scholarly journals Effect of operation technic on development of postoperative complications after appendectomy

2018 ◽  
Vol 9 (4) ◽  
pp. 63-66
Author(s):  
P. M. Lavreshin ◽  
V. K. Gobedgishvili ◽  
V. V. Gobedgishvili ◽  
E. V. Kochkarov ◽  
O. V. Vladimirova
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Fast Track ◽  
Test System ◽  
Abdominal Adhesions ◽  
Fast Track Surgery ◽  
Results Of Treatment ◽  
Connective Tissue Dysplasia ◽  
Instrumental Methods

Objective: to improve the results of treatment of patients with acute appendicitis. Te results of surgical treatment of 360 patients with acute appendicitis were presented.Materials and methods: in predicting of development of intra-abdominal adhesions in patients afer appendectomy and of effectiveness of anti-adhesion therapy in postoperative period was used clinical, laboratorial (phenotype signs of connective tissue dysplasia syndrome, activity of the enzyme N-acetyltransferase, a test system based on sorbents with magnetic properties with immobilized granular antigen from adhesive tissue), instrumental methods of research. Te frst group included 120 (50%) patients who underwent standard appendectomy. In 120 patients with acute appendicitis (the second group) the elements of “Fast-Track” surgery was used in performing classical laparotomy appendectomy. Te third group consisted of 120 patients who underwent laparoscopic appendectomy.Results: all patients with diagnosed adhesive process in the early stages of its development in postoperative period were provided with anti-adhesion therapy. Te least number of postoperative complications was observed in cases of multimodal approach to treatment of acute appendicitis.Conclusions: application of “Fast-Track” surgery principles allowed to reduce development of intra-abdominal adhesion afer surgery compared with traditional appendectomy on 6.6 %, and with laparoscopic — on 2.8 %.

scholarly journals «FAST-TRACK» SURGERY OF ACUTE DESTRUCTIVE CHOLECYSTITIS

2020 ◽  
pp. 27-30
Author(s):  
A. N. Veligotsky ◽  
A. S. Chebotaryov ◽  
V. S. Strakhovetsky ◽  
S. G. Fedorovskyi ◽  
A. S. Fomina
Keyword(s):  
Experimental Study ◽  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Fast Track ◽  
Control Group ◽  
Study Group ◽  
Fast Track Surgery ◽  
Results Of Treatment ◽  
The Right

Summary. Aim. Introduction of «FAST-TRACK» principles in laparoscopic surgery of acute destructive cholecystitis. Materials and methods. The paper presents the results of an experimental study of the treatment of 210 patients with acute destructive cholecystitis, 104 patients in the control group and 106 comparative patients who were hospitalized and operated on in the clinic for the period from 2012 to 2019. Results and their discussion. In the control group, conversion and cholecystectomy were performed by lateral mini-access in the right hypochondrium. In the study group of patients performed laparoscopic cholecystectomy in similar conditions, but using original methods. Conclusions. As a result of the study it was possible to improve the results of treatment by 3.2 % and reduce the patient’s stay in the hospital from 6.5 days to 5.4 and reduce the number of postoperative complications by 80 % from 5 to 1 complication.

scholarly journals Acute appendicitis in children in the context of the new coronavirus infection (COVID-19)

2021 ◽  
Vol 25 (1) ◽  
pp. 25-28
Author(s):  
V. G. Svarich ◽  
I. M. Kagantsov ◽  
V. A. Svarich ◽  
E. G. Perevozchikov
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Medical Care ◽  
Surgical Care ◽  
Komi Republic ◽  
Complicated Appendicitis ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Significant Difference ◽  
Coronavirus Infection

Introduction. The first publications about acute appendicitis in the conditions of the new COVID-19 coronavirus infection have appeared. Most authors point to the increased time of seeking medical help in such patients and an increase in the level of postoperative complications.Material and methods. A retrospective study of 192 case histories of patients aged 3 to 17 years with various forms of acute appendicitis who were treated in the surgical Department of the Republican children’s clinical hospital in the period from 2019 to November 2020 was conducted. Children operated on during 2019 before the start of the new coronavirus pandemic were included in the first group (n = 114). Children operated on in 2020 after the development of a new coronavirus pandemic were included in the second group (n = 78).Results. The age of patients in both groups compared did not differ significantly. The course of the disease was within the average accumulated indicators and the terms of hospitalization did not change significantly. According to our observations, the time of admission to the surgical hospital from the time of the disease in the pre-coronavirus period and during it also did not differ significantly, which indicates that the same availability of medical care remains even during the epidemic. Our study also showed that the number of requests for complicated appendicitis in children during the COVID-19 epidemic even decreased, which ultimately led to a decrease in the level of postoperative complications. The study did not establish a significant difference between the main results of treatment of children with acute appendicitis before and during the new COVID-19 coronavirus infection. Only the level of postoperative complications significantly decreased in patients operated during the COVID-19 epidemic, which is associated with a lower admission of children with complicated appendicitis.Conclusion. With the onset of the pandemic, the organization of medical care for the child population with acute pathology in the Komi Republic did not change and did not have any restrictions, which made it possible to maintain the timely provision of surgical care to children with acute appendicitis at the proper level.

Fast‐track surgery for acute appendicitis in children: a systematic review of protocol‐based care

2019 ◽  
Vol 89 (11) ◽  
pp. 1379-1385 ◽  
Author(s):  
Montgommery Do‐Wyeld ◽  
Thomas Rogerson ◽  
Stefan Court‐Kowalski ◽  
Thomas P. Cundy ◽  
Sanjeev Khurana
Keyword(s):  
Systematic Review ◽  
Acute Appendicitis ◽  
Fast Track ◽  
Fast Track Surgery

THE EFFECT OF CYTOREDUCTIVE SURGERY AND INTRAPERITONEAL HYPERTHERMIC CHEMOPERFUSION (HIPEC) ON THE CLINICAL OUTCOME OF TREATMENT OF PATIENTS WITH ADVANCED GASTRIC CANCER

2021 ◽  
Author(s):  
V. M. Sokolov ◽  
O. V. Bondar ◽  
S. G. Chetverikov ◽  
V. E. Maksimovskyi ◽  
D. V. Atanasov ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Side Effects ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Cytoreductive Surgery ◽  
Clinical Course ◽  
Chemotherapeutic Drugs ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Chemotherapeutic Treatment

Introduction. For gastric cancer (GC), metastatic peritoneal carcinomatosis (PC) is a typical process. PC and its consequences usually lead to the death of 20-40 % of patients with GC. For carefully selected patients, intraperitoneal hyperthermic chemoperfusion may be considered. The aim of the study was to investigate the effect of cytoreductive surgery in combination with HIPEC on the clinical course of the postoperative period, the frequency of postoperative complications and side effects of chemotherapeutic drugs in the treatment of advanced GC. Materials and methods. The results of treatment of 34 patients with advanced GC were considered. The patients were divided into two groups: IA group — 24 patients with advanced GC, who first underwent complete primary cytoreductive surgery (CRS) with adjuvant chemotherapy (ACT) according to the FLOT scheme and IB group — 10 patients with advanced GC treated by CRS + ACT + HIPEC. Results. Comparing the number of patients with postoperative complications in groups IA (CRS + ACT) and IB (CRS + HIPEC + ACT) using the exact bilateral Fisher’s test p> 0. 05. Comparing the frequency of side effects of chemotherapeutic treatment in the FLOT mode in groups IA (CRS + ACT) and IB (CRS + HIPEC + ACT), the values ??of χ2 = 20. 750, χ2Cr = 28. 568 (p = 0. 0622) were obtained. Conclusions. The usage of HIPEC in combination with complete CRS and ACT is a promising method of treatment of this group of patients. As a result of this study, it was proved that there is no statistically significant effect on the clinical course of the postoperative period due to the increase in the frequency of postoperative complications or side effects of chemotherapeutic drugs.

scholarly journals Fast-track surgery and enhanced recovery after surgery concepts after their application in hernia repair

2021 ◽  
Vol 68 (1) ◽  
pp. 10-16
Author(s):  
V.V. Boiko ◽  
◽  
K.Y. Parkhomenko ◽  
O.E. Feskov ◽  
A.Y. Gavrikov ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Postoperative Period ◽  
Efficient Solution ◽  
Fast Track ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Preoperative Preparation ◽  
Fast Track Surgery ◽  
Postoperative Rehabilitation ◽  
Surgical Interventions

The growing number of surgical interventions that occur worldwide, along with the increasing prevalence of general somatic pathology, keeps current the problem of preventing complications during surgery and in the postoperative period. An efficient solution to this problem is to determine the risk of surgery, directed preoperative preparation, taking into account the comorbidity, optimization of surgery and postoperative rehabilitation. Fast-track surgery and enhanced recovery after surgery programs have significant potential for improving outcomes of surgery. These programs are widely used in various fields of surgery, but their effectiveness in herniology, especially in the performing simultaneous surgeries, there are very few reports, and the results of individual studies are contradictory. The review provides an analysis of holistic strategies of fast-track surgery and enhanced recovery and individual measures to assess the effectiveness of their impact on the immediate results of surgical interventions.

scholarly journals Effectiveness of the concept of fast-trak surgery for simultaneous laparoscopic hernioplastics and cholecistectomy

2021 ◽  
Keyword(s):  
Postoperative Period ◽  
Inpatient Treatment ◽  
Fast Track ◽  
Early Postoperative Period ◽  
Wound Complications ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Group I ◽  
Laparoscopic Hernioplasty ◽  
Group Ii

The aim of the research was to study the feasibility and effectiveness of simultaneous laparoscopic hernioplasty and cholecystectomy in patients with combined abdominal pathology. Material and methods. Simultaneous laparoscopic hernioplasty and cholecystectomy during 2015–2019 performed on 70 patients, including 49 (70 %) women, mean age 57.3 ± 6.5 g. In 37 patients the principles of Fast-track surgery were applied (group I), including thorough examination for diagnostics of combined abdominal pathology and clinically significant general somatic pathology; if necessary a course of therapy for full compensation of general somatic pathology was prescribed; during the operation of epidural prolonged anesthesia; choice in favor of laparoscopic technology; at the end of the operation – irrigation of the subdiaphragmatic space with local anesthetic; postoperatively: early drainage removal; withdrawal from opioids by prescribing parenteral paracetomol; activation of the patient 6-8 hours after surgery; on the day of surgery – use of chewing gum and fluid intake. In 33 patients the standard complex of perioperative management (group II) is applied. The immediate results of surgical interventions have been studied. Results. There were no significant complications during the operation and in the early postoperative period. In the first group, seroma (after open alloplasty) was detected in 2 (5 %) cases, and in the second group, small wound complications were detected in 4 (12 %) cases (p > 0.05 according to the χ2 criterion). The duration of inpatient treatment in patients of group I is 4.4 ± 1.2 months, in group II – 7.0 ± 1.3 days (р < 0.001 by Student’s test). Conclusion. Application of the principles of Fast-track surgery and accelerated recovery at all stages of simultaneous laparoscopic hernioplasty and cholecystectomy (preparation for surgery, during the operation and in the postoperative period) does not increase the number of postoperative complications and decreased duration of inpatient treatment from 7,0 ± 1,3 in patients with traditional postoperative management to 4,4 ± 1,2 days.

scholarly journals WAYS OF PREVENTION SYNDROME OF INTRA-ABDOMINAL HYPERTENSION IN BARIATRIC SURGERY

2019 ◽  
Vol 178 (5) ◽  
pp. 16-21
Author(s):  
M. I. Neimark ◽  
A. Yu. Elizariev ◽  
R. V. Kiselev
Keyword(s):  
Bariatric Surgery ◽  
Continuous Infusion ◽  
Postoperative Period ◽  
Fast Track ◽  
Perioperative Period ◽  
Abdominal Pressure ◽  
Fast Track Surgery ◽  
Beach Chair Position ◽  
Abdominal Hypertension ◽  
Combined Anesthesia

Patients with obesity who have undergone intra-abdominal endoscopic intervention belong to the category of patients with an increased risk of developing the syndrome of intra-abdominal hypertension (SIAH), which dictates the need to develop interventions aimed at its prevention.The OBJECTIVE was to evaluate the effectiveness of complex integrated methods of SIAH prevention in patients with morbid obesity with endoscopic bariatric surgery.MATERIAL AND METHODS. A randomized trial of 69 patients with a body mass index >35 kg/m INTENSIVE 2 was conducted; patients were divided into two groups depending on the type of anesthesia. In the 1st group (n=34), the operation was performed under combined anesthesia based on low-flow inhalation with desflurane in combination with prolonged epidural analgesia (PEA) with ropivacaine. Maintaining a deep level of myorelaxation under the control of acceleromyography in the post-tetanic counts (PTC) mode was achieved by continuous infusion of rocuronium. In the perioperative period, the infusion patients were in the «beach chair» position, and their research was carried out according to the principles of fast track surgery. In the 2nd group (n=35), the operation was performed under combined anesthesia based on lowflow inhalation with desflurane, neuromuscular blockade was performed by bolus injection of rocuronium under the control of acceleromyography in train of four (TOF) mode. Analgesia was provided by systemic administration of opioids. In both groups, markers of kidney injury were investigated, intra-abdominal pressure was monitored, the effectiveness of recovery after surgery and the quality of postoperative analgesia were assessed.RESULTS. A significantly lower level диурез of intra-abdominal pressure (IAP), связь higher compliance evaluation of the anterior crit abdominal внутрибрюшной wall, and a significantly стаканов lower level управляемой of markers of renal study injury in the отмечено postoperative period bariatric were revealed raga in the first дозе group compared to the second group during темпу the perioperative study period. keulenaerСONCLUSION. The effectiveness of using the position of deep muscle relaxation in the continuous infusion mode, adequate analgesia in the perioperative period using neuraxial techniques, using the «beach chair» position on the operating table and in the postoperative period, managing patients using fast track surgery for preventing the development of SIAG was identified.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.

scholarly journals Opportunities for Unsalted Management of the Postoperative Period in Patients with Uncomplicated Ureterolithiasis

Health of Man ◽  
2021 ◽  
pp. 32-38
Author(s):  
Oleh Nikitin ◽  
Yurii Roshchyn ◽  
Ihor Komisarenko ◽  
Oleksandr Fukszon ◽  
Sviatoslav Smikhun
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Upper Urinary Tract ◽  
Ureteral Stones ◽  
Cost Of Treatment ◽  
Results Of Treatment ◽  
Technical Advances ◽  
Ureteral Stenting ◽  
Stent Complications

When performing surgeries for ureteral stones, ureteral stenting is traditionally performed to avoid obstruction of the ureter in the postoperative period due to edema or stone fragments. Modern technical advances allow ureteroscopy to be performed relatively atraumatically and to avoid routine ureteral stenting, which makes it possible to exclude exacerbations of pyelonephritis caused by reflux, reduce stent costs, improve the quality of life in the postoperative period, and avoid cystoscopy for dentition. The objective: studying the possibility of non-drainage management of the postoperative period, identifying risk factors for postoperative complications in patients with uncomplicated ureteral stones. Materials and methods. The analysis of the results of treatment of 198 patients with uncomplicated ureterolithiasis, in whom it was decided to refuse stenting after ureteroscopy, was carried out. Results. The analysis of the condition of patients in the postoperative period was carried out. To identify the factors influencing the decision on non-drainage management of the patient in the postoperative period, as well as factors that could be predictors of postoperative complications, we analyzed various indicators. Conclusions. In the case of uncomplicated ureterolithiasis, in most cases (in 68.2 % of patients) in the postoperative period, there is no need to drain the upper urinary tract using a stent. At the same time, in a number of cases – namely in 31.8 % of patients – upon refusal to install a stent, complications arose that significantly influenced the duration and cost of treatment, in some cases requiring an increase in the volume of therapy, additional procedures – installation stent and puncture nephrostomy.

scholarly journals MULTIMODAL REHABILITATION OF PATIENTS OPERATED ON FOR PANCREATIC NECROSIS

2021 ◽  
pp. 36-39
Author(s):  
I. A. Kryvoruchko ◽  
K. Yu. Parkhomenko ◽  
A. G. Drozdova ◽  
V. A. Vovk ◽  
K. E. Payunov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Fast Track ◽  
Pancreatic Necrosis ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Financial Costs ◽  
Commercial Enterprise ◽  
Bed Days

Summary. The aim of the study — to improve the results of surgical treatment of patients operated on for pancreatic necrosis. Matherials and Methods of the study. The results of treatment of 56 patients operated on for pancreatic necrosis who were treated in the surgical department of the Municipal non-commercial enterprise of the Kharkov regional council «Regional Clinical Hospital» from 2018 to 2020, aged 22 to 69, were analyzed. In the treatment of all patients, a “step-up approach” tacktics was used and the principles of the concept of “fast-track surgery” or multimodal rehabilitation of patients after surgery were implemented. Results of the study. Along with the performed surgical interventions (mostly minimally invasive), a “staged” method of managing the postoperative period in patients operated on for pancreatic necrosis is proposed and implemented. As a result, there is a decrease in the incidence of postoperative complications and a decrease in the length of stay in the surgical department (14.6 bed-days). Conclusions. This example confirms the appropriateness of applying the principles of “fast-track surgery” in everyday surgical practice in the complex treatment of patients with pancreatic necrosis, as the results of surgical treatment of this category of patients are improved and financial costs for treatment are reduced.

CLINICAL FEATURES AND DIAGNOSIS OF ACUTE APPENDICITIS IN ELDERLY PATIENTS

2020 ◽  
pp. 134-137
Author(s):  
V. V. Lesnoy ◽  
A. S. Lesnay
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Elderly Patients ◽  
Clinical Features ◽  
Diagnostic Laparoscopy ◽  
Diagnostic Algorithm ◽  
Objective Data ◽  
Results Of Treatment ◽  
Prognostic Groups ◽  
Instrumental Methods

Summary. Aim. To analyze features of clinic and diagnostics of acute appendicitis (AA) in elderly patients. Materials and methods. The work is based on the analysis of the results of treatment of 38 patients with AA clinic at the age > 60 years. Results. The patients were divided into prognostic groups according to the Alvarado scale. The diagnostic algorithm for each group is compiled and the characteristics of clinical features, laboratory parameters, instrumental methods are given. Conclusion. Only 23.6 % of patients older than 60 years are diagnosed with AA based on objective data, which is why computed tomography or diagnostic laparoscopy is required in the diagnostic algorithm.

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