scholarly journals Complications after toe-to-hand transfers in children with pathologies of the hand

2017 ◽  
Vol 5 (4) ◽  
pp. 16-23
Author(s):  
Sergey I. Golyana ◽  
Tatiana I. Tikhonenko ◽  
Anton V. Govorov ◽  
Natal’ya V. Zaytseva ◽  
Aleksey V. Balashov
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Blood Supply ◽  
Conservative Therapy ◽  
Treatment Method ◽  
Early Postoperative Period ◽  
Ischemic Complications ◽  
Microcirculatory Disorders ◽  
Post Traumatic

Background. Complications after microsurgical toe-to-hand transfer is a problem for which there is no common approach to treatment. The aim of this study was to analyze the ischemic complications after microsurgical operations in children with pathologies of the hand to improve the quality of surgical treatment. Materials and methods. From 2007 to 2016, we performed 210 microsurgical toe-to-hand transfers involving 306 transplants, 267 (87.3%) of which were performed in patients with congenital pathologies and 39 (12.7%) in patients with post-traumatic deformities of the hand. In total, 352 fingers were reconstructed. Results. Blood supply disturbance following toe transplants occurred in 19 (6.2%) of the 306 transplants, most often in the early postoperative period (73.7%). The main cause of microcirculatory disorders was thrombosis of the venous or arterial trunks (8 cases). In 6 patients, the blood supply disturbance occurred because of thrombosis of autovenous grafts. Two patients underwent necrectomy at days 7 and 18 because conservative and operative treatments were not successful. Conclusion. The treatment method of choice after the first appearance of signs of blood supply disturbance in a transferred toe is conservative therapy, which includes disaggregants, anticoagulants, and hirudotherapy. Conservative therapy should be performed within 3 hours from the beginning of ischemia; if ischemia is absent, the patient must undergo surgery. The operation includes soft tissue decompression, mechanical pumping across vascular anastomoses, and if necessary, excision of the abnormal vessel part with subsequent autoplasty.

scholarly journals Operative Treatment of Patients with Pancreatic Pseudocysts

2017 ◽  
Vol 2 (1) ◽  
pp. 472
Author(s):  
G.Ts. Dambaev ◽  
V.E. Gunther ◽  
N.V. Merzlikin ◽  
N.A. Brazhnikova ◽  
O.S. Popov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Conservative Therapy ◽  
Early Postoperative Period ◽  
Long Term Results ◽  
Pancreatic Pseudocysts ◽  
Medical University ◽  
Surgical Clinic

The article presents the results of surgical treatment of patients with pancreatic pseudocysts spent in hospital surgical clinic Siberian State Medical University from 2004 to 2016. 7 (17.5%) patients underwent conservative therapy. In the early postoperative period and in the long term (18 months) the analysis of the effectiveness of different methods of surgical treatment. According to the results of the research, the operations of the internal drainage along with resection and resection-draining interventions in assessing the quality of life showed similar long-term results. In turn, these interventions have provided significantly better quality of life (p> 0.05) than external drainage operation.

scholarly journals A perioperative phlebotropic therapy compliance study in patients with varicose veins

2020 ◽  
pp. 81-88
Author(s):  
S. N. Zhabin ◽  
A. A. Shitikov ◽  
A. V. Tsukanov ◽  
E. G. Obedkov ◽  
S. S. Dudchenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lower Extremity ◽  
Varicose Vein ◽  
Conservative Therapy ◽  
Varicose Veins ◽  
Laser Coagulation ◽  
Entire Study ◽  
Wide Range ◽  
Vein Disease

Introduction: Lower extremity varicose vein disease is one of the common problems in vascular surgery. Clinically, this disease is accompanied by a wide range of complaints and external symptoms, which eventually lead to a worse patients’ quality of life. The integrated approach is being applied to the disease treatment, which involves the use of various phlebotropic drugs as conservative therapy along with minimally invasive surgical correction and sclerotherapy.Objective: to improve the quality of phlebotropic therapy for patients with lower extremity varicose vein disease, based on the study of factors that shape the patient’s compliance with the effective treatment of clinical symptoms. The term «compliance» means the precise and informed implementation of the doctor’s recommendations during the treatment by the patient. Most often, «compliance» is assessed by the drug use index, which is the quotient of dividing the number of days on which the full dose of the drug was taken by the duration of the entire study period. Materials and methods: The analysis of 368 + 111 patients with lower extremity varicose vein disease was carried out. Of these, 111 patients turned out to be beyond the correct study of compliance (a phlebectomy was performed in a hospital). 368 patients were divided into the following groups: Group 1: the patients, who were assigned modern surgical treatment of varicose veins (endovenous laser coagulation, scleroobliteration); Group 2: the patients, who withdrew from assigned interventions. As it turned out, the different groups of patients differed in compliance.Results. The patients who were shown and performed surgical treatment – 320 (86.9%), can be considered highly compliant with the prescribed conservative therapy – the average value of the compliance index is 0.83, compared to the representatives who refused to perform the recommended surgical procedures recommended by them – 48 (13.1%), the compliance index is 0.78.In the course of the investigation, the factors shaping compliance with phlebotropic drugs were identified, a comparative assessment was carried out on the main indicators of the effectiveness of phlebotropic drugs.Conclusion. Thus, the compliance of the patients suffering from LEVVV during the treatment with phlebotropic drugs varies depending on the multiplicity and convenience of the form of the drug, on the effectiveness of the proposed phlebotropic therapy according to the influence on the complaints and symptoms, on the psychological readiness of the patient to entrust the result of the final treatment of the disease to the surgeon.

scholarly journals POST-TRAUMATIC ANAL SPHINCTER INSUFFICIENCY

2017 ◽  
pp. 52-54
Author(s):  
A. V. Muravyev ◽  
V. I. Linchenko ◽  
K. A. Muravyev ◽  
P. I. Chumakov ◽  
C. І. Petrosyans ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Anal Sphincter ◽  
Conservative Therapy ◽  
Surgical Care ◽  
Emergency Procedure ◽  
Sphincter Injury ◽  
Defunctioning Stoma ◽  
Wound Debridement ◽  
Post Traumatic ◽  
Sphincter Insufficiency

AIM. To develop tactics of treatment for post-traumatic anal sphincter insufficiency in emergency surgery. MATERIALS AND METHODS. 472 patients with anal sphincter insufficiency were treated between 1977-2015. Of them 125 had conservative therapy. Surgical treatment was performed in 347 patients. Twenty-four patients had emergency procedure. RESULTS AND CONCLUSIONS. The success of the rehabilitation of these patients depends on the timely and adequate surgical care at the time of the sphincter injury. 3 degrees of perineum tears in labor should be sutured by experienced obstetricians and only in layers. Sphincteroplasty without colostomy is indicated within 24 hours after injury, while later admission ot hospital requires defunctioning stoma. Gunshot sphincter damage require wound debridement without sphincteroplasty and defunctioning stoma.

scholarly journals Low-intensity low-frequency magnetotherapy in the early postoperative period in patients with breast cancer

2020 ◽  
Vol 17 (5) ◽  
pp. 233-240
Author(s):  
Inna S. Evstigneeva ◽  
Marina Yu. Gerasimenko
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Upper Limb ◽  
Low Frequency ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Advanced Technique ◽  
Low Intensity ◽  
Extended Technique

Background. Rehabilitation of patients after radical treatment of breast cancer is especially relevant due to the fact that successes in diagnostics and treatment of this disease in recent years have led to an increase in the life expectancy of female patients. Aim. to compare the efficiency of various methods of low-frequency low-intensity magnetotherapy in patients operated on for breast cancer, in the early terms (24 days) after surgery. Methods. Objective and instrumental examination was performed in 78 patients after radical surgical treatment of breast cancer in the early stages (24 days) after surgery. All patients received a course of low-frequency low-intensity magnetotherapy. Results. When applying the extended technique (the effect on the segmental-reflex region and upper limb from the side of the surgery), patients noted an improvement in the quality of life, a decrease in swelling of the upper limb, and a decrease in pain syndrome. A decrease in the number of postoperative complications and the duration of lymphorrhea was noted. Conclusion. Thus, the use of various methods of low-frequency low-intensity magnetotherapy is advisable to use in the early terms (24 days) after surgical treatment, however, the use of the advanced technique provides high function capabilities and enables to get a more pronounced and lasting clinical result.

scholarly journals Plastic surgery of extensive soft tissue defects of the lower leg in children with the use of a parotid flap after its prefabrication with tissue expanders (preliminary report)

2020 ◽  
Vol 8 (2) ◽  
pp. 197-206
Author(s):  
Olga V. Filippova ◽  
Anton V. Govorov ◽  
Yaroslav N. Proshchenko ◽  
Konstantin A. Afonichev ◽  
Natalia S. Galkina
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Plastic Surgery ◽  
Scar Tissue ◽  
Lower Leg ◽  
Soft Tissue Defects ◽  
Tissue Expanders ◽  
Donor Area ◽  
Tissue Defects

Background. Extensive deep soft tissue defects in children are an indication for the microsurgical reconstruction using autotransplantation of a tissue complex. The use of a flap prefabrication before their microsurgical transplantation to various segments and areas is a promising approach in reconstructive surgery. Aim. The aim of this study was to evaluate the possibilities and immediate results of plastic surgery of extensive soft tissue defects of the lower leg with a tissue complex, after its prefabrication with a tissue expander, and the state of the donor area in different surgical treatment options. Materials and methods. Six patients aged 13 2.3 years were operated on for deep scar deformities of the lower leg and foot. For plastic surgery, a pericarpial flap was used. In two patients, the flap was prefabricated with tissue expanders at a volume of 720 ml. After filling the expander, the second stage of surgical treatment was performed. First, the expander was removed. Next, the flap on the artery surrounding the scapula was isolated. Last, it was transplanted into a soft tissue defect of the lower leg with the imposition of microvascular anastomoses. A layer-by-layer suture was applied to the donor wound. The Vancouver scale was used to assess the quality of the scar tissue in the donor area. Results. The removal of the tissue complex after the prefabrication with expanders made it possible to perform plastic surgery of extensive soft tissue defects of the lower leg in one stage of surgical treatment with the application of a cosmetic suture in the donor area. There were no complications in the postoperative period. At the examination after six months, patients who did not undergo flap prefabrication complained of cosmetic defects and discomfort when moving in the donor area. The evaluation of the quality of scar tissue by the Vancouver scale showed that the scars in patients after flap prefabrication were similar to optimal (total score in two patients is 2). In two patients without flap prefabrication, the total score was 7, and in two patients, it was 9, which indicated unsatisfactory cosmetic parameters of the postoperative scar. Conclusion. The prefabrication of a tissue complex using tissue expanders before microsurgical transplantation enables the collection of a large volume of tissue for plastic surgery of extensive defects. It also reduces the risk of trophic complications in the postoperative period and creates optimal conditions for closing the donor site.

scholarly journals Hemorrhoids and quality of life: “… two things incompatible”?

2021 ◽  
pp. 74-79
Author(s):  
M. V. Abritsova ◽  
A. M. Bogomazov ◽  
E. B. Golovko ◽  
E. A. Zagriadskii
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Social Life ◽  
Well Being ◽  
Treatment Method ◽  
Social Adaptation ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Surgical Methods

Hemorrhoids is one of the most common diseases in human. According to the latest data for 2017, the prevalence rates of hemorrhoids per 100 000 population in Russia are 410,3 in adults, 26.7 in children aged 15 to 17 years and 4,0 in children under 14 years old. Quality of life (QoL) is an important non-specific subjective parameter of well-being, representing an integrative characteristic of the physical, psychological, social and emotional status of the patient. Despite the high prevalence of hemorrhoids and the variety of modern methods of surgical treatment, there are very few studies addressing the QoL in this category of patients. There are significant differences between the patient and the Coloproctologist in the perception of HD, which, possibly, can lead to the hypertrophy of indications for surgical treatment. Understanding the effect of HD on social life and the concept of the well-being of a particular patient can help the doctor choose between conservative and surgical approaches in the treatment of hemorrhoids. On the other hand, due to the excessive shyness and mentality in our country, patients with HD tend to adapt to their disease, which leads to later seeking medical help and suboptimal efficacy of conservative therapy and minimally invasive surgical methods.This review presents the first Russian multicenter observational program EQUALISER (impact of different trEatment modalities on QUAlity of life of the patientS with acute and chronic hEmorRhoid disease) aimed at assessing the QoL of patients with HD, as well as the effect of the treatment method and types of surgical treatment on the social adaptation of the population.

scholarly journals Chronic constipation: modern view on the problem. A review

2021 ◽  
Author(s):  
I. M. Leshchyshyn ◽  
Y. M. Susak ◽  
O. I. Okhots’ka ◽  
P. L. Byk ◽  
L. Y. Markulan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Chronic Constipation ◽  
Treatment Method ◽  
Slow Transit Constipation ◽  
Adequate Treatment ◽  
Wide Range ◽  
Slow Transit ◽  
Transit Constipation

Chronic constipation is a frequently diagnosed heterogeneous pathology that significantly impairs the quality of life in all population groups and its frequency increases with age. It commonly affects up to 10 — 15  % of the population. There are numerous classifications of constipation due to a great number of disorders that cause it. The types of constipation are identified based on the etiology or mechanism of its development. Different criteria are used to specify the categorization of constipation, but it is still difficult to find one general classification including all types of constipation. The Rome IV criteria categorize disorders of chronic constipation into four subgroups. The treatment depends on the subtype. The significant increase of constipation cases is observed nowadays. This disorder is facilitated by a sedentary lifestyle, insufficient amount of fiber and fluid in the diet, a wide range of diseases that directly lead to the development of chronic constipation, congenital and acquired pathologies, abnormal intake of laxatives and opioids or a combination of these factors. Despite numerous publications on slow transit constipation, the latter is still the subject of research for many specialists. A lot of recent scientific works have been dedicated to the immunohistochemical studies of interstitial pacemaker cells. The numbers of markers they express were found. Consequently, the investigations of modern scientists are aimed to develop and implement new laboratory methods for determining the indications for surgical treatment depending on a diagnosed disorder of the intestinal neurophysiology. These methods will ensure a differentiated selection of patients for surgical treatment. The step approach to the diagnosis of chronic constipation allows choosing an adequate treatment method in order to improve symptoms, the quality of life, and patient satisfaction. The literature review indicates that surgery still remains the most radical treatment method for patients with slow transit constipation.  

scholarly journals The use of general magnetic therapy in the early postoperative period in patients with breast cancer

2019 ◽  
Vol 18 (1) ◽  
pp. 9-16
Author(s):  
Marina Yu. Gerasimenko ◽  
Inna S. Evstigneeva
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Early Stage ◽  
Early Postoperative Period ◽  
Venous Stasis ◽  
Cancer Breast ◽  
Shoulder Region ◽  
Intensity Duration Frequency ◽  
Magnetic Therapy

We conducted an objective and instrumental examination in 64 patients who underwent radical surgical treatment of breast cancer (breast cancer) at an early stage (24 days) after surgery. Patients were divided into 2 groups by simple randomization: the 1st group of patients received a course of general magnetic therapy, the 2nd group received a placebo procedure. Patients who received general magnetic therapy showed improvement in quality of life, reducing the intensity, duration, frequency and radiation of pain; decrease in the circumference of the upper limb from the surgical treatment; a decrease in the manifestations of the syndrome of inflammation, improve microcirculation from the surgical treatment, and also on reducing venous stasis and muscular-tonic syndrome of shoulder region. Thus, the use of general magnetic therapy is advisable to use in the early stages (24 days) after surgical treatment for breast cancer.

scholarly journals Surgical treatment of the parieto-occipital region extensive scalped wound

2021 ◽  
Vol 8 (1) ◽  
pp. 42-49
Author(s):  
V. А. Mitish ◽  
P. V. Medinsky ◽  
V. G. Bagaev
Keyword(s):  
Surgical Treatment ◽  
Plastic Surgery ◽  
Soft Tissues ◽  
Early Postoperative Period ◽  
Occipital Region ◽  
Primary Wound Closure ◽  
Combined Use ◽  
Scalp Wound ◽  
Cutaneous Flap ◽  
Post Traumatic

In the presented clinical case, we consider the surgical treatment of a 9-year-old girl with an extensive post-traumatic scalp wound in the parieto-occipital region resulting from hair getting into the moving mechanism of a go-kart car and incomplete separation of the scalp in the parieto-occipital region of the head. The early postoperative period (surgical treatment with primary wound closure) was complicated by the development of skin necrosis. An extensive wound defect in the soft tissues of the scalp (up to 150 cm2) was replaced with local related tissues. For this, various methods of plastic surgery were used in different areas of the wound defect: plastic surgery with local tissues, replacement of the defect with a rotated fascio-cutaneous flap and plastic surgery with local tissues using the dosed stretching method. The combined use of these methods made it possible to completely restore full-fledged soft tissues and hair of the injured parieto-occipital region. 

RISK FACTORS FOR COMPLICATIONS AFTER OPEN ADENOMECTOMY IN BENIGN PROSTATIC HYPERPLASIA IN A PATIENT WITH DIABETES MELLITUS

Vestnik ◽  
2021 ◽  
pp. 166-169
Author(s):  
Е.Б. Толегенов ◽  
Е.М. Коныров ◽  
Ж.К. Даулетбаев ◽  
Р.С. Байрамов ◽  
М.Ж. Ташкеева ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Gold Standard ◽  
European Association ◽  
Lower Urinary Tract ◽  
Conservative Therapy ◽  
Treatment Method ◽  
Prostatic Hyperplasia ◽  
Urinary Tract Symptoms ◽  
New Treatment ◽  
Lower Urinary

Наиболее часто пациенты с наличием симптомов нижних мочевых путей тяжелой степени (по шкале IPSS), которые резистентные к консервативной терапии, а также пациенты с наличием аденомы размерами 80 см3 и более, являются кандидатами на оперативное лечение.[1] Долгие годы трансуретральная резекция гиперплазии предстательной железы является «золотым стандартом» оперативного лечения (с точки зрения эффективности), однако возникновение осложнений стимулировали исследователей к разработке новых методов лечения.[2] Открытая аденомэктомия (чаще всего чрезпузырная), рекомендованная Европейской Ассоциацией Урологов как эффективный метод лечения пациентов с объемом железы >80 см3, характеризуется длительным пребыванием в стационаре и серьезными осложнениями, такими как кровотечение из послеоперационной раны, инфекция, образование рубцов в мочевыводящих каналах, временное недержание мочи, стриктура уретры[3]. Most often, patients with severe lower urinary tract symptoms (according to the IPSS scale) who are resistant to conservative therapy, as well as patients with adenomas of 80 cm3 or more, are candidates for surgical treatment.[1] For many years, transurethral resection of prostatic hyperplasia has been the "gold standard" of surgical treatment (in terms of effectiveness), but the occurrence of complications has stimulated researchers to develop new treatment methods.[2] Open adenomectomy (most often percutaneous), recommended by the European Association of Urologists as an effective treatment method for patients with a gland volume >80 cm3, it is characterized by a long hospital stay and serious complications, such as bleeding from a postoperative wound, infection, scarring in the urinary channels, temporary urinary incontinence, urethral stricture.

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