
文献类型：
--
作者：
Yildirim, Sedat;Tarim, Akin;Haberal, Mehmet
背景和目标：本研究的目的是介绍在一个中心治疗的14例棉花瘤[滞留手术海绵（RSS）]的病因、临床表现、诊断和治疗，并强调这种潜在并发症的重要性。方法：回顾性分析1999年1月至2004年12月收治的14例RSS患者的临床资料。详细记录术前评估、人口统计学特征和手术结果。还记录了腹部X线、超声检查、计算机断层扫描、磁共振成像和上消化道内窥镜检查的使用和结果。结果：所有病例均手术切除RSS。14例患者中有13例有症状，最常见的发现是非特异性腹痛和肠梗阻。4名患者需要紧急手术，因为海绵引起肠梗阻或腹腔内败血症。根据病史、体格检查结果和影像学诊断，其中5例患者术前诊断为RSS。术后并发症，包括手术部位感染和内脏，发生在5例。结论：RSS会导致患者和医生之间的重大医疗和法律的问题。RSS可能在术前被错误诊断，这可能导致不必要的侵入性诊断程序和手术。必须采取严格措施防止这种并发症。
Background and aims: The objective of this study was to present the etiology, clinical presentation, diagnosis, and management for 14 cases of gossypiboma [ retained surgical sponge (RSS)] treated at a single center and to emphasize the importance of this potential complication. Methods: Data for 14 cases of RSS treated between January 1999 and December 2004 were retrospectively assessed. The details of preoperative evaluation, demographic features, and operative findings were recorded. Use of, and findings from, abdominal x-ray, ultrasonography, computed tomography, magnetic resonance imaging, and upper-gastrointestinal endoscopy were also noted. Results: In all cases, the RSS was surgically removed. Thirteen of the 14 patients were symptomatic, and the most frequent finding was nonspecific abdominal pain and intestinal obstruction. Four patients required urgent surgery because the sponges were causing intestinal obstruction or intraabdominal sepsis. Based on history, physical examination findings, and diagnostic imaging, RSS was diagnosed preoperatively in five of the patients. Postoperative complications, including surgical site infection and evisceration, occurred in five cases. Conclusion: RSS can lead to significant medical and legal problems between the patient and the doctor. RSS may be incorrectly diagnosed preoperatively, which can lead to unnecessary invasive diagnostic procedures and operations. Strict measures must be taken to prevent this complication.