Delayed recurrence of postoperative intra-abdominal abscess: an unusual case and review of the literature.

BACKGROUND: Although intra-abdominal abscess is one of the major complications of abdominal surgery, the literature documents only a few cases of recurrence after a long asymptomatic period. METHODS: Case report and literature review. RESULTS: A 66-year-old woman developed a primary subphrenic abscess secondary to anastomotic leakage after total gastrectomy. Percutaneous drainage succeeded in evacuating the abscess cavity, and broad-spectrum antibiotics apparently eradicated the infection. However, a recurrent subphrenic abscess appeared eight years later with no intervening signs or symptoms. CONCLUSIONS: The unexpected outcome in this case may call into question the appropriate follow-up period after treatment for subphrenic abscess. Our experience indicates that clinicians should be aware of the possibility of rare delayed recurrence of intra-abdominal abscess.

Ultrathin bronchoscopic barium marking with virtual bronchoscopic navigation for fluoroscopy-assisted thoracoscopic surgery.

STUDY OBJECTIVES: To facilitate marking and to reduce its complications, we performed barium marking using an ultrathin bronchoscope with virtual bronchoscopic (VB) navigation before thoracoscopic surgery for small pulmonary peripheral lesions. We then evaluated the feasibility, safety, and efficacy of this technique. DESIGN: A pilot study. SETTING: A tertiary teaching hospital. PATIENTS: The subjects were consecutive patients with small pulmonary peripheral lesions (ie,

Antitumor effects of residual tumor after cryoablation: the combined effect of residual tumor and a protein-bound polysaccharide on multiple liver metastases in a murine model.

Cryoablation is a low-invasive surgical treatment for malignant tumors. It may induce an immunological response leading to the eradication of distant metastases or alternatively it might promote the growth of residual tumors. In this paper we confirm the occurrence of both phenomena and we describe the preventive effect of a protein-bound polysaccharide preparation. Metastatic liver tumors were produced in BALB/c mice by the intrasplenic inoculation of colon 26 cells and cryoablation was carried out using liquid nitrogen (-170 degrees C) applied by a contact method. The value of combining cryoablation with administration of the polysaccharide preparation in the prevention of growth of residual tumors was investigated. It was shown that the number of metastatic liver nodules and the size of the primary tumor at the site of inoculation in the spleen were significantly lower when the volume that was frozen was small. The production by splenocytes of the tumor necrosis factor TNF-alpha, interferon INF-gamma, and the interleukins IL-4 and IL-10 increased significantly after freezing and thawing of the tumor tissue. The polysaccharide treatment significantly reduced the production of IL-4 and IL-10 following cryoablation; the production of TNF-alpha and INF-gamma was slightly promoted; the natural killer and cytotoxic T-cell activities of splenocytes were slightly enhanced. It was concluded that the polysaccharide preparation was beneficial by suppressing IL-4 and IL-10 production and might inhibit the growth of residual tumor that is sometimes induced by large-volume cryoablation.