Evaluation of immediate and long-term results of treatment of post-radiation injuries of the rectum

Introduction. Treatment of post-radiation damage to the rectum is a complex medical problem. The search for new methods of treatment for this category of patients based on modern achievements in regenerative surgery is urgent.The aim of the study was to evaluate the immediate and long-term results of treatment of post-radiation lesions of the rectum using microfat grafting.Materials and methods. The study involved 66 patients — women aged 28 to 83 years inclusive with complications of radiation therapy (rectovaginal fistulas, radiation proctitis, radiation ulcers).Results and discussion. After the treatment, there is a tendency to improve the condition. So, if before the procedure the average sizes of fistulas and ulcers were 1.67 ± 0.54 cm in diameter, then after 3 months these indicators were 1.39 ± 0.54, and after 6 months — 1.1 ± 0.56 cm Complete epithelialization of the defect was observed in all patients. The period for which it was possible to achieve complete epithelialization varies from 6 months to 2 years. On average, to achieve complete epithelialization of post-radiation damage to the rectum, most patients required 3 injections of autologous adipose tissue. Also, all patients showed an improvement in elastometry indices over time. As a result of treatment, there is a tendency to improve the quality of life of patients.Conclutions. The study allows us to conclude about the effectiveness of the treatment, as well as that in the long term, the treatment will also be effective, the likelihood of relapse is minimal.

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Lumbar periarticular cysts of arcorray joint

Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery) ◽

10.33920/med-01-2003-06 ◽

2020 ◽

pp. 47-57

Author(s):

Anton Yarikov ◽

Maxim Shpagin ◽

Iliya Nazmeev ◽

Sergey Gorelov ◽

Olga Perlmutter

Keyword(s):

Minimally Invasive ◽

Severe Pain ◽

Pain Syndrome ◽

Long Term Results ◽

Lumbar Region ◽

Results Of Treatment ◽

Invasive Method ◽

Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

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EFFICACY OF GASTRODUODENAL ANASTOMOSIS IN SURGERY OF DISTAL STOMACH CANCER: FROM PAST TO PRESENT

Problems in oncology ◽

10.37469/0507-3758-2018-64-1-28-33 ◽

2020 ◽

Vol 64 (1) ◽

pp. 28-33

Author(s):

T. Morgoshiya

Keyword(s):

Functional Results ◽

Long Term Results ◽

Billroth Ii ◽

Distal Stomach ◽

Surgical Interventions ◽

Billroth I ◽

Results Of Treatment ◽

Operated Stomach

When comparing the results of surgical interventions in the modifications of Billroth-I and Billroth-II concerning carcinoma there are no significant differences both in immediate and in long-term results of treatment. At the same time the functional results of interventions and quality of life of patients are better after reconstruction of the digestive tract with the help of gastroduodenal anastomosis. Gastric stump cancer is more often occur after Billroth-II surgery. The main cause of the development of carcinoma in this case is the appearance of atrophic gastritis as a result of denervation of the organ and the transfer of bile to the operated stomach.

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LONG-TERM RESULTS OF THE MICROSURGICAL TREATMENT OF THE CEREBRAL ANEURYSM RUPTURES IN PATIENTS AT A COMPENSATED STATE

Kuban Scientific Medical Bulletin ◽

10.25207/1608-6228-2018-25-3-129-132 ◽

2018 ◽

Vol 25 (3) ◽

pp. 129-132

Author(s):

L. V. SHAGAL ◽

V. V. TKACHEV ◽

V. V. SHAGAL ◽

I. S. BLUMENAU ◽

N. V. ZABOLOTSKIKH ◽

...

Keyword(s):

Quality Of Life ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Cerebral Aneurysms ◽

Severe Headache ◽

Severe Disability ◽

Long Term Results ◽

Anxiety And Depression ◽

Results Of Treatment

Aim. To study the severity of cognitive and psychoemotional disorders in the outcome of treatment of the patients with cerebral aneurysms ruptures, who were admitted in a compensated condition.Materials and methods. 57 cases are analyzed in the article. These are the cases of patients who were operated on in an acute state of aneurysmal subarachnoid hemorrhage. The severity of their state when they were admitted was 1-3 according to the Hunt-Hess scale. Depending on the results of treatment, the patients were divided into 2 groups: the first included 37 patients with excellent immediate results of treatment on the inverted Glasgow outcome scale (GOS 1), the second included 20 patients with moderate and severe disability (GOS 2-3).Results. The patients with moderate and severe disability as immediate results of treatment have a lower quality of life than patients with excellent results, due to the presence of severe headache, anxiety and depression disorders.Conclusion. The decline in the quality of life of patients with moderate and severe disability as immediate results of treatment of the cerebral aneurysms ruptures requires a rehabilitation therapy.

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WAYS TO IMPROVE RESULTS OF ENDOSURGICAL TREATMENT OF ACHALASIA

Surgical Practice ◽

10.38181/2223-2427-2020-2-5-9 ◽

2020 ◽

pp. 5-9

Author(s):

O. V. Galimov ◽

V. O. Khanov ◽

M. R. Bakirov ◽

R. R. Saifullin ◽

D. O. Galimov

Keyword(s):

Distal Part ◽

New Technologies ◽

Esophageal Achalasia ◽

Original Method ◽

Long Term Results ◽

Results Of Treatment ◽

Medical University ◽

Oncology Center

Aim. To improve the method of Heller cardiomyotomy for best immediate and long-term results of treatment of esophageal achalasia.Materials and methods. Analyzing the results of surgical treatment of 280 patients with esophageal achalasia who were treated in the Department of Surgical Diseases and New Technologies of the Bashkir State Medical University (Ufa) and the Department of Surgery and Stomach of the Republican Clinical Oncology Center (Kazan) for a period from 2000 to 2019. We conducted a cohort retrospective study in 2 groups (laparoscopic esophagocardiomyotomy according to Heller, supplemented by anterior modified hemifundoplication according to Dor (n = 74) and traditional laparoscopic interventions (n = 206).Results. The authors have developed an original method of laparoscopic esophagocardiomyotomy, including the use of devices that facilitate the mobilization of cardia and the formation of fundoplication cuffs. Patients were examined by performing esophagogastroduodenoscopy, contrast X-ray scopy of the esophagus and stomach, esophagomanometry, pH-measurement in distal part of esophagus. Long-term results of up to 2 years were tracked. Surgically treated patients were tested by special application forms. Received results showed the restoration of quality of life in most of the subjects.Conclusion The developed technique of laparoscopic esophagocardiomyotomy, including the use of intra-esophageal transillumination and a device for measuring the esophagus, prevents damage to the esophagus wall and postoperative complications associated with insufficient or excessive narrowing of the esophagus. Of the 74 patients, 66 (89.2 %) rated the result as excellent and good, 6 (8.1 %) as satisfactory, and 2 (2.7 %) as unsatisfactory.

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Long-term results of treatment of newborns and infants with necrosis and perforation of the stomach and duodenum

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic718 ◽

2021 ◽

Vol 11 (1) ◽

pp. 7-16

Author(s):

Anastasiia A. Skopetc ◽

Svetlana A. Karavaeva ◽

Tatiana K. Nemilova

Keyword(s):

Quality Of Life ◽

Nutritional Status ◽

Neurological Deficits ◽

Long Term Results ◽

First Year ◽

Health Profile ◽

Results Of Treatment ◽

First Year Of Life

INTRODUCTION: Necrosis and perforation of the stomach and /or duodenum in newborns and infants is a rare but severe disease with high mortality. There are many theories about the etiology and pathogenesis of the necrosis and perforation of the stomach and duodenum in children of this age. Various treatment options are described, but neither foreign nor Russian publications have assessed the long-term results of the treatment of patients with perforation of the stomach and duodenum during the first year of life and the quality of their life. AIM: This study aimed to analyze the results of treatment of newborns and infants with perforation of the stomach and duodenum and to assess their long-term quality of life. MATERIALS AND METHODS: The study analyzes the long-term results of treatment of 21 children, aged 212 yrs, with perforation of the stomach and duodenum. The volumetric evacuation function of the stomach and duodenum and the childs nutritional status were assessed. A survey of patients and their parents was also carried out to assess the quality of life of the child using questionnaires from the EuroQol Research Foundation version EQ5D-Y. RESULTS: The volumetric evacuation function of the stomach and duodenum recovered completely. The nutritional status of 16 (76%) children corresponds to their age. According to the results of the analysis of the questionnaire of the quality of life, eight patients aged 8 yrs and 15 parents consider the health profile of children as the best (71%), the parents of one patient assess the health profile of their child as satisfactory, and five mothers of children with neurological deficits rated as unsatisfactory. CONCLUSION: Owing to the high adaptation capacity of the newborn and infants of the first year of life, most of the examined patients have a good quality of life and a normal nutritional status. The volumetric evacuation function of the stomach and duodenum recovered in all patients within 13 yrs after surgery.

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New approach to treatment of ventral hernias of the medial localization

Vestnik of Experimental and Clinical Surgery ◽

10.18499/2070-478x-2020-13-1-10-17 ◽

2020 ◽

Vol 13 (1) ◽

pp. 10-17

Author(s):

Boris Semyonovich Sukovatykh ◽

Pyotr Mikhailovich Nazarenko ◽

Yuriy Yurievich Polevoy ◽

Yuriy Yurievich Blinkov ◽

Andrey Alexeevich Netyaga ◽

...

Keyword(s):

Quality Of Life ◽

Abdominal Wall ◽

Functional Results ◽

Long Term Results ◽

Abdominal Muscles ◽

Results Of Treatment ◽

Thread Diameter ◽

Ventral Hernias

Importance. Functional results of treatment of the ventral hernias of the medial localization after endoprosthetics of the abdominal wall by the standard polypropylene prosthesis remain unsatisfactory because of the limited flexibility of the abdominal wall. Purpose. To improve functional results of treatment of patients with ventral hernias of the medial localization by applying a light strengthened endoprosthesis. Materials and methods. There was done a comparative analysis of the results of treatment of 60 patients with medial hernias of the anterior abdominal wall. Patients were divided into two groups with 30 people in each group. In the first group over-aponeurotic endoprosthetics of the abdominal wall defect was provided with the use of a standard polypropylene prosthesis with the thread diameter 120 micron, while in the second group there was used a light strengthened endoprosthesis with the thread diameter in the basic zones 90 micron and in the strengthened zones 120 and 90 micron. Effectiveness of treatment in the nearest post-operative period was evaluated by the degree of severity of inflammatory implantation response, and in the long-term period evaluation was done on the base of functional state of the abdominal muscles, quality of life of patients and results of treatment by four point scale. Results and their discussion. Inflammatory exudative response on implantation of the light strengthened endoprosthesis was less and reparative response was 1,1 times higher compare to a standard prosthesis. Endoprosthetics of the abdominal wall with a light strengthened endoprosthesis improved contractility of the abdominal muscles in 1,2 times. Restoration of the functions of the abdominal muscles had a positive influence on quality of life, namely, physical component of health improved by 4,5%, as well as on long-term results of treatment by the increased number of excellent and good results of treatment by 20% and reduction of satisfactory results by 20%. Conclusions. The use of a light strengthened endoprosthesis enables to improve the functional results of treatment of ventral hernias of the medial localization.

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THE ANALYSIS OF THE REMOTE FUNCTIONAL RESULTS OF THE ELECTIVE COLONIC RESECTION AT DIVERTICULAR DISEASES

Koloproktologia ◽

10.33878/2073-7556-2016-0-1-30-34 ◽

2016 ◽

pp. 30-34

Author(s):

V. I. Pomazkin ◽

V. V. Khodakov

Keyword(s):

Functional Results ◽

Colonic Resection ◽

Long Term Results ◽

Average Score ◽

Results Of Treatment ◽

Recurrent Diverticulitis ◽

Number Of Patients ◽

Sf 36

AIM. To evaluate long-term results of treatment of patients with the complicated diverticular diseases, after elective colonic resection. PATIENTS. The outcome of 53 patient operated on pretreated recurrent diverticulitis were compared to results of treatment of 50 patients with diverticulitis complicated by perforation and treated initially by colostomy formation. RESULTS. In the first group the number of patients with postoperative functional gastrointestinal frustration and infringements in psychic and emotional sphere were higher, than in second group and correlated to presence of them before operation. Assessment of quality of life using MOS-SF 36 demonstrated decrease of score in all scales of the questionnaire infirst group, while in second group average score was comparable to healthy individuals. CONCLUSION. Indications for elective colonic resectionfor recurrent diverticulitis should be stricter.

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APPLICATION OF NEW TECHNIQUES IN THE TREATMENT OF PATIENTS WITH FRACTURES OF LONG TUBULAR BONES IN SEVERE COMBINED TRAUMA

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2021-23-9-59-66 ◽

2021 ◽

pp. 59-66

Author(s):

Khromov A.A. ◽

Gumanenko E.K. ◽

Linnik S.A.

Keyword(s):

Quality Of Life ◽

Surgical Intervention ◽

Term Treatment ◽

Long Term Results ◽

Results Of Treatment ◽

Long Term Treatment ◽

Combined Injuries ◽

Tubular Bones

Severe combined injuries, and especially polytrauma, differ significantly from other types of injuries by high requirements for the organization of medical care at all its stages, miltidisciplinarity, high financial costs, poor short-term outcomes and long-term treatment results. Therefore, the search for new concepts, strategies and tactics for the treatment of victims is an urgent problem not only for surgeons, resuscitators and traumatologists, but also for healthcare in general. Fractures of long tubular bones accompanying severe combined injuries or polytrauma pose a lesser threat to the life of the victim than severe traumatic brain injuries or damage to internal organs, but they are the main cause of long-term treatment and disability. Such victims make up a significant group of patients-66.2%, therefore they represent a separate problem in traumatology and injury surgery. A modern solution to this problem, improving the results of treatment and the quality of life of victims after suffering a severe combined injury or polytrauma is possible on the basis of new approaches, as well as on the new ideology of osteosynthesis. In the present study, 392 minimally invasive osteosyntheses were performed in 274 patients with severe combined trauma and polytrauma. The indication was the need to fix fractures in order to create favorable conditions for rapid and lasting fusion, early functional treatment and rehabilitation of victims, and to achieve the highest possible level of quality of life after treatment. The possibility and duration of osteosynthesis were determined by the severity of the condition of the victims, assessed by objective methods: a simple clinical scale of VPH-SG or, much less often, specialized resuscitation scales of VPH-SS, SAPS or MODS. The surgical intervention was possible when the severity of the victim's condition reached the highest level of compensation: 16-30 points on the VPH-SG scale. The immediate outcomes of treatment of 274 patients with severe combined trauma and polytrauma after performing a full and final volume of surgery were good. There were no fatal outcomes. The frequency of mild local infectious complications in the field of surgical intervention was 4.0%. The average duration of inpatient treatment was 23.8±2.3 days: with closed intramedullary osteosynthesis - 19.8±0.3 days, with bone osteosynthesis - 24.2±1.2 days, with non - focal osteosynthesis-27.3±1.9 days. The long-term and anatomical and functional results of treatment were analyzed in 158 patients. There were no unsatisfactory long-term results of treatment. Good long-term results were achieved in 81.0%, satisfactory – in 19.0% of the victims. Thus, the results of the analysis of the immediate outcomes and long-term results of treatment of fractures of long tubular bones using the technology of minimally invasive osteosynthesis in patients with severe combined trauma and polytrauma demonstrated the high effectiveness of this surgical technology, on the one hand, and the direct dependence of the treatment outcomes on the severity of the injuries, the severity of the condition of the victims and the number of fractures in one victim, on the other hand.

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