PubMed Health⌕ Search

Biomedical subjects

D Maccabee

Publications and source records attributed to D Maccabee.

2 recordsLinked to original sources
PubMed2003

Prevention of percutaneous endoscopic gastrostomy stoma metastases in patients with active oropharyngeal malignancy.

The implantation of metastasis of oropharyngeal or esophageal cancer to percutaneous endoscopic gastrostomy (PEG) stomata is considered an uncommon complication, but it is being recognized with increasing frequency. The incidence of this complication is not known. Multiple theories of metastatic spread have been proposed. We describe a case following retrograde endoscopy via a PEG stoma site. A National Library of Medicine literature search was performed, and case reports and bibliographies were reviewed. We estimate the incidence of this complication as 1% minimum. Direct seeding of the site is the only reasonable hypothesis to explain this phenomenon. Health care providers need to be educated about this problem. Although there is no direct evidence that metastases are spread by direct contact, we believe that transgression of the active primary tumor during gastrostomy tube placement should be avoided. Laparoscopic gastrostomy tube placement provides a safe, effective, and minimally invasive method of enteral access, which avoids transgression of the primary tumor site, and may prevent stomal metastases in patients with active aerodigestive tract malignancies who require gastrostomy.

Carcinoma, Squamous Cell↗
PubMed2003

The laparoscopic sponge.

PURPOSE: Hemorrhage and spillage of enteric contents during laparoscopic surgery can be problematic and obscure the operative field. Although the suction device can often clear the field, we have found that use of a sponge is often more efficient and effective. MATERIAL AND METHODS: An unrolled 4 x 4 sponge can be introduced down a 10-mm port without difficulty. The addition of a suture tied to one corner of the sponge allows easy retrieval of the sponge and eliminates the possibility of leaving the sponge in the abdomen. CONCLUSIONS: The laparoscopic sponge is simply constructed and is easily introduced and retrieved through a trocar. It can be used to deal with a troublesome hemorrhage, either to put on direct pressure or to absorb blood. It can also be used as a blunt retractor and dissector. With the addition of the suture tail, it is quickly retrieved and cannot be forgotten within the abdomen.

Blood Loss, Surgical↗