scholarly journals Experience of the use of anti-adhesive barrier based on sodium hyaluronate and carboxymethylcellulose in gynecological surgery

2019 ◽  
pp. 149-153
Author(s):  
A. S. Molotkov ◽  
E. N. Popov ◽  
A. O. Ivanova ◽  
E. V. Kazantseva
Keyword(s):  
Postoperative Period ◽  
Abdominal Cavity ◽  
Uterine Fibroids ◽  
Sodium Hyaluronate ◽  
Uterine Cavity ◽  
Early Postoperative Period ◽  
Gynecological Surgery ◽  
Surgical Interventions ◽  
And Control

The article presents our experience in the use of anti-adhesive barrier based on hyaluronic acid and carboxymethylcellulose in gynecological surgery. The study included 63 patients who underwent removal of polyps, uterine fibroids, intrauterine synechiae, removal of ovarian cysts. At the end of operations an anti-adhesive gel was introduced into the uterine cavity and into the abdominal cavity to prevent adhesions. Efficacy and safety were assessed in the early postoperative period and with a further sixmonth follow-up of patients. It is noted that the introduction of the gel does not lead to the development of hyperthermic reactions, and in the postoperative period in patients there is no increase in the level of leukocytes (6.3 ± 0.2 x 109/L before the operation and 5.8 ± 0.5 x 109/L in postoperative period). In 89.7% of patients after surgical interventions, normalization of the menstrual cycle was noted, in 23% of patients with infertility, pregnancy was noted. When carrying out ultrasound of the pelvic organs and control hysteroscopy (in 7 cases), no evidence of the occurrence of adhesions was obtained.

Results of infertility treatment using ART methods in patients who underwent myomectomy: risk factors for repeated unsuccessful ART programs

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 44-49
Author(s):  
Irena F. Kozachenko ◽  
Veronika Y. Smolnikova ◽  
Leila V. Adamyan
Keyword(s):  
Risk Factors ◽  
Uterine Fibroids ◽  
Uterine Cavity ◽  
Art Programs ◽  
Hysteroscopic Myomectomy ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Art Program ◽  
Adverse Pregnancy

Aim. To evaluate the results of treatment of patients with uterine fibroids and infertility with ineffective art programs in the anamnesis and to identify possible risk factors for repeated art failures. Materials and methods. 510 patients with uterine fibroids and infertility were examined and surgically treated prior to the ART program. Myomectomy was performed using various approaches: laparoscopic access in 250 patients, laparotomic access in 70 patients, hysteroscopic myomectomy in 100 patients, and combined access (laparoscopic and hysteroscopic) in 90 women. Results. Primary infertility was observed in 38.0%, secondary in 62.0% of patients. The average duration of infertility was 4.41.9 years. ART had in history 54.5% of patients. During the follow-up period up to 2 years, 24.3% of women had recurrent uterine fibroids. After carrying out of surgical treatment and the following ART pregnancy was achieved in 44.3% of patients. Pregnancies ended in childbirth in 58.8% of cases, which exceeded the total share (41.6%) of adverse pregnancy outcomes (ectopic pregnancy, abortions, spontaneous miscarriages at various times) by 1.4 times. Conclusion. Risk factors for repeated ART failures in patients who have undergone myomectomy are: age over 40 years; duration of infertility for more than 5 years and the presence of 3 or more ineffective IVF attempts in the history; the presence of previous surgical interventions such as uterine artery embolization and FUS-ablation; the presence of submucous fibroids, a dominant node located close to the uterine cavity and myoma with signs of blood supply disorders; the combination of uterine fibroids with external genital endometriosis and chronic endometritis.

scholarly journals Repair of Saphenofemoral Transition: Reşat Operation for Patients With Venous Reflux

2018 ◽  
Vol 102 (9-10) ◽  
pp. 446-458
Author(s):  
Ilker Alat
Keyword(s):  
Postoperative Period ◽  
Valsalva Maneuver ◽  
Color Doppler ◽  
Early Postoperative Period ◽  
Venous Reflux ◽  
Surgical Interventions ◽  
First Choice ◽  
Physical Examinations ◽  
Late Postoperative Period

Objective: To develop a new solution superior to the current surgical interventions in patients with venous reflux in the great saphenous vein (GSV). Materials and Methods: Patients with the symptoms of venous incompetence in their legs like pain, edema, and cramp were also examined with color Doppler ultrasonography (CDU). One hundred ninety-one extremities with venous reflux at the saphenofemoral transition (SFT) were subjected to surgery over 8 years. A newly designed operation, the Reşat operation, was performed in all of the patients. The Reşat Operation was performed only in the patients with continuous reflux at their saphenofemoral transition during the entire Valsalva maneuver. The follow-up time spanned more than 8 years. The patients' complaints, physical examinations, and CDU findings were evaluated. Results: All of the patients had continuous reflux at the SFT for the duration of the entire Valsalva maneuver preoperatively. However, 67.88% of the patients had no reflux postoperatively (P < 0.001). Additionally, 95.76% of the patients recovered to different degrees in the early postoperative period ultrasonographically (P < 0.001). All of the patients reported being satisfied with the result in the early postoperative period (P < 0.001). In the late postoperative period, although the CDU reports of some patients showed reflux at the GSV, no patient complained about their condition. Conclusion: The Reşat operation is a well-tolerated operation and reconstitutes the saphenofemoral transitions successfully. Its early and late postoperative results are satisfactory. The Reşat operation should be the first-choice surgical treatment in patients with venous reflux at the saphenofemoral transition.

scholarly journals The use of enoxaparin as bridge to therapeutic INR after LVAD implantation

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zubair Shah ◽  
Ioannis Mastoris ◽  
Prakash Acharya ◽  
Aniket S. Rali ◽  
Moghni Mohammed ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Left Ventricular ◽  
Early Postoperative Period ◽  
Index Admission ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Bleeding Events ◽  
Ventricular Assist ◽  
Safety Outcome

Abstract Background Left ventricular assist devices (LVAD) have been increasingly used in the treatment of end-stage heart failure. While warfarin has been uniformly recommended in the long-term as anticoagulation strategy, no clear recommendation exists for the post-operative period. We sought to evaluate the feasibility of enoxaparin in the immediate and early postoperative period after LVAD implantation. Methods This is a two-center, retrospective analysis of 250 consecutive patients undergoing LVAD implantation between January 2017 and December 2018. Patients were bridged postoperatively to therapeutic INR by either receiving unfractionated heparin (UFH) or low molecular weight heparin (LMWH). Patients were followed while inpatient and for 3 months after LVAD implantation. The efficacy outcome was occurrence of first and subsequent cerebrovascular accident while safety outcome was the occurrence of bleeding events. Length of stay (LOS) was also assessed. Results Two hundred fifty and 246 patients were analyzed for index admission and 3-month follow up respectively. No statistically significant differences were found between the two groups in CVA (OR = 0.67; CI = 0.07–6.39, P = 0.73) or bleeding events (OR = 0.91; CI = 0.27–3.04, P = 0.88) during index admission. Similarly, there were no differences at 3 months in either CVAs or bleeding events (OR = 0.85; 0.31–2.34; p = 0.76). No fatal events occurred during the study follow-up period. Median LOS was significantly lower (4 days; p = 0.03) in the LMWH group. Conclusions LMWH in the immediate and early postoperative period after LVAD implantation appears to be a concurrently safe and efficacious option allowing earlier postoperative discharge and avoidance of recurrent hospitalizations due to sub-therapeutic INR.

scholarly journals Predicting the Probability of Meningioma Recurrence in the Preoperative and Early Postoperative Period: A Multivariate Analysis in the Midterm Follow-Up

Skull Base ◽  
2007 ◽  
Vol 17 (3) ◽  
pp. 157-171 ◽  
Author(s):  
Faruk İldan ◽  
Tahsin Erman ◽  
A. Göçer ◽  
Metin Tuna ◽  
Hüseyin Bağdatoğlu ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Meningioma Recurrence

Seizures after evacuation of subdural hematomas: incidence, risk factors, and functional impact

2010 ◽  
Vol 112 (2) ◽  
pp. 455-460 ◽  
Author(s):  
Alejandro A. Rabinstein ◽  
Seung Young Chung ◽  
Leslie A. Rudzinski ◽  
Giuseppe Lanzino
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Functional Impairment ◽  
Postoperative Period ◽  
Strong Association ◽  
Early Postoperative Period ◽  
Acute Subdural Hematoma ◽  
Early Functional Outcome ◽  
Gcs Score

Object The purpose of this study was to evaluate the incidence of seizures or epileptiform abnormalities on electroencephalography (EEG) studies in patients undergoing surgical treatment for acute subdural hematoma (SDH). Methods This was a retrospective study of 134 consecutive patients with acute or acute-on-chronic SDH who underwent surgical treatment at the authors' institution between January 2004 and July 2008. Detailed information was collected regarding baseline clinical data (including preexistent functional impairment); Glasgow Coma Scale (GCS) sum scores before and 24 hours after surgery; presence of clinical seizures; EEG findings; and functional outcome on discharge and up to the 6-month follow-up. All brain CT scans were reviewed to calculate SDH volume and midline shift. The Glasgow Outcome Scale (GOS) score was used for functional assessment, and GOS scores of 1–3 were considered indicative of poor outcome. Univariate and multivariate logistic regression analyses were performed to identify statistical associations. Results Clinical seizures or epileptiform changes on EEG were observed during the acute postoperative period in 33 patients (25%). Preexistent functional impairment and seizures/epileptiform EEG findings after surgery were independently associated with poor functional outcome upon hospital discharge (p < 0.001 for both). Preexistent functional impairment (p < 0.001), lower GCS score before surgery (p = 0.04), and lower GCS score 24 hours after surgery (p = 0.007), but not seizures/epileptiform EEG findings, were independently associated with poor functional recovery at 1- to 6-month follow-up evaluations. Seizures/epileptiform EEG findings had a strong association with lower GCS scores after surgery (p = 0.01), and they were more common in patients who underwent evacuation by craniotomy (p = 0.02). Conclusions Epileptic complications are common after acute SDH evacuation, and should be suspected in patients with an unanticipated depressed level of consciousness after surgery. Seizures worsen early functional outcome, but delayed favorable recovery is possible. Therefore, one should be cautious when discussing prognosis in the early postoperative period of patients with epileptic complications.

scholarly journals EFFECTS OF HYPERBARIC OXYGEN THERAPY ON THE POST-OPERATIVE PERIOD IN PATIENTS WITH A DIFFERENT FUNCTIONAL STATUS

2019 ◽  
Vol 26 (2) ◽  
pp. 93-105
Author(s):  
Andrey V. Stakanov ◽  
Vladislav V. Golubtsov ◽  
Alexey E. Muronov
Keyword(s):  
General Population ◽  
Functional Status ◽  
Postoperative Period ◽  
Perioperative Complications ◽  
Colonic Obstruction ◽  
Combined Treatment ◽  
Risk Groups ◽  
Early Postoperative Period ◽  
Surgical Interventions ◽  
Complications And Mortality

Aim. To evaluate the effi cacy of hyperbaric oxygenation (HBO) in patients with a different functional status (FS) after the elimination of acute colonic obstruction (ACO).Materials and methods. A retrospective analysis of 210 medical records of patients who had undergone emergency surgical interventions aimed at ACO elimination was carried out. Based on the value of the direct current potential (DCP), the patients were divided into three groups: 1st (n = 96) with the DCP value from –30 mV and below — FS subcompensation; 2nd (n = 60) with average negative DCP values from –15 to –29.9 mV — FS compensation; 3rd (n = 54) with low negative and positive DCP values from –14.9 mV and higher — FS decompensation. The correlation between patients’ FS and the incidence of postoperative complications was studied, and independent predictors of fatal outcomes were identifi ed. Subsequently, a quantitative analysis of complications and mortality was carried out in each group depending on the use of HBO sessions in the postoperative period, followed by an assessment of their effi cacy.Results. According to the number of perioperative complications and mortality, risk groups in terms of the unfavourable course of the postoperative period were identifi ed: patients with high negative DCP values, for whom the arterial hypotension and acute kidney injury (AKI) could serve as the independent predictors of death; and patients with low negative and positive DCP values, for whom the statistically signifi cant predictors of mortality were shown to be the DCP level, hypotension, AKI and pneumonia. HBO sessions in the postoperative period allow the number of complications in the general population to be reduced: pneumonia by 7%, delirium by 8.8%, AKI by 6.3%, intestinal dysfunction for more than 3 days by 7.3%. In addition, HBO contributed to a 2.9% decrease in suppurative diseases. The analysis of the data on the HBO application in the general population and FS information showed HBO to have a positive effect on the general somatic status of ACO patients. In addition, HBO treatment is shown to decrease the incidence of complications in the early postoperative period. The effi cacy of HBO is found to be higher in the cohort of the most severe patients with decompensated FS, where such complications as delirium, pneumonia and gastrointestinal paresis were decreased by 22.2%, 13% and 18.5%, respectively. As a result, in this group of patients, a signifi cant decrease of 11.1% in 30-day mortality was achieved.Conclusion. The postoperative period depends on the actual FS. The conducted analysis of HBO therapy has convincingly confi rmed its effi cacy in the combined treatment of patients after the elimination of ACO. 

scholarly journals Does mitral valve repair matter in infants with ventricular septal defect combined with mitral regurgitation?

2018 ◽  
Vol 11 (2) ◽  
pp. 85-92
Author(s):  
Yuriy Yu Kulyabin ◽  
Ilya A Soynov ◽  
Alexey V Zubritskiy ◽  
Alexey V Voitov ◽  
Nataliya R Nichay ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Ventricular Septal Defect ◽  
Postoperative Period ◽  
Septal Defect ◽  
Early Postoperative Period ◽  
Valve Repair ◽  
Significant Difference

OBJECTIVES: This study aimed to assess mitral valve function after repair of ventricular septal defect (VSD) combined with mitral regurgitation (MR) in the mid-term follow-up period, to evaluate the clinical utility of simultaneous mitral valve repair (MVR). METHODS: From June 2005 to March 2014, 60 patients with VSD and MR underwent surgical treatment. After performing propensity score analysis (1:1) for the entire sample, 46 patients were selected and divided into 2 groups: those with VSD closure and MVR - 23 patients and those with VSD closure without mitral valve intervention - 23 patients. The follow-up period - 32 (28;40) months. RESULTS: There was no postoperative mortality in either group. There was no significant difference in the duration of the postoperative period between groups. Mean cardiopulmonary bypass time and aortic cross-clamping time were significantly longer in the 'VSD + MVR' group (cardiopulmonary bypass, P=0.023; aortic cross-clamp, P< 0.001). There was no significant difference in regurgitation area (P=0.30) and MR grade (P= 0.76) between groups postoperatively. There was no significant difference in freedom from MR ≥ 2+ between groups (log-rank test, P= 0.28). The only significant risk factor for recurrent MR ≥ 2+ during the follow-up period was mild residual MR in the early postoperative period ( P=0.037). CONCLUSIONS: In infants with VSD combined with MR, simultaneous MVR has no benefits simultaneous MVR provided no advantage over that of isolated VSD closure. We found that the presence of mild residual MR in the early postoperative period predisposes the development of MR ≥ 2+ in follow-up period.

scholarly journals Photodynamic therapy in the treatment of stomach cancer

2018 ◽  
Keyword(s):  
Photodynamic Therapy ◽  
Postoperative Period ◽  
Intestinal Anastomosis ◽  
Effective Means ◽  
Combined Treatment ◽  
Early Postoperative Period ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Biopsy Channel ◽  
Small Intestinal

The analysis of the results of treatment of 10 patients with gastric cancer with high surgical risk, who in the treatment complex used photodynamic therapy with photosensitizer Photolon and further irradiation with a semiconductor laser with a wavelength of λ = 0.67 μm cross-irradiation fields introduced through the biopsy channel of the endoscope. Endoscopic PDT can be used at the stage of combined treatment in combination with drug therapy and surgical interventions and is an effective means of preventing the development of esopha- geal-small intestinal anastomosis failures in the early postoperative period. Endoscopic PDT can also be used in the postoperative period as a prophylaxis of early postoperative complications in cases of detection of tumor cells in the margins of resection.

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