scholarly journals Laparoscopy in the Treatment of Children with Intussusception

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
A A Pereyaslov ◽  
A O Dvorakevych ◽  
O M Nykyforuk
Keyword(s):  
Ileocecal Valve ◽  
Intestinal Loop ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Laparoscopic Equipment ◽  
Intussusception Reduction ◽  
Open Laparotomy ◽  
Selection Of Patients ◽  
Timely Treatment ◽  
Selection Of

Intussusception is one of the main causes of intestinal obstruction in children that requires timely treatment. Despite the high efficacy of therapeutic methods of intussusception reduction, some patients need the surgery. The question of the surgery method choice, namely open laparotomy or laparoscopy, is still under debate.The objective of the research was to summarize own experience of laparoscopy in children with an intussusception.The research was grounded on the results of treatment of 28 children operated in the first surgical department of the Lviv Regional Children’s Clinical Hospital «OHMATDYT» during 2008-2015. Optical system Strayker 1088 HD (Germany) with the 3-, 5-mm laparoscopic equipment was used for laparoscopy. The reduction of intussusception was performed by the retrograde traction of small intestine with the sliding catches.Laparoscopic intussusception reduction was successful in 67.9% of patients, conversion was conducted in 32.1% of patients. The main reasons for the conversion were the necrosis of intestinal loop needing resection, presence of the complex intussusception, and the presence of polyp clear to the ileocecal valve. In 10.7% patients the laparoscopic reduction was supplemented by per rectum pneumoreduction with the help of Richardons’ system. During the last year, in cases of intestine resection need, the video-assisted operations were applied, when the intestine mobilization was performed laparoscopically and anastomosis was applied extraperitonealy. Complications during laparoscopic reduction and in the postoperative period were not observed.Laparoscopy is the safe and effective method of patients with the intussusception treatment. Thorough selection of patients for the laparoscopic intussusception reduction makes it possible to decrease the rate of conversion.

scholarly journals THE SELECTION OF PATIENTS FOR MINIMALLY INVASIVE PROCEDURES ON THE THYROID NODULES

2020 ◽  
Vol 23 (2) ◽  
pp. 187-194
Author(s):  
V. G. Saltykova ◽  
Yu. K. Aleksandrov ◽  
Yu. N. Patrunov
Keyword(s):  
Minimally Invasive ◽  
Focused Ultrasound ◽  
Thyroid Nodules ◽  
Size Structure ◽  
High Intensity Focused Ultrasound ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Results Of Treatment ◽  
Selection Of Patients ◽  
Selection Of

Percutaneous laser ablation (PLA), high-intensity focused ultrasound (HIFU), and ultrasound-guided sclerotherapy (PIE) are minimally invasive treatments for benign thyroid nodules (MIT). Methods have different effectiveness depending on the size, structure, and localization of thyroid nodes. When selecting patients for treatment, the technical and biological features of various minimally invasive treatment methods are essential. Out of 124 people with thyroid nodules, 32 patients were selected for minimally invasive treatment. Conducting minimally invasive treatment and evaluating early treatment results in 32 people allowed us to identify the characteristics of thyroid nodes that affect the choice of modes of methods, the technique of their implementation, as well as the likely prognosis of the results of treatment of thyroid nodes (partial regression, complete destruction, the formation of fibrosis). When selecting patients for minimally invasive treatment, the leading method is ultrasound, which allows us to objectively assess risks, prevent possible complications, and predict the dynamics of inflammatory and regenerative processes based on the analysis of the ultrasound pattern.

scholarly journals DIFFERENTIATED TREATMENT TACTICS IN PATIENTS WITH RECTAL FOREIGN BODIES

2020 ◽  
pp. 175-179
Author(s):  
V. P. Shevchenko ◽  
V. V. Shevchenko ◽  
M. M. Kobiletsky ◽  
S. M. Kobiletsky ◽  
H. I. Pyatikop ◽  
...  
Keyword(s):  
Foreign Body ◽  
Local Anesthesia ◽  
Muscle Relaxants ◽  
Long Term Results ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Standardized Protocol ◽  
Open Laparotomy ◽  
Violent Acts

Summary. Patients with rectal foreign body (RFB) are quite rare in the practice of emergency surgeons. There are different techniques for deleting RFB depending on the features of the object being entered. There is still no standardized protocol for the surgical treatment of such patients. Aim. To analyze the immediate and long-term results of treatment of patients with RFB. Introduce differentiated therapeutic tactics into the practice of urgent surgeons depending on the characteristics of the foreign body and the presence of complications. Materials and research methods. Three patients with RFB were treated in the surgical department of SRCH during 2018-2019. Their average age was (38 ± 3.6) years. The algorithm of the examination consisted of a physical examination, a rectal finger examination, a radiological and a laboratory examination. Results and discussion. In two of the patients, the cause of RFB was sexual abuse, and in the third, violent acts. Removed objects: dildo, metal deodorant bottle and glass beaker. RFB in all individuals was diagnosed with a finger rectal examination. In one patient with RFB was removed under local anesthesia, and in two patients used general anesthesia with muscle relaxants. In one case, an attempt to remove RFB was successful, in the other, a laparotomy, colotomy, and preventive sigmostomy were required. Conclusions. Patients with RFB need differentiated therapeutic tactics. In most patients, it is possible to remove it in a conservative way, peranally, using local anesthesia or endotracheal narcosis with muscle relaxants. For large, tightly clamped objects that cannot be removed conservatively indicated open laparotomy, colotomy.

scholarly journals COMPLICATION OF LAPAROSCOPIC PLASTIC OF VENTRAL HERNIAS

2020 ◽  
pp. 185-188
Author(s):  
A. V. Sivogelezo ◽  
М. O. Sykal ◽  
V. V. Chugai ◽  
O. A. Tonkoglas
Keyword(s):  
Early Recognition ◽  
Test Time ◽  
Surgical Infection ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Abdominal Organs ◽  
Laparoscopic Hernioplasty ◽  
Surgery Department ◽  
Ventral Hernias ◽  
Timely Treatment

Summary. LGP passed test time, and its popularity grows. Today more and more surgeons readily accept it. Thanks to standardization of methods we can minimize quantity of postoperative complications and improve results of treatment of patients with ventral hernias. Materials and methods. In clinic of surgery department No. 2 on the basis of surgical department of Regional Hospital from 2017 performed 1231 operations of ventral hernias. At 411 (33 %) patients the laparoscopic hernioplasty is executed. Results and discussion. Intraoperative bleedings, intestines injuries, a surgical infection, an infection of a mesh, seroma and others belong to specific intraoperative and extra operational complications of laparoscopic hernioplasty of ventral hernias. We observed bleedings from an abdominal wall in 6 cases and from abdominal organs at 2 patients from 411 patients that made 1,9 %. In 3 cases it is noted infection of a mesh after laparoscopic hernioplasty (0,8 %). At 2 patients the inflammation managed to be liquidated in the conservative way, at 1 patient were forced to remove abscess with the part of a mesh. The most widespread complication after laparoscopic hernioplasty, according to our data - the seroma is noted at 34 of 411 patients (8,2 %). Conclusion. Laparoscopic interventions concerning ventral hernias demand care in time and after operation, early recognition of complications and their timely treatment, important for reduction of the risks.

Selection of patients for portal-systemic shunts

JAMA ◽  
1966 ◽  
Vol 196 (12) ◽  
pp. 1039-1044 ◽  
Author(s):  
R. E. Hermann
Keyword(s):  
Selection Of Patients ◽  
Selection Of

Perioperative acute internal carotid thrombosis after general surgery

2020 ◽  
Vol 99 (3) ◽  
pp. 136-140
Keyword(s):  
Cardiac Surgery ◽  
Internal Carotid ◽  
Right Hemicolectomy ◽  
Diagnostic Assessment ◽  
Left Carotid Artery ◽  
Perioperative Stroke ◽  
Internal Carotid Occlusion ◽  
Acute Brain Ischemia ◽  
Selection Of Patients ◽  
Selection Of

Introduction: The average incidence of perioperative stroke during major non-cardiac surgery is less than 1%, suggesting that it is rarely a major problem for the vast majority of patients. Methods: In our paper we present a 46-year-old patient undergoing acute right hemicolectomy who developed right-sided hemiparesis in the perioperative setting. Immediate CTAg examination showed an ischemic stroke in the left hemisphere as a result of left internal carotid thrombosis. A surgical procedure to recanalize the left carotid artery was performed 14 hours from the onset of neurological symptomatology and the neurological deficit gradually recovered fully. Conclusion: Our case report supports studies showing that a thorough diagnostic assessment allows the selection of patients who may benefit from urgent revascularization of acute internal carotid occlusion during the phase of acute brain ischemia.

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