Analysis of surgical treatment of liver hemangiomas

Objective. Development of criteria for optimal tactics of surgical treatment of liver hemangiomas of various sizes and localizations. Materials and methods. A retrospective analysis of 247 patients with hepatic hemangiomas observed on an outpatient basis and in a hospital was carried out; 59 of them (23.89 %) were operated including 12 men and 47 women over the period of 19992019. Liver resection with hemangioma was performed in 30 patients, hemangioma enucleation in 21, X-ray endovascular occlusion in 8 patients. The diagnosis was established on the basis of ultrasound of the abdominal organs, CT and MRI with contrast as well as angiographic research methods. Results. The postoperative complications developed in 4 (6.78 %) cases: reactive pleurisy was detected in 2 patients after the right-sided hemihepatectomy, hematomas in the resection zone of segments of the right lobe of the liver with a tumor were diagnosed in 2 patients. All complications were eliminated by conservative measures. There were no lethal outcomes. Conclusions. Surgical treatment of patients with hemangiomas includes resection of the liver with a tumor, enucleation of the hemangioma, and various types of local destruction. In order to reduce the blood circulation of the tumor and decrease the risk of intraoperative blood loss, the ECA of the branches of the hepatic artery was indicated. A comparative analysis of the results of treatment of patients with liver hemangiomas using various methods of surgical interventions made it possible to develop optimal surgical tactics, a system of intra- and perioperative safety in this category of patients.

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SURGICAL TREATMENT OF CHRONIC VENOUS DEFICIENCY OF LOWER EXTREMITIES

Kharkiv Surgical School ◽

10.37699/2308-7005.3.2020.14 ◽

2020 ◽

pp. 68-73

Author(s):

I. B. Babynkina ◽

A. A. Novikova ◽

G. P. Babynkina

Keyword(s):

Surgical Treatment ◽

Lower Extremities ◽

Outpatient Basis ◽

Perforating Veins ◽

Results Of Treatment ◽

Cosmetic Effect ◽

Modern Economic ◽

Surgical Tactics ◽

Tissue Trauma ◽

Standard Operations

Summary. The aim. Improving the results of treatment of patients with decompensated forms of chronic venous insufficiency in post-thrombophlebitic and varicose diseases based on the use of differentiated pathogenetically substantiated surgical tactics. Materials and methods. The basis of the work is the study of the results of surgical treatment of 102 patients not previously operated on with postthrombophlebitic disease of the lower extremities in the decompensated stage of CVI. All patients underwent combined surgical treatment, including the elimination of perforating insufficiency and various modifications of the operation on the superficial veins to eliminate vertical reflux. Results and discussion. The combined operation for clipping perforating veins allows the operation to interrupt blood circulation through insolvent perforating veins, including on an outpatient basis, minimizing tissue trauma during puncture rather than sectional access to a vein. The cosmetic effect of the operation is significantly increased, which is especially important in the treatment of women. Since the operation can be performed on an outpatient basis, the number of days of incapacity for work is significantly reduced compared to standard operations on perforating veins, which is a particularly important circumstance in modern economic conditions. Conclusion. Using the proposed method allows to achieve optimal conditions for the restoration of trophism of affected tissues, leading to a decrease in the number of complications and a reduction in hospitalization.

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Carbuncle - the actual problem of modern surgery (Literature review)

Vestnik of Russian military medical Academy ◽

10.17816/brmma20655 ◽

2019 ◽

Vol 21 (4) ◽

pp. 19-24

Author(s):

K V Lipatov ◽

Yu E Cherkasov ◽

V I Khrupkin ◽

M V Lysenko ◽

E I Dekhissi

Keyword(s):

Surgical Treatment ◽

Literature Review ◽

Plastic Surgery ◽

Pathological Process ◽

Tissue Viability ◽

Actual Problem ◽

Surgical Interventions ◽

Timely Diagnosis ◽

Results Of Treatment ◽

Surgical Tactics

Analyzed the features of the surgical treatment of carbuncles. The severity of the purulent-necrotic process was assessed, the significance of the timely diagnosis of the inflammatory stage and the choice of the timing of surgical treatment is shown. The features of the options of surgical tactics - from gentle to radical surgical interventions, methods of intraoperative assessment of tissue viability in the inflammatory focus are described. The necessity of a differentiated approach to the treatment of carbuncles depending on the stage of the disease, the prevalence of the pathological process and its localization is substantiated. The significance of restorative skin-plastic surgery in the replacement of postnecrectomy defects of epithelial tissues in the treatment of extensive carbuncles is shown. Ways of improving the results of treatment of patients with carbuncles are outlined, including timely diagnosis, a differentiated approach to surgical treatment, rational antibacterial therapy, and adequate general treatment.

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Surgical treatment of patients with descending purulent mediastinitis

Medicni perspektivi (Medical perspectives) ◽

10.26641/2307-0404.2021.4.248192 ◽

2021 ◽

Vol 26 (4) ◽

pp. 118-123

Author(s):

I.M. Shevchuk ◽

S.S. Snizhko

Keyword(s):

Surgical Treatment ◽

Pleural Cavity ◽

Comparison Group ◽

Postoperative Mortality ◽

Complete Removal ◽

Main Group ◽

Surgical Interventions ◽

Results Of Treatment ◽

Minimally Invasive Surgical ◽

Surgical Tactics

The aim of the study was to improve the results of treatment of patients with descending purulent mediastinitis by means of individualized surgical tactics with the priority use of minimally invasive surgical interventions and developed methods of drainage of the mediastinum and pleural cavity. Examination and treatment of 73 patients with descending purulent mediastinitis receiving treatment in the department of thoracic surgery of Ivano-Frankivsk regional clinical hospital was carried out. Treatment of patients in the main group included intramediastinal administration of antibiotics, the use of the developed method of cascade drainage of the mediastinum and pleural cavity, the priority use of video-assisted thoracoscopy and surgical tactics aimed at anticipating the spread of the purulent process in the mediastinum. The rapid and reliable decrease in the indices of endogenous intoxication in the main group confirms the effectiveness of the developed tactics of surgical treatment of patients with mediastinitis, adequate sanation of purulent mediastinatis, complete removal of the purulent substrate from the mediastinum and pleural cavity. The developed tactics of surgical treatment of purulent mediastinitis allowed reducing the overall postoperative mortality from 26.3% in the comparison group to 11.4% in the main group of patients.

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VIDEOTRACOSCOPIC INTERFERENCE WITH BULLOUS EMPHYSEMA COMPLICATED BY SPONTANEOUS PNEUMOTHORAX

Kharkiv Surgical School ◽

10.37699/2308-7005.3-4.2019.11 ◽

2019 ◽

pp. 59-63

Author(s):

V. V. Boyko ◽

K. L. Gaft ◽

E. V. Nakonechny ◽

M. V. Shilina

Keyword(s):

Surgical Treatment ◽

Spontaneous Pneumothorax ◽

Comparison Group ◽

Pulmonary Tissue ◽

Surgical Interventions ◽

Results Of Treatment ◽

Integral Component ◽

Surgical Tactics ◽

Definition Of

Objective. To study the factors of a large number of relapses of spontaneous pneumothorax in bullous emphysema (BE) of the lungs and to improve the results of treatment of patients with various forms of BE with the help of developed methods. Methods. The study is based on the study of the results of surgical treatment of 423 patients with different forms of BE, which used traditional and developed surgical tactics using patented methods for determining the elastic capacity of pulmonary tissue and autohemoplévoidosis as an integral component of radical surgical interventions. Results. The use of developed surgical tactics using videotrakaskopicheskoy biopsy to further determine the destructive index in patients with different forms of BE has reduced the overall number of relapses from 18.8% in the comparison group to 5.1%. Conclusion. Videotracoscopic biopsy with the definition of a destructive index allows to more objectively distribute FE in forms that allows to choose optimal surgical tactics.

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SURGICAL TREATMENT OF ANOMALIES OF FIXATION OF THE COLON IN CHILDREN

Clinical anatomy and operative surgery ◽

10.24061/1727-0847.19.4.2020.48 ◽

2020 ◽

Vol 19 (4) ◽

pp. 32-36

Author(s):

O. Bodnar

Keyword(s):

Congenital Anomaly ◽

Surgical Treatment ◽

Clinical Symptoms ◽

Clinical Manifestations ◽

Results Of Treatment ◽

Left Diaphragm ◽

Comparative Group ◽

The Right ◽

Paroxysmal Pain ◽

Over Time

Pyrrhic disease is a congenital anomaly that occurs during embryogenesis due to the fixation of the splenic angle of the colon by a short and highly located left transverse-diaphragmatic ligament, creating a sharp bend and forming a "wellbore". In this case the passage of feces on a cross colon becomes difficult, there is also its sagging to a small pelvis. This pathology is characterized by paroxysmal pain (aggravated by exercise and after eating) and prolonged constipation, which progresses over time. Hilaiditis syndrome is a rather rare pathology in which there is an interposition of the hepatic angle of the colon between the liver and the diaphragm. There are permanent and intermittent localizations. The work generalizes the experience of evaluation of clinical manifestations and remote results of treatment of children with chronic colostasis caused by fixation abnormalities of the colon. 58 children were detected to have Payre’s disease, with Cyilaiditi’s syndrome – 3 children. 24 patients with Payre’s disease and 2 Cyilaiditi’s syndrome were operated on. To assess the effectiveness of surgery, children were divided into two groups: I group – comparative and II group - experienced. In I group (n=12 children) – the analysis of surgical treatment was performed traditionally. In II group (n=14 children) – the analysis of surgical treatment was conducted by means of the methods proposed. Traditional surgical treatment of Payre’s disease in children was followed by relapse of chronic constipation in 45,45%, pain in 50%, flatulence in 33,33% and failure of the ileocoecal closing apparatus in 100% of children. Unsatisfactory outcomes of surgical treatment of Cyilaiditi’s syndrome was observed in a child from the comparative group. Relapse of clinical symptoms to a lesser degree than before the surgery was found in 1 child from the experienced group. To treat Payre’s disease the following operation is proposed: intersection of the left diaphragm-colon ligament, resection of transverse colon and colofixation of the left bending of the colon. To treat Cyilaiditi’s syndrome (in case of dolichoascendocolon) the following operation is suggested: hepatopexy, resection of the right bending of the colon with ascending transversal anastomosis “end to end”, fixing of right bending of the colon. Their reasonability is being proved.

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Therapeutic tactics in the deep forms of rectal abscesses complicated by fournie gangrene

Wiadomości Lekarskie ◽

10.36740/wlek202002116 ◽

2020 ◽

Vol 73 (2) ◽

pp. 293-297

Author(s):

Oleh E. Kanikovskyi ◽

Andrii V. Osadchyі ◽

Sergey I. Androsov ◽

Anatolii V. Tomashevsky ◽

Oleh A. Yarmak ◽

...

Keyword(s):

Surgical Treatment ◽

Antibacterial Therapy ◽

Treatment Duration ◽

Complex Treatment ◽

Surgical Interventions ◽

Results Of Treatment ◽

Surgical Clinic ◽

Modern Technologies ◽

Clinical Emergency ◽

Early Surgical Treatment

The aim: To conduct an analysis of the complex treatment of severe forms of rectal abscesses complicated by NF. Materials and methods: The results of treatment in 471 patients with deep forms of RA was performed. In 38(8%) the spread of the process and rotten-necrotic affection of the perineal fascia. Patients were treated at the surgical clinic of the medical faculty №2, VNPMMU, and Vinnytsya Clinical Emergency Hospital in the period from 2010-2018. Results: Total lethality 8(1,7%). Mortality in GF was 8(19,5%). It is worth noting the reduction of the treatment duration against the background of the modern technologies usage in the period from 2016 to 12 days in relation to the total figure of 15 days. Conclusions: Early surgical treatment, adequate necrectomy, fasciotomy and antibacterial therapy stop the necrotic process. The active aspiration reduces the timing of wound cleansing and further ensures the accelerated implementation of reconstructive surgical interventions.

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Diagnosis and surgical treatment of liver echinococcosis

Medicni perspektivi (Medical perspectives) ◽

10.26641/2307-0404.2021.4.248172 ◽

2021 ◽

Vol 26 (4) ◽

pp. 113-117

Author(s):

V.O. Shaprinskyi ◽

O.O. Vorovskyi ◽

O.A. Kaminskyi ◽

Ya.M. Pashynskyi

Keyword(s):

Blood Loss ◽

Pleural Cavity ◽

Abdominal Cavity ◽

Diagnostic Value ◽

Results Of Treatment ◽

Before And After ◽

Residual Cavity ◽

Right Lobe ◽

The Right ◽

Duration Of Operation

The results of treatment of 72 patients with echinococcosis of the liver were analyzed, women – 62 (86.2%), men – 10 (13.8%). Primary echinococcosis was detected in 69 (95.8%) patients, secondary – in 3 (4.2%). Among instrumental research methods, ultrasound and computed tomography examination were of diagnostic value. Single liver cysts were found in 63 (87.5%) patients, multiple – in 9 (12.5%). Among patients with solitary cysts, the right lobe was more often affected than the left – 48 (66.7%) vs 24 (33.3%) cases. Echinococcosis of central localization was less common and was noted in 8 (11.1%) cases. Echinococcosis complications were observed in 16 (22.2%) patients. Among them, most often there were suppurations of the cyst – in 13 (18.1%); a bursting of the cyst into the free abdominal cavity – in 1 (1.4%), in the pleural cavity – 1 (1.4%), in the biliary tract – in 1 (1.4%). Partial or complete liming of the hand was observed in 12 (16.7%) patients. In 20 (27.8%) cases, the operation was performed from the upper median access, in 42 (58.3%) – from oblique hypochondria accesses by Kocher or by Fedorov. Pericystectomy was performed in 48 (66.7%) patients, in 8 (11.1%) patients underwent resections of liver segments with an echinococcal cyst, in 4 (5.6%) – cyst opening with removal of contents and treatment of its cavity. Laparoscopic echinococectomy was used in 12 (16.7%) patients. In the postoperative period complications were observed in 16 (22.2%) patients. The use of the welding electrocoagulator EK-300M "Swarmed" in the thermal rehabilitation of the walls of the residual cavity after echinococectomy allowed to reduce blood loss from 2200±210 ml to 250±50 ml. With the use of laparoscopic echinococectomy, intraoperative blood loss was reduced by 9 times (р=0.0001); duration of operation – 2 times (р<0.05), stay in hospital – 3.3 times (р=0.002). There were no fatal outcomes. Before and after operation antirelapse antiparasitic therapy with albendazole (Vormil) was performed in two cycles of 28 days, separated by a 14-day break. The dose at body weight over 60 kg was 400 mg 2 times a day, and for less than 60 kg the drug was calculated at a rate of 15 mg/kg/day. There were 2 (2.8%) cases of relapse, there was no mortality.

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Full Robotic Colorectal Resections for Cancer Combined With Other Major Surgical Procedures: Early Experience With the da Vinci Xi

Surgical Innovation ◽

10.1177/1553350617697183 ◽

2017 ◽

Vol 24 (4) ◽

pp. 321-327 ◽

Cited By ~ 8

Author(s):

Luca Morelli ◽

Gregorio Di Franco ◽

Simone Guadagni ◽

Matteo Palmeri ◽

Desirée Gianardi ◽

...

Keyword(s):

Da Vinci ◽

Da Vinci Xi ◽

Port Placement ◽

Synchronous Tumors ◽

Lower Quadrant ◽

Surgical Interventions ◽

Abdominal Organs ◽

Simultaneous Procedures ◽

The Mean ◽

The Right

Background. The da Vinci Xi has been developed to overcome some of the limitations of the previous platform, thereby increasing the acceptance of its use in robotic multiorgan surgery. Methods. Between January 2015 and October 2015, 10 patients with synchronous tumors of the colorectum and others abdominal organs underwent robotic combined resections with the da Vinci Xi. Trocar positions respected the Universal Port Placement Guidelines provided by Intuitive Surgical for “left lower quadrant,” with trocars centered on the umbilical area, or shifted 2 to 3 cm to the right or to the left, depending on the type of combined surgical procedure. Results. All procedures were completed with the full robotic technique. Simultaneous procedures in same quadrant or left quadrant and pelvis, or left/right and upper, were performed with a single docking/single targeting approach; in cases of left/right quadrant or right quadrant/pelvis, we performed a dual-targeting operation. No external collisions or problems related to trocar positions were noted. No patient experienced postoperative surgical complications and the mean hospital stay was 6 days. Conclusions. The high success rate of full robotic colorectal resection combined with other surgical interventions for synchronous tumors, suggest the efficacy of the da Vinci Xi in this setting.

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A SURGICAL TACTICS IN THE INJURY OF TRACHEA AND BRONCHI IN CHILDREN

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2019-23-6-351-354 ◽

2020 ◽

Vol 23 (6) ◽

pp. 351-354

Author(s):

Viacheslav I. Ponomarev ◽

A. V. Pisklakov ◽

A. V. Lysov ◽

V. V. Vysotsky

Keyword(s):

Surgical Treatment ◽

Incidence Structure ◽

Early Period ◽

Early Postoperative Period ◽

Long Term Results ◽

Airway Patency ◽

Surgical Interventions ◽

Ventilation Failure ◽

Surgical Tactics ◽

Trachea And Bronchi

Introduction. Tracheal and bronchial injuries in children are not at the last place in the trauma incidence structure . It is an urgent issue for both adult and pediatric surgeons. Purpose. To show ways for obtaining good outcomes in patients with trachea and bronchi rupture. Material and methods. The researchers analyzed outcomes of surgical treatment of 19 patients with trachea and bronchi ruptures. The patients had surgeries at various intervals after the injury: from few hours to 10 days. X-ray and tracheobronchoscopy examinations were made. On the first day after the injury, a radical surgery was performed to restore the airway patency. Late surgical interventions ended with pulmonectomy or lobectomy. At the final stage of the trial, early and long-term results were analyzed. Results. The radical surgical treatment consisting of thoracotomy and complete restoration of anatomical integrity and airway patency had 16 children of various age on the first day after their injury . Surgery lasted for 85 ± 15 min. There were no any complications during the surgery. At the early period of observation after the surgery, a ventilation failure of degree I was seen in 3 patients. Two years later, compensated stenosis of the bronchus without signs of ventilation failure was seen in one child. Three children were operated on in 10 days after their injury. Organ-sparing surgeries were performed in them (lobectomy and pulmonectomy). These surgeries lasted for 130 ± 15 min. At the early postoperative period, all three patients had ventilation failure of degree II. In 2 years, two children developed a persistent deformation of the chest, two children were disabled. Conclusion. A successful treatment of children with lower airways injury may be expected if the radical assistance is provided by a thoracic surgeon and shortly after the injury.

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Analysis of the results of different treatment methods for patellar dislocation

Kazan medical journal ◽

10.17816/kmj2018-504 ◽

2018 ◽

Vol 99 (3) ◽

pp. 504-507

Author(s):

G P Kotel'nikov ◽

P V Ryzhov ◽

Yu V Lartsev ◽

D S Kudashev ◽

S D Zuev-Ratnikov ◽

...

Keyword(s):

Surgical Treatment ◽

Patellar Dislocation ◽

Surgical Techniques ◽

Correction Method ◽

Invasive Treatment ◽

Surgical Interventions ◽

Individual Approach ◽

Results Of Treatment ◽

Habitual Dislocation ◽

Time Periods

The aim of the study was the analysis of domestic and foreign medical literature of different time periods, which describes the basic methods of surgical and conservative treatment of congenital or habitual dislocation of patella, as well as statistical analysis of the results of treatment. Due to the existence of a large number of options of surgical treatment for this pathology (more than 150 methods were developed) and high variability of its manifestations, it is necessary to know the basic methods and their results for planning tactics of treatment with individual approach to each patient. Based on this review, analysis was performed for the results of using different options for invasive treatment of congenital or habitual dislocation of patella. Also, the paper contains the indications and efficacy of conservative therapy for this disease. A comparative analysis was made on the results of surgical and conservative methods of treatment of patellar dislocation, which were used in different time periods, from the initial description of the first results of treatment of this pathology to modern surgical techniques that are currently used. It is shown that all methods of surgical treatment of the pathology are divided into three main groups: myofascioplastic surgeries, osteoplastic and combined surgical interventions. It is underlined that the diseases requires individual approach to the choice of correction method in each certain case to achieve positive outcomes.

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