scholarly journals Surgical treatment of the patients with tubal infertility using endoscopic and microsurgical methods

2013 ◽  
Vol 62 (5) ◽  
pp. 85-90
Author(s):  
Natalya Vyacheslavovna Yakovleva ◽  
Igor Olegovich Marinkin
Keyword(s):  
Surgical Treatment ◽  
Fallopian Tubes ◽  
Tubal Infertility ◽  
Surgical Interventions ◽  
Proximal Occlusion ◽  
Distal Occlusion

There are the results of the surgical treatment of 1257 patients with tubal infertility. It was demonstrated that surgical interventions with endo- and video-support are the most effective in the case of patients with distal occlusion of the fallopian tubes and proximal occlusion associated to the synechiae, little polyps, foreign substances. Microsurgical intervention is the method of choice in patients with real fibroid occlusion in the proximal tubes.

scholarly journals Differentiated approach to the use of the modern surgical technologies in patients with tubal infertility

2013 ◽  
Vol 94 (6) ◽  
pp. 821-825
Author(s):  
N V Yakovleva
Keyword(s):  
Surgical Treatment ◽  
Distal Part ◽  
Reproductive Function ◽  
Pelvic Cavity ◽  
Surgical Trauma ◽  
Tubal Infertility ◽  
Peritoneal Adhesions ◽  
Surgical Interventions ◽  
Surgical Sterilization ◽  
Proximal Occlusion

Aim. To elaborate the differentiated approach to the surgical treatment of the patients with tubal and peritoneal infertility using the endoscopic and microsurgical methods and to evaluate its efficiency. Methods. 1840 female patients with infertility underwent complex clinical and laboratory examination, including endoscopy. 1257 patients underwent surgical treatment. Endo-video-surgical interventions were carried out in 1070 women, microsurgical techniques were applied in 187 patients. Results. The laparoscopic reconstructive plastic surgery was the most effective manipulation in patients with the disease of the distal part of the fallopian tubes and peritoneal adhesions. Treatment results were defined by the severity of distal part of the uterine tubes damage and severity of peritoneal adhesions in the pelvic cavity. The most favorable results of the treatment were noted after salpingo-ovariolysis (success rate 61.4%), by 2.3 times exceeding the pregnancy frequency after salpingoneostomy (26.9%; p 0.001) and by 1.6 times compared to fimbrioplasty (39.2%; p 0.001). In patients with proximal occlusion, results depended on the type of the tubular occlusion. In 69.7% patients with proximal occlusion due to synechiae, small polyps, foreign bodies, hysteroscopic interventions were an effective method of recanalization, allowing to restore the reproductive function in 40.2% patients. The microsurgical method demonstrated the 5.9 fold higher efficiency in patients with fibroid proximal occlusion of the uterine tubes compared to the laparoscopic methods (41.7% vs 7.1%). The microsurgical method was the most effective in patients with true fibrous proximal occlusion after the surgery on uterine tubes for tubular pregnancy and surgical sterilization. Conclusion. The differentiated approach to the surgical treatment of the patients with tubal infertility allowed to use the endo-video-surgical method in 85.1% of cases, improving the treatment’s results due to the decrease the surgical trauma and surgery duration, due to economic and cosmetic effect.

Surgical Treatment of the Tubal Infertility: Issues and Options

10.12737/3303 ◽  
2014 ◽  
Vol 21 (1) ◽  
pp. 121-127 ◽  
Author(s):  
Яковлева ◽  
Natalya Yakovleva
Keyword(s):  
Surgical Treatment ◽  
Surgical Management ◽  
High Efficiency ◽  
Assisted Reproductive Technologies ◽  
Adhesion Formation ◽  
Reproductive Technologies ◽  
Postoperative Adhesion ◽  
Fallopian Tubes ◽  
Tubal Infertility ◽  
Surgical Methods

There are two basic principles in the treatment of the tubal infertility: surgery and assisted reproductive technologies. The high efficiency of the surgical methods of the female reproductive functions recovery in comparison with in vitro fertilization is demonstrated in this paper. According to the literature review there are two effective basic surgical methods: microsurgery and endo-video-surgery in the treatment of the patients with tubal infertility. It was demonstrated that the unsuccessful results of the surgical treatment of the patients with tubal infertility are essentially connected to the fallopian tubes reocclusion and adhesive process recurrence in the small pelvis cavity. According to the new literature data, the different intra-operative and postoperative methods of the improvement of the effectiveness of the surgical management of this patient population were analyzed. However the further examinations are necessary, they will determine strict criteria for the treatment method choice of the patients with tubal infertility. The possible ways to increase the surgical management efficiency of the tubal infertility will be the surgical technique development and working out of the new methods of the rehabilitation therapy oriented to the prophylaxis of the fallopian tubes reocclusion, restoration of their functional activity, prophylaxis of the postoperative adhesion formation. The literature data review showed that surgical treatment and assisted reproductive technology must be considered as complement each other methods that may be used particularly and in combination.

OPERATIVE TREATMENT OF ECTOPIC PREGNANCY: FEATURES OF VARIOUS TYPES OF SURGICAL INTERVENTIONS

2020 ◽  
pp. 68-73
Author(s):  
Sutugina O.N. ◽  
Shubin L.B.
Keyword(s):  
Surgical Treatment ◽  
Maternal Mortality ◽  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Reproductive Function ◽  
Clinical Situation ◽  
Fallopian Tubes ◽  
Surgical Interventions ◽  
Preg Nancy ◽  
The World

Ectopic pregnancy is one of the most pressing prob-lems associated with reproductive problems all over the world. Unfortunately, so far, impaired ectopic pregnancy in some cases leads to maternal mortality. Suspicion of ectopic pregnancy requires a full clinical and diagnostic examination and hospitalization of the patient in the gynecological Department. In most cas-es, ectopic pregnancy is localized in the fallopian tube. Most often, according to the literature, patients with ectopic pregnancy are subjected to surgical treatment, which subsequently negatively affects the reproductive function of women, since the removal of ectopic pregnancy leads to both the removal of the tube and its injury, which increases the risk of repeat-ed ectopic pregnancy. The choice of the type of surgi-cal intervention on the fallopian tube in ectopic preg-nancy should be personalized and appropriate to the specific clinical situation. This paper analyzes various types of surgical interventions on the fallopian tubes in ectopic pregnancy.

scholarly journals ‘A transverse scar on the neck’ – psychosomatic approach in the differential diagnosis and surgical treatment of hyperthyroidism in post-war Finland

2021 ◽  
Vol 65 (2) ◽  
pp. 140-156
Author(s):  
Eve-Riina Hyrkäs
Keyword(s):  
Surgical Treatment ◽  
Psychiatric Patients ◽  
Differential Diagnostics ◽  
Historical Study ◽  
Complex Nature ◽  
Surgical Interventions ◽  
Somatic Illness ◽  
Post War ◽  
Definition Of ◽  
The Mind

AbstractIn the Finnish medical discussion during the middle decades of the twentieth century, the challenging differential diagnostics between hyperthyroidism and various neuroses was perceived to yield a risk of unnecessary surgical interventions of psychiatric patients. In 1963, the Finnish surgeon Erkki Saarenmaa claimed that ‘the most significant mark of a neurotic was a transverse scar on the neck’, a result of an unnecessary thyroid surgery. The utterance was connected to the complex nature of thyroid diseases, which seemed to be to ‘a great extent psychosomatic’. Setting forth from this statement, the article aims to decipher the connection between hyperthyroidism, unnecessary surgical treatment and the psychosomatic approach in Finnish medicine. Utilising a wide variety of published medical research and discussion in specialist journals, the article examines the theoretical debate around troublesome diagnostics of functional complaints. It focuses on the introduction of new medical ideas, namely the concepts of ‘psychosomatics’ and ‘stress’. In the process, the article aims to unveil a definition of psychosomatic illness that places it on a continuum between psychological and somatic illness. That psychosomatic approach creates a space with interpretative potential can be applied to the historiography of psychosomatic phenomena more generally. Further inquiry into the intersections of surgery and psychosomatics would enrich both historiographies. It is also argued that the historical study of psychosomatic syndromes may become skewed, if the term ‘psychosomatic’ is from the outset taken to signify something that is all in the mind.

Surgical treatment of acute abscesses and gangrene of the lungs

1982 ◽  
Vol 63 (1) ◽  
pp. 28-31
Author(s):  
E. A. Wagner ◽  
V. M. Subbotin ◽  
V. D. Firsov ◽  
V. A. Cherkasov ◽  
V. I. Ilchishin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Surgical Interventions

Abstract. The experience of treating 263 patients with acute abscesses and lung gangrene is generalized. Acute abscesses are mainly subject to conservative treatment; surgical interventions were performed in 13%. With gangrene of the lung, conservative treatment and palliative operations are futile. Preference is given to early radical operations performed before dangerous complications occur. Possible ways to reduce mortality in acute pulmonary suppuration are indicated.

Problems of surgical treatment of the anterior pelvic ring chronic injuries

2021 ◽  
Vol 19 (3) ◽  
pp. 47-54
Author(s):  
A. F. LAZAREV ◽  
◽  
E. I. SOLOD ◽  
YA. G. GUDUSHAURI ◽  
E. I. KALININ ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pelvic Ring ◽  
Metal Structure ◽  
Complex Problem ◽  
Long Term Results ◽  
Fixation Method ◽  
Surgical Interventions ◽  
Anterior Section ◽  
Pelvic Injuries ◽  
Study Results

A surgical treatment of the joints of the pelvic ring, especially the pubic joint is a separate and complex problem. When using standard plates, which are applied in the treatment of patients with fresh injuries to stabilize old injuries of the pelvic ring, problems arise with fatigue fracture of plates, destabilization of the metal structure and the need for repeated surgical interventions. Therefore, in the case of old injuries, during surgical treatment, it is necessary to use other tactical approaches to fixing pelvic injuries and to search for adapted structures for such cases. The purpose — to study the features of fixation of old injuries of the pelvic ring and to determine the results of different methods of the anterior pelvis fixation in old cases. Materials and methods. A retrospective analysis of the performed surgical treatment was carried out. In 2000-2015, in the first department of National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov, 117 patients underwent surgical treatment of old injuries of the anterior pelvic ring under our supervision using standard reconstructive plates applied in the surgical treatment of new injuries of the pelvic ring. Results. Of the 65 patients who underwent fixation of an old injury of the anterior semiring with AO reconstructive plates and AO pelvic plates, installed in a standard manner as in new injuries, 12 patients (10,2%) experienced migration or fracture of structures within 2 to 6 months from the operation. In 52 patients, fixation of the anterior section with two AO plates was applied, one of which was located in a standard way along the upper edge of the pubic bones, the second was implanted additionally along the anterior surface of the pelvic ring perpendicular to the first one. In this group, migration and destabilization of the structures was observed in 7 patients (13,4%) within a period from 2 weeks to 2 months from the date of the operation. Conclusion. The analysis of the study results suggests that surgical treatment of old injuries of the anterior pelvic ring requires a special approach to the choice of the surgical fixation method, which differs from the treatment of new injuries. Over time, in the absence of treatment for injuries and ruptures of the pelvic ring, cicatricial-fibrous adhesions of the pelvic ring occur, which does not always ensure the stability of the pelvic ring, but leads to rigid post-traumatic deformity of the pelvis. Taking into account the cases of destabilization in groups 1 — 10,2% and 2 — 13,4%, as well as the assessment of the long-term results according to the Majeed scale, the use of standard methods for fixing the anterior pelvic semiring can be considered ineffective in old pelvic injuries.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

scholarly journals Surgical treatment of pulmonary tuberculosis in patients with concurrent parenteral viral hepatitis

2020 ◽  
Vol 98 (6) ◽  
pp. 22-26
Author(s):  
S. N. Shugаevа ◽  
А. E. Suzdаlnitskiy ◽  
E. D. Sаvilov ◽  
S. I. Mаlov ◽  
I. V. Mаlov
Keyword(s):  
Drug Resistance ◽  
Surgical Treatment ◽  
Viral Hepatitis ◽  
Hepatitis Virus ◽  
Small Scale ◽  
Surgical Interventions ◽  
Tuberculosis Patients ◽  
Continuous Sampling ◽  
Extensive Drug Resistance ◽  
Chronic Course

The objective: to assess the effect of parenteral viral hepatitis on the manifestations of respiratory tuberculosis and the nature of surgical interventions for tuberculosis.Subjects and methods. An ambispective observational study was conducted with a continuous sampling of 475 respiratory tuberculosis patients over 18 years old who underwent surgical interventions. The patients are divided into two groups: the group of RTB+PVH consisted of 92 patients with concurrent respiratory tuberculosis and chronic parenteral viral hepatitis; the group of RTB included 383 patients with respiratory tuberculosis and no parenteral viral hepatitis.Results. It was found that compared with RTB group, in RTB+PVH group (regardless of the type of hepatitis virus), a chronic course of tuberculosis was registered significantly more often (42.4%; p = 0.005; OS = 2.0); more often bacillary excretion was documented (68.5%; p = 0.035; OR = 1.7), including those with multiple and extensive drug resistance (52.4% of cases with positive sputum tests, p = 0.048; OR = 1.8). Radical (69.6%; p = 0.05; OS = 1.7) and small-scale surgical interventions (64.1%; p = 0.037; OS = 1.8) were significantly less frequently performed in RTB+PVH patients; and such patients often developed postoperative complications (8.7%; p = 0.009; OS = 2.9).

scholarly journals The key role of pancreatic fibrosis severity in the surgical treatment algorithm of patients with chronic pancreatitis

2020 ◽  
Vol 73 (2) ◽  
pp. 235-238
Author(s):  
Oleh E. Kanikovskiy ◽  
Ihor V. Pavlyk ◽  
Iryna V. Oliinyk ◽  
Vasyl V. Mosondz
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Treatment Algorithm ◽  
Pathological Process ◽  
The Body ◽  
Nutrition Status ◽  
Tissue Pressure ◽  
Surgical Interventions ◽  
Computer Morphometry ◽  
Definition Of

The aim of the work was to improve the results of surgical treatment of complicated forms of chronic pancreatitis. Materials and methods: The results of surgical treatment of 181 patients with complicated forms of chronic pancreatitis have been analyzed. All these patients were treated in surgical clinic of 2 nd medical faculty of National Pyrogov Memorial Medical University in Vinnytsya. Results: It is possible preoperative indirectly assess the severity of fibro- degenerative changes in pancreas, that includes 1 – the definition of pain type; 2 – CT or MRI (Marseilles- Rome classification); 3 – assessment of the stage of chronic pancreatitis (Büchler classification); 4 – patient's nutrition status and preoperative differential diagnosis with pancreatic cancer; 5 – assessment of the fibrosis severity (elastomers). The key point in treatment depended on intraoperative examination: detection of strictures of the main pancreatic duct (pacemaker of chronic pancreatitis); the tissue pressure resistance to the liquid, which is the maximum value> 200 mmHg, in the region of stricture and falls in other parts of the pancreas; pressure in the main pancreas duct, which rises only in 59.5% of patients. The head of the pancreas was involved in the pathological process in 83.8%, in 16.2% it was isolated in the isthmus or the body and tail of the pancreas. In general, the distal pancreas was involved in 37.8%. At computer morphometry of histological samples, the area of connective tissue fields reached 81.4 ± 6.62%, preserved exocrine part in 4.87 ± 1.62%, endocrine – 1.92 ± 0.12%, total area of ducts – 6 , 47 ± 1.12%. Conclusions: The combined Frey-Izbickiy local resection provides a wide excision of the pacemaker (stricture) of chronic pancreatitis. In case of extrapancreatic complications or repeated surgical interventions on the pancreas due to chronic pancreatitis, this effect can be achieved by pancreatoduodenal resection.

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