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Po-Ju Lai,Sheng-Fen Wang,Tsung-Ting Tsai,Yun-Da Li,Ping-Yeh Chiu,Ming-Kai Hsieh,Fu-Cheng Kao 대한척추신경외과학회 2021 Neurospine Vol.18 No.4
Objective: Surgical treatment of severe infectious spondylodiskitis remains challenging. Although minimally invasive percutaneous endoscopic drainage and debridement (PEDD) may yield good results in complicated cases, outcomes of patients with extensive structural damage and mechanical instability may be unsatisfactory. To address severe infectious spondylodiskitis, we have developed a surgical technique called percutaneous endoscopic interbody debridement and fusion (PEIDF), which comprises endoscopic debridement, bone-graft interbody fusion, and percutaneous posterior instrumentation. Methods: Outcomes of PEIDF in 12 patients and PEDD in 15 patients with infectious spondylodiskitis from April 2014 to July 2018 were reviewed retrospectively. Outcome were compared between 2 kinds of surgical procedures. Results: Patients in PEIDF group had significantly lower rate of revision surgery (8.3% vs. 58.3%), better kyphosis angle (-5.73°±8.74 vs. 1.07°±2.70 in postoperative; 7.09°±7.23 vs. 0.79°±4.08 in kyphosis correction at 1 year), and higher fusion rate (83.3% vs. 46.7%) than those who received PEDD. Conclusion: PEIDF is an effective approach for treating infectious spondylodiskitis, especially in patients with spinal instability and multiple medical comorbidities.
Li-Hsiang Wang,Ming-Fen Tsai,Chin-Yen Stacey Han,Yi-Chi Huang,Hsueh-Erh Liu 한국간호과학회 2016 Asian Nursing Research Vol.10 No.3
Purpose: Urinary catheterization is a common technique in clinical practice. There is, however, no consensus on management prior to removal of the indwelling catheter for short-term patients. This systematic review examined the necessity of clamping before removal of an indwelling urinary catheter in short-term patients. Methods: A systematic literature review was conducted using eight databases and predetermined keywords-guided searches. Some 2,515 studies were evaluated. Ten studies that met the inclusion criteria were selected. Results: The quality of the studies was assessed using the Jadad scoring system. Only 40.0% of studies were rated as high quality. This review found that catheter clamping prior to removal was not necessary for the short-term patient. When made a comparison with the unclamping group, there was no significant difference in recatheterization risk, risk of urine retention, patients’ subjective perceptions and rate of urinary tract infection. Conclusions: This review indicated that bladder training by clamping prior to removal of urinary catheters is not necessary in short-term catheter patients. In addition, clamping carries the risk of complications such as prolonging urinary catheter retention and urinary tract injury. Further investigation requires higher quality methodologies and more diverse study designs.