使用视频辅助胸腔镜手术恢复断裂的导丝。

Journal of the Korean Surgical Society Pub Date : 2013-11-01 Epub Date: 2013-10-25 DOI:10.4174/jkss.2013.85.5.244
Jin-Beom Cho, Il-Young Park, Ki-Young Sung, Jong-Min Baek, Jun-Hyun Lee, Do-Sang Lee
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引用次数: 6

摘要

锁骨下静脉置管曾广泛应用于容积复苏、急诊静脉通路、化疗、肠外营养和血液透析。然而,由于危及生命的并发症,如血胸、气胸,它的使用最近急剧减少。在本病例中,患者入院接受预定手术,术前、术中、术后均行右锁骨下静脉置管和肠外营养。手术由一位经验丰富的资深住院医师进行。尽管在导丝插入过程中检测到轻微阻力,但住院医生仍继续手术,直到无法推进或取出导丝,然后试图强行取出导丝,但导丝破裂并卡在胸腔内。我们试图通过锁骨下皮肤切口取出导丝,但没有成功。所以我们使用了视频胸腔镜手术来移除断裂的导丝。这一事件表明锁骨下静脉置管的风险和使用适当和温和技术的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Use of video-assisted thoracoscopic surgery to retrieve a broken guidewire.

Use of video-assisted thoracoscopic surgery to retrieve a broken guidewire.

Use of video-assisted thoracoscopic surgery to retrieve a broken guidewire.

Use of video-assisted thoracoscopic surgery to retrieve a broken guidewire.

Subclavian venous catheterization was once widely used for volume resuscitation, emergency venous access, chemotherapy, parenteral nutrition, and hemodialysis. However, its use has drastically reduced recently because of life-threatening complications such as hemothorax, pneumothorax. In this case, a patient admitted for a scheduled operation underwent right subclavian venous catheterization for preoperative, intraoperative, and postoperative volume resuscitation and parenteral nutrition. The procedure was performed by an experienced senior resident. Despite detecting slight resistance during the guidewire insertion, the resident continued the procedure to the point of being unable to advance or remove it, then attempted to forcefully remove the guidewire, but it broke and became entrapped within the thorax. We tried to remove the guidewire through infraclavicular skin incision but failed. So video-assisted thoracoscopic surgery was used to remove the broken guidewire. This incident demonstrates the risks of subclavian venous catheterization and the importance of using a proper and gentle technique.

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