scholarly journals CHOLELITHIASIS IN INFANTS – CONSERVATIVE OR SURGICAL TREATMENT?

2018 ◽  
Vol 63 (4) ◽  
pp. 63-68
Author(s):  
N. G. Lupash ◽  
K. A. Shakaryan ◽  
S. Yu. Matalayeva ◽  
L. A. Kharitonova
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Conservative Therapy ◽  
Treatment Effectiveness ◽  
Contractile Function ◽  
Morphological Changes ◽  
Gallbladder Wall ◽  
Priority Method ◽  
Second Year ◽  
Dissolution Of Gallstones

The aim of the research: to optimize the treatment strategy of cholelithiasis in infants by studying the conservative therapy and surgical treatment effectiveness.Children with cholelithiasis were divided into three groups: 60 children received conservative treatment; 14 children were not treated; 22 children underwent cholecystectomy. Conservative treatment was carried out by administration of Ursofalk suspension (Dr. Falk Farma, Germany) on the daily dose basis – 20 mg/kg of body weight per day once a day – at bedtime. Duration of litholysis ranged from 6 to 24 months. The therapeutic effect was controlled every 3 months by ultrasound examination of the bile ducts and biochemical analysis of blood serum.Results. Contractile function of the gallbladder normalized after 6 months, biochemical markers of cholestasis after 3 weeks, lipidogram by the end of  the second year of conservative treatment. All children tolerated therapy well. No side effects were found. No spontaneous dissolution of gallstones was observed in 14 children who did not receive litholytic therapy. In 22 children, who underwent surgery, morphological changes in the gallbladder wall were reversible, but most of them formed post-cholecystectomy syndrome. In view of the aforesaid, conservative therapy should be considered the priority method of cholelithiasis treatment in children under 3 years of age. Surgical treatment should be performed only according to vital indications. 

scholarly journals Outpatient management of patients with discogenic lumbosacral radiculopathy

2021 ◽  
pp. 420-425
Author(s):  
V. S. Prokopovich
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Muscle Relaxant ◽  
Conservative Therapy ◽  
Surgical Intervention ◽  
Outpatient Management ◽  
Lumbosacral Radiculopathy ◽  
Intravenous Drip ◽  
Outpatient Practice ◽  
Group B

Disсоgenic lumbosacral radiculopathy (DLSR) is less common than lumbar musculoskeletal pains, but has a worse forecast and is more often accompanied by a long disabilities. Most patients with DLSR can effectively be treated under polyclinic conditions, but it is not clear how effective conservative methods of DLSR therapy are used in real outpatient practice. This study was carried out in order to analyze the outpatient maintenance of patients with DLSR, which were surgical treatment (lumbar microdiskectomy) due to the ineffectiveness of conservative therapy.Materials and methods. 90 patients (33 men, 57 women, average age – 59.78 ± 12) years suffered surgical treatment (microdiskectomy) due to the ineffectiveness of conservative DLSR. The duration of the disease to operation ranged from 2 to 14 weeks and was an average of 6 ± 3 weeks.Results. Patients were not informed about the favorable course of the DLSR, the possibilities of natural (without surgical intervention) of the regression of the disk hernia, as well as expediency to maintain all types of activity, avoid a long bed mode. Only half of the patients were conducted by therapeutic gymnastics. 94.4% of patients received non-steroidal anti-inflammatory funds, 92.2% – muscle relaxant, 79.8% – a complex of vitamins of group B, and epidural blockade with anesthetics and corticosteroids were not used. Relatively widely used ineffective methods of therapy of the DLSR: paravertebral blockade of analgesics (42.2%), intravenous drip administration of actovegin and/or pentoxyfalline (26.7%), magnetotherapy and/or laser and therapy (36.7%).Conclusion. In an outpatient practice, patients with DLSR do not receive effective conservative treatment, which may be a reason for the early (after 6 weeks) directions for surgical treatment. Polyclinic doctors are poorly informed about the effective conservative methods of DLSR therapy.

scholarly journals CONSERVATIVE TREATMENT EXPERIENCE SEVERE PERIODONTITIS USING MODERN METHODS DESTRUCTION OF BIOFILM AND TECHNOLOGY PLASMOLIFTING

2014 ◽  
Vol 10 (1) ◽  
pp. 13-18
Author(s):  
Р. Буляков ◽  
R. Bulyakov ◽  
Р. Сабитова ◽  
R. Sabitova ◽  
О. Гуляева ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Standard Therapy ◽  
Conservative Therapy ◽  
High Efficiency ◽  
Clinical Signs ◽  
Severe Periodontitis ◽  
Modern Methods ◽  
Non Surgical Treatment ◽  
Observation Period

<p>With the purpose of search of new effective methods of non-surgical treatment of chronic generalized severe periodontitis we carried out a complex conservative treatment of 27 patients, includes in addition to the standard therapy following combination:  hardware remo val  subgingival bio films  and  t e chnology Plasmolifting.</p><p>The absence of clinical signs of inflammation, stable level values hygienic indexes for the whole observation period and the reduction of the depth of periodontal pockets, confirmed the high efficiency of conservative therapy  of severe periodontitis, developed by  our therapeutic complex.</p>

Cesarean scar defects: diagnosis and treatment in non-pregnant women

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 6-10
Author(s):  
Sergey A. Martynov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Genital Tract ◽  
Conservative Therapy ◽  
Clinical Manifestations ◽  
Subsequent Pregnancy ◽  
Resonance Imaging ◽  
Diagnostic Features ◽  
Pregnancy And Childbirth

The aim of the review was to summarize information on clinical manifestations, diagnostic features, as well as methods for correction of scar defects after cesarean section (CS) outside pregnancy. Lack of the scar after CS, niche, isthmocele are a myometrium defect in the area of scar after CS, which is most often detected by ultrasound, sonohysterography or magnetic resonance imaging and is manifested by postmenstrual bleeding from the genital tract. In some cases, it can cause menorrhagia, dyspareunia, pelvic pain, infertility, uterine rupture during subsequent pregnancy and childbirth. Conservative therapy or surgical treatment with laparoscopy, laparotomy or vaginal approach is carried out depending on the symptoms, size of the defect, the thickness of the residual myometrium, as well as the womans reproductive plans.

Chemical Ablation in Adenoid Surgery

2018 ◽  
Vol 69 (10) ◽  
pp. 2722-2724
Author(s):  
Teodora Ioana Ghindea ◽  
Alexandru Dumitras Meius ◽  
Dragos Cristian Stefanescu ◽  
Catalina Pietrosanu ◽  
Irina Ionita ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Chronic Inflammation ◽  
Lymphatic Tissue ◽  
Tissue Mass ◽  
Surgical Method ◽  
Endoscopic Control ◽  
Chemical Ablation ◽  
Pharyngeal Tonsil

The pharyngeal tonsil is a lymphatic tissue mass located in the roof of the nasopharynx. The function of the pharyngeal tonsil is to prevent infections with the help of antibodies. Chronic inflammation and allergies lead to hyperplasia of the adenoids that is found almost exclusively in children. The treatment of choice is surgical treatment; conservative treatment is only indicated preoperatively or if surgery is contraindicated. In this paper, we will present a new surgical method for adenoidectomy performed trans-orally with coblation, under endoscopic control.

scholarly journals Efficacy and safety of condylectomy with minimally invasive surgery in the treatment of interdigital corns of the lesser toes compared to conservative treatment

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Luis M. Marti-Martinez ◽  
Rubén Lorca-Gutierrez ◽  
Salvador Pedro Sánchez-Pérez ◽  
Jonatan Garcia-Campos ◽  
Nadia Fernández Ehrling ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Minimally Invasive ◽  
Functional Status ◽  
Invasive Surgery ◽  
Joint Stiffness ◽  
Efficacy And Safety ◽  
Clinical And Functional Status

Abstract Background Minimally invasive surgery (MIS) procedures cause less trauma to the patient and might improve recovery. This study aimed to determine the efficacy and safety of condylectomy with MIS to treat interdigital corns of the lesser toes. Methods This prospective cohort study was conducted in seven podiatry centers. Patients with interdigital corns of the lesser toes, progressing for more than a year, with one or more recurrences in the last year following conservative treatments were eligible. The recruited patients were classified according to their treatment: conservative or surgical (condylectomy with MIS) and were compared. Patient satisfaction, pain, the clinical and functional status of the foot and the appearance of sequelae were assessed at 3 and 6 months after treatment. Results At 6 months, patients in the surgical treatment group showed no pain on pressure, which significantly differed from the conservative treatment group (p <  0.001). They also improved clinical and functional status of the foot, reaching values comparable to those of the standard population. No paresthesia, joint stiffness or instability, toe malalignment, or corn transfer to a contiguous site resulted from the surgical treatment. Conclusions Condylectomy with MIS is effective and safe to treat interdigital corns of the lesser toes.

scholarly journals Effect of childhood overweight on distal metaphyseal radius fractures treated by closed reduction

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu Liu ◽  
Chunjie Liu ◽  
Dongmei Guo ◽  
Ning Wang ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Closed Reduction ◽  
Pediatric Population ◽  
Normal Weight ◽  
Medical Community ◽  
Overweight Children ◽  
Radius Fractures

Abstract Background The medical community has recognized overweight as an epidemic negatively affecting a large proportion of the pediatric population, but few studies have been performed to investigate the relationship between overweight and failure of conservative treatment for distal radius fractures (DRFs). This study was performed to investigate the effect of overweight on the outcome of conservative treatment for DRFs in children. Methods We performed a retrospective study of children with closed displaced distal metaphyseal radius fractures in our hospital from January 2015 to May 2020. Closed reduction was initially performed; if closed reduction failed, surgical treatment was performed. Patients were followed up regularly after treatment, and redisplacement was diagnosed on the basis of imaging findings. Potential risk factors for redisplacement were collected and analyzed. Results In total, 142 children were included in this study. The final reduction procedure failed in 21 patients, all of whom finally underwent surgical treatment. The incidences of failed final reduction and fair reduction were significantly higher in the overweight/obesity group than in the normal-weight group (P = 0.046 and P = 0.041, respectively). During follow-up, 32 (26.4%) patients developed redisplacement after closed reduction and cast immobilization. The three risk factors associated with the incidence of redisplacement were overweight/obesity [odds ratio (OR), 2.149; 95% confidence interval (CI), 1.320–3.498], an associated ulnar fracture (OR, 2.127; 95% CI, 1.169–3.870), and a three-point index of ≥ 0.40 (OR, 3.272; 95% CI, 1.975–5.421). Conclusions Overweight increases the risk of reduction failure and decreases the reduction effect. Overweight children were two times more likely to develop redisplacement than normal-weight children in the present study. Thus, overweight children may benefit from stricter clinical follow-up and perhaps a lower threshold for surgical intervention.

Achievements of the Clinic of Traumatology and Orthopedics of Moscow State Medical and Dentistry University named after A. I. Evdokimov in treatment of complications and consequences of fractures of long bones of extremities

2021 ◽  
Vol 19 (3) ◽  
pp. 144-151
Author(s):  
P. E. ELDZAROV ◽  
Keyword(s):  
Surgical Treatment ◽  
Treatment Process ◽  
Treatment Effectiveness ◽  
Chronic Osteomyelitis ◽  
Surgical Techniques ◽  
Long Bones ◽  
Delayed Fracture ◽  
Reconstructive Operations ◽  
Fracture Consolidation ◽  
Rapid Restoration

The work is devoted to improving the effectiveness of treatment of patients with complications and consequences of fractures of the long bones of the extremities by improving and developing new surgical techniques aimed at early individual social and household rehabilitation due to the maximally complete and rapid restoration of the integrity and functions of the damaged segment. Reconstructive operations were performed in 285 patients with delayed fracture consolidation, incorrectly fused fractures, false joints, and false joints with chronic osteomyelitis. The analysis of the applied treatment methods effectiveness from the viewpoint of optimizing the treatment process allowed us to develop an algorithm for the surgical treatment of patients with complications and consequences of fractures of the long bones of the extremities. The use of the proposed algorithm in surgical treatment maximally eliminates possible errors and increases the treatment effectiveness.

Surgical treatment of acute abscesses and gangrene of the lungs

1982 ◽  
Vol 63 (1) ◽  
pp. 28-31
Author(s):  
E. A. Wagner ◽  
V. M. Subbotin ◽  
V. D. Firsov ◽  
V. A. Cherkasov ◽  
V. I. Ilchishin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Surgical Interventions

Abstract. The experience of treating 263 patients with acute abscesses and lung gangrene is generalized. Acute abscesses are mainly subject to conservative treatment; surgical interventions were performed in 13%. With gangrene of the lung, conservative treatment and palliative operations are futile. Preference is given to early radical operations performed before dangerous complications occur. Possible ways to reduce mortality in acute pulmonary suppuration are indicated.

Features of surgical treatment of Brown's syndrome in children

2021 ◽  
pp. 11-16
Author(s):  
N.A. Malinovskaya ◽  
◽  
E.V. Semyonova ◽  
A. Toriya ◽  
P.A. Nikonorova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Binocular Vision ◽  
Rectus Muscle ◽  
Oblique Muscle ◽  
Double Vision ◽  
Inferior Rectus ◽  
Inferior Oblique Muscle ◽  
Straight Position ◽  
Third Stage

Purpose. To study the features of surgical treatment of Brown's syndrome in children. Material and methods. 47 children with Brown's syndrome aged from one to 10 years were treated: 4 children had bilateral form, 43 had congenital form and 4 had acquired form. The operation was performed for 44 children. The indications for surgical treatment were double vision in a straight position, forced position of the head, impaired binocular vision. Results. Three children with acquired Brown's syndrome had a positive effect on the background of conservative treatment. Surgical treatment of Brown's syndrome was effective, but often required repeated interventions (31 patients, 70%): the first stage was weakening of the superior oblique muscle (tenotomy, recession, prolongation), the second stage was recession of the inferior oblique muscle, the third stage was recession of the contralateral inferior rectus muscles (4 patients, 9%). In a number of cases (5 children, 11%), at the outcome of surgical treatment, asymmetry of the palpebral fissures was noted due to mild enophthalmos in the operated eye (the result of weakening of the oblique muscles that «pull» the eyes out of the orbit and weakening of the contralateral inferior rectus muscle that «tightens» the eyeball). Conclusion. Surgery for Brown's syndrome is effective, but often requires reoperation. With acquired forms of Brown's syndrome, examination and the first stage of conservative treatment are required. The absolute indications for surgical treatment of Brown's syndrome are forced head position, double vision in a straight position and impaired binocular vision. Keywords: Brown's syndrome, double vision in a straight position, forced position of the head, impaired binocular vision, surgical treatment.

Role of hyperbaric oxygenation in preoperative preparation of patients with pyloroduodenal ulcers

1986 ◽  
Vol 67 (3) ◽  
pp. 164-166
Author(s):  
A. A. Chernyavsky ◽  
P. S. Zubeev ◽  
O. V. Milovidova ◽  
N. G. Mikhailova
Keyword(s):  
Surgical Treatment ◽  
Hyperbaric Oxygenation ◽  
Conservative Therapy ◽  
Selective Proximal Vagotomy ◽  
Preoperative Preparation ◽  
Duodenal Ulcers ◽  
Operative Method ◽  
Surgical Practice

Although conservative therapy remains the main treatment for duodenal ulcers, however, 20-30% of patients require surgical treatment. In recent years a new operative method - selective proximal vagotomy - has been introduced into the wide surgical practice of pyloroduodenal ulcers treatment. Its performance is connected with the decision on the surgeon's tactics concerning the ulcerous niche: should it be excised or left?

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