Safety in parathyroid surgery: innovation in diagnostic and minimally invasive operations

2021 ◽  
Vol 23 (3) ◽  
pp. 29-34
Author(s):  
Pavel N. Romashchenko ◽  
Nikolaj A. Maistrenko ◽  
Dmitry O. Vshivtsev ◽  
Denis S. Krivolapov ◽  
Andrey S. Pryadko
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Traditional Approach ◽  
Treatment Method ◽  
Intraoperative Neuromonitoring ◽  
Parathyroid Glands ◽  
Safety Level ◽  
Tertiary Hyperparathyroidism ◽  
Surgical Interventions ◽  
Comprehensive Examination

The main treatment method of primary and tertiary hyperparathyroidism is surgery. However, surgical interventions on the parathyroid glands can lead to formidable complications such as laryngeal paresis and hypocalcemia. With this background, a comprehensive study examined the effectiveness of modern methods of diagnosis and surgical treatment of hyperparathyroidism to increase the safety level in surgery of the thyroid gland. The results of a comprehensive examination and treatment of 53 patients with hyperparathyroidism who underwent surgery using three methods were analyzed: traditional (n = 18/34); minimally invasive endoscopically assisted (n = 32/60), and endoscopic (transoral) (n = 3/6). Intraoperative neuromonitoring was also performed in all surgical interventions. Parathyroidectomy was performed under parathyroid monitoring for intraoperative topical diagnosis of parathyroid tumors in nine patients. The use of minimally invasive endoscopically assisted access to the parathyroid glands, as an alternative to the traditional approach, indicated that the preoperative potential in the diagnosis of parathyroid disorders. Moreover, intraoperative neuromonitoring and parathyroid monitoring demonstrated efficiency based on the decline in the incidence of specific postoperative complications with a tolerable increase in operative time, maintenance of the average duration of stationary treatment after surgery, and increased safety level of surgical treatment of hyperparathyroidism.

scholarly journals ТREATMENT OF STENOSIS OF THE PYLORIC BULBAR ZONE OF ULCERATIVE GENESIS USING MINIMALLY INVASIVE SURGERY

2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Clinical Signs ◽  
State Institution ◽  
Disease Recurrence ◽  
Control Group ◽  
Surgical Interventions ◽  
Remote Observation

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions. Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions. Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.

Vitrectomy for Vitreous Opacities

2021 ◽  
pp. 7-9
Keyword(s):  
Patient Satisfaction ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Effective Treatment ◽  
Pars Plana Vitrectomy ◽  
Treatment Method ◽  
Vitreous Floaters ◽  
Vitreous Opacities ◽  
Pars Plana ◽  
Risk And Benefit

Pars plana vitrectomy (PPV) surgery in vitreous opacities is an effective treatment method that increases patient satisfaction. However, due to the risks associated with PPV surgery, its application in vitreous floaters is controversial. Instead, performing sutureless, minimally invasive PPV surgery with 25 gauge trocars on floaters may reduce the risks. For surgical treatment, it is important to select appropriate patients, evaluation of the risk and benefit balance of PPV, and application the treatment.

scholarly journals Inguinal hernias in elderly patients. Strategy for choosing a surgical treatment method

2021 ◽  
pp. 71-78
Author(s):  
S. M. Smotryn ◽  
S. A. Zhuk ◽  
V. S. Novitskaya ◽  
A. V. Kopytski
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Inguinal Canal ◽  
The Elderly ◽  
Treatment Method ◽  
Surgical Interventions ◽  
Inguinal Hernias ◽  
Inguinal Herniation ◽  
Anatomical Parameters

Objective: to evaluate the existing approaches to the treatment of inguinal hernias in the elderly and to propose a strategy for choosing the method of surgical treatment taking into account the metric assessment of the state of the topographical and anatomical parameters of the inguinal canal.Materials and methods. The analysis of surgical interventions for inguinal hernias in elderly patients in surgical in-patient clinics of the Grodno region over 2018–2019 was carried out. The morphometric parameters of the inguinal canal being determinants for choosing the method of hernioplasty were studied in 39 elderly patients.Results. The coefficient for choosing the method of inguinal herniation (K) has been proposed. It is calculated by the formula: К = h : m, where h is the height of the inguinal space (mm), m is the total thickness of the upper wall of the inguinal canal (mm). At K>4.83 they choose atension methods of hernioplasty.Conclusion. The use of the coefficient for choosing the method of inguinal hernioplasty has made it possible to reduce the number of recurrent hernias in the long-term postoperative period from 5.7 % to 2.0 % of cases.

scholarly journals Staged surgical treatment of cholangiogenic abscesses of the liver

2020 ◽  
pp. 20-23
Author(s):  
V. V. Boyko ◽  
V. M. Lykhman ◽  
D. A. Miroshnichenko ◽  
A. A. Merkulov ◽  
S. V. Tkach ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Mortality ◽  
Treatment Method ◽  
Stage Ii ◽  
Abscess Cavity ◽  
Controlled Drainage ◽  
Results Of Treatment ◽  
Liver Abscesses ◽  
Single Lumen

The aim of the work: to improve the results of treatment of patients with cholangiogenic liver abscesses by means of staged treatment methods using minimally invasive interventions. Materials and Methods. 82 patients with cholangiogenic liver abscesses aged 21 to 80 years who underwent 130 operations were examined and treated. The main group consisted of 40 (48.4 %) patients who underwent ultrasound-controlled drainage of abscess cavities (stage I), followed by removal of the source of cholangiogenic abscesses (stage II). The comparison group consisted of 42 (51.6 %) patients who underwent rehabilitation and drainage only with laparotomy access. Results and Discussion. Minimally invasive methods of surgical treatment included ultrasound-controlled drainage with simultaneous rehabilitation of abscess cavities. The dimensions of the cavities averaged (150±23.3) cm³. One drainage was used to drain the liver abscess with a diameter of up to 10.0 cm. When the diameter of the abscess was more than 5.0 cm, drainage was carried out by two single-lumen tubes followed by suction-flow washing of the abscess cavity. Monitoring the standing of the drainage and reducing the cavity of abscesses was carried out on 3, 7, 14 days after setting. The drainage tube was removed after the disappearance of the cavity according to ultrasound and control fistulography, which coincided with the normalization of the general condition and body temperature, the disappearance of signs of purulent intoxication. Duration of drainage averaged from 7 to 30 days (an average of 15.2). The proposed treatment method is not very traumatic, the ability to control the effectiveness of the treatment, and most importantly – positive results in 87 % of patients. Second stage in 38 (95 %) was performed laparoscopic cholecystectomy of technical features. The optimal duration of stage II was considered (13±3) days after extraction of the drainage. In the diagnosis and treatment of cholangiogenic liver abscesses, it is necessary to use puncture ultrasound-controlled drainage methods. The stage-by-stage treatment of cholangiogenic liver abscesses with rehabilitation of the abscess cavity made it possible to reduce the incidence of sepsis from 9.5 to 2.5 %, reduce postoperative mortality in extremely severe patients to 2.4 %, and develop complications by 7.3 %.

scholarly journals Surgical treatment of benign prostatic hyperplasia: the past and the present

2019 ◽  
Vol 9 (1) ◽  
pp. 47-56
Author(s):  
Ali T. Mustafaev ◽  
Pavel S. Kyzlasov ◽  
Maksim P. Dianov ◽  
Aleksej G. Martov ◽  
Dmitrij V. Ergakov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Minimally Invasive ◽  
Prostatic Hyperplasia ◽  
Surgical Interventions ◽  
The Past ◽  
Minimally Invasive Surgical ◽  
History Of

The article reflects the history of treatment of benign prostatic hyperplasia from the age of antiquity to the present day. Approaches to surgical treatment have undergone significant changes in the last century – from traumatic open operations to minimally invasive surgical interventions using innovative endoscopic technologies. However, some issues in the treatment of benign prostatic hyperplasia remain unresolved which leads to the search for new, safer and more effective methods of surgical treatment of the disease.

scholarly journals MODERN VIEWS ON ETIOLOGY AND PATHOGENESIS OF CYSTIC-ADENOMATOUS PULMONARY MALFORMATION IN CHILDREN. PART II

2019 ◽  
Vol 23 (3) ◽  
pp. 143-145
Author(s):  
S. B. Suleymanova
Keyword(s):  
Minimally Invasive Surgery ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Molecular Genetics ◽  
Invasive Surgery ◽  
Lung Diseases ◽  
Developmental Anomalies ◽  
Surgical Interventions ◽  
Cytogenetic Studies

The review is devoted to modern ideas of etiology, pathogenesis, methods of diagnostics and surgical treatment of cystic adenomatous malformation in children. The authors have made a review of domestic and foreign literature on the evolution of molecular genetics and cytogenetic studies. The role of histochemical and ultrastructural analysis in pre- and postnatal diagnostics of congenital lung diseases in children was assessed. The authors also discuss opinion of some specialists as to the terms and tactics of surgical interventions as well as advantages of minimally invasive surgery for congenital lung developmental anomalies.

Choice of treatment method of obstructive jaundice in patients with tumors of the hepatopancreatobiliary region

2021 ◽  
Vol 23 (3) ◽  
pp. 125-132
Author(s):  
Pavel N. Romashchenko ◽  
Nicolay A. Maistrenko ◽  
Andrey I. Kuznetsov ◽  
Andrey S. Pryadko ◽  
Arsen K. Aliev
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Biliary Tract ◽  
Bile Ducts ◽  
Laboratory Diagnostics ◽  
Endoscopic Stenting ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Tumor Origin ◽  
Block Level

The leading criteria for choosing minimally invasive surgical treatment of mechanical jaundice of tumor origin in the hepatopancreatobiliary zone are substantiated, which increase the effectiveness of surgical intervention and reduce the number of complications and mortality. The examination and surgical treatment results of 325 patients with mechanical jaundice of tumor origin, who underwent minimally invasive decompression of the biliary tract after clinical and laboratory diagnostics following national clinical recommendations, were analyzed. Based on the treatment results, the leading criteria that affect the selection of the method of minimally invasive drainage surgery are identified. The main criteria influencing the choice of minimally invasive intervention to decompress the bile ducts were as follows: level of bile duct block, severity of mechanical jaundice (according to the classification of E.I. Galperin), and the operability of the patient. Endoscopic stenting was the method of choice in inoperable cases at the level of block I with mechanical jaundice of classes A and B. Moreover, endoscopic stenting was the most successful intervention with a minimum number of complications in people with block II level. The indication for percutaneous transhepatic biliary drainage was a level III biliary tract block, as well as the ineffectiveness of endoscopic stenting. Cholecystostomy is the safest and most effective in patients with block level I with class C mechanical jaundice and in operable cases with the same block level. In general, results of surgical interventions aimed at eliminating mechanical jaundice of tumor origin, conducted using modern examination methods of patients and taking into account the assessment of criteria such as the block level of the bile ducts, severity of mechanical jaundice, and general condition allow us to justify the choice of the most successful and safe option for its elimination.

scholarly journals X-RAY-ENDOVASCULAR EMBOLIZATION OF PARAPANCREATIC VESSELS IN THE TREATMENT OF CHRONIC PANCREATITIS COMPLICATIONS

2021 ◽  
pp. 85-90
Author(s):  
K.S. Belyuk ◽  
E.V. Mogilevets ◽  
R.S. Shilo ◽  
L.F. Vasilchuk ◽  
S.P. Antonenko ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Research Methods ◽  
Endovascular Embolization ◽  
Vascular Pathology ◽  
Laboratory Research ◽  
Surgical Interventions ◽  
X Ray ◽  
History Of

Goal. To improve the results of surgical treatment of chronic pancreatitis complicated by vascular pathology of the parapancreatic zone. Materials and methods. On the basis of the "Grodno University Clinic" in the department of X-ray Endovascular Surgery of the period 2010 to April 2020, were performed 16 embolizations of the arteries of the parapancreatic zone due to complications of chronic pancreatitis. Among the patients there were 13 (81.25%) men and 3 (18.75%) women. They had a history of chronic pancreatitis, which was confirmed using instrumental and laboratory research methods. One of the patients (6.25%) had a stationary aneurysm.15 (93.75%) patients had a bleeding clinic, which required urgent surgical interventions. Results. Angioembolization of the parapancreatic arteries was effective in 15 (93.75%) patients, which was confirmed by the results of control angiograms. Conclusions. The use of intraluminal embolization for vascular pathology of the parapancreatic zone in treatment of chronic pancreatitis complications is a minimally invasive and effective method.

scholarly journals Surgical tactics in patients with pancreatic necrosis and its complications

2016 ◽  
Vol 97 (6) ◽  
pp. 898-903
Author(s):  
D M Krasil’nikov ◽  
A V Abdul’janov ◽  
I V Zajnullin ◽  
M A Borodin ◽  
R A Zefirov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Pancreatic Necrosis ◽  
Treatment Options ◽  
Postoperative Mortality ◽  
Surgical Interventions ◽  
Surgical Tactics ◽  
Medical University ◽  
Surgical Clinic

Aim. Improving the results of surgical treatment of patients with pancreatic necrosis and its complications based on developing optimal variants of surgical interventions for each case.Methods. The article presents experience of surgical treatment of 344 patients with pancreatic necrosis admitted to surgical clinic №1 of Kazan state medical university in Republican clinical hospital (Kazan) during the period from 2009 to 2015. According to the developed procedure of choosing the optimal treatment options for patients with pancreatic necrosis, depending on the stage, degree of involvement of pancreas and retroperitoneal space and the presence of complications, patients underwent a variety of options and combinations of types of surgical interventions. Under the guidance of X-ray 124 surgeries were performed, in 69 (20.1%) cases surgical interventions under ultrasound (US) guidance were completed with open surgical intervention.Results. Videolaparoscopic interventions with therapeutic and diagnostic purposes were performed in 198 patients with lethal outcomes in 3 (3.1%) cases. As a completed intervention videolaparoscopy was performed in 49 (24.7%) cases. 226 (65.7%) patients underwent open surgery. Most patients required combined surgical treatment, which included a combination of minimally invasive procedures and open surgery in 199 (57.9%) patients.Conclusion. Use of combined methods of surgical treatment in patients with infected pancreatic necrosis greatly improves treatment outcomes; a combination of minimally invasive and open surgery can significantly reduce postoperative mortality in pancreatic necrosis from 17.8% to 12.5%.

SURGICAL TREATMENT OF LYMPHATIC MALFORMATIONS OF THE HEAD AND NECK AREA IN CHILDREN

2021 ◽  
Vol 100 (3) ◽  
pp. 141-146
Author(s):  
R.S. Oganesyan ◽  
◽  
N.S. Grachev ◽  
◽  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Head And Neck ◽  
Neck Region ◽  
Unified Approach ◽  
Lymphatic Malformations ◽  
Head And Neck Region ◽  
Surgical Interventions ◽  
Wide Range ◽  
Neck Area

The variety of forms and localizations of lymphatic malformations (LMs) in the head and neck region determine the lack of unified approach to the treatment of this pathology. The surgical approach is divided into minimally invasive sclerotherapy technique, used mainly for macrocystic forms of LM, and classical surgery, which includes a wide range of surgical interventions on organs and structures of the head and neck. A combination of these two methods and planning of surgical staging are the key to success in the treatment of mixed forms of LMs and malformations of complex localizations with extensive distribution.

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