scholarly journals Experience of application anti adgesivebarrier in the treatment of patients with Asherman’s syndrome

2016 ◽  
Vol 65 (5) ◽  
pp. 29-32
Author(s):  
Tatyana A Makarenko ◽  
Daria E Nikiforova ◽  
Inga O Ul’yanova
Keyword(s):  
Uterine Cavity ◽  
Intrauterine Adhesions ◽  
Asherman’S Syndrome ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Group I ◽  
Extreme Degree ◽  
Group Ii ◽  
Research On Application ◽  
Prevention Of Recurrence

Relevance. Asherman’s syndrome is one of the most difficult problems in gynecologic practice, because in addition to complex clinical picture, which includes secondary amenorrhea and infertility is a significant difficulty in diagnosis and treatment. The purpose was to improve the results of treatment of Аsherman’s syndrome after conducting hysteroresectoscope adhesiolysis using anti adhesive barrier “Antiadgezin”.Materials and methods. The study included 36 patients with peritoneal process in the uterus of varying severity. Group I consisted of 20 women who are in the postoperative period in the uterine cavity was entered “Antiadgezin”, group II — 16 women with similar pathology without introducing anti adgesive barriers.Results. All women 3 months after adhesiolysis was performed a control hysteroscopy. The presence of adhesions was diagnosed in 2 (10%) patients in the first group, while adhesions were isolated delicate and easily destroyed by the sheath of a hysteroscope. In group II adhesions had recurrences in 5 (31,3%) patients (p = 0,038), and one patient was visualized “tunnel” — uterus, which is extremely unfavorable course of disease.Conclusion. Treatment of Asherman’s syndrome, as extreme degree of intrauterine adhesions, requires a comprehensive approach, which is based on prevention of recurrence of the formation of adhesions after surgical interventions. Research on application anti adgesivebarriers will continue, as intrauterine their use on the example of antiadgezin showed good results.

Endometrial Regeneration in Asherman's Syndrome: Clinical and Translational evidence of Stem Cell Therapies

2019 ◽  
Vol 14 (6) ◽  
pp. 454-459
Author(s):  
Xuejing Hou ◽  
Ying Liu ◽  
Isabelle Streuli ◽  
Patrick Dällenbach ◽  
Jean Dubuisson ◽  
...  
Keyword(s):  
Stem Cell ◽  
Molecular Mechanisms ◽  
Uterine Cavity ◽  
Stem Cell Therapies ◽  
Intrauterine Adhesions ◽  
Asherman’S Syndrome ◽  
Cell Therapies ◽  
Fibrotic Process ◽  
Physical Barriers

Asherman’s Syndrome or Intrauterine adhesions is an acquired uterine condition where fibrous scarring forms within the uterine cavity, resulting in reduced menstrual flow, pelvic pain and infertility. Until recently, the molecular mechanisms leading to the formation of fibrosis were poorly understood, and the treatment of Asherman’s syndrome has largely focused on hysteroscopic resection of adhesions, hormonal therapy, and physical barriers. Numerous studies have begun exploring the molecular mechanisms behind the fibrotic process underlying Asherman’s Syndrome as well as the role of stem cells in the regeneration of the endometrium as a treatment modality. The present review offers a summary of available stem cell-based regeneration studies, as well as highlighting current gaps in research.

scholarly journals ADVANTAGES OF INTRATHECAL BUPIVACAINE AND DEXMEDETOMIDINE COMBINATION OVER BUPIVACAINE AND CLONIDINE: A COMPARATIVE ANALYSIS IN GYNAECOLOGICAL INTERVENTIONS

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Aruna Mahanta ◽  
Keshav Saran Agrawal
Keyword(s):  
Regional Anaesthesia ◽  
Motor Block ◽  
Surgical Intervention ◽  
Average Duration ◽  
Sensory Block ◽  
Lower Side ◽  
Regional Analgesia ◽  
Surgical Interventions ◽  
Group I ◽  
Group Ii

Background: most of the gynaecological interventions are generally done under regional anaesthesia. Currently dexmedetomidine came out as a beneficial adjunct for regional analgesia as well as anaesthesia. It is a highly selective α-2 agonist. Aims & objectives: to compare the effects & behavior of dexmedetomidine with clonidine when both are used with bupivacaine for spinal analgesia. Material and Methods: 100 cases of ASA grade 1 & 2 who were undergoing elective gynaecological surgical intervention were studied. They were divided into two groups (50 each). Group I received combination of bupivacaine & clonidine while group II received combination of bupivacaine + dexmedetomidine. Results: Average duration of onset of sensory block was earlier in group II. Arrival of motor block in Group I was slightly on lower side than Group II. Ten cases in Group I and eighteen cases from group II had notable bradycardia and hypotension. Discussion: Our study concludes that dexmedetomidine when used in combination with bupivacaine is very effective in gynaecological surgical interventions that demand longer duration & have comparatively lesser side effects. Keywords: dexmedetomidine, clonidine, Bupivacaine, gynaecological procedures.

scholarly journals Surgical treatment of patients with sagittal imbalance of degenerative etiology: a comparison of two methods

2020 ◽  
Vol 27 (3) ◽  
pp. 16-26
Author(s):  
Evgenii S. Baykov ◽  
Alexey V. Peleganchuk ◽  
Abdugafur J. Sanginov ◽  
Olga N. Leonova ◽  
Aleksandr V. Krutko
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Perioperative Complications ◽  
Sagittal Imbalance ◽  
Radiological Parameters ◽  
Results Of Treatment ◽  
Group I ◽  
Surgical Methods ◽  
Group Ii ◽  
Clinical And Radiological Results

Purpose. Compare the clinical and radiological results of treatment of patients with spinal deformities operated on using the PSO method and corrective fusion in the lumbar spine. Materials and methods. Retrospective monocenter cohort study. The data of 42 patients were analyzed. PSO (group I) was performed in 12 patients; 30 patients had a combination of surgical methods (group II) with mandatory ventral corrective spinal fusion at levels L4-L5, L5-S1. Clinical and radiological parameters were evaluated during hospitalization and at least 1 year later. Results. Postoperative hospitalization in group I 32.5 7.4 days, 27.1 7.4 in group II (p = 0.558758). The duration of the operation in group I was 402.5 55.6 minutes, in group II 526.0 116.2 minutes (p = 0.001124); blood loss 1862.5 454.3 ml versus 1096.0 543.3 ml (p = 0.000171). In both groups, significantly improved clinical and radiological parameters after surgery and after 1 year (p 0.05). In group II, as compared with group I after surgery and more than 1 year: lower back pain according to VAS (p = 0.015424 and p = 0.015424); below ODI after 1 year was (p = 0.000001). In group I, compared with group II after surgery and after 1 year, SVA is less (p = 0.029879 and p = 0.000014), lumbar lordosis is higher (p = 0.045002 and p = 0.024120), LDI is restored more optimally (p = 0.000001 and p = 0.000002), the GAP is lower (p = 0.005845 and p = 0.002639). The ideal Russoly type is restored more often in patients of group II (p = 0,00032). Complications in group I were noted in 12 (100%) patients, in group II in 13 (43.3%) patients (p = 0.001). Conclusions. In multistep surgical treatment compared with PSO, the anterior corrective interbody fusion L4-L5, L5-S1 reliably better and more harmoniously restores the sagittal balance parameters, has significantly lower volume of intraoperative blood loss, fewer perioperative complications and significantly improves the quality of life of patients.

scholarly journals Regarding operative treatment of thoracoabdominal injuries

2019 ◽  
Vol 36 (1) ◽  
pp. 14-20
Author(s):  
Dmitriy G. Amarantov ◽  
Mikhail F. Zarivchatsky ◽  
Andrey A. Kholodar ◽  
Andrey S. Nagaev ◽  
Oleg S. Gudkov
Keyword(s):  
Operative Treatment ◽  
Clinical Situation ◽  
Rational Approach ◽  
Quality Of Treatment ◽  
Results Of Treatment ◽  
Group I ◽  
Thoracoabdominal Injuries ◽  
Group Ii

Aim. To improve the results of treatment in patients with thoracoabdominal injuries (TAI) by means of creating the method of determining indications for the use of classical or endoscopic surgeries in respect of this pathology. Materials and methods. Seventy-six sufferers from TAI were divided into 2 groups. Results. The method of successive determination of indications for the use of classical or endoscopic surgeries in patients with TAI was created on the basis of treatment of 41 (53.95 %) patients of group II. This method was used to treat 35 (46.05 %) patients of group I. Conclusions. Rational approach to the choice between the use of advantages of classical and endoscopic surgeries depending on characteristics of clinical situation permitted to elevate the quality of treatment in patients with TAI.

scholarly journals The role of external osteosynthesis in treatment of unstable pelvic osseous injuries

2019 ◽  
Vol 86 (5) ◽  
pp. 48-53
Author(s):  
N. L. Аnkin ◽  
L. N. Аnkin ◽  
T. M. Petryk ◽  
V. А. Ladyka
Keyword(s):  
External Fixation ◽  
Pelvic Ring ◽  
Fixation Method ◽  
Group Iii ◽  
Results Of Treatment ◽  
Pelvic Injuries ◽  
Group I ◽  
Joint Revision ◽  
Effect Of Treatment ◽  
Group Ii

Objective. To specify the role and indications for application of аpparatus of external fixation (АEF) in treatment of unstable pelvic osseous injuries (UPOI); to study up the advantages and faults of the external fixation method; to share the experience of treatment, using this procedure. Маterials and methods. There were 229 patients, suffering pelvic injuries, examined on the base of orthopedic-traumatological centre of Kyiv’s Regional Clinical Hospital in 2005 - 2017 yrs and distributed into three Groups. In Group I 143 (62.4%) injured persons were included, in whom external osteosynthesis played the function of temporary measures of fixation, in Group II - 27 (11.8%) patients, in whom while hospitalization a fracture was fixed, using AEF, аnd after stabilization of the state the posterior pelvis osteosynthesis and reposition was conducted, in Group III - 59 (25.8%) patients, who, using several indications, were definitely treated, applying the external fixation method only. Results. Excellent effect of treatment in Group I was registered in 23 (19.0%), a good one - in 58 (47.9%), satisfactory - in 32 (26.4%), poor - in 8 (6.6%) of 121 patients; in Group II - accordingly, - in 5 (20.8%), 11 (45.8%), 7 (29.2%) and 1 (4.2%) of 24 patients; in Group III - accordingly, in 4 (8.3%), 12 (25%), 23 (47.9%) and 9 (18.6%) of 48 patients. Conclusion. Best results of treatment of patients with unstable pelvic osseous injuries were obtained while applying the tactics of change from external fixation into internal one. On the first stage the pelvic ring fixation, using AEF, was performed, аnd after stabilization of a patient general status - internal osteosynthesis. Application of the internal osteosynthesis method permits to control and stabilize the reposition achieved, to conduct the sacro-ileal joint revision.

scholarly journals Method of Enteral Insufficiency Syndrome Correction in Patients with Generalized Peritonitis

2021 ◽  
Vol 14 (3) ◽  
pp. 182-192
Author(s):  
Evgeny A. Korymasov ◽  
Sergey A. Ivanov ◽  
Mariya Kenarskaya ◽  
Maxim U. Khoroshilov
Keyword(s):  
Rating Scale ◽  
Study Groups ◽  
Albumin Level ◽  
C Reactive Protein ◽  
Surgical Interventions ◽  
Reactive Protein ◽  
Generalized Peritonitis ◽  
Group I ◽  
Group Ii ◽  
Insufficiency Syndrome

Introduction. Mortality in generalized peritonitis (GP) reaches 30%, and with the development of multiple organ failure, the lethal outcome is observed in 80-90% of cases. Enteral insufficiency syndrome (EIS) plays a leading role in the progression of generalized peritonitis. The aim of the study was to develop a differentiated approach of enteral insufficiency syndrome correction in patients with generalized peritonitis. Material and methods. This research was a retrospective prospective study. The study included 50 patients with GP, who received treatment at the Surgery Department of the Samara Regional Clinical Hospital in the period from 2017 to 2019. Depending on the chosen treatment tactics, the patients were divided into two clinical groups. Group I included 29 patients, admitted in the period from 2017 to 2018, who had received the standard GP treatment. A long-term endogenous intoxication in patients of this group associated with the progressive enteric failure led to the repeated surgeries; at the same time, a high frequency of postoperative complications was preserved. The analysis of the results in patients of Group I necessitated development of the therapeutic and diagnostic algorithm aimed at early diagnostics and timely correction of EIS. Group II included 21 patients with GP, admitted in the period from 2018 to 2019, who was treated using the new algorithm. Results. The objective criteria for the relief of EIS in GP in patients of the study groups were a decrease in the level of serum albumin and C-reactive protein, a significant decrease in the amount and qualitative change in the intestinal discharge via an intestinal tube, a decrease in the recovery time of the functions of the small intestine and start of defecation. On the 6th postoperative day, in patients of Group II there was no significant albumin level reduction in comparison with the 1st day of monitoring (28.310.77 g/l vs 37.334.69 g/l). Whereas in Group I the albumin level was significantly lower (19.30.51 g/l) than the same parameter in Group II, and in comparison with the 1st day of monitoring (19.30.51 g/l vs 39.56.05 g/l; р = 0.00001). On the 6th postoperative day, the C-reactive protein level differed significantly between the groups as well: Group I 104.7613.49 mg/l, Group II - 58.0029.05 mg/l, p = 0.003. The control of GP in patients of the Group I was reached after 4.52.5 repeated abdominal interventions, while in patients of Group II generalized peritonitis was arrested after 2.30.9 surgical interventions (p = 0.000171), which is 1.9 times less. Conclusions. The proposed algorithm of EIS control is based on the individual approach to the treatment of patients with GP. The developed EIS rating scale allows determining not only the degree and dynamics of the pathological process, but also monitoring the effectiveness of treatment options applied in a particular patient.

scholarly journals INFLUENCE OF PHYSICAL REHABILITATION ON QUALITY OF LIFE AFTER RENAL TRANSPLANTATION

2015 ◽  
Vol 69 (3-4) ◽  
pp. 65-70 ◽  
Author(s):  
T. Y. Zhirnova ◽  
E. E. Аchkasov ◽  
O. M. Tsirulnikova ◽  
E. M. Shilov ◽  
O. B. Dobrovolskiy
Keyword(s):  
Quality Of Life ◽  
Kidney Transplantation ◽  
Organ Transplant ◽  
Rehabilitation Program ◽  
Physical Rehabilitation ◽  
Group Iii ◽  
Results Of Treatment ◽  
Group I ◽  
Group Ii

Background: Aim of this study was to evaluate the role of physical rehabilitation to improve the quality of life (QOL) of people after kidney transplantation. Patients and methods: Analyzes the results of treatment of 57 recipients (mean age 35±9,65 years) donor kidney at different times of the postoperative period. Depending on the physical rehabilitation program allocated 3 groups of patients: group II — physical rehabilitation was carried out only in the first week after surgery to prevent early postoperative complications, in group I — during the year; in group III combined 30 relatively healthy people do not need an organ transplant and with a mean age 33,7±8,7 years, leading a normal life, not engaged in regular recreational physical culture. Quality of life was assessed using a questionnaire SF36 at 1, 3, 6 and a 12 months after surgery. Results: One year after surgery in both groups compared with preoperative indicators marked improvement according to all scales of the questionnaire. However, in group I indicators of quality of life were higher than in group II from 11,4 to 19,7%, and even some items questionnaire SF-36 is higher than in group III which is associated with the physical rehabilitation. Conclusion: It has been shown that exercises is an important component of treatment and rehabilitation after kidney transplantation and help improve both the psychological and the physical component of quality of life.

scholarly journals EVALUATION OF PUNCTURE DRAINING INTERVENTIONS EFFICACY IN PATIENTS WITH PANCREATIC FLUID COLLECTIONS

2020 ◽  
Vol 24 (3-4) ◽  
pp. 3-5
Author(s):  
Ohanezian Aikanush
Keyword(s):  
Ultrasound Guidance ◽  
Minimal Invasive ◽  
Ultrasound Guided ◽  
Septic Complications ◽  
Surgical Interventions ◽  
Group I ◽  
Specific Sign ◽  
Group Ii ◽  
Ultrasound Guided Puncture ◽  
Guided Puncture

The aim of the research is to evaluate the effectiveness of ultrasound guided punctures and drainage for FCs in AP. The results of the examination and treatment of 72 patients with FCs in AP who have been treated using step up approach in the period from 2010 till 2018 are analyzed. Patients were divided on two groups: The first group included 40 patients, who underwent draining of FCs under ultrasound guidance as a first stage of treatment. The second group included 32 patients, who underwent puncture of FCs under ultrasound guidance as the first stage of treatment. In the majority of patients in Group I (65.0%) we observed acute post-necrotic FCs. In 30 (75.0%) patients draining under ultrasound guidance was final in treatment. 10 (25.0%) patients with infected acute postnecrotic FCs, after drainage and aspiration underwent necrectomy. In most of patients of group II (62.5%) were noted acute postnecrotic FCs too. 17 patients underwent ultrasound guided puncture and aspiration of FCs. 15 patients of group II underwent drainage of acute post-necrotic FCs under the ultrasound guidance. In 11 (73.3%) of them the drainage of FCs was definitive in treatment, 4 (26.7%) - required the necrosectomy. In group II, in 81.2% patients minimal invasive surgical interventions were effective. SIRS was noted as in patients with aseptic FCs so in patients with infected FCs. In patients with acute pancreatitis, the duration of the disease up to 4 weeks, as well as the presence of SIRS, is not a specific sign of infection only. Ultrasound-guided diagnostic puncture of FCs is a safe method that facilitates early diagnosis of infected FCs. Ultrasound guided puncture with aspiration can reduce the incidence of purulent-septic complications and be definitive in treatment for aseptic acute parapancreatic FCs and aseptic acute post-necrotic FCs. Infected FCs without suppuration do not require routine drainage. Drainage is absolutely indicated in case of purulent content and persistent SIRS in patients after primary puncture of infected FCs.

Results of infertility treatment using ART methods in patients who underwent myomectomy: risk factors for repeated unsuccessful ART programs

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 44-49
Author(s):  
Irena F. Kozachenko ◽  
Veronika Y. Smolnikova ◽  
Leila V. Adamyan
Keyword(s):  
Risk Factors ◽  
Uterine Fibroids ◽  
Uterine Cavity ◽  
Art Programs ◽  
Hysteroscopic Myomectomy ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Art Program ◽  
Adverse Pregnancy

Aim. To evaluate the results of treatment of patients with uterine fibroids and infertility with ineffective art programs in the anamnesis and to identify possible risk factors for repeated art failures. Materials and methods. 510 patients with uterine fibroids and infertility were examined and surgically treated prior to the ART program. Myomectomy was performed using various approaches: laparoscopic access in 250 patients, laparotomic access in 70 patients, hysteroscopic myomectomy in 100 patients, and combined access (laparoscopic and hysteroscopic) in 90 women. Results. Primary infertility was observed in 38.0%, secondary in 62.0% of patients. The average duration of infertility was 4.41.9 years. ART had in history 54.5% of patients. During the follow-up period up to 2 years, 24.3% of women had recurrent uterine fibroids. After carrying out of surgical treatment and the following ART pregnancy was achieved in 44.3% of patients. Pregnancies ended in childbirth in 58.8% of cases, which exceeded the total share (41.6%) of adverse pregnancy outcomes (ectopic pregnancy, abortions, spontaneous miscarriages at various times) by 1.4 times. Conclusion. Risk factors for repeated ART failures in patients who have undergone myomectomy are: age over 40 years; duration of infertility for more than 5 years and the presence of 3 or more ineffective IVF attempts in the history; the presence of previous surgical interventions such as uterine artery embolization and FUS-ablation; the presence of submucous fibroids, a dominant node located close to the uterine cavity and myoma with signs of blood supply disorders; the combination of uterine fibroids with external genital endometriosis and chronic endometritis.

Prevention of de novo adhesion formation in patients with Asherman's syndrome

2021 ◽  
Vol 86 (4) ◽  
pp. 273-278
Author(s):  
Barbora Boudová ◽  
◽  
Zdeňka Lisá ◽  
Adéla Richtárová ◽  
David Kužel ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
De Novo ◽  
Meta Analysis ◽  
Adhesion Formation ◽  
Hormonal Treatment ◽  
Intrauterine Adhesions ◽  
Asherman’S Syndrome ◽  
Surgical Interventions ◽  
Literature Evidence ◽  
Semi Solid

Summary: Objective: To summarize recent data and knowledge of secondary prevention of the recurrence of intrauterine adhesions in patients with Asherman's syndrome. Methods: Analysis of literature evidence and clinical experience of the authors. Results: Asherman's syndrome is iatrogenic disease with problematic therapy. One of the basic issues is a need for repeated surgical interventions since the recurrence of adhesions is very frequent. Secondary prevention is a crucial factor for successful therapy in these patients. The methods applied include second-look hysteroscopy, hormonal treatment and different types of barriers. To compare their efficacy is difficult and the results of meta-analysis are contradictory. Conclusion: There are many diff erent possibilities of secondary prevention of the recurrence of intrauterine adhesions; unfortunately, none of them is perfect. The usage of solid or semi-solid barriers in combination with the support of endometrium regeneration with hormonal therapy seems most reasonable.

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