RESUMO
OBJECTIVE: To analyze the incidence of cardiac surgeries and postoperative sternal osteomyelitis/sternomediastinitis, as well as treatment outcomes in these patients. MATERIAL AND METHODS: We summarized 171 patients with postoperative sternal osteomyelitis and sternomediastinitis. RESULTS: Organization of the Khabarovsk center for cardiovascular surgery in the Far Eastern Federal District was followed by 7.9- and 24.9-fold increase of the number of cardiac surgeries and CABG in 2005-2019, respectively. As a result, the number of patients with sternal osteomyelitis and sternomediastinitis after cardiac surgery increased from 0.50±0.10 to 1.59±0.17 cases per 100.000 (t=3.01; p<0.01). CPB and aortic clamping time (t=3.97; p<0.01), as well as surgery time (t=2.4; p<0.05) were significant risk factors of early postoperative complications. Two-stage surgical treatment of postoperative sternal osteomyelitis and sternomediastinitis (removal of ligatures and foreign bodies, sternal curettage with removal of sequesters at the first stage; resection of sternum with chest wall repair at the second stage) reduced hospital-stay from 31.9±13.4 to 29.2±10.8 days.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Osteomielite , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Humanos , Osteomielite/diagnóstico , Osteomielite/etiologia , Osteomielite/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Esterno/cirurgia , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/cirurgiaAssuntos
Mediastinite/cirurgia , Doença Aguda , Adulto , Feminino , Humanos , Masculino , Mediastinite/diagnóstico , Mediastinite/etiologia , Mediastino/cirurgia , Métodos , SucçãoRESUMO
The authors have analysed the diagnostics, clinical course and surgical measures in mediastinal neoplasms in 196 patients from 4 months to 72 years of age. Operations were performed in 84.7% of the patients, lethality was 1.8%. Postoperative complications were noted in 4.6% of the patients. The authors find it expedient to remove small mediastinal new formations in patients with an asymptomatic clinical course of the disease due to the danger of their future growth and resulting problems concerned with their excision. A detailed examination and surgical treatment of such patients should be performed in thoracal departments.
