tetracycline and Fistula

The results of treatment of 226 patients with unspecific spontaneous pneumothorax in 1980-1990 are discussed. Poor efficacy of punctures of the pleural cavity (32.4%) is noted. Pleural cavity drainage proved to be effective in 79.7% of cases, both in primary and in recurrent pneumothorax. Chemical pleurodesis with tetracycline and 4% sodium bicarbonate solution was conducted in patients with complicated forms of pneumothorax (bronchopleural fistulas, hydropneumothorax). The advantage of 4% sodium bicarbonate solution over the tetracycline solution was obvious. To prevent the development of encapsulated hydrothorax the authors improved the method of pleural cavity drainage. The described method of instrumental treatment of spontaneous pneumothorax allowed injurious surgical intervention and recurrent pneumothorax to be avoided in 100% of cases.

Topics: Adult; Animals; Bronchial Fistula; Combined Modality Therapy; Drainage; Female; Fistula; Humans; Hydropneumothorax; Male; Middle Aged; Pleural Diseases; Pneumothorax; Punctures; Rats; Recurrence; Sodium Bicarbonate; Tetracycline

Topics: Bronchial Fistula; Doxycycline; Embolization, Therapeutic; Fistula; Humans; Pleural Diseases; Tetracycline

Persistent bronchopleural fistulas (BPF) due to infection, trauma, or thoracic surgical procedures are often difficult to manage. We report a patient with fulminant Staphylococcus aureus pneumonia complicated by chronic BPF formation which prevented weaning from mechanical ventilation due to severe air leak. Fistula closure was obtained by instillation of tetracycline into the fistula via a fiberoptic bronchoscope using a balloon catheter and blood clot occlusion technique. This closed the BPF and allowed successful weaning from mechanical ventilation.

Topics: Adolescent; Bronchial Fistula; Bronchoscopy; Fistula; Humans; Instillation, Drug; Male; Pleural Diseases; Pneumonia, Staphylococcal; Sclerotherapy; Tetracycline

Topics: Aged; Esophageal Fistula; Female; Fistula; Heart Atria; Heart Diseases; Humans; Tetracycline

Two hundred neck dissections performed at Toronto General Hospital over a 3 year period are reviewed. There were six intra-operative lymph leaks and five postoperative chylous fistulae. The postoperative chylous fistulae are analysed in detail and the approach to conservative management of lymph leaks is discussed. Two cases required re-exploration of the neck; difficulty in identifying the site of leakage and of sealing lymph channels is discussed. Also reported is the successful use of topical tetracycline powder in two cases and a review of the various treatment modalities advocated in the literature.

Topics: Aged; Chyle; Fistula; Humans; Lymph; Lymphatic Diseases; Male; Middle Aged; Neck; Nutritional Requirements; Postoperative Complications; Retrospective Studies; Tetracycline

The management of chylous fistulae remains controversial. A detailed conservative protocol and guidelines regarding surgical intervention are lacking in the literature. This paper presents our experience in the management of two cases of persistent chylous fistulae by successfully employing topical tetracycline. Our regimen of management is discussed and illustrated with the above two cases. An updated review of the pertinent anatomy, physiology, and literature is presented.

Topics: Administration, Topical; Chyle; Female; Fistula; Head and Neck Neoplasms; Humans; Larynx; Male; Middle Aged; Neck; Pharynx; Postoperative Complications; Tetracycline; Thoracic Duct

In chylous fistulas following radical neck dissections, we have found reexploration to be unrewarding, with infrequent identification of a specific leakage site intraoperatively and persistent fluid accumulation postoperatively. As an alternative, we injected tetracycline hydrochloride into the supraclavicular wound bed. This procedure resulted in a rapid, sustained decline in fistula output in two of three cases, avoiding surgical intervention. Tetracycline sclerotherapy has been described for treatment of intrathoracic and other intracavitary fluid collections. We believe that tetracycline sclerotherapy is an effective adjunct in the management of chylous fistulas following radical neck dissections and that this therapy should be attempted before surgical reexploration.

Topics: Adenocarcinoma; Aged; Carcinoma, Squamous Cell; Chyle; Drainage; Female; Fistula; Head and Neck Neoplasms; Humans; Male; Methods; Neck Dissection; Parotid Neoplasms; Postoperative Complications; Sclerosing Solutions; Tetracycline; Time Factors

Topics: Actinobacillus; Actinobacillus Infections; Fistula; Humans; Intestinal Fistula; Lumbosacral Region; Male; Middle Aged; Retroperitoneal Space; Skin Diseases; Tetracycline

Topics: Arthritis; Behcet Syndrome; Dentures; Esophageal Diseases; Fistula; Humans; Male; Middle Aged; Mouth Diseases; Pharyngeal Diseases; Tetracycline

Topics: Angiography; Aortic Diseases; Aortography; Drug Therapy; Duodenal Diseases; Fistula; Hematoma; Humans; Intestinal Fistula; Postoperative Complications; Spinal Puncture; Tetracycline

Topics: Abscess; Actinomycosis; Anal Canal; Drug Therapy; Fistula; Humans; Perineum; Protein Synthesis Inhibitors; Rectal Fistula; Rectum; Tetracycline

Topics: Colon, Sigmoid; Colonic Neoplasms; Colostomy; Diagnosis, Differential; Diverticulitis; Diverticulitis, Colonic; Fistula; Geriatrics; Humans; Intestinal Obstruction; Mortality; Neomycin; Peritonitis; Postoperative Complications; Preoperative Care; Rectum; Statistics as Topic; Sulfathiazoles; Surgical Procedures, Operative; Surgical Wound Infection; Tetracycline