scholarly journals Relaparotomija po pilvo traumų

2004 ◽  
Vol 2 (4) ◽  
pp. 0-0
Author(s):  
Jonas Dauderys ◽  
Donatas Venskutonis
Keyword(s):  
Abdominal Trauma ◽  
Diffuse Peritonitis ◽  
Treatment Results ◽  
Operative Complications ◽  
Trauma Diagnostics ◽  
Abdominal Hemorrhage ◽  
Post Operative Complications

Jonas Dauderys, Donatas VenskutonisKauno medicinos universitetoBendrosios chirurgijos klinika,VšĮ II Kauno klinikinė ligoninėJosvainių g. 2, LT-47144 KaunasEl. paštas: [email protected] Tikslas Aptarti pilvo traumos diagnostikos ir gydymo problemas, išanalizuoti gydymo (relaparotomijų) rezultatus, palyginti juos su aprašytais literatūroje. Ligoniai ir metodai Išanalizuotos 1981–1999 m. nuo uždaros (792) ir atviros (414) pilvo traumos gydytų 1206 ligonių ligos istorijos. Įtarus vidaus organų sužalojimą atliktos 395 laparotomijos. Rezultatai 82 (96,4%) operuoti ligoniai pasveiko, 13 (3,4%) – mirė. Dėl pooperacinių komplikacijų 25 (6,5%) ligoniams atlikta relaparatomija. Penkiolikai ligonių relaparotomija atlikta dėl išplitusio ar riboto peritonito, aštuoniems – dėl ankstyvo žarnyno nepraeinamumo ir dviem – dėl vidinio kraujavimo. Iš jų 20 (80%) ligonių pasveiko, o 5 (20%) mirė. Dviem ligoniams atlikta po dvi pakartotines operacijas. Išvados Relaparotomija turi būti motyvuota, ankstyva, optimalios apimties, pašalinti komplikacijos priežastį. Maitinamoji mikrojejunostomija turi būti sudėtinė tokios operacijos dalis. Programuota relaparotomija šiuolaikinėmis diagnostikos ir gydymo sąlygomis atliekama labai retai. Reikšminiai žodžiai: pilvo trauma, diagnostinė echoskopija, laparocentezė, laparoskopija, relaparatomija Relaparotomy after abdominal trauma Jonas Dauderys, Donatas Venskutonis Objective To define abdominal trauma diagnostics and treatment problems, analyze treatment results (including relaparotomies), and compare them with literature data. Patients and methods From 1981 till 1999 we treated 1206 patients with blunt (792) and open (414) abdominal trauma. Laparotomy was performed in 395 patients. Results 389 patients (96.4%) were healed, and 13 died (3.4%). Relaparotomy was performed in 25 patients (6.5%) due to post–operative complications. 15 laparotomies were performed because of diffuse or local peritonitis, 8 – because of ileus, and 2 – because of intra abdominal hemorrhage. Twenty patients were healed (80%), and 5 died (20%). In 2 patients relaparotomies were performed twice. Conclusions Relaparotomy must be motivated, timely, and must certainly remove cause of the complication. Formalion of feeding microjejunostomy should be a component of the relaparotomy. In case of diffuse peritonitis a repeated programmed relaparotomies nowdays are not advisable. Keywords: abdominal trauma, diagnostic ultrasaund, laparocenthesis, laparoscopy, relaparotomy

scholarly journals The experience of surgical treatment of the patients with extended cicatricial esophageal strictures

2020 ◽  
Vol 73 (2) ◽  
pp. 229-234
Author(s):  
Valeriy V. Boyko ◽  
Serhii O. Savvi ◽  
Alla Yu. Korolevska ◽  
Serhii Yu. Bytyak ◽  
Vitalii V. Zhydetskyi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Life Quality ◽  
Main Group ◽  
Single Step ◽  
Treatment Results ◽  
Short Term ◽  
Operative Complications ◽  
Post Operative Complications

The aim of the researce was the improvement of treatment results of patients with extended post-burn esophageal cicatricial strictures. Materials and methods: The treatment results are presented for 102 patients which were divided into two groups. In 49 patients with extended post-burn esophageal cicatricial strictures of the main group modified esophagoplasty were performed. Traditional esophagoplasty in 53 patients of the comparison group was performed. Results: A trend was observed on reduction in both short-term and long-term post-operative complications and lethality. The comparative analysis showed statistically valid reduction in number of complications caused by radical surgery: in the main group the frequency of short-term post-operative complications was 10,2 %, in the comparison group – 45,3 %, the frequency of long-term post-operative complications being in the main group 8,2 %, and in the comparison group 26,4%. A trend was observed on reduction of both local and general complications, which may be explained by both peculiarities of the operative interventions with application of improved surgical treatment methods and by more efficient pre-operation preparation of the patients. Post-operative lethality level was 2,0 % in the main group, and 3,8% in the comparison group. Life quality parameters in the main group patients in the long-term post-operation period were statistically significantly better. Conclusions: In patients with extended post-burn esophageal cicatricial stricture application of the proposed surgical tactics, modified method of single-step esophagoplasty and esophagoplasty as Step II of the surgical treatment for persons who have a formed contact gastrostomy is an efficient means for patients’ treatment improvement.

Pelvic Canal Narrowing Caused by Triple Pelvic Osteotomy in the Dog

1994 ◽  
Vol 07 (03) ◽  
pp. 110-113 ◽  
Author(s):  
D. L. Holmberg ◽  
M. B. Hurtig ◽  
H. R. Sukhiani
Keyword(s):  
Postoperative Complications ◽  
Pelvic Osteotomy ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Canal Width ◽  
Operative Complications ◽  
Post Operative Complications

SummaryDuring a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.

scholarly journals Functional outcomes of patients with short-segment Hirschsprung disease after transanal endorectal pull-through

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gunadi ◽  
Gabriele Ivana ◽  
Desyifa Annisa Mursalin ◽  
Ririd Tri Pitaka ◽  
Muhammad Wildan Zain ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Hirschsprung Disease ◽  
Treatment Method ◽  
Strongly Correlated ◽  
Short Segment ◽  
Multicenter Studies ◽  
Operative Complications ◽  
Pull Through ◽  
Larger Sample ◽  
Post Operative Complications

Abstract Background Transanal endorectal pull-through (TEPT) is considered the most preferable treatment method for Hirschsprung disease (HSCR) since it is less invasive and has fewer morbidities than transabdominal pull-through. Here, functional outcomes in short-segment HSCR patients after TEPT were assessed and associated with the prognostic factors. Methods Krickenbeck classification was used to assess the functional outcomes in patients with HSCR after TEPT surgery at our institution from 2012 to 2020. Results Fifty patients were involved in this study. Voluntary bowel movement (VBM) was achieved in 82% of subjects. Nine (18%) subjects had soiling grade 1, while two (4%) and two (4%) patients suffered constipation that was manageable with diet and laxative agents, respectively. Patients who underwent TEPT at ≥ 4 years old tended to have soiling more than patients who underwent TEPT at < 4 years old (OR = 16.47 [95% CI 0.9–301.61]; p = 0.06), whereas patients with post-operative complications had 10.5-fold higher risk for constipation than patients without post-operative complications (p = 0.037; 95% CI 1.15–95.92). Multivariate analysis showed male sex was significantly associated with VBM (OR = 9.25 [95% CI 1.34–63.77]; p = 0.024), while post-operative complications were strongly correlated with constipation (OR = 10 [95% CI 1.09–91.44]; p = 0.04). Conclusions The functional outcomes of HSCR patients after TEPT in our institution are considered relatively good. Moreover, the VBM, soiling, and constipation risk after TEPT might be affected by sex, age at TEPT performed, and post-operative complications, respectively, while the age at TEPT performed might not be associated with functional outcomes. Further multicenter studies with a larger sample size are necessary to clarify and confirm our findings.

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