scholarly journals Rehabilitation of women after conservative and surgical treatment

2021 ◽  
Author(s):  
R. S. Moldassarina ◽  
G. K. Manabayeva ◽  
Z. Ye. Akylzhanova ◽  
A. M. Rashidova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Healing Process ◽  
Psychological Trauma ◽  
The Body ◽  
Medical Rehabilitation ◽  
Practical Significance ◽  
Modern World ◽  
Surgical Interventions ◽  
Conservative And Surgical Treatment

The relevance of the study is due to the increase in the volume of conservative and surgical care for women who need mandatory rehabilitation measures in the postoperative period. Until relatively recently, there were very few rehabilitation facilities in the country where women could recover under the supervision of a nurse. Therefore, rehabilitation could drag on for many months and it was very difficult to fully return to normal life. In the modern world, it has become possible to undergo all the necessary analyzes and conduct treatment using the latest scientific methods on high-precision equipment, and then perform a full course of postoperative regeneration. After all, medical centers have great technological capabilities today and control the healing process as soon as possible. The nature of the measures for the recovery of women depends on the changes in the body, which are due to the individual background at the time of treatment. It is important to understand the dependence of a woman's position at the time of recovery: the duration of taking medications, the presence of psychological trauma, the development of chronic diseases, the frequency of repeated interventions. The aim of the study is a step-by-step volumetric study of the implementation of various measures aimed at the rehabilitation of women after conservative and surgical treatment. Modern approaches require responsibility, high qualifications of medical personnel and the direct participation of the patient himself in this process. Timely start of rehabilitation ensures productive restoration of lost functions. The main principle of success is the use of standardized methods, informing the patient at all stages of treatment, using techniques with minimal consequences and maximum impact, and analyzing the course of the postoperative period. The need for an in-depth study of the features of providing medical care to patients with gynecological diseases, including after surgical interventions, is confirmed. The practical significance of the material lies in the high-quality and effective organization of medical rehabilitation, which is of key importance for the full restoration of the functions of the woman's reproductive system.

scholarly journals NEW APPROACHES IN THE TREATMENT OF ACUTE INFLAMMATION OF THE EPITHELIAL PILONIDAL SINUS

2016 ◽  
Vol 7 (4) ◽  
pp. 49-57
Author(s):  
N K Gigin ◽  
N I Chernyi ◽  
Yu V Ivanov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Pilonidal Sinus ◽  
Patient Management ◽  
Acute Inflammation ◽  
Wound Closure ◽  
Surgical Interventions ◽  
New Approaches ◽  
Surgical Access ◽  
Conservative And Surgical Treatment

Presents an overview of russian and foreign publications, devoted to contemporary methods of conservative and surgical treatment of acute inflammation of the epithelial pilonidal sinus. Details of surgical interventions, techniques, indications and contraindications. Special attention is paid to pre-operative preparation for surgery, wound closure after surgical access, patient management in the postoperative period.

scholarly journals The key role of pancreatic fibrosis severity in the surgical treatment algorithm of patients with chronic pancreatitis

2020 ◽  
Vol 73 (2) ◽  
pp. 235-238
Author(s):  
Oleh E. Kanikovskiy ◽  
Ihor V. Pavlyk ◽  
Iryna V. Oliinyk ◽  
Vasyl V. Mosondz
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Treatment Algorithm ◽  
Pathological Process ◽  
The Body ◽  
Nutrition Status ◽  
Tissue Pressure ◽  
Surgical Interventions ◽  
Computer Morphometry ◽  
Definition Of

The aim of the work was to improve the results of surgical treatment of complicated forms of chronic pancreatitis. Materials and methods: The results of surgical treatment of 181 patients with complicated forms of chronic pancreatitis have been analyzed. All these patients were treated in surgical clinic of 2 nd medical faculty of National Pyrogov Memorial Medical University in Vinnytsya. Results: It is possible preoperative indirectly assess the severity of fibro- degenerative changes in pancreas, that includes 1 – the definition of pain type; 2 – CT or MRI (Marseilles- Rome classification); 3 – assessment of the stage of chronic pancreatitis (Büchler classification); 4 – patient's nutrition status and preoperative differential diagnosis with pancreatic cancer; 5 – assessment of the fibrosis severity (elastomers). The key point in treatment depended on intraoperative examination: detection of strictures of the main pancreatic duct (pacemaker of chronic pancreatitis); the tissue pressure resistance to the liquid, which is the maximum value> 200 mmHg, in the region of stricture and falls in other parts of the pancreas; pressure in the main pancreas duct, which rises only in 59.5% of patients. The head of the pancreas was involved in the pathological process in 83.8%, in 16.2% it was isolated in the isthmus or the body and tail of the pancreas. In general, the distal pancreas was involved in 37.8%. At computer morphometry of histological samples, the area of connective tissue fields reached 81.4 ± 6.62%, preserved exocrine part in 4.87 ± 1.62%, endocrine – 1.92 ± 0.12%, total area of ducts – 6 , 47 ± 1.12%. Conclusions: The combined Frey-Izbickiy local resection provides a wide excision of the pacemaker (stricture) of chronic pancreatitis. In case of extrapancreatic complications or repeated surgical interventions on the pancreas due to chronic pancreatitis, this effect can be achieved by pancreatoduodenal resection.

scholarly journals ТREATMENT OF STENOSIS OF THE PYLORIC BULBAR ZONE OF ULCERATIVE GENESIS USING MINIMALLY INVASIVE SURGERY

2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Clinical Signs ◽  
State Institution ◽  
Disease Recurrence ◽  
Control Group ◽  
Surgical Interventions ◽  
Remote Observation

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions. Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions. Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.

Evaluation of Thrombotic Events in Haemophiliacs Undergoing Major Orthopaedic Surgery without Thrombosis Prophylaxis.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4072-4072
Author(s):  
Manuela Krause ◽  
Charis von Auer ◽  
Andreas Kurth ◽  
Martina Boehm ◽  
L. Hovy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Replacement ◽  
Postoperative Period ◽  
The Body ◽  
Treatment Center ◽  
Major Surgery ◽  
Thrombosis Prophylaxis ◽  
Compression Stockings ◽  
Surgical Interventions ◽  
Apc Resistance

Abstract Introduction:Major orthopaedic procedures and the presence of thrombophilia are risk factors of thrombotic events. In patients with haemophilia undergoing hip or knee replacement the importance of thrombosis prophylaxis with heparin in the postoperative period is still unknown. The aim of the present study was to evaluate the occurence of thrombotic events in haemophiliacs undergoing major surgery without thrombosis prophylaxis. Patients: A total of 32 pts with haemophilia A (severe:27 pts, moderate:4 pts, mild:1pt; median age:47yrs, range:27–73yrs) undergoing hip (n=9)or knee (n=35) replacement were analysed in our haemophilia treatment center. Pts with inhibitors were excluded. Surgical interventions were performed using recombinant (n=37) or plasma-derived (n=7) FVIII for 12 to 15 postoperative days. The median initial dose of FVIII was 82 IU/Kg−1, followed by median FVIII doses of 54 IU/kg−1over the first four days. All pts received thrombosis prophylaxis with graduated compression stockings only. In addition to factor VIII activity, APC resistance, FV G1691A mutation and the FII G20210A variant (FII) were investigated. Results: No thrombotic events in the postoperative period was dokumented. The median FVIII activity was 153% (range:85–347%), the Body mass index (BMI:kg/m2) was 23.1(range:18.2–30.5). During the first four postoperative days FVIII levels >150% were measured in 24/44 (55%) operative procedures. BMI>25 were shown in 12/32 (38%) pts, and age >40yrs was documented in 23/32 (72%) pts. In 1/30 (3%) pt APC resistance and none of our pts FII were identified. Conclusion: In our study group elevated FVIII levels and additional risk factors (BMI>25, age>40years) seems not to influence relevantly the occurrence of thrombotic events in pts with haemophilia undergoing hip or knee replacement without thrombosis prophylaxis. Further studies are required to confirm whether a thrombosis prophylaxis with heparin is needed in haemophiliacs undergoing high risk surgery.

scholarly journals Anaesthesia and Stress Response to Surgery

2008 ◽  
Vol 62 (4-5) ◽  
pp. 141-147 ◽  
Author(s):  
Iveta Golubovska ◽  
Indulis Vanags
Keyword(s):  
Stress Response ◽  
Postoperative Period ◽  
Surgical Stress ◽  
Healing Process ◽  
Immune Defense ◽  
The Body ◽  
Compensatory Mechanism ◽  
Anaesthetic Agents ◽  
Essential Components ◽  
General Response

Anaesthesia and Stress Response to Surgery The body reaction to surgery ranges from minor to massive both locally and generally. General response is in the form of widespread endocrinal, metabolic and biochemical reactions throughout the body. Neuro-endocrinal hormone system and inflammation mediators are involved and this process is called "stress response". The response has a compensatory mechanism and provides a maximum chance of survival because of increased cardio-vascular functions, fluid preservation and supply of increased demands for energy generating substrates. If the stress response is prolonged, it may result in exhaustion of essential components of the body, fatigue, decreased resistance, delayed ambulation and increased morbidity and mortality. Suppression of immune defense mechanisms has been demonstrated in the postoperative period. Such immune compromise can affect the postoperative infection rate, healing process, and the rate and size of tumour metastases disseminated during surgery. The mechanism of immunosuppression in the postoperative period is not fully understood. The known mediators of immune depression are neuroendocrine response as well as intravenous opioids and inhalational agents, which have shown to increase the susceptibility to infection through a significant cautions in choosing anaesthetic agents, to minimise harm to the patients. In this paper we review the data about the influence of different anaesthetic agents on neuroendocrine, immune and inflammatory response to surgical stress.

scholarly journals Analysis of risk factors for different types of anesthetic support of newborns and infants with surgical pathology

2020 ◽  
pp. 28-34
Author(s):  
V.I. Snisar ◽  
◽  
O.O. Vlasov ◽  
I.A. Makedonskyy ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Logistic Regression ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Congenital Malformations ◽  
Fatal Case ◽  
The Body ◽  
Surgical Correction ◽  
Simple Logistic

High-quality anesthetic support during surgical correction of congenital malformations of internal organs and the postoperative period in newborns and infants is complicated by concomitant diseases, significantly affects the processes of metabolism, gas exchange, homeostasis, cerebral, peripheral hemodynamics, etc. before, during and after the surgical intervention. Purpose — to identify the leading risk factors associated with death in various types of anesthetic support for newborns and infants during surgical correction of congenital malformations. Materials and methods. The retrospective study included newborns with congenital malformations of the surgical profile, as well as infants who received and continued stepwise surgical treatment for congenital malformations, depending on the chosen combined anesthetic accompaniment (inhalation + regional anesthesia and inhalation + intravenous anesthesia). The study was carried out in the following stages: 1) to conduct surgical treatment and anesthetic support, 2) introduction of the child into anesthesia, 3) the traumatic stage of the operation, 4) within 1 hour after the operation, 5) 24 hours after the operation. Risk factors were determined by simple logistic regression with the calculation of the odds ratio, 95% confidence interval (95% CI). Results. Among the functional indicators of the vital functions of the body of children with congenital disorders before, during, immediately and 24 hours after surgery against the background of combined anesthesia, with a simple logistic regression analysis, the chance of a fatal case increases with deviations from the norm of peripheral saturation — at all stages of surgical support (7.8–15.0 times); cerebral oxygenation of the child — at the moments of induction into anesthesia and in the postoperative period (10.8 at the stage 2, 72.0 times at the stage 4); increased diastolic blood pressure at the stage of induction of the child into anesthesia (1.6 times). Conclusions. To prevent the chances of death under various types of anesthesia for children with congenital malformations during surgical treatment, it is advisable to more closely monitor blood pressure, cerebral, peripheral oximetry and promptly correct the impaired condition of the child. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: newborns, infants, congenital malformations, anesthesia, risk factors.

scholarly journals Surgical treatment of complications of Crohn’s disease

2018 ◽  
Vol 20 (1) ◽  
pp. 111-116
Author(s):  
I A Solovev ◽  
A M Pershko ◽  
D P Kurilo ◽  
M V Vasilchenko ◽  
E S Silchenko ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Surgical Treatment ◽  
Crohn's Disease ◽  
Surgical Intervention ◽  
Intestinal Anastomosis ◽  
Clinical Manifestations ◽  
Intestinal Fistula ◽  
Subtotal Resection ◽  
Surgical Interventions ◽  
Conservative And Surgical Treatment

Possibilities and options of surgical treatment of complications of Crohn’s disease in the general surgical hospital are considered. Patients underwent various surgical interventions: ileum resection with «side-to-side» anastomosis (4 patients), resection of ileocecal department with the formation of ileoascendoanastomosis (2 patients), total coloproctectomy with the formation of ileostomy (2 patients), right-sided hemicolectomy (1 patient), obstructive resection of transverse colon (1 patient), obstructive resection of sigmoid colon (2 patients). Postoperative complications developed in 3 patients (25%), among them: postoperative wound suppuration - 2, dehiscence of anastomosis in 1 patient, which led to the formation of internal intestinal fistula and death. It was found that with limited lesions of colon in Crohn’s disease (less than a third of the colon) can be limited to resection of the affected segment with formation of intestinal anastomosis in the limits of healthy tissues. In the presence of lesions in the ascending department of colon proximal border of resection should be at the level of middle colic vessels with preservation of the latter. In long Crohn’s disease of colon with severe clinical manifestations of the operation of choice is a subtotal resection of colon with the imposition of single-barrel ileostomy. Surgical treatment of complicated forms of Crohn’s disease is in all cases performed in surgical profile hospitals, taking patients by ambulance. Most often, patients have delayed indications for operations, which gives the opportunity to carry out a comprehensive preoperative preparation. In all cases, complications of Crohn’s disease requires an individual approach, which combines conservative and surgical treatment. Surgical intervention is determined by the shape and characteristics of the course of complications of Crohn’s disease.

scholarly journals Formation of Adhesive Arachnoiditis with Epidural Fibrosis as a Cause of Repeated Surgical Interventions (Clinical Case)

2020 ◽  
Vol 5 (3) ◽  
pp. 54-61
Author(s):  
A. P. Zhivotenko ◽  
V. A. Sorokovikov ◽  
Z. V. Koshkareva
Keyword(s):  
Surgical Treatment ◽  
Epidural Space ◽  
Clinical Case ◽  
Intraoperative Complications ◽  
Failed Back Surgery Syndrome ◽  
Unsatisfactory Result ◽  
Surgical Interventions ◽  
Constant Pain ◽  
Failed Back Surgery ◽  
Conservative And Surgical Treatment

The work presents a rare clinical case of adhesive arachnoiditis, which developed against the background of epidural fibrosis during repeated surgical interventions. The cicatricial adhesion in the epidural space is formed in 100% of cases after surgery and is a frequent cause of intraoperative complications during repeated surgical interventions (bleeding, damage to the spinal cord and the dura mater with subsequent outflow of cerebrospinal fluid) and, therefore, an unsatisfactory result of surgical treatment with the formation of constant pain of various intensity, pseudomeningocele, commissural arachnoiditis, etc. The cicatricial adhesion in the epidural space is the main reason for the development of failed back surgery syndrome (FBSS), which today is an important and unresolved problem in spinal surgery. The epidural, as well as the subdural and subarachnoid space of the operated spinal motor segment of the spinal canal can be involved in the cicatricial adhesion, as it is shown in our clinical example. In this regard, it is important to prevent the development of the cicatricial adhesion in the epidural space during primary spinal surgeries, since with the increase in life expectancy of the population and increase in surgical activity during spinal surgeries, the patient can be operated repeatedly. Consequently, the question arises of preventing the formation of the cicatricial adhesion in 100% of cases with each surgical intervention, since the formed cicatricial adhesion in the epidural space does not have effective methods of conservative and surgical treatment and worsens favorable and satisfactory forecasts of surgical treatment for repeated surgical interventions.

scholarly journals Stationary replacement technologies in the surgical treatment of simultaneous pathology in gynecological patients

2018 ◽  
pp. 64-71
Author(s):  
A. N. Shikhmetov ◽  
L. A. Osin ◽  
A. M. Zadikyan ◽  
A. A. Pazichev
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Subsequent Treatment ◽  
The Body ◽  
Operating Table ◽  
Operating Team ◽  
Simultaneous Operations ◽  
Repeated Surgery

The authors analyzed the results of simultaneous operations in 238 patients with regard to the combined surgical and gynecological pathology performed in the hospital-replacing environment of the ВСDС of PAO «Gazprom». Previously, all patients were assigned to the sequence of stages, the location of trocars, taking into account the additional stages of the operation, the position of the monitor, the location of the operating team, the position of the patient on the operating table during each stage. Performing simultaneous laparoscopic operations does not lead to an increase in the number of intra- and postoperative complications in comparison with isolated interventions and is not accompanied by great technical difficulties, but causes a somewhat longer duration (on average, 20.6 ± 1.5 min), which, in our opinion , is not critical for anesthesia. There were no significant differences in the course of the early postoperative period and the intensity of the functional systems of the body. Advantages of simultaneous operations are undeniable: two or three surgical diseases are cured simultaneously, progression or serious complication of the disease is prevented, operative treatment of which would be postponed for a later period, the risk of repeated surgery and anesthesia is eliminated, the time of total stay of the patient in the hospital and subsequent treatment is reduced, economic efficiency of treatment is increased.

Vertebral hydatid disease

1976 ◽  
Vol 44 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Werner L. Apt ◽  
Juan L. Fierro ◽  
Ciro Calderón ◽  
Carlos Pérez ◽  
Patricio Mujica
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Postoperative Period ◽  
Long Term Results ◽  
Common Procedure ◽  
Laboratory Findings ◽  
Content Type ◽  
Surgical Interventions ◽  
Fine Print

✓ The authors present 27 cases of vertebral hydatidosis with clinical and laboratory findings. The most frequent location of the lesion was the lumbar spine. Principal neurological symptoms were paraparesis, sphincter disturbances, paresthesia and paraplegia. The average number of surgical interventions per patient was 2.6; the most common procedure was laminectomy with extirpation of the cyst and surgical toilet. The results of surgical treatment were generally good in the immediate postoperative period, but long-term results were poor.

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