Groin pain syndrome in athletes. Differential surgical treatment system

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

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Prevention of pain syndrome and immediate postoperative complications in the surgical treatment of chronic hemorrhoids

Pacific Medical Journal ◽

10.34215/1609-1175-2020-1-68-71 ◽

2020 ◽

pp. 68-71

Author(s):

V. N. Ishchenko ◽

A. E. Krasnobaev ◽

A. A. Grigoryuk

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Urinary Retention ◽

Acute Urinary Retention ◽

Surgical Intervention ◽

Pain Syndrome ◽

Modified Technique ◽

Postoperative Urinary Retention ◽

Clinical Comparison ◽

Suggested Technique

Objective: To assess the efficacy of hemorrhoidectomy with Milligan-Morgan technique in the author’s modification.Methods: Results of surgical treatment of 558 patients aged 21–72 years with complicated hemorrhoids of III–IV stage were analyzed. The group of clinical comparison (207 patients) was operated according to standard scheme, the main group (351 patients) – according to author’s technology with modified technique for treating the hemorrhoid bolus using betamethasone.Results: When using the author’s technique, a more significant decrease in postoperative pain syndrome severity was achieved: injection analgesics were not required already in a day, and after 6 days the pain syndrome was stopped in all cases. Only three patients (0.9%) demonstrated an acute urinary retention up to two days. The group of clinical comparison maintained a longterm (up to three months) pain syndrome; postoperative urinary retention was registered in 38 cases (18.4%); 9 patients (4.3%) developed blood loss in the area of surgical intervention.Conclusions: Suggested technique of surgical treatment for hemorrhoids is quite effective, simple and can be implemented in any surgical inpatient facility.

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The substantiation of chronic pancreatitis surgical treatment method selection

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2007-3-43-50 ◽

2007 ◽

Vol 6 (3) ◽

pp. 43-50

Author(s):

V. A. Koubyshkin ◽

I. A. Kozlov ◽

N. I. Yashina ◽

T. V. Shevchenko

Keyword(s):

Chronic Pancreatitis ◽

Surgical Treatment ◽

Gastric Resection ◽

Clinical Manifestations ◽

Pancreatic Head ◽

Pain Syndrome ◽

Treatment Method ◽

Pancreas Head ◽

Resection Of The Pancreas

The experience of surgical treatment of 154 patients having chronic pancreatitis with preferential injury of the pancreas head which underwent different operative interventions: isolated resection of pancreatic head ( based upon Berger surgery - 24, Frey surgery - 39), pancreatoduodenal resection ( with gastric resection - 22, with preserved pylorus - 43) and drainage surgeries - 26 is presented in the article. The surgery of isolated resection of pancreatic head has less number of nearest unfavorable results compared with pancretoduodenal resection with preserved pylorus. Proximal resection of the pancreas the variants of which are different isolated resection of pancreatic head is superior upon surgeries with full or partly resection of the duodenum due to fast normalization of the motor-evacuation function, less rate of the intestinal reflux and portion character of duodenal evacuation. In the follow-up period after pancreatoduodenal resection, atrophic processes occur in distal areas of the pancreas which are followed by clinical manifestations of exo- and endocrinous insufficiency. The surgery of longitudinal pancreatic jejunostomy does not avoid pathologic changes in the organ head and pain syndrome.

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Minimal Invazive Surgical Treatment of Piriformis Syndrome and the Results

Advances in Neurology and Neuroscience ◽

10.33140/an.02.01.01 ◽

2019 ◽

Vol 2 (1) ◽

Keyword(s):

Surgical Treatment ◽

Sciatic Nerve ◽

Conservative Treatment ◽

Surgical Procedures ◽

Pain Syndrome ◽

Anatomical Variations ◽

Clinical Findings ◽

Piriformis Syndrome ◽

Minimally Invasive Surgical ◽

Magnetic Resonance Imaging Mri

Piriformis syndrome is a neuromuscular pain syndrome occurring as a result of compression on the underlying sciatic nerve due to various causes including the hypertrophy, inflammation, mass lesions or anatomical variations occuring in the deep gluteal space. Patients with piriformis syndrome often experience pain and numbness in the hip, thigh and leg, similar to those of sciatica. In addition to clinical findings, electrophysiological examinations and magnetic resonance imaging (MRI) is useful for diagnosis. Once diagnosed, the treatment approach is stepwise and conservative treatment is successful in majority of cases. Surgical treatment should be performed for the cases in whom conservative treatment methods fail and when the sciatic nerve should be decompressed. Surgery is an important treatment option for unresolved piriformis syndrome with its simplicity and low morbidity. Several surgical procedures have been described for the decompression of affected sciatic nerve. Due to excessive fibrosis tissue that may be developed around the sciatic nerve in classical surgical procedures, person's return to social and work life may be delayed. In the present study, we will evaluate the surgical indication criteria of our cases who underwent minimally invasive surgical treatment due to piriformis syndrome, the definition of the surgical procedure and the outcomes.

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Correction of gastrocardial syndrome in patients with hernias of the esophageal orifice of the diaphragm during antireflux operations

Medical Council ◽

10.21518/2079-701x-2021-21-2-62-71 ◽

2022 ◽

pp. 62-71

Author(s):

T. V. Khorobrykh ◽

A. A. Voevodina ◽

D. A. Efremov ◽

V. I. Korotkiy ◽

N. R. Khusainova ◽

...

Keyword(s):

Surgical Treatment ◽

Angina Pectoris ◽

Hiatal Hernia ◽

Reflux Esophagitis ◽

Antireflux Surgery ◽

Pain Syndrome ◽

Ecg Monitoring ◽

Younger Age ◽

Before And After ◽

Antireflux Operations

Introduction. Hernia of the esophageal opening of the diaphragm in 90% of cases is the main cause of the development of reflux esophagitis. The doctrine highlighted a large group of extraesophageal manifestations of reflux esophagitis, including gastrocardiac syndrome.Аim. The purpose of this publication is to evaluate the effectiveness of antireflux surgery in patients with hiatal hernia through the prism of its effectiveness in the dynamics of gastrocardial syndrome regression.Material and мethods. The paper presents the results of diagnostics and surgical treatment of 101 patients with hiatal hernia.Results. According to the data of instrumental research methods, cardiac hernias of the esophageal opening of the diaphragm were detected in 45 (44.5%) patients, cardiofundal in 40 (39.6%), subtotal in 15 (14.8%), total in 1 (0.9%). The main place in the clinical picture of gastrocardial syndrome was occupied by the pain syndrome behind the breastbone (83.1%). Thus, arrhythmias were found in 16 (40.0%) patients with cardiofundal, in 10 (66.6%) subtotal and in 1 (100.0%) total hiatal hernia, and angina pectoris is characteristic of cardiac hernias and was observed in 20 (44.4%) patients. The clinical manifestation of reflex angina pectoris and arrhythmias depended on the degree of shortening of the esophagus. Thus, arrhythmias were more common in patients with cardiofundal (50.0%), subtotal (71.4%), total (100.0%) hiatal hernia with II degree of shortening of the esophagus, and angina pectoris characteristic of cardiac (75.0%) hiatal hernia. with II degree of shortening of the esophagus. Reflex angina is typical for patients of the older age group, and manifestations of arrhythmia are recorded at a younger age. Heart rate variability was considered, according to electrocardiogram and Holter ECG monitoring before and after surgical treatment, where the parameters significantly (p> 0.05) decreased.Conclusions. The phenomena of gastrocardial syndrome regressed after antireflux surgery in 44 (43.5%) patients. Surgical treatment from the endovideosurgical approach did not worsen the results of surgical treatment.

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MIGRATION OF THE INTRAUTERINE DEVICE TO THE ABDOMINAL CAVITY

I P Pavlov Russian Medical Biological Herald ◽

10.23888/pavlovj20172247-262 ◽

2017 ◽

Vol 25 (2) ◽

pp. 247-262

Author(s):

D. A. Rahmonov ◽

F. Sh. Rashidov ◽

E. L. Kalmykov ◽

M. M. Marizoeva ◽

O. B. Bobdjonova ◽

...

Keyword(s):

Surgical Treatment ◽

Intrauterine Device ◽

Abdominal Cavity ◽

Clinical Signs ◽

Uterine Cavity ◽

Pain Syndrome ◽

Pregnant Patient ◽

Pelvic Cavity ◽

And Migration ◽

Laparoscopic Removal

The aim: demonstration of our experience of surgical treatment of patients with migrated intrauterine device (IUD) into the abdominal cavity. The results of surgical treatment of migrated IUDs in the pelvic cavity are summarized in 17 women. The average age of the patients was 33,23,4 years. The timing of implantation of the IUDs varied from 10 days to 24 months. In all cases, the intra operational finding was T-shaped a copper device. The reason behind the women's consultation was an increase in pain syndrome in the lesser pelvis (n=15), dysuric phenomenon (n=1) and the onset of pregnancy (n=1). Perforation of the uterus and migration of the spiral occurred from 10 days to 2 years after its implantation. All patients were operated laparoscopicaly. The average duration of operations was 45,510,5 minutes. In the postoperative period there were no complications from the pelvic organs and postoperative wounds. The period of hospitalization of patients was 3,50,7 days. In all cases there was a regression of clinical signs and recovery. In one pregnant patient (gestation period 5-6 weeks) the pregnancy proceeded without particular pathological abnormalities and resulted in the birth of a full-term child. Laparoscopic removal of the IUD migrating from the uterine cavity to the abdominal cavity is the method of choice in the treatment of this group of patients, avoiding development of intra- and postoperative complications and a shorter length of stay in the hospital. The effectiveness of the procedure reaches 100%. The most common cause of complication of the IUD is the perforation of the uterus during its implantation.

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Result of using a minimally invasive method of surgical treatment of purulent-necrotic complications in a patient with diabetic foot syndrome

Russian Military Medical Academy Reports ◽

10.17816/rmmar64986 ◽

2020 ◽

Vol 39 (3) ◽

pp. 60-64

Author(s):

Sergey Y. Ivanusa ◽

Boris V. Risman ◽

Andrey V. Yanishevskiy

Keyword(s):

Surgical Treatment ◽

Minimally Invasive ◽

Diabetic Foot ◽

Pain Syndrome ◽

Diabetic Foot Syndrome ◽

Military Medical Academy ◽

Results Of Treatment ◽

Medical Academy ◽

Invasive Method ◽

Short Time

The article presents an analysis of the results of treatment of a patient with purulent-necrotic complications of diabetic foot syndrome, who, in the framework of surgical treatment, used a minimally invasive method of treatment of purulent-necrotic complications of diabetic foot syndrome, developed at the departments of general surgery and normal anatomy of the S.M. Kirov Military Medical Academy. The effectiveness of the developed method has been demonstrated, which makes it possible to sanitize the purulent cavity in a short time, stop pain syndrome and restore the support ability of the foot (4 figs, 1 table, bibliography: 7 refs).

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Chronic infectious lesions of the cervical spine in adults: monocentric cohort analysis and literature review

Hirurgiâ pozvonočnika ◽

10.14531/ss2021.3.68-76 ◽

2021 ◽

Vol 18 (3) ◽

pp. 68-76

Author(s):

D. G. Naumov ◽

S. G. Tkach ◽

A. Yu. Mushkin ◽

M. E. Makogonova

Keyword(s):

Cervical Spine ◽

Surgical Treatment ◽

Sagittal Balance ◽

Cohort Analysis ◽

Pain Syndrome ◽

Vertical Axis ◽

Sagittal Vertical Axis ◽

Comorbidity Index ◽

Anterior Reconstruction ◽

Infectious Spondylitis

Objective. To analyze the results of surgical treatment of chronic infectious cervical spondylitis and literature data.Material and Methods. Design: retrospective monocentric cohort study for 2017–2020. The study included medical history and clinical and instrumental data of 25 patients who underwent 28 reconstructive surgeries on the suboccipital (n1 = 3) and subaxial (n2 = 25) spine. The average follow-up period was 1 year 2 months ± 4 months. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 22.0.Results. The effect of the duration of the therapeutic pause (p = 0.043) and the T1 slope (T1S) (p = 0.022) on the intensity of vertebrogenic pain syndrome was established. When assessing the parameters of the sagittal balance a direct relationship between the age of patients and the value of cervical sagittal vertical axis (CSVA) (p = 0.035) was revealed, while CSVA (p = 0.514) and neck tilt angle (NTA) (p = 0.617) did not significantly affect the intensity of vertebral pain syndrome. The extent of vertebral destruction did not affect either the intensity of vertebral pain (p = 0.872) or the indices of the sagittal balance: CSVA (p = 0.116), T1S (p = 0.154), and NTA (p = 0.562). A significant predictor of postoperative complications is the level of comorbidity with an index of 7 or more (p = 0.027) according to the Charlson scale.Conclusion. The leading predictors of complications of surgical treatment of cervical infectious spondylitis are the Charlson comorbidity index (7 points or more) and the variant of anterior reconstruction (the use of a blocked extraspinal plate). The factors influencing the intensity of vertebrogenic pain syndrome in this pathology are the duration of the therapeutic pause and the magnitude of T1S compensation. Anterior reconstruction of the cervical spine in the presence of infectious spondylitis provides a correction of the sagittal balance parameters, with the possibility of long-term maintaining the achieved values.

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