First outcomes of simultaneous videosurgery in bilateral kidney tumours

2020 ◽  
Vol 8 (1) ◽  
pp. 5-9
Author(s):  
D.Yu. Britvin ◽  
◽  
A.V. Proskura ◽  
Kh.М. Ismailov ◽  
D.V. Chinenov ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Abdominal Cavity ◽  
Pathological Process ◽  
Early Postoperative Period ◽  
Cancer Symptoms ◽  
One Stage ◽  
Classical Triad ◽  
Differential Control ◽  
Staged Treatment ◽  
Medical University

Objective. To improve the outcomes of treatment of patients with bilateral kidney tumours. Patients and methods. 30 patients with synchronous bilateral kidney tumours received laparoscopic and retroperitoneoscopic treatment in the Institute of Urology and Reproductive Health, I.M.Sechenov First Moscow State Medical University (Sechenov University) from March 2012 to August 2018. 22 patients underwent staged operative treatment, 8 patients had one-stage surgery. The patients’ stage of disease was classified as Т1аN0M0 to Т3аN0M0. In most cases, the histological type had a malignant character. Results. 22 patients underwent 3D modelling of pathological process at the stage of preoperative preparation. The classical triad of renal cancer symptoms was not found. 7 operations were performed by the retroperitoneoscopic access, the others laparoscopically. The number of operations with retro- and retro-approach was 1, retro- and laparo-approach was 3, with laparolaparo-approach was 4. Performance of bilateral laparoscopic resection takes more time as compared with the combination of retro- and laparoscopic approaches. Two resections performed from the retro- and laparoscopic accesses make possible an operation without the surgeons going to the opposite side and changing the position of the endosurgical equipment, which shortens preparation to the second step of surgery and the duration of anaesthesia. Apparently, division of the surgical approach to the kidneys into the abdominal cavity and the retroperitoneal space is preferable, since it allows an adequate evaluation of the course of the early postoperative period and a differential control over the development of complications, first of all, bleeding. Conclusion. First evaluation of the outcomes of treating 8 patients, who underwent one-stage surgery, showed that this approach is safe, since it is not associated with an increase of intraoperative blood loss or other complications as compared with two-stage operations. Also, the duration of anaesthesia is shorter in one-stage surgery than in staged treatment. Enhancement of the volume of operative treatment does not reduce the length of hospitalization but rules out the need for repeated hospitalisation. We have obtained positive results that encourage further enrolment of patients and assessment of long-term outcomes of treatment. Key words: bilateral kidney cancer, synchronous cancer, organ-preserving surgery, nephrectomy, simultaneous and staged surgery, laparoscopic and retroperitoneoscopic surgery

scholarly journals Dynamics of the abdominal organs malignant tumors regional morbidity, taking into account certain factors

2021 ◽  
Vol 25 (1(97)) ◽  
pp. 37-45
Author(s):  
O. Ivashchuk ◽  
I. Malyshevsky ◽  
Yu. Myshkovsky
Keyword(s):  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Pathological Process ◽  
Malignant Neoplasms ◽  
Software Packages ◽  
Abdominal Organs ◽  
Microsoft Office ◽  
Medical University ◽  
Epidemiological Characteristics ◽  
Oncology Center

The aim of the work is to determine the dynamics of the incidence of malignant neoplasms of the abdominal cavity in the Bukovina region and possible determinants. Material and methods. The study was performed on the basis of RMNE "Chernivtsi Regional Clinical Oncology Center" and Clinic of Oncology of Bukovinian State Medical University and covers observation materials during 2015-2019 and statistical reporting on 102,247 cases of tumors of various localizations. The indicators were calculated using Access and Excel software packages based on the Microsoft Office environment. The results. The total number of malignant neoplasms of different localizations is relatively stable throughout the study period and ranged from 19903 to 21259 cases per year (average 20449.4±508.2 registered during the year). Neoplasms of the abdominal cavity are about the third of the total number of tumors of different localization with a certain tendency to grow. The distribution of patients with neoplasms of the abdominal cavity by stages of development is relatively uniform, despite significant variations in different localizations of tumors. Conclusions. A significant part of tumors of the abdominal cavity is diagnosed in the late (III-IV) stages of the pathological process, which leads to a decrease in the effectiveness of treatment. Significant differences in the clinical and epidemiological characteristics of neoplasms of various abdominal organs have been identified, which requires further study.

scholarly journals Peculiarities of expression indicators and accentuated personality traits in men with psoriasis without taking into account somatotype and in representatives of meso- and endo-mesomorphic somatotypes

2021 ◽  
Vol 25 (4) ◽  
pp. 540-544
Author(s):  
Obadeh Bassam Abdel-Rahman Al-Qaraleh ◽  
V. I. Stepanenko ◽  
T. G. Kryvonis ◽  
V. S. Shkolnikov ◽  
S. V. Prokopenko
Keyword(s):  
Personality Traits ◽  
Social Stigma ◽  
Postgraduate Education ◽  
Pathological Process ◽  
The Body ◽  
Individual Traits ◽  
Clinical Center ◽  
The Difference ◽  
High Level ◽  
Medical University

Annotation. Exacerbation and aggravation of psoriasis increases the chances of neurosis, depression, can significantly impair mental health through social stigma and leads to social isolation and maladaptation, a significant reduction in quality of life. Studying this problem from the standpoint of comparative assessment of the distribution of character accentuations in patients with different dermatoses can provide insight into how a certain level of adequacy of psychological adaptive response is associated with organic pathological process or genetically existing expression of certain traits. The aim of the study was to found the features of indicators of expression and features of accentuated personality traits in men with psoriasis without taking into account somatotype and in representatives of meso- and endo-mesomorphic somatotypes. Men aged 22 to 35 years, patients with psoriasis (n=100, including 32 with mild and 68 with severe course) at the Department of Skin and Venereal Diseases with a course of postgraduate education National Pirogov Memorial Medical University, Vinnytsya and Military Medical Clinical Center of the Central Region, conducted an anthropometric survey by V. V. Bunak Estimation of the expression and features of accentuated personality traits made according to G. Shmishek The reliability of the difference between the values between the independent quantitative values was determined using the U-Mann-Whitney test. In healthy subjects, taking into account and without taking into account the somatotype, it is seen that the type of physique did not significantly affect the severity of individual traits and their combinations in this group of people. With the increase in the course of psoriasis among subjects without somatotype, there is a decrease in the percentage of persons with hyperthymic and demonstrative and an increase – with emotional, pedantic, anxious, cyclothymic, excitable, dysthymic and exalted type of character accentuation; among patients of mesomorphic somatotype there is a decrease in the percentage of people with stuck and demonstrative and an increase – with emotional, pedantic, anxious, cyclothymic, excitable, dysthymic and exalted type of character accentuation; among patients of endo-mesomorphic somatotype there is a decrease in the percentage of people with hypertension and an increase – with stuck, demonstrative and excitable type of character accentuation. All this maintains a pathologically high level of affective tension, which disrupts the autonomic balance in the body, can be a pathogenic factor in the development of psychosomatic illness and leads to ineffective treatment of psoriasis.

scholarly journals One - stage laparoscopic treatment of chronic inflammatory complications of diverticular colon disease

2019 ◽  
Vol 10 (2) ◽  
pp. 70-76
Author(s):  
E. A. Gallyamov ◽  
Y. B. Busyrev ◽  
I. V. Gorbacheva ◽  
V. A. Dugin
Keyword(s):  
Laparoscopic Surgery ◽  
Sigmoid Colon ◽  
Abdominal Cavity ◽  
Prostate Gland ◽  
Long Term Results ◽  
Surgical Department ◽  
Aged People ◽  
One Stage ◽  
Short Time ◽  
And Control

Introduction. Diverticulosis of the colon is one of the most common diseases of the intestine. In recent years, there has been an increasing tendency for diverticular disease (DD) to manifest itself at earlier age, as well as to the more frequent development of complications in young and middle - aged people. Most interventions for planned surgical treatment of DD complications are performed by two - stage access for laparotomy. One - stage laparoscopic intervention is a relatively new approach to treatment. Case report. 40-year - old man was hospitalized in the surgical department with complaints of air release during urination and aching pain in the lower part of abdomen. Outpatient examination excluded the pathology of the prostate gland and revealed infiltration between the urinary bladder and sigmoid colon. A complex examination, including cystoscopy, colonoscopy, multispiral computed tomography with contrast, showed the presence of chronic paracolic infiltration and blad - derntestinal fistula, which complicated the latent course of colon DD. Laparoscopic opening the abscess, resection of the sigmoid colon, the formation of descendo - rectal anastomosis was performed in one - step. Intra - and postoperative complications were not observed, dynamic observation and control examination after 6 months showed no symptoms. Discussion. One - stage laparoscopic surgery in the treatment of chronic inflammatory complications of colon DD is currently available procedure, which allows in a short time to relieve patients from symptoms and has good immediate and long - term results. The condition for the use of this technique is a sufficient experience of laparoscopic surgery of the abdominal cavity, retroperitoneal space and pelvis.

scholarly journals SYNTHETIC PATCH INFECTION IN CAROTID ENDARTERECTOMY

2019 ◽  
pp. 126-129
Author(s):  
I. S. Pulyaeva
Keyword(s):  
Postoperative Complications ◽  
Carotid Endarterectomy ◽  
Operative Treatment ◽  
Postoperative Period ◽  
Neurological Deficit ◽  
Internal Carotid ◽  
Clinical Status ◽  
Infectious Complications ◽  
Early Postoperative Period ◽  
Direct Results

Aim. To define tactics of treatment of patients with infecting of synthetic patch after carotid endarterectomia(CEA). Materials and methods. As a result of treatment of 123 patients with hemodynamically meaningful stenosises of carotids and/or presence of embolic plate in SI «Zaycev V.T. IGUS of NAMSU» from 2014 for 2018 51 CEA was executed with in seaming of patch. In 5 cases autove in used as a patch, at 46 patients were used synthetic patch. As a rule, this group was entered by patients with extensive stenosis (more than 2 cm) - 33 patients, patients with insufficient retrograde pressure and/or presence of neurological deficit in the period of crossclamping of internal carotid — 18 patients. Results. The direct results of operation we estimated complex on the basis of degree of change of clinical status and presence of postoperative complications. At 43 patients in a postoperative period are not educed complications. At 8 patients an early postoperative period was complicated by bleeding from a patch, that demanded the repeated operative treatment. In two cases through 2 and 2,5 year, infecting of synthetic patch, that demanded urgent operative intervention as excision of synthetic patch and inseaming of autovein patch, was educed. To the patients control of passableness of carotids was executed through every 6 months Hemodynamically meaningful Restenilооm was observed in 3 cases at this group of patients. Conclusion. At hemodynamically meaningful extensive stenosises of carotids and insufficient level of retrograde arteriotony it is necessary to execute CEA with inseaming of synthetic patch. In case of the repeated interference on a carotid careful hemostasis and antibacterial therapy allows to bring down the level of infectious complications.

scholarly journals MINI-INVASIVE PERCUTANEOUS USP-CONTROLLED DRAINING OF PSEUDOCYSTS OF THE PANCREAS, SUPPLEMENTED WITH LASER VAPORIZATION

2020 ◽  
pp. 32-36
Author(s):  
Ya. V. Naboychenko ◽  
R. S. Shevchenko
Keyword(s):  
Minimally Invasive ◽  
Research Methods ◽  
Surgical Intervention ◽  
Average Length ◽  
Abdominal Cavity ◽  
Surgical Techniques ◽  
Early Postoperative Period ◽  
Laser Vaporization ◽  
Pancreatic Pseudocysts ◽  
Surgical Methods

Summary. Aim. The aim of this study was to evaluate the results of percutaneous minimally invasive ultrasound-controlled drainage of pancreatic pseudocysts, supplemented by laser vaporization, compared with classical surgical methods of treatment. Materials and research methods. This work is based on the results of examination and surgical treatment of 51 patients with PCPD, which were divided into two clinical groups. To optimize the choice of the method of surgical intervention, instrumental research methods were used: ultrasound (PHILIPS HD 11 XE apparatus (Austria), EGDS, ERCP, CT of the pancreas, ECG, X-ray examination of the chest and abdominal cavity, laparoscopy. Research results. The paper establishes options for choosing a puncture point for a pancreatic pseudocyst with minimal traumatic effect, as a result of which damage to neighboring organs is excluded. Selected the most effective methods of intraoperative use of laser radiation, depending on the formation of the pseudocyst wall and the type of complication. The main surgical techniques for intraoperative use of percutaneous puncture laser vaporization of the pseudocyst wall, with external and internal drainage, are presented. Conclusions. When comparing minimally invasive methods of surgical intervention with laparotomic ones, the effectiveness of the former is evidence-based, while the proportion of complications in the early postoperative period and the average length of hospital stay when using minimally invasive interventions are much less. The use of laser irradiation for the purpose of debridement and vaporization (for percutaneous minimally invasive interventions) made it possible to reduce the number of external drainage operations to 41.0 %, and to increase the number of internal digestive drainage operations to 48.7 %. In the long-term period, there was a decrease in the recurrence of pseudocysts to 12.5 %. The proposed method of treating patients with PCPD can be used as an operation of choice in the presence of clinical conditions and technical support.

scholarly journals The first experience of partial spleen embolization for the correction of thrombocytopenia in patients with liver cirrhosis

2021 ◽  
Vol 26 (3) ◽  
pp. 97-103
Author(s):  
A. V. Shabunin ◽  
V. V. Bedin ◽  
P. A. Drozdov ◽  
O. N. Levina ◽  
V. A. Tsurkan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Liver Cirrhosis ◽  
Postoperative Period ◽  
Primary Liver Cancer ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Computed Tomography Scan ◽  
Intravenous Contrast ◽  
Viral Hepatitis C ◽  
Tomography Scan

Aim. To assess the efficacy and safety of interventional endovascular partial spleen embolization for the correction of thrombocytopenia in patients with liver cirrhosis.Material and methods. From September 2019 to March 2020, 5 partial spleen embolizations were performed at the surgical clinic of the Botkin Hospital. The indication was the impossibility of conducting courses of regional chemotherapy for primary liver cancer in 2 patients with cirrhosis, portal hypertension, hypersplenism, thrombocytopenia, in 3 patients – the impossibility of conducting adequate antiviral therapy with cirrhosis as a result of chronic viral hepatitis C. The platelet count was < 25 thousand/μl (19.34 ± 1.34 thousand/μl) in all patients at the time of the procedure. The median spleen volume was 1967.54 ± 476.13 (1324.34–2163.54) cm3 . We used Progreat® Terumo 2.8 Fr microcatheter 130 cm for catheterization branches of the splenic artery. Endovascular embolization was performed with microspheres 600 ± 75 nm – 2 ml before occlusion. Computed tomography scan of abdominal cavity with intravenous contrast enhancement and laboratory test of platelet levels were performed. Follow up of patients was carried out at 1, 3 and 6 months after this intervention.Results. The postoperative period in all patients was uncomplicated. Postembolization syndrome (pain, hyperthermia) developed in the early postoperative period in all patients on the next day after the procedure. Computed tomography scan of the abdominal cavity revealed areas of an irregular shape of low density that did not accumulate a contrast agent. The duration of hospitalization was 7.63 ± 3.32 (5–11) days. There were not in-hospital and 30-day mortality in our study.Conclusion. The first experience of endovascular partial spleen embolization showed its safety and efficacy in the correction of thrombocytopenia in patients with liver cirrhosis.

scholarly journals Diagnostics and treatment of abdominal complications after gynecological endoscopic operations

2021 ◽  
Vol 1 ◽  
pp. 75-79
Author(s):  
Yu.P.  Vdovichenko ◽  
V.I.  Boyko ◽  
V.A.  Terehov
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Main Group ◽  
Laparoscopic Technique ◽  
Control Group ◽  
Diffuse Peritonitis ◽  
Abdominal Complications

The objective: to analyze the results of repeated laparoscopy in gynecological patients with suspected intraperitoneal postoperative complications.Materials and methods. The study involved 42 patients (mean age 46±11,3 years), in whom postoperative abdominal complications after surgical treatment of various gynecological diseases required repeated operations. Depending on the method of re-intervention, the patients were divided into 2 groups: the main group (n=20) – women who only used laparoscopy to correct postoperative complications; control (n=22) – women who were given indications for relaparotomy to correct postoperative complications during diagnostic laparoscopy. Relaparotomy was performed in 8 patients of the control group. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in terms of age and structure of operations performed on the pelvic organs, and statistically comparable.Results. During the study, the results of repeated laparoscopy of 34 gynecological patients with suspected intraperitoneal postoperative complications were analyzed. In all patients of the main group (47,6%), laparoscopy was revealed as the only and final method of treatment of postoperative complications, while in 7 women repeated relaparoscopy was used from 2 to 4 times, and in 13 women laparoscopy was performed once. In the control group (53,3%), 10 patients during diagnostic laparoscopy were exposed to indications for relaparotomy, in 4 patients the capabilities of the operating team and laparoscopic technique allowed performing some elements of the operation and completing it with a minilaparotomy approach, and 8 patients underwent relaparotomy immediately.Peritonitis and intraperitoneal bleeding prevail in the structure of early abdominal complications. The use of the video laparoscopic technique made it possible in 28,6% of patients with diffuse peritonitis to successfully eliminate the developed complication, eliminate its source and sanitize the abdominal cavity. Laparoscopic hemostasis was successfully performed in 7 patients.Compared with the standard, the use of video endoscopic technique allowed improving the indicators of diagnostic value: to increase the sensitivity level by 1,07 times, specificity by 1,39 times and diagnostic accuracy by 1,11 times.Conclusion. In general, in the early postoperative period, 47 relaparoscopies were performed for suspected complications, which is explained by programmed abdominal sanitization and the use of dynamic laparoscopy to control the course of intraperitoneal complications. Based on the analysis of the material under study, we proposed general indications and contraindications for relaparoscopy in the early postoperative period in order to diagnose and treat postoperative complications. Justifying each of the points, we were guided by the real possibilities of the method in general clinical practice, which in some cases are inferior in their effectiveness to relaparotomy.

scholarly journals One-Stage Repair of Aortic Arch Hypoplasia Associated With Ventricular Septal Defect

2020 ◽  
pp. 52-56
Author(s):  
Y. Truba ◽  
R. Sekelyk ◽  
I. Dzyurii ◽  
L. Prokopovych ◽  
O. Golovenko ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Postoperative Period ◽  
Balloon Dilation ◽  
Early Postoperative Period ◽  
Long Term Results ◽  
One Stage ◽  
The Mean ◽  
Aortic Arch Hypoplasia

  Background. Aortic arch hypoplasia is a congenital anomaly of the development of the aortic arch characterized by ground. Aortic arch hypoplasia is a congenital anomaly of the development of the aortic arch characterized by hemodynamically significant narrowing of one or more segments of the aortic arch. Aortic arch hypoplasia combined ynamically significant narrowing of one or more segments of the aortic arch. Aortic arch hypop with ventricular septal defect (VSD) characterizes a special category of children who are in serious condition and need ptal defect (VSD) characterizes a special category immediate surgery. Despite the improvement in the results of surgical treatment of this abnormality in recent years, the gery. Despite the imp issue of choosing treatment tactics remains debatable. g The aim. To analyze immediate and long-term results of one-stage aortic arch hypoplasia repair and VSD repair in infants. Materials and methods. From 2011 to 2019, 55 infants underwent simultaneous aortic arch hypoplasia repair in ypoplasia rep conjunction with VSD repair at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine and junction with VSD repair at the National Amosov Institute of Cardiovascular Surgery Ukrainian Children’s Cardiac Center. There were 30 (55%) male patients and 25 (45%) female patients. The mean age of (55%) male patients and 25 (45%) female patients. The mean ag the patients was 1.3 ± 1.2 months (from 0.1 to 9.1 months), the average body weight was 3.9 ± 1.3 kg (from 2.4 to 8.7 patients was 1.3 ± 1.2 months (from 0.1 to 9.1 months), the average body weight was 3.9 ± 1.3 kg ( kg). The mean body surface area was 0.27 ± 0.1 m2. Antegrade selective cerebral perfusion was performed in 23 (42%) g). The mean body patients during the aortic arch reconstruction. g Results.The hospital mortality rate was 1.8% (n = 1). The average duration of artificial circulation was 108.5 ± 38.6 minpital mortality rate was 1.8% (n = 1). The averag utes (from 55 to 204 minutes), aortic clamping time was 56.9 ± 36.4 minutes (from 21 to 126 minutes), the time of selec(from 55 to 204 minutes), aortic clamping time was 56.9 ± 36.4 minutes (from 21 to 126 minutes) tive cerebral perfusion was 26.4 ± 11.5 minutes (14 to 49 minutes). In eight patients (14.5%) the sternum was spread perfusion was 26.4 ± 11.5 minutes (14 to 49 minutes). In eight patients (14.5%) the sternum was sp apart in the early postoperative period. Echocardiography before discharge revealed the average pressure gradient at the part in the early postoperative period. Echocardiograp site of plasticity of the aortic arch of 20.5 ± 14.9 mm Hg. plasticity of the aortic arch of 20.5 ± 14.9 mm Hg. The mean long-term follow-up was 2.6 ± 2.1 years (from two months to 8.1 years). There were no fatal cases in the reg-term follow-up was 2.6 ± 2.1 years (from two months to 8.1 years) mote period. In 5 (9.1%) patients aortic arch restenosis occurred in the postoperative period; it was successfully treated period. In 5 (9.1%) patients aortic arch restenosis occurred in the postoperative period; it was successfully endovascularly by balloon dilation in 3 patients, the other 2 of them underwent repeated aortic arch repair. Long-term y by balloon dilation in 3 patients, the other 2 of them underwent repeated aortic arch repair. Long follow-up of other patients showed good results with respect to the pressure gradient at the aortic arch. There were p of other patients showed good results with respect to the pressure g no hemodynamically significant gradient after VSD closure. There were no neurological complications in the long-term follow-up. p Conclusions. One-stage complete repair is an effective and safe treatment for infants which provides good immedige complete repair is an effective and safe treatment for infants which provides g ate and long-term results. This surgical strategy may be an acceptable alternative to two-stage surgical treatment of this g complex pathology.

scholarly journals One-stage Laparoscopic Nephrectomy and Ovariohysterectomy for Concurrent Dioctophymosis and Pyometra in a Bitch

2018 ◽  
Vol 46 ◽  
pp. 4
Author(s):  
Hellen Fialho Hartmann ◽  
Marília Teresa De Oliveira ◽  
João Pedro Scussel Feranti ◽  
Gabriela Pesamosca Coradini ◽  
Bibiana Zoppas Pierezan ◽  
...  
Keyword(s):  
Abdominal Cavity ◽  
Laparoscopic Approach ◽  
Renal Parenchyma ◽  
Laparoscopic Nephrectomy ◽  
Intermediate Hosts ◽  
Polyglactin 910 ◽  
Invasive Approach ◽  
One Stage ◽  
Port Access ◽  
The Right

Background: Dioctophyme renale, also known as “giant kidney worm”, is a cosmopolitan parasite, which usually affects domestic and wildlife canids in wetlands. Nephrotomy and nephrectomy are the only treatment options. Laparoscopic nephrectomy for dioctophymosis was first performed in veterinary patients in the late 90’s. Canine pyometra is one of themost frequent surgical disorder in the small animal setting. The purpose of this study was to report a case of successful one-stage laparoscopic approach for nephrectomy and ovariohysterectomy in a bitch.Case: A female stray dog, rescued from a riverside community, was presenting hematuria. Abdominal echography revealed presence of Dioctophyme renale worms within the right renal parenchyma. Moreover, the uterus was moderately filled by anechoic content. The patient was clinically stable and undergone laparoscopy. A 10-mm trocar was established at the middle third of the right flank, followed by 12-mmHg CO2 insufflation. The telescope was inserted and a giant worm wasseen free within the abdominal cavity. A second 10-mm port was inserted cranial and dorsally to the first one. The parasite was retrieved using a laparoscopic Kelly forceps. A third 5-mm trocar was inserted in a classic laparoscopic triangulation port positioning. Renal artery and vein were individually triple ligated using titanium clips and then transected. The rightovarian pedicle was sequentially coagulated and transected using laparoscopic bipolar forceps. The right kidney was then dissected and detached from the abdominal wall, followed by cauterization and transection of the left ovarian pedicle. The uterus was exposed out of the abdominal cavity through the 5-mm port access. Uterine body and vessels were double ligated using polyglactin 910, with transfixating ligatures, and then transected. The opening of the retrieval bag was exposed through the cranial port site incision. Eight dioctophyme worms and the kidney sections were withdrawn through the sacusing a Kelly hemostat. Abdominal wounds were closed in two layers using cross-mattress polyglactin 910 sutures. Skinwas closed using interrupted horizontal mattress nylon sutures. Patient was discharged on the early post-op, receiving tramadol chloride and sodium dipyrone for three days and enrofloxacin for seven days. The patient recovered uneventfully. Owner was contacted by phone eight months following surgery, which informed the bitch was clinically stable.Discussion: Riverside stray dogs present high incidence of dioctophymosis worldwide, due to irregular feeding and consequent intake of intermediate hosts. The reported patient met those features, without previous background regarding infestation episode. It presented hematuria, which usually results from renal parenchyma consumption by the worms. The patient was retrieved nine dioctophyme worms. Laparoscopic approach for nephrectomy has already been reported in veterinary patients, as well as three-port lap-assisted OVH have been performed. Innovative aspect of this case report concerns the one-stage laparoscopic approach for both nephrectomy and OVH. Moreover, the procedures required only three-port access, which was considered a suitable and safe minimally invasive approach in dogs affected by Dioctophyme renale and concurrent indication for OVH. The three-port access shown is adequate to perform one-stage nephrectomy and ovariohysterectomy in bitches, for reaching benefits of laparoscopic surgery in comparison to conventional approaches.Keywords: canine, endosurgery, kidney, laparoscopy, videosurgery.

scholarly journals PUNCTIONAL DRAINAGES UNDER ULTRASOUND CONTROL IN ABDOMINAL SURGERY

2018 ◽  
Vol 14 (1-2) ◽  
pp. 49-53
Author(s):  
R.A. Sydorenko
Keyword(s):  
Abdominal Cavity ◽  
Surgical Care ◽  
Operative Management ◽  
Pathological Process ◽  
Term Treatment ◽  
Main Task ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Endogenous Factors ◽  
Abdominal Organs

Relevance. Punctic-drainage interventions under the control of ultrasound have become an effective help in complex treatment. But some technological aspects in the procedure and post-operative management of patients remain the subject of discussion. Objective: to improve the results of the use of punctional drainages under ultrasound control in abdominal and retroperitoneal pathology. Materials and methods. Echo-controlled puncture-drainage interventions are used in 89 patients: with pancreatogenic fluid concentrations in the stuffing box, parapancreatic cellular spaces (34); with intra-abdominal complications following operations on the abdominal organs (18), inflammatory processes in the gall bladder (15), tumor obstruction of the bile ducts (12), and with liver abscesses (10). Depending on the nature of the contents of the "target", its localization for puncture drainage was used by trokars of various modifications and diameters, as well as stylet-catheters of the type "PIGTAIL". Manipulation was carried out using ultrasonic devices with convection (frequency 3.5 MHz) and linear (frequency 7-12 MHz) sensors. In 68 patients, the display for intervention was infected fluid formation. In 12 – jaundice syndrome and 9 patients – sterile clusters of enzymatically active content. The main task of puncture-drainage procedures was the evacuation of the content of pathological or anatomical fluid formations to reduce intoxication and (or) their decompression. In assessing the effectiveness of minimally invasive techniques, account was taken of the effectiveness of the operation, that is, the target effect for which the intervention was performed, and the number of complications. Results. Puncture-drainage interventions have become independent and end-of-term treatment in 68 out of 85 cases (with the exception of 4 patients who, due to complications during the procedure, used other methods). The reasons for the reduced effectiveness of echo-controlled puncture-drainage interventions in 9 patients were: the predominance of the tissue component (large sequester) in the cavity, the presence of multiple isolated gates, the use of drainage structures with insufficient drainage properties. Fatal consequences in 5 patients are caused both by the above reasons, and by endogenous factors (a significant prevalence of the pathological process, decompensated background pathology, reduction of internal reserves of the organism). Conclusions. Puncture-draining interventions under ultrasound control are an alternative to open surgical interventions, especially in patients with severe concomitant pathology, severe general condition. In this case, they can be as element (stage) of complex treatment and an independent, final method of surgical care. The choice of echo-controlled interventional technologies as a method of operational correction should be carried out with understanding their capabilities. The effectiveness of such mini-invasive methods allows us to recommend their acceptance in surgical hospitals for diseases of the abdominal cavity organs and retroperitoneal space.

Sign in / Sign up

Export Citation Format

Share Document