目的 探讨铜绿假单胞菌注射液治疗甲状腺癌颈部淋巴结清扫术后淋巴漏的方法及效果。方法 笔者所在医院2012年4月至2012年7月期间共治疗甲状腺癌颈部淋巴结清扫术后顽固性淋巴漏患者4例，均采用铜绿假单胞菌注射液治疗。将铜绿假单胞菌注射液（1mL或2mL）通过引流管逆行注射到创腔，夹闭引流管1h后再开放引流管。结果 4例患者注射前1d24h引流量分别为200、350、540及810mL，其中2例患者为乳糜漏，引流时间分别为7d和15d；另2例患者为单纯淋巴漏，引流时间分别为13d和14d。注射1d后，引流量分别减少至20、45、120及255mL，4d后4例患者均顺利拔除引流管。4例患者治疗后均有不同程度的发热，经物理降温后体温恢复；均有不同程度的局部疼痛感，3例患者疼痛能耐受，另1例疼痛剧烈患者予以美洛昔康口服后缓解。结论 铜绿假单胞菌注射液治疗甲状腺癌颈部淋巴结清扫术后顽固性淋巴漏的疗效显著。
ObjectiveTo observe the effectiveness and safety of pseudomonas aeruginosa preparation in treating refractory seroma after breast cancer surgery.MethodsA total of 76 patients with refractory seroma after breast cancer surgery who underwent surgery from October 2018 to August 2019 in our hospital were selected. The subjects were randomly divided into two groups. The patients in the control group (n=36) adopted negative pressure drainage connected with indwelling needle in the lower position of the seroma chamber; on the basis, patients in the experimental group (n=400) were injected with pseudomonas aeruginosa preparation into the seroma chamber. The drainage time, total drainage volume, recurrence rate, and incidence of complications of the two groups were compared.ResultsThere were 4 cases in the experimental group and 3 cases in the control group were lost followed-up, so only 69 cases enrolled in data analysis. The drainage time, total drainage volume, and the recurrence rate of the experimental group were all shorter or less than those of the control group (P<0.05). But there was no significant difference in the incidence of complications between the experimental group and the control group (P>0.05), such as fever, inflamed skin, and infection of incision.ConclusionPseudomonas aeruginosa preparation is an effective treatment for refractory seroma after breast cancer surgery, which can shorten the drainage time and promote wound healing.
ObjectiveTo evaluate the safty of recurrent laryngeal nerve (RLN) and parathyroid if Pseudomonas aeruginosa injection (PAI) is used after total thyroidectomy and central neck dissection (CND).MethodsFrom Mar. 2016 to Oct. 2017, we recruited 113 patients with papillary thyroid cancer (PTC) who accepted total thyroidectomy and CND. During operation, 1 mL of PAI was applied in 58 patients (local spray group) and 55 not (control group). The hoarseness, hypoparathyroidism, chylous fistula, drainage volume, hospital stay, and incidence of complications were compared between the two groups.ResultsThe two groups embraced few difference in age, gender, BMI, tumor site, the diameter of tumor and the number of metastatic and the harvested lymph nodes (P>0.05). There were nobody who has suffered in hoarseness and permanent hypoparathyroidism in both groups at any time after operation. There was no significant differences of complication between the two groups. The drainage volume at 24 h after operation in the local spraying group was more than that in the control group, and the difference was statistically significant (P=0.023). There were 2 patients had chylous fistula after surgery in the control group but none in the local spray group. The total volumes of drainage, incidence of fever and incision infection, the mean stay in the hospital, and the postoperative pain score had no statistic significance in the both groups.ConclusionAfter total thyroidectomy and CND, local spraying of PAI in the wound cavity is safe and will not damage the recurrent laryngeal nerve.
ObjectiveTo investigate the impact of postoperative application of Pseudomonas aeruginosa injection on recurrence free survival (RFS) and overall survival (OS) in patients with abnormal serum calcitonin levels following surgery for medullary thyroid carcinoma (MTC). MethodsA retrospective collection of data was conducted for 214 patients with abnormal serum calcitonin levels following MTC surgery at West China Hospital of Sichuan University from January 2015 to April 2024. Propensity score matching (1∶2) was utilized to match patients’ data to reduce confounding bias, comparing RFS and OS between patients who used (Pseudomonas group) and did not use (control group) Pseudomonas aeruginosa injection. ResultsAfter propensity score matching, 72 patients with abnormal postoperative calcitonin levels were included, with 24 in the Pseudomonas group and 48 in the control group. The median follow-up time for the 72 patients was 66 months (11–168 months). The 1-year RFS rates for the Pseudomonas group and the control group were 100% and 75.0%, respectively, and the 2-year RFS rates were 87.5% and 56.3%, respectively. The RFS in the Pseudomonas group was superior to that in the control group (χ2=4.791, P=0.029). The 5-year OS rates for the Pseudomonas group and the control group were 90.9% and 93.5%, respectively, with no significant difference between the two groups (χ2=0.469, P=0.491). The Cox proportional hazards regression model indicated that the median RFS was extended in the Pseudomonas group [25 months vs. 21 months, RR=0.350, 95%CI (0.135, 0.900), P=0.029], but there was no significant impact on OS [66 months vs. 69 months, RR=2.22, 95%CI (0.229, 21.444), P=0.503]. ConclusionPostoperative use of Pseudomonas aeruginosa injection in MTC patients with abnormal serum calcitonin level shows significant improvement in RFS, but no significant change in OS.