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Kirurgi vid respiratoriska papillom kräver god ventilation: personalen måste skyddas mot HPV-smitta – högfrekvent jetventilationsteknik kan ge bättre operationsresultat
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
2016 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, no 41, D3CPArticle in journal (Refereed) Published
Abstract [en]

We describe a non-smoking patient with juvenile onset recurrent respiratory papillomatosis (RRP), genotyped as human papilloma virus (HPV)11. The patient has undergone a total of 133 surgical CO2 laser sessions, whereof the last 28 using a high frequency jet ventilation technique (HFJV). Since completed vaccination (Gardasil) in February 2013, the patient underwent one surgery in September 2013 and was considered being in remission. In March 2015, the patient was diagnosed with a left-sided lung cancer, genotyped as HPV11, a HPV subtype associated with a more aggressive disease with higher morbidity and mortality. We advocate that RRP patients should be ventilated with HFJV technique in order to enhance surgical radicality. Furthermore, the operation should be performed in operating theaters with high air exchange/minute, optimized local exhaust ventilation, and specific masks to ensure safe conditions for patients and staff.

Abstract [sv]

Här beskrivs en icke-rökande patient med recidiverande respiratoriska papillom, genotypade som humant papillomvirus typ 11 (HPV 11). Patienten har behandlats med koldioxidlaser 133 gånger; de senaste 28 gångerna ventilerades han med högfrekvent jetventilationsteknik. Efter HPV-vaccination med Gardasil och operation i september 2013 bedömdes patienten vara i remission, men i mars 2015 ställdes diagnosen HPV 11-positiv lungcancer. Patienter med recidiverande respiratoriska papillom bör ventileras med högfrekvent jetventilationsteknik för att ge bästa förutsättningar för kirurgisk radikalitet och bevarad funktionalitet. Operationspersonal bör skyddas mot droppburen respiratorisk HPV-smitta genom munskydd, optimerat lokalt utsug och hög luftväxling på operationssal.

Place, publisher, year, edition, pages
2016. Vol. 113, no 41, D3CP
National Category
Otorhinolaryngology
Identifiers
URN: urn:nbn:se:umu:diva-134334OAI: oai:DiVA.org:umu-134334DiVA: diva2:1092198
Available from: 2017-05-02 Created: 2017-05-02 Last updated: 2017-05-16Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
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