scholarly journals Esophagoplasty in patients with burn strictures of the esophagus

2011 ◽  
Vol 4 (1) ◽  
pp. 57-62
Author(s):  
Yury Vladimirovich Cikini ◽  
Evgeny Aleksandrovich Drobyazgin ◽  
Anton Vadimovich Kutepov ◽  
Inessa Viktorovna Berkasova

Esophagoplasty in cicatricial narrowing of the esophagus is made postburns 116 patients. Disease duration - from 1 month to 31 years. Subtotal shunt esophagocolonoplastik left half of the colon made 68, extirpation of the esophagus with a plastic colon 9, extirpation of the esophagus with a plastic stomach tube in 38 patients. Long-term results of surgical intervention were studied in all patients during the period from 1 month to 13 years. Study of long-term results and quality of life after esophagoplasty showed significant benefits extirpation of the esophagus with esophagogastroplasty before esophagocolonoplastik.

Author(s):  
Khromov A.A. ◽  
Gumanenko E.K. ◽  
Linnik S.A.

Severe combined injuries, and especially polytrauma, differ significantly from other types of injuries by high requirements for the organization of medical care at all its stages, miltidisciplinarity, high financial costs, poor short-term outcomes and long-term treatment results. Therefore, the search for new concepts, strategies and tactics for the treatment of victims is an urgent problem not only for surgeons, resuscitators and traumatologists, but also for healthcare in general. Fractures of long tubular bones accompanying severe combined injuries or polytrauma pose a lesser threat to the life of the victim than severe traumatic brain injuries or damage to internal organs, but they are the main cause of long-term treatment and disability. Such victims make up a significant group of patients-66.2%, therefore they represent a separate problem in traumatology and injury surgery. A modern solution to this problem, improving the results of treatment and the quality of life of victims after suffering a severe combined injury or polytrauma is possible on the basis of new approaches, as well as on the new ideology of osteosynthesis. In the present study, 392 minimally invasive osteosyntheses were performed in 274 patients with severe combined trauma and polytrauma. The indication was the need to fix fractures in order to create favorable conditions for rapid and lasting fusion, early functional treatment and rehabilitation of victims, and to achieve the highest possible level of quality of life after treatment. The possibility and duration of osteosynthesis were determined by the severity of the condition of the victims, assessed by objective methods: a simple clinical scale of VPH-SG or, much less often, specialized resuscitation scales of VPH-SS, SAPS or MODS. The surgical intervention was possible when the severity of the victim's condition reached the highest level of compensation: 16-30 points on the VPH-SG scale. The immediate outcomes of treatment of 274 patients with severe combined trauma and polytrauma after performing a full and final volume of surgery were good. There were no fatal outcomes. The frequency of mild local infectious complications in the field of surgical intervention was 4.0%. The average duration of inpatient treatment was 23.8±2.3 days: with closed intramedullary osteosynthesis - 19.8±0.3 days, with bone osteosynthesis - 24.2±1.2 days, with non - focal osteosynthesis-27.3±1.9 days. The long-term and anatomical and functional results of treatment were analyzed in 158 patients. There were no unsatisfactory long-term results of treatment. Good long-term results were achieved in 81.0%, satisfactory – in 19.0% of the victims. Thus, the results of the analysis of the immediate outcomes and long-term results of treatment of fractures of long tubular bones using the technology of minimally invasive osteosynthesis in patients with severe combined trauma and polytrauma demonstrated the high effectiveness of this surgical technology, on the one hand, and the direct dependence of the treatment outcomes on the severity of the injuries, the severity of the condition of the victims and the number of fractures in one victim, on the other hand.


2021 ◽  
Author(s):  
Melanie Le ◽  
Konrad Reinshagen ◽  
Christian Tomuschat

Abstract Purpose: Advances in surgical techniques and perioperative care have improved patients' short-and mid-term postoperative outcomes with Biliary Atresia (BA). However, the long-term results of these patients have not been thoroughly investigated. This systematic review aims to determine the long-term outcomes and the patients' health-related Quality of life (HrQoL) with their native livers or liver transplantation. Methods: A systematic literature-based search for relevant cohorts was performed using Pubmed/Medline, Cochrane Library from its inception to August 2021. Original studies reporting on BA, Hepatoportoenterostomie, portoenterostomy, Kasai, Liver transplantation, Quality of life, or HrQoL were included. Pooled prevalence has been calculated for cholangitis, secondary liver transplantation, or associated malformations using MetaXL (version 5.3). Subgroup analysis on HrQoL followed surgical treatment after BA was calculated by using RevMan (version 5.4).Results: 12 articles were considered for data synthesis. Nine studies compared biliary atresia patients to an age-matched healthy reference group. 4/9 (n = 338) of these studies indicated lower scores for biliary atresia patients; 5/9 (n = 127) stated similar health status. A Forest plot analysis including all studies with total HrQoL showed a tendency of higher scores towards healthy controls (MD -0.79, 95% CI: -6.00-4.41). Comparing patients after Kasai Hepatoportoenterostomy with healthy controls demonstrated favorable outcomes for the control group (MD -3.22, 95% CI: -7.20-0.75) with no statistical significance (p = 0.11). The pooled estimation of the prevalence of cholangitis, secondary liver transplantation and associated malformations are 0.33 (95% CI: 0.06–0.66), 0.59 (95% CI: 0,42–0.75) and 0.13 (95% CI: 0,01–0.33).Conclusion: Biliary atresia patients have an overall high prevalence of progressive liver-related complications and risk of lower HrQoL compared to their healthy peers. Furthermore, those patients who received liver transplantation appear to have the same Quality of life as those living with their native livers. Targeted and evidence-based follow-up procedures and transitional care are essential to meet these patients' long-term care needs. Prospective and multicenter research das focuses on the attributes and predictors of the long-term prognosis of patients with biliary atresia are necessary.


2004 ◽  
Vol 14 (5) ◽  
pp. 648-654 ◽  
Author(s):  
Tarja Martikainen ◽  
Elina Pirinen ◽  
Esko Alhava ◽  
Eero Poikolainen ◽  
Matti Pääkkönen ◽  
...  

2003 ◽  
pp. 1003-1006 ◽  
Author(s):  
Robert P. Sutcliffe ◽  
Donal D. Maguire ◽  
Paolo Muiesan ◽  
Anil Dhawan ◽  
Giorgina Mieli-Vergani ◽  
...  

Author(s):  
Martina CAPITANIO ◽  
Riccardo GUANÁ ◽  
Salvatore GAROFALO ◽  
Federico SCOTTONI ◽  
Maria Grazia CORTESE ◽  
...  

2021 ◽  
pp. 44-53
Author(s):  
Oleg Nikolaevich Zuban ◽  
Andrey Aleksandrovich Volkov

Various diseases of the bladder lead to the loss of its function and the need for periodic catheterization of the patient or the installation of permanent urinary drainage. Reconstruction of the lower urinary tract, based on the Mitrofanov principle, improves the quality of life of patients. However, this operation has a significant number of early and late operational complications. We represent a small group of patients — 6 people who underwent continental cutaneous urine diversion in our modification, the purpose of which was to reduce incontinence. Long-term results of the operation demonstrate a good result of this technique.


2016 ◽  
Vol 7 (01) ◽  
pp. 87-90 ◽  
Author(s):  
Serdal Albayrak ◽  
Sait Ozturk ◽  
Emre Durdag ◽  
Ömer Ayden

ABSTRACT Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs) and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05). None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results.


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