Results of surgical treatment of gastric and duodenal ulcers

1937 ◽  
Vol 33 (3) ◽  
pp. 317-322
Author(s):  
G. I. Mukhamedyarov ◽  
V. I. Mikhailov
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Gastric Ulcers ◽  
Malignant Degeneration ◽  
Duodenal Ulcers

The question of indications for surgical treatment of gastric ulcers and duodenal ulcers cannot be considered fully resolved until now, as well as the question of the nature of the surgical intervention itself. The readings are divided into absolute and relative. The first include: a) perforation of the ulcer into the free abdominal cavity, b) its malignant degeneration, c) cicatricial narrowing of the pylorus. Chronic gastric and duodenal ulcers are considered relative indications. There is no disagreement about absolute indications among surgeons and therapists, which is not the case for relative indications.

scholarly journals Method of spleen reduction in laparoscopic splenectomy in children with hereditary autoimmune hemolytic anemia

2020 ◽  
Vol 10 (4) ◽  
pp. 429-433
Author(s):  
Vyacheslav G. Svarich ◽  
Ilya M. Kagantsov ◽  
Violetta A. Svarich
Keyword(s):  
Surgical Treatment ◽  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Laparoscopic Splenectomy ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Operation Time ◽  
Spleen Tissue ◽  
Surgical Department ◽  
Large Size

Purpose. This study aimed to improve the results of surgical treatment of children with hereditary autoimmune hemolytic anemia by laparoscopic splenectomy. Materials and methods. In the period from 1991 to 2020, a total 47 patients with hereditary autoimmune hemolytic anemia were treated in the surgical department of the Republican Childrens Clinical Hospital of Syktyvkar. Splenectomy was performed by the open method in 25 children, and laparoscopic method in 22 patients. Since 2019, the method of spleen reduction during laparoscopic splenectomy has been used in 3 patients when the large size of the mobilized spleen does not correspond to the size of the endoscopic container. Results. On average, surgical intervention using the above-described method of spleen reduction lasted for 19 2 min lesser than with laparoscopic splenectomy without the above method, due to the possibility of removing a significantly smaller volume of spleen tissue from the endoscopic sac outside the abdominal cavity. However, the most important achievement was the almost complete elimination of the risk of getting free fragments of a pathologically altered spleen with its possible replantation and recurrence of the clinic of autoimmune hemolytic anemia. The postoperative period was smooth, and all patients were discharged at their place of residence 7 days after the laparoscopic splenectomy. Intra-abdominal complications and relapses of the disease associated with the above-described method of operation did not occur in any patient within 612 months postoperative. Conclusion. The proposed method of spleen reduction during laparoscopic splenectomy made it possible to avoid relapses of the disease, reduce the operation time, as a result, improved the results of surgical treatment in children with hereditary autoimmune hemolytic anemia.

scholarly journals The complex treatment of patients with perforated gastroduodenal ulcers

2018 ◽  
Vol 22 (3) ◽  
pp. 479-484
Author(s):  
M.I. Pokydko ◽  
T.V. Formanchuk ◽  
O.V. Goncharenko ◽  
A.M. Formanchuk ◽  
V.A. Katsal
Keyword(s):  
Gastroduodenal Ulcer ◽  
Abdominal Cavity ◽  
Postoperative Mortality ◽  
Multiple Organ ◽  
Integrated Treatment ◽  
Gastric Ulcers ◽  
Duodenal Ulcers ◽  
Gastroduodenal Ulcers ◽  
The Moment ◽  
Sole Criterion

To improve the immediate results of surgical treatment of patients with perforated gastroduodenal ulcers using minimally invasive correction and an integrated treatment. The results of 253 patients with perforated gastroduodenal ulcers who were treated from 2013 to 2018 were analyzed. Chronic ulcers were found in 82 (32%) cases among all gastric ulcers, acute ones constituted 42 (16%) cases. Chronic duodenal ulcers reached 94 (37%), acute ones constituted 35 (14%). The diagnostic laparoscopy was performed in 13 (5%) patients, in 8 (3%) patients the perforated hole was sutured laparoscopically and in 5 (2%) patients the conversion was performed. Abdominocentesis with preoperative abdominal cavity drainage was carried out in 45(18%) patients. Through this drainage after exudate evacuation 200 ml of dekasan solution was injected. In 119 cultures of abdominal exudates with determinate pathogenic microflora Enterococcus faecalis dominated - 31 patients (26%). Among the postoperative complications the failure of intestinal sutures was observed in 4 (1.5%) patients. Postoperative mortality was 11.5%. Progression of multiple organ failure became the cause of mortality in 17 (59%) patients. Thus, the time from the moment of perforation till the moment of surgery must not be the sole criterion in the choice of method of operative intervention, and it is insufficient as an absolute indicator for the possibility of the radical surgical procedures (gastric resection). Undoubtedly laparoscopic suturing of the perforated gastroduodenal ulcer has advantages over laparotomy.

On the question of peptic ulcers of the anastomosis and jejunum

1930 ◽  
Vol 26 (8) ◽  
pp. 793-796
Author(s):  
N. I. Shaviner
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Clinical Course ◽  
Point Of View ◽  
Peptic Ulcers ◽  
Duodenal Ulcers ◽  
Gastric Or Duodenal Ulcers

The reasons for the occurrence of peptic ulcers after one or another surgical intervention for gastric or duodenal ulcers remain poorly understood. Indications of ulcerative constitutions, methods of surgical intervention, deficiencies in instrumentation, etc., as the causes of peptic ulcers, remain purely theoretical. The study of this question, obviously, should proceed along the path of collecting a lot of material and comparing individual cases. To this end, we present in this report two observations of postoperative peptic ulcers, which, from our point of view, are of interest both in terms of clinical course and surgical treatment.

scholarly journals TREATMENT OF CHILDREN WITH PERFORATED ULCERS OF THE STOMACH AND DUODENUM IN TASHKENT

2020 ◽  
Vol 24 (1) ◽  
pp. 53-56
Author(s):  
H. A. Akilov ◽  
Nozim T. Urmanov ◽  
N. R. Khodjayarov
Keyword(s):  
Surgical Treatment ◽  
Acute Abdomen ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Laparoscopic Suturing ◽  
Free Gas

The authors have analyzed outcomes of examination and surgical treatment of 68 children aged 6 - 18 with perforated ulcers of the stomach and duodenum who were treated in hospitals in 2005-2018. The authors concluded that children with the picture of acute abdomen and no free gas (radiographically) in their abdominal cavity, especially children of puberty period, are recommended to have esophago-gastro-duodenoscopy (EGDS). The choice of surgical intervention is laparoscopic suturing.

Nursing the uroabdomen patient

2021 ◽  
Vol 12 (3) ◽  
pp. 131-138
Author(s):  
Sam McGaw
Keyword(s):  
Metabolic Acidosis ◽  
Urinary Tract ◽  
Diagnostic Imaging ◽  
Urinary Diversion ◽  
Nursing Care ◽  
Postoperative Care ◽  
Surgical Intervention ◽  
Urinary Catheter ◽  
Abdominal Cavity ◽  
Patient Presentation

Uroabdomen, the presence of urine in the abdominal cavity, commonly occurs in dogs and cats, particularly following a trauma. Initial stabilisation of the patient is essential to treat the multisystemic effects of electrolyte and metabolic derangements, including hyperkalaemia, azotaemia and metabolic acidosis. Diagnosis is confirmed by comparing laboratory analysis of abdominal fluid and serum. Urinary diversion is required, often via placement of a urinary catheter, to prevent continuing urine accumulation. Once haemodynamically stable, diagnostic imaging may be performed to confirm the location of the urinary tract rupture, with several modes of imaging available. Surgical intervention may be necessary to repair the urinary leak, this is dependent on the location and severity of the trauma to the urinary tract. Registered veterinary nurses play an important role in the management of the uroabdomen patient, from initial triage and stabilisation, to assisting with imaging, anaesthetic monitoring and postoperative care. This article will discuss the aetiology of the uroabdomen, patient presentation and how to effectively treat the critical patient. Nursing care is vital for ensuring patient welfare and identifying complications that may arise.

The Use of Eye Tracking to Discern the Threshold at Which Metopic Orbitofrontal Deformity Attracts Attention

2020 ◽  
Vol 57 (12) ◽  
pp. 1392-1401
Author(s):  
Mark P. Pressler ◽  
Emily L. Geisler ◽  
Rami R. Hallac ◽  
James R. Seaward ◽  
Alex A. Kane
Keyword(s):  
Surgical Treatment ◽  
Graduate Students ◽  
Eye Tracking ◽  
Dwell Time ◽  
Surgical Intervention ◽  
Three Dimensional ◽  
Average Dwell Time ◽  
Eye Tracker ◽  
Gaze Patterns ◽  
Areas Of Interest

Introduction and Objectives: Surgical treatment for trigonocephaly aims to eliminate a stigmatizing deformity, yet the severity that captures unwanted attention is unknown. Surgeons intervene at different points of severity, eliciting controversy. This study used eye tracking to investigate when deformity is perceived. Material and Methods: Three-dimensional photogrammetric images of a normal child and a child with trigonocephaly were mathematically deformed, in 10% increments, to create a spectrum of 11 images. These images were shown to participants using an eye tracker. Participants’ gaze patterns were analyzed, and participants were asked if each image looked “normal” or “abnormal.” Results: Sixty-six graduate students were recruited. Average dwell time toward pathologic areas of interest (AOIs) increased proportionally, from 0.77 ± 0.33 seconds at 0% deformity to 1.08 ± 0.75 seconds at 100% deformity ( P < .0001). A majority of participants did not agree an image looked “abnormal” until 90% deformity from any angle. Conclusion: Eye tracking can be used as a proxy for attention threshold toward orbitofrontal deformity. The amount of attention toward orbitofrontal AOIs increased proportionally with severity. Participants did not generally agree there was “abnormality” until deformity was severe. This study supports the assertion that surgical intervention may be best reserved for more severe deformity.

scholarly journals MEAN 6 YEAR CLINICAL OUTCOMES, SURVIVORSHIP, AND RETURN TO SPORTS AFTER ARTHROSCOPIC CAPSULAR REPAIR WITH SUTURE ANCHORS FOR ADOLESCENT MULTIDIRECTIONAL SHOULDER INSTABILITY

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0002
Author(s):  
Brendon C. Mitchell ◽  
Matthew Y. Siow ◽  
Alyssa Carrol ◽  
Andrew T. Pennock ◽  
Eric W. Edmonds
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Shoulder Instability ◽  
Surgical Intervention ◽  
Operation Time ◽  
Demographic Variables ◽  
Return To Sports ◽  
Suture Anchors ◽  
Surgical Failure

Background: Multidirectional shoulder instability (MDI) refractory to rehabilitation can be treated with arthroscopic capsulolabral reconstruction with suture anchors. No studies have reported on outcomes or examined the risk factors that may contribute to poor outcomes in adolescent athletes. Hypothesis/Purpose: To identify risk factors for surgical failure by comparing anatomic, clinical, and demographic variables in adolescents who underwent surgical intervention for MDI. Methods: All patients undergoing arthroscopic shoulder surgery at one institution between January 2009 and April 2017 were reviewed. Patients >20 years old at presentation were excluded. Multidirectional instability was defined by positive drive-through sign on arthroscopy plus positive sulcus sign and/or multidirectional laxity on anterior and posterior drawer testing while under anesthesia. Two-year minimum follow-up was required, but those whose treatment failed earlier were included for reporting purposes. Demographics and intraoperative findings were recorded, as were Single Assessment Numeric Evaluation (SANE) scoring, Pediatric and Adolescent Shoulder Survey (PASS), and the short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) results. Results: Eighty adolescents (88 shoulders) were identified for having undergone surgical treatment of MDI. Of these 80 patients, 42 (50 shoulders; 31 female, 19 male) were available at a minimum of 2-year follow-up. Mean follow-up was 6.3 years (range, 2.8-10.2 years). Thirteen (26.0%) shoulders experienced surgical failure defined by recurrence of subluxation and instability, all of which underwent re-operation. Time to re-operation occurred at a mean of 1.9 years (range, 0.8-3.2). Our cohort had an overall survivorship of 96% at 1 year after surgery and 76% at 3 years. None of the anatomic, clinical, or demographic variables tested, or the presence of generalized ligamentous laxity, were correlated with subjective outcomes or re-operation. Number of anchors used was not different between those that failed and those that did not fail. Patients reported a mean SANE score of 83.3, PASS score of 85.0, and QuickDASH score of 6.8. Return to prior level of sport (RTS) occurred in 56% of patients. Conclusion: Multidirectional shoulder instability is a complex disorder that can be challenging to treat. Adolescent MDI that is refractory to non-surgical management appears to have long-term outcomes after surgical intervention that are comparable to adolescent patients with unidirectional instability. In patients who do experience failure of capsulorraphy, we show that failure will most likely occur within 3 years of the index surgical treatment. [Table: see text][Figure: see text]

Role of hyperbaric oxygenation in preoperative preparation of patients with pyloroduodenal ulcers

1986 ◽  
Vol 67 (3) ◽  
pp. 164-166
Author(s):  
A. A. Chernyavsky ◽  
P. S. Zubeev ◽  
O. V. Milovidova ◽  
N. G. Mikhailova
Keyword(s):  
Surgical Treatment ◽  
Hyperbaric Oxygenation ◽  
Conservative Therapy ◽  
Selective Proximal Vagotomy ◽  
Preoperative Preparation ◽  
Duodenal Ulcers ◽  
Operative Method ◽  
Surgical Practice

Although conservative therapy remains the main treatment for duodenal ulcers, however, 20-30% of patients require surgical treatment. In recent years a new operative method - selective proximal vagotomy - has been introduced into the wide surgical practice of pyloroduodenal ulcers treatment. Its performance is connected with the decision on the surgeon's tactics concerning the ulcerous niche: should it be excised or left?

Surgical treatment of gastroduodenal ulcers

1935 ◽  
Vol 31 (1) ◽  
pp. 143-143
Author(s):  
V. Pshenichnikov
Keyword(s):  
Surgical Treatment ◽  
Indications For Surgery ◽  
Duodenal Ulcers ◽  
Gastroduodenal Ulcers

At a meeting of the Socit Royale de Medecine de Gand, 28 X 1934, Finsterer made a presentation on the surgical treatment of gastric and duodenal ulcers. F. distinguishes between absolute and relative indications for surgery.

Predictors of Surgical Intervention in Patients with Inflammatory Bowel Disease

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Hamdy Abd El Megeed ◽  
Shereen Abou Bakr Saleh ◽  
Christina Alphonse Anwar ◽  
Ahmed Elkattary Mohamed Elkattary
Keyword(s):  
Inflammatory Bowel Disease ◽  
Surgical Treatment ◽  
Bowel Disease ◽  
Surgical Intervention ◽  
High Sensitivity ◽  
Medical Patients ◽  
Mayo Score ◽  
Calprotectin Level ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Background Inflammatory bowel disease (IBD) is comprised of two major disorders: Ulcerative Colitis and Crohn’s disease. Ulcerative Colitis affects the colon, where as Crohn’s disease can involve any component of the gastrointestinal tract from the mouth to the perianal area. These disorders have somewhat different pathologic and clinical characteristics, but with substantial overlap; their pathogenesis remains poorly understood. Objective To determine & detect different predictors that help us to characterize patients with high probability of undergoing surgical intervention for inflammatory bowel diseases. Patients and Methods The present study was designed to detect & identify possible factors that can be used to predict surgical intervention in patients with IBD. The present study was a case control study that was conducted on 80 patients with inflammatory bowel disease (either controlled by medical treatment or needed surgical intervention as a part of disease control) who were recruited form Ain-Shams university hospitals and El Quabbary general hospital in Alexandria. In the present study, the mean age of the included patients was 36.67 ±8.5 years old and 50% of the patients were males. The mean age at the onset of the disease was 25.81 ±6.8 years old. Results In the present study, there were statistically significant differences between surgical and medical patients in terms of CDAI for CD (p &lt; 0.001) and Mayo score for UC (p &lt; 0.001). Surgical patients were more likely to have higher scores. CDAI and Mayo score were negative predictors of surgical treatment. CDAI score &gt; 287 and Mayo score &gt; 8.5 achieved high sensitivity and specificity for the detection of surgical treatment. In the present study, we found that there was statistically significant differences between surgical and medical patients in terms of Stool Calprotectin level. Surgical patients were more likely to have higher Stool Calprotectin level. Stool Calprotectin level was negative predictor of surgical treatment at a level of &gt; 341.5 microgm/gm with high sensitivity and specificity. Conclusion Surgical treatment is a common outcome in IBD. Certain clinical features and the extent of disease are risk factors for surgical intervention. Our study indicates that smoking, Chron’s disease, perianal disease, granulomas, higher severity scores, higher stool Calprotectin level, CRP, and ESR were associated with higher risks of surgical intervention. In addition, smoking, peri-anal disease, CDAI, Mayo score, Stool Calprotectin level, and CRP level were predictors of surgical treatment. The findings of our analysis have implications for practice, particularly in the promotion of preoperative individualized risk prediction. The ability to predict which patients will need surgery and target more intensive, early treatment to that group would be invaluable. Further research through large prospective cohort studies is needed to confirm our findings and conclusions.

Sign in / Sign up

Export Citation Format

Share Document