scholarly journals Surgery of hypertensive intracranial hematomas using one-portal mini-access and video endoscopic assistance

2021 ◽  
Vol 27 (5) ◽  
pp. 562-571
Author(s):  
P. A. Svyatochevsky ◽  
D. A. Gulyaev ◽  
I. V. Chistova ◽  
T. V. Shchukina ◽  
E. Y. Vasiliev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Disease Onset ◽  
Complete Recovery ◽  
Intracerebral Hematoma ◽  
Rapid Improvement ◽  
Median Volume ◽  
Intracranial Hematomas ◽  
Endoscopic Assistance ◽  
Hypertensive Intracerebral Hemorrhage

Background. Hypertensive intracranial hemorrhage is an extremely serious complication of hypertension, which accounts for 10 % to 20 % of all cerebral strokes. About 50 % patients die within the next year, and their 5-year survival rate does not exceed 30 %. Objective. To study the effectiveness of surgical treatment of hypertensive intracranial hematomas using one-portal mini-access and video endoscopic assistance. Design and methods. The study included 23 patients with supratentorial intracerebral hypertensive hematomas aged 26 to 70 years (median age 55 (50; 61) years). All patients underwent one-portal endoscopic surgery. The median volume of intracerebral hematoma, calculated according to the Tada formula, was 50 (40; 60) ml. The comparison group included 28 patients who received conservative treatment. The dynamics of the severity was assessed using the Glasgow Coma Scale (GCS), NIHSS, Rankin, Rivermead scales upon admission to the hospital, on days 3 and 7 of treatment, at discharge for outpatient treatment, and after 6 months.Results. There were no lethal outcomes in either the main group or the comparison group. The hematoma was removed totally in all patients, which was accompanied by a rapid improvement of general cerebral symptoms and, as a consequence, an increase in GCS values from 13 (12; 14) to 13 (12; 15) points by 3rd day after the disease onset. By the 7th day, there was a slow positive dynamic in both groups, however, all patients still had a pronounced or severe disability according to the Rankin scale. After 6 months, patients who underwent surgical treatment showed faster and more complete recovery. Conclusions. The results of the study are consistent with current worldwide data on the effectiveness of modern endoscopic technologies in patients with hypertensive intracerebral hemorrhage in relation to the rate and degree of regression of neurological loss.

MANAGEMENT OF MULTIPLE TRAUMATIC INTRACRANIAL HEMATOMAS

2020 ◽  
Vol 3 (1) ◽  
pp. 70-74
Author(s):  
Rustam Hazratkulov ◽  
Keyword(s):  
Traumatic Brain Injury ◽  
Surgical Treatment ◽  
Brain Injury ◽  
Hospital Stay ◽  
Treatment Outcomes ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Diagnostic Approach ◽  
Early Activation ◽  
Intracranial Hematomas

Multiple traumatic hematomas (MG) account for 0.74% of all traumatic brain injuries. A comprehensive diagnostic approach to multiple traumatic intracranial hematomas allows to establish a diagnosis in the early stages of traumatic brain injury and to determine treatment tactics. A differentiated approach to the choice of surgical treatment of multiple hematomas allows to achieve satisfactory results and treatment outcomes, which accordingly contributes to the early activation of the patient, a reduction in hospital stay, a decrease in mortality and disabilityin patients with traumatic brain injury

Acute Otitis Media and Facial Paralysis in Children

1996 ◽  
Vol 105 (1) ◽  
pp. 58-62 ◽  
Author(s):  
Clark A. Elliott ◽  
George H. Zalzal ◽  
Wendy R. Gottlieb
Keyword(s):  
Facial Nerve ◽  
Otitis Media ◽  
Facial Paralysis ◽  
Acute Otitis Media ◽  
Complete Recovery ◽  
Rapid Improvement ◽  
Nerve Decompression ◽  
Complete Paralysis ◽  
Prolonged Recovery ◽  
Facial Nerve Decompression

We reviewed 10 children who presented with facial paralysis after the onset of acute otitis media. The objective of the study was to examine the outcome of facial paralysis in children with acute otitis media treated without facial nerve decompression. Two groups were identified: 8 patients with incomplete paralysis and 2 with complete paralysis. Seven of the 8 patients with incomplete paralysis had rapid return of function after myringotomy and intravenous antibiotics. The eighth patient had delayed recovery requiring 9 months before complete return of function. The 2 patients with complete paralysis required mastoidectomy to control otorrhea and fever after initial myringotomy and antibiotics. Both patients had a prolonged recovery requiring 3 and 7 months for complete recovery. Patients with incomplete paralysis generally show rapid improvement following wide myringotomy and antibiotic treatment. A more protracted recovery may be expected in patients with complete paralysis; excellent return of function is expected when mastoidectomy without facial nerve decompression is employed.

New possibilities of the use of surgical lasers in obstetrics

1997 ◽  
Vol 78 (6) ◽  
pp. 434-438
Author(s):  
I. F. Fatkullin
Keyword(s):  
Surgical Treatment ◽  
High Risk ◽  
Postoperative Complications ◽  
Cesarean Section ◽  
Laser Welding ◽  
Comparison Group ◽  
Obstetrics And Gynecology ◽  
Septic Complications ◽  
Basic Group ◽  
Section Operation

The laser welding suture of peritoneum in pregnants and in women in labor with high risk of pyo-septic complications is used in cesarean section operation. In the basic group the postoperative complications are three times as little than in the comparison group. The promise of the use of the biological laser @welding@ in obstetrics and gynecology to improve technology and results of surgical treatment especially in delivery of women with high risk of pyo-septic complications is noted.

Differential diagnosis of chiasmal-cellular cyst

2020 ◽  
pp. 47-59
Author(s):  
Nikita Sergeevich Puzakov ◽  
Vladislav Yurievich Cherebillo ◽  
Ilya Aleksandrovich Tregubenko ◽  
Evgeniy Igorevich Kozak ◽  
Yuliya Igorevna Ryumina
Keyword(s):  
Surgical Treatment ◽  
Pituitary Adenomas ◽  
Comparison Group ◽  
Clinical Symptoms ◽  
Differential Diagnostics ◽  
Diagnostic Features ◽  
Accurate Preoperative Diagnosis ◽  
Colloid Cysts ◽  
Surgical Tactics ◽  
Cellular Area

The clinical symptoms of chiasmal-cellular formations are similar, which significantly complicates its differential diagnostics. The differential diagnostics of chiasmal-cellular cysts, which include colloid cysts, arachnoid cysts, Rathke’s pouch cysts, epidermoid and dermoid cysts, is especially difficult. Nevertheless, an accurate preoperative differential diagnostics of chiasmal-cellular cysts is an important stage of preparation for surgical treatment, which allows determining the surgical tactics in advance, because each group of chiasmal-cellular cysts has its own features of surgical treatment, which significantly reduce the number of complications and minimize the number of recurrences. This study intended to improve the efficiency of diagnostics of the chiasmal-cellular cysts by determining the criteria for its differential diagnostics. 94 patients with chiasmal-cellular cysts and pituitary adenomas were examined and treated in the period of 2009 and 2018 for this purpose. As the most frequent pathology of the chiasmal-cellular area, pituitary adenomas were selected as a comparison group due to the fact that it is often necessary to differentiate chiasmal-cellular cysts with this pathology. Patients were divided into 5 groups according to the nosology of the disease. Clinical picture, laboratory analysis and MRI data were studied in each group. Statistical analysis and comparison of the data obtained among all groups were performed, and it allowed to determine the distinctive diagnostic features incidental to each group. It is possible to make an accurate preoperative diagnosis based on the specific features of differential diagnostics.

Surgical treatment of patients with deep infiltrating endometriosis of the rectovaginal septum

2021 ◽  
Vol 20 (4) ◽  
pp. 5-11
Author(s):  
E.A. Galliamov ◽  
◽  
L.N. Aminova ◽  
V.A. Alimov ◽  
A.G. Kozub ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Comparison Group ◽  
Chronic Pelvic Pain Syndrome ◽  
Main Group ◽  
Pelvic Pain Syndrome ◽  
Deep Infiltrating Endometriosis ◽  
Rectovaginal Septum ◽  
Infiltrating Endometriosis

Objective. To optimize the tactics of surgical treatment of deep infiltrating endometriosis of the rectovaginal septum, including with bowel involvement. Patients and methods. The study included 122 patients diagnosed with deep infiltrating endometriosis of the rectovaginal septum, who underwent surgical interventions of different volumes using laparoscopy. The patients were divided into a main group and a comparison group. The main group consisted of 92 patients with deep infiltrating endometriosis of the rectovaginal septum who underwent surgical treatment using the original technique of systematic approach; the comparison group consisted of 30 patients who were operated using the generally accepted technique. Results. There was a statistically significant decrease in the operation duration, intraoperative blood loss, as well as more effective relief of dysmenorrhea and chronic pelvic pain syndrome, less complications and relapses in the main group compared to the comparison group. In addition, it was found that the combination of three symptoms such as dysmenorrhea, dyspareunia and chronic pelvic pain increase the likelihood of deep infiltrating endometriosis up to 93%. Conclusion. Based on the results obtained, the proposed method of surgical treatment of deep infiltrating endometriosis is more efficient and safer in comparison with the generally accepted technique, which can be considered as a valid reason for its wide introduction into clinical practice. Key words: deep infiltrating endometriosis, bowel endometriosis, surgical treatment of endometriosis, treatment algorithm

scholarly journals Surgical treatment of peripheral hepatic cholangiocarcinoma with a visceral vein invasion

2020 ◽  
Vol 87 (7-8) ◽  
pp. 3-9
Author(s):  
О. Yu. Usenko ◽  
О. V. Hrynenko ◽  
А. І. Zhylenko ◽  
О. О. Popov ◽  
А. V. Husiev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hepatic Resection ◽  
Comparison Group ◽  
Postoperative Mortality ◽  
Late Results ◽  
Peripheral Cholangiocarcinoma ◽  
Group A ◽  
Comparative Group ◽  
Biliary Ducts ◽  
Clinically Significant

Objective. To estimate the immediate and late results of surgical treatment in patients, suffering peripheral cholangiocarcinoma with invasion of visceral vein. Маterials and methods. Retrospective analysis was accomplished for surgical treatment of 84 patients, suffering peripheral cholangiocarcinoma, in whom radical operations were performed in Department of Transplantation and Hepatic Surgery of Shalimov National Istitute of Surgery and Transplantology in a period from Jan. 2004 tо Dec. 2018 yrs. The investigated group consisted of 28 patients, to whom hepatic resection with simultant resection and plasty of visceral veins for tumoral vascular invasion was performed. Into comparison group 56 patients were included, in whom hepatic resection was not accompanied with vascular resection. Results. Trustworthy differences were absent between groups in accordance to following indices: the patients’ age (p=0.16-0.7), gender (p=0.3), physical status (p=0.36), pre- and postoperative stationary stay (p=0.4). In the investigated group there were performed 14.3% hemihepatectomies, 32.1% extended hemihepatectomies and 53.6% threesectioectomies, and in a comparative one - 57.2% (р ≤ 0.001), 14.3% (р = 0.054) and 21.4% (р = 0.002), accordingly. Simultant intervention on biliary ducts was done in 37.5% patients from investigated group and in 25% patients from comparative group (р = 0.305), the adjacent organs resection - in 14.3 and 12.5% (р = 0.819) patients, accordingly. Clinically significant postoperative complications were observed in 25 and 30.4% (р = 0.262) patients, accordingly. In the investigated group postoperative mortality was absent, while in a comparative one it constituted 3.5%. In the investigated group a 3-years and a 5-years total survival was noted in 47 and 35% patients, accordingly, while in a comparison group - in 49% (р = 0.317) and 38% (р = 0.003) patients, accordingly. In investigated group a 3-years and a 5-years survival without a recurrence was noted in 39 and 28% patients, accordingly, and in a comparative group - in 44% (р = 0.04) and 31% (р=0.002) patients, accordingly. Conclusion. Іnvasion of peripheral cholangiocarcinoma into visceral veins does not constitute a contraindication for operative treatment, if it is conducted in a highly specialized multidisciplinary centre.

scholarly journals Rehabilitation Methods after Surgical Treatment of the Static Foot Deformities

2017 ◽  
Vol 10 (1) ◽  
pp. 54-63
Author(s):  
Denis Vladimirovich Ilchenko ◽  
Andrey Aslanovich Kardanov ◽  
Aleksandr Sergeevich Karandin ◽  
Andrey Vadimovich Korolev
Keyword(s):  
Surgical Treatment ◽  
Manual Therapy ◽  
Physical Training ◽  
Contemporary Literature ◽  
Recovery Process ◽  
Complete Recovery ◽  
Foot Deformities ◽  
Rehabilitation Process ◽  
Operative Recovery

Background The issue of rehabilitation after surgical treatment of the foot deformities is not sufficiently covered in the contemporary literature. In spite of diversity of certain approaches used in the rehabilitation process, there is no consistency in their application. In addition, there is no consensus on the effectiveness of various techniques, on the quantity and quality of the procedures and the timing of their introduction in the rehabilitation process. The objective of this article is to analyze the effectiveness of the techniques used in the rehabilitation of patients after surgical treatment of the foot deformities. Methods The article describes methods that are, in our opinion, the most effective and well-established in the post-operative recovery of patients. The  principles of complex usage of conservative treatment methods, including lymph drainage massage, manual therapy and therapeutic physical training, are covered. Results The introduction of the protocols we have developed in the rehabilitation of patients after surgical treatment of the foot deformities helped to organize the recovery process, to clarify the timing of rehabilitation measures, to improve the final result of treatment. Conclusions The use of pathogenetically justified methods of rehabilitation, which include massage, manual therapy and therapeutic physical training, promotes the most rapid and complete recovery of motor functions in patients after surgical treatment of the foot deformities.  

THE USE OF THORACOPLASTY IN THE TREATMENT OF DESTRUCTIVE PULMONARY TUBERCULOSIS

2021 ◽  
pp. 18-28
Author(s):  
Andrey V. Ivanov ◽  
Alexey A. Malov ◽  
Vadim A. Kichigin ◽  
Vasily A. Ivanov ◽  
Larisa V. Tarasova
Keyword(s):  
Drug Resistance ◽  
Body Weight ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Pulmonary Tuberculosis ◽  
Comparison Group ◽  
Main Group ◽  
Negative Reaction ◽  
Normal Body ◽  
Normal Body Weight

Despite a decrease in the incidence of pulmonary tuberculosis in the Russian Federation in recent years, among the newly diagnosed patients there remains a significant proportion of patients with bacterial excretion and destructive pulmonary tuberculosis. In patients with destructive pulmonary tuberculosis, surgical treatment is often the only possible method for saving lives. We studied the results of extrapleural posterosuperior thoracoplasty in 42 patients with destructive pulmonary tuberculosis. The comparison group consisted of 30 patients who received medicamentous therapy. The mortality rate for 3 years of follow-up in the conservative treatment group was 36.7%, in the surgical treatment group it was 23.8%, p = 0.237. Among patients with more than 2 years of disease experience, mortality was 45% in the main group, 88% in the comparison group, p = 0.070. In the absence of drug resistance, mortality in the main group was 4%, that in the comparison group – 14.2%, p = 0.283. Mortality in individuals with normal body weight was lower in the group of patients who underwent thoracoplasty than in the comparison group: 17.6% vs. 33.3% (p = 0.202). Among those who did not achieve sputum negative reaction, mortality was lower, and passing to the 3rd group of dispensary care was more common in the surgical treatment group – 41.7% vs. 71.4% (p = 0.077) and 33.3% vs. 21.4% (p = 0.426). Among patients with drug resistance or low body weight or unachieved sputum negative reaction, mortality rates were comparable in both groups. Thus, thoracoplasty, in comparison with conservative therapy, makes it possible to improve treatment results in patients regardless of the length of the disease in groups with Mycobacterium tuberculosis sensitive process, with normal body weight, with preservation of elimination of bacilli. The effectiveness of thoracoplasty decreases in patients with an increase in the disease duration.

scholarly journals Anconeus Epitrochlearis Muscle as a Cause of Ulnar Nerve Compression at the Elbow

2017 ◽  
Vol 36 (03) ◽  
pp. 190-193
Author(s):  
Luiz Cannoni ◽  
Luciano Haddad
Keyword(s):  
Surgical Treatment ◽  
Ulnar Nerve ◽  
Complete Recovery ◽  
Nerve Entrapment ◽  
Ulnar Nerve Compression ◽  
Left Hand ◽  
Ulnar Nerve Entrapment ◽  
Compressive Neuropathy ◽  
Tunnel Syndrome ◽  
Magnetic Resonance Imaging Mri

AbstractUlnar nerve entrapment is the second most common compressive neuropathy in the upper limb, after carpal tunnel syndrome (Dellon, 1986). One of the causes that must be considered is the accessory anconeus epitrochlearis muscle, which is present in 4% to 34% of the general population (Husarik et al, 2010; Vanderpool et al, 1968; Nellans et al, 2014).We describe a patient with symptoms of compression of the left ulnar nerve at the elbow and the result of the surgical treatment.The patient presented with hypoesthesia in the fourth and fifth fingers of the left hand, and reduction of strength in the fifth finger abduction. No alterations were found in the thumb adduction.Initially, the treatment was conservative (splint, physiotherapy, analgesics); surgical treatment was indicated due to the continuity of the symptoms.The ulnar nerve was surgically released and transposed, with complete recovery after 6 months of follow-up.Ulnar nerve entrapment at the elbow by the anconeus epitrochlearis muscle is not common, but it must not be ignored (Chalmers, 1978). Ultrasonography (Jung et al, 2013; Bargalló et al, 2010), elbow magnetic resonance imaging (MRI) (Jeon, 2005), and electromyography (Byun, 2011) can help establish the proper diagnosis.

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