Descending necrotizing mediastinitis: a challenging infection. Selected results of a Moroccan bicentric study.

IF 0.6 Q4 SURGERY
Massine El Hammoumi, Saloua Ouraini, Mohammed Bhairis, Hamid Kouatli, Kemini Marius Kamdem, El Hassane Kabiri
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引用次数: 0

Abstract

Introduction: Mediastinal infection is a persistent and difficult widespread infectious disease caused by secondary complications of adjacent organs. It spreads easily and is often misdiagnosed because of the lack of typical manifestations.

Material and methods: To highlight the clinical features, medical and surgical strategy of descending necrotizing mediastinitis we performed a retrospective study of 25 documented cases during a 10-year period at our hospital, all treated surgically, 10 from the ORL department and 15 from our thoracic surgery department.

Results: Patients were aged from 20 to 84 years, with a median age of 41 years, male predominance (19 men and 6 women), sex ratio of 3.6. A cervicotomy (in 40% of cases) was associated or not with videothoracoscopy (one case) or thoracotomy (in 20% of cases) and wide-spectrum antibiotherapy. In the postoperative period, an irrigation-suction system was used on the drains in 15 patients. In 1 case a rethoracotomy was necessary to remove a residual right pyothorax, and one patient required a tracheostomy. Twenty-two (88%) patients recovered from their mediastinitis. Death of 3 patients by sepsis multiorgan failure occurred. Postoperative follow-up during one year was uneventful without recurrence.

Conclusions: According to our experience, we believe the more aggressive local treatment is, the better are the results.

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下行坏死性纵隔炎:一种具有挑战性的感染。摩洛哥双中心研究的选定结果。
摘要纵隔感染是一种由邻近脏器继发性并发症引起的持续性、难治的广泛性传染病。它很容易传播,由于缺乏典型的表现,经常被误诊。材料和方法:为了突出下行坏死性纵隔炎的临床特点、内科和外科治疗策略,我们对我院10年间25例有记录的病例进行了回顾性研究,所有病例均采用手术治疗,其中10例来自ORL科,15例来自胸外科。结果:患者年龄20 ~ 84岁,中位年龄41岁,男性为主(男性19例,女性6例),性别比3.6。宫颈切开术(40%的病例)与胸腔镜(1例)或开胸术(20%的病例)和广谱抗生素治疗相关或不相关。术后15例患者在引流管上采用灌吸系统。1例需要开胸切除残留的右脓胸,1例需要气管切开术。22例(88%)患者从纵隔炎中恢复。脓毒症并发多器官功能衰竭死亡3例。术后随访1年,无复发。结论:根据我们的经验,我们认为局部治疗越积极,效果越好。
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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Polish Journal of Thoracic and Cardiovascular Surgery is a quarterly aimed at cardiologists, cardiosurgeons and thoracic surgeons. Includes the original works (experimental, research and development), illustrative and casuistical works about cardiology and cardiosurgery.
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