scholarly journals РОЛЬ МЕСТНОГО ИСПОЛЬЗОВАНИЯ КОНЪЮГИРОВАННОГО ЭСТРОГЕНА В УЛУЧШЕНИИ ИСХОДОВ ОПЕРАТИВНОГО ЛЕЧЕНИЯ ПРОЛАПСА ГЕНИТАЛИЙ

Innova ◽  
2019 ◽  
Vol 15 ◽  
pp. 20-23
Author(s):  
Максумова Н.Б. ◽  
◽  
Ниязметов Р.Э. ◽  
Матякубов Б.Б. ◽  
Усинова З.Б.
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Hormonal Therapy ◽  
Genital Prolapse ◽  
Efficacy And Safety ◽  
High Efficacy ◽  
Regenerative Processes ◽  
Genitourinary System ◽  
Surgical Methods ◽  
Conjugated Estrogen

The available surgical methods for the treatment of genital prolapse cannot guarantee the absence of complications in the postoperative period and relapse. In this article, we describe the possibilities of preventing postoperative complications and repeated episodes of prolapse of the genital organs of local hormonal therapy with conjugated estrogen (femistrone) preparations, which directly improves the regenerative processes in the tissues of the genitourinary system. Based on our clinical experience, we came to the conclusion about the high efficacy and safety of topical application of conjugated estrogen (femistrone) for 5-7 days in the preparation of the vaginal walls for surgical treatment.

scholarly journals РОЛЬ МЕСТНОГО ИСПОЛЬЗОВАНИЯ КОНЪЮГИРОВАННОГО ЭСТРОГЕНА В УЛУЧШЕНИИ ИСХОДОВ ОПЕРАТИВНОГО ЛЕЧЕНИЯ ПРОЛАПСА ГЕНИТАЛИЙ

Innova ◽  
2019 ◽  
Vol 15 ◽  
pp. 20-23
Author(s):  
Максумова Н.Б. ◽  
◽  
Ниязметов Р.Э. ◽  
Матякубов Б.Б. ◽  
Усинова З.Б.
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Hormonal Therapy ◽  
Genital Prolapse ◽  
Efficacy And Safety ◽  
High Efficacy ◽  
Regenerative Processes ◽  
Genitourinary System ◽  
Surgical Methods ◽  
Conjugated Estrogen

The available surgical methods for the treatment of genital prolapse cannot guarantee the absence of complications in the postoperative period and relapse. In this article, we describe the possibilities of preventing postoperative complications and repeated episodes of prolapse of the genital organs of local hormonal therapy with conjugated estrogen (femistrone) preparations, which directly improves the regenerative processes in the tissues of the genitourinary system. Based on our clinical experience, we came to the conclusion about the high efficacy and safety of topical application of conjugated estrogen (femistrone) for 5-7 days in the preparation of the vaginal walls for surgical treatment.

Efficacy and safety of surgery for spontaneous pneumothorax in elderly patients

2019 ◽  
Author(s):  
Shunichi Nagata ◽  
Mitsugu Omasa ◽  
Kosuke Tokushige ◽  
Takao Nakanishi ◽  
Hideki Motoyama
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Spontaneous Pneumothorax ◽  
Performance Status ◽  
Multivariable Analysis ◽  
Efficacy And Safety ◽  
Air Leaks ◽  
Grade 3

Abstract OBJECTIVES There is no clear consensus on the surgical indications for spontaneous pneumothorax in elderly patients. In this study, we aimed to assess the efficacy and safety of surgical treatment of spontaneous pneumothorax in patients aged ≥70 years. We also sought to identify the risk factors for postoperative prolonged air leaks and complications in such patients. METHODS Data pertaining to 104 elderly patients who underwent surgery out of 206 patients (aged ≥70 years) who were diagnosed with spontaneous pneumothorax at our institution between 1994 and 2018 were retrospectively reviewed. The incidences of postoperative persistent air leaks (≥2 days) and postoperative complications (≥grade 3; Clavien–Dindo classification) were analysed for efficacy and safety assessment, respectively. RESULTS Median postoperative air leaks continued for 0 days (range 0–25); 14.4% patients developed ≥grade 3 postoperative complications. On the basis of results of multivariable analysis, it was observed that a higher PaCO2 level was significantly associated with prolonged postoperative air leaks [odds ratio (OR) 1.08, 95% confidence interval (CI) 1.00–1.17; P = 0.047]. Poorer performance status was associated with a significantly increased risk of postoperative complications, as assessed by multivariable analysis (OR 6.13, 95% CI 1.38–27.3; P = 0.017). The recurrence rate was 4.8%; mortality rate of patients was 2.9%. Three-year survival rate after surgery was 73.8%. CONCLUSIONS Surgical treatment of spontaneous pneumothorax may be effective and safe in selected elderly patients. Moreover, higher PaCO2 and poorer performance status were independent risk factors for postoperative persistent air leaks and complications, respectively.

scholarly journals The Efficacy and Safety of Surgical Treatment for Patients With Tuberculosis Destroyed Lung With or Without Chronic Pulmonary Aspergillosis

2021 ◽  
Author(s):  
Hongyun Ruan ◽  
Changfan Gong ◽  
Jinxiang Wang
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Mortality ◽  
Efficacy And Safety ◽  
Pulmonary Aspergillosis ◽  
Preoperative Serum ◽  
Chronic Pulmonary Aspergillosis ◽  
Independent Risk Factors ◽  
Destroyed Lung

Abstract Background To evaluate the efficacy and safety of surgical treatment of tuberculosis destroyed lung (TDL), and the influence of chronic pulmonary aspergillosis (CPA) on the outcomes of surgical treatment of TDL. Methods We performed a retrospective analysis of 113 patients with TDL who underwent surgical treatment from January 2005 to December 2019. Among them, 30 of these cases were complicated with CPA. The patients were divided into two groups: TDL group and TDL + CPA group. We analyzed the effectiveness and safety of surgical treatment of TDL, and further compared the effectiveness and safety of surgical treatment of TDL with or withoutthe presence of CPA. Results The TDL + CPA group had a significantly higher age (P=0.003), symptoms of hemoptysis (P=0.000), and a higher proportion of patients with preoperative serum albumin <30 g/L (P=0.014) as compared with TDL group. For all enrolled patients, the incidence of severe postoperative complications was 12.4% (14/113) and the postoperative mortality within 30 days after discharge was 4.4% (5/113). 86.7% (98/113) of the patients recovered and discharged, the incidence of severe postoperative complications in the TDA + CPA group was higher than that of TDL group (23.3% vs 8.4%, P = 0.034), although there was no difference in mortality between the two groups (P = 1.000). A binary logistic regression analysis showed that the independent risk factors for severe postoperative complications were male (OR 25.24, 95% CI 2.31–275.64; P = 0.008) and age ≥ 40 years (OR 10.34, 95% CI 1.56–68.65; P = 0.016). Conclusion Surgical treatment for patients with TDL is effective with an acceptable mortality rate whether or not the disease is complicated with CPA. The independent risk factors identified for severe postoperative complications in patients with TDL were male and ≥ 40 years old. It implies that when treating patients with TDA + CPA, particular attention should be paid to these patients who have these independent risk factors to avoid a poor outcome.

scholarly journals Modern approaches to the treatment of genital prolapse in obese women

2021 ◽  
Vol 11 (7) ◽  
pp. 324-334
Author(s):  
R. Safonov ◽  
V. Lazurenko ◽  
O. Lyashchenko ◽  
I. Afanasyev ◽  
K. Garkavenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Polypropylene Mesh ◽  
Comparison Group ◽  
Genital Prolapse ◽  
Normal Weight ◽  
Control Group ◽  
Obese Women ◽  
Transvaginal Surgery ◽  
Septic Complications ◽  
Surgical Methods

Introduction. The problem of female genital prolapse (GP) remains in the sportlight of gynecologists, because despite the variety of surgical methods, there are still recurrences of the disease, which are associated not only with the failure of the restored ligaments, fascia, muscles, damaged pelvic floor and perineum, but with the imperfection of the operation. The solution of this problem is especially important in the treatment of patients with extragenital pathology, in particular obesity. The purpose: to optimize the treatment of genital prolapse in obese patients by determining an individual approach to planning surgical treatment taking into account the degree of obesity and concomitant pathology. Materials and methods. We examined 65 patients of which 20 had genital prolapse and obesity (main group), 25 had genital prolapse and normal weight (comparison group), 20 women did not have gynecological diseases and extragenital pathology made up control group. To diagnose obesity and determine its degree we calculated body mass index (BMI). To determine the degree of GP its quantitative assessment was used (POP-Q; 1996). Surgical intervention included transvaginal extirpation of the uterus without appendages, anterior colporrhaphy, colpoperineoraphy with levatoplasty, sacrospinal colpopexy. Transabdominal and laparoscopic colposacropexy in obese women were not used due to the presence of relative contraindications for laparoscopy (cardiovascular disease, respiratory pathology, adhesions, the condition after hernias’ surgery). Therefore, all operations on women with GP and obesity were performed transvaginally due to the inability to perform abdominal access. In comparison group transvaginal surgery was performed. All the groups under study were representative. Before the use of polypropylene mesh "Polymesh" to minimize purulent-septic complications associated with the use of synthetic prostheses aquadissection was performed with 0.9% saline with the addition of 1 g of ceftriaxone per 200 ml. After the operation, the women used suppositories with hyaluronic acid (revitax). Results. The results of surgical treatment have been analyzed and the following data were obtained: recurrences in the main and in the comparison group were 4% (2 women in whom operations were performed with the use of their own tissues without  mesh prosthesis). Infectious complications, dyspareunia and pelvic pain were not observed. Conclusions. Surgical treatment of GP in obese women by using polypropylene mesh "Polymesh" for colposacropexy after transvaginal uterine extirpation increases the effectiveness of treatment  and redduces the number of recurrences. Hydropreparation of the mesh with an antibacterial agent and postoperative use of hyaluronidase intravaginally helps to reduce purulent-septic complications of surgery and improves the patients’quality of life.

scholarly journals Drainage devices in refractory glaucoma surgery

2019 ◽  
Vol 12 (3) ◽  
pp. 85-93
Author(s):  
S. I. Anisimov ◽  
S. Yu. Anisimova ◽  
L. L. Arutyunyan ◽  
A. P. Voznyuk
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Glaucoma Surgery ◽  
Long Term Results ◽  
Refractory Glaucoma ◽  
Eye Tissues ◽  
Surgical Methods ◽  
Methods Of Treatment ◽  
Fibroblastic Activity

Glaucoma is a socially sensitive disease, being one of the leading causes of irreversible visual impairment and blindness. Refractory glaucoma is one of the most severe forms of the disease as it is resistant to conservative and surgical methods of treatment. Because of pronounced postoperative fibroblastic activity of eye tissues, leading to gross scarring and obliteration of outflow paths, modern materials and methods of drainage surgery are needed. The review presents a variety of drains used today and considers in detail their main characteristics and the biocompatibility of the material used with eye tissues. Various groups of implants are presented, whose effectiveness and safety are compared and assessed. The statistics of postoperative complications and long-term results of surgical treatment are given.

scholarly journals Results of surgical treatment of uclear bleed in patients with ischemic heart disease

2020 ◽  
pp. 110-116
Author(s):  
A. M. Khajibayev ◽  
R. I. Rakhimov ◽  
A. A. Nabiev ◽  
A. G. Mahamadaminov
Keyword(s):  
Palliative Care ◽  
Heart Disease ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Ischemic Heart Disease ◽  
Technical Skill ◽  
Ischemic Heart ◽  
Treatment Methods ◽  
Surgical Interventions ◽  
Surgical Methods

Introduction. This article is devoted to one of the urgent problems of modern emergency abdominal surgery – the result of surgical treatment of ulcer bleed in patients with ischemic heart disease.Undoubtedly intensive hemostatic conservative therapy and endoscopic hemostasis methods are the main treatment methods for this group of patients. However, in a certain number of patients with NGDK with various variants of IHD, such treatment is ineffective and there is a need to perform surgical hemostasis in an emergency and urgently.Surgical methods of hemostasis of NGDK patients with different variants of IHD are shown only in cases of inefficiency of conservative and endoscopic treatment methods. Among surgical interventions, radical surgeries are more preferable, which, if performed against the background of intensive resuscitation support, allow to achieve reliable hemostasis and thus avoid postoperative recurrent bleeding. Palliative surgery should be used when radical surgery is not possible due to the severity of the patient’s condition or lack of technical skill of surgeons. Finally, it is clear that in order to improve treatment results in patients in this category, correction of changes caused by the accompanying IHD is necessary.Materials and methods: In our research material, 89 out of 997 patients had such a need, which was 8.9%. It mainly corresponds to the modern literature data.Results: An analysis of the results of these patients’ palliative and radical surgical interventions clearly showed that the last ones were more preferable.The basis for this judgment was the high percentage of mortality after palliative care compared to radical care with approximately the same number of postoperative complications.In addition, it is noteworthy that postoperative complications typical of palliative care in the form of recurrent ulcerative bleeding are often fatal, because half of these patients in our observations have not experienced repeated radical interventions.Conclusion: At the same time, the necessary condition for performing radical operations is, firstly, appropriate technical skill of the surgeon, and secondly, providing the latter with intensive resuscitation support. In case of impossibility of performance of these conditions the method of a choice should serve palliative care.

scholarly journals Alternative combined surgical treatment of severe pelvic organ prolapsed

2019 ◽  
pp. 26-30
Author(s):  
Seikina VA ◽  
Zharkin NA ◽  
Burova NA ◽  
Prohvatilov SA
Keyword(s):  
Surgical Treatment ◽  
Pelvic Organ Prolapse ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Genital Prolapse ◽  
Pelvic Organ ◽  
Fast Track Surgery ◽  
Organ Function ◽  
Prolapse Recurrence ◽  
Duration Of Surgery

Objective: This study aimed to evaluate the rate of satisfactory outcomes of surgery on women with severe genital prolapse using fast-track surgery including an improved method of combined surgical treatment. Materials and methods: The study included 60 women with severe forms of pelvic organ prolapse. The average age of patients with POP-Q II was 56.4 (20 women from 52 to 63), those with POP-Q III-59.4 (40 patients from 54 to 68). Results: A new method of combination surgery for severe forms of pelvic organ prolapse using abdominal mesh and native tissues was developed. The following parameters were evaluated as objective criteria for effectiveness of treatment: duration of surgery, amount of blood loss, postoperative complications, time until and forms of pelvic organ prolapse recurrence: their number, variety, relapse stage, time of relapse. The average duration of surgery was 120 min. The average blood loss was 200 ml. There were 6 cases of early postoperative complications. The rate of relapses was 2%. An analysis of outcomes indicates high effectiveness of treatment and recovery of pelvic organ function. Thus, this method can be recommended for surgical treatment of combined forms of severe genital prolapse.

Evaluation of mid-term results of bipolar transurethral resection in the treatment of benign prostatic hyperplasia

2018 ◽  
pp. 1-9
Author(s):  
А.С. Векильян
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Blood Loss ◽  
Endoscopic Surgery ◽  
Transurethral Resection ◽  
Operating Time ◽  
Clinical Results ◽  
Massive Bleeding ◽  
Prostatic Hyperplasia ◽  
Surgical Methods

Представлены клинические результаты хирургического лечения доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом до 100 см3 методом биполярной трансуретральной резекции простаты (БТУР -74 пациента) в сравнении с открытой чреспузырной простатэктомией (ОПЭ - 96 пациентов), ранее применявшейся для подобных клинических случаев в урологической клинике "Железнодорожной больницы" г. Волгоград. При статистически равном операционном времени обоих хирургических методов для БТУР отмечено существенное снижение интраоперационной кровопотери, сроков послеоперационной катетеризации и пребывания в стационаре, минимальная частота геморрагических и инфекционно-воспалительных осложнений. Наблюдение за урологическим статусом пациентов в течение первого послеоперационного года показало одинаковую клиническую эффективность сравниваемых хирургических методов. Значительное снижение объема кровопотери в ходе операции БТУР можно считать большим достижением, поскольку улучшение видимости в зоне хирургического вмешательства позволяет оптимизировать гемостаз, предотвратить массивные кровотечения как во время, так и после операции, сократить сроки послеоперационной катетеризации мочевого пузыря, что в свою очередь, снижает частоту развития инфекционно-воспалительных осложнений. Более быстрое восстановление пациентов после эндоскопических операций имеет медико-социальное и экономическое значение, поскольку минимальное количество послеоперационных осложнений и сокращение сроков госпитализации позволяет существенно снизить затраты на лечение и быстрее нормализовать качество жизни пациентов. Полученные результаты демонстрируют перспективность внедрения биполярных методов эндоскопических операций для лечения ДГПЖ в хирургическую практику урологических стационаров в целях повышения безопасности оперативного лечения и экономии затрат на госпитализацию. The clinical results of surgical treatment of benign prostatic hyperplasia (BPH) up to 100 cm3 by bipolar transurethral resection of the prostate (BTUR - 74 patients) in comparison with open transvesical prostatectomy (OPE - 96 patients), previously used for such clinical cases in the urological clinic "Railway hospital" in Volgograd are presented. With statistically equal operating time of both surgical methods, there was a significant decrease in intraoperative blood loss, the terms of postoperative catheterization and hospital stay, the minimum frequency of hemorrhagic and infectious-inflammatory complications. Observation of the urological status of patients during the first postoperative year showed the same clinical efficacy of the compared surgical methods. A significant reduction in the volume of blood loss during the operation, can be considered a great achievement, since the improvement of visibility in the area of surgical intervention allows to optimize the hemostasis, to prevent massive bleeding during and after surgery, to reduce the duration of postoperative bladder catheterization, which, in turn, reduces the incidence of infectious-inflammatory complications. Faster recovery of patients after endoscopic surgery of medical,social and economic importance, as the minimum number of postoperative complications and reduction of hospitalization can significantly reduce the cost of treatment and quickly normalize the quality of life of patients. The results demonstrate the prospects of the introduction of bipolar methods of endoscopic surgery for the treatment of BPH in the surgical practice of urological hospitals in order to improve the safety of surgical treatment and save costs for hospitalization.

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