scholarly journals Clinical case of surgical treatment of giant central anastomosis aneurysm after autovenous femoropopliteal bypass

2021 ◽  
Vol 38 (1) ◽  
pp. 144-150
Author(s):  
Vladimir A. Samartsev ◽  
Dmitry S. Vaganov ◽  
Andrey Yu. Oparin ◽  
Ilya A. Karasov ◽  
Eugeny V. Kruglov ◽  
...  

Ahterosclerosis of vessels of the lower extremities is widely distributed in the population. Open surgical revascularization is an efficient method for treatment of this pathology. One of the rare postoperative complications is an anastomosis aneurysm development. We report about a clinical case of a 74-year-old male with a giant (25 cm in diameter) aneurysm of the proximal anastomosis after femoropopliteal bypass. Open aneurysmectomy was performed, and the postoperative period was uneventful.

2018 ◽  
Vol 9 (1) ◽  
pp. 44-49
Author(s):  
D. I. Korshunov ◽  
R. I. Khabazov ◽  
N. V. Ustiantseva ◽  
A. V. Chupin ◽  
S. V. Deryabin

EVAR (endovascular aneurism repair) is the preferred method for the surgical treatment of ananeurysm. The advantage of this type of surgical intervention is that a smaller number of postoperative complications will occur. The main diagnostic tasks for patients after EVAR are to determine the size of the aneurysmal sac, detection of an endoleak, detection of the endoprosthesis migration and the deformation of the stent graft itself. Conclusion: early detection of complications in the postoperative period remains the main problem for monitoring patients after EVAR. Duplex scanning is a safe, non-invasive and effective method of measuring the size of an aneurysmal sac and detecting possible complications after EVAR.


10.12737/6454 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Антонов ◽  
A. Antonov

Use elixir Altai ("Vitavis") in combination with ion-activated with water by means of such a complex contingent cancer patients as patients with metastatic bone fractures of the upper and lower limbs can reduce the early postoperative period, and to reduce to a minimum infectious complications and improve quality of life. The problem of postoperative complications, until now, is not solved. In oncologic patients, and those more in by III and As IV stages occurs it immunnodefitsit, which is caused not only by basic disease, but also by conse-quences of khimio- beam therapy. In connection with this appears the difficulty in the surgical treatment, caused by postoperative complications. As a result surgical treatment appears surgical injury, oxidizing stress, disturbance of homeostasis and oppression of immunity, which leads to an even larger disturbance of immunity in oncologic patients, which decreases the unspecific resistibility of organism. The application of adaptogena of the elixir of Altai (“Vitavis”) in combination with the ionic- activated aqueous means makes it possible to level and to reduce on no oxidizing stress, to increase the unspecific resistibility of the organism of oncologic patient and to increase immuni-ty. Moreover, powerful antioxidant - the ionic- activated aqueous means strengthens the action of adaptogena of the elixer of Altai (“Vitavis”), which leads to the decrease of postoperative infectious complications, reduces postoperative period, improves the quality of life and enlarges indications to the surgical treatment in oncologic patients with III it and IV by the stages of diseases.


Author(s):  
LUIGI CARLO DA SILVA COSTA ◽  
JOÃO GABRIEL ROMERO BRAGA ◽  
VALDIR TERCIOTI JUNIOR ◽  
JOÃO DE SOUZA COELHO NETO ◽  
JOSÉ ANTÔNIO POSSATTO FERRER ◽  
...  

ABSTRACT Objective: to analyze the surgical treatment of patients with recurrent megaesophagus followed at the esophageal-stomach-duodenal outpatient clinic of the Hospital de Clínicas - UNICAMP. Methods: a retrospective study, from 2011 to 2017, with 26 patients with Chagas or idiopathic megaesophagus, surgically treated, and who recurred with dysphagia. Clinical, endoscopic and radiographic aspects were assessed and correlated with the performed surgical procedures. Results: 50% had dysphagia for liquids, 69% regurgitation, 65.3% heartburn, 69.2% weight loss and 69.2% had Chagas disease. In addition, 38.4% had megaesophagus stage 1 and 2 and 61.5% stage 3 and 4. Regarding the reoperations, 53% of them underwent Heller-Pinotti surgery by laparoscopy, Serra-Dória in 30.7% and esophageal mucosectomy in 7.9%. In 72% of the reoperations there were no postoperative complications, and 80% of the patients had a good outcome, with reduction or elimination of dysphagia. Among the reoperated patients undergoing the laparoscopic Heller-Pinotti technique, three reported little improvement of dysphagia in the postoperative period and among those who underwent Serra-Dória surgery, 100% had no dysphagia. It was observed that, when the time between the first procedure and the reoperation was longer, the better the surgical result was, with statistical significant decreased dysphagia (p=0.0013, p<0.05). Conclusions: there was a preference to perform laparoscopic re-miotomy and, as a second option, Serra-Dória surgery, for patients with recurrent megaesophagus. Esophagectomy or esophageal mucosectomy were reserved for more severe patients.


2020 ◽  
Vol 56 (2) ◽  
pp. 35-43
Author(s):  
G. B. Adilbayev ◽  
M. E. Kaibarov ◽  
G. Z. Kydyrbayeva ◽  
B. T. Mykhamadiev ◽  
N. V. Sloneva

Actuality: Paraganglioma originates from the nerve ganglia along a.carotis, the ganglion of n.vagus, and the nerve plexuses around the sigmoid sinus, and has a rich tumor vasculature. Paraganglioma accounts for 0.8% of all CNS tumors and occurs most often at 40-60 years. Chemodectoma is located in the common carotid artery bifurcation zone and accounts for 2/3 of all glomus tumors. Purpose: The article describes a clinical case of multiple primary thyroid cancer in combination with malignant paraganglioma of the neck complicated by acute cerebrovascular event (ACE) in the postoperative period treated at the Head and Neck Tumor Center of the Kazakh Institute of Oncology and Radiology. Results: The presented clinical case demonstrates the results of the treatment of multiple primary cancer complicated by an ACE in the postoperative period. The qualification of doctors, adequate diagnostics contributed to choosing the right ACE treatment tactics taking into account all the patient-specific features, the tumor localization, and possible postoperative complications. Conclusion: The presented clinical case confirms the available data on the necessity of all diagnostic procedures and their effectiveness in the assessment of the prevalence of the process and the involvement of the adjacent anatomical structures in the suspected chemodectoma to avoid postoperative consequences that can lead to disability and fatal outcome. A wrong choice of the volume of surgical intervention can result in severe postoperative complications. Timely diagnosis and knowledge of the clinical course of the ACE helped restore the patient’s general condition and stop signs of cerebral ischemia. Successful recovery of a patient depends on the qualifications of the doctors and the prevalence of the tumor process. Adequate symptomatic therapy has a huge impact on the course of a complicated postoperative period.


2020 ◽  
Vol 10 (4) ◽  
pp. 309-316
Author(s):  
Toirkhon Kh. Nazarov ◽  
Anisjon I. Tursunov ◽  
Ivan V. Rychkov ◽  
Magomed A. Ahmedov ◽  
Kseniya E. Trubnikova ◽  
...  

Improving the effectiveness of treatment of urolithiasis is a topical issue in modern urology. Despite a large number of studies on this problem, there is currently no unified algorithm for assessing postoperative complications of removal of calculi of the renal cavity system by transurethral access. Purpose of the study: based on a retrospective analysis to adapt the classification of postoperative complications according to Clavien Dind from 2004 to describe the complications of transurethral contact pyelocalicolithotripsy. Materials and methods. A retrospective analysis of the results of surgical treatment of 211 patients with kidney stones with a density of 960 HU to 1840 HU was performed. Ultrasonic energy was used for lithotripsy. Criteria for the normal course of the postoperative period in patients have been formulated. Results. The number of postoperative complications was calculated. The obtained data are distributed according to the corresponding gradations of the adapted Clavien Dindо classification. Conclusion. The improved Clavien Dindo classification, taking into account the adaptation, can be used as an up-to-date, accessible and logical template for assessing the postoperative complications of transurethral contact pyelocalicolithotripsy.


2012 ◽  
Vol 93 (1) ◽  
pp. 56-61
Author(s):  
E A Zubkov ◽  
M E Sitdykova

Aim. To determine the frequency and develop methods for prevention of possible complications of transvesical adenomectomy. Methods. Conducted was an analysis of results of surgical treatment of 492 patients with prostate adenoma. One-stage suprapubic transvesical adenomectomy with a primary blind suture of the urinary bladder and hemostasis of the adenoma bed was performed in 347 patients. Results. In the postoperative period inflammatory complications of the urinary tract were observed in 5 (1.4%) out of 347 operated patients. It was established that the frequency and nature of both early and late pyo-inflammatory and obstructive postoperative complications of the suprapubic adenomectomy depend on the method of hemostasis of the bed of the adenoma and on the time of urination recovery. Conclusion. The main measures of prevention of complications during suprapubic adenomectomy are hemostasis of the bed of the adenoma by temporary retriganization with removable hemostatic ligatures, early recovery of urethral voiding (2-4 days) and application of antibiotics to the bed of the adenoma via the drainages of the deference ducts.


2020 ◽  
Vol 24 (2) ◽  
pp. 62-70
Author(s):  
O. V. Karaseva ◽  
Kseniia E. Utkina ◽  
A. L. Gorelik ◽  
A. V. Timofeeva ◽  
D. E. Golikov ◽  
...  

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.


Author(s):  
A. N. Shikhmetov ◽  
L. A. Osin ◽  
A. M. Zadikyan ◽  
A. A. Pazichev

The authors analyzed the results of simultaneous operations in 238 patients with regard to the combined surgical and gynecological pathology performed in the hospital-replacing environment of the ВСDС of PAO «Gazprom». Previously, all patients were assigned to the sequence of stages, the location of trocars, taking into account the additional stages of the operation, the position of the monitor, the location of the operating team, the position of the patient on the operating table during each stage. Performing simultaneous laparoscopic operations does not lead to an increase in the number of intra- and postoperative complications in comparison with isolated interventions and is not accompanied by great technical difficulties, but causes a somewhat longer duration (on average, 20.6 ± 1.5 min), which, in our opinion , is not critical for anesthesia. There were no significant differences in the course of the early postoperative period and the intensity of the functional systems of the body. Advantages of simultaneous operations are undeniable: two or three surgical diseases are cured simultaneously, progression or serious complication of the disease is prevented, operative treatment of which would be postponed for a later period, the risk of repeated surgery and anesthesia is eliminated, the time of total stay of the patient in the hospital and subsequent treatment is reduced, economic efficiency of treatment is increased.


2004 ◽  
Vol 57 (7-8) ◽  
pp. 343-348
Author(s):  
Srdjan Djurdjevic ◽  
Dimitrije Segedi

Vulvar carcinomas account for almost 3-5% of all malignant tumors of the female genital organs. The primary therapeutic approach is surgical in all cases. Since 1994, we have used a separate "S" incision for inguinofemoral lymphadenectomy in the treatment of invasive vulvar carcinoma. In the period from 1985 to 2003, 46 patients with invasive forms of vulvar carcinoma were operated at the Department of Obstetrics and Gynecology in Novi Sad. Inguinofemoral lymphadenectomy was performed in 37 (84.4%) patients. During 1994, a wide "block" dissection of the vulva, mons pubis and inguinal area of a "butterfly" shape was performed, whereas during the following period, the operative area was reduced by application of separate inguinal "S" incisions leaving a tissue bridge in between. There were 5 patients with stage I, 1 with stage II and 4 with stage III carcinoma. By applying the technique of two separate inguinal "S" incisions we achieved shortening the intrahospital postoperative period to 14 days and reduction of the risk of wound dehiscence and postoperative complications in the period following 1994.


2019 ◽  
Vol 23 (1) ◽  
pp. 38-39
Author(s):  
A. A. Baulin ◽  
L. I. Pogozhev ◽  
N. A. Popov ◽  
V. P. Shishkanov ◽  
V. V. Sretenskii ◽  
...  

The article presents a clinical case of a traumatic complete rupture of the pancreas at the level of the isthmus in a 6-year-old child. Twelve hours after the injury, laparoscopy, laparotomy, a pancreas rupture at the level of the isthmus was performed. Surgical treatment consisted in stenting the main pancreatic duct with a catheter, carrying the latter through a large duodenal nipple, sealing the parenchyma of the gland, and draining the gland bag. In the early postoperative period, no complications were noted. The stent is removed 5 weeks after the operation. The catamnesis was followed for about a year, complications were not observed.


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