scholarly journals The first experience of stapled intestinal anastomoses application in children in Ukraine

2020 ◽  
pp. 15-20
Author(s):  
O. Sliepov ◽  
◽  
M. Migur ◽  
O. Ponomarenko ◽  
O. Gladyshko ◽  
...  
Keyword(s):  
Body Weight ◽  
Necrotizing Enterocolitis ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Operation Time ◽  
Developed Countries ◽  
Premature Baby ◽  
Diffuse Peritonitis ◽  
Level Of Evidence ◽  
Intestinal Anastomoses

Introduction. Conducting reconstructive surgery in children, especially those with low body weight, associated with an increase in the operation time and a worsening of the postoperative period. Therefore, to reduce the operation time, surgical clinics in developed countries of the world use linear staplers for anastomoses in children, especially young children. Case report. A premature newborn, with a birth weight of 1420 g, was diagnosed with necrotizing enterocolitis, with ileal perforation and diffuse peritonitis. According to vital indications, the operation was performed: laparotomy, revision of the abdominal cavity, Mikulich enterostomy. After complete stabilization of the general condition of the child, upon reaching 2550 g of body weight, at the age of 2 months, enterostomy closure was performed with the imposition of a stapled side-to-side functional end-to-end ileoileostomy. In 14 days after the operation, the child achieved full enteral autonomy. There were no postoperative surgical complications. In the late postoperative period, the child gains weight well, grows and develops according to age. Conclusion. The use of linear staplers in time of enteroanastomoses creation can significantly reduce operation time in children, in particular, premature babies with low body weight. Level of evidence. Level V. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an participating institution.The informed consent of the child’s parents was obtained from the studies. No conflict of interest was declared by the authors. Key words: linear staplers, enteroanastomosis, necrotizing enterocolitis, perforation of the small intestine, newborn premature baby.

scholarly journals Diagnostics and treatment of abdominal complications after gynecological endoscopic operations

2021 ◽  
Vol 1 ◽  
pp. 75-79
Author(s):  
Yu.P.  Vdovichenko ◽  
V.I.  Boyko ◽  
V.A.  Terehov
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Main Group ◽  
Laparoscopic Technique ◽  
Control Group ◽  
Diffuse Peritonitis ◽  
Abdominal Complications

The objective: to analyze the results of repeated laparoscopy in gynecological patients with suspected intraperitoneal postoperative complications.Materials and methods. The study involved 42 patients (mean age 46±11,3 years), in whom postoperative abdominal complications after surgical treatment of various gynecological diseases required repeated operations. Depending on the method of re-intervention, the patients were divided into 2 groups: the main group (n=20) – women who only used laparoscopy to correct postoperative complications; control (n=22) – women who were given indications for relaparotomy to correct postoperative complications during diagnostic laparoscopy. Relaparotomy was performed in 8 patients of the control group. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in terms of age and structure of operations performed on the pelvic organs, and statistically comparable.Results. During the study, the results of repeated laparoscopy of 34 gynecological patients with suspected intraperitoneal postoperative complications were analyzed. In all patients of the main group (47,6%), laparoscopy was revealed as the only and final method of treatment of postoperative complications, while in 7 women repeated relaparoscopy was used from 2 to 4 times, and in 13 women laparoscopy was performed once. In the control group (53,3%), 10 patients during diagnostic laparoscopy were exposed to indications for relaparotomy, in 4 patients the capabilities of the operating team and laparoscopic technique allowed performing some elements of the operation and completing it with a minilaparotomy approach, and 8 patients underwent relaparotomy immediately.Peritonitis and intraperitoneal bleeding prevail in the structure of early abdominal complications. The use of the video laparoscopic technique made it possible in 28,6% of patients with diffuse peritonitis to successfully eliminate the developed complication, eliminate its source and sanitize the abdominal cavity. Laparoscopic hemostasis was successfully performed in 7 patients.Compared with the standard, the use of video endoscopic technique allowed improving the indicators of diagnostic value: to increase the sensitivity level by 1,07 times, specificity by 1,39 times and diagnostic accuracy by 1,11 times.Conclusion. In general, in the early postoperative period, 47 relaparoscopies were performed for suspected complications, which is explained by programmed abdominal sanitization and the use of dynamic laparoscopy to control the course of intraperitoneal complications. Based on the analysis of the material under study, we proposed general indications and contraindications for relaparoscopy in the early postoperative period in order to diagnose and treat postoperative complications. Justifying each of the points, we were guided by the real possibilities of the method in general clinical practice, which in some cases are inferior in their effectiveness to relaparotomy.

scholarly journals The impact of fat distribution in obesity

1996 ◽  
Vol 42 (6) ◽  
pp. 30-34 ◽  
Author(s):  
M. M. Ginzburg ◽  
G. S. Kozupitsa
Keyword(s):  
Body Weight ◽  
Abdominal Cavity ◽  
Fat Distribution ◽  
Insulin Dependent Diabetes Mellitus ◽  
Developed Countries ◽  
Long Term Results ◽  
Dependent Diabetes Mellitus ◽  
Excess Body Weight ◽  
Common Disease ◽  
The Impact

Obesity remains the most common disease in the population of economically developed countries. 16-25% of the inhabitants of these countries have a body weight exceeding the norm by more than 15%. There has been an increase in the incidence of obesity over the past 20 years. The connection between overweight and such formidable diseases as hypertension, coronary heart disease, and non-insulin-dependent diabetes mellitus (NIDDM) is well known. The current state and especially long-term results of the treatment of obesity remain unsatisfactory. It is known that in more than 80% of patients the initial body weight is restored within the first 3-6 months after the end of the course of treatment. The mechanisms of the development of diseases associated with obesity have not been fully studied, and therefore pathogenetically substantiated treatment regimens have not been developed. After the classic work of J. Vague, performed more than 40 years ago, there are many studies showing that the risk of developing diseases associated with obesity depends not only on the degree of excess body weight, patient age, duration of the disease, but also on the distribution of fat. According to some reports, the dependence on the distribution of fat is more pronounced than the dependence on other factors, in particular on the degree of obesity. It turned out that complications are more characteristic for patients with a predominant accumulation of fat on the trunk and in the abdominal cavity (android, or abdominal, or visceral, or upper obesity) and are less typical for patients with a predominant deposition of fat on the buttocks and hips (gynoid, or gluteofemoral, or lower obesity).

scholarly journals Multiple intestinal anastomosis in newborns and infants

2021 ◽  
Vol 25 (3) ◽  
pp. 153-157
Author(s):  
Yu. A. Kozlov ◽  
M. N. Mochalov ◽  
K. A. Kovalkov ◽  
S. S. Poloyan ◽  
P. Zh. Baradieva ◽  
...  
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Necrotizing Enterocolitis ◽  
Average Length ◽  
Intestinal Anastomosis ◽  
Abdominal Cavity ◽  
Average Weight ◽  
Intestinal Anastomoses ◽  
Short Bowel ◽  
Second Surgery

Introduction. The present trial systematizes data, taken from one surgical center as an example, on treating patients with intestinal atresia and necrotizing enterocolitis with multiple intestinal anastomoses.Material and methods. The trial is a retrospective review on the treatment of 13 newborn infants who since 2010 have been put multiple intestinal anastomoses; the treatment was approved by the Hospital Ethics Committee. The average gestational age of patients was 31.2 weeks. The average age at the time of surgery – 7,9 days. Average weight - 2007 grams. The average number of anastomoses was 3.7 (range: 2-7). The average length of remained small intestine after the second surgery was 67.4 cm (range: 12-120 cm). No other surgical procedures, including gastrostomy or enterostomy, were performed. In all cases, surgical intervention ended with hermetic suturing of the abdominal cavity. Among them, there were 6 patients with the multifocal form of necrotizing enterocolitis; 6 patients had type IV atresia of the small intestine; 1 patient had the Ladd’s syndrome. Connection of intestinal segments was made by constructing several “end-to-end” anastomoses, double-row precision seam with PDS II 7/0 suture.Results. In the postoperative period, complications associated with anastomosis construction, such as leakage and narrowing, were not recorded. Transit function of the gastrointestinal tract restored on day 4, on average, after the surgery (range: 2-6 days). There were no early lethal outcomes within the first 28 days after the surgery which were associated with the surgery. 2 patients with short bowel syndrome (remained small intestine was 12 and 25 cm) and multivisceral disorders died on day 72 and 64 after the surgery. Survived patients were transferred to full enteral feeding in 56 days, in average, after the second surgery (range - 15-120 days).Conclusion. In our study, we have demonstrated potentials of a new surgical approach: one-stage formation of multiple intestinal anastomoses in case of multiple intestinal atresias as well as in case of multifocal forms of necrotizing enterocolitis. Maintaining the bowel length with multiple bowel anastomoses is very important factor for better survival of patients with the short bowel syndrome.  

Evaluation of PROMIS Outcomes for Surgical Treatment of Cubital Tunnel Syndrome With and Without Carpal Tunnel Syndrome

Hand ◽  
2021 ◽  
pp. 155894472110289
Author(s):  
Amy Phan ◽  
Warren Hammert
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Postoperative Period ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Measurement Information ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Tunnel Syndrome ◽  
Measurement Information System

Background: Assessment of outcomes for cubital tunnel syndrome (CuTS) surgeries has been difficult due to heterogeneity in outcome reporting. Our objective was to evaluate the outcomes for 2 cohorts treated surgically for isolated CuTS and for combined CuTS and carpal tunnel syndrome (CTS) using Patient Reported Outcomes Measurement Information System (PROMIS). Methods: There were 29 patients in the isolated CuTS cohort and 30 patients in the combined CuTS and CTS cohort. PROMIS Physical Function (PF), Pain Interference (PI), Depression, and Upper Extremity (UE) were completed preoperatively and 1-week, 6-weeks, and 3-months postoperatively. Responsiveness was evaluated by standardized response means (SRM). Results: Significant improvements from the 1-week to 6-week postoperative period are shown in the isolated CuTS cohort for PROMIS PF ( P = .002), PI ( P = .0002), and UE ( P = .02), but scores plateau after 6-weeks postoperatively. A similar pattern for the same time points was seen for the combined CuTS and CTS group for PROMIS PF ( P = .001), PI ( P = .02), and UE ( P = .04), with a plateau of scores beyond 6 weeks postoperatively. PROMIS UE was more responsive (SRM range: 0.11-1.03) than the PF (SRM range: 0.02-0.52) and PI (SRM range: 0.11-0.40), which were both mildly responsive for both cohorts. Conclusions: PROMIS lacks the sensitivity to show improvement beyond 6-weeks postoperatively for both isolated CuTS and combined CuTS and CTS. Patients with combined nerve compressions follow similar trajectories in the postoperative period as those with isolated CuTS. Level of Evidence: Level IV.

scholarly journals ALTERNATIVE TO THE INVERTED “Y” INCISION IN SCOLIOSIS SECONDARY TO MYELOMENINGOCELE

2019 ◽  
Vol 18 (1) ◽  
pp. 14-16
Author(s):  
Diego Veiga Bezerra ◽  
Luis Eduardo Munhoz da Rocha ◽  
Dulce Helena Grimm ◽  
Carlos Abreu de Aguiar ◽  
Luiz Müller Ávila ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Spina Bifida ◽  
Postoperative Period ◽  
Medical Records ◽  
Surgical Intervention ◽  
Case Series ◽  
Material Failure ◽  
Spinal Deformities ◽  
Level Of Evidence ◽  
Skin Conditions

ABSTRACT Objective: To evaluate the healing of the modified inverted “Y” incision in patients with scoliosis due to myelomeningocele. Methods: Retrospective study through medical records review of patients with myelomeningocele surgically treated with a modified inverted “Y” approach between January 2013 and December 2015. Results: We analyzed the medical records of six patients. Two patients progressed with skin complications in the immediate postoperative period and only one of them required surgical intervention for debridement and suturing. In another patient, it was necessary to perform two surgical reviews due to material failure without skin complications in these interventions. Conclusions: The modified inverted “Y” technique is a great alternative to traditional incision and inverted “Y” because it has good results in patients with spina bifida associated with poor skin conditions treated surgically for correction of spinal deformities. Level of Evidence IV; Case series.

Treatment of purulent diffuse peritonitis

1927 ◽  
Vol 23 (3) ◽  
pp. 351-352
Author(s):  
A. Timofeev
Keyword(s):  
Abdominal Cavity ◽  
Harmful Effect ◽  
Diffuse Peritonitis ◽  
Infectious Focus ◽  
Perforative Peritonitis

The author reports that in Petrivalskis' clinic in the treatment of diffuse perforative peritonitis drainage is not used if the infectious focus is removed; abscesses are drained; antiseptics are also not used due to their harmful effect on the vital properties of the peritoneal endothelium, but it is recommended to infuse 50-100 cc into the abdominal cavity. 3% solution of hydrogenii superoxydati, and the resulting foam mechanically cleans the abdominal cavity, and the released oxygen produces oxidation of toxins.

scholarly journals ADOLESCENT IDIOPATHIC SCOLIOSIS AND SIMILAR CONDITIONS: NEW TOOL TO MEASURE THE CORONAL PLANE

2018 ◽  
Vol 17 (4) ◽  
pp. 281-285
Author(s):  
Enguer Beraldo Garcia ◽  
Guilherme Brescia Payão ◽  
Liliane Faria Garcia ◽  
Enguer Beraldo Garcia Jr ◽  
Marcos Felipe Camarinha ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Postoperative Period ◽  
Central Line ◽  
Coronal Plane ◽  
Fixation Method ◽  
Preoperative Period ◽  
Level Of Evidence ◽  
Proximal Extension ◽  
The Difference ◽  
Third Line

ABSTRACT Objective: To create a method to measure the overall coronal plane of the spine, called the sacral clavicular angle (SCA). Methods: A line is drawn at the base of the sacrum; a second central line is drawn perpendicular to the first one in the proximal extension of the spine. A third line is drawn passing through the intersections of the superior points of the clavicles with the two second ribs, forming two angles, the greater of which is measured. Therefore, the degrees exceeding 90° are the SCA values. This tool was tested retrospectively in a study of 46 patients with idiopathic scoliosis who underwent short, apical, single or multiple fixations. Third generation instrumentation was used and the SCA was evaluated in the pre- and postoperative periods, which were compared with another group of 46 patients treated with the traditional technique. Results: Patients submitted to the traditional fixation method presented a median SCA of 3° in the preoperative period, and in the postoperative period, the SCA remained in 3°. Therefore, there was a 0% reduction. Patients submitted to short, apical, single or multiple fixation method presented a median preoperative SCA of 6°, and a postoperative median SCA of 1°, a reduction of approximately 83%. Conclusions: The group treated with short, apical, single or multiple instrumentation presented a reduction in the SCA of approximately 83% in the postoperative period compared to the preoperative period. The difference between preoperative and postoperative values was considered statistically significant. Level of Evidence II; Retrospective study.

scholarly journals Effect of the anticancer drug methotrexate on the ascites form of a teratocarcinoma and survival of mice

2018 ◽  
Vol 16 (3) ◽  
pp. 32-35
Author(s):  
Pavel A. Dyban
Keyword(s):  
Stem Cells ◽  
Body Weight ◽  
Morphological Analysis ◽  
Abdominal Cavity ◽  
Dependent Effect ◽  
Experimental Animals ◽  
Body Weights ◽  
Ascites Form ◽  
Dose Dependent ◽  
Dose Dependent Effect

The dose-dependent effect of a methotrexate is established as on an ascite form of a teratocarcinoma CBA9H6, and mice-recipients, however various doses of the entered methotrexate (6; 4 and 2 mkg/g body weights of an animal), at repeated introduction at an interval of 48 and 24 hours, don't destroy all population of embrioid bodies. So, at 3-fold and even 10-fold daily injections in a dose of 2 mkg/g of body weight in an abdominal cavity of mice 1,6 ± 0,2% and 0,038 ± 0,01% embrioid bodies (ascite form of a teratocarcinoma ) remain, respectively, at survival of mice 93,0 ± 8,5% and 14,0 ± 3,0%. The morphological analysis of a mode of a differentiation of embrioid bodies retransplantated from experimental animals to intact has shown earlier that the methotrexate hasn't had effect on histoblastic potentialities of stem cells of a teratocarcinoma CBA9H6.

scholarly journals Medical and social characteristics of families and psychological characteristics of mothers of children born with a body weight of less than 1500 g

2020 ◽  
Vol 64 (6) ◽  
pp. 45-52
Author(s):  
E. A. Matveeva ◽  
A. I. Malyshkina ◽  
O. M. Filkina ◽  
O. Yu. Kocherova ◽  
N. V. Dolotova
Keyword(s):  
Body Weight ◽  
High Frequency ◽  
First Trimester ◽  
Premature Baby ◽  
Psychological Characteristics ◽  
Social Characteristics ◽  
Stressful Situation ◽  
Intellectual Activity ◽  
Mothers And Fathers ◽  
The Impact

In order to study the medical and social characteristics of families, an analysis of the biological and social history of mothers and fathers of children born with a body weight less than 1500 was carried out. To identify the psychological characteristics, mothers were tested.It has been established that the social characteristics of the families of children born with a body weight of less than 1500 g was favorable – most families were two-parent, had satisfactory living conditions, mothers and fathers of these children were working and had education not lower than secondary special. The majority of fathers (80%) considered themselves healthy, the state of health of mothers was characterized by a high frequency of somatic pathology, only 27% of women were healthy. The majority of fathers and mothers noted the impact of occupational hazards, while the mothers’ adverse factors were mainly associated with intellectual activity, and the fathers – with physical labor. Half of mothers and 70% of fathers belonged to the age group of 30 years and older. Despite the favorable characteristics of reproductive behavior at the stage of pregravid preparation and in the first trimester of pregnancy, mothers who gave birth to children weighing less than 1500 g were characterized by an unfavorable obstetric gynecological history and a high incidence of gynecological pathology. Psychological features of mothers consisted in a high frequency of accentuation of hyperthymic character traits, a desire to emphasize determination and masculinity, anxiety, impulsivity, which may indicate a compensatory reaction to a stressful situation – the birth of a premature baby. This is also indicated by the high frequency of psychosomatic (45.9%) and authoritarian (29.5%) types of attitude to the problems of the child. In this regard, only 62.2% of mothers established optimal emotional contact with the child by the end of the neonatal period. The revealed psychological characteristics of mothers require early psychological and psychotherapeutic correction to successfully overcome the stress of giving birth to a premature baby and consolidate all the efforts of a woman for habilitation.

Sign in / Sign up

Export Citation Format

Share Document