Objective Ligation is a widely used wound closure method after chest drain removal in thoracic surgery. Knotless suture, which does not require ligation or suture removal, has been developed and is currently used in our institution. This study compared the efficacy of the drain wound closure method between knotless suture and our previous mattress suture. Methods We examined the clinical performance of knotless suture for chest drain wound closure in 117 patients who underwent surgery following this method in our department from October 2020 to April 2021. We compared outcomes with those of mattress suture using 2-0 nylon in 115 patients who underwent thoracic surgery at our institution between October 2018 and April 2019. Hydrocolloid dressing is applied to the drain wound after chest drain removal in a knotless suture. We conducted an analysis of both groups based on the condition of wound closure and drain wound complication. Results Appropriate wound closure was obtained and no patient required a prolonged hospital stay because of incomplete wound closure in both methods. The rate of chest drain wound infection for knotless suture (0.0%, 0/117 patient) was significantly lower than that of mattress suture (5.2%, 6/115 patients) at the outpatient follow-up ( p = 0.01). The rate of delayed drain wound healing was also significantly lower than that of mattress suture (0.9% vs. 7.0%; p = 0.02). Conclusions The results of knotless closure were better than those of conventional mattress suture regarding wound complications. Moreover, knotless suturing requires no suture removal, indicating its usefulness.
Background Dedifferentiated liposarcoma (DDLPS) is a rare tumor and generally shows poor prognosis with the lung frequent metastatic site. 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used for staging or metastatic evaluation of this disease. We report a case of bilateral lung metastases of DDLPS showing uncommon imaging on FDG-PET/CT with completely different FDG uptake, which made preoperative diagnosis difficult. Case presentation The patient was a male in his 60 s and bilateral lung nodules were noted after proton beam therapy for retroperitoneal DDLPS. FDG-PET/CT showed high FDG uptake in the left S3 15-mm nodule but no uptake in the right S8 10-mm nodule. Thoracoscopic wedge resection for the left nodule was performed, and the pathology revealed metastasis of dedifferentiated liposarcoma. After resection of the left nodule, the right S8 nodule enlarged without FDG uptake. Thoracoscopic right S8 segmentectomy was performed, and metastasis of dedifferentiated liposarcoma was diagnosed. The 2 tumors showed completely different appearances on FDG-PET/CT with similar histopathological findings. Conclusions We encountered a case of multiple pulmonary metastases of DDLPS which did not follow the same imaging appearance on FDG-PET/CT. Appropriate timing of surgical resection for pathological diagnosis should be determined carefully.
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