scholarly journals Pain syndrome after laparoscopic cholecystectomy

2016 ◽  
Vol 10 (4) ◽  
pp. 262-272
Author(s):  
Sergey V. Sviridov ◽  
I. V Vedenina ◽  
S. D Taylor
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Gold Standard ◽  
Pain Syndrome ◽  
Calculous Cholecystitis

Laparoscopic cholecystectomy is the «gold» standard for the surgical treatment of patients with calculous cholecystitis. It is believed that laparoscopic cholecystectomy is not only safe, but also is painless in the postoperative period. At the same time the pain syndrome after laparoscopic cholecystectomy may be very serious. The article discusses the formation and localization of the pain syndrome, diagnostics and pharmacotherapy of the pain syndrome after laparoscopic cholecystectomy.

scholarly journals Optimization of management of patients with coloproctological profile in outpatient surgical treatment of hemorrhoids

2020 ◽  
Vol 37 (2) ◽  
pp. 93-100
Author(s):  
A. L. Lisichkin ◽  
Yu. B. Busyrev ◽  
T. I. Karpunina
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Postoperative Bleeding ◽  
Pain Syndrome ◽  
Test System ◽  
Interleukin 4 ◽  
Enzyme Linked Immunosorbent Assay ◽  
Outpatient Basis ◽  
Local Inflammation ◽  
Hemorrhoidal Artery Ligation

Objective. Various aspects of the organization and optimization of diagnosis and treatment, including surgical, in patients with hemorrhoids one of the most common diseases in coloproctology are still the subject of discussion. Problems of the postoperative period can be prolonged spasm of anal sphincter, severe pain syndrome and delayed postoperative bleeding. Materials and methods. We conducted a one-center prospective study in 214 patients, undergoing surgical treatment for stage 34 chronic hemorrhoids. The most common surgery for hemorrhoids was a different combination of hemorrhoidal artery ligation (HAL), rectomucopexy (RAR) and excision of one to three external hemorrhoids in one and the same patient. In all the observations, we used a specially developed questionnaire, including a visual-analog scale (VAS) and registration of taking anesthetiсs per day, so as to objectify the assessment of the level of pain after surgery. Identification of local inflammation included taking a blood sample in an amount of 0.1 ml when punctured with a GU insulin syringe during anoscopy and enzyme-linked immunosorbent assay in accordance with test system instructions and determining interleukin 1 (IL-1), interleukin 4 (IL-4), tumor necrosis factor (FNO-) and interleukin 8 (IL-8). Results. According to the results obtained (severity of pain syndrome and amount of anesthetics, absence of complications), patients were conditionally divided into three groups with mild reaction to surgery 44 (20.5 %), moderate 100 (46.5 %) and severe 70 (32.5 %). In the group with mild reaction, the level of the analyzed indices was almost consistent with the norm; in group II, there was an elevation of two of them; in group III, the level of at least three tests was higher than the norm. Conclusions. More favorably, the postoperative period proceeds against the background of initially unexpressed local inflammation. The proposed additional examination method, which allows identifying subclinical local inflammation and assessing its severity, should help to optimize the selection and, as a result, increase the efficiency and safety of surgical treatment of hemorrhoids on an outpatient basis.

Features of the course of postoperative period during surgical treatment laparotomic and laparoscopic access to gynecological diseases in women with extragenital pathology

2017 ◽  
pp. 111-115
Author(s):  
V.V. Kostikov ◽  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Clinical Laboratory ◽  
Pain Syndrome ◽  
Abdominal Pressure ◽  
Laboratory Assessment ◽  
Gynecological Diseases ◽  
Case Rate ◽  
A Current ◽  
Gynecologic Patients

The objective: tactics definition postoperative period at surgical treatment of gynecologic patients with extragenital pathology. Patients and methods. Research included 240 patients who stayed on treatment in a hospital and were operative concerning diseases of internal genitals laparotomical and laparoscopic accesses. All patients had an extragenital pathology. Depending on operation access all patients were divided into two groups. The main group was made by 120 patients who were operated by laparoscopic access. The group of comparison was made by 120 patients whom was operative laparotomical access. Everything patients carried out a clinical-laboratory assessment of a current of the postoperative period. Results. Results of the conducted researches testify that at the compensated accompanying cardiovascular and pulmonary diseases, a diabetes mellitus and an obesity at gynecologic patients at identical gynecologic and extragenital pathology laparoscopic access is more preferable since takes less time, is less travmatical and morbid, is accompanied by a smaller hemorrhage in comparison with the laparotomical. Aftertreatment after laparoscopic operations takes less time that is bound to existence of less expressed pain syndrome, lack of disturbance of function of an intestine, faster restoration of a physical activity and thereof in the smaller postoperative afternoon. At the same time rising of intra abdominal pressure and the provision of Trendelenburg negatively affect hemodynamic indicators at patients with cardiovascular diseases though it doesn’t lead to a decompensation of activity of cardiovascular system. Conclusion. Tactics of maintaining the postoperative period at gynecologic patients with extragenital pathology depends on character of a somatic case rate, option quick to access, a hemorrhage and results of clinical-laboratory inspection. Key words: gynecologic operations, laparotomy, laparoscopy, postpoerative period.

scholarly journals THE USE OF MATHEMATICAL MODELING TO DETERMINE THE ANGLE OF SPATIAL ORIENTATION OF THE VIEWING LAPAROSCOPY DURING CHOLECYSTECTOMY

2018 ◽  
Vol 11 (4) ◽  
pp. 237-241
Author(s):  
Yulia Sergeevna Musina ◽  
Olga Borisovna Nuzova ◽  
Natalia Ivanovna Kolosova ◽  
Ilya Iosifovich Kagan
Keyword(s):  
Mathematical Modeling ◽  
Laparoscopic Cholecystectomy ◽  
Spatial Orientation ◽  
Gold Standard ◽  
Inpatient Treatment ◽  
Abdominal Cavity ◽  
Rational Approach ◽  
Important Condition ◽  
Optimal Angle ◽  
Calculous Cholecystitis

Relevance. Treatment of patients with calculous cholecystitis is an important task of modern surgery. Laparoscopic cholecystectomy become the "gold standard" for the treatment of cholelithiasis. The safety of laparoscopic cholecystectomy can be ensured by rational approach to the placement of laparaports. The aim of the study is to improve the results of laparoscopic cholecystectomy on the basis of determining the optimal angle of spatial orientation of the viewing laparoscope during cholecystectomy with the help of mathematical modeling. Materials and methods. Clinical studies were based on data of 122 patients with acute and chronic calculous cholecystitis who underwent endovisual analysis of anatomy of the structures and organs of the upper sector of abdominal cavity, depending on the spatial orientation of the viewing laparoscope during cholecystectomy. Results. As result of the multiple regression analysis, there has been developed the model that makes it possible to calculate the optimal angle of spatial orientation of the viewing laparoscope during cholecystectomy, which is important for preventing complications and improving the results of laparoscopic cholecystectomy. Сonclusion. Using the obtained model, it is possible to determine the optimal angle of spatial orientation of the viewing laparoscope for cholecystectomy, which is an important condition for improving the results of laparoscopic cholecystectomy and for the prevention of complications. The above model makes it possible to reduce the duration of inpatient treatment and the rebilitation period.

scholarly journals Muscular syndrome manifestations at the patients in the late postoperative period after the herniation of invertebral disk surgical treatment

2008 ◽  
Vol 7 (5-2) ◽  
pp. 448-450
Author(s):  
S. A. Fedyanin
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Spinal Canal ◽  
Pain Syndrome ◽  
Neurological Status ◽  
Resonance Imaging ◽  
Canal Stenosis ◽  
Adjacent Segments ◽  
Ultrasound Investigation ◽  
Late Postoperative Period

Checkup of 215 patients in the late period after the dick herniation surgical treatment. Middle age (45,6 ± 0,6) years. Postoperative period is (7,4 ± 0,4) years. The patients were examined: neurological status, lumbar spine radiography, magnetic resonance imaging procedure, spinal canal ultrasound investigation, muscular syndrome index determination. Revealed pain syndrome caused by the disk herniation relapse in operated and adjacent segments, spondylosis and spondylarthrosis, spinal canal stenosis, aseptic epiduritis. The pain syndrome at those patients entails by development of the muscular syndrome and pathologic motor skill.

scholarly journals The role of reflex-pain syndrome of osteochondrosis and spondyloarthrosis in the results of surgical treatment compressive syndrome offers by disc gerniation (diagnostics and neuron-surgical treatment)

2011 ◽  
Vol 10 (2) ◽  
pp. 73-76
Author(s):  
Ye. B. Kolotov ◽  
R. R. Aminov ◽  
S. V. Yelagin ◽  
V. V. Kelmakov ◽  
Ye. V. Kolotova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Facet Joints ◽  
In Series

To improve the results of surgical treatment the patients with discogenic compressive syndromes. Using the denervation of interbody discs and facet joints in series allow us, first off all, to induce, and then to discontinue the reflex-pain syndrome in 41 patients in preoperational period, and in 39 patients in long-term postoperative period. Good results come to 82,8 и 89,8% (р < 0,05) accordingly.

scholarly journals Comparative estimation of a pain syndrome in patients after combined operations for coexistent pathology of anal channel and rectum with application of modern and standard surgical technologies

2021 ◽  
Vol 88 (5-6) ◽  
pp. 36-41
Author(s):  
V. V. Balytskyy
Keyword(s):  
Surgical Treatment ◽  
Thin Layer ◽  
Radio Wave ◽  
Postoperative Period ◽  
High Frequency ◽  
Pain Syndrome ◽  
Coagulation Necrosis ◽  
Control Group ◽  
Combined Operations ◽  
Frequency Apparatus

Objective. Comparative estimation of the pain syndrome in patients with concomitant pathology of anal channel and rectum after performance of combined operations, using modern high-frequency electro-surgical and radio-surgical apparatuses, as well as conventional scalpel. Materials and methods. The results of surgical treatment of 689 patients with concomitant pathology of anal channel and rectum, using apparatuses of a high-frequency electro-surgery and radio-wave surgery, were analyzed, using the pain syndrome estimation on 1-7th postoperative day. The patients were distributed into 4 investigation groups and a control group, consisting of 112 patients, operated on using metallic conventional surgical scalpel. Results. The pain syndrome on the first postoperative day was mostly expressed in patients of control group, for anesthesia they needed (4 ± 1) ml of 2% solution of promedol, while the patients of the first, third and fourth groups investigated, in which, accordingly, apparatus of radio-wave surgery «Surgitron» and high-frequency electro-surgical apparatuses «EFA» and «KLS Martin» were used, needed for anesthesia (2 ± 1) ml of 2% solution of promedol. While application of the electro-surgical high-frequency apparatus «ERBE ICC 200» the necessity for the 2% solution of promedol for anesthesia have constituted (3 ± 1) ml. Conclusion. Combined operations, using modern apparatuses of high-frequency electro-surgery and radio-wave surgery give significantly better results, than application of conventional surgical metallic scalpel, because it produces significantly reduced pain syndrome due to thin layer of coagulation necrosis, promoting formation of delicate elastic cicatrix and preventing development of cicatricial strictures of anal channel in postoperative period.

scholarly journals Transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control in surgical treatment of hemorrhoids

2020 ◽  
Vol 87 (11-12) ◽  
pp. 62-66
Author(s):  
A. A. Nykonenko ◽  
G. I. Okhrimenko ◽  
E. I. Haidarzhi ◽  
N. G. Golovko ◽  
I. V. Zubryk ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Main Group ◽  
Control Group ◽  
Results Of Treatment

Objective. To study the immediate and late follow-up results of treatment in patients, suffering hemorrhoids, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was done, and to compare them with results of treatment in patients, operated in accordance to procedure of standard hemorrhoidectomy. Materials and methods. There were analyzed the results of treatment of 111 patients, suffering hemorrhoids. The main group have consisted of 50 patients, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was performed. Into control group 61 patients were included, who were operated in accordance to Parks procedure. Results. In the main group the average time of the operation have constituted (50.1 ± 1.4) min, the patient stationary stay - (9.9 ± 0.7) days, the pain syndrome intensity in postoperative period was estimated as 2 - 3 points, what have appeared significantly lesser, than in the control group of the patients (p < 0.01). Good late follow-up results were achieved in 100% patients of the main group and in 88% of the control group. Conclusion. There was established, that transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control permits to reduce essentially the average time of the operation, the patients’ stationary stay, to lower the pain syndrome intensity, and to improve late follow-up results of the hemorrhoids treatment.

scholarly journals PECULIARITIES OF THE REHABILITATION PROGRAM IN ELDERLY PATIENTS IN THE POST-OPERATIVE PERIOD WITH ACUTE CALCULOUS CHOLECYSTITIS

2021 ◽  
pp. 108-113
Author(s):  
I. K. Churpiy ◽  
V. K. Churpiy ◽  
K. L. Churpiy ◽  
N. R. Golod ◽  
L. P. Fedorivska
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Rehabilitation Program ◽  
Early Postoperative Period ◽  
The Body ◽  
Maximum Efficiency ◽  
Surgical Trauma ◽  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis

Currently, the elderly and senile account for 10 to 25% of all hospitalized for acute calculous cholecystitis. High operative-anesthetic risk, concomitant diseases and low resistance to surgical trauma are the cause of high frequency of postoperative complications and fatalities in this category of patients. In recent years, a reduction in postoperative mortality in acute cholecystitis, which is currently 0.28-2.9%, with gangrenous cholecystitis, it is higher to 17.8%. The aim of the study is to analyze and develop a rehabilitation program in the postoperative period in elderly and senile patients after surgery with acute calculous cholecystitis. Materials and methods We conducted an analysis of surgical treatment of 53 elderly and senile patients with acute calculous cholecystitis. In all patients, this diagnosis was confirmed intraoperatively and histologically. The age of all patients ranged from 61 to 89 years (mean 72.4 ± 8.7 years). Among the examined sick men there were 12 (22.6%), women - 41 (77.4%). The main criteria for assessing and creating a rehabilitation program in patients after surgery with acute calculous cholecystitis were the following processes: improving the general condition of patients, restoring intestinal motility, restoring or improving all impaired cardiovascular and respiratory functions, prevention of general complications (cardiovascular, respiratory, urinary, digestive and other systems), local (from the wound), normalization of blood parameters, One of the important components of successful surgical treatment of patients in the postoperative period is the timely restoration of respiratory, cardiovascular, digestive system after surgery. a guarantee of prevention of probable postoperative complications which are formed in the first 3-5 days after surgery. Objectives of the rehabilitation program in the early postoperative period in elderly and senile patients with acute calculous cholecystitis: to reduce the impact of drugs and accelerate the excretion of toxic substances from the body; restore adequate respiration and oxygen saturation; improve external respiration function, bronchial patency and bronchial drainage function; stabilize central hemodynamics to reduce peripheral circulatory disorders; prevent complications from the gastrointestinal tract, thromboembolic complications; prevent complications from the postoperative wound. Conclusions: Development of a rehabilitation program is a mandatory component in operated patients. Particular attention is paid to elderly and senile patients, who require a set of rehabilitation measures to be minimal, but sufficient to restore lost or reduced body functions in the early postoperative period, but at the same time, it should not exceed the patient's capabilities and ensure maximum efficiency. restoration. Start a rehabilitation program (breathing exercises, kinesiotherapy, massage, inhalation in combination with physiotherapy procedures) should be 12 - 16 hours after surgery. Prospects for further development Continue to develop a rehabilitation program for elderly and senile patients, taking into account the functional capabilities of the body in the long period of rehabilitation.

scholarly journals Minilaparoscopic cholecystectomy and Nissen fundoplication in combination with a fast track protocols in the Covid-19 pandemia environment

2020 ◽  
Vol 87 (5-6) ◽  
pp. 3-8
Author(s):  
V. N. Zaporozhan ◽  
A. V. Malynovskyi ◽  
M. M. Galimon
Keyword(s):  
Postoperative Period ◽  
Fast Track ◽  
Nissen Fundoplication ◽  
Average Duration ◽  
Pain Syndrome ◽  
Esophageal Reflux ◽  
Bed Days ◽  
Calculous Cholecystitis

Objective. Studying of the results of application of minilaparoscopic cholecystectomy and minilaparoscopic Nissen fundoplication in combination with protocols fast track in the Covid-19 pandemia environment. Materials and metods. Minilaparoscopic cholecystectomy was conducted in 17 patients, minilaparoscopic Nissen fundoplication - in 8 patients.Results. For minilaparoscopic cholecystectomy were used one 10-mm, one 5-mm trocar and two 3-mm trocars for minigraspers. For minilaparoscopic fundoplication there were applied two 5-mm trocars and two 3-mm trocars for minigraspers, also 5-mm Nathanson’s retractor was installed without trocar. After mimilaparoscopic cholecystectomy the pain syndrome on the second day was estimated at average (1.3 ± 1.4) points (0 - 5 points), average duration of postoperative period have constituted (2.2 ± 0.4) bed-days (2 - 3 bed-days). After minilaparoscopic fundoplication the pain syndrome on the second day was estimated at average in (1.4 ± 1.4) points (0 - 3 points), average duration of postoperative period have constituted (2.7 ± 0.9) bed-days (2 - 4 bed-days). Conclusion. Minilaparoscopic operations may be applied successfully in chronic calculous cholecystitis, small axial hiatal hernias and gastro-esophageal reflux disease. After minilaparoscopic operations in combination with elaborated protocol of fast track minimizes the pain syndrome and terms of the patients’ stationary stay, what is actual in the Covid-19 pandemia environment, and cosmetic result is improving as well. Further elaboration of the material for determination of role of these minilaparoscopic operations is needed.

scholarly journals False postoperative liver cyst: A rare cause of acute cholangitis

2020 ◽  
pp. 88-90
Author(s):  
G. V. Martynova ◽  
A. V. Svyatnenko ◽  
A. V. Osipov ◽  
A. E. Demko ◽  
D. A. Surov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Biliary Obstruction ◽  
Clinical Case ◽  
Acute Cholangitis ◽  
Liver Cyst ◽  
Stage Of Diagnosis ◽  
Extrahepatic Biliary Obstruction

Clinical case of extrahepatic biliary obstruction of acquired false liver cyst having occurred in a woman aged 52 years old after laparoscopic cholecystectomy. Stage of diagnosis of biliary unit, surgical treatment and the course of postoperative period are presented.

Sign in / Sign up

Export Citation Format

Share Document