Features of expeditious treatment of gynecologic diseases laparotomic and laparoscopic accesses at women with extragenital pathology

2017 ◽  
pp. 111-114
Author(s):  
V.V. Kostikov ◽  
Keyword(s):  
Cardiovascular Diseases ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Abdominal Pressure ◽  
Short Term ◽  
Comparison Results ◽  
Pulmonary Pathology ◽  
Definition Of ◽  
Gynecologic Patients

The objective: definition of optimum access of an operative measure at gynecologic patients with extragenital pathology. Patients and methods. Were included in research of 240 patients who were on treatment inhospital and operated concerning diseases of internal genitalias laparotomic and laparoscopic accesses. All patients had an extragenital pathology. Depending on operation access all patients were divided into two groups. The main group was made by 120 patients operated with laparoscopic access. 120 patients operated with laparotomic access, made group of comparison. Results. Results of the conducted researches testify that at gynecologic patients with cardiovascular, broncho-pulmonary pathology, an obesity and a diabetes mellitus preferable quick access it is necessary to consider laparoscopy. Operation by laparoscopic access at patients with cardiovascular diseases is accompanied short-term (till 5 minutes) by deterioration of indicators of a hemodynamic at the time of rising of intra abdominal pressure and creation of provision of Trendelenburga. The specified changes quickly are normalized and remain stable throughout operation and in the early postoperative period. Laparotomic access leads to more expressed and long deterioration of hemodynamic indicators at patients with cardiovascular diseases during operation and in the early postoperative period. Laparoscopic operations at patients with extragenital pathology are less enduring, minimum traumatic, are accompanied by small hemorrhage. At the patients operated with laparoscopic access, the pain syndrome, disturbances of function of an intestine is less expressed, a physical activity is quickly restored, terms of stay in hospital and after treatment terms are reduced. Conclusion. At gynecologic patients with the compensated extragenital pathology can be given preference to laparoscopic access of an operative measure. Key words: gynecologic operations, laparotomy, laparoscopy.

Features of the course of postoperative period during surgical treatment laparotomic and laparoscopic access to gynecological diseases in women with extragenital pathology

2017 ◽  
pp. 111-115
Author(s):  
V.V. Kostikov ◽  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Clinical Laboratory ◽  
Pain Syndrome ◽  
Abdominal Pressure ◽  
Laboratory Assessment ◽  
Gynecological Diseases ◽  
Case Rate ◽  
A Current ◽  
Gynecologic Patients

The objective: tactics definition postoperative period at surgical treatment of gynecologic patients with extragenital pathology. Patients and methods. Research included 240 patients who stayed on treatment in a hospital and were operative concerning diseases of internal genitals laparotomical and laparoscopic accesses. All patients had an extragenital pathology. Depending on operation access all patients were divided into two groups. The main group was made by 120 patients who were operated by laparoscopic access. The group of comparison was made by 120 patients whom was operative laparotomical access. Everything patients carried out a clinical-laboratory assessment of a current of the postoperative period. Results. Results of the conducted researches testify that at the compensated accompanying cardiovascular and pulmonary diseases, a diabetes mellitus and an obesity at gynecologic patients at identical gynecologic and extragenital pathology laparoscopic access is more preferable since takes less time, is less travmatical and morbid, is accompanied by a smaller hemorrhage in comparison with the laparotomical. Aftertreatment after laparoscopic operations takes less time that is bound to existence of less expressed pain syndrome, lack of disturbance of function of an intestine, faster restoration of a physical activity and thereof in the smaller postoperative afternoon. At the same time rising of intra abdominal pressure and the provision of Trendelenburg negatively affect hemodynamic indicators at patients with cardiovascular diseases though it doesn’t lead to a decompensation of activity of cardiovascular system. Conclusion. Tactics of maintaining the postoperative period at gynecologic patients with extragenital pathology depends on character of a somatic case rate, option quick to access, a hemorrhage and results of clinical-laboratory inspection. Key words: gynecologic operations, laparotomy, laparoscopy, postpoerative period.

Early Hypotony

2013 ◽  
Author(s):  
Paul A. Sidoti
Keyword(s):  
Postoperative Period ◽  
Insertion Site ◽  
Early Postoperative Period ◽  
Tube Flow ◽  
Secondary Complications ◽  
Ocular Hypotony ◽  
Aqueous Flow ◽  
23 Gauge ◽  
Definition Of ◽  
Tube Shunt

Ocular hypotony in the early postoperative period following tube shunt surgery is relatively common. The pressure level at which structural compromise of the eye and resultant secondary complications (e.g., shallow/ flat anterior chamber, serous and/or hemorrhagic choroidal detachment, chorioretinal folds, corneal folds) occur varies considerably. Some patients may tolerate extremely low pressures well for extended periods of time. However, an increased amount of secondary complications is often seen with intraocular pressures (IOPs) below 6 mm Hg. For the purpose of the ensuing discussion, we will adopt a definition of hypotony based solely on this pressure criterion without regard to the clinical state of the eye. An understanding of the causes of hypotony is critical to its prevention as well as its treatment. The etiologies of hypotony can be broken down into 2 broad categories: general (Table 34.1) and device-specific (Table 34.2). The device-specific causes can be further categorized into those that occur with valved devices and those that occur with non-valved devices. Aqueous flow around the tube at the scleral insertion site may result in early postoperative hypotony regardless of the type of tube shunt used. A 23-gauge needle generally creates a tight track in an area of normal sclera with little potential for excess flow around the tube. Rarely, however, the scleral entry track can be significantly wider than the external diameter of the tube, resulting in peri-tube flow and a low IOP, which are particularly likely to occur following excessive manipulation of the scleral opening as it is created or during tube insertion. The use of a 22-gauge or wider needle will increase the risk of peri-tube flow. Leak around the tube may also occur when a 23-gauge needle is used to create the fistula through an area of abnormally thin, ectatic sclera. Additionally, when 2 or more scleral openings are made in an effort to optimize tube placement, aqueous flow through an unused scleral entry site may result in overfiltration and early postoperative hypotony if the sclerostomy is not tightly closed. Aqueous hyposecretion secondary to ciliary body dysfunction may also result in transient ocular hypotony in the early postoperative period.

scholarly journals Choice of surgical treatment for chronic composite hemorrhoid

2020 ◽  
Vol 39 (3) ◽  
pp. 27-31
Author(s):  
Oleg A. Litvinov ◽  
Evgeniy V. Zhitikhin ◽  
Igor G. Ignatovich ◽  
Hovannes A. Arutyunyan ◽  
Artur G. Arustamov ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Rating Scale ◽  
Stage Iv ◽  
Pain Syndrome ◽  
Numeric Rating Scale ◽  
Early Postoperative Period ◽  
Control Group ◽  
Scientific Center ◽  
Cavernous Tissue ◽  
Numeric Rating

A comparative analysis of the treatment of 142 patients operated on chronic hemorrhoid stage IIIIV has been passed by way of assess the results of using new version of hemorrhoidectomy. The age of patients ranged from 27 to 80 (mean age was 50.46.7). 86 (60.6%) patients were diagnosed with stage III chronic hemorrhoid, at 56 (39.4%) patients the stage IV. For this study patients were divided into basic and controlled groups. The basic group consisted of 73 (51.4%) patients that have had hemorrhoidectomy using our modification. There were 69 (48.6%) patients in control group that have been operated by MilliganMorgan method in second modify of State Scientific Center of Proctology using bipolar coagulator LigaSure. The level of pain was assessed in the early postoperative period by numeric rating scale. The patients had been operated by our method mentioned that the pain syndrome was less pronounced (3.2 against 4.9 balls), that required less painkillers in the early postoperative period. In the case of doing semicircle cuts on the border of anocutaneous crinkle and bringing down mucous membrane, the significant excision of the cavernous tissue doesnt lead to contraction of the anal canal by that reduces the number of functional disorders after hemorrhoidectomy (4 figs, 1 table, bibliography: 7 refs).

Lymphatic Function in the Early Postoperative Period of Breast Cancer Has No Short-Term Clinical Impact

2016 ◽  
Vol 14 (4) ◽  
pp. 220-225
Author(s):  
Mariana Maia Freire de Oliveira ◽  
Luis Otávio Sarian ◽  
Maria Salete Costa Gurgel ◽  
José Geraldo Almeida Filho ◽  
Celso Darío Ramos ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Clinical Impact ◽  
Short Term ◽  
Lymphatic Function

scholarly journals Photobiomodulation of acute pain syndrome after septoplasty

2021 ◽  
Vol 10 (2) ◽  
pp. 34-41
Author(s):  
I. V. Kastyro ◽  
Yu. S. Romanko ◽  
G. M. Muradov ◽  
V. I. Popadyuk ◽  
I. K. Kalmykov ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Acute Pain ◽  
Postoperative Period ◽  
Low Frequency ◽  
Pain Syndrome ◽  
Frequency Component ◽  
Early Postoperative Period ◽  
Total Power ◽  
Laser Exposure

The paper evaluates the effectiveness of the use of therapeutic laser exposure (photobiomodulation therapy – PBMT) to minimize acute pain in the early postoperative period in patients after septoplasty. The study included two groups of patients. Patients of the first group (31 patients) underwent septoplasty with standard management in the postoperative period. Patients of the second group (31 patients) also underwent septoplasty, and then added PBMT to the standard measures of the postoperative period at 3, 6 and 24 h after septoplasty (λ = 0.890 μm, P = 10 W, 2 min) and then intranasally 48 h after septoplasty (λ = 0.630 μm, P = 8 W, 2 min). In patients of both groups, heart rate variability and pain were assessed using a visual analog scale within 48 hours after septoplasty. In patients of the second group, after the use of PBMT, the indicators of heart rate variability had a significantly lower total power, compared with patients of the first group. So, after PBMT, the ultra-low-frequency component of the spectral analysis of heart rate variability in the first group was 18580 ± 2067 ms2, which is significantly higher than in the second group (8086 ± 3003 ms2) (p <0.001). The low-frequency component of heart rate variability was also significantly higher in the first group (1871 ± 405 ms2) compared to the second (1095 ± 190 ms2) (p <0.005), which indicates an increase in the tension of the sympathetic part of the autonomic nervous system in the group without the use of PBMT. In the first 3 hours after surgery, the severity of pain between the groups did not differ significantly (p = 0.07). In the period from 6 to 24 hours after surgery, patients who did not undergo PBMT experienced significantly higher pain than patients with PBMT (p <0.001). Thus, in our study, the group of patients with PBMT showed better results in pain and heart rate variability compared to the classical rehabilitation of patients after septoplasty.

scholarly journals Protocol of intravenous lidocaine infusion in the postoperative period in children operated on abdominal organs

2021 ◽  
Vol 15 (1) ◽  
pp. 41-47
Author(s):  
Evgeny Y. Felker ◽  
Dmitry V. Zabolotskii
Keyword(s):  
Postoperative Period ◽  
Pediatric Anesthesia ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Standards Of Care ◽  
World Federation ◽  
Intravenous Lidocaine ◽  
Surgical Interventions ◽  
Perioperative Analgesia ◽  
Abdominal Organs

BACKGROUND: Many studies indicate the effectiveness of intravenous lidocaine infusion for perioperative analgesia and treatment of intestinal paresis in adults. In the scientific literature, only a few publications focus on the intravenous infusion of lidocaine in pediatric practice. The purpose of the work is to increase the effectiveness of the treatment of pain syndrome after operations on abdominal organs in children by creating a protocol for intravenous lidocaine infusion. MATERIALS AND METHODS: In the development of the clinical protocol, publications included in the databases PubMed, Cochrane, American Society of Anesthesiologists, World Federation of Pediatric Intensive and Critical Care Societies, and American Academy of Pediatrics were considered. The recommendations and standards of care for this problem from the Committee on Pediatric Anesthesiology (Statement on Practice Recommendations for Pediatric Anesthesia, 2016), Society for Paediatric Anesthesia Anaesthesiology, and our own materials for our research performed at the St. Petersburg State Pediatric Medical University. RESULTS: The developed protocol includes 11 provisions, including indications and contraindications to the use of lidocaine infusion, preoperative examination, a list of necessary equipment, the method of infusion, methods of evaluation, and control of postoperative pain syndrome. CONCLUSIONS: A protocol for the management of children in the early postoperative period using intravenous lidocaine infusion, as an alternative to prolonged epidural blockade and systemic anesthesia, is developed. The authors express confidence that further implementation of the protocol in clinical practice will improve the quality of medical care for children after abdominal surgical interventions.

scholarly journals THE APPLICATION OF MAGNETIC FIELDS AND FLUCTUORIZATION IN THE EARLY POSTOPERATIVE PERIOD IN PATIENTS AFTER RADICAL MASTECTOMY

2019 ◽  
Vol 6 (3) ◽  
pp. 157-162
Author(s):  
Marina Yu. Gerasimenko ◽  
Inna S. Evstigneyeva ◽  
O. M Perfil’yeva ◽  
L. V Tumbinskaya
Keyword(s):  
Postoperative Period ◽  
Radical Mastectomy ◽  
Pain Syndrome ◽  
Shoulder Girdle ◽  
Early Postoperative Period ◽  
Physical Factors ◽  
Operative Interference ◽  
Group 2 ◽  
Magnetic Therapy

We conducted an objective and instrumental examination in 76 patients with radical mastectomy in the early postoperative period (2-4 days), after which the patients of the 1st group (n = 38) underwent a course of fluctuation of the muscles of the shoulder girdle and upper extremity from the side of operative interference without interruption. Group 2 (n = 38) after the course, the course of fluctuation of the muscles of the shoulder girdle and upper limb from the side of operative interference without interruption was carried out extended low-intensity magnetic therapy of the postoperative area and arm. It has been proved that with this combination, the patient notes an improvement in the quality of life, postoperative swelling decreases, pain syndrome decreases, lymphorrhea periods shorten. As a result of the study, the number of postoperative complications in the wound area decreased (inflammation, infectious processes, pain, seam divergence). There is an increase in the amount and quality of movements, reduced sensitivity disorders in the upper limbs. The results of remote infrared thermography showed that the positive dynamics remained only in patients from both groups who received the combined use of two factors, which proves the prolongation of the clinical effect. Thus, the combination of two physical factors in the early postoperative period, in patients after radical mastectomy, has broad functionality and allows to obtain a more pronounced and stable clinical result.

scholarly journals Clinical justification of the device for the prevention of post-operating eventration

2020 ◽  
Vol 19 (1) ◽  
pp. 78-83
Author(s):  
I. K. Morar
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Surgical Techniques ◽  
Early Postoperative Period ◽  
Main Group ◽  
Abdominal Pressure ◽  
Non Invasive ◽  
Significant Difference

Postoperative surgery is one of the most dangerous complications, especially in patients with malignant tumors of the abdominal cavity, where secondary immunodeficiency, cachexia, anemia, etc. occur. Today, there are many ways to prevent postoperative surgery in patients at high risk for this complication, but all of them, along with their advantages, have a number of disadvantages that greatly limit their use. Developing an effective, non-invasive device for preventing postoperative surgery may to some extent solve this problem. The purpose of the study is to substantiate the effectiveness of the device for the prevention of postoperative events, by studying the frequency of development of postoperative complications in patients with malignant tumors of the abdominal organs. Material and methods. We have proposed a device for the prevention of postoperative surgery, the use of which does not require additional surgical techniques during surgery, and also allows the use of the latter in the event of the incomplete (subcutaneous) event (patent No. 120209 from 25.10.2017). The device consists of 5 soft plates lined with soft cloth and connected to each other by the widest parts. The central plate is adjustable depending on the width of the back surface of the patient's torso. The two side plates at the free edges have 11 lacing loops. To substantiate the effectiveness of the use of this device, we investigated 107 operated patients with malignant tumors of the abdominal cavity. The comparison group consisted of 60 people who did not use the proposed device. The main group consisted of 47 patients who used the above device in the early postoperative period. Results of the study and their discussion. The results obtained indicate a significant predominance of the incidence of postoperative events in patients in the main group. It should be noted that there is no significant difference in the frequency of development of "systemic" and other "local" postoperative complications between the two study groups of patients, which indicates the representativeness of the sample since "local" postoperative complications lead to the development of eventration. Patients in the main group, starting from day 2 after surgery, had a markedly lower intra-abdominal pressure during the first 12 days of the early postoperative period. Conclusion. The use of the proposed device for the prevention of postoperative surgery allows a non-invasive way to prevent the development of the latter, as well as the occurrence of the incomplete event to prevent the development of full, without significantly affecting the level of intra-abdominal pressure, compared with conventional use of the bandage.

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