ГОСТРИЙ ТРОМБОЗ ГЕМОРОЇДАЛЬНИХ ВУЗЛІВ: КЛІНІЧНИЙ ПРОФІЛЬ ПАЦІЄНТА ТА ЛІКУВАЛЬНА ТАКТИКА

Мета дослідження – визначити клінічний профіль пацієнта та порівняти результати консервативного та хірургічного лікування гострого тромбозу гемороїдальних вузлів. Методи. Протягом 2014-2018 рр. в проктологічному відділенні Івано-Франківської обласної клінічної лікарні лікувались 98 пацієнтів з гострим тромбозом гемороїдальних вузлів. Серед них 60 (61,2 %) чоловіків, 38 (38,8 %) жінок. Вивчали скарги пацієнтів при поступленні, можливі причини виникнення захворювання, тривалість захворювання до звернення за допомогою, дані об’єктивного обстеження. Зв’язок між скаргами та даними об’єктивного обстеження визначали за допомогою коефіцієнтів асоціації та контингенції. Оцінювали вплив консервативного та хірургічного лікування гострого тромбозу гемороїдальних вузлів на тривалість застосування ненаркотичних анальгетиків та терміни перебування у стаціонарі. Результати дослідження. Тривалість прийому ненаркотичних анальгетиків та терміни перебування у стаціонарі скорочуються у 1,8 та 1,7 рази відповідно, при проведенні тромбектомії, та тромбектомії в поєднанні з некректомією, у пацієнтів з гострим тромбозом гемороїдальних вузлів І степені тяжкості. Тривалість прийому ненаркотичних анальгетиків скорочується у 1,4 рази при відтермінуванні гемороїдектомії по Мілігану-Моргану до 5,3±1,0 днів при ІІ степені тяжкості. Висновки. При гострому тромбозі гемороїдальних вузлів І степені тжкості потрібно дотримуватись активної хірургічної тактики, при ІІ-ІІІ степені тяжкості проводити хірургічне лікування після зменшення набряку, ознак запалення та курсу консервативної терапії The purpose of the study is to determine the clinical profile of the patient and compare the results of conservative and surgical treatment of acute hemorrhoid thrombosis. Methods. During 2014-2018, 98 patients with acute thrombosis of hemorrhoids were treated at the proctologic department of the Ivano-Frankivsk Regional Clinical Hospital. Among them, 60 (61.2%) men, 38 (38.8%) women. Studied the complaints of patients upon admission, the possible causes of the disease, the duration of the disease before treatment, the data of objective examination. The relationship between complaints and the objective survey data was determined using association and contingency ratios. The influence of conservative and surgical treatment of acute thrombosis of hemorrhoids on the duration of use of non-narcotic analgesics and the length of stay in hospital were evaluated. Research results. The duration of admission of non-narcotic analgesics and the terms of stay in the hospital decreases by 1.8 and 1.7 times, respectively, during thrombectomy, and thrombectomy in combination with necrectomy, in patients with acute thrombosis of hemorrhoids I degrees of severity. The duration of admission of non-narcotic analgesics is reduced by 1.4 times when delayed hemorrhoidectomy by Miligan-Morgan to 5.3 ± 1.0 days with II degree of severity. Conclusions. In acute thrombosis of hemorrhoidal nodes of the I degree of severity, one must adhere to active surgical tactics, with II-III degree of severity, surgical treatment after reduction of edema, signs of inflammation and course of conservative therapy.

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HEMORRHOIDS IN THE PEDIATRIC POPULATION: CLINICAL MANIFESTATIONS, DIAGNOSTICS AND TREATMENT

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2019-23-3-119-123 ◽

2019 ◽

Vol 23 (3) ◽

pp. 119-123

Author(s):

Pyae Swe Aung ◽

Viktoria V. Kholostova

Keyword(s):

Surgical Treatment ◽

Conservative Therapy ◽

Ultrasound Examination ◽

Pediatric Population ◽

Age Groups ◽

Clinical Manifestations ◽

Pain Syndrome ◽

Effective Technique ◽

Younger Age ◽

Conservative And Surgical Treatment

Introduction. Hemorrhoids in childhood is a rare disease. That is why one can find only few works on this problem. Material and methods. 56 children with diagnosed hemorrhoids aged 4-18 were taken into the study. They had various clinical manifestations of the disease: perianal protrusion (76.4%), bleeding (82.3%), pain syndrome (71.5%). 51 patient (91.1%) had external hemorrhoids; 3 children (5.3%) - internal; 2 children (3.6%) - combined. Patients, by their clinical course, were distributed as follows: acute hemorrhoids - 33 children (58.9%), chronic one - 23 (41.1%). Ultrasound examination and sigmoidoscopy were used for diagnostics. Different curative techniques followed the developed curative algorithm: conservative therapy and surgery (open surgery and with the LigaSure apparatus) as well as sclerotherapy. Results. The most effective technique, having better cosmetic and clinical outcomes, was hemorrhoidectomy. Conservative treatment (more than 80%) can be a method of choice at early stages of the disease and at younger age groups. Outcomes after sclerotherapy are comparable with outcomes of conservative and surgical treatment. Sclerotherapy is recommended at the internal stages of hemorrhoids and in case of any contraindications to surgical treatment.

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CHYLOPERITONEUM IN NEWBORNS: ETIOLOGY, PATHOGENESIS, DIAGNOSTICS AND TREATMENT

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2019-23-3-139-142 ◽

2019 ◽

Vol 23 (3) ◽

pp. 139-142

Author(s):

Yury I. Kucherov ◽

N. V. Kholodnova ◽

S. R. Adleiba ◽

A. L. Belaya ◽

L. M. Makarova ◽

...

Keyword(s):

Surgical Treatment ◽

Literature Review ◽

Parenteral Nutrition ◽

Present Article ◽

Fibrin Glue ◽

Conservative Therapy ◽

Abdominal Cavity ◽

Management Protocol ◽

Conservative And Surgical Treatment

The present article is a literature review on etiopathogenesis, diagnosis, conservative and surgical treatment of chyloperitoneum in newborns. Chyloperitoneum is an extremely rare pathology in children and, not in all cases it is possible to find its cause. The management protocol for chyloperitoneum has not been developed. The most effective approach for managing this disease is a starvation pause, than transfer to full parenteral nutrition, administration of somatostatin (octreotide) and drainage of the abdominal cavity. Conservative therapy may take several months and, its effectiveness reaches 60-100%. Surgical treatment is aimed to indentify a focus of lymph leakage and its elimination; in severe cases, the fibrin glue is used.

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Laparoscopic alloplasty of troacary hernia paraumbilically area

Клінічна та профілактична медицина ◽

10.31612/2616-4868.2(8).2019.05 ◽

2019 ◽

Vol 2 (8) ◽

pp. 47-52

Author(s):

Ia.P. Feleshtynsky ◽

V. А. Dadayan

Keyword(s):

Surgical Treatment ◽

Length Of Stay ◽

Early Postoperative Period ◽

Surgical Department ◽

Abdominal Hernias ◽

Scientific Justification ◽

Group 5 ◽

Group 2 ◽

Surgical Tactics ◽

Number Of Faces

Currently, researchers continue to debate about the choice of surgical treatment for such hernias, which is more appropriate to use: classic laparoscopic alogioplasty or a modified laparoscopic alloplasty technique. Objective. The scientific justification for the choice of surgical tactics and improve the results of surgical treatment of trocar hernias of the paraumbilical site and prove the effectiveness of the proposed method. Materials and methods. The article presents the results of the analysis of surgical treatment of trocar abdominal hernias in 64 patients aged 30 to 75 years. During the analysis, we divided the patients into two groups equal in number of faces, the inclusion factor in the first group was classical laparoscopic alogioplasty (32 patients), and the second group included patients who underwent our modified surgery - laparoscopic alloplasty of postoperative trocar hernias paraumbilical plot. Research results and discussion. When conducting a comparative analysis of the course of the early postoperative period in patients of the first group, we found that seroma was observed in 12.5% (4) patients, the second group – in 6.3% (2) patients. Postoperative wound infection was observed in only one (3.1%) patient of the first group. The length of stay of patients in the clinic, in the inpatient department, ranged from 7 to 2 days. Patients of the first group - 5 ± 2.12 (p <0.05) days, and patients of the second group - 2 ± 1.31 (p <0.05) days, respectively. Findings. Therefore, we found that laparoscopic alloplasty of trocar hernias of the abdomen has significant advantages over open by reducing the frequency of postoperative complications by more than two times from the side of the wound. In addition, the length of stay of such patients in the surgical department is reduced by 2.5 times, which, in turn, significantly reduces costs. During the prospective observation of patients who underwent laparoscopic allogernioplasty of trocar abdominal hernias (within three years after the intervention), we can state that the elimination of the defect by the proposed method is not accompanied by relapse.

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Plantar fascial release

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-84-12-607 ◽

1994 ◽

Vol 84 (12) ◽

pp. 607-613 ◽

Cited By ~ 13

Author(s):

DL White

Keyword(s):

Retrospective Study ◽

Surgical Treatment ◽

Conservative Therapy ◽

Heel Pain ◽

Plantar Heel Pain ◽

Conservative And Surgical Treatment ◽

Treatment Alternatives

The author reviews the literature for the possible etiology and the conservative and surgical treatment alternatives for mechanically induced plantar heel pain. A long-term retrospective study on a plantar fascial release surgery performed on patients with recalcitrant plantar heel pain, all of whom were unresponsive to conservative therapy, is presented.

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Surgical Treatment of Early Acute Thrombosis of Mechanical Mitral Prosthesis

The Heart Surgery Forum ◽

10.1532/hsf98.20101032 ◽

2010 ◽

Vol 13 (5) ◽

pp. E322-E323

Author(s):

Shengli Jiang ◽

Tao Zhang ◽

Chonglei Ren ◽

Yao Wang

Keyword(s):

Surgical Treatment ◽

Acute Thrombosis ◽

Mitral Prosthesis

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Modern determinants of endometrium hyperplastic processes pathogenesis

HEALTH OF WOMAN ◽

10.15574/hw.2016.111.137 ◽

2016 ◽

pp. 137-142

Author(s):

V.O. Benyuk ◽

◽

V.M. Goncharenko ◽

T.R. Nykoniuk ◽

◽

...

Keyword(s):

Conservative Therapy ◽

Solid Phase ◽

Research Direction ◽

Immunohistochemical Method ◽

Results Of Treatment ◽

Treatment And Prevention ◽

Receptor Phenotype ◽

The Relationship ◽

Endometrial Proliferation

The objective: to еxplore the relationship between the activity of endometrial proliferation and the state of the local immune response in the uterus in the conditions berprestasi process. Patients and methods. Examined 228 women of reproductive and perimenopausal age with endometrial pathology using ultrasound and then performing hysteroresectoscopy. Determination of the concentrations of the cytokines IL-1, IL-2, IL-6 and TNF was performed by solid phase ELISA. Results. Found a trend that confirms the loss of sensitivity to hormones at the stage of malignancy of the endometrium and can be used as diagnostic determinants in determining the nature of intrauterine pathology and criterion of the effectiveness of conservative therapy. Conclusion. Improving etiopatogenetice approach to the therapy of hyperplastic proce.sses of endometrium with determination of receptor phenotype of the endometrium is a research direction in modern gynecology, which will help to improve the results of treatment and prevention of intrauterine pathology. Key words: endometrial hyperplasia,the receptors for progesterone and estrogen, immunohistochemical method.

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

GYNECOLOGY ◽

10.26442/20795696.2020.3.200189 ◽

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.

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