scholarly journals Result of using a minimally invasive method of surgical treatment of purulent-necrotic complications in a patient with diabetic foot syndrome

2020 ◽  
Vol 39 (3) ◽  
pp. 60-64
Author(s):  
Sergey Y. Ivanusa ◽  
Boris V. Risman ◽  
Andrey V. Yanishevskiy
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Diabetic Foot ◽  
Pain Syndrome ◽  
Diabetic Foot Syndrome ◽  
Military Medical Academy ◽  
Results Of Treatment ◽  
Medical Academy ◽  
Invasive Method ◽  
Short Time

The article presents an analysis of the results of treatment of a patient with purulent-necrotic complications of diabetic foot syndrome, who, in the framework of surgical treatment, used a minimally invasive method of treatment of purulent-necrotic complications of diabetic foot syndrome, developed at the departments of general surgery and normal anatomy of the S.M. Kirov Military Medical Academy. The effectiveness of the developed method has been demonstrated, which makes it possible to sanitize the purulent cavity in a short time, stop pain syndrome and restore the support ability of the foot (4 figs, 1 table, bibliography: 7 refs).

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

Results of surgical treatment of aggressive hemangiomas of the treatmental spine by the method of punctive vertebroplasty

2021 ◽  
Vol 19 (3) ◽  
pp. 75-80
Author(s):  
Sh. Sh. SHATURSUNOV ◽  
◽  
S. A. MIRZAKHANOV ◽  
A. R. SATTAROV ◽  
A. O. KOBILOV ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Thoracolumbar Spine ◽  
Pain Syndrome ◽  
Average Score ◽  
Treatment Results ◽  
Antitumor Effects ◽  
X Ray ◽  
Mri Studies ◽  
Invasive Method

The purpose — to analyze the results of surgical treatment of patients with hemangiomas of the thoracolumbar spine by puncture vertebroplasty. Material and methods. Clinical data and results of surgical treatment of 124 patients operated on in 2014-2020 were analyzed. Preoperative examinations included clinical studies, WAS, Oswestry, X-ray, MSCT, and MRI. MSCT and MRI studies were carried out for diagnosis and to study the treatment results. Single hemangiomas were present in 63 (50,8%) patients, 44 (35,4%) patients had hemangiomas at two or more levels. In 17 (13,7%) patients, hemangiomas were present in both the thoracic and lumbar regions. Results. In 87,8% of cases, MSCT studies in the postoperative period showed filling the hemangioma cavity by more than 80%. Control MRI studies 6 months and a year after surgery in none of the cases revealed a continued growth of hemangioma. Pain syndrome according to WAS before surgery averaged 46/56 points, after 12 months — 15/20 points. According to the Oswestry questionnaire, the average score reduced from 32 to 6 points after 6 months. Conclusion. Puncture vertebroplasty with bone cement is an effective, safe and minimally invasive method for treating hemangiomas of the thoracolumbar spine. The main goals of vertebroplasty are to restore the supporting ability of the affected vertebra, achieve analgesic and antitumor effects.

scholarly journals Capabilities of gravitational surgery for improvement of treatment results in patients with diabetic foot syndrome

2018 ◽  
Vol 99 (3) ◽  
pp. 385-391
Author(s):  
M B Akhmedov ◽  
N S Abushov ◽  
E Dz Zakirdzaev ◽  
Dz V Kosaev ◽  
N I Babaev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lipoic Acid ◽  
Diabetic Foot ◽  
Perioperative Period ◽  
Diabetic Foot Syndrome ◽  
Control Group ◽  
Study Group ◽  
Treatment Results ◽  
Narcotic Analgesics ◽  
Results Of Treatment

Aim. Improvement of complex treatment results in patients with diabetic foot syndrome by introducing methods of gravitational surgery and α-lipoic acid. Methods. The results of treatment were analyzed for 558 patients with diabetic foot syndrome treated in Scientific Centre of Surgery named after M.A. Topchubashov (Baku, Azerbaijan) from 1988 to 2015. The age varied from 28 to 83 years. The patients included 416 men and 142 women. The control group included 90 patients who at the perioperative period underwent basic therapy including antibiotics, anticoagulants, antiaggregants, dextrans, angioprotectors, spasmolytics, corticosteroids, narcotic and non-narcotic analgesics. The study group included 468 patients, along with traditional therapy receiving efferent methods (plasmapheresis, ultraviolet blood irradiation, ozone therapy) and α-lipoic acid. 282 patients of the study group received outpatient treatment and 186 - complex inpatient surgical treatment. A comparative evaluation of the results was performed separately in three groups: angiopathy, neuropathy, angioneuropathy. The results were evaluated by clinical and instrumental examinations before and after treatment (6, 12, 60 months and more). Results. In the study group a satisfactory result of treatment was registered in 85.5% of patients, in the control group - in 62.2%, unsatisfactory in 14.5 and 37.8% of patients, respectively (p=0.046). Conclusion. The use of efferent methods and α-lipoic acid provided prompt elimination of numerous pathogenetic disorders observed in diabetes mellitus, decrease of amputation frequency and improvement of complex surgical treatment results in patients with diabetic foot syndrome.

scholarly journals Choledocholithiasis: modern possibilities of diagnosis and surgical treatment

2021 ◽  
Vol 23 (3) ◽  
pp. 109-116
Author(s):  
Eveniy S. Zherebtsov ◽  
Pavel N. Romashchenko ◽  
Nicolay A. Maistrenko
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Diagnostic Value ◽  
Alternative Methods ◽  
Two Stage ◽  
One Stage ◽  
Military Medical Academy ◽  
Rendezvous Technique ◽  
Medical Academy ◽  
Examination Methods

Studies have examined various approaches in the diagnosis and surgical treatment of patients with cholelithiasis complicated by choledocholithiasis, evaluated the possibilities of using modern methods of treating the disease, and proposed a strategy to prevent the abandonment of bile duct concretions. The relevance of this problem is related to the variety of diagnostic and surgical treatment methods of choledocholithiasis, high disease frequency, and nonexistence of a unified approach to the examination and choice of surgical treatment in patients with cholelithiasis complicated by choledocholithiasis. These issues indicate the need to study this problem and identify optimal approaches to examination and treatment, including modern minimally invasive methods of treatment. The analysis of the diagnostic value of various examination methods and surgical outcomes was based on the experience of treating 154 patients with cholelithiasis complicated by choledocholithiasis in the clinic of the S.P. Fedorov Faculty of Surgery of the S.M. Kirov Military Medical Academy. An algorithm for examining patients with cholelithiasis was formed based on the diagnostic value of various research methods, which allows timely detection of choledocholithiasis. The results of various approaches to the surgical treatment of patients with cholelithiasis complicated by choledocholithiasis were analyzed. In the absence of general somatic contraindications and the availability of technical capabilities, a one-stage approach to surgical treatment was suggested. Moreover, an individual approach is necessary for the treatment of patients with cholelithiasis complicated by choledocholithiasis, taking into account the nature of the disease course and its complications, comorbid status of the patient, and technical capabilities of a particular hospital. The sequence and timing of operations with a two-stage approach should be determined, taking into account the acute conditions and comorbidities of the patient. The use of modern minimally invasive technologies, such as transpapillary and trans-bubble choledochoscopy, dosed papillotomy, and rendezvous technique for the cannulation of the large papilla of the duodenum, allows us to improve the results of surgical treatment and reduce the risk of complications. Transpapillary and trans-bubble nanoelectroimpulse lithotripsy are alternative methods of resolving major choledocholithiasis in both one-stage and two-stage treatment.

scholarly journals Outcomes of ophtalmologic surgical procedures of esotropia in children and adolescents

2008 ◽  
Vol 65 (8) ◽  
pp. 627-631
Author(s):  
Tamara Kljakovic-Avramovic ◽  
Miroslav Vukosavljevic ◽  
Sinisa Avramovic
Keyword(s):  
Surgical Treatment ◽  
Prospective Study ◽  
Children And Adolescents ◽  
Deviation Angle ◽  
Group Iii ◽  
Military Medical Academy ◽  
Group I ◽  
Medical Academy ◽  
Group Ii ◽  
Common Manifestation

Background/Aim. Esotropia is the most common manifestation form of strabism accompanied by refraction deviations and amblyopia. The aim of this prospective study was to present the outcomes of surgical treatment of esotropia in children and adolescents. Methods. Within the period from January 1st 2006 to February 1st 2007 at the Clinic for Ophtalmology, Military Medical Academy, Belgrade a total of 25 patients with esotropia (34 eyes) and previously corrected refraction anomaly and treated amblyopia were operated on. The patients were 4-19-year of age. All of the patients were submitted to a complete ophtalmologic and orthoptic examination prior to the surgery, and a month, three months and six months after the surgery. The surgery was performed under general anesthesia. Out of the total number of the patients nine were operated on both eyes, while 16 patients on one eye with amblyopia or frequent esodeviation. Nine patients were submitted to retroposition of the inner straight muscle, two to myectomy of the outer straight muscle, while in 14 of the patients a combination of retroposition and myectomy was performed. The patients were divided into three groups according to the preoperative angle at the distance and followed-up accordingly after the surgery. Deviation angle at the distance in the group I was 18-25 DP, in the group II 26-35 PD, while in the group III it was 36-60 PD. Results. The most numerous, group I (12 patients; 48%), a month following the surgery showed angle reduction by 55.58%, after three months 63.25%, and after six months 63.92%. The group II consisted of 8 patients (32%) showed angle reduction by 70.75% a month following the surgery, by 76% after three months, and by 79.12% after six months. The group III (5 patients; 20%) showed angle reduction by 72.20% a month following the surgery, 79.20 after three months, and 80.12% after six months following the surgery. Conclusion. The best postoperative outcomes after a month, three and six months were obtained in the group of patients with the highest esodeviation angle at the distance solved by the surgery on both eyes. Timely surgical treatment befell into major precondition for developing and maintaining the elements of binocular vision in the operated on patients. .

scholarly journals Possibilities of combined surgical treatment of pyonecrotic lesions in the neuroischemic form of diabetic foot syndrome

2009 ◽  
Vol 12 (1) ◽  
pp. 8-13
Author(s):  
Valeriy Afanas'evich Mitish ◽  
I A Eroshkin ◽  
Gagik Radikovich Galstyan ◽  
Lyudmila Petrovna Doronina ◽  
Yu S Paskhalova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diabetic Foot ◽  
Lower Extremities ◽  
Lower Leg ◽  
Diabetic Foot Syndrome ◽  
Diagnostic Tools ◽  
Critical Ischemia ◽  
Adequate Treatment ◽  
Patients With Diabetes ◽  
Foot Lesions

Aim. To present results of combined surgical treatment of the ischemic form of diabetic foot syndrome complicated by pyonecrotic process. To show thatthe use of modern diagnostic tools and the choice of adequate treatment strategy permits to substantially reduce the number of above-the-knee amputations. Materials and methods. A total of 140 patients with diabetes mellitus and critical ischemia of lower extremities were under observation during 2004-2008.All of them had purulent and/or necrotic foot lesions. The patients were examined by X-ray, computed and magneto-resonance tomography of the feet,duplex scanning of lower leg vasculature, transcutaneous measurement of PO2, pelvic and lower leg arterial angiography. Results. A strategy of surgical treatment was developed to be used depending on the patients health status, clinical features and severity of pyonecroticprocesses in the foot, and the degree of involvement of the main blood vessels of lower extremities. Conclusion. Combination of endovascular surgery with various methods for plastic wound closure permits to extend the range of possibilities for the treatmentof high-risk patients, such as those with pyonecrotic lesions and neuroischemic form of diabetic foot syndrome. This approach opens up prospects fora significant decrease of percentage of above-the-knee amputations and improves the quality of life in these patients.

Treating diabetic foot syndrome at the General Surgery Clinic of the S.M. Kirov Military Medical Academy

2021 ◽  
Vol 2 (3(5)) ◽  
pp. 20-29
Author(s):  
S.Ya. Ivanusa ◽  
◽  
B.V. Risman ◽  
A.V. Yanishevsky ◽  
R.E. Shayakhmetov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Diabetic Foot ◽  
Local Treatment ◽  
Diagnostic Algorithm ◽  
Ultrasonic Cavitation ◽  
Diabetic Foot Syndrome ◽  
Control Group ◽  
Physical Methods ◽  
Purulent Wounds

We examined 180 patients with purulent-necrotic complications of diabetic foot syndrome, in whom the proposed diagnostic algorithm was used. Magnetic resonance imaging of the feet, ultrasound Doppler with duplex angioscanning, magnetic resonance and computed angiography of the lower extremities, as well as assessment of transcutaneous oxygen tension were performed. Surgical treatment tactics depended on the form of the diabetic foot syndrome, as well as the severity of the disease. As a local treatment, physical methods were used to accelerate the course of the wound process. The proposed diagnostic algorithm for the diagnosis and selection of surgical treatment for various forms of diabetic foot syndrome has made it possible to reduce the number of “high” amputations and maintain a supporting limb. Purpose of the study is to improve treatment outcomes for purulent-necrotic complications of diabetic foot syndrome by developing and applying a diagnostic algorithm and differentiated treatment tactics. The main group consisted of 180 patients with purulent-necrotic complications of diabetic foot syndrome, in whom the developed diagnostic algorithm and differentiated tactics of surgical treatment were used, as well as physical methods of influencing the wound process (ultrasonic cavitation and local ozonation) were used as local treatment. The control group included 40 patients with purulent-necrotic complications of diabetic foot syndrome, whose treatment involved the use of drugs that improve the rheological properties of blood and tissue microcirculation (rheopolyglucin, trental, actovegin) according to conventional schemes. Local treatment included sanitation and treatment of wound and ulcerative surfaces with antiseptic solutions and ointments, depending on the phase of the wound process. Data analysis in this group was carried out based on a retrospective study of case histories and an assessment of long-term results of treatment by follow-up examinations and telephone interviews. Control group included 25 (63%) men and 15 (37%) women; the average age was 67.3±10.3 years. The developed unified approaches in diagnosing and treating patients with purulent-necrotic complications of diabetic foot syndrome, who, in complex treatment, underwent staged necrectomy with simultaneous ultrasonic cavitation of purulent wounds and their ozonization, can reliably reduce the number of ulcer recurrences from 28% to 2.7%, high amputations by 34%, and the number of re-amputations ― 10 times. The use of minimally invasive surgical technologies for the rehabilitation of deep purulent foci of the foot, in comparison with the classical principles of treatment of purulent wounds, makes it possible to achieve a complete cleansing of wounds, preparation for plastic surgery, and an increase in the number of functional supportable lower limbs by 42.7%. According to the data obtained, it is optimal to perform sanitizing operations after revascularization of at least one artery no earlier than 3–4 days, which makes it possible to increase their efficiency and reduce the number of repeated surgical interventions. The approach to managing patients with diabetic foot syndrome at all stages of treatment and rehabilitation should be interdisciplinary and include the following specialists: endocrinologist, orthopedist, surgeon, psychologist, trained nursing staff.

Treatment of the pilonidal sinus in children using laser radiation

2021 ◽  
Vol 24 (4) ◽  
pp. 32-36
Author(s):  
D. S. Zolotukhin ◽  
I. V. Krochek ◽  
S. V. Sergiyko
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Hospital Stay ◽  
Pain Syndrome ◽  
Surgical Excision ◽  
Duration Of Surgery ◽  
Invasive Method ◽  
Open Excision ◽  
Interstitial Thermotherapy ◽  
Late Postoperative Period

The work carried out a comparative analysis of the results of surgical treatment of the epithelial-coccygeal course of ECC in 133 children aged 3 to 17 years, using laser-induced interstitial thermotherapy (LIT) and open excision. Comparative analysis was carried out according to the following criteria: duration of surgery, average time of hospital stay, duration of pain syndrome on a 10-point scale (VAS), the presence of complications in the early and late postoperative period. In the main group, the average time of hospital stay was 4.9 ± 0.3; the duration of surgical treatment was 17.2 ± 2.8 minutes. The duration of the pain syndrome was 5.3 ± 2.1 hours, and its severity was 2.7 ± 0.8 points. Average terms of epithelialization of fistulas are 3.1 ± 2.8 days. Recurrence of ECC was observed in 7 patients (11.7%), which required re-intervention. In 3 (5.0%) patients, LIT was used, and in 4 (6.7%), excision using plastics according to the Bascom method. In the comparison group, the duration of surgical treatment was 32.6 ± 5.4 minutes. The duration of inpatient treatment is 16.7 ± 1.4 days. Pain syndrome averaged 71.8 ± 11.9 hours, severity 6.5 ± 2.3 points. The number of relapses was 9 (12.3%), of which 5 (6.8%) children underwent laser treatment, and 4 (5.5%) repeated surgical excision with Bascom with recovery. This technique is an effective and minimally invasive method for treating ECC, which makes it possible to recommend this method for use in pediatric surgical practice.

Actual cost of complex surgical treatment of patients with neuroischemic form of diabetic foot syndrome

2015 ◽  
pp. 48 ◽  
Author(s):  
◽  
V. A. Mitish ◽  
F. T. Mahkamova ◽  
Ju. S. Pashalova ◽  
V. A. Gruzman ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diabetic Foot ◽  
Diabetic Foot Syndrome ◽  
Actual Cost
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