scholarly journals The results of sphincterometry in patients after sorgion treatment of extrasphintery anal fistula

2021 ◽  
Vol 11 (10) ◽  
pp. 311-319
Author(s):  
R. Paliyenko ◽  
Z. Mishura
Keyword(s):  
Surgical Treatment ◽  
Anal Sphincter ◽  
Functional State ◽  
Postoperative Period ◽  
External Anal Sphincter ◽  
Control Group ◽  
Compression Force ◽  
Maximum Compression ◽  
Basal Tone ◽  
Late Postoperative Period

More than 30% of patients with chronic paraproctitis have complex forms. They are most often complicated by external sphincter insufficiency due to deformation of the anal canal and scarring of the sphincters. The main principle of substantiation of surgical treatment of extrasphincteric pararectal fistulas is the individual choice of method in each particular patient. It is based on a comprehensive assessment of such factors as the etiology of the fistula, its distance from the edge of the anus, the relationship of the defect or fistula with the sphincter muscles apparatus, the severity of the scarring process, the functional state of the rectum. Aim. Evaluation of the functional state of the sphincter apparatus of the rectum in patients with extrasphincteric pararectal fistulas in the preoperative, early and late postoperative periods. Materials and methods. To determine the average indicators of anal sphincter function, basal tone and maximal compression force were measured using a sphincterometer "Sphinctometer STM-0164-SM" in 114 healthy individuals (68 men and 46 women) of different ages (16 to 80 years) who objectively had no signs of anal incontinence. In all patients, sphincterometry was preceded by a thorough proctological examination, and proctological pathology was excluded. Therefore, hemorrhoids or anal fissures, which lead to increased basal tone at rest, were excluded so as not to lead to falsified values. Results. Indicators of the maximum compression force in the early postoperative period, ie the compression force of the external anal sphincter, in both groups were significantly lower than preoperative and ranged from 55 to 154 mm Hg, respectively. and from 63 to 137 mm Hg. This can be explained by the presence of a granulating wound in the pararectal tissue, edema and partial injury of the external anal sphincter during surgery. In the late postoperative period, 6-12 months after surgery, the indicators of basal tone in both groups approached the preoperative indicators. In the main group, the study was performed in 22 patients. In these 22 patients, the tone of the internal anal sphincter did not differ significantly from the preoperative and ranged from 20 to 37 mm Hg. In the control group, in all 32 patients, the basal tone of the anal sphincter was significantly lower than before surgery - from 17 to 28 mm Hg. There were no clinical manifestations of incontinence at rest in either main or control groups. In the late postoperative period in both groups a decrease in the maximum compression force of the external anal sphincter was revealed. In the main group the maximum compression force of the external anal sphincter varied from 71 to 186 mm Hg, and in the control group from 77 to 135 mm Hg, respectively. Conclusion. Surgical treatment of patients with extrasphincteric pararectal fistulas significantly reduces the contractile function of the external anal sphincter in the postoperative period, regardless of the choice of surgery.

scholarly journals Quality of life changes after surgical treatment of retinal detachment

2014 ◽  
Vol 7 (2) ◽  
pp. 23-29
Author(s):  
Z Zh Al-Rashid ◽  
Aleksey Vladislavovich Malyshev ◽  
Ol’ga Igorevna Lysenko
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
Visual Function ◽  
Progressive Increase ◽  
Control Group ◽  
Life Changes ◽  
Late Postoperative Period

Purpose. To study the effect of vitrectomy in retinal detachment (RD) treatment on the quality of life (QOL) of patients. Methods. We examined 67 patients who underwent surgical treatment of RD. QOL was assessed by VFQ-25 questionnaire before surgery and after 1 week and 6 months of it. Results. When assessing QOL before surgery, there was a significant reduction of the total QOL index by an average of 35% in comparison to the control group (p < 0.001). In the late postoperative period, a progressive increase of the total QOL index and visual function was recorded. Conclusion. Vitrectomy for the treatment of retinal detachment improves patients’ visual function and quality of life.

scholarly journals ТREATMENT OF STENOSIS OF THE PYLORIC BULBAR ZONE OF ULCERATIVE GENESIS USING MINIMALLY INVASIVE SURGERY

2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Clinical Signs ◽  
State Institution ◽  
Disease Recurrence ◽  
Control Group ◽  
Surgical Interventions ◽  
Remote Observation

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions. Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions. Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.

scholarly journals Brachicefalinių arterijų chirurginės korekcijos rezultatai

2003 ◽  
Vol 1 (4) ◽  
pp. 0-0
Author(s):  
Ilona Bičkuvienė
Keyword(s):  
Health Status ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Postoperative Period ◽  
Clinical Symptoms ◽  
Neurological Symptoms ◽  
Surgical Correction ◽  
Control Group ◽  
Combined Lesions ◽  
Brachiocephalic Arteries

Ilona BičkuvienėVilniaus universiteto Neurologijos ir neurochirurgijos klinikaVilniaus greitosios pagalbos universitetinės ligoninėsNeuroangiochirurgijos centrasŠiltnamių g. 29, LT-2043 Vilnius Įvadas / tikslas Įvertinti vertebrobazilinės ligos klinikinę raišką ligoniams, kuriems yra įvairi brachicefalinių arterijų patologija, iki ir po šių arterijų rekonstrukcijos. Ligoniai ir metodai Ištirti 288 ligoniai, kuriems pasireiškė vertebrobazilinės ligos klinikiniai simptomai ir įvairi brachicefalinių arterijų patologija. Chirurgiškai gydyti 228 ligoniai, o konservatyviai – 60 ligonių, kurie sudarė kontrolinę grupę. Visi ligoniai ištirti neurologo, jiems atliktas brachicefalinių arterijų dvigubas skenavimas ir aortos lanko šakų angiografija. Operuotų arterijų neurologiniai klinikiniai pokyčiai ir kraujotaka buvo vertinama per 3 metų laikotarpį. Rezultatai Paroksizmai yra būdingi neurologiniai simptomai esant brachicefalinių arterijų patologijai. Šių arterijų chirurginė korekcija atliekama, jei konservatyvus gydymas buvo neveiksmingas, o neurologinė simptomatika progresavo. Chirurginiam gydymui įvertinti ligoniai tirti po operacijos praėjus ne daugiau kaip 2 savaitėms, iki 1 metų ir nuo 1 iki 3 metų. Pagrindinis dėmesys buvo sutelktas į neurologinių simptomų pokyčius trečiuoju pooperaciniu laikotarpiu. Teigiami klinikiniai pokyčiai (paroksizmai po operacijos visiškai nebesikartojo) nustatyti daugiausia tiems ligoniams, kuriems buvo brachicefalinių arterijų anomalijos (82,86%) ir deformacijos (72,54%). Chirurginis gydymas buvo neveiksmingas 30% ligonių, kuriems yra brachicefalinių arterijų ateroskleroze, ir 21% – mišri patologija. Papildomų simptomų, kurių iki operacijos nebuvo, atsirado mišrios patologijos grupės ligoniams (3,41%). Chirurginio gydymo veiksmingumui įrodyti ištirta 60 kontrolinės grupės ligonių. Teigiamų sveikatos būklės pokyčių nenustatyta. Ketvirtadalio ligonių sveikatos būklė nepakito, kitų – pablogėjo dėl naujų praeinančių smegenų išemijos priepuolių ir insultų. Išvados Teigiami pooperaciniai pokyčiai per trejų metų laikotarpį leidžia teigti, jog subjektyvūs ir objektyvūs neurologinai vertebrobazilinės ligos simptomai siejasi su įvairia brachicefalinių arterijų patologija. Tais atvejais, kai konservatyvus gydymas neveiksmingas, galima chirurginė brachicefalinių arterijų korekcija. Prasminai žodžiai: brachicefalinės arterijos, vertebrobazilinė liga, chirurginis gydymas, pooperaciniai rezultatai Vertebrobasilar disease. Results of surgical correction of brachiocephalic arteries Ilona Bičkuvienė Background / objective The aim of this study was to analyze preoperative and 3-year follow-up postoperative symptoms of vertebrobasilar disease due to the pathology of brachiocephalic arteries. Methods 288 patients with symptoms of vertebrobasilar disease due to the pathology of brachiocephalic arteries have been examined. 228 patients were operated on and 60 (control group) were treated conservatively. All the patients were examined by the neurologist, duplex scanner and angiographycally. Neurological clinical dynamics and blood flow in operated on arteries were evaluated in a 3-year period. Results Paroxysms are characteristic of the lesions of the brachiocephalic arteries. Surgical correction of the lesions was performed if the conservative treatment had no effect and the neurological symptoms were progressing. To evaluate the effectiveness of surgical treatment, the patients were examined in the early postoperative (2 weeks after operation) and late postoperative period: 1) until 1 year and 2) from 1 to 3 years. Attention was focused on the dynamics of the neurological symptoms in the third postoperative period (from 1 to 3 years). Positive clinical dynamics (paroxysms disappeared) was ascertained mostly in the groups with anomalies of the brachiocephalic arteries (82.86%) and deformations (72.54%). This surgical treatment was ineffective in 30% of cases in the group with atherosclerotic and in 21% with combined lesions of brachiocephalic arteries. New additional symptoms after operation were ascertained in the group with combined lesions (3,41%). To approve the effectiveness of surgical treatment, 60 patients (control group) were examined. They had been treated conservatively, without a positive dynamics of their health status. There were no changes in the health status for the quarter of the patients. In all the others the health status worsened – TIA and strokes appeared. Conclusions A 3-year positive postoperative dynamics allow us to conclude that the subjective and objective clinical symptoms are connected with various types of pathology of brachiocephalic arteries. In cases when conservative treatment is unsuccessful, surgical treatment of brachiocephalic arteries can be applied. Keywords: brachiocephalic arteries, vertebrobasilar disease, surgical treatment, postoperative results

scholarly journals CHANGE IN THE QUALITY OF LIFE OF CHILDREN AFTER SURGICAL TREATMENT OF RETINAL DETACHMENT

2018 ◽  
Vol 25 (6) ◽  
pp. 149-153
Author(s):  
A. N. Sergienko ◽  
V. V. Dashina ◽  
A. V. Malyshev ◽  
O. I. Lysenko ◽  
S. V. Yanchenko
Keyword(s):  
Quality Of Life ◽  
Statistical Analysis ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
Control Group ◽  
Russian Version ◽  
Group I ◽  
Group Ii

Aim.The study was designed for the evaluation of the quality of life of children with retinal detachment during vitrectomy.Materials and methods. 23 children with retinal detachment aged from 10 to 17 years were treated. Surgical treatment consisted of a three-port vitrectomy and a laser endocoagulation of the retina. 3 groups were formed with the help of a random sampling. During the surgical treatment of group I (n=8), only balanced non-oxidant solutions of salts (Balsed Salt Solution − BSS) were used. Tablets of antioxidant preparations were not assigned. Saline solutions with antioxidants (BSS plus) were used to carry out surgery for group II (n=8). Group III (n=7) was additionally taking antioxidant preparations peros for 3 months in the postoperative period . The quality of life was studied using the abridged Russian version of the VFQ-25 questionnaire. 10 children of the same age with no indications of surgical treatment of retinal detachment were selected for the control group. Statistical analysis of the obtained data was carried out using a set of programs for applied statistical analysis Analyst Soft, Bio Stat 2007.Results.A week after the surgical treatment, no increase in visometric data was observed. Six months later, a significant increase in visual acuity was revealed. The highest visometric data were observed in group II due to the minimal progression of lens opacities. Group I patients had the lowest values of this index.Conclusion.The positive effect of the surgical treatment of retinal detachment positively influenced the patients’ quality of life in the early and late postoperative period.

New Potentialities in Surgical Treatment of Proximal Humerus

2011 ◽  
Vol 18 (1) ◽  
pp. 21-27
Author(s):  
Eduard Ivanovich Solod ◽  
A F Lazarev ◽  
Ya G Gudushauri ◽  
M G Kakabadze ◽  
A S Roskidaylo ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Surgical Treatment ◽  
General Condition ◽  
Postoperative Period ◽  
Proximal Humerus ◽  
Original Method ◽  
Early Postoperative Period ◽  
Early Rehabilitation ◽  
Control Group ◽  
Stable Fixation

Original method of stressed osteosynthesis for the treatment of proximal humerus is proposed. Primary tension of Y-shaped pin fixative and secondary tension that is created at its intramedullar insertion and blocking enable to achieve stable fixation of fragments without inflicting additional intraoperative injury in patients of any age and independently of their general condition. Preservation of blood supple in fragments, low traumatic osteosynthesis, and possibility of patients' early rehabilitation define the prospective of this technique for the treatment of patients with fractures on the background of osteoporosis. The importance of drug therapy for osteoporosis in the early postoperative period is shown. Experience in treatment of 62 patients aged from 23 to 78 years is presented. Control group included 30 patients with similar fractures who were treated using osteosynthesis. In the main group good results were achieved in 82.3% of patients, satisfactory - in 17.7%, no poor results were observed. In control group good results made up 40%, satisfactory - 56.7%, poor 0 3.3%.

scholarly journals Muscular syndrome manifestations at the patients in the late postoperative period after the herniation of invertebral disk surgical treatment

2008 ◽  
Vol 7 (5-2) ◽  
pp. 448-450
Author(s):  
S. A. Fedyanin
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Spinal Canal ◽  
Pain Syndrome ◽  
Neurological Status ◽  
Resonance Imaging ◽  
Canal Stenosis ◽  
Adjacent Segments ◽  
Ultrasound Investigation ◽  
Late Postoperative Period

Checkup of 215 patients in the late period after the dick herniation surgical treatment. Middle age (45,6 ± 0,6) years. Postoperative period is (7,4 ± 0,4) years. The patients were examined: neurological status, lumbar spine radiography, magnetic resonance imaging procedure, spinal canal ultrasound investigation, muscular syndrome index determination. Revealed pain syndrome caused by the disk herniation relapse in operated and adjacent segments, spondylosis and spondylarthrosis, spinal canal stenosis, aseptic epiduritis. The pain syndrome at those patients entails by development of the muscular syndrome and pathologic motor skill.

scholarly journals The choice of surgical treatment method of perforated pyloroduodenal ulcer

2021 ◽  
Vol 88 (1-2) ◽  
pp. 8-13
Author(s):  
D. V. Maksymchuk ◽  
V. I. Mamchich ◽  
V. D. Maksymchuk
Keyword(s):  
Surgical Treatment ◽  
Clinical Application ◽  
Pyloric Stenosis ◽  
Postoperative Period ◽  
Physiological Function ◽  
Treatment Method ◽  
Main Group ◽  
Control Group ◽  
Surgical Tactics ◽  
Suturing Methods

Objective. To develop a method of organ-saving operation aimed at preservation of the physiological function of the pylorus and the normal physiological functioning of the pyloroduodenal area in patients with combined perforated, stenotic pyloroduodenal ulcers. Materials and methods. The study included 60 patients who faced surgery treatment in relation to complicated combined perforated, stenotic pyloroduodenal ulcers. Depending on diagnostic and surgical tactics applied, patients were conditionally divided into two groups. The control group consisted of 30 patients who underwent standard suturing methods. The main group also consisted of 30 patients in whom the developed method was applicated. Results. In the control group at the postoperative period of 30 patients operated in different ways complications occurred in 12 persons or in 40% of cases. In the main group of 30 patients operated according to the proposed method, complication in the form of anastomositis occurred in 1 patient only. Conclusions. The obtained results substantiate recommendation to clinical application the suggested method of organ-saving operation aimed to preserve the physiological function of the pyloroduodenal area, which excludes perforated ulcers suturing without pyloric stenosis elimination and gastrectomy on the background of peritonitis.

scholarly journals Older patients with proximal femur fractures and SARS-CoV-2 infection – An observational study

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 5
Author(s):  
Abdus S Burahee ◽  
Veronica E Barry ◽  
Robert P Sutcliffe ◽  
Sabreena Mahroof
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Hip Fractures ◽  
Postoperative Period ◽  
Older Patients ◽  
Supplemental Oxygen ◽  
Organ Support ◽  
Control Group ◽  
Femur Fractures ◽  
Increased Risk

Background: Older patients are at increased risk of severe COVID-19 infection and associated mortality. There are limited data evaluating the outcome of older patients with hip fractures treated during the COVID-19 pandemic, and it has been suggested that these patients should be treated non-operatively due to high mortality risk. The aim of this study was to report the outcomes of COVID-19 infected hip fracture patients treated at a single centre. Methods: This was a retrospective cohort study. Data were collected from February 2020 (after the first confirmed COVID-19 infected patient was reported in the Midlands region of the UK). All patients admitted to the hospital with femoral neck fractures were included. Patient demographics, comorbidity, COVID-19 status, and short-term clinical outcomes were obtained by review of electronic medical records. The outcomes of COVID-19 infected patients were compared with non-COVID-19 patients treated during the study period. Results: Twenty-nine patients were included (mean age of 80 years), of whom 14 (48%) were tested positive for COVID-19 infection in the postoperative period. Overall, 26 patients (90%) underwent surgical treatment. COVID-19 infected patients had significantly higher Charlson comorbidity scores compared to the control group (5 vs. 4; p = 0.047). Only 5 COVID-19 infected patients (36%) required supplemental oxygen therapy in the postoperative period, and no patients required respiratory or other organ support. The 30-day mortality rate in COVID-19 patients was 14% compared to 0% in the negative controls (p = 0.22). Interpretation: COVID-19 infection did not increase the mortality rate of older patients undergoing surgery for hip fractures during the pandemic. The authors recommend careful assessment of patient fitness and prompt surgical treatment. In addition, it was noted that nearly all admissions were either given large boluses of Vitamin D or were on maintenance supplementation, which may have affected the severity of the response to COVID-19 infections.

scholarly journals The role of cytokines in the pathogenesis of infectious complications in surgical treatment of obstructive jaundice of gallstone origin

2021 ◽  
Vol 20 (3) ◽  
pp. 105-111
Author(s):  
O. V. Smirnova ◽  
N. G. Elmanova
Keyword(s):  
Surgical Treatment ◽  
Obstructive Jaundice ◽  
Blood Serum ◽  
Proinflammatory Cytokines ◽  
Postoperative Period ◽  
Infectious Complications ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Necrosis Factor Alpha ◽  
High Concentrations

Aim. To study the content of cytokines in the blood serum of patients with obstructive jaundice of gallstone origin before and after surgical treatment, depending on the development of postoperative complications.Materials and methods. The treatment group consisted of 70 patients with the diagnosis of obstructive jaundice of gallstone origin, verified following a comprehensive clinical and instrumental examination. In 54 patients, the postoperative period was uncomplicated, and in 16 patients, various infectious complications in the postoperative period were revealed. The control group consisted of 125 healthy volunteers. The concentration of six cytokines (interleukin (IL)-2, IL-4, IL-18, IL-10, tumor necrosis factor alpha (TNFα), and interferon gamma (INF γ)) was determined using reagent kits manufactured by Vector-Best LLC (Novosibirsk, Russian Federation) by enzyme-linked immunosorbent assay on the Thermo Scientific analyzer (BioMerieux, France).Results. We identified significantly high concentrations of proinflammatory cytokines in the blood serum of patients with obstructive jaundice of gallstone origin upon admission, compared with the data obtained in the study of blood serum in the control group and in patients with obstructive jaundice after surgery. In the postoperative period in patients with obstructive jaundice without complications, the proinflammatory cytokines are significantly reduced and IL-4 is increased, whereas with the development of infectious complications, the level of proinflammatory cytokines is significantly elevated.Conclusion. In the pathogenesis of obstructive jaundice, a local inflammatory process plays an essential role. This is confirmed by statistically significant changes in the studied cytokines. The established increase in the concentration of IL-4, which has anti-inflammatory activity, indicates its importance in the mechanisms underlying the absence of infectious complications in the postoperative period of obstructive jaundice of gallstone origin. The revealed increase in the levels of IL-18, TNFα, and INFγ in the blood serum of patients suggests their role in the pathogenesis of infectious complications in the postoperative period of obstructive jaundice of gallstone origin.

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