Surgical treatment in patients with chronic pancreatitis in a multidisciplinary hospital

2021 ◽  
Vol 23 (3) ◽  
pp. 55-60
Author(s):  
Rustam K. Aliev ◽  
Pavel N. Romashchenko ◽  
Nicolay A. Maistrenko ◽  
Andrey S. Pryadko ◽  
Arsen K. Aliev
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Morphological Changes ◽  
Specific Patient ◽  
Surgical Decision ◽  
Surgical Interventions

A rational personalized program of surgical treatment of patients with various clinical and morphological forms of chronic pancreatitis is substantiated, integrating modern diagnostic and minimally invasive technologies. Examination results and treatment of 354 patients with chronic pancreatitis were analyzed. Patients were divided into three groups according to the modified Marseille-Rome Classification of Chronic pancreatitis (1988). Calcifying chronic pancreatitis was detected in 119 patients, obstructive in 81, and inflammatory in 154. Modern methods of diagnosis and treatment of chronic pancreatitis allowed the modification of the classification by allocating subgroups for each disease form. The justified use of the entire range of modern surgical technologies, taking into account the morphological changes of the pancreas, allows the maximum correction of complications of chronic pancreatitis with minimal complications and good quality of life in the long-term. The choice of surgical aid in patients with chronic pancreatitis is established to primarily depend on the form and variant of the disease course. The main criteria for choosing a surgical aid should be the state of the pancreatic ductal system, the degree and nature of changes in its parenchyma, and the presence of a cystic or inflammatory component during the surgical decision making. Important adjustments in the stage of surgical interventions are made due to mechanical jaundice, portal hypertension, decompensated duodenal stenosis, and concomitant somatic pathology in patients. Subgroups of patients with identified main chronic pancreatitis form, according to its modified classification, allows the determination of the surgical intervention volume, type, and access for each specific patient.

scholarly journals Long-term oncological and functional results of robot-assisted radical prostatectomy

2021 ◽  
Vol 17 (3) ◽  
pp. 121-128
Author(s):  
K. K. Ramazanov ◽  
K. B. Kolontarev ◽  
G. P. Gens ◽  
A. V. Govorov ◽  
A. O. Vasilyev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Radical Prostatectomy ◽  
Length Of Hospital Stay ◽  
Functional Results ◽  
State University ◽  
Robot Assisted ◽  
Surgical Interventions ◽  
Long Term Follow Up

Prostate cancer (РСа), being one of the leading causes of cancer mortality in men in Russia and in a number of other countries of the world, remains an urgent problem for modern oncourology, and the choice of surgical method is an important task for a surgeon. Such a pronounced interest in robot-assisted radical prostatectomy (RARP) in patients is driven by good tolerance and effectiveness of these surgical interventions, despite the fact that radical prostatectomy is considered to be the "gold standard" for treatment of patients with clinically localized РСа with regard to European Association of Urology data. The long-term oncological and functional results and the quality of life of patients after RARP deserve close attention and thorough study. According to the data presented in this article, it is obvious that RARP is the preferred method for surgical treatment of РСа, since oncological and functional results in the long-term follow-up are comparable to the results after radical prostatectomy, and according to some authors, these results are superior to the results of radical prostatectomy. The results of the study will allow to continue further introduction of RARP into clinical practice and its popularization as a method of surgical treatment of patients with localized PCa, which will reduce the length of hospital stay of patients, accelerate their medical and social rehabilitation, and improve the quality of medical care.The amount of data on the study of distant oncological and functional results of RARP as well as its superiority over other treatment methods is limited in medical literature, which prompted us to conduct our own research. Currently the urological clinic of the A.I. Evdokimov Moscow State University of Medicine and Dentistry continues work aimed at studying the longterm results of RARP in the first patients in Russia.

scholarly journals Comparative evaluation of the effect of different methods of surgical treatment of chronic pancreatitis on the quality of life of patients

2012 ◽  
Vol 93 (1) ◽  
pp. 34-38
Author(s):  
A A Karpachev ◽  
I P Parfenov ◽  
A Yu Khlynin ◽  
A L Yarosh ◽  
A V Soloshenko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Psychological Health ◽  
Comparative Evaluation ◽  
General Health Questionnaire ◽  
Life Quality ◽  
Surgical Interventions ◽  
Physical And Psychological Health

Aim. To conduct a comparative evaluation of the effectiveness of surgical treatment of chronic pancreatitis and define the quality of life of patients depending on the methods of surgical treatment. Methods. The study included 81 of the 165 patients with chronic pancreatitis, who underwent the following operations: endoscopic transmural interventions through the wall of the stomach and duodenum, endoscopic transpapillary surgery, percutaneous interventions for sanitation and drainage of the cystic cavity, laparotomic operations of internal drainage, resection interventions. The quality of life of patients was assessed using the general health questionnaire SF-36. Results. The lowest level of life quality was established in the group of patients after endoscopic transpapillary interventions. Statistically significant differences in the level of physical and psychological health were established when comparing patients after endoscopic transpapillary interventions and after endoscopic transmural surgical interventions, which were carried out through the wall of the stomach and duodenum; differences only in the level of physical health were noted when comparing with the group of resection interventions. Conclusion. The quality of life of patients with chronic pancreatitis depends on the type of surgical intervention, age and sex of the patients.

scholarly journals Assessment of deciduous trees state and phyllophagous composition in Yoshkar-Ola

2017 ◽  
Vol 6 (4) ◽  
pp. 80-84
Author(s):  
Nina Valeryevna Turmuhametova
Keyword(s):  
Relative Abundance ◽  
Leaf Blade ◽  
Morphological Analysis ◽  
Morphological Changes ◽  
Urban Ecosystem ◽  
The State ◽  
Transport Emissions

This paper presents the results of long-term observations of the state of plantations of Betula pendula Roth and Tilia cordata Mill. in Yoshkar-Ola. Assessment of trees state was carried out by morphological analysis of the leaf blade, since the plants assimilation organs are most exposed to atmospheric toxicants, attacks of insects and pathogenic microorganisms. Based on the assumption that pollutants affect directly phytophages or through the forage resource, the species composition of the phyllophagous insects and mites was studied in the gradient of the increase in industrial transport emissions. Morphological changes in leaves and an increase in the area of damage in the pollution gradient are described. In this case, the area of the leaf blade can both increase in B. pendula , and decrease in T. cordata . Determination of the arachnoentomological material and the establishment of herbivorous insects and mites for characteristic lesions made it possible to describe in the crowns of B. pendula 84 dendrobiotic species, T. cordata - 100 species. Among the phyllophagous there are gnawing and sucking leaves, miners and gall producers. The representatives of Coleoptera predominate. Under environmental conditions, the proportion of arthropods that are monophages and form protective devices increases. Under the conditions of the urban ecosystem, a decrease in the variety of phyllophages was revealed, but an increase in the relative abundance of the most protected species Aphidoidae (Homoptera), Cecidomyiidae (Diptera), Eriophyidae (Acarina). The calculation of the number of insects per unit volume of the crown was carried out. As a bioindicative indicator of the quality of habitat, it is suggested to use the state of tree leaves, the diversity and relative abundance of insects and mites of phyllophages.

scholarly journals Optimal time for surgical treatment of chronic pancreatitis or optimal surgery?

2021 ◽  
Vol 55 (3) ◽  
pp. 191-198
Author(s):  
V.G. Yareshko ◽  
Iu.O. Mikheiev ◽  
O.F. Shpylenko ◽  
O.M. Babii
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Long Term Results ◽  
Early Surgery ◽  
Surgery Group ◽  
Sf 36 ◽  
Eortc Qlq

Background. The majority of studies on the surgical treatment of chronic pancreatitis (CP) compare treatment outcomes by the type of the procedure. However, some studies, especially systematic reviews and meta-analyses, indicate the equality of different surgeries by their long-term results. During last 5–9 years, several studies showed advantages of early surgery in chronic pancreatitis, within three years after symptoms onset. Objective: to analyze the short- and long-term results of surgical treatment for chronic pancreatitis regarding timing and, accordingly, the neglect of the disease. Materials and methods. Retrospective analysis of data of 147 patients from 2001 to 2020, the main intervention was surgery aimed at the main manifestations of CP, such as pancreatic ductal and/or parenchymal hypertension. Patients who suffered from CP symptoms 3 years or more were included in the control group (late surgery), and those who noted symptoms of CP for less than 3 years were included in the study group (early surgery). All patients completed the EORTC QLQ-30, SF-36 questionnaires, as well as the questionnaire developed by the study authors, via telephone or mail, or during the visit. Results. According to all scales of the SF-36 questionnaire, except for Physical functioning, the group of early surgery prevails over the group of late surgery. The early surgery group had the best average scores on all functional scales of the EORTC QLQ-30 questionnaire compared to the late surgery group, except for the Cognitive functioning. Of the symptomatic scales, the early surgery group had the best averages on Pain and Diarrhea. The average Health/Quality of life scale was significantly better in the early surgery group. Conclusions. The quality of life, pain control, pancreatic function in patients operated within 3 years from the onset of CP symptoms were better compared to those with longer disease duration, with the same short-term results. The duration of the disease is a major factor for the success of surgical treatment of chronic pancreatitis in terms of long-term results. The early surgery is effective approach to obtain better long-term outcomes in chronic pancreatitis.

scholarly journals DYNAMICS IN CHANGES OF FREE-RADIAL OXIDATION PROTEINS, REGENERATOR PROCESSES, MICROBIAL DISTRIBUTION AND NON-SPECIFIC IMMUNITY IN THE HOMOGENATES OF SCAR TISSUES AT DIFFERENT STAGES OF THE POSTOPERATIVE PERIOD

2018 ◽  
Vol 22 (3-4) ◽  
pp. 3-6
Author(s):  
L.R. Krinichko ◽  
S.M. Grigorov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Biochemical Parameters ◽  
Surgical Interventions ◽  
Aesthetic Result ◽  
Microbial Distribution ◽  
Combined Use ◽  
Biochemical Mechanisms

The problem of excessive scar formation deserves a particular attention, primarily in the open areas of the human body, because the biochemical mechanisms of the regulation of collagenosynthesis processes after planned surgical interventions of the skin are not well-substantiated. The aim of the study was to optimize the prevention of pathological scars after surgical treatment of congenital neck cysts by determination of the dynamics of changes in biochemical parameters occurring in the neck skin at various stages of healing. It was proved that the combined use of PRF-clot at the intraoperative stage of prophylaxis and ceruloplasmin at the post-operative, in contrast to monotherapy with fibrin membranes, obtained from platelets-rich plasma caused a better functional and aesthetic result, which significantly improved the quality of life of patients in the early and late postoperative periods.

scholarly journals Сomparative analysis of outcomes of chronic pancreatitis surgical treatment

2021 ◽  
pp. 80-87
Author(s):  
N.Yu. Sled ◽  
◽  
O.N. Sled ◽  
N.V. Merzlikin ◽  
V.F. Tskhai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Pancreatic Head ◽  
Long Term Results ◽  
Pancreatic Cysts ◽  
Combined Resection ◽  
Sf 36

Aim of study. To compare short-term and long-term outcomes of surgical treatment for patients with chronic pancreatitis. Material and methods. In the period of 2002-2020, a total of 123 patients underwent surgery for treatment of complications associated with chronic pancreatitis. The patients were divided into three groups depending on the type of intervention. Patients in Group 1 underwent drainage (n=46), patients in Group 2 underwent resection (n=26) and patients in Group 3 combined resection and draining procedures (n=51). Results. After Roux-en-Y cystojejunostomy of cysts in distal parts of the pancreas(n=11), the amount of complications was lower (3 (27 [6; 61]%)) than after distal resection (n=20): 10 (50 [27; 73]%)), and the quality of life (SF-36) was higher in the long term (PSC: 55.75, MCS: 53.53 against PCS: 48.09, MCS – 49,72) after resection repair. The frequency of postoperative complications and lethality rate were higher in patients after different variants of sparing resection of pancreatic parenchyma with duct system drainage than in the group of patients treated with longitudinal cystojejunostomy. In the long term, lower lethality (5 [0; 23]%; p<0.05) and a higher level of physical (PCS – 61.31) and mental (MCS – 61.73) health were registered after the original variant of combined resection and draining intervention in comparison with traditional pancreatojejunostomy and duodenum-preserving surgery. Conclusion. Draining interventions on pancreatic cysts in distal parts of the pancreas is accompanied by better immediate and long-term results. Drainage without consideration for changes in the pancreatic head leads to a higher recurrence rate (27 [8; 55]%, р=0.013). Immediate results of the proposed combined resection and draining intervention are comparable with duodenum-preserving surgery but are characterised by lower mortality (5 [0; 23]%, р=0.06) and higher quality of life (SF-36) in the long term.

scholarly journals SURGICAL TREATMENT AND POSTOPERATIVE MANAGEMENT OF PATIENTS WITH BROAD FOREFOOT

2017 ◽  
Vol 2 (3) ◽  
pp. 55-57
Author(s):  
DA A Rasputin
Keyword(s):  
Surgical Treatment ◽  
Postoperative Management ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
Surgical Interventions ◽  
New Methods ◽  
Results Of Treatment ◽  
Based Medicine

The article considers the problem of broad forefoot, which is one of the most frequent deformities of the musculoskeletal system. Aim - to improve the results of treatment of patients with transverse platypodia by the use of new methods of surgical interventions, and to improve the tactics of postoperative management of such patients. Material and methods. The study involved analysis of the results of treatment of 375 patients. For evaluating the long-term outcomes of treatment, methods of evidence-based medicine were used, reflecting a reduction in the relative risk of interventions and an increase in their relative benefit. Results. The study of the long-term results of treatment showed that there were good and satisfactory outcomes in 92.7% cases (267 patients) and only 7.3% of unsatisfactory results (21 patients) in the main group; in comparison group - 74.7% (65 patients) and 25.3% (22 patients) respectively. The evaluation of the adequacy of anesthesia on the first day after the operation revealed good and satisfactory quality of anesthesia in the first group in 89.9% patients (259), in the second - only in 55.2% patients (48). Conclusion. The use of the above mentioned methods of surgical treatment and enhancement of tactics of postoperative management improve outcomes of patients with transverse flatfoot, and, consequently, are recommended for widespread use in clinical practice.

RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH CHRONIC PANCREATITIS AND THE RISK OF CANCER AFTER SURGICAL TREATMENT

2018 ◽  
Vol 64 (2) ◽  
pp. 228-233
Author(s):  
Vladimir Lubyanskiy ◽  
Vasiliy Seroshtanov ◽  
Ye. Semenova
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Fibrous Tissue ◽  
Pancreatic Head ◽  
Head Region ◽  
Intestinal Anastomoses ◽  
Resection Of The Pancreas ◽  
Risk Of Cancer

The aim: To analyze results of surgical treatment of patients with chronic pancreatitis (CP) and to assess the causes of pancreatic cancer after surgical treatment. Materials and methods: 137 patients had duodenum-preserving resections of the pancreas. Results: In the histological examination of the pancreas it was established that the growth of fibrous tissue was registered in patients with CP., which in 19 (13.8%) almost completely replaced the acinar tissue. In the long term after the operation from 6 months to 2 years in 8 patients (5.8%) pancreatic cancer was detected. Possible causes of tumor origin were analyzed, the value of preservation of ductal hypertension, which affects the state of the duct’s epithelium, was established. The most commonly used for treatment of chronic pancreatitis the Frey surgery removed pancreatic hypertension but in two patients during the operation an insufficient volume of the pancreatic head was reconstructed. In the case of the abandonment of a large array of fibrous tissue, local hypertension was retained in the region of the ductal structures of the head, which led to the transformation of the duct epithelium. An essential factor in the problem of the preservation of pancreatic hypertension were the stenosis of pancreatic intestinal anastomoses, they arose in the long term in 4 operated patients. With stenosis of anastomosis after duodenum-preserving resection both the hypertension factor and the regeneration factor could be realized, which under certain circumstances might be significant. Conclusion: After resection of the pancreas for CP cancer was diagnosed in 5.8% of patients. The main method of preventing the risk of cancer was performing the Frey surgery for CP eliminating pancreatic hypertension in the head region of the pancreas. Diagnosis of stenosis in the late period after resection of the pancreas was an important element in the prevention of recurrence of cancer since a timely reconstructive operation could improve the drainage of duct structures.

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