Analysis of the severity of clinical manifestations of endometriosis in the long term after radical surgical treatment

2021 ◽  
Vol 50 (4) ◽  
pp. 21-24
Author(s):  
V. I. Konovalov ◽  
A. V. Vorontsova
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Pelvic Area

Comparative analysis of the endometriosis main clinical manifestations (pain syndrome in the small pelvic area, menstrual and generative functions disorders, adjacent organs dysfunction) has been carried out in 111 women in long-term period after efficient operative interventions and 371 women with endometriosis who didnt get any treatment. None of the above-mentioned methods of the efficient surgical treatment turned to be optimal (long-term and effective) for cutting short the main clinical manifestations of endometriosis.

scholarly journals The substantiation of chronic pancreatitis surgical treatment method selection

2007 ◽  
Vol 6 (3) ◽  
pp. 43-50
Author(s):  
V. A. Koubyshkin ◽  
I. A. Kozlov ◽  
N. I. Yashina ◽  
T. V. Shevchenko
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Gastric Resection ◽  
Clinical Manifestations ◽  
Pancreatic Head ◽  
Pain Syndrome ◽  
Treatment Method ◽  
Pancreas Head ◽  
Resection Of The Pancreas

The experience of surgical treatment of 154 patients having chronic pancreatitis with preferential injury of the pancreas head which underwent different operative interventions: isolated resection of pancreatic head ( based upon Berger surgery - 24, Frey surgery - 39), pancreatoduodenal resection ( with gastric resection - 22, with preserved pylorus - 43) and drainage surgeries - 26 is presented in the article. The surgery of isolated resection of pancreatic head has less number of nearest unfavorable results compared with pancretoduodenal resection with preserved pylorus. Proximal resection of the pancreas the variants of which are different isolated resection of pancreatic head is superior upon surgeries with full or partly resection of the duodenum due to fast normalization of the motor-evacuation function, less rate of the intestinal reflux and portion character of duodenal evacuation. In the follow-up period after pancreatoduodenal resection, atrophic processes occur in distal areas of the pancreas which are followed by clinical manifestations of exo- and endocrinous insufficiency. The surgery of longitudinal pancreatic jejunostomy does not avoid pathologic changes in the organ head and pain syndrome.

Treatment of the pilonidal sinus in children using laser radiation

2021 ◽  
Vol 24 (4) ◽  
pp. 32-36
Author(s):  
D. S. Zolotukhin ◽  
I. V. Krochek ◽  
S. V. Sergiyko
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Hospital Stay ◽  
Pain Syndrome ◽  
Surgical Excision ◽  
Duration Of Surgery ◽  
Invasive Method ◽  
Open Excision ◽  
Interstitial Thermotherapy ◽  
Late Postoperative Period

The work carried out a comparative analysis of the results of surgical treatment of the epithelial-coccygeal course of ECC in 133 children aged 3 to 17 years, using laser-induced interstitial thermotherapy (LIT) and open excision. Comparative analysis was carried out according to the following criteria: duration of surgery, average time of hospital stay, duration of pain syndrome on a 10-point scale (VAS), the presence of complications in the early and late postoperative period. In the main group, the average time of hospital stay was 4.9 ± 0.3; the duration of surgical treatment was 17.2 ± 2.8 minutes. The duration of the pain syndrome was 5.3 ± 2.1 hours, and its severity was 2.7 ± 0.8 points. Average terms of epithelialization of fistulas are 3.1 ± 2.8 days. Recurrence of ECC was observed in 7 patients (11.7%), which required re-intervention. In 3 (5.0%) patients, LIT was used, and in 4 (6.7%), excision using plastics according to the Bascom method. In the comparison group, the duration of surgical treatment was 32.6 ± 5.4 minutes. The duration of inpatient treatment is 16.7 ± 1.4 days. Pain syndrome averaged 71.8 ± 11.9 hours, severity 6.5 ± 2.3 points. The number of relapses was 9 (12.3%), of which 5 (6.8%) children underwent laser treatment, and 4 (5.5%) repeated surgical excision with Bascom with recovery. This technique is an effective and minimally invasive method for treating ECC, which makes it possible to recommend this method for use in pediatric surgical practice.

scholarly journals Long-term results after surgical treatment of subacromial pain syndrome with or without rotator cuff tear

2018 ◽  
Vol 15 (3) ◽  
pp. 757-760 ◽  
Author(s):  
Eivind Inderhaug ◽  
Maiken Kalsvik ◽  
Kristin H. Kollevold ◽  
Janne Hegna ◽  
Eirik Solheim
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Cuff Tear ◽  
Subacromial Pain Syndrome

scholarly journals The results of surgical treatment of patients with lumbosacral radiculopathy, caused by paraarticular and disc cysts

2019 ◽  
Vol 21 (2) ◽  
pp. 63-69
Author(s):  
M N Kravtsov ◽  
D V Pomet'ko ◽  
V I Leonov ◽  
B V Gaydar ◽  
D V Svistov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Average Duration ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Subjective Assessment ◽  
Resonance Imaging ◽  
Hospitalization Period

The results of the conservative and surgical treatment of 12 patients at the Neurosurgery Clinic of the Military medical academy. CM. Kirov, in the period 2016-2018, about the paraarticular and disc cysts of the lumbar spine. Performed open microsurgical and full-endoscopic operational aids. Evaluation of the effectiveness of surgical treatment was carried out using the subjective assessment scale and magnetic resonance imaging over time. The follow-up period ranged from 6 to 24 months. Most often, extradural cysts were located at the level of the LIV-LV segment. Clinical manifestations were characterized by radiculopathy and local back pain. The average duration of pain syndrome was 3±0,7 months. Conservative treatment led to a regression of pain and resorption of a disk cyst in one patient. In other cases, surgical treatment was required. The average duration of a microsurgical operation was 131,6±73,4 minutes, video endoscopic - 80±10,8 minutes. The hospitalization period in the group of microsurgical treatment was 10,4 days, in the group of video endoscopy - 4,7 days. Control magnetic resonance imaging revealed the recurrence of paraarticular cysts in the area of the previous operation in 3 patients. Relapse in patients with disc cysts is not marked. Necessity in repeated operations did not arise in one supervision. It has been established that the main clinical manifestations of extradural cysts of the lumbar spine are local moderate pain, radiculopathy, and intermittent claudication. Microsurgical and percutaneous video endoscopic treatment of lumboischialgia due to extradural cysts is significantly more effective compared with conservative therapy. Full-endoscopic interventions in comparison with microsurgical ones are less invasive and long-lasting and can reduce the time of inpatient treatment.

EXPERIENCE OF LONG-TERM USE OF DIENOGEST FOR THE TREATMENT OF ADENOMYOSIS

2021 ◽  
pp. 92-99
Author(s):  
Kalinkina O.B. ◽  
Tezikov Yu.V. ◽  
Lipatov I.S. ◽  
Aravina O.R.
Keyword(s):  
Drug Therapy ◽  
Clinical Manifestation ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Management Plan ◽  
Uterine Bleeding ◽  
Dynamic Monitoring ◽  
Good Tolerability ◽  
Selection Of

Endometriosis refers to a chronic, often recurrent disease that requires the appointment of a long-term management plan and the patient with the appointment of therapy that effectively affects the clinic of this disease, at the same time having good tolerability, ensuring the patient's adherence to this method of treatment. This dictates the need for careful selection of a drug that meets such requirements. Moreover, studies of drug therapy for endometriosis should also be prolonged. In this case, they allow you to qualitatively assess the effectiveness of a particular type of treatment in the context of routine clinical practice. The main clinical manifestations of endometriosis of the uterine body-adenomyosis are pain syndrome, manifested by various types of pain (dysmenorrhea, dyspareunia, dyschesia, chronic pelvic pain) and the presence of abundant uterine bleeding. The presented clinical case demonstrates the effectiveness of long-term (for 36 months) use of dienogest at a dosage of 2 mg per day (the drug Vizanna) in a continuous mode in the treatment of a patient with adenomyosis. By the 4th month of therapy, the pain syndrome, manifested by dysmenorrhea and dyspareunia, which is the leading clinical manifestation of this pathology in the patient, was completely stopped. The proposed type of therapy has also demonstrated its effectiveness in relation to another clinical manifestation of the disease - heavy uterine bleeding. By the 6th month of therapy, the patient had developed persistent amenorrhea. Good tolerability and the absence of side effects, along with a pronounced clinical effect, led to a high adherence of the patient to this type of drug therapy and allowed her to continue it in the future with dynamic monitoring.

scholarly journals Experience of surgical treatment of infective endocarditis in children

2019 ◽  
pp. 67-83
Author(s):  
L. Prokopovуch ◽  
O. Golovenko ◽  
Y. Truba ◽  
M. Rudenko ◽  
O. Senyko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Heart Defects ◽  
Subcutaneous Fat ◽  
Clinical Manifestations ◽  
Infectious Endocarditis ◽  
Average Weight ◽  
Kaplan Meier ◽  
The Mean

Surgical treatment of infectious endocarditis in children, single-center experience. The paper analyzes the experience of surgical treatment of infectious endocarditis (IE) in children. In the period from January 1999 to July 2019, 69 children with IE were operated at National Amosov Institute of Cardiovascular Surgery of NAMS of Ukraine, 44 of them (63.8%) developed the disease on the background of congenital heart defects (CHD). The mean age of the patients at the time of surgery was 9.1 ± 6.1 years. The average weight is 31.5 ± 21.7 (3.6 to 85 kg). The duration of the disease at the time of hospitalization was 5.3 ± 1.1 months. The average duration of the fever before hospitalization was 10.2 ± 8.5 weeks. Among the causes of IE, we observed three groups of inflammatory diseases: infections of the skin and subcutaneous fat in 15 (21.7%) cases, pathology of ENT – organs – 14 (20.2%) and broncho-pulmonary diseases – 9 (13.1%) cases. The risk factors were: presence of CHD – 44 (63.7%) and also nosocomial factors. The microbiological spectrum of pathogens included gram-positive microorganisms – 33 (71.7%), gram-negative microorganisms 4 (8.7%) and fungal microflora 9 (19.6%). The mean values of bypass circulation were 111.5 ± 62.4 minutes, and the time of aortic clamping was 71.4 ± 43.9 minutes, respectively. Hospital mortality in the general group of patients was 4 (5.8%) cases. In the follow-up period, 59 patients were examined, representing 90.7% of those discharged at the hospital stage. The observation period lasted from one month to 19.4 years (9.6 ± 5.7 years). According to the Kaplan-Meier analysis, the cumulative survival rate of patients in the CHD group at one year after surgery was 97.1%, at 10 years – 93.5%; after 15 years – 93.5%. Survival in the non-CHD group at 5, 10, and 15 years was 100%. In the long term, two patients died (3.4%). The recurrence rate of IE in the distant period was 2 (3.4%) cases. The incidence of long-term reoperation was 8 (13.6%) cases, three were recurrent IE and five were non-recurrent. According to Kaplan-Meier analysis, the proportion of patients without recurrent surgery in the long-term follow-up at 5 years was 87.9%, at 10 years – 84.1%, after 15 years – 77.1% in the CHD group. In the group without CHD 5 years – 95.2%, 10 years – 95.2%, 15 years – 81.6%. In the long term, as a result of performed surgical interventions, the regression of clinical manifestations of heart failure was noted in the majority of patients.

scholarly journals Conservative treatment of traumatic injuries of the rotatory-bicepital complex

2019 ◽  
Vol 16 (1) ◽  
pp. 7-12
Author(s):  
О. A. Danilenko ◽  
E. R. Makarevich ◽  
N. S. Serdiuchenko
Keyword(s):  
Conservative Treatment ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Regional Hospital ◽  
Long Term Results ◽  
Treatment Results ◽  
Traumatic Injuries ◽  
Treatment Indications

The effectiveness of the developed approaches to the conservative treatment of traumatic injuries of the rotatory-bicepital complex is assessed. The long-term results of conservative treatment of 29 patients for the period from 2004 to 2017 and treated in the Mogilyov regional hospital and the SCTC of the 6th Minsk city clinical hospital were studied. The conservative treatment indications were considered to be the cases with traumatic partial local or extensive injuries of the rotator-bicepital complex in the presence of clinical manifestations in the form of pain syndrome and limitation of limb movements and in the absence of a decrease in limb strength in the sectoral testing of elements. The proposed tactical approaches implied immobilization, physiotherapy, local injection therapy.The developed conservative approaches to treating patients with damage to the rotary element of RBC allowed one to achieve a favorable outcome in the absolute majority of cases with long periods of patient follow-up, which improved the performance evaluation indicators according to the Oxford questionnaire for Me shoulder from 56 [48–58] to 12 [12–32] (Me [Q25–Q75]). The applied conservative approaches to treating patients with damage to the rotary element of RBC are a promising way to improve the clinical treatment results of patients with partial injuries of the rotator-bicepital complex.

scholarly journals Minilaparotomy in the treatment of choledochal malformations in children

2021 ◽  
Vol 25 (3) ◽  
pp. 165-173
Author(s):  
A. Yu. Razumovskiy ◽  
Z. B. Mitupov ◽  
N. V. Kulikova ◽  
N. S. Stepanenko ◽  
A. S. Zadvernyuk ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Techniques ◽  
Clinical Manifestations ◽  
Postoperative Outcomes ◽  
Short Term ◽  
Surgical Time ◽  
Chi Square ◽  
Surgical Interventions ◽  
Mini Laparotomy

Introduction. The article presents the analysis of surgical treatment of children with choledochal malformations (CM) with mini-laparotomy and laparoscopy techniques.Purpose. The aim of the study is to improve outcomes of surgical treatment of choledochal malformations in children.Material and methods. For the last ten years (January 2010 - May 2020), 84 children with choledochal malformations (CM) (n = 84) were operated on with different surgical techniques in our hospitals. Group 1 - patients who had Roux-en-Y hepaticojejunoanastomosis (RYHJ, n = 68, 81%); Group 2 - patients who had hepaticoduodenoanastomosis (HD, n = 16, 19%). The authors compared outcomes because Roux-en-Y hepaticojejunostomosis and hepaticoduodenanastomosis were formed under mini-laparotomic (ML) and laparoscopic (LS) accesses. Surgical time, short-term and long-term postoperative outcomes were assessed.Results. The groups were comparable in gender, age, clinical manifestations, CM complications before surgery, comorbidities (p > 0.05). A statistically significant (p = 0.0000001, Mann–Whitney U-test) decrease in the surgical time was revealed when using mini-laparotomy access. Independent defecation appeared 3 times faster in the subgroup with mini-laparotomy and Roux-en-Y hepaticojejunostomy (ML RYHJ) than in the subgroup of laparoscopic Roux-en-Y hepaticojejunostomy (LS RYHJ) (p = 0.033, Mann–Whitney U-test), mainly due to early enteral loading in the first subgroup (on 0-1 postoperative day). Long-term postoperative outcomes in laparoscopic subgroups revealed a statistically insignificant (p> 0.05) prevalence of 4 anastomotic stenosis requiring repeated surgical interventions. Good outcomes were seen in 90% of patients after ML RYHJ (p = 0.002, Pearson’s Chi-square with Yates’ correction) versus 52.6% after LS RYHJ.Conclusion. Currently, laparoscopy is not a method of choice in children with CM due to the development of short-term and long-term postoperative complications. Minilaparotomy gives promising results in pediatric CM and can be “a gold standard” in the treatment of children with this pathology.

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