scholarly journals Multistage treatment of a patient with spontaneous rupture of the esophagus in a multidisciplinary hospital setting

2019 ◽  
Vol 11 (3) ◽  
pp. 93-95
Author(s):  
Andrey E. Demko ◽  
Georgii I. Sinenchenko ◽  
Vladimir I. Kulagin ◽  
Vladimir I. Ivanov ◽  
Aleksandr I. Babich
Keyword(s):  
Elderly Patient ◽  
Severe Sepsis ◽  
Minimally Invasive ◽  
Spontaneous Rupture ◽  
Clinical Case ◽  
Pleural Cavity ◽  
Hospital Setting ◽  
Surgical Trauma ◽  
Digestive Tube ◽  
Second Stage

The article presents a clinical case of 2-stage treatment of an elderly patient with spontaneous rupture of the esophagus. Exclusion the esophagus in the first stage of treatment with the use of minimally invasive technologies (endoscopy, laparoscopy, drainage of the pleural cavity) allowed to minimize surgical trauma and create conditions for the recovery of the patient, relief of mediastinitis, sepsis and restore the natural passage of food through the digestive tube during the second stage of treatment. The presented clinical case demonstrates the feasibility of the multistage approach using minimally invasive technology in the treatment of eldery patients with spontaneous rupture of the esophagus and severe sepsis.

Low invasive surgical treatment of choledocholithiasis in an elderly patient. Description of own clinical case and operating technique

2020 ◽  
Vol 21 (4) ◽  
pp. 100-104
Author(s):  
K. M. Autlev ◽  
◽  
E. V. Kruchinin ◽  
V. F. Aliev ◽  
G. A. Petukhova ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Surgical Treatment ◽  
Bile Duct ◽  
Minimally Invasive ◽  
Clinical Case ◽  
Extrahepatic Bile Duct ◽  
Minimally Invasive Surgical ◽  
Complicated Form ◽  
The Status ◽  
Bile Duct Calculi

In modern surgery, choledocholithiasis has acquired the status of an independent problem, on the solution of which the further progress of surgery of the hepatobiliopancreatoduodenal zone depends. The article is based on a clinical case of surgical treatment with a diagnosis of a complicated form of cholelithiasis, choledocholithiasis. Purpose of the study. To demonstrate minimally invasive surgical treatment of choledocholithiasis in an elderly patient, based on the example of our own clinical case. Materials and methods. A retrospective analysis of a case of surgical treatment of a complicated form of cholelithiasis, choledocholithiasis, in an elderly patient was carried out. The patient is 84 years old. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP), non-cannulation papillosphincterotomy (NPST) and stenting of the common bile duct for choledocholithiasis. The calculi were not removed due to their large size. Later she turned to JSC “NSC” Neftyanik” (Tyumen). Results. Taking into account the patient’s extrahepatic bile duct calculi, the phenomena of previous cholangitis, the patient underwent laparoscopic cholecystectomy, choledochotomy, extraction of calculi and stent, intraoperative choledochoscopy, and completed the operation with laparoscopic choledochoduodenoanastomosis under ETN on 11/19/2019. Conclusion. In this clinical case, we come to the conclusion that the only possible treatment option is the removal of calculi. If it is impossible to remove calculi by minimally invasive antegrade or retrograde methods, they can be considered as preparing the patient for further radical surgical treatment. Modern minimally invasive methods, in particular, laparoscopy, makes it possible to carry out an operation at almost any age aimed at completely eliminating the disease, thereby improving the quality of life.

Invasive therapeutic options in truncal varicosity of the great saphenous vein

VASA ◽  
2006 ◽  
Vol 35 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Hach-Wunderle ◽  
Hach
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Stage Iii ◽  
High Ligation ◽  
Surgical Trauma ◽  
Disease Stages

It is known from current pathophysiology that disease stages I and II of truncal varicosity of the great saphenous vein do not cause changes in venous pressure on dynamic phlebodynamometry. This is possibly also the case for mild cases of the disease in stage III. In pronounced cases of stage III and all cases of stage IV, however, venous hypertension occurs which triggers the symptoms of secondary deep venous insufficiency and all the complications of chronic venous insufficiency. From these facts the therapeutic consequence is inferred that in stages I and II and perhaps also in very mild cases of stage III disease, it is enough "merely" to remove varicose veins without expecting there to be any other serious complications in the patient’s further life caused by the varicosity. Recurrence rates are not included in this analysis. In marked cases of disease stages III and IV of the great saphenous vein, however, secondary deep venous insufficiency is to be expected sooner or later. The classical operation with saphenofemoral high ligation ("crossectomy") and stripping strictly adheres to the recognized pathophysiologic principles. It also takes into account in the greatest detail aspects of minimally invasive surgery and esthetics. In the past few years, developments have been advanced to further minimize surgical trauma and to replace the stripping maneuver using occlusion of the trunk vein which is left in place. Obliteration of the vessel is subsequently performed via transmission of energy through an inserted catheter. This includes the techniques of radiofrequency ablation and endovenous laser treatment. High ligation is not performed as a matter of principle. In a similar way, sclerotherapy using microfoam is minimally invasive in character. All these procedures may be indicated for disease stages I and II, and with reservations also in mild forms of stage III disease. Perhaps high ligation previously constituted overtreatment in some cases. Targeted studies are still needed to prove whether secondary deep venous insufficiency can be avoided in advanced stages of varicose vein disease without high ligation and thus without exclusion of the whole recirculation circuit.

FEATURES OF PLEURAL CAVITY DRAINAGE IN PATIENTS WITH ACUTE NONSPECIFIC PLEURAL EMPYEMA

2020 ◽  
pp. 39-42
Author(s):  
D. V. Minukhin ◽  
O. I. Tsyvenko ◽  
A. Yu. Korolevska ◽  
L. G. Tarasenko ◽  
D. Yu. Melnyk ◽  
...  
Keyword(s):  
Chest Wall ◽  
Pleural Cavity ◽  
Pleural Empyema ◽  
Pleural Drainage ◽  
Main Method ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Minor Surgery ◽  
Surgical Manipulation

Most authors considered pleural cavity drainage to be the main method of treatment of acute pleural empyema using minor surgery. Despite the simplicity of drainage of the pleural cavity, the number of complications after this surgical manipulation, according to the reports of some authors, varies from 3 to 8 %. The complications of pleural drainage in the patients with acute nonspecific pleural empyema have been studied and the technique of pleural drainage "blindly" has been introduced, which allows drainage to be located along the chest wall. At the first stage of the four−stage study, the complications of pleural drainage in 38 patients with acute nonspecific pleural empyema were analyzed, at the second stage a device for drainage of the pleural cavity "blindly" was developed to place drainage in parallel to the chest wall, at the third stage patients were tested; on IV −− drainage of the pleural cavity of 34 patients was performed according to the proposed method. The reason for the development of drainage complications in the pleural cavity of patients with acute pleural empyema was the inadequate location of drainage in the pleural cavity, drainage of the pleural cavity was carried out in general hospitals without the use of thoracoscopic equipment. Curved thoracoport with trocar for a blind drainage of the pleural cavity "blindly" was developed and introduced into clinical practice. This technique eliminates the involuntary location of the drainage in the pleural cavity, installing it along the chest wall, and is safe. Complications associated with drainage of the pleural cavity according to the developed method using a curved thoracoport with a trocar, inadequate location of drainage, were not observed in patients. Key words: acute pleural empyema, pleural cavity drainage, curved trocar.

Minimally Invasive Plate Osteosynthesis Using Locking Plates for AO 43–Type Fractures: Lessons Learnt From a Prospective Study

2017 ◽  
Vol 11 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Rajeev Shukla ◽  
Nikhil Jain ◽  
Ravi Kant Jain ◽  
Shravan Patidar ◽  
Vivek Kiyawat
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Plate Osteosynthesis ◽  
Distal Tibia ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Surgical Trauma ◽  
Locking Plates ◽  
Soft Tissue Dissection ◽  
Tibia Fractures ◽  
Radiological Union

Introduction. Managing fractures of distal tibia is still a subject of debate for orthopaedic surgeons in terms of both, reduction and fixation. Subcutaneous location and soft tissue anatomy predisposes it to angular and rotational instability as well as other bony and soft tissue complexities. Minimally invasive plating offers many advantages over conventional open techniques. It causes minimal soft tissue dissection and surgical trauma to the bone. Minimally invasive plate osteosynthesis(MIPO) maintains biological configuration of distal tibia and fracture hematoma and also provides a construct, which is biomechanically more stable. Objectives. Evaluation of results of MIPO in management of distal tibia fractures considering radiological union, ankle function restoration, and complications. Materials and Methods. In our study, 25 closed distal one-third tibia fracture with/without articular extension were taken, fulfilling the inclusion criteria (AO classification: 10, 43A1; 3, 43A2; 2, 43B1; 4, 43B2; and 6, 43C1). MIPO with locking plates was the treatment undertaken. Patients were followed up for 18 months prospectively. Results. Average injury-hospital interval was 11.16 hours and average injury-operation interval was 2.44 days. All fractures showed radiological union at an average duration of 20.5 weeks (14-28 weeks). Olerud and Molander score was used for evaluation at 3, 6, and 18 months. One patient had union with valgus angulation >5° but there was no nonunion. There was 1 superficial postoperative wound infection. Conclusion. Our study shows that plating with MIPO is an effective treatment for closed distal one-third tibia fractures, considering union time and complications rate. Younger age promotes early union and functional recovery. Levels of Evidence: Therapeutic, Level II: Prospective

scholarly journals Staged surgical treatment of the patient with chronic pancreatitis

2021 ◽  
Vol 26 (3) ◽  
pp. 149-155
Author(s):  
N. Yu. Kokhanenko ◽  
A. V. Glebova ◽  
O. G. Vavilova ◽  
A. A. Kashintsev ◽  
S. A. Kaliuzhnyi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Clinical Case ◽  
Minimally Invasive Treatment ◽  
Gastric Fistula ◽  
Invasive Treatment ◽  
Head Of The Pancreas ◽  
Staged Treatment

A clinical case of successful surgical treatment of a patient with chronic pancreatitis, complicated by suppuration of a postnecrotic cyst and the formation of a cysto-gastric fistula. As a result of the conservative and minimally invasive treatment, the pseudocyst was drained, and the cystogastric fistula was closed. The staged treatment was completed by resection of the head of the pancreas with the formation of an anastomosis.

scholarly journals Neurospinal Surgery Innovations

2017 ◽  
Vol 3 (3) ◽  
pp. 121-122
Author(s):  
James Wang
Keyword(s):  
Spinal Cord ◽  
Minimally Invasive ◽  
Treatment Plan ◽  
Invasive Technique ◽  
Surgical Trauma ◽  
The Past ◽  
The World ◽  
Spine Diseases ◽  
Invasive Techniques ◽  
Important Branch

Over the past few decades, majority of neurosurgeons only specialize in spinal cord diseases. However, with the advances in spine surgery, more and more neurosurgeons focus on spine diseases. Precision minimally invasive technique in surgery of spine and spinal cord is an important branch of neurosurgery. As traditional surgery has been gradually replaced by precision surgery, open surgery has been gradually replaced by minimally invasive surgery (MIS), the diagnosis and treatment of spine diseases has been benefiting from minimally invasive techniques. With minimal surgical trauma, precise localization, MIS has become the inevitable trend of new neurosurgery. The model of multidisciplinary team is gradually becoming universal in the world in order to make the best treatment plan for the patient with spine diseases on the basis of the comprehensive disciplinary opinion.

scholarly journals Injúria renal aguda durante sepse grave em ambiente hospitalar / Acute kidney injury during severe sepsis in a hospital setting

2020 ◽  
Vol 3 (5) ◽  
pp. 13557-13564
Author(s):  
Bárbara Caldeira Pires ◽  
Noelly Mayra Silva de Carvalho ◽  
Joice Ribeiro Lopes ◽  
Guilherme Abreu Azevedo ◽  
Kamilla Linhares Silva
Keyword(s):  
Acute Kidney Injury ◽  
Severe Sepsis ◽  
Hospital Setting ◽  
Kidney Injury

scholarly journals Hybrid minimally invasive multivessel coronary artery bypass grafting to achieve complete myocardial revascularisation: the first clinical case

2020 ◽  
Vol 24 (3S) ◽  
pp. 108
Author(s):  
I. F. Shabaev ◽  
K. A. Kozyrin ◽  
R. S. Tarasov
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Conflict Of Interest ◽  
Graft Failure ◽  
Clinical Case ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Myocardial Revascularisation

<p><strong>Aim</strong>. To report the first clinical case of the hybrid procedure combining off-pump minimally invasive multivessel coronary artery bypass grafting (MICS-CABG) and percutaneous coronary intervention (PCI) of the obtuse marginal (OM) artery to achieve complete myocardial revascularisation.</p><p><strong>Clinical case</strong>. Bilateral in situ skeletonised left internal mammary artery (IMA) grafting to the left anterior descending artery was performed, and a Y-shape anastomosis was created from the left IMA-right IMA to the circumflex branch. At 2 hours postoperatively, graft failure caused by subtotal stenosis at the graft was diagnosed. Reconstruction of the anastomosis improved the transit time flow measurement by 3.5 hours postoperatively. Acute myocardial infarction did not develop. On postoperative day 1, graft patency was assessed, and then the OM stent was placed. On postoperative day 8, the patient was discharged and referred to the outpatient centre for further treatment and rehabilitation. Hybrid revascularisation offers the advantages of both CABG and PCI; however, the technical complexity is a major limitation for its widespread use. This case reports the development of adverse events during the surgeon's training to perform this nonstandard technology. Timely diagnosis of the initial graft failure and surgical revision led to a successful and complication-free outcome and avoided prolonged patient rehabilitation.</p><p><strong>Conclusion</strong>. Hybrid revascularisation combining MICS-CABG and PCI with new-generation drug-eluting stents can be a worthwhile alternative to conventional multivessel CABG with minimal invasiveness and complete revascularisation.</p><p>Received 5 June 2020. Revised 10 September 2020. Accepted 15 September 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

scholarly journals Modern approaches to surgical treatment of thoraco-abdominal wounds

2018 ◽  
Vol 177 (5) ◽  
pp. 100-104
Author(s):  
D. G. Amarantov ◽  
M. F. Zarivchatskii ◽  
A. A. Kholodar ◽  
O. S. Gudkov ◽  
E. V. Kolyshova
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Pleural Cavity ◽  
Optimal Combination ◽  
Surgical Correction ◽  
Severe Injuries ◽  
Wide Range

Thoraco-abdominal wounds are the most severe injuries of the chest and abdomen, with mortality reaching 13–20 %. The main focus of treatment of such patients is surgical correction of the injuries. Wide range of classical and minimally invasive interventions is used for treatment of victims . The paper presents the range of views of modern researchers on the indications for laparocentesis, drainage of the pleural cavity, thoracoscopy and laparoscopy, thoracotomy and laparotomy in this pathology. The opinions of various researchers on the optimal combination of interventions and tactics of surgical treatment of victims with thoraco-abdominal wounds are presented. It is necessary to continue the search for optimal combinations of classical and minimally invasive interventions in relation to a variety of clinic situations that arise in the treatment of patients with thoraco-abdominal wounds.

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