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Drainless Day Case Superficial parotidectomy with ARTISS [Solutions for Sealant]

International Journal of Otolaryngology and Head & Neck Surgery 2020年第6期9卷 194-202页

作者： Jacob Duffin Craig McCaffer Lakh Pabla Shane Lester ENT Department James Cook University Hospital Middlesbrough UK

Aims: Superficial parotidectomy (SP) is a commonly performed procedure which traditionally requires a drain and overnight hospital stay. This series aimed to show the safety and efficacy of drainless day case parotidectomy using ARTISS [Solution for Sealant] fibrin glue. Materials and Methods: Patients with a superficial parotid lump with benign preoperative sampling underwent an SP. We initially used both ARTISS and a drain, which was removed when output was Objectives: We prospectively collected data and divided groups into ARTISS alone and ARTISS with a drain to compare patients’ length of stay and complication rates. Results: 88 patients were included;52 ARTISS alone, 22 as a day case. 42.3% of patients where ARTISS alone was used were discharged within 24 hours, with the remainder between 24 - 48 hours. Comparatively, no ARTISS and drain patients were discharged within 24 hours and 86.1% were discharged between 24 - 48 hours with the remainder over 48 hours. There were 3 postoperative haematomas and none in the drainless group;a statistically significant difference (p = 0.034). Of the 6 recorded salivary leaks, 4 were in the drain group and 2 in the ARTISS alone group (p > 0.05). Conclusions: Comparable complication rates and reduced length of stay suggest that ARTISS in SP is safe and effective. These findings stand to benefit both patients and the NHS by improving the patient journey and reducing overall costs.

关键词： parotid Gland parotid neoplasms Fibrin Tissue Adhesive

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Advanced Stage Stuck Gland Adenocarcinoma:Case Report

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Modern Research in Inflammation 2020年第1期9卷 1-7页

作者： Miriam Viviane Baron Michele Paula dos Santos Gabriela Di Lorenzo Garcia Scherer Luis Manuel Ley Dominguez Vitoria Pereira Itaquy Natalia Cardoso Nascimento Fernanda Nerys Tais Michele Werle Carolina Paz Mohamad Isa Carina Marangoni Mariana Martins Dantas Santos Marcus Vinicius de Mello Pinto Janine Koepp Daiana Klein Weber Carissimi Joice Nedel Ott Carolina Goncalves Pinheiro Nathália Ken Pereira Iketani Bartira Ercília Pinheiro da Costa Postgraduate Program in Medicine and Health Sciences of the Pontifical Catholic University of Rio Grande do Sul(PUC/RS) Porto AlegreBrazil Improvement of Higher Education Personnel Brazil(CAPES)Distrito FederalBrazil School of Medicine of the Pontifical Catholic University of Rio Grande do Sul(PUC/RS) Porto AlegreBrazil School of Health and Life Sciences of the Pontifical Catholic University of Rio Grande do Sul(PUC/RS) Porto AlegreBrazil Celulare Institute PetrópolisRio de JaneiroBrazil Undergraduate Nursing Course of the University of Santa Cruz do Sul(UNISC) Santa Cruz do SulBrazil Postgraduate Program in Health Sciences of the Faculty of Medicine of ABC(FMABC) Sao PauloBrazil Undergraduate Physiotherapy Course of the Vale do Salgado Faculty(FVS) CearáBrazil Physiotherapy of the Hospital Beneficiente Portuguesa of Belém ParáBrazil

parotid gland adenocarcinoma is commonly a tumor of low malignancy and low incidence worldwide. The reported case shows the rapid progression of this tumor in an elderly patient and infrequent effects, such as a presentation of facial edema not commonly described in the medical literature. Patient was admitted to hospital in November 2019 with secretion and partial hearing loss in the right ear and infiltrative and stone lesion with initial skin ulceration in the right cervical region. After 42 days, he returned and was admitted to the intensive care unit with significant swelling of the face, hardened and hyperemic neck, difficulty in speech and inability to open the eye. He presented changes in the mobility of the speech and hearing organs, reduced laryngeal mobility, vocal changes, speech with altered articulation and severe oropharyngeal dysphagia with risk of bronchoaspiration. The patient was diagnosed in September 2019 with a parotid tumor (salivary gland adenocarcinoma T4). The medical team requested computed tomography, computed tomography angiography of the chest and cervical vessels and computed tomography of the neck, in addition to evaluation by the head and neck surgery service and general surgery. After analyzing the results, the medical team suggested a hypothesis of tumor invasion that could result in obstruction of local lymphatic drainage, something unusual in the evolution of this type of tumor. In addition, it was not possible to adhere to radiotherapy treatment due to the extent of the lesion and there was also no confirmation of metastases. The reported case shows us that parotid gland adenocarcinoma, when diagnosed in an advanced stage, can limit the approach to treatment. It was chosen in agreement with the family to proceed with palliative care without invasive measures. Palliative care may be the best option for cases like this, bringing some comfort to the patient and his family.

关键词： parotid neoplasms Cancer of the parotid Palliative Care Critical Care

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