scholarly journals VIDEO-ASSISTED GASTROENTEROSTOMY PILORODUDODENAL STENOSISIN PATIENTS WITH SENIOR AND SENIOR AGE

2017 ◽  
Vol 9 (4) ◽  
pp. 23-28
Author(s):  
N I Glushkov ◽  
T L Gorshenin ◽  
S K Dulaeva
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Nutritional Support ◽  
Age Groups ◽  
Electrolyte Balance ◽  
Preoperative Preparation ◽  
Acid Base ◽  
Optimal Variant ◽  
Surgical Tactics ◽  
Complications And Mortality

Introduction. The immediate results of surgical treatment of 80 patients with pyloroduodenal stenosis of older age groups, operated in the traditional way and with the use of endovideosurgical techniques, were analyzed. An optimal variant of preoperative preparation with inclusion of early enteral therapy and nutritional support was offered, which allowed to reduce the degree of hypovolemia and tissue dehydration, to correct the water-electrolyte balance and acid-base state. The incidence of postoperative complications and mortality in both groups were studied. Individualized surgical tactics that allowed to reduce the number of postoperative complications and lethality were proposed.

scholarly journals Peculiarities of surgical tactics in postoperative ventral hernias in elderly patients

2011 ◽  
Vol 4 (1) ◽  
pp. 10-16
Author(s):  
Maksim Aleksandrovich Evseev ◽  
Roman Anatolievich Golovin ◽  
Dmitry Nikolaevich Sotnikov ◽  
Nataliya Mikhailovna Lazarieva
Keyword(s):  
Postoperative Complications ◽  
Elderly Patients ◽  
Abdominal Wall ◽  
Age Groups ◽  
Selection Method ◽  
Preoperative Preparation ◽  
Preparation Program ◽  
Algorithmic Approach ◽  
Surgical Tactics ◽  
Ventral Hernias

The questions of surgical tactics in large and giant postoperative hernia in patients of older age groups. An analysis of the causes of recurrent hernias and postoperative complications identified the need to use algorithmic approach to the selection method of plasty of abdominal wall, defined the criteria for the possibility of operational benefits in patients with severe concomitant diseases, as well as a preoperative preparation program.

scholarly journals CLASSIFICATION, DIAGNOSIS AND MODERN APPROACHES TO THE SURGICAL CORRECTION OF MIRIZZY SYNDROME

2020 ◽  
pp. 89-93
Author(s):  
Y. D. Khvorostov ◽  
V. V. Derykolenko ◽  
S. A. Bychkov ◽  
O. I. Tsivenko ◽  
R. N. Hrynov
Keyword(s):  
Postoperative Complications ◽  
High Reliability ◽  
Practical Importance ◽  
Surgical Access ◽  
Preoperative Stage ◽  
Surgical Tactics ◽  
Definition Of ◽  
Technical Solutions ◽  
Complications And Mortality

Summary. Until now, there is no consensus on the classification, diagnosis, and definition of treatment tactics for Mirizzy syndrome (MS). Materials and Methods. Examination and treatment of 152 patients with MS were analyzed. We used the classification of MS that we developed. It systematizes the concepts of Mirizzy syndrome, takes into account the staged formation of a biliary mobility and is of practical importance in the choice of surgical tactics, surgical access and scope of operation. Results and discussion. The standardization of surgical tactics on the basis of the developed classification allows to significantly reduce postoperative complications and mortality. Criteria have also been identified that allow with high reliability to identify the presence of MS at the preoperative stage according to ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). Conclusions. The presented classification is structurally simple and practical in the selection of tactical and technical solutions in the treatment of MS. Clearly defines the clinical, pathomorphological and therapeutic-tactical aspects of this problem. Takes into account the staged formation of biliary mobility. The standardization of surgical tactics based on the developed classification allowed us to significantly reduce postoperative complications and mortality.

scholarly journals APPLICATION OF I.PONSETI TECHNIQUE IN SURGICAL TREATMENT OF CONGENITAL CLUBFOOT IN CHILDREN

2019 ◽  
Vol 111 (3) ◽  
pp. 6-10
Author(s):  
Oleksii Holubenko ◽  
Anatolii Levytskyi ◽  
Oleksandr Karabeniuk
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Ponseti Method ◽  
Idiopathic Clubfoot ◽  
Preoperative Preparation ◽  
Congenital Clubfoot ◽  
High Relapse Rate ◽  
Group I ◽  
Initial Correction ◽  
Prevention Of Recurrence

Summary. One of the most common malformation of the musculoskeletal system in children is congenital clubfoot, which occurs from 2 to 5 cases per 1000 newborns. Treatment of idiopathic clubfoot by the Ponseti method is now standard, and most feet can achieve satisfactory initial correction using this technique. But the high relapse rate (from 20 to 40%) and the existing postoperative complications necessitate the search for approaches to reduce them. One of such approaches is the application of the I.Ponseti technique at the stages of preoperative preparation. The aim of our work is to reduce the incidence of complications in the surgical treatment of congenital clubfoot by applying the I.Ponseti technique. Materials and methods. An analysis was made of the treatment of 62 children (74 feet) with idiopathic congenital clubfoot, who were inpatient and outpatient treatment at the NSH «Ohmatdet» from september 2015 to august 2018. Of these, 39 were patients with recurrence of congenital clubfoot after the initial treatment according to method I.Ponseti and 23 patients with relapsed deformity after initial surgical treatment. Of these, 35 boys and 27 girls. All patients were separated into two groups. Group I – 27 patients (32 feet) who did not use casting according to the I.Ponseti technique before surgical treatment. Group II – 35 patients (42 feet) who underwent staging casting according to I.Ponseti technique at the stages of preoperative planning. The average age of the patients is 4 ± 0.85 years. Result. Use of the I.Ponseti technique at the stages of preoperative preparation in the treatment of congenital clubfoot can significantly reduce the incidence of postoperative complications. The result of which is the possibility of early rehabilitation of patients and prevention of recurrence of deformity.

scholarly journals THE STRUCTURE OF THYROID NODULES IN CHILDREN SUBJECTED TO SURGICAL TREATMENT

2019 ◽  
Vol 21 (1) ◽  
pp. 63-66
Author(s):  
A V Gostimskii ◽  
Y L Skorodok ◽  
A A Taraikovich ◽  
S S Peredereev
Keyword(s):  
Thyroid Cancer ◽  
Surgical Treatment ◽  
High Risk ◽  
Thyroid Gland ◽  
Thyroid Nodules ◽  
Age Groups ◽  
Case Histories ◽  
Surgical Interventions ◽  
High Incidence ◽  
Surgical Tactics

The article provides the literary information and the results of our own research on the structure of the thyroid nodules in operated children.The clinical significance of nodular neoplasms of the thyroid gland is determined by the relatively high risk of carcinomas. Along with this, the relevance of this research is due to the increasing of surgical interventions and the fact that the features of nodules in children and tactics of management of patients remain debatable.The aim of the work was to study the structure of thyroid nodules in childrenin various age groups. The case histories of 225 operated childrenfrom 4 to 17 years oldfrom 2007 to 2017 were analyzed. Nodular neoplasms of the thyroid in children were more common. Tumor-like diseases - colloid nodes in childhood were rare, only in 2.2% of cases. The high incidence of thyroid cancer (35.6%) under the mask of nodal goiter determines active surgical tactics in patients with nodal neoplasms in childhood.

scholarly journals APPENDICULAR PERITONITIS IN CHILDREN: AN EFFICIENT SURGICAL APPROACH AND INTENSIVE CARE

2020 ◽  
Vol 24 (2) ◽  
pp. 62-70
Author(s):  
O. V. Karaseva ◽  
Kseniia E. Utkina ◽  
A. L. Gorelik ◽  
A. V. Timofeeva ◽  
D. E. Golikov ◽  
...  
Keyword(s):  
Intensive Care ◽  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Intestinal Obstruction ◽  
Postoperative Period ◽  
Diffuse Peritonitis ◽  
Surgical Tactics ◽  
Adhesive Intestinal Obstruction ◽  
Local Protocol

Introduction. Currently, there is no any unified approach to the treatment of complicated forms of acute appendicitis in children. The purpose of our study is to evaluate the effectiveness of the local Protocol for diagnostics and treatment of appendicular peritonitis (AP) in children. Material and methods. 149 children with AP, aged 2 - 17 (11 ± 3.5 ), were included into the study. All of them were treated at the Clinical and Research Institute Emergency Pediatric Surgery and Trauma (CRIEPST) in 2015-2018. In the gender structure, boys (104; 69.8%) prevailed over girls (45; 30.2%). The following parameters were evaluated: AP structure, surgical tactics, postoperative course (incidence of postoperative intestinal failure syndrome (IFS), postoperative complications, length of hospital stay). A tactics for surgical treatment and volume of intensive care in the postoperative period were defined depending on AP severity and according to the local Protocol. Laparoscopic appendectomy was performed in 145 (97.3%) patients. There were no intraoperative complications and conversions in the studied group. In case of periappendiular abscess (PA) 3 (2.7%), patients had puncture and abscess drainage under ultrasound control. Results. While analyzing the AP structure by forms , the following picture was shown: free and abscessed forms were approximately equal - 72 (48.3%) and 77 (51.7%), respectively (p > 0.05). Diffuse peritonitis - 31.5%; generalized - 16.8%; combined - 17.4%; periappendicular abscess (PA) stage 1-14.8%; PA 2-16.8%; PA 3-2.7%. Postoperative complications - 4 (2.7%): postoperative abdominal abscesses - 3 (2.0%); early adhesive intestinal obstruction - 1 (0.7%). In postoperative abscesses, puncture and drainage were performed under ultrasound control; in early adhesive intestinal obstruction - laparoscopic adhesiolysis. All the children recovered. Length of intensive care was 2.9 ± 1.8 days; hospitalization - 12.0 ± 5.2 days. Conclusion. The local Protocol developed by the researchers helps to define a surgical tactics and volume of intensive care in the postoperative period. Laparoscopic surgery, in the vast majority of cases, is an optimal and effective technique for AP surgical treatment in children. Contraindications to laparoscopic surgery are PA 3 and total abscessing peritonitis.

scholarly journals The impact of preoperative preparation on postoperative complications in patients with colorectal cancer

2016 ◽  
Vol 11 (4) ◽  
pp. 311-316
Author(s):  
Octavia Cristina RUSU ◽  
◽  
Radu Virgil COSTEA ◽  
Cristian Constantin POPA ◽  
Ştefan Ilie NEAGU ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Bowel Preparation ◽  
Nutritional Support ◽  
Mechanical Bowel Preparation ◽  
Antimicrobial Treatment ◽  
Cancer Death ◽  
Preoperative Preparation ◽  
Meta Analyses ◽  
The Impact

Colorectal cancer is a frequently encountered disease. In most countries, it represents the second leading cause of cancer death. The treatment with radical intent of this condition is surgical. Objective: Through this study, we want to update some data regarding the impact of nutrition and the preoperative mechanical bowel preparation on postoperative complications, in patients who need surgical treatment for colorectal cancer. Material and Method: Relevant articles in the field, contained in international databases were analysed, with no language exclusion, including clinical trials and meta-analyses performed between 1994 and 2015. Conclusions: Preoperative preparation is particularly important in the postoperative evolution of the patients with colorectal cancer and it is based on several main principles: nutritional support, antimicrobial treatment and mechanical bowel preparation.

scholarly journals Role of disarticulation and guillotine amputation of the shin in the lower limb ischemic gangrene surgical treatment strategy

2020 ◽  
Vol 7 (1) ◽  
pp. 26-35
Author(s):  
V. A. Mitish ◽  
Yu. S. Paskhalova ◽  
A. A. Ushakov ◽  
S. Yu. Slepnev ◽  
E. A. Mishurinskaya
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
General Condition ◽  
Lower Limb ◽  
Treatment Strategy ◽  
Limb Amputation ◽  
Individual Treatment ◽  
City Hospital ◽  
Amputation Level ◽  
Complications And Mortality

Ischemic foot gangrene is one of the most common reasons of nontraumatic low limb amputations all over the world. Objective: to analyze the clinical effectiveness of an individual treatment strategy application for patients with absolute indications for high limb amputation, aimed to reduce amputation level, the number of postoperative complications and mortality. Materials and methods. This article presents the results of comparative clinical trial executing a lower-extremity amputation in 992 patients with ischemic gangrene. Applied in this study strategy of surgical treatment included usual below-knee, above-knee amputations and guillotine amputations in the lower third of the shin also the shin exarticulation without wound plastic. Guillotine amputations was used as an intermediate stage of treatment in cases where due to the severe general condition of patients to perform a classic myoplastic amputation with stump formation was impossible, since it is accompanied by a very high risk of postoperative complications and mortality. Results. Using guillotine amputations and shin exarticulation as the first stage of complex surgical strategy aimed to rapid elimination of the purulent focus with minimal risks and the speedy stabilization of the patients general condition, emaciated and weakened by developing gangrene, led to reduce general lethality by 17.1 % and increased the quantity of below-knee amputations by 23.0 % compared with the comparison group. Conclusion. Patients with ischemic gangrene require the development of an individual strategy for surgical treatment (taking into account the severity of the patients general condition, the prevalence of the purulent-necrotic process in the lower limb, the nature and degree of peripheral macroangiopathy), which can reliably and significantly reduce the number of amputations at the hip level (by 46.2%), as well as reduce mortality after high amputations of the lower extremities (by 17.1%) in an emergency city hospital. We consider it extremely important to reduce the number of primary amputations at the hip level!

scholarly journals An acute complicated pancreatitis: principles of surgical tactics, using miniinvasive technologies and standard operations

2018 ◽  
Vol 85 (6) ◽  
pp. 10-12 ◽  
Author(s):  
V. P. Andriushchenko ◽  
O. T. Girniak ◽  
D. V. Andriushchenko
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Main Group ◽  
Surgical Interventions ◽  
Combined Application ◽  
Closed Drainage ◽  
Comparative Group ◽  
Surgical Tactics ◽  
Complications Rate ◽  
Standard Operations

Objective. To elaborate a surgical tactics for patients, suffering  an acute complicated pancreatitis (ACP), using miniinvasive technologies (МІТ) and standard surgical interventions. Маterials and methods. There were operated 170 patients, suffering ACP. In the main group (109 patients) a МІТ was applied, and in a comparative one (61 patients) the standard operations were used. Results. МІТ as the «definite» were applied in 62 (57%), «staged» - in 16 (15%) and «the patient’s state stabilizing» - in 12 (11%) patients. The part of operative interventions in the main group have constituted 26%, and in a comparative one - 12% (χ2=4.002; р=0.04). Primary laparotomic operations were performed in 41 (67%) patients of a comparative group and 19 (17%) patients of the main group (χ2=40.291; р<0.0001). Standard operations, mainly consisted of necrosequestrectomies (NSE) with the closed drainage in accordance to Berger procedure were performed in 26 (55%) patients of the main and in15 (31%) patients of comparative group (χ2=5.018; р=0.02). The NSE quantity with further staged sanations, which were conducted in patients, suffering extended purulent-necrotic affections, was comparable in both groups: 11 (23%) - in the main and 13 (26%) - in a comparative group (χ2=0.0013; р > 0.05). Conclusion. Application of elaborated tactics of surgical treatment of an ACP with a separate or combined application of МІТ and standard operations was accompanied by reduction of postoperative complications rate from 13.1 tо 8.3% and lethality - from 14.8 tо 9.2%.

scholarly journals Diagnostics and surgical tactics in case of combined complications of colon cancer in elderly and senile patients

2018 ◽  
Vol 10 (2) ◽  
pp. 79-86
Author(s):  
N I Glushkov ◽  
T L Gorshenin ◽  
S K Dulaeva
Keyword(s):  
Colon Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Traditional Methods ◽  
Western State ◽  
Surgical Tactics ◽  
Medical University ◽  
Ray Methods ◽  
North Western

The results of diagnostics and surgical treatment of the combined complications of colon cancer in elderly and senile patients are presented. It is established that modern ray methods of research, along with traditional methods, allow to improve the quality of diagnostics of combined complications. The introduction of endovideosurgical technologies helps to reduce the number of postoperative complications and lethality. (For citation: Glushkov NI, Gorshenin TL, Dulaeva SK. Diagnostics and surgical tactics in case of combined complications of colon cancer in elderly and senile patients. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):79-86. doi: 10.17816/mechnikov201810279-86).

scholarly journals Improvement of diagnostic and surgical treatment of colon cancer complicated with perifocal inflammation in patients of the elderly and senile age

2019 ◽  
Vol 11 (3) ◽  
pp. 41-48
Author(s):  
Nikolay I. Glushkov ◽  
Maksim Yu. Kabanov ◽  
Timofey L. Gorshenin ◽  
Konstantin V. Sementsov ◽  
Maria Ya. Belikova ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Treatment Modality ◽  
Age Groups ◽  
Postoperative Mortality ◽  
The Elderly ◽  
Treatment Results ◽  
High Level ◽  
Cancer Complications

The article analyzes the treatment of patients in older age groups with colon cancer complicated by perifocal inflammation. It is shown that the treatment modality for this category of patients depends largely on the severity of paracancrosis inflammation. A large number of postoperative complications and a high level of postoperative mortality accompany traditional operations performed for colon cancer complications. The introduction of laparoscopic technology allows improving the treatment results in patients of elderly and senile age.

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