The option of surgery for gastric stump cancer in patients who have previously undergone pancreaticoduodenectomy

Gastric stump cancer is a carcinoma which forms no earlier than 5years after surgery for benign disease. The incidence ranges from 2.4 to 5% among patients with stomach cancer. Previous operations lead to the emergence of an adhesive process in the abdominal cavity, changes in the anatomy and topography of the abdominal organs, as well as the development of new ways of lymph outflow. These factors lead to the re-surgery becomes technically more complicated and requires high professional training from the surgeon. Of particular surgical interest is the issue of restoration of the digestive tract, which directly depends on the nature and volume of the previous surgery. In this paper, the authors describe cases of surgical treatment of gastric stump cancer in two patients, who had previously undergone pancreaticoduodenectomy.

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Gastric Stump Cancer After Distal Gastrectomy for Benign Disease: Clinicopathological Features and Surgical Outcomes

Annals of Surgical Oncology ◽

10.1245/s10434-014-3633-6 ◽

2014 ◽

Vol 21 (8) ◽

pp. 2594-2600 ◽

Cited By ~ 15

Author(s):

Alberto Di Leo ◽

Corrado Pedrazzani ◽

Maria Bencivenga ◽

Arianna Coniglio ◽

Fausto Rosa ◽

...

Keyword(s):

Surgical Outcomes ◽

Distal Gastrectomy ◽

Benign Disease ◽

Clinicopathological Features ◽

Gastric Stump ◽

Gastric Stump Cancer

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SUCCESSFUL SURGICAL TREATMENT OF A NEWBORN WITH CHYLOPERITONEUM

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.30946/2219-4061-2019-9-1-96-103 ◽

2019 ◽

Vol 9 (1) ◽

pp. 96-103

Author(s):

Yu. I. Kucherov ◽

N. V. Kholodnova ◽

S. R. Adleiba ◽

A. L. Belaya ◽

L. M. Makarova ◽

...

Keyword(s):

Surgical Treatment ◽

High Risk ◽

Conservative Treatment ◽

Clinical Observation ◽

Fetal Death ◽

Abdominal Cavity ◽

Satisfactory Condition ◽

Fluid Analysis ◽

Abdominal Organs ◽

Positive Effect

The article describes clinical observation of treatment of a premature infant with chyloperitoneum. Accumulation of fluid in the abdominal cavity was diagnosed prenatally at 31–32 weeks of gestation. Premature surgical delivery was performed at 34– 35 weeks due to the high risk of antenatal fetal death. Paracentesis with fluid analysis was done; chylous exudate was confirmed. Total parenteral nutrition, octreotide and drainage of the abdominal cavity were used during conservative treatment. It was decided to perform a surgery as the therapy was ineffective. At the age of 2 months and 7 days laparotomy was conducted, abdominal organs were revised, lymph ducts were ligated, and abdominal cavity was drained producing a positive effect. The fluid outflow was terminated and the child was discharged in a satisfactory condition.

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Staged treatment strategy in patients with acute abdomen

Kazan medical journal ◽

10.17750/kmj2015-022 ◽

2015 ◽

Vol 96 (1) ◽

pp. 22-27

Author(s):

P V Polenok

Keyword(s):

Surgical Treatment ◽

Treatment Strategy ◽

Abdominal Cavity ◽

Intervention Group ◽

Postoperative Mortality ◽

Control Group ◽

Early Total Care ◽

Abdominal Organs ◽

Total Care ◽

Staged Treatment

Aim. To reason the strategy of staged surgical treatment in patients with acute abdomen.Methods. The study included 72 patients, of them 32 were included in the main group, in which the staged surgical treatment strategy was implemented. To assess the effect of such approach, control group including 40 patients who were treated using the early total care strategy, was formed retrospectively. The decision on the certain strategy use (early total care strategy or staged treatment strategy («aborted operation») was made in every included patient by operating surgeon during the operation.Results. The modern method of surgical treatment («aborted operation» strategy) was introduced into the clinical practice for treating acute surgical abdominal diseases. A new method for patient’s condition severity assessment and operative risk prognosis based on the physical signs, as well as the scale of the indications for the «aborted operation» approach were developed. An original method for laparotomy wound closure was proposed. Device for laparostomy consists of two details - frame, which is stitched to the edges of surgical wound, and replaceable cap, which can be fixed to the frame. The device is made of soft elastic organic material, which is transparent and non-reactive. The key advantage of the device is the transparency of the cap material, allowing to review the condition of abdominal organs at any moment after the surgery without additional analgesia. The device act as a «viewport», allowing to clearly visualize the changes of abdominal organs, to diagnose the possible complications and to timely recognize the indications for programmed abdominal cavity debridement. The mortality in the control group was 100%, in the intervention group - 59%.Conclusion. Staged treatment strategy may significantly reduce the postoperative mortality, being an alternative to standard tactical and technical approaches used in emergency abdominal surgery.

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Application of endovideosurgery in the treatment of ventral hernias after gunshot wounds of the abdomen

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2018-22(3)-15 ◽

2018 ◽

Vol 22 (3) ◽

pp. 471-473

Author(s):

M.A. Kashtalian ◽

O. S. Herasymenko ◽

R.V. Yenin ◽

A.A. Kvasnevskiy

Keyword(s):

Surgical Treatment ◽

Abdominal Cavity ◽

Gunshot Wounds ◽

Surgical Interventions ◽

The Third ◽

The Past ◽

Abdominal Organs ◽

Laparoscopic Techniques ◽

Ventral Hernias ◽

Abdominal Compartment

Gunshot wounds of the abdomen are often accompanied by a significant destruction of the abdominal cavity with the development of peritonitis, and in the future — various complications (failure of anastomoses, abscess formation, repeated bleeding, etc.), which requires repeated surgical interventions, and as a consequence — the formation of postoperative ventral hernias. The aim of the study is to improve the results of surgical treatment of ventral hernias after gunshot wounds of the abdomen due to the use of laparoscopic techniques. The analysis of treatment of 21 patients with postoperative ventral hernias formed as a result of operations concerning gunshot wounds of the abdomen was carried out. 14 wounded suffered one operation on the abdominal organs in the past (66.7%), 5 — two operations (23.8%), 1 — three operations (4.8%), 1 — five operations (4.8%). The dimensions of the hernial gates and the risk of recurrence were determined according to the SWE classification: W1 — 9 patients (42.9%), W2 — 8 (38.1%), W3 — (9.5%), W4 — 2 (9.5% ). The third patients underwent laparoscopic allogernioplasty according to the IROM technique with a Teflon allograft, which was fixed in 2 cases with the help of a herniostepler, in the 1st — with transdermal separate seams with Teflon filament. Complications after laparoscopic operations were not. The use of laparoscopic techniques can significantly reduce bed-day, avoid the development of abdominal compartment syndrome, previously to activate the patient. Laparoscopic allogernioplasty according to the method of IPOM by the Teflon graft is considered to be the operation of choice.

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Influence of the visceral vessels structure variations on peculiarity of radical surgical treatment of stomach cancer

Annals of Oncology ◽

10.1093/annonc/mdy151.090 ◽

2018 ◽

Vol 29 ◽

pp. v25

Author(s):

S. Khoshimov ◽

S. Lukmonov

Keyword(s):

Surgical Treatment ◽

Stomach Cancer

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A case of resection of the upper jaw with the use of a prosthesis (demonstration of the patient and preparations)

Kazan medical journal ◽

10.17816/kazmj46674 ◽

1909 ◽

Vol 9 (7-8) ◽

pp. 365-377

Author(s):

I. M. Timofeev

Keyword(s):

Surgical Treatment ◽

Surgical Technique ◽

Digestive Tract ◽

Human Body ◽

Postoperative Care ◽

Upper Jaw

Many diseases of the human body, which need surgical treatment, require from the surgeon not only the elimination of this disease according to all the rules of surgical technique and modern asepsis, but also proper postoperative care. The latter is sometimes quite difficult, especially on wounds located near the so-called natural openings and on the path of the respiratory and digestive tract, due to the constant contamination of the wound by the separation and discharge of these pathways.

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The Feasibility of Laparoscopic Cholecystectomy in Patients with Previous Abdominal Surgery

HPB Surgery ◽

10.1155/1998/35456 ◽

1998 ◽

Vol 10 (6) ◽

pp. 353-356 ◽

Cited By ~ 15

Author(s):

J. Diez ◽

R. Delbene ◽

A. Ferreres

Keyword(s):

Laparoscopic Cholecystectomy ◽

Abdominal Surgery ◽

Marlex Mesh ◽

Previous Surgery ◽

Open Laparoscopy ◽

Previous Abdominal Surgery ◽

Abdominal Organs ◽

Abdominal Operations ◽

Elective Laparoscopic Cholecystectomy ◽

Verres Needle

A retrospective study was carried in 1500 patients submitted to elective laparoscopic cholecystectomy to ascertain its feasibility in patients with previous abdominal surgery. In 411 patients (27.4%) previous infraumbilical intraperitoneal surgery had been performed, and 106 of them (7.06%) had 2 or more operations. Twenty five patients (1.66%) had previous supraumbilical intraperitoneal operations (colonic resection, hydatid liver cysts, gastrectomies, etc.) One of them had been operated 3 times. In this group of 25 patients the first trocar and pneumoperitoneum were performed by open laparoscopy. In 2 patients a Marlex mesh was present from previous surgery for supraumbilical hernias. Previous infraumbilical intraperitoneal surgery did not interfere with laparoscopic cholecystectomy, even in patients with several operations. There was no morbidity from Verres needle or trocars. In the 25 patients with supraumbilical intraperitoneal operations, laparoscopic cholecystectomy was completed in 22. In 3, adhesions prevented the visualization of the gallbladder and these patients were converted to an open procedure. In the 2 patients Marlex mesh prevented laparoscopic cholecystectomy because of adhesions to abdominal organs. We conclude that in most instances previous abdominal operations are no contraindication to laparoscopic cholecystectomy.

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Evolution of diagnosis and surgical treatment of intra-abdominal infiltrates, abscesses of primary and postoperative origin in patients

Paediatric Surgery Ukraine ◽

10.15574/ps.2021.72.15 ◽

2021 ◽

pp. 15-29

Author(s):

V.V. Skyba ◽

◽

V.F. Rybalchenko ◽

A.V. Ivanko ◽

R.М. Borys ◽

...

Keyword(s):

Duodenal Ulcer ◽

Gastric Ulcer ◽

Surgical Treatment ◽

Abdominal Cavity ◽

Postoperative Mortality ◽

Multiple Organ ◽

Long Term Results ◽

Control Group ◽

Study Group ◽

Perforated Gastric Ulcer

Purpose – to improve the results of surgical treatment of patients with intra-abdominal infiltrates and abscesses through the introduction of the latest imaging methods and surgical technologies. Materials and methods. In the clinic of the Department of Surgical Diseases No 1, on the basis of the Surgery Center of the Kyiv City Clinical Hospital No. 1 from 2006 to 2019 218 patients with primary and secondary intra-abdominal infiltrates, abscesses and fluid formations were treated. The patients’ age ranged from 16 to 85 years. There were 107 (49.08%) male patients, 111 (50.92%) female patients. Depending on the time of hospitalization (by years), the patients were divided into two groups: the control group (CG) (2006–2012) 117 (53.67%) patients and the study group (SG) (2013–2019) 101 (46.33%) patients. The SG used the latest imaging technologies and improved methods of surgical treatment. Results. The patients were divided into two groups: primary in 191 (87.61%) and secondary postoperative infiltrates and abscesses in 27 (12.39%). The causes of primary infiltrates and abscesses were: complicated forms of appendicitis in 74 (33.94%), perforated stomach and duodenal ulcer in 48 (22.02%), complicated forms of cholecystitis in 69 (31.65%). Postoperative infiltrates and abscesses were observed in 27 (12.39%) patients who underwent urgent surgery: adgeolysis of adhesive ileus in 14 (6.42%) and complicated hernias of various localization in 13 (5.97%). Postoperative complications were diagnosed in 43 (19.72%) patients, of whom 34 (15.59%) from the surgical wound and 29 (15.18%) of the abdominal cavity, who required relaparotomy or laparoscopy, with destructive appendicitis in 10 (13.51%), perforated gastric ulcer and 12 duodenal ulcer in 6 (12.5%), destructive cholecystitis in 9 (13.04%), adhesive intestinal obstruction in 13 (19.12%) and with strangulated and complicated hernias in 14 (17.28%) of the examined patients. During relaparotomy, incompetence of the intestinal wall and intestinal sutures was established in 11 out of 32 patients, an ileostomy was imposed in 7, and cecostomy in 1 patient. Actually, in the control group, 8 (6.84%) patients died on the background of ongoing peritonitis, thrombosis of mesenteric vessels and multiple organ failure and concomitant ailments and in the study group 4 (3.96%) patients died. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis of 69 (36.13%) patients, 48 (25.13%) had laparotomy and 21 (11.00%) had laparoscopic examination. The use of the latest imaging and treatment technologies: Doppler ultrasonography, hydrojet scalpel and laparoscopy in 64 (33.51%), allowed to have better near and long-term results and to reduce postoperative mortality from 6.84% to 3.96%, with an average of 5.5%. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: destructive appendicitis, cholecystitis, perforated gastric ulcer and 12-duodenal ulcer, adhesive leakage, strangulated hernias, diagnosis and treatment.

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Intraoperative Tactics of Local Surgical Hemostasis in Injuries and Planned Operations on the Parenchymal Organs of the Abdominal Cavity

Vestnik of Experimental and Clinical Surgery ◽

10.18499/2070-478x-2020-13-3-268-278 ◽

2020 ◽

Vol 13 (3) ◽

pp. 268-278

Author(s):

Dmitriy Andreevich Severinov ◽

Gennady Alekseevich Bondarev ◽

Vyacheslav Alexandrovich Lipatov ◽

Araik Rubenovich Saakyan

Keyword(s):

Surgical Treatment ◽

Abdominal Cavity ◽

Structural Features ◽

Main Indication ◽

Anatomical Features ◽

Abdominal Bleeding ◽

Adhesive Compositions ◽

Liver Injuries ◽

Operation Techniques ◽

Manual Skills

Currently, mortality rate in the liver and spleen injuries remains high, despite the present-day level of advances in the diagnosis and treatment of surgical diseases. Damage to parenchymal organs leads to the development of intra-abdominal bleeding. The severity of bleeding depends on the anatomical features of the blood supply to the damaged organ and the massiveness of the lesion, the type of traumatic agent. Intraoperative provision of reliable hemostasis is a significant problem in liver and spleen injuries. This paper summarizes the experience of Russian and foreign experts on surgical treatment of various types of parenchymal organ injuries. Stitching, adhesive compositions, biological and synthetic films, non-contact methods are used to achieve the final intraoperative hemostasis for parenchymal organ injuries; electrocoagulation is also very popular. Currently, the issues of surgical treatment tactics of spleen and liver injuries are not fully resolved. The search for optimal options, as well as technical advancement of organ-preserving operation techniques involving parenchymal organs, remains relevant. This depends on the structural features of these organs, availability of the methods of local hemostasis listed in this paper and surgeon's knowledge and manual skills. Moreover, at present, hemostatic application agents are widely introduced into clinical practice, parenchymal bleeding caused by superficial planar injuries of parenchymal organs being the main indication for the use of these agents.

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