scholarly journals WHO Surgical Complication Prevention Checklist: a Comparative Analysis of Two Clinics

2021 ◽  
Vol 14 (1) ◽  
pp. 33-41
Author(s):  
Machmud Vilevich Timerbulatov ◽  
Shamil Vilevich Timerbulatov ◽  
Timur Rustemovich Nizamutdinov ◽  
Vil Mamilovich Timerbulatov ◽  
Ekaterina Alexandrovna Grushevskaya
Keyword(s):  
Comparative Analysis ◽  
Postoperative Complications ◽  
Inpatient Treatment ◽  
Surgical Intervention ◽  
Surgical Complication ◽  
Surgical Interventions ◽  
Surgical Safety ◽  
Surgical Department ◽  
Who Checklist ◽  
Surgical Operations

The aim of the study was to examine the effectiveness of the adherence to the WHO surgical safety checklist.Material and methods. A comparative analysis of the performance of the surgical departments in two clinics was carried out: in the first clinic the WHO checklist was applied to control the performance of the surgical department; in the second clinic these recommendations were not used. The results of 3012 (first clinic) and 3527 surgical interventions (second clinic) were analyzed. The authors studied the frequency of postoperative complications, the effectiveness when using all the points of the recommendations.Results. The frequency of antibiotic prophylaxis during general surgical operations in clinic I was 89.3%, in clinic II - 63.7%, the frequency of infection in the area of ​​surgical intervention was by 13.2% and up to two times higher in clinic II, mortality rates after surgery were also significantly higher in clinic II; consequently, the duration of inpatient treatment was 8.7 in clinic I versus 16.4 days in clinic II.Conclusion. The adherence to the surgical safety checklist can effectively reduce the number of postoperative complications, mortality, and reduce the time of inpatient treatment.

OPERATIONS FOR ANEURISM OF THE ABDOMINAL AORTIC DEPARTMENT - RESECTION WITH THE FOLLOWING PROSTHETICS AND ENDOPROSTHETICS: A COMPARATIVE ANALYSIS OF COMPLICATIONS

2020 ◽  
pp. 43-49
Author(s):  
Андрей Анатольевич Иванов ◽  
Александр Иванович Жданов ◽  
Максим Сергеевич Шевелин ◽  
Александр Сергеевич Брежнев
Keyword(s):  
Comparative Analysis ◽  
Postoperative Complications ◽  
Statistical Significance ◽  
Aortic Aneurysms ◽  
Surgical Interventions ◽  
Vein Thrombosis ◽  
Scientific Hypothesis ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
High Level

В статье представлены данные оригинального исследования по улучшению хирургического лечения аневризм брюшного отдела аорты. С этой целью произведен сравнительный анализ двух альтернативных друг другу операций: 1) резекции аневризмы с последующим протезированием аорты; 2) эндопротезирования аорты. Сформулировано научное предположение о том, что замена «классических» операций резекции аневризмы на «альтернативные» операции эндопротезирования приведет к принципиальному снижению уровня послеоперационных осложнений. В независимых группах пациентов с использованием сравниваемых хирургических вмешательств произведена точная качественная и количественная оценка послеоперационных осложнений: нетромботических - кардиальных, пульмональных, ренальных и тромботических - тромбозов глубоких вен и тромбозов браншей протеза. После реализации исследования было установлено, что замена «классических» операций на «альтернативные» достоверно приводит к принципиальному снижению уровня наиболее жизнеопасных осложнений - кардиальных (острых форм ишемической болезни сердца, нарушений сердечного ритма), пульмональных (пневмоний, тромбоэмболии легочной артерии, респираторного дистресс-синдрома взрослых) и ренальных (острой почечной недостаточности). Некоторое исключение составили менее жизнеопасные тромботические осложнения. Полученные результаты имеют высокий уровень статистической значимости, что позволяет рекомендовать их к рассмотрению к использованию в практике сосудистой хирургии The article presents data from an original study to improve the surgical treatment of abdominal aortic aneurysms. For this purpose, a comparative analysis of two alternate operations was performed: 1) aneurysm resection followed by aortic prosthetics; 2) aortic endoprosthetics. The scientific hypothesis is formulated that the replacement of the «classical» operations of resection of the aneurysm with «alternative» operations of endoprosthetics will lead to a fundamental decrease in the level of postoperative complications. In independent groups of patients using the compared surgical interventions, an accurate qualitative and quantitative assessment of postoperative complications was made: non-thrombotic - cardiac, pulmonary, renal and thrombotic - deep vein thrombosis and prosthetic jaw thrombosis. After the study was completed, it was found that the fundamental replacement of «classical» operations with «alternative» reliably leads to a fundamental decrease in the level of the most life-threatening complications - cardiac (acute forms of coronary heart disease, cardiac arrhythmias), pulmonary (pneumonia, pulmonary thromboembolism, respiratory distress syndrome of adults) and renal (acute renal failure). Some exceptions were less life-threatening thrombotic complications. The results obtained have a high level of statistical significance, which allows us to recommend them for consideration in the practice of vascular surgery

scholarly journals MODERN TRENDS IN THE TREATMENT OF ACUTE ADHESION IN INTESTINAL OBSTRUCTION

2020 ◽  
pp. 58-61
Author(s):  
V. V. Lesnoy ◽  
A. S. Lesnay
Keyword(s):  
Intestinal Obstruction ◽  
Inpatient Treatment ◽  
Conservative Therapy ◽  
Postoperative Treatment ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Restoration Time ◽  
Days Open ◽  
Adhesive Obstruction

Summary. Aim. To perform the modern tactics of acute adhesive obstruction (AAO) treatment. Materials and methods. The basis of the work is the analysis of the results of treatment of 38 patients hospitalized in an urgent order to the surgical department with the clinic AAO. Results. 20 (52.6 %) patients with the background of conservative therapy, the phenomenon of intestinal obstruction was regressed. Repeated hospitalization during the year with the hospital was required by AAO 2 (5.3 %) patients. Laparoscopic adhesion was performed 4 (10.5 %) patients whose average intestinal restoration time was (1.8±1.2) days, and the duration of postoperative inpatient treatment was (5.1±1.3) days. Open surgical interventions were performed 14 (36.8 %) patients, in whom the period of restoration of the intestine function was (3.8±1.5) days, and the duration of postoperative treatment was (10.1±1.2) days. Conclusion. Conservative therapy is effective in 52.6 % of patients. Laparoscopic adhesion is indicated in the absence of peritoneal symptoms, if ≤ 2 laparotomies were noted in the history, with a peritoneal index of adhesion ≤ 9 points.

INDICATIONS AND CONTRAINDICATIONS FOR REMOVAL OF FOREIGN BODIES OF LUNGS OF FLAMMABLE ORIGIN

2021 ◽  
pp. 43-47
Author(s):  
V. Kupriyanchuk ◽  
Y. Bunin ◽  
R. Mikhailusov ◽  
V. Negoduyko ◽  
E. Khoroshun ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Foreign Bodies ◽  
Comparison Group ◽  
Gunshot Wounds ◽  
Northern Region ◽  
Main Group ◽  
Surgical Instruments ◽  
Surgical Trauma ◽  
Surgical Interventions ◽  
Surgical Department

Summary. The purpose of the study is to establish the indications and contraindications for the removal of foreign bodies of lungs of gunshot origin. Materials and methods. In the surgical department of the surgical clinic of the Military Medical Clinical Center of the Northern Region, 207 wounded who received gunshot wounds penetrating the chest were examined. The wounded were divided into 2 groups depending on the operational tactics used. The main group of 97 wounded who were treated using modern video endoscopic technology and magnetic surgical instruments. The comparison group consisted of 110 wounded who received traditional treatment. Results and their discussion. Using video endoscopic technologies and magnetic surgical instruments during surgery, 42 (54.5%) in the main group were removed, in the comparison group — 23 (27.4%) foreign bodies. The amount of surgery should not exceed the amount of damage that minimizes surgical trauma. The article presents indications and contraindications to the removal of foreign bodies of pulmonary origin. The differential approach allows to determine the surgical tactics depending on the location of the foreign body, its size and the fit of foreign bodies to the vessels, bronchi, mediastinum. Adherence to the rules of removal of foreign bodies of the lung, depending on the location of its location and size leads to a decrease in inappropriate surgical interventions and postoperative complications. Conclusions. 1. The distribution of foreign bodies by location and size allows you to clearly determine the tactics of treatment and avoid postoperative complications. 2. Surgical interventions to remove foreign bodies should be performed in the first days after stabilization of the patient’s condition using minimally invasive technologies.

scholarly journals Сучасні підходи до хірургічного лікування хворих на генералізова- ний пародонтит із використанням дентальних імплантатів

2017 ◽  
Author(s):  
H. B. Prots ◽  
V. P. Piuryk
Keyword(s):  
Postoperative Complications ◽  
Bone Tissue ◽  
Surgical Intervention ◽  
Positive Development ◽  
Duration Of Treatment ◽  
Surgical Interventions ◽  
Periodontal Tissues ◽  
Dental Implantation ◽  
Simultaneous Surgery

The main postulate of periodontal treatment is the elimination of factors injuring periodontal disease, creating conditions for the normalization of its properties. Structures with additional supports on the intraosseous implants are optimal for orthopaedic treatment. The possibilities and conditions for surgical intervention on periodontal tissues and implantation in patients with varying severity of chronic GP were generally poorly understood.The aim of the study – to improve the treatment of patients with partial edentia and chronic generalized periodontitis by including dental implantation to the complex of therapeutic measures.Materials and Methods. There are presented the results of 360 patients with varying severity degrees of generalized periodontitis who underwent surgery on periodontal tissues with dental implantation.Results and Discussion. Our research showed that implantation in patients with mild generalized periodontitis can achieve consistently good results regardless the method of treatment. Simultaneous surgery on periodontal tissues and the dental implantation shortens treatment duration in 1.5–2 times without compromising its quality. It is shown that in patients with moderate and severe degrees of generalized periodontitis it is appropriate to perform periodontal surgery separately followed by dental implantation to prevent postoperative complications and implant loss. When planning for dental implants and periodontal surgical intervention it is necessary to determine the quality of bone remodeling to assess the structural and functional state of bone tissue and differentiated destination osteotropic drugs that promote positive postoperative period.Conclusions. Therefore, in order to increase the effectiveness of dental implantation and surgical periodontal intervention, bone remodelling markers should be determined to assess the structural and functional status of bone tissue and for the differentiated use of osteotropic drugs, which will contribute to the positive development of the postoperative period. Simultaneous surgical intervention on periodontal tissues and dental implantation in 1.5–2 times reduces the duration of treatment without reducing its quality. In patients with moderate to severe degrees, it is expedient to carry out surgical interventions with subsequent dental implantation in order to prevent postoperative complications and loss of implants.

scholarly journals PROVISION OF SURGICAL SAFETY

2017 ◽  
Vol 176 (2) ◽  
pp. 83-85 ◽  
Author(s):  
V. M. Timerbulatov ◽  
Sh. V. Timerbulatov
Keyword(s):  
Postoperative Complications ◽  
Temperature Control ◽  
Thromboembolic Complications ◽  
Surgical Safety ◽  
Who Checklist ◽  
Operating Unit

OBJECTIVE. The research assessed the efficacy of WHO checklist for prevention of avoidable complications in surgery. MATERIALS AND METHODS. The article presents the results of implementation of WHO recommendations (checklist of measures) for prevention of so-called avoidable complications in surgery during performance of 35300 operations in 3-year period. The authors included two additional issues in the checklist about prevention of thromboembolic complications and temperature control in the operating unit. RESULTS. The number of preventable complications decreased in clinic after the implementation of WHO recommendations. The rate of thromboembolic and different postoperative complications also reduced in comparison with other clinic, where these recommendations haven’t been applied. CONCLUSIONS. The introduction of principles of prevention of complications in surgery according to WHO recommendations allowed significant decrease of the number of avoidable complications.

ENDOVASCULAR AND OPEN SURGICAL OPERATIONS OF CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES

Vestnik ◽  
2021 ◽  
pp. 304-312
Author(s):  
Д.Д. Поцелуев ◽  
С.Е. Турсынбаев ◽  
Р.А. Сапарбаев ◽  
Е.А. Асылбеков ◽  
С.А. Илиев ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Comparative Analysis ◽  
Vascular Surgery ◽  
Lower Extremities ◽  
Clinical Results ◽  
Main Section ◽  
Critical Ischemia ◽  
Surgical Interventions ◽  
Surgical Operations

В отделении сосудистой хирургии на протяжении 40 лет (с 1972 по 2012 гг.) было выполнено 9800 открытых операций у больных с КИНК II-IIIст, клинические результаты которых представлены в соответствующем разделе статьи для сравнительного анализа. В основном разделе работы рассматриваются результаты эндоваскулярных хирургических и открытых операций, выполненных у 1088 больных с критической ишемией нижних конечностей II-IIIст (КИНК) и сахарным диабетом (СД). Проведен сравнительный анализ показателей частоты ампутаций при открытых и эндоваскулярных хирургических вмешательствах (ЭХВ). Установлено преимущество ЭХВ в сравнении с открытыми операциями на основании снижения числа ампутаций после выполненных ЭХВ соотвественно с 52,3% до 3,5%. In the department of vascular surgery, for 40 years (from 1972 to 2012), 9800 open operations were performed in patients with CLI II-IIIst, the clinical results of which are presented in the corresponding section of the article for comparative analysis. The main section of the work examines the results of endovascular surgical and open operations performed in 1088 patients with critical ischemia of the lower extremities II-IIIst (CLI) and diabetes mellitus (DM). A comparative analysis of indicators of the frequency of amputations during open and endovascular surgical interventions (ECS) was carried out. The advantage of ECV in comparison with open operations was established on the basis of a decrease in the number of amputations after ECV performed, from 52.3% to 3.5%, respectively.

scholarly journals Surgical Rehabilitation of Patients with Atypical Anatomical and Functional States after Radical Organ-Preserving Operations for Non-Tumour Colon Diseases

2018 ◽  
pp. 38-43
Author(s):  
V. M. Melnyk ◽  
O. I. Poida ◽  
Abdulrakhman Abdul Kadir
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Surgical Intervention ◽  
Modern Society ◽  
Functional Results ◽  
Pathological Conditions ◽  
Functional States ◽  
Colon Diseases ◽  
Radical Reconstruction ◽  
Surgical Operations

The aim of the work: to demonstrate modern possibilities and ways of providing rehabilitation of patients after radical surgical treatment of non-tumour colon diseases with available non-typical anatomical and functional states. Materials and Methods. The system of surgical rehabilitation measures was developed, which was used in 32 patients with available atypical anatomical and functional states after radical organ-preserving operations in non-tumour colon diseases. They are aimed at implementing sufficiently radical, reconstruction and restoration operations, forecasting and preventing postoperative complications, improving functional results, reducing the incidence and severity of severe forms of diarrhea and postcolectomy syndromes. Results and Discussion. In 2 (6.3 %) patients there were complications due to the implementation of reconstruction and restoration stage of surgical intervention. They led to the necessity of extirpation of the anal canal fistula, removal of ileoendoanal anastomosis, and the formation of a lifelong ileostomy. In 30 (93.7 %) patients, favourable functional results were obtained, and a significant level of surgical and social work rehabilitation was achieved. A significant level of rehabilitation of operated patients was achieved through the implementation of sufficiently radical and developed reconstruction and restoration operations that prevented the relapse of the disease, the emergence of pathological conditions caused by the removal of the large intestine; prognostication and purposeful prevention of severe postoperative complications, stage monitoring of the condition of operated patients. Conclusions. 1. Surgical rehabilitation of patients operated for serious non-tumour colon diseases is a complex of organizational and therapeutic and prophylactic means aimed at returning to a society of a citizen sufficiently adapted to the conditions of modern society. Surgical rehabilitation of patients with atypical anatomical and functional states in the radical surgical treatment of non-tumour colon diseases requires further improvement of surgical treatment methods and lifelong monitoring of the condition of operated patients. 3. Performing sufficiently radical surgical operations, developing new reconstruction and rehabilitation operations for existing non-typical anatomical and functional states contributed to the provision of favourable functional results, a significant level of surgical and social and labour rehabilitation in 93.7% of patients.

scholarly journals Technique for Spleen Resection Using Radiofrequency Ablation

2021 ◽  
pp. 1-7
Author(s):  
Ionkin Dmitry ◽  
Ionkin Dmitry ◽  
Stepanova Yulia Aleksandrovna ◽  
Alimurzaeva Maksalina Zakaryaevna ◽  
Vishnevsky Vladimir Aleksandrovich
Keyword(s):  
Comparative Analysis ◽  
Radiofrequency Ablation ◽  
Blood Loss ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Spleen Tissue ◽  
Surgical Interventions ◽  
National Medical ◽  
A New Technique

From modern positions, removal of the spleen is undesirable due to the risk of post-splenectomy syndrome development, where first of all, the clinical manifestations of the syndrome of suppressive post-splenectomy infections are taken into account, which justifies either performing organ-preserving surgical interventions on the spleen, or heterotopic autotransplantation of spleen tissue. Spleen resection is accompanied by significant blood loss, both during the intervention and in the postoperative period. The various methods of prevention of bleeding (clips, coagulation instruments, local hemostatics, etc.) are not always effective. Currently, there have been reports of the possibility of using radiofrequency ablation (RFA) in interventions on the spleen. The literature data and own 10 observations of spleen resection with the use of RFA in patients with focal organ lesions are presented. All described in literature technologies use the Rita® device for RF destruction and the corresponding attachment, which consists of 4 needle active electrodes. The spleen parenchyma is "burned" blindly, and the organ parenchyma is divided in the middle, between the treated injections. A new technique for performing spleen resection using radiofrequency ablation has been proposed at A.V. Vishnevsky National Medical Research Center of Surgery. The essence of our proposed method for minimizing blood loss during spleen resection is as follows: RFA-exposure is carried out along the zone of organ ischaemia under the control of ultrasound. For RFA, we used a Radionics Cool-Tip® Ablation System and a set of water-cooled electrodes (MEDTRONIC, USA). The features of the surgical intervention are noted. No bleeding was noted either intraoperatively or in the postoperative period in any case. A comparative analysis of the results of various methods of organ-saving surgical treatment is presented.

scholarly journals CLINICAL AND ECONOMIC EFFICIENCY OF LAPAROSCOPIC OPERATIONS IN EMERGENCY ABDOMINAL SURGERY IN CHILDREN

2019 ◽  
Vol 21 (3) ◽  
pp. 182-187
Author(s):  
Elena Yu. Dyakonova ◽  
I. V. Kirgizov ◽  
I. V. Poddubny ◽  
T. M. Glibina ◽  
S. P. Yatsyk ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Abdominal Cavity ◽  
Pain Syndrome ◽  
Surgical Pathology ◽  
Early Recovery ◽  
Surgical Interventions ◽  
Excellent Cosmetic Result ◽  
Emergency Abdominal Surgery ◽  
Surgical Operations

The data of the analysis of the efficacy of the use of laparoscopic operations in comparison with open surgical interventions for ten years in 8462 children with the acute surgical pathology of the abdominal cavity on the basis of an emergency surgical hospital are presented. Laparoscopic operations were performed in 4984 (59%) patients, and open surgical operations were performed in 3478 (41%) patients. In the treatment of acute surgical pathology in children, laparoscopic operations have been established to provide: low traumatic operative access and manipulation; visual control of all stages of the operation; relief of pain syndrome and intestinal paresis; early recovery of impaired functions and the patient activity; decline in the number of postoperative complications, the prevalence of adhesions; significant reduction in the length of stay in the hospital; excellent cosmetic result. The authors showed the execution of laparoscopic surgical interventions to be economically more profitable if compared with open operations in children.

scholarly journals SURGICAL TREATMENT OF CHRONIC RECURRENT HEMATOGENOUS OSTEOMYELITIS

2019 ◽  
pp. 48-51
Author(s):  
А. М. Shamsiev ◽  
S. S. Zayniev
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Satisfactory Result ◽  
Inpatient Treatment ◽  
Surgical Intervention ◽  
Control Group ◽  
Basic Group ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
Duration Of Disease

SUMMARY. According to the WHO data, the acute hematogenous osteomyelitis becomes chronic in 20–60 % of patients. The aim – to improve the results of surgical treatment of chronic recurrent hematogenous osteo­myelitis (CRHO) by optimizing the surgical intervention. Material and Methods. 180 patients with CRHO were involved (from 1995 to 2016), average age was (15.5±5.9) years, the ratio of boys and girls was 2.3/1. The duration of disease in 63.3 % of patients exceeded 4 years, including 12.8 % – 10 years. All patients were divided into two clinical groups: the control group consisted of 74 (41.1 %) – patients who received traditional surgical treatment from 1995 to 2003 (local sequesternecrectomy in the zone of greatest lesion). The basic group of patients consisted of 106 (58.9 %) patients who underwent surgical treatment in the period from 2004 to 2016 according to the developed methodology (a technique of extended sequesternecrectomy with recanalization of the affected bone). Results. The proposed tactics of surgical treatment of CRHO allowed to statistically significantly reduce the frequency of wound purulent complications from 20.3 to 3.8 %, reduce the overall duration of inpatient treatment (from (31.2±2.1) to (21.9±0.6) days) and the duration of stay in the clinic in the postoperative period (from (18.3±0.9) to (14.9±0.35). Special questionnaire for assessment of the distant results of surgical treatment of CRHO, demonstrated good results in the main group in 97.7 %, in the control group – only in 34.7 % of cases. A satisfactory result in the basic group was in 1 (1.2 %) patient, while in the control group there were 32.7 %. The number of unsatisfactory results in the basic group was significantly lower (1.2 %) than in the control group (32.7 %). Conclusions. Comparative analysis of the outcomes of CRHO treatment showed that the developed tactics of surgical treatment allowed reducing the recurrence rate of the disease from 32.7 % to 1.2 % and in 98.9 % of patients getting good and satisfactory results.

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