scholarly journals COMPLICATIONS OF SURGICAL TREATMENT OF LUMBAR STENOSIS IN THE EARLY POSTOPERATIVE PERIOD

2018 ◽  
Vol 17 (3) ◽  
pp. 185-187
Author(s):  
Igor Vadimovich Basankin ◽  
Vladimir Alexeevich Porkhanov ◽  
Asker Alievich Afaunov ◽  
Alexander Veniaminovich Kuzmenko ◽  
Vladimir Konstantinovich Shapovalov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Intraoperative Complications ◽  
Clinical Manifestations ◽  
Early Postoperative Period ◽  
Lower Limbs ◽  
Wound Complications ◽  
Lumbar Stenosis ◽  
Results Of Treatment ◽  
Acute Radiculopathy

ABSTRACT Objective: To analyze the structure of degenerative lumbar stenosis surgical treatment complications and to analyze their effect on the results and indications for revision operations. Methods: Between 2009 and 2013, 513 patients with lumbar stenosis of degenerative etiology were surgically treated. There were 205 men, 308 women, aged 23 to 74 years. The main clinical manifestations were persistent compression radiculopathy, chronic pain in the back and lower limbs, and difficulty walking. The intensity of the pain was assessed by the VAS. At the time of hospitalization, VAS was 55-90 points. Results: Of the 513 operated patients, 65 (12.67%) had complications in the early postoperative period (up to three months after the operation); intraoperative complications occurred in 26 (5.1%) patients; intraoperative dura mater injury occurred in 24 (4.67%); pulmonary embolism (PE) occurred in 2 (0.39%) patients; 39 patients had early postoperative complications; acute radiculopathy occurred in 22 patients (4.28%); and 17 patients (3.31%) had surgical wound complications. Conclusions: Liquorrhea, postoperative hematomas and acute radiculopathy had no negative effect on the results of treatment in any of the cases. In the early postoperative period, 4 (0.77%) deaths were recorded intraoperatively and in 2 (0.39%) cases, intraoperative PE occurred. Two cases (0.39%) resulted in sepsis and multiple organ failure. In eight (1.55%) patients, the results of the treatment were unsatisfactory: in 4 (0.77%) cases due to death, and in a further 4 (0.77%) due to elimination of the system by the spinal column as a result of suppuration. Level of Evidence IV; Therapeutic studies - Investing the results of treatment.

Treatment of atypical forms of progressive varicose veins in pregnant women (varicose veins of the inguinal canal)

2017 ◽  
pp. 57-62
Author(s):  
V.M. Antonyuk-Kysil ◽  
◽  
І.Ya. Dziubanovskyi ◽  
V.M. Yenikeeva ◽  
S.I. Lichner ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pregnant Women ◽  
Postoperative Period ◽  
Inguinal Canal ◽  
Varicose Veins ◽  
External Genitalia ◽  
Lower Limbs ◽  
Duplex Scanning ◽  
Results Of Treatment ◽  
Internal Iliac

The objective: development and implementation of the use of duplex scanning data for safe treatment of various forms of primary progressive varicose veins of the inguinal canal (IIVIII) in the II-III trimesters of pregnancy. Materials and methods. On the basis of the communal institution «Regional Perinatal Center» of the Rivne Regional Council, from the beginning of 2013 to January 2017 inclusive, 14,093 patients gave birth. Among them, 825 (5.85%) were diagnosed with progressive primary multifocal varicose disease of the lower limbs C2-4s, Ep, As, p, Pr (clinical class according to CEAP classification: C2 in 250, C3 in 566, C4 in 9 Pregnant women), perineum and external genitalia and inguinal canal and their combination. In 196 (23.76%) pregnant women, this pathology was detected in the first pregnancy, in 401 (48.6%) patients - during pregnancy, and in 228 (27.64%) patients - in subsequent pregnancies (two or more) . Results. The data of surgical treatment of 54 pregnant women who agreed to carry out the operation according to the indications and methods developed by us in the II-III trimesters with PPVRVPK, both in isolated form and in combination with multifocal dilatation of the veins of the lower extremities, external genital organs and perineum . The main accessible, safe, non-invasive method of examining veins in pregnant women for establishing with a high probability of diagnosis and obtaining information on the results of treatment in the postoperative period is duplex scanning. 54 pregnant women with a positive result of treatment in all patients were operated on. There were no complications from both the fetuses and pregnant women, which is confirmed by stable within the limits of the norm indicators of cardiotocography, blood flow in the artery of the umbilical cord, the middle cerebral artery of the fetuses, internal iliac arteries of pregnant women according to duplex scanning data. The conclusion. In the analysis of the results of surgical treatment, a high (100%) safety was confirmed for both the fetus and the pregnant woman with a 100% positive clinical result in the postoperative period. Key words: progressive varicose veins of the inguinal canal (PVVIC), venous duplex scan, surgical treatment of PVVIC in pregnant women.

DIENOGEST IN POST OPERATIVE MANAGEMENT’S OF PATIENT’S WITH ENDOMETRIOSIS

2020 ◽  
pp. 22-26
Author(s):  
Porsukova B.D. ◽  
Dzhumagulova D.D.
Keyword(s):  
Surgical Treatment ◽  
Combination Treatment ◽  
Postoperative Period ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Hormonal Treatment ◽  
Early Postoperative Period ◽  
Main Group ◽  
Uterine Ligaments ◽  
Severity Of The Disease

To assess the effectiveness of using dienogest in combination with postoperative interventions in patients with endometriosis. There were enrolled 102 patients with signs of external endometriosis underwent examination and surgical treatment, subdivided into 2 groups: 67 – main group (after surgical treatment, received dienogest 2 mg/day for 6 months), 35 – comparison group received no hormone therapy in the postoperative period. Surgical treatment included removal of endometrioid ovarian cysts, endometriosis foci on the pelvic peritoneum and sacral uterine ligaments. Course of the early postoperative period (up to 1 month after the intervention) as well as the long-term dynamics of the disease manifestations (3, 6, 12 and 15 months later) were assessed. Dienogest was administered after surgical treatment due to endometriosis that reduced the severity of dyspareunia and intensity of chronic pelvic pain by 3.5- and 2-fold, respectively. The probability of achieving control over uterine bleeding 6 month after the onset of treatment due to endometriosis manifested with metrorrhagia showed that combination treatment (consisting of dienogest) was 3.19-fold higher compared to surgical treatment alone (OR = 3.19; 95 % CI = 1.70–11,0; p < 0,05). Recovery of normal menstrual cycle in 63 (94.0%) women of the main group was established 1.5–2 months after completing of hormonal treatment, while in the comparison group pain and dysmenorrhea relapsed in some patients at the 6-month follow-up. Decreased libido as a side effect in patients who treated with dienogest was observed in 2 (3.0 %) women. Dienogest was highly effective in the combination treatment of patients with verified endometriosis that resulted in reduced severity of pain and metrorrhagia. The drug was featured by low level of side effects. Thus, a combination treatment of endometriosis containing dienogest at a dose of 2 mg/day applied during postoperative period allows to reduce the severity of the disease clinical manifestations and improve treatment outcome.

scholarly journals Postoperative management of patients with endometriosis

2020 ◽  
Vol 14 (2) ◽  
pp. 182-191 ◽  
Author(s):  
Ju. E. Dobrokhotova ◽  
D. M. Kalimatova ◽  
I. Yu. Ilyina
Keyword(s):  
Surgical Treatment ◽  
Combination Treatment ◽  
Postoperative Period ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Hormonal Treatment ◽  
Postoperative Management ◽  
Early Postoperative Period ◽  
Main Group ◽  
Uterine Ligaments

Aim: to assess the effectiveness of using dienogest in combination with postoperative interventions in patients with endometriosis.Materials and methods. There were enrolled 102 patients with signs of external endometriosis underwent examination and surgical treatment, subdivided into 2 groups: 67 – main group (after surgical treatment, received dienogest 2 mg/day for 6 months), 35 – comparison group received no hormone therapy in the postoperative period. Surgical treatment included removal of endometrioid ovarian cysts, endometriosis foci on the pelvic peritoneum and sacral uterine ligaments. Course of the early postoperative period (up to 1 month after the intervention) as well as the long-term dynamics of the disease manifestations (3, 6, 12 and 15 months later) were assessed.Results. Dienogest was administered after surgical treatment due to endometriosis that reduced the severity of dyspareunia and intensity of chronic pelvic pain by 3.5- and 2-fold, respectively. The probability of achieving control over uterine bleeding 6 month after the onset of treatment due to endometriosis manifested with metrorrhagia showed that combination treatment (consisting of dienogest) was 3.19-fold higher compared to surgical treatment alone (OR = 3.19; 95 % CI = 1.70–11,0; p < 0,05). Recovery of normal menstrual cycle in 63 (94.0%) women of the main group was established 1.5–2 months after completing of hormonal treatment, while in the comparison group pain and dysmenorrhea relapsed in some patients at the 6-month follow-up. Decreased libido as a side effect in patients who treated with dienogest was observed in 2 (3.0 %) women.Conclusion. Dienogest was highly effective in the combination treatment of patients with verified endometriosis that resulted in reduced severity of pain and metrorrhagia. The drug was featured by low level of side effects. Thus, a combination treatment of endometriosis containing dienogest at a dose of 2 mg/day applied during postoperative period allows to reduce the severity of the disease clinical manifestations and improve treatment outcome.

scholarly journals Changes in Indicators of Microcirculation in the Early Postoperative Period in the Treatment of Diaphyseal Fractures of the Shin Bones Using a Plate with Limited Contact

2019 ◽  
Vol 4 (3) ◽  
pp. 58-62
Author(s):  
A. I. Plakhov ◽  
L. I. Kolesnikova ◽  
L. I. Korytov ◽  
V. G. Vinogradov ◽  
M. A. Darenskaya
Keyword(s):  
Postoperative Period ◽  
Lower Limb ◽  
Blood Circulation ◽  
Early Period ◽  
Metal Plate ◽  
Early Postoperative Period ◽  
Control Group ◽  
Doppler Flowmetry ◽  
Results Of Treatment ◽  
Diaphyseal Fractures

Background. Unsatisfactory results of treatment, such as delayed consolidation and non-fusion of fractures, the formation of false joints and limb bone defects, have no tendency to decrease. We can assume that one of the leading factors of complications in traumatology is a violation of microcirculation in the affected segment of the limb.Aims. To identify patterns of changes in the parameters of the microcirculatory bed of the damaged segment of the lower limb when fixing bone fragments with a plate with limited contact in the early period after surgery.Materials and methods. In 25 patients, we studied four parameters of microcirculation of the lower limb segment with application of laser Doppler flowmetry. The control group consisted of 25 healthy volunteers, comparable in age and sex with the study group.Results. We found that in the early postoperative period (from the first to the 10th day after the surgery) in patients with diaphyseal fractures of the tibia operated with metal plate with limited contact there was an increase in microcirculation by 75.69 %, an increase in the proportion of the nutritive component of microcirculation compared to the shunt fraction by 24.64 %, as well as an increase in more than one ratio of the amplitude of the heart and respiratory range. All of that indicates a local circulatory disorder in the nutritive arterial hyperemia. We note that the increase in the amplitude of the respiratory component by 17.22 % and the equality of the amplitude of the cardiac range compared with the control group indicate violations of local blood circulation by the type of venous stagnation.Conclusion. On the basis of the results obtained, we note that patients with diaphyseal fractures of the shin bones treated with metal osteosynthesis with a plate with limited contact in the early postoperative period develop a violation of local blood circulation in the stagnant-hyperemic type.

scholarly journals SURGICAL TREATMENT OF ANOMALIES OF FIXATION OF THE COLON IN CHILDREN

2020 ◽  
Vol 19 (4) ◽  
pp. 32-36
Author(s):  
O. Bodnar
Keyword(s):  
Congenital Anomaly ◽  
Surgical Treatment ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Results Of Treatment ◽  
Left Diaphragm ◽  
Comparative Group ◽  
The Right ◽  
Paroxysmal Pain ◽  
Over Time

Pyrrhic disease is a congenital anomaly that occurs during embryogenesis due to the fixation of the splenic angle of the colon by a short and highly located left transverse-diaphragmatic ligament, creating a sharp bend and forming a "wellbore". In this case the passage of feces on a cross colon becomes difficult, there is also its sagging to a small pelvis. This pathology is characterized by paroxysmal pain (aggravated by exercise and after eating) and prolonged constipation, which progresses over time. Hilaiditis syndrome is a rather rare pathology in which there is an interposition of the hepatic angle of the colon between the liver and the diaphragm. There are permanent and intermittent localizations. The work generalizes the experience of evaluation of clinical manifestations and remote results of treatment of children with chronic colostasis caused by fixation abnormalities of the colon. 58 children were detected to have Payre’s disease, with Cyilaiditi’s syndrome – 3 children. 24 patients with Payre’s disease and 2 Cyilaiditi’s syndrome were operated on. To assess the effectiveness of surgery, children were divided into two groups: I group – comparative and II group - experienced. In I group (n=12 children) – the analysis of surgical treatment was performed traditionally. In II group (n=14 children) – the analysis of surgical treatment was conducted by means of the methods proposed. Traditional surgical treatment of Payre’s disease in children was followed by relapse of chronic constipation in 45,45%, pain in 50%, flatulence in 33,33% and failure of the ileocoecal closing apparatus in 100% of children. Unsatisfactory outcomes of surgical treatment of Cyilaiditi’s syndrome was observed in a child from the comparative group. Relapse of clinical symptoms to a lesser degree than before the surgery was found in 1 child from the experienced group. To treat Payre’s disease the following operation is proposed: intersection of the left diaphragm-colon ligament, resection of transverse colon and colofixation of the left bending of the colon. To treat Cyilaiditi’s syndrome (in case of dolichoascendocolon) the following operation is suggested: hepatopexy, resection of the right bending of the colon with ascending transversal anastomosis “end to end”, fixing of right bending of the colon. Their reasonability is being proved.

Castleman Disease In Children: Diagnosis and Treatment

2020 ◽  
Author(s):  
Hung Dinh Viet
Keyword(s):  
Lymph Node ◽  
Postoperative Period ◽  
Case Reports ◽  
Abdominal Mass ◽  
Clinical Manifestations ◽  
Castleman Disease ◽  
Results Of Treatment ◽  
Benign Lymph Node ◽  
Lymph Node Hyperplasia

Background: We describe the experiences in diagnosis and results of treatment in pediatric Castleman disease. Method: Serial case reports. Result: From 2016 to 2019, we had 7 cases of pediatric Castleman disease: 3 boys and 4 girl. The median age at diagnosis was 147 months (121-173 months). Clinical manifestations were found in five cases. They were all unicentric Castleman disease (6 abdominal mass, one left infraclavicular mass). All patients were operated with postoperative period uneventful. The median time of postoperative follow up was 22.7 months (11-53 months) with no signs of relapse. Conclusions: Pediatric Castleman disease is a rare benign lymph node hyperplasia, it can be localised or disseminated. Operation is the treatment of choice for localised Castleman disease.

Improving the efficiency of the postoperative period in the surgical treatment cancer patients with metastatic bone fractures upper and lower extremities using elixir altai ("vitavis") in combination with ion-activated water resources

10.12737/6454 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Антонов ◽  
A. Antonov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Postoperative Period ◽  
Bone Fractures ◽  
Infectious Complications ◽  
Lower Limbs ◽  
Oncologic Patients

Use elixir Altai (&#34;Vitavis&#34;) in combination with ion-activated with water by means of such a complex contingent cancer patients as patients with metastatic bone fractures of the upper and lower limbs can reduce the early postoperative period, and to reduce to a minimum infectious complications and improve quality of life. The problem of postoperative complications, until now, is not solved. In oncologic patients, and those more in by III and As IV stages occurs it immunnodefitsit, which is caused not only by basic disease, but also by conse-quences of khimio- beam therapy. In connection with this appears the difficulty in the surgical treatment, caused by postoperative complications. As a result surgical treatment appears surgical injury, oxidizing stress, disturbance of homeostasis and oppression of immunity, which leads to an even larger disturbance of immunity in oncologic patients, which decreases the unspecific resistibility of organism. The application of adaptogena of the elixir of Altai (“Vitavis”) in combination with the ionic- activated aqueous means makes it possible to level and to reduce on no oxidizing stress, to increase the unspecific resistibility of the organism of oncologic patient and to increase immuni-ty. Moreover, powerful antioxidant - the ionic- activated aqueous means strengthens the action of adaptogena of the elixer of Altai (“Vitavis”), which leads to the decrease of postoperative infectious complications, reduces postoperative period, improves the quality of life and enlarges indications to the surgical treatment in oncologic patients with III it and IV by the stages of diseases.

Seizures after evacuation of subdural hematomas: incidence, risk factors, and functional impact

2010 ◽  
Vol 112 (2) ◽  
pp. 455-460 ◽  
Author(s):  
Alejandro A. Rabinstein ◽  
Seung Young Chung ◽  
Leslie A. Rudzinski ◽  
Giuseppe Lanzino
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Functional Impairment ◽  
Postoperative Period ◽  
Strong Association ◽  
Early Postoperative Period ◽  
Acute Subdural Hematoma ◽  
Early Functional Outcome ◽  
Gcs Score

Object The purpose of this study was to evaluate the incidence of seizures or epileptiform abnormalities on electroencephalography (EEG) studies in patients undergoing surgical treatment for acute subdural hematoma (SDH). Methods This was a retrospective study of 134 consecutive patients with acute or acute-on-chronic SDH who underwent surgical treatment at the authors' institution between January 2004 and July 2008. Detailed information was collected regarding baseline clinical data (including preexistent functional impairment); Glasgow Coma Scale (GCS) sum scores before and 24 hours after surgery; presence of clinical seizures; EEG findings; and functional outcome on discharge and up to the 6-month follow-up. All brain CT scans were reviewed to calculate SDH volume and midline shift. The Glasgow Outcome Scale (GOS) score was used for functional assessment, and GOS scores of 1–3 were considered indicative of poor outcome. Univariate and multivariate logistic regression analyses were performed to identify statistical associations. Results Clinical seizures or epileptiform changes on EEG were observed during the acute postoperative period in 33 patients (25%). Preexistent functional impairment and seizures/epileptiform EEG findings after surgery were independently associated with poor functional outcome upon hospital discharge (p < 0.001 for both). Preexistent functional impairment (p < 0.001), lower GCS score before surgery (p = 0.04), and lower GCS score 24 hours after surgery (p = 0.007), but not seizures/epileptiform EEG findings, were independently associated with poor functional recovery at 1- to 6-month follow-up evaluations. Seizures/epileptiform EEG findings had a strong association with lower GCS scores after surgery (p = 0.01), and they were more common in patients who underwent evacuation by craniotomy (p = 0.02). Conclusions Epileptic complications are common after acute SDH evacuation, and should be suspected in patients with an unanticipated depressed level of consciousness after surgery. Seizures worsen early functional outcome, but delayed favorable recovery is possible. Therefore, one should be cautious when discussing prognosis in the early postoperative period of patients with epileptic complications.

scholarly journals SURGICAL TREATMENT OF CAROTID STENOSIS IN PATIENTS WITH CORONARY HEAR+T DISEASE IN ORDER TO PREVENT ISCHEMIC STROKE

2020 ◽  
pp. 124-126
Author(s):  
I. S. Pulyaeva ◽  
V. A. Prasol
Keyword(s):  
Ischemic Stroke ◽  
Surgical Treatment ◽  
Carotid Stenosis ◽  
Postoperative Period ◽  
Stable State ◽  
Length Of Hospital Stay ◽  
Early Postoperative Period ◽  
Main Stage ◽  
Simultaneous Operations ◽  
Ischemic Attack

Summary. Goal. To analyze the results of surgical treatment of carotid stenosis in patients with coronary heart disease in order to prevent ischemic stroke. Materials and methods. The analysis included 18 patients treated in the SI «V. T. Zaitseva IGUS of NAMNU» from 2017 to 2019 in combined atherosclerotic lesions of the coronary and carotid arteries which evaluated the reserve brain. Results and discussion. All patients with two-stage treatment of the first and second groups were discharged in a stable state, one had a clinic of transient ischemic attack in the postoperative period. Conclusions. Simultaneous operations are advisable in patients with a reduced reserve of both coronary and cerebral circulation. The risk of developing cerebral and cardiac postoperative complications is comparable with the results of phased operations, reducing the length of hospital stay of the patient. The results of the hypoxic test serve as an additional criterion for the decision to impose an internal intra-arterial shunt. This allows you to reduce the time of the main stage of carotid endarterectomy and to avoid additional possible complications in the early postoperative period.

scholarly journals Photodynamic therapy in the treatment of stomach cancer

2018 ◽  
Keyword(s):  
Photodynamic Therapy ◽  
Postoperative Period ◽  
Intestinal Anastomosis ◽  
Effective Means ◽  
Combined Treatment ◽  
Early Postoperative Period ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Biopsy Channel ◽  
Small Intestinal

The analysis of the results of treatment of 10 patients with gastric cancer with high surgical risk, who in the treatment complex used photodynamic therapy with photosensitizer Photolon and further irradiation with a semiconductor laser with a wavelength of λ = 0.67 μm cross-irradiation fields introduced through the biopsy channel of the endoscope. Endoscopic PDT can be used at the stage of combined treatment in combination with drug therapy and surgical interventions and is an effective means of preventing the development of esopha- geal-small intestinal anastomosis failures in the early postoperative period. Endoscopic PDT can also be used in the postoperative period as a prophylaxis of early postoperative complications in cases of detection of tumor cells in the margins of resection.

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