Actively adjust medication. Rheumatoid arthritis patients can also give birth smoothly. Can people on kidney dialysis also take phosphorus binders? Chronic kidney disease stage 5: end-stage renal disease, uremia symptoms appear. Don’t forget to check the sugar content before drinking. Excessive intake may increase heart disease

Uncle Cai, 72, who lives in Yunlin, has a family inheritance , coupled with his work relationship and often eating seafood with beer, he suffered from frequent gout attacks since he was young. As I grow older, gout attacks become more frequent, and crystal stones may even grow on my hands, feet, knees, and other places, and my joints may become distorted.

The children and grandson could not bear the torture of Uncle Cai, so they took him to the hospital for evaluation and surgery. However, because the tophi had eroded the ligaments and joints, traditional surgery could easily cause large wounds and complications. Uncle Cai was not there. Although he dared to make up his mind to have an operation, he delayed it for decades until his feet were deformed and he could no longer wear shoes, and his hands were deformed to the point where he could no longer take care of himself. Only then did he go to Yadong Hospital to undergo minimally invasive surgery using ultrasonic scalpel to shatter tophi. ”.

The tiny ultrasonic scalpel probe can crush tophi and wash it out without harming the tissue and the wound is small

Wu Kaiwen, a physician at the Department of Orthopedics of Yadong Hospital, said that the tophi is used in surgery to remove tophi "Ultrasonic scalpel" is a non-traditional scalpel. It is an instrument that uses high-speed ultrasonic vibration to break up tophi and wash it out. Its characteristic is that it "cuts soft but not hard", which is different from traditional scalpels. Ultrasonic scalpel can shatter tophi without damaging muscles, nerves or cartilage tissue, reducing unnecessary damage. This surgery is very suitable for patients like Uncle Cai. After the operation, Uncle Cai recovered well and can now wear shoes again, successfully solving the problems he had suffered for many years.

Reducing the surgical area has a high chance of not requiring hospitalization

Dr. Wu Kaiwen pointed out that the ultrasonic knife is different from traditional knives, and the surgical wound is smaller than a 1 yuan coin. It is still small, sometimes even just a small hole. The wound is not large and recovers quickly, which can greatly reduce the chance of infection. For some people suffering from cardiovascular diseases, metabolic diseases or diabetes, minimally invasive surgery with ultrasonic scalpel requires only half-body anesthesia or local anesthesia, which is less likely to cause complications and reduces the risk of large-area surgery or general anesthesia.

Wu Kaiwen said that if the tophi is located without large nerves and blood vessels, is not in a commonly used joint, is superficial and the deposited stone is not large, hospitalization is usually not required after the operation and you can go home immediately. However, doctors also emphasized that in order to determine whether hospitalization is required after surgery, the patient's uric acid control status must be assessed first, and then assisted observation through X-ray or ultrasound, which cannot be judged by appearance. Wu Kaiwen pointed out that if the patient has multiple or large tophi removed at one time, or if the tophi needs drainage after the removal of the tophi, it will still be recommended to be hospitalized for observation.

There are few sequelae and you can move around after surgery

Dr. Wu Kaiwen mentioned that if the tophi does not invade the joints, more than 90% of the patients can walk after anesthesia is over, and some even have tophi. Patients with minor or superficial diseases may not feel any abnormality after surgery. Doctors also suggest that post-operative patients should carefully take care of the affected area by not touching water for 7-10 days, keeping the wound clean, and also avoid eating and drinking more water to reduce the inflammation index and avoid seeking medical attention due to excessive uric acid during the recovery period.

Under what circumstances does stone removal need surgery?

Kevin Wu suggested that if tophi has affected daily life and the effect of drug dissolution is limited, surgery can be considered. Wu Kaiwen also called on patients to seek medical treatment as soon as possible, because many patients wait until the joints are deformed and the tophi are swollen to the point where the skin breaks before they are willing to undergo surgery. However, if severe gout stones are removed at this time, it will destroy the blood circulation of the surface skin. , it is easy to cause skin necrosis around the joint after surgery, joint exposure, increase the risk of surgery, and the wound is more difficult to heal, and severe cases may face amputation.

Wu Kaiwen also mentioned that some patients will be complicated by other metabolic diseases, making the surgery more complicated. He suggested that patients should not have a wait-and-see mentality when the attending physician says that surgery is needed, which may lead to The crystals accumulate into stones, which increases the risk of surgery and misses the golden time for treatment.

Yadong Hospital:

femh/mainpage/default.aspx Topics: Minimally invasive, tophi, ultrasonic knife