NEW APPROACHES IN THE TREATMENT OF ACUTE INFLAMMATION OF THE EPITHELIAL PILONIDAL SINUS

Presents an overview of russian and foreign publications, devoted to contemporary methods of conservative and surgical treatment of acute inflammation of the epithelial pilonidal sinus. Details of surgical interventions, techniques, indications and contraindications. Special attention is paid to pre-operative preparation for surgery, wound closure after surgical access, patient management in the postoperative period.

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Rehabilitation of women after conservative and surgical treatment

Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH) ◽

10.20340/vmi-rvz.2021.5.clin.4 ◽

2021 ◽

Author(s):

R. S. Moldassarina ◽

G. K. Manabayeva ◽

Z. Ye. Akylzhanova ◽

A. M. Rashidova

Keyword(s):

Surgical Treatment ◽

Postoperative Period ◽

Healing Process ◽

Psychological Trauma ◽

The Body ◽

Medical Rehabilitation ◽

Practical Significance ◽

Modern World ◽

Surgical Interventions ◽

Conservative And Surgical Treatment

The relevance of the study is due to the increase in the volume of conservative and surgical care for women who need mandatory rehabilitation measures in the postoperative period. Until relatively recently, there were very few rehabilitation facilities in the country where women could recover under the supervision of a nurse. Therefore, rehabilitation could drag on for many months and it was very difficult to fully return to normal life. In the modern world, it has become possible to undergo all the necessary analyzes and conduct treatment using the latest scientific methods on high-precision equipment, and then perform a full course of postoperative regeneration. After all, medical centers have great technological capabilities today and control the healing process as soon as possible. The nature of the measures for the recovery of women depends on the changes in the body, which are due to the individual background at the time of treatment. It is important to understand the dependence of a woman's position at the time of recovery: the duration of taking medications, the presence of psychological trauma, the development of chronic diseases, the frequency of repeated interventions. The aim of the study is a step-by-step volumetric study of the implementation of various measures aimed at the rehabilitation of women after conservative and surgical treatment. Modern approaches require responsibility, high qualifications of medical personnel and the direct participation of the patient himself in this process. Timely start of rehabilitation ensures productive restoration of lost functions. The main principle of success is the use of standardized methods, informing the patient at all stages of treatment, using techniques with minimal consequences and maximum impact, and analyzing the course of the postoperative period. The need for an in-depth study of the features of providing medical care to patients with gynecological diseases, including after surgical interventions, is confirmed. The practical significance of the material lies in the high-quality and effective organization of medical rehabilitation, which is of key importance for the full restoration of the functions of the woman's reproductive system.

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

Kharkiv Surgical School ◽

10.37699/2308-7005.2.2020.33 ◽

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.

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Evaluation of the effectiveness of the use of low-traumatic surgical access in the reverse shoulder arthroplasty

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto64822 ◽

2021 ◽

Vol 28 (2) ◽

pp. 21-28

Author(s):

Gurgen A. Kesyan ◽

Grigoriy S. Karapetyan ◽

Artem A. Shuyskiy ◽

Rashid Z. Urazgil'deev ◽

Igor' G. Arsen'ev ◽

...

Keyword(s):

Surgical Treatment ◽

Surgical Technique ◽

Shoulder Arthroplasty ◽

Shoulder Joint ◽

Subcutaneous Tissue ◽

Reverse Shoulder Arthroplasty ◽

Main Group ◽

Control Group ◽

Surgical Interventions ◽

Surgical Access

BACKGROUND: The number of reversible shoulder joint endoprostheses installed in the world at the present stage is several times greater than the number of hemiarthroplasty performed. Nevertheless shoulder arthroplasty is considered a traumatic operation and can be accompanied by a number of complications, both from the side of implants and due to the traumatic nature of the surgical technique. During surgical interventions on the shoulder joint with a wide dissection of the skin and subcutaneous tissue, iatrogenic damage to structures such as the axillary nerve, posterior and anterior arteries and veins surrounding the humerus can often be detected, which triggers a whole cascade of pathophysiological and regulatory processes in which Interventions immediately release inflammatory mediators. Therefore, orthopedic traumatologists strive to reduce the risk of intra- and postoperative complications, and it is necessary to improve the surgical technique of surgical interventions towards their less traumatic performance. AIM: Development and evaluation of the effectiveness of the use of low-traumatic surgical access when performing reverse shoulder arthroplasty. MATERIALS AND METHODS: In the period 20172020, 169 patients with various diseases, injuries of the shoulder joint and their consequences were operated on in the Department of Adult Orthopedics of the N.N. Priorov National Research Medical Center of the Russian Federation, who underwent reverse shoulder arthroplasty according to generally accepted indications. In the main group (84 patients), surgical treatment was performed using a low-traumatic surgical approach, while the control group (85 patients) underwent standard procedures. Functional, clinical and radiological results of surgical treatment of patients of the main and control groups were evaluated and compared after 3, 6 and 12 months. RESULTS: In the main group, excellent results (25 points on DASH) were observed in 73 patients, good results (2650 points) in 10 patients. In 1 patient, the results were assessed as satisfactory (5175 points). In the control group of observation, the clinical result was worse (68 excellent, 16 good and 1 satisfactory result). CONCLUSION: On the basis of the performed study, taking into account the better results in the main group of patients, the technique of low-traumatic surgical access for reverse shoulder arthroplasty can be recommended for wide use in clinical practice.

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Surgical treatment of complications of Crohn’s disease

Vestnik of Russian military medical Academy ◽

10.17816/brmma12241 ◽

2018 ◽

Vol 20 (1) ◽

pp. 111-116

Author(s):

I A Solovev ◽

A M Pershko ◽

D P Kurilo ◽

M V Vasilchenko ◽

E S Silchenko ◽

...

Keyword(s):

Crohn’S Disease ◽

Surgical Treatment ◽

Crohn's Disease ◽

Surgical Intervention ◽

Intestinal Anastomosis ◽

Clinical Manifestations ◽

Intestinal Fistula ◽

Subtotal Resection ◽

Surgical Interventions ◽

Conservative And Surgical Treatment

Possibilities and options of surgical treatment of complications of Crohn’s disease in the general surgical hospital are considered. Patients underwent various surgical interventions: ileum resection with «side-to-side» anastomosis (4 patients), resection of ileocecal department with the formation of ileoascendoanastomosis (2 patients), total coloproctectomy with the formation of ileostomy (2 patients), right-sided hemicolectomy (1 patient), obstructive resection of transverse colon (1 patient), obstructive resection of sigmoid colon (2 patients). Postoperative complications developed in 3 patients (25%), among them: postoperative wound suppuration - 2, dehiscence of anastomosis in 1 patient, which led to the formation of internal intestinal fistula and death. It was found that with limited lesions of colon in Crohn’s disease (less than a third of the colon) can be limited to resection of the affected segment with formation of intestinal anastomosis in the limits of healthy tissues. In the presence of lesions in the ascending department of colon proximal border of resection should be at the level of middle colic vessels with preservation of the latter. In long Crohn’s disease of colon with severe clinical manifestations of the operation of choice is a subtotal resection of colon with the imposition of single-barrel ileostomy. Surgical treatment of complicated forms of Crohn’s disease is in all cases performed in surgical profile hospitals, taking patients by ambulance. Most often, patients have delayed indications for operations, which gives the opportunity to carry out a comprehensive preoperative preparation. In all cases, complications of Crohn’s disease requires an individual approach, which combines conservative and surgical treatment. Surgical intervention is determined by the shape and characteristics of the course of complications of Crohn’s disease.

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Formation of Adhesive Arachnoiditis with Epidural Fibrosis as a Cause of Repeated Surgical Interventions (Clinical Case)

Acta biomedica scientifica ◽

10.29413/abs.2020-5.3.8 ◽

2020 ◽

Vol 5 (3) ◽

pp. 54-61

Author(s):

A. P. Zhivotenko ◽

V. A. Sorokovikov ◽

Z. V. Koshkareva

Keyword(s):

Surgical Treatment ◽

Epidural Space ◽

Clinical Case ◽

Intraoperative Complications ◽

Failed Back Surgery Syndrome ◽

Unsatisfactory Result ◽

Surgical Interventions ◽

Constant Pain ◽

Failed Back Surgery ◽

Conservative And Surgical Treatment

The work presents a rare clinical case of adhesive arachnoiditis, which developed against the background of epidural fibrosis during repeated surgical interventions. The cicatricial adhesion in the epidural space is formed in 100% of cases after surgery and is a frequent cause of intraoperative complications during repeated surgical interventions (bleeding, damage to the spinal cord and the dura mater with subsequent outflow of cerebrospinal fluid) and, therefore, an unsatisfactory result of surgical treatment with the formation of constant pain of various intensity, pseudomeningocele, commissural arachnoiditis, etc. The cicatricial adhesion in the epidural space is the main reason for the development of failed back surgery syndrome (FBSS), which today is an important and unresolved problem in spinal surgery. The epidural, as well as the subdural and subarachnoid space of the operated spinal motor segment of the spinal canal can be involved in the cicatricial adhesion, as it is shown in our clinical example. In this regard, it is important to prevent the development of the cicatricial adhesion in the epidural space during primary spinal surgeries, since with the increase in life expectancy of the population and increase in surgical activity during spinal surgeries, the patient can be operated repeatedly. Consequently, the question arises of preventing the formation of the cicatricial adhesion in 100% of cases with each surgical intervention, since the formed cicatricial adhesion in the epidural space does not have effective methods of conservative and surgical treatment and worsens favorable and satisfactory forecasts of surgical treatment for repeated surgical interventions.

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Vertebral hydatid disease

Journal of Neurosurgery ◽

10.3171/jns.1976.44.1.0072 ◽

1976 ◽

Vol 44 (1) ◽

pp. 72-76 ◽

Cited By ~ 40

Author(s):

Werner L. Apt ◽

Juan L. Fierro ◽

Ciro Calderón ◽

Carlos Pérez ◽

Patricio Mujica

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Postoperative Period ◽

Long Term Results ◽

Common Procedure ◽

Laboratory Findings ◽

Content Type ◽

Surgical Interventions ◽

Fine Print

✓ The authors present 27 cases of vertebral hydatidosis with clinical and laboratory findings. The most frequent location of the lesion was the lumbar spine. Principal neurological symptoms were paraparesis, sphincter disturbances, paresthesia and paraplegia. The average number of surgical interventions per patient was 2.6; the most common procedure was laminectomy with extirpation of the cyst and surgical toilet. The results of surgical treatment were generally good in the immediate postoperative period, but long-term results were poor.

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HIDDEN COMPLICATIONS OF THE POSTOPERATIVE PERIOD: DIAGNOSIS AND TREATMENT

Likarska sprava ◽

10.31640/jvd.3.2019(6) ◽

2019 ◽

pp. 43-47

Author(s):

O. A. Halushko

Keyword(s):

Surgical Treatment ◽

Clinical Improvement ◽

Intravenous Administration ◽

Postoperative Period ◽

Diagnosis And Treatment ◽

Surgical Interventions ◽

Results Of Treatment ◽

Phosphate Exchange ◽

Surgical Operations

One of the hidden complications of the postoperative period is hypophosphatemia (HPE), which often develops imperceptibly, but can worsen the overall results of treatment. The objective of the work: to investigate the frequency of development of disorders of phosphate exchange in the postoperative period and to establish the possibility and effectiveness of correction of such violations. Materials and methods. The determination of phosphate levels was carried out in 328 patients undergoing surgical treatment in surgical operations of various surgical status. Results. The highest rate of HPE was observed in patients with burns (23.08 %), after neurosurgical (17.94 %) and abdominal (17.64 %) surgical interventions. It is established that the correction of severe HPE is advisable by intravenous administration of sodium D-fructose-1,6-diphosphate. Conclusion. In the postoperative period, HPE is common, but is successfully corrected to abstract values, which coincides with the clinical improvement of patients.

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Modern capacities of surgical mallet toe deformity correction

Kazan medical journal ◽

10.17750/kmj2017-296 ◽

2017 ◽

Vol 98 (2) ◽

pp. 296-299

Author(s):

A M Privalov

Keyword(s):

Surgical Treatment ◽

Postoperative Period ◽

Deformity Correction ◽

Average Score ◽

Foot And Ankle ◽

Aim Analysis ◽

Actual Problem ◽

Surgical Interventions ◽

American Orthopaedic ◽

Toe Deformity

Aim. Analysis of gathered experience of surgical treatment of severe mallet toe deformity which is an actual problem of modern foot and ankle surgery. Methods. The results of 23 arthrodeses with IPP-ON interphalangeal implant in the treatment of mallet toe deformity in 14 patients. The period of observation was from January 2015 to March 2016. All patients were operated on and subsequently were observed in International Clinic «MEDEM». Results. All operated patients were females at the age of 27 to 65 years. All of them had confirmed stage III mallet toe deformity (according to M.I. Kuslik’s classification). In 64.3% of cases the surgeries were performed on both feet, in 35.7% - on one foot. All surgical interventions were combined with respective metatrsal Weil-osteotomy. Follow up period was 8 to 20 months. Evaluation of the results was performed by means of AOFAS scale (American Orthopaedic Foot and Ankle Society). An average score before the surgery was 46, after the surgery it reached 90. Foot function improved from 18 to 40 points. Toe deformity improved from 2.8 before the surgery to 11.6 in postoperative period. Conclusion. Arthrodesis with IPP-ON interphalangeal implant is effective in surgical treatment of severe mallet toe deformity; use of the implant allows ro achieve good functional and cosmetic effect in postoperative period.

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SURGICAL TREATMENT OF CEREBRAL PERIVENTRICULAR GLIOMAS: CONSEQUENCES OF THE OF PORENCEPHALY FORMATION AND FEATURES OF SURGICAL WOUND CLOSURE

Ukrainian Scientific Medical Youth Journal ◽

10.32345/usmyj.1(121).2021.106-111 ◽

2021 ◽

Vol 121 (1) ◽

pp. 106-111

Author(s):

Artem Rozumenko ◽

Valentyn Kliuchka ◽

Volodymir Rozumenko ◽

Andriy Daschakovskiy

Keyword(s):

Cerebrospinal Fluid ◽

Surgical Treatment ◽

Postoperative Period ◽

Wound Closure ◽

Surgical Wound ◽

Results Of Treatment ◽

Factors Influencing

The paper presents the experience of surgical treatment of patients with cerebral periventricular gliomas. The factors influencing on the results of treatment in the short postoperative period were analyzed. Methods of surgical wound closure preventing the development of cerebrospinal fluid disorders due to the formation of porencephaly were proposed.

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Methods of prevention and elimination of the most frequent intraoperative and postoperative complications in the surgical treatment of pulmonary and pleural tuberculosis using video-assisted surgical interventions

Tuberculosis Lung Diseases HIV Infection ◽

10.30978/tb2021-1-51 ◽

2021 ◽

pp. 51-59

Author(s):

M.S. Opanasenko ◽

V.I. Lysenko ◽

O.V. Tereshkovych ◽

B.M. Konik ◽

M.I. Kalenichenko ◽

...

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Postoperative Period ◽

Intraoperative Complications ◽

Diagnostic Methods ◽

Surgical Interventions ◽

Pleural Tuberculosis ◽

Preoperative Stage ◽

Operation And Management ◽

Selection Of

Objective — to identify and analyze methods of prevention and elimination of the most common intraoperative and postoperative complications in the surgical treatment of pulmonary tuberculosis and pleura using VATS. Materials and methods. In the Department of Thoracic Surgery and Invasive Diagnostic Methods of the National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky NAMS of Ukraine for the period from 2008 to 2019 performed 169 VATS operations on patients with tuberculosis surgery, of which: 130 (79.3 ± 3.2) % VATS lung resections; 35 (20.7 ± 3.1) % VATS pleurectomy with decortication (PE with DC) of the lung; 4 (2.4 ± 1.2) % of patients underwent other VATS interventions. Results and discussions. The level of intraoperative complications among all 169 operated patients was recorded in 9 (5.3 %) cases. Postoperative complications were detected in 29 (17.1 %) patients.Methods of prevention of complications in VATS are the selection of patients at the preoperative stage, correction of hemostasis, safe areas of thoracoport and minitracotomy, lymph dissection, separate treatment of lung root elements, conversion to thoracotomy. Conclusions. VATS interventions are minimally invasive, effective and convenient methods of surgical treatment of patients with pulmonary and pleural tuberculosis. Adequate assessment of the possibility of performing VATS, methods of prevention of complications and their timely application provides a predictable course of the postoperative period and reduces the number of complications. Diagnosis of complications and timely use of various methods of their elimination allows you to effectively and reliably apply medical manipulations to resolve both intra and postoperative complications in this type of surgery. Understanding and using methods of prevention and elimination of complications, allows to determine the correct tactics of operation and management of the postoperative period.

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