Surgical methods of treatment of intestinal passage disturbances with the characteristics of constipation in patients with intestinal stoma based on own experience

AbstractStoma is an intestinal fistula created in emergency or by elective indications, and it is done to drain out the digestive tract content. In some patients there is a disturbance passage of gastric contents through the stoma, which may take the form of chronic constipation or even periodic subileus that will sooner or later require surgical treatment.The aim of the study was the assessment of the causes and method of treatment of constipation in patients with intestinal stoma.Material and methods. A total of 331 patients with stoma followed by Ostomy and Proctology Outpatient Clinic were included in the study in the years 2011-2014. The study included 146 women and 185 men and the average age was 61.3 ± 12.7 years. Within the entire froup, 273 patients had the end stoma performed whereas in 58 patients the loop stoma was created. The highest percentage of patients were the ones with diverticulosis and colorectal cancer, i.e. 132 and 114 patients respectively. A stoma was created in 35 patients due to inflammatory bowel disease (IBD), in 23 patients because of cancer, in 14 as a result of injuries and in 13 due to rectovaginal fistula.Results. Out of the entire group subject to study (331 patients) 93 patients (28.1%) suffered from constipation. 50 patients with constipation required surgical intervention. The most common indication for surgical treatment was the parastomal hernia (36 patients, 72%), other indications were the narrowing of the stoma (5 patients, 10%), its collapse (6 patients, 12%) or prolapse (3 patients, 6%). Parastomal hernia was responsible for 84% of constipation within the stoma and 86.1% were treated with laparotomy (31 out of 36 patients). Other causes of constipation were the stomal stenoses (5 patients), collapse of the stoma (6 patients) and stomal prolapse (3 patients). All patients were treated surgically with a good final result.Conclusions. Constipation associated with dysfunction of the stoma in most cases should be treated surgically. Parastomal hernia is the most common cause of constipation in the stoma. Treatment should be performed in due time because of the possibility of developing complications, especially dangerous one is a strangulated parastomal hernia and ischemia of stoma.

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Treatment of inflammatory diseases of the female genitalia with iontophoresis

Kazan medical journal ◽

10.17816/kazmj76684 ◽

1927 ◽

Vol 23 (4) ◽

pp. 425-429

Author(s):

N. S. Utochnikova

Keyword(s):

Young Women ◽

Surgical Intervention ◽

Inflammatory Diseases ◽

The Other ◽

Female Genitalia ◽

Physical Methods ◽

Surgical Methods ◽

The One ◽

Methods Of Treatment ◽

Female Genital

The treatment of inflammatory diseases of the female genitalia has long been one of the most important tasks of the gynecologist. With the development of surgery, surgical methods of treatment began to be applied: exudates were removed, the uterus and inflamed appendages were extirpated, etc.; but the danger of surgical intervention on the one hand, and on the other - the severe consequences of removal of organs such as ovaries, especially in young women - forced gynecologists to spend much effort in discovering and improving non-operative methods of treatment of inflammatory diseases of the female genital parts. Among these methods, physical methods such as water, mud, light baths, massage, etc., as well as those related to electricity have long been prominent.

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Predictors of Surgical Intervention in Patients with Inflammatory Bowel Disease

QJM ◽

10.1093/qjmed/hcab100.017 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Khaled Hamdy Abd El Megeed ◽

Shereen Abou Bakr Saleh ◽

Christina Alphonse Anwar ◽

Ahmed Elkattary Mohamed Elkattary

Keyword(s):

Inflammatory Bowel Disease ◽

Surgical Treatment ◽

Bowel Disease ◽

Surgical Intervention ◽

High Sensitivity ◽

Medical Patients ◽

Mayo Score ◽

Calprotectin Level ◽

Inflammatory Bowel ◽

The Mean

Abstract Background Inflammatory bowel disease (IBD) is comprised of two major disorders: Ulcerative Colitis and Crohn’s disease. Ulcerative Colitis affects the colon, where as Crohn’s disease can involve any component of the gastrointestinal tract from the mouth to the perianal area. These disorders have somewhat different pathologic and clinical characteristics, but with substantial overlap; their pathogenesis remains poorly understood. Objective To determine & detect different predictors that help us to characterize patients with high probability of undergoing surgical intervention for inflammatory bowel diseases. Patients and Methods The present study was designed to detect & identify possible factors that can be used to predict surgical intervention in patients with IBD. The present study was a case control study that was conducted on 80 patients with inflammatory bowel disease (either controlled by medical treatment or needed surgical intervention as a part of disease control) who were recruited form Ain-Shams university hospitals and El Quabbary general hospital in Alexandria. In the present study, the mean age of the included patients was 36.67 ±8.5 years old and 50% of the patients were males. The mean age at the onset of the disease was 25.81 ±6.8 years old. Results In the present study, there were statistically significant differences between surgical and medical patients in terms of CDAI for CD (p < 0.001) and Mayo score for UC (p < 0.001). Surgical patients were more likely to have higher scores. CDAI and Mayo score were negative predictors of surgical treatment. CDAI score > 287 and Mayo score > 8.5 achieved high sensitivity and specificity for the detection of surgical treatment. In the present study, we found that there was statistically significant differences between surgical and medical patients in terms of Stool Calprotectin level. Surgical patients were more likely to have higher Stool Calprotectin level. Stool Calprotectin level was negative predictor of surgical treatment at a level of > 341.5 microgm/gm with high sensitivity and specificity. Conclusion Surgical treatment is a common outcome in IBD. Certain clinical features and the extent of disease are risk factors for surgical intervention. Our study indicates that smoking, Chron’s disease, perianal disease, granulomas, higher severity scores, higher stool Calprotectin level, CRP, and ESR were associated with higher risks of surgical intervention. In addition, smoking, peri-anal disease, CDAI, Mayo score, Stool Calprotectin level, and CRP level were predictors of surgical treatment. The findings of our analysis have implications for practice, particularly in the promotion of preoperative individualized risk prediction. The ability to predict which patients will need surgery and target more intensive, early treatment to that group would be invaluable. Further research through large prospective cohort studies is needed to confirm our findings and conclusions.

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Results of surgical treatment of Peyroni’s disease

Urologicheskie vedomosti ◽

10.17816/uroved7125-29 ◽

2017 ◽

Vol 7 (1) ◽

pp. 25 ◽

Cited By ~ 1

Author(s):

Yuliya S Moscaleva ◽

Igor A Korneyev

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Erectile Function ◽

Peyronie’S Disease ◽

Surgical Methods ◽

Peyronie's Disease ◽

Methods Of Treatment

Surgical methods of treatment of Peyronie’s disease by plication corporoplasty proved to be effective in the near and distant postoperative periods in the examined group of patients. These methods made it possible to quickly achieve the normalization of the shape of the penis without affecting the erectile function which enabled for patients to restore copulative activity and improve the quality of life.

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Surgical treatment of complications of Crohn’s disease

Vestnik of Russian military medical Academy ◽

10.17816/brmma12241 ◽

2018 ◽

Vol 20 (1) ◽

pp. 111-116

Author(s):

I A Solovev ◽

A M Pershko ◽

D P Kurilo ◽

M V Vasilchenko ◽

E S Silchenko ◽

...

Keyword(s):

Crohn’S Disease ◽

Surgical Treatment ◽

Crohn's Disease ◽

Surgical Intervention ◽

Intestinal Anastomosis ◽

Clinical Manifestations ◽

Intestinal Fistula ◽

Subtotal Resection ◽

Surgical Interventions ◽

Conservative And Surgical Treatment

Possibilities and options of surgical treatment of complications of Crohn’s disease in the general surgical hospital are considered. Patients underwent various surgical interventions: ileum resection with «side-to-side» anastomosis (4 patients), resection of ileocecal department with the formation of ileoascendoanastomosis (2 patients), total coloproctectomy with the formation of ileostomy (2 patients), right-sided hemicolectomy (1 patient), obstructive resection of transverse colon (1 patient), obstructive resection of sigmoid colon (2 patients). Postoperative complications developed in 3 patients (25%), among them: postoperative wound suppuration - 2, dehiscence of anastomosis in 1 patient, which led to the formation of internal intestinal fistula and death. It was found that with limited lesions of colon in Crohn’s disease (less than a third of the colon) can be limited to resection of the affected segment with formation of intestinal anastomosis in the limits of healthy tissues. In the presence of lesions in the ascending department of colon proximal border of resection should be at the level of middle colic vessels with preservation of the latter. In long Crohn’s disease of colon with severe clinical manifestations of the operation of choice is a subtotal resection of colon with the imposition of single-barrel ileostomy. Surgical treatment of complicated forms of Crohn’s disease is in all cases performed in surgical profile hospitals, taking patients by ambulance. Most often, patients have delayed indications for operations, which gives the opportunity to carry out a comprehensive preoperative preparation. In all cases, complications of Crohn’s disease requires an individual approach, which combines conservative and surgical treatment. Surgical intervention is determined by the shape and characteristics of the course of complications of Crohn’s disease.

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"The effectiveness of ultrasound and CT in the diagnosis of saliva stone disease. Conservative methods of treatment of salivary stone disease as an alternative to surgery.»

The actual problems in dentistry ◽

10.18481/2077-7566-2018-14-4-58-63 ◽

2018 ◽

Vol 14 (4) ◽

pp. 58-63

Author(s):

Лариса Зюлькина ◽

Larisa Zyul'kina ◽

Екатерина Костригина ◽

Ekaterina Kostrigina ◽

Евгений Афанасьев ◽

...

Keyword(s):

Salivary Gland ◽

Surgical Treatment ◽

Salivary Glands ◽

Stone Disease ◽

Ct Diagnosis ◽

Main Method ◽

Surgical Methods ◽

Modern Methods ◽

Inflammatory Processes ◽

Methods Of Treatment

Subject: Salivary stone disease is a disease that occurs as a result of inflammatory processes occurring in the salivary glands. More recently, salivary stone disease was considered a rare disease. Thanks to the available modern methods of diagnosis, the detection of salivary stone disease is significantly progressing. Purpose: In our work we aimed to figure out the most effective methods of diagnosis of salivary stone disease . Among the private methods of radiation diagnosis of salivary stone disease, we have identified ultrasound and CT examination of the salivary glands and ducts. Our task was also to determine how conservative treatment is competitive with the surgical method of treatment of this disease. Results: As a result of our studies , we concluded that the ultrasound method in the diagnosis of inflammation of the salivary glands and the presence of concretions in the glands and ducts is highly informative , safe and accessible to patients . Conservative methods of treatment used in patients who were diagnosed with the presence of concretions at the outlet of the salivary gland ducts are no less effective than surgical methods. Surgical treatment of salivary stone disease is advisable only in cases of block of the salivary gland and ducts concretions more than 0.5 cm in diameter. Conclusion: Salivary Stone disease in our medical institution is diagnosed quite often. The method of ultrasound diagnosis is the main method of examination of patients who came to us with symptoms of salivary stone disease. CT method is advisable to carry out patients in need of surgical treatment of the disease. The method of CT diagnosis allows to establish the exact coordinates and sizes of concretions located in the salivary glands and deep in the ducts.

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Pathophysiological features of development, clinical features and treatment of malignant glaucoma

Ophthalmology journal ◽

10.17816/ov15379 ◽

2019 ◽

Vol 12 (3) ◽

pp. 59-65

Author(s):

Olga A. Kiseleva ◽

Srbui M. Kosakyan ◽

Liya V. Yakubova ◽

Alexander M. Bessmertny ◽

Lubov’ V. Vasilenkova

Keyword(s):

Surgical Treatment ◽

Laser Treatment ◽

Treatment Process ◽

Diagnostic Methods ◽

Pathophysiological Mechanisms ◽

Pathological Conditions ◽

Malignant Glaucoma ◽

Surgical Methods ◽

Mechanisms Of Development ◽

Methods Of Treatment

Malignant glaucoma is a difficult task for an ophthalmologist in the treatment process. This is a multifactorial condition that occurs in anatomically predisposed eyes. Malignant glaucoma remains one of the most severe clinical forms of glaucoma requiring timely diagnosis and immediate treatment. Diagnostic issues, pathophysiological mechanisms of development and methods of treatment are still controversial. The diagnosis of malignant glaucoma is often late due to similarity with some other pathological conditions. In many cases malignant glaucoma is resistant to medication and laser treatment. Surgical treatment of malignant glaucoma is complex and not always effective. The review discusses the possible pathophysiological mechanisms of development, diagnostic methods of research, as well as the applied conservative, laser and surgical methods of treatment of malignant glaucoma.

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SURGICAL TREATMENT OF PATIENTS WITH DISLOCATION OF HEAD OF THE ARM AND ROTATIONAL CONTRACTURE OF THE FOREARM WITH BIRTH PALSY OF THE UPPER EXTREMITY

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors2132-38 ◽

2014 ◽

Vol 2 (1) ◽

pp. 32-38

Author(s):

Nikolai Alexandrovich Ovsyankin ◽

Natalia Anatolievna Naumochkina

Keyword(s):

Surgical Treatment ◽

Upper Extremity ◽

Upper Limb ◽

Diagnostic Methods ◽

Pediatric Orthopedics ◽

Actual Problem ◽

Surgical Methods ◽

High Incidence ◽

Birth Palsy ◽

Methods Of Treatment

Introduction. The obstetrical upper limb paralysis and its sequelae are an actual problem of pediatric orthopedics and traumatology. Relevance of the problem is due to high incidence of this disease and increase of child disability. Purpose. To present the method of treating patients with a dislocated radius head and forearm rotation contracture in birth paralysis of the upper extremity. ^Materials and Methods. This article presents the clinical material on the survey in the Institute and the surgical treatment of 12 patients aged from three to 15 years with the pathology of the elbow and forearm, developed after the obstetrical upper limb paralysis. Results. We present the clinical picture, diagnostic methods, indications to surgical treatment, as well as new and effective methods of performing the proximal radioulnar joint arthrodesis in young children with obstetrical paralysis of the upper extremity. The use of surgical methods of treatment in such patients has improved the function of the arm and self-care in 95 per cent of cases, reduced their disability and increased their choice for occupation activities.

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Anesthesia for arthroscopic surgery on the lower extremities in elderly patients

Innovative medicine of Kuban ◽

10.35401/2500-0268-2020-20-4-65-72 ◽

2020 ◽

pp. 65-72

Author(s):

M. V. Korolev ◽

V. Ya. Vartanov ◽

S. A. Stolyarov ◽

A. A. Gusak

Keyword(s):

Surgical Treatment ◽

Elderly Patients ◽

Arthroscopic Surgery ◽

Lower Extremities ◽

Day Surgery ◽

Review Of Literature ◽

Minimal Invasiveness ◽

Surgical Methods ◽

Methods Of Treatment

A significant increase in arthrosis and arthritis causes not only conservative but also other various methods of surgical treatment. Minimal invasiveness, less trauma compared to traditional surgical methods of treatment, the ability to carry out treatment on the principle of one-day surgery determine their greater demand.The paper presents a review of literature data on the features of anesthesia in elderly patients who underwent arthroscopic surgery on the lower extremities.

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Outcome of complete macular rupture (two clinical cases)

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-114-116 ◽

2021 ◽

pp. 114-116

Author(s):

S.I. Makogon ◽

◽

E.N. Kuznetsova ◽

Y.A. Bryukhanova ◽

◽

...

Keyword(s):

Visual Acuity ◽

Surgical Treatment ◽

Key Words ◽

Visual Functions ◽

Optical Media ◽

Surgical Methods ◽

Modern Methods ◽

Methods Of Treatment ◽

Management Tactics ◽

Clinical Cases

Purpose. To present the course of a complete macular rupture, depending on the management tactics. Material and methods. On the example of two clinical cases, the outcome of a complete macular rupture is presented: without surgical treatment and as a result of surgery. Results. Surgical methods of treatment made it possible to obtain high visual functions in the patient - visual acuity up to 0.9. Conclusions. Modern methods of surgical treatment of MR provide restoration of the structure of the outer layers of the retina and high visual functions, provided that the optical media of the eye are transparent. Key words: macular rupture, surgical treatment of macular rupture, course of macular rupture without treatment.

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ESTIMATION OF RESERVES FOR IMPROVING THE RESULTS OF PATIENTS WITH MULTIPRESISTANT PULMONARY TUBERCULOSIS IN THE APPLICATION OF SURGICAL METHODS BASED ON ANALYSIS OF THE EFFICIENCY OF CONSERVATIVE TREATMENT OF A SPECIFIED COHORT

EUREKA Health Sciences ◽

10.21303/2504-5679.2018.00737 ◽

2018 ◽

Vol 5 ◽

pp. 33-39

Author(s):

Oleg Khmel ◽

Igor Kalabukha ◽

Vladimir Ivashchenko

Keyword(s):

Surgical Treatment ◽

Conservative Treatment ◽

Pulmonary Tuberculosis ◽

Surgical Intervention ◽

Cohort Analysis ◽

Multidrug Resistant ◽

Complete Cure ◽

Results Of Treatment ◽

Number Of Patients ◽

Surgical Methods

In order to improve the results of treatment of patients with multi-resistant pulmonary tuberculosis with the use of surgical methods, the effectiveness estimation of conservative treatment of 176 patients with this form of tuberculosis according to cohort analysis data in two districts of Kyiv were done. In the list were included following parameters: type of the tuberculosis, its clinical-radiological form and the prevalence of the process, the results of conservative treatment in patients who completely finished the course of anti-TB chemotherapy and the results of conservative treatment of 81 patients who had indications for surgical treatment but had not been operated. Processing of the materials of the study was carried out with the use of licensed software products included in the Microsoft Office Professional 2007 package. The predicted results of treatment were calculated on the condition of surgical intervention. Out of the total sample of patients, 31.3 % of the patients completed treatment. Mortality was 16.5 %, transferred to palliative care 11.9 %. More than one in three patients (35.2 %) stopped treatment at different times from the start. According to the clinic of thoracic surgery SU "National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky NAMS of Ukraine ", the overall effectiveness of treatment for patients with limited multidrug-resistant tuberculosis with the use of surgical intervention is about 95 % in the absence of mortality. We have modelled the potential results of treatment of the selected cohort in case of the surgical stage is fully and timely applied in a complex of therapeutic treatment. If all 81 patients with indications for surgical treatment used that way, then, with the above efficiency, a complete cure could be predicted in 77 patients (44.5 % of the total number of observations), which in turn would allow predicting the achievement completion of treatment at 64.2 % with complete cure for 60.6 % of patients. Thus, it is established that the positive result of surgical treatment in the general complex of treatment measures in patients with multidrug-resistant pulmonary tuberculosis is able to improve the results of treatment of this contingent more than twice, reduce the mortality almost by three times, reduce the need for repeated courses of treatment from 7.4 % to 1.7 %, as well as to reduce the epidemiological reservoir of infection due to a significant decrease in the number of patients with failure to treat tuberculosis, interrupted and palliative treatment.

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