Anterior diaphragmatic hernias in children: long-term surgical outcomes

2021 ◽  
Vol 16 (3) ◽  
pp. 7-15
Author(s):  
D.A. Morozov ◽  
◽  
D.V. Khaspekov ◽  
E.A. Okulov ◽  
V.G. Masevkin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diaphragmatic Hernia ◽  
Complex Analysis ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
X Ray ◽  
Hernial Sac ◽  
Chest X Ray ◽  
Diaphragmatic Hernias

Anterior diaphragmatic hernia (ADH) is a rare congenital pathology that occurs in children with a frequency of 1:4800 (1–6% of all congenital diaphragmatic hernias). There are many controversial aspects in the surgical treatment of patients with ADH: the choice of surgical approach, the method of diaphragmatic repair and the feasibility of excision of the hernial sac. Objective. To conduct a comparative analysis of the surgical treatment of patients with ADH in different clinics, assessing longterm outcomes. Patients and methods. The medical records of 7 children with ADH who underwent surgical repair in different clinics (in time period from 2009 to 2019) were retrospecively reviewed. Evaluating the long-term results of ADH repair was made by telephone and online surveys of the parents of patients and by outpatient examination of children (chest x-ray in two projections). Results. In a ten-year period, 7 patients (4 boys and 3 girls) were operated on with a diagnosis of “anterior diaphragmatic hernia” at the age of 3 months to 12 years. In most children, a hernia was discovered accidentally by chest x-ray. Laparoscopic correction was performed in 5 (71%) cases, thoracoscopic correction – in 2 cases (29%). The main difference in surgical tactics in ADH patients was the manipulation with the hernial sac – the hernial sac was excised in 4 (57%) patients, but it was left in three cases (43%). The defect closure was performed by “full-thickness” separated sutures that fix the diaphragm to the anterior abdominal wall during laparoscopy (5) and to the chest tissue during thoracoscopy (2); in some cases, additional fixation to the rib (4) was performed. Sutures were tied extracorporeally and buried in the subcutaneous layer in 6 (86%) patients. Average follow-up was 7 years. While evaluating long-term outcomes no ADH recurrence were found. Conclusions. There are still many controversial aspects in the surgical treatment of ADH patients. In our opinion, multicenter studies with complex analysis of long-term results are required to standardize the surgical treatment of such patients. Key words: anterior diaphragmatic hernia, Larrey hernia, long-term outcomes, Morgani hernia

Long-term results of surgical treatment of gastric cancer

1986 ◽  
Vol 67 (2) ◽  
pp. 104-106
Author(s):  
A. S. Abdullin ◽  
F. Sh. Akhmetzyanov ◽  
A. A. Samigullin ◽  
Z. N. Shemeunova ◽  
V. A. Arinin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Stomach Cancer ◽  
Stage Iv ◽  
Stage Ii ◽  
Stage Iii ◽  
Disease Stage ◽  
Long Term Results ◽  
Long Term Outcomes

We analyzed long-term outcomes of the treatment of 217 patients (men - 126, women - 91), who underwent radical operations for stomach cancer in the period of 1972 till 1976. 14 patients were under 39, 52 - from 40 to 49, 50 to 59 - 52, 60 to 69 - 80, over 70 years old - 19. The youngest patient was 28 years old and the oldest - 76 years old. Most patients (185) were operated on at stage III of the disease, stage II was diagnosed in 27 patients, and stage IV - in 5 patients.

Persistent foreign body sensation and pharyngeal pain due to retention of staples: an interesting sequelae of endoscopic stapling procedure

2001 ◽  
Vol 115 (5) ◽  
pp. 425-427 ◽  
Author(s):  
P. S. Arunachalam ◽  
D. S. Cameron
Keyword(s):  
Surgical Treatment ◽  
Foreign Body ◽  
Foreign Body Sensation ◽  
Long Term Results ◽  
Barium Swallow ◽  
Pharyngeal Pouch ◽  
X Ray ◽  
Repeat Endoscopy ◽  
Body Sensation

The surgical treatment of a pharyngeal pouch with endoscopic stapling diverticulotomy is a relatively new concept. Long-term results and complications are yet to be fully studied. We describe a patient who developed persistent pharyngeal pain and foreign body sensation due to retention of a clump of staples at the cricopharyngeal sphincter. This complication has not been reported before. This case highlights the need for repeat endoscopy rather than a barium swallow X-ray if the patients are symptomatic after stapling procedures.

scholarly journals LONG-TERM RESULTS AFTER VIDEO ENDOSCOPIC MYOTOMY BY HELLER WITH FUNDOPLICATION BY DOR IN PATIENTS WITH 2-4 STAGES OF ACHALASIA

2021 ◽  
pp. 40-49
Author(s):  
V. A. Gankov ◽  
E. A. Tseimakh ◽  
G. I. Bagdasaryan ◽  
A. R. Andreasyan ◽  
S. A. Maslikova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Long Term Results ◽  
Esophageal Function ◽  
X Ray ◽  
Leading Symptom ◽  
Instrumental Methods

Relevance. Treatment of achalasia of the cardia (AС) is currently palliative, aimed at reducing the manifestation of clinical symptoms of the disease. Together with instrumental methods of examination of esophageal function, the Eckardt scale and the GIGLI questionnaire are convenient and simple tools for evaluating results in the long-term postoperative period.The aim of the study was to evaluate the long-term results of surgical treatment of patients with 2-4 stages of AС, after laparoscopic Нeller myotomy with anterior hemiesophagofundoplication by Dor to the results of special methods of esophageal examination and patient questionnaires using the Eckardt scale and the GIGLI questionnaire.Materials and methods. The work included the results of examinations of 103 patients who underwent video laparoscopic Нeller myotomy, with anterior hemiesophagofundoplication by Dor. The period of examination in the postoperative period was from 3 to 7 years. The results of X-ray examination of the esophagus and stomach, manometry of the esophageal and esophageal-gastric junction before and after surgery were studied , and patients were also surveyed according to the Eckardt scale and the GIGLI questionnaire.Results. The analysis of the results of instrumental methods of studying the function of the esophagus in the pre – and postoperative periods showed that the given manometry of the esophagus and esophageal-gastric junction, X-ray of the esophagus and stomach significantly improved in the postoperative period in patients with all stages of the disease. The results of patients of 4th stage AC compared with the results of 2nd and 3rd stages patients were worse(p<0,05).The leading symptom of AK-dysphagia in the long-term postoperative period decreased in all the studied patients, the results were better in patients with stage 2, worse in patients with stage 4 of AK (p<0,05).The leading symptom of AK-dysphagia in the long-term postoperative period decreased in all the studied patients, the 2nd stage patients results were better, 4th stage patients results were worse (p<0,05).Conclusions. After video-endoscopic Нeller myotomy with fundoplication by Dor, the indicators of esophageal manometry and esophageal and stomach radiography significantly improve, the results of the Eckardt scale and GIGLI questionnaire survey of patients show a significant decrease in the severity of clinical manifestations of AC in the balls. This method of surgical treatment can be recommended already at the 2nd stage of AC and as an organpreserving operation for 4th stage.

Justification of the diagnostic algorithm and treatment strategies in patients with severe chronic slow-transit constipation

2021 ◽  
Vol 23 (3) ◽  
pp. 75-82
Author(s):  
Vadim B. Samedov ◽  
Pavel N. Romashchenko ◽  
Gennady O. Revin
Keyword(s):  
Surgical Treatment ◽  
Sigmoid Colon ◽  
Diagnostic Algorithm ◽  
Long Term Results ◽  
Subtotal Resection ◽  
Slow Transit Constipation ◽  
X Ray ◽  
Slow Transit ◽  
Transit Constipation

Surgical treatment of patients with chronic slow-transit constipation leads to unsatisfactory results in almost a third of cases. It appears relevant to the search for the causes of unsatisfactory results of surgical interventions in such patients and the need to develop a rational diagnostic algorithm; its implementation will allow us to determine the indications for surgical treatment and justify the volume of colon resection. For this purpose, the results of the examination and treatment of 53 patients with constipation were analyzed. The median disease duration was 15 years, and the median duration of constipation was 6.2 1.6 days. Patients were divided into a group with a positive effect of conservative treatment and a group without the expected effect. The symptoms, results of laboratory tests of blood and feces, and instrumental studies of the colon were analyzed. A balloon expulsion test was used to exclude proctogenic constipation. The evacuation function of the colon was studied by X-ray examination, while the transit time of barium sulfate or X-ray contrast markers through the gastrointestinal tract was estimated. Twenty-four patients underwent surgery for chronic slow-transit constipation, while the sigmoid colon was removed in one patient, including 7-left-sided hemicolectomy and 16-subtotal resection of the colon. Long-term results were examined in the period from 3 to 6 months after surgery. In the total examination of the semiotics of chronic slow-transit constipation, the results did not show significant differences between the groups of patients and did not allow us to justify the stratification into severe and non-severe disease course by its specific symptoms. The use of X-ray contrast markers for the assessment of the state of the evacuation function of the colon makes it possible to quantify the severity of various motor disorders and justify the choice of the volume of its resection. The analysis of the long-term results of the treatment of patients with chronic slow-transit constipation allows us to conclude that segmental resections of the colon (left-sided hemicolectomy, resection of the sigmoid colon) have a good therapeutic effect if the preoperative examination revealed a segmental type of failure of the evacuation function of the colon, and subtotal resection of the colon is appropriate for the common type. The absence of negative results of surgical treatment of patients with chronic slow-transit constipation, in which the formation of a colonic anastomosis was performed with a short stump of the sigmoid colon, indicates the possibility of using this option to complete the surgical intervention.

scholarly journals Tension Viscerothorax in a Patient with Missed Traumatic Diaphragmatic Hernia. A Case Report.

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Herbert Butana ◽  
Ntawunga Laurance ◽  
Desire Rubanguka ◽  
Isaie Sibomana
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Diaphragmatic Hernia ◽  
Rare Case ◽  
Case Presentation ◽  
X Ray ◽  
Traumatic Diaphragmatic Hernia ◽  
Provincial Hospital ◽  
Chest X Ray ◽  
Diaphragmatic Hernias

Background: Diaphragmatic hernias occurring post trauma are a challenge to diagnose early especially when they follow blunt trauma. Many of those diagnosed early occur in penetrating thoraco-abdominal trauma which necessitates emergency exploration where the diagnosis is picked. Rarity of traumatic diaphragmatic hernia coupled with poor sensitivity of easily available imaging modalities makes it a big challenge to pick up this potentially fatal pathology. Case presentation: We present a rare case of tension viscerothorax in a young man who had presented to the emergency department at a provincial hospital of Rwanda three days before the second consultation where the chest x-ray was interpreted as normal and later as a pneumothorax before the diagnosis and treatment of tension viscerothorax could be made. Conclusion: Viscerothorax is an elusive diagnosis which when missed can complicate to strangulation of hernia contents or tension viscerothorax which carry a high mortality.

scholarly journals Experience of using the ilizarov external fixator in the treatment of children with recurrent congenital clubfoot

2016 ◽  
Vol 4 (1) ◽  
pp. 5-10
Author(s):  
Vadim V Kozhevnikov ◽  
Evgeny V Voronchikhin ◽  
Lyudmila G Grigoricheva ◽  
Zhanna N Radimova
Keyword(s):  
Surgical Treatment ◽  
External Fixator ◽  
Long Term Results ◽  
Foot Deformity ◽  
Congenital Clubfoot ◽  
Ilizarov External Fixator ◽  
X Ray ◽  
Number Of Children ◽  
Younger Age

Introduction: Congenital clubfoot is a complex orthopedic problem, and the frequency of recurrence or secondary deformities may reach up to 60% in some cases.Purpose: To determine indicators for the surgical treatment of recurrent foot deformity using the Ilizarov external fixator and to evaluate the effectiveness of this approach.Materials and Methods: The feet of 78 children with recurrent congenital clubfoot were analyzed using X-ray and ultrasound to investigate their clinical and functional characteristics. According to the characteristics of the deformity, we performed tenoligamentocapsulotomy combined with tarsal osteotomies and tendon plastics. Furthermore, we determined the indicators for the surgical treatment of foot deformity using the Ilizarov external fixator.Results: In total, 33 children (56 feet) were treated using a distraction external fixator combined with tenoligamentocapsulotomy. Following treatment, long term results were assessed using a three-point scale: good, satisfactory, and unsatisfactory. The number of children of 8 years of age whose treatment was graded as either good or satisfactory was higher than children who were over 9 years of age. Functional recovery was also better in the younger age group.Conclusion: By determining specific indications for different treatment methods, physicians are able to apply an individual approach for diagnosing and treating recurrent congenital clubfoot. Good and satisfactory long term results were obtained in approximately 90 % of cases.

scholarly journals ZENKER-DIVERTICULUM: DIAGNOSTICS AND TREATMENT

2017 ◽  
Vol 176 (4) ◽  
pp. 96-99
Author(s):  
A. N. Tulupov ◽  
G. I. Sinenchenko ◽  
M. I. Safoev ◽  
A. V. Nikitin
Keyword(s):  
Surgical Treatment ◽  
Long Term Results ◽  
Optimal Method ◽  
X Ray ◽  
Zenker Diverticulum

OBJECTIVE. The study determined an optimal method of surgical treatment of Zenker-diverticulum. MATERIALS AND METHODS. The patients (12 men) were examined using X-ray contrasting of the esophagus and fibroesophagoscopy. The planned diverticulectomy from cervical access was performed on all patients. RESULTS. The treatment was without complications and the patients had favorable outcomes and good long-term results. CONCLUSIONS. The open diverticulectomy using cervical access is the operation of choice.

scholarly journals SURGICAL TREATMENT AND POSTOPERATIVE MANAGEMENT OF PATIENTS WITH BROAD FOREFOOT

2017 ◽  
Vol 2 (3) ◽  
pp. 55-57
Author(s):  
DA A Rasputin
Keyword(s):  
Surgical Treatment ◽  
Postoperative Management ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
Surgical Interventions ◽  
New Methods ◽  
Results Of Treatment ◽  
Based Medicine

The article considers the problem of broad forefoot, which is one of the most frequent deformities of the musculoskeletal system. Aim - to improve the results of treatment of patients with transverse platypodia by the use of new methods of surgical interventions, and to improve the tactics of postoperative management of such patients. Material and methods. The study involved analysis of the results of treatment of 375 patients. For evaluating the long-term outcomes of treatment, methods of evidence-based medicine were used, reflecting a reduction in the relative risk of interventions and an increase in their relative benefit. Results. The study of the long-term results of treatment showed that there were good and satisfactory outcomes in 92.7% cases (267 patients) and only 7.3% of unsatisfactory results (21 patients) in the main group; in comparison group - 74.7% (65 patients) and 25.3% (22 patients) respectively. The evaluation of the adequacy of anesthesia on the first day after the operation revealed good and satisfactory quality of anesthesia in the first group in 89.9% patients (259), in the second - only in 55.2% patients (48). Conclusion. The use of the above mentioned methods of surgical treatment and enhancement of tactics of postoperative management improve outcomes of patients with transverse flatfoot, and, consequently, are recommended for widespread use in clinical practice.

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