RESUMEN
OBJECTIVE: Unrecognized ureteral and bladder injury increase morbidity and mortality in gynecologic surgery. The primary objective of this study is to analyze the efficiency of a systematic intra-venous (IV) injection of carmine indigo to detect bladder injury in gynecologic vaginal surgery for benign disease. The secondary objective is to analyze the cost and use of carmine indigo. STUDY DESIGN: A retrospective, monocentric study was conducted in a tertiary hospital between January 2018 and October 2021. All patients undergoing a vaginal surgery of hysterectomy for benign disease or anterior prolapse were systematically included. Patients can be systematically included by the automatic coding of surgery. After anesthesia, during the patient's installation, an intravenous injection of 5 mL of intravenous indigo carmine (Carmyne®) diluted in 100 mL of physiological serum was systematically administered by the anesthesia team. Intraoperative cystoscopy was performed only in cases of suspected associated ureteral injury. RESULTS: We recorded 443 vaginal hysterectomies for benign disease and 95 vaginal anterior prolapse surgeries. There were 6 (1,4%) bladder injuries during vaginal hysterectomies and 1 (1,1%) bladder injury during vaginal prolapse surgery. All bladder injuries were diagnosed intraoperatively. No ureteral injury was diagnosed in this series of patients. No complication related to IV indigo carmine injection was found. In this tertiary hospital, 1085 ampoules of carmine indigo were ordered during the same period, approximatively 270 per year. The total cost to the gynecology and obstetrics department was 19,600 euros, or about 4,900 euros per year. Half of the carmine indigo was used in vaginal surgery and half in laparotomy, caesarean section and endometriosis surgery for suspected bladder or ureteral injury.
Asunto(s)
Enfermedades Urológicas , Prolapso Uterino , Humanos , Embarazo , Femenino , Carmin de Índigo/efectos adversos , Carmín , Colorantes/efectos adversos , Estudios Retrospectivos , Cesárea , Enfermedades Urológicas/diagnóstico , Prolapso Uterino/cirugíaRESUMEN
As indústrias têxteis geram efluentes ricos em corantes durante toda a sua cadeia produtiva. Neste estudo, ensaios cinéticos foram realizados utilizando biomassas mortas de Aspergillus niger, diferentemente tratadas, como adsorvente para a remoção de índigo carmim a partir de soluções aquosas. Ensaio cinético com carvão ativado comercial também foi realizado para comparação. Os resultados obtidos indicam que a biomassa fúngica sem tratamento algum foi capaz de remover 95% do índigo carmim da solução aquosa, remoção equivalente àquela obtida pelo carvão ativado comercial. Os experimentos mostraram que os tratamentos ácidos melhoraram consideravelmente a cinética da remoção do corante, não influenciando, contudo, a capacidade adsortiva máxima do material. Os tratamentos salinos e alcalinos diminuíram tanto a capacidade máxima quanto a cinética de adsorção.
Textile industries produce effluents rich in dyes throughout its production chain. In this study, kinetic experiments were carried using the dead and treated biomass of Aspergillus niger for indigo carmine removal from the synthetic aqueous solutions of this dye. A kinetic run with activated carbon was also carried for comparison. The obtained results suggest that non-treated fungal biomass has been capable of remove 95% of carmine indigo from the aqueous solutions. This removal was similar to that obtained with activated carbon. The results also indicate that acid treatments considerably improve the kinetic of the dye removal, but they are not influenced the maximum adsorptive capacity of the adsorbent. Moreover, saline and alkaline treatments decreased both the maximum capacity and the kinetic of adsorption.