scholarly journals Myoma pseudocapsule - a biological and surgical structure to respect during myomectomy

2020 ◽  
Vol 148 (3-4) ◽  
pp. 236-241
Author(s):  
Andrea Tinelli ◽  
Radmila Sparic
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Biological Process ◽  
Positive Impact ◽  
Uterine Fibroids ◽  
Reproductive Function ◽  
Muscle Scar ◽  
New Techniques ◽  
Anatomical Studies ◽  
Surgical Practice

Uterine fibroids affect almost one in two patients, causing many pelvic problems and requiring pharmacologic and surgical treatment. For many years, the importance of the fibroid was emphasized as uterine pathology, without focusing on the complex myometrial biology peripheral to fibroid. Moreover, the traditional surgical technique in fibroid removal has not been investigated for years. In recent years, on the contrary, morphological, neuroendocrine and anatomical studies have demonstrated the importance of a biological and surgical structure surrounding myoma, rich in neurotransmitters and neurofibres, the myoma pseudocapsule. This structure is formed in the womb peripheral to fibroid onset, it separates the fibroid from the myometrium and acts as a tissue regenerator after the removal of the fibroid from the uterus. The translation of scientific research on pseudocapsules into surgical practice has allowed us to identify new techniques of myomectomy, removing the myoma inside the pseudocapsule and promoting the pseudocapsules sparing surgery. All this to favor the subsequent biological process of uterine scarring and healing, by activating the neurotransmitters and neurofibres present in the myometrial fovea. The correct healing after fibroid removal restores the uterine anatomy, with a positive impact on subsequent reproductive function, reducing problems related to the muscle scar.

scholarly journals A comparative study regarding the intraoperative efficacy of conventional open (Milligan-Morgan) and harmonic scalpel haemorrhoidectomies

2019 ◽  
Vol 6 (12) ◽  
pp. 4440
Author(s):  
Swapnil P. Madankar ◽  
Girish L. Jatkar ◽  
Mahendra S. Dandge
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Positive Impact ◽  
Human Beings ◽  
Operative Blood Loss ◽  
Interventional Study ◽  
Single Blind ◽  
Operative Monitoring

Background: Human beings have suffered from haemorrhoids since they have started to walk. The surgical treatment for haemorrhoids is called ‘Haemorrhoidectomy’. Many techniques have been developed to minimize the morbidity and hasten the recovery. This study compares two such techniques: conventional open haemorrhoidectomy (Milligan-Morgan) and the harmonic scalpel haemorrhoidectomy, in terms of intraoperative efficacy.Methods: This was a randomized, prospective, single blind (patients), non-crossover type interventional study was carried out on patients more than 18 years of age presenting with haemorrhoids requiring surgical treatment. They were randomly divided into two groups and the surgeries were carried out accordingly. Intraoperative and immediate post-operative monitoring was done.Results: Operative time, intraoperative and immediate post-operative blood loss was less in the harmonic group compared to the conventional group.Conclusions: Harmonic scalpel haemorrhoidectomy is better surgical technique than conventional open haemorrhoidectomy as it has better intraoperative efficacy having significant positive impact on the morbidity and recovery of the patient. 

scholarly journals Reproductive outcomes following surgical removal of uterine fibroids

2019 ◽  
pp. 110-118
Author(s):  
A. E. Mitichkin ◽  
Yu. E. Dobrokhotova ◽  
N. Yu. Ivannikov ◽  
V. I. Dimitrova ◽  
O. A. Slyusareva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Drug Withdrawal ◽  
Uterine Fibroids ◽  
Reproductive Function ◽  
Uterine Myoma ◽  
Surgical Removal ◽  
Birth Canal ◽  
Uterine Arteries ◽  
Natural Birth ◽  
Prospective Comparative Study

The cohort prospective comparative study investigated the efficacy of mifepristone use in patients after surgical treatment of uterine myoma. It was shown that the use of mifepristone at a dose of 50 mg/day in a continuous mode for 3 months after surgical treatment for proliferating uterine myoma led to the absence of recurrences of the disease for 2 years after the drug withdrawal. The use of mifepristone after embolization of uterine arteries allowed to significantly reduce the size of the node by 25% during 12 months and by 50% (p<0.05) after 24 months. Complex treatment of uterine myoma, including myomectomy and drug therapy with mifepristone, allowed to realize reproductive function in 46% of patients, and delivery through the natural birth canal occurred in 24% of patients.

scholarly journals Analysis of modern views on the uterine fibroids and methods of its treatment

2021 ◽  
Vol 3 ◽  
pp. 41-47
Author(s):  
L.M. Kuzomenska ◽  
S.L. Chyrva
Keyword(s):  
Surgical Treatment ◽  
Uterine Fibroids ◽  
Reproductive Function ◽  
Risk Groups ◽  
Reproductive Age ◽  
Modern Approach ◽  
Pregnancy And Childbirth ◽  
Independent Unit ◽  
Progressive Growth ◽  
Organ Sparing

Despite a significant amount of research on the pathogenesis, diagnosis and treatment of uterine fibroids, many questions remain unanswered today. The appearance and progressive growth of this formation is the result of a whole complex of disorders in the female body: neurohumoral, genetic, inflammatory and others that suppress reproductive function and worsen the course of the disease. Given the number of key factors in the pathogenesis and pathophysiology of uterine fibroids, the treatment of this group of patients should be comprehensive, aimed at early detection, treatment of concomitant gynecological diseases and correction of hormonal disorders.In recent decades, hormone therapy has been widely used for the conservative treatment of uterine hyperplastic diseases. However, according to some data, the use of COCs or intrauterine hormonal releasing system has a slight blocking effect on fibroid growth processes. Pharmacotherapy of the disease can be both a stage for preoperative preparation on the organ, and an independent unit for stabilizing the nodes and getting rid of surgical treatment. And although the results of conservative treatments indicate their effectiveness, it should be stated that the main method of treatment of uterine fibroids is surgery.In the age of endoscopic surgery, this discussion has not exhausted itself and the modern approach to the treatment of uterine fibroids dictates the expansion of indications for organ-sparing operations. The choice of their methodology should be considered and determined by the size, location, clinical picture of the disease and the feasibility of preserving menstrual and reproductive function of women. Laparoscopic myomectomy is considered a minimally invasive and less traumatic intervention, contributes to a favorable course of the postoperative period and reduces pain. With effective organ-sparing surgical treatment of uterine fibroids in women of reproductive age, the menstrual cycle is normalized, reproductive function is restored, and pregnancies usually occur in 1,5-2 years after surgery.Endoscopic treatments are now successfully used both for planning a pregnancy and for its onset. A significant amount of patients have an uncomplicated course of pregnancy and childbirth, even in the presence of multiple and small nodes. Of course, pregnant women with fibroids can not be considered as a homogeneous group of patients, clearly recommending the preservation of pregnancy. The predominant location and size of the tumor, the degree of pathological changes in the myometrium, the duration of the disease, the state of health of the woman, the age of the woman giving birth for the first time, determine different degrees of risk of pregnancy and childbirth for mother and fetus. The division of patients into risk groups allows to differentiate the question of the feasibility of maintaining pregnancy, to carry out appropriate clinical and laboratory examinations and preventive measures to prevent complications.

Modern approaches to the prevention and treatment of alterations in reproductive health in women with somatoform disorders and autonomic homeostasis

2016 ◽  
pp. 98-101
Author(s):  
Vl.V. Podolsky ◽  
◽  
V.V. Podolsky ◽  
Keyword(s):  
Reproductive Health ◽  
Hormonal Regulation ◽  
Preventive Measures ◽  
Somatoform Disorders ◽  
Emotional Health ◽  
Uterine Fibroids ◽  
Reproductive Function ◽  
Epidemiological Studies ◽  
Prevention And Treatment ◽  
Artificial Abortion

The objective: the developing of a system of preventive measures and principles of pregravid preparation for women with somatoform disorders and violation of autonomic homeostasis (VAH), in which observed changes in reproductive health (CRH) in the shape of states after undergoing artificial abortion, infertility and uterine fibroids. Patients and methods. Conducted clinical and epidemiological studies in the population of women of fertile age (WFA) allowed identifying for further examination of women with CRH in the form of state after undergoing artificial abortion, infertility and uterine fibroids in women with VAH. Further women were examined, in particular the conducted clinical and instrumental methods of research; determined the state of autonomic homeostasis and psycho emotional health of the biotopes of the organism, immunity; analyzed the hormonal regulation of the menstrual cycle; performed genetic studies and determined the morphofunctional state of reproductive system. Results. The most frequent complications during pregnancy in women who had CRH in history in the form of abortions, infertility and uterine fibroids and in the background of the PAF, there was a threat of interruption of pregnancy (often in I and II trimester – 56%) and preterm delivery (21%). The study of the catamnesis of further reproductive health found that in the case of well-conducted therapeutic measures in women undergoing artificial abortion, had infertility and uterine leiomyoma in the background of VAH, restore reproductive function, and in 82% of cases occurred a pregnancy. Conclusion. The the provided study of reproductive health, and state of various organs and systems of fertile aged women with somatoform disorders and violations of the autonomic homeostasis allowed to develop preventive measures for these women and pregravid preparation with the inclusion to the therapy Magnesium and vitamins (Magne-В6®). Key words: somatoform disorders, violation of autonomic homeostasis, changes in reproductive health, prevention and treatment, women of fertile age, Magne-В6®.

A case of resection of the upper jaw with the use of a prosthesis (demonstration of the patient and preparations)

1909 ◽  
Vol 9 (7-8) ◽  
pp. 365-377
Author(s):  
I. M. Timofeev
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Digestive Tract ◽  
Human Body ◽  
Postoperative Care ◽  
Upper Jaw

Many diseases of the human body, which need surgical treatment, require from the surgeon not only the elimination of this disease according to all the rules of surgical technique and modern asepsis, but also proper postoperative care. The latter is sometimes quite difficult, especially on wounds located near the so-called natural openings and on the path of the respiratory and digestive tract, due to the constant contamination of the wound by the separation and discharge of these pathways.

Role of hyperbaric oxygenation in preoperative preparation of patients with pyloroduodenal ulcers

1986 ◽  
Vol 67 (3) ◽  
pp. 164-166
Author(s):  
A. A. Chernyavsky ◽  
P. S. Zubeev ◽  
O. V. Milovidova ◽  
N. G. Mikhailova
Keyword(s):  
Surgical Treatment ◽  
Hyperbaric Oxygenation ◽  
Conservative Therapy ◽  
Selective Proximal Vagotomy ◽  
Preoperative Preparation ◽  
Duodenal Ulcers ◽  
Operative Method ◽  
Surgical Practice

Although conservative therapy remains the main treatment for duodenal ulcers, however, 20-30% of patients require surgical treatment. In recent years a new operative method - selective proximal vagotomy - has been introduced into the wide surgical practice of pyloroduodenal ulcers treatment. Its performance is connected with the decision on the surgeon's tactics concerning the ulcerous niche: should it be excised or left?

scholarly journals Calcaneonavicular coalition resection

2020 ◽  
Vol 14 (3) ◽  
pp. 297-300
Author(s):  
Mercedes Juncay ◽  
Rafael Sposeto ◽  
Alexandre Godoy-Santos ◽  
Túlio Fernandes
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Conservative Treatment ◽  
Treatment Option ◽  
Expert Opinion ◽  
Tarsal Bone ◽  
Tarsal Coalition ◽  
Level Of Evidence ◽  
Calcaneonavicular Coalition ◽  
Tarsal Bones

Tarsal coalition is an abnormal connection between tarsal bones, caused by an embryogenic failure. Its most common forms are calcaneonavicular and talocalcaneal coalition, which are present in 53% and 37% of the cases, respectively. The onset of symptoms is related to tarsal bone ossification, and mean age for this event is estimated at 16 years for calcaneonavicular coalition. Surgical treatment is indicated for patients who did not improve symptoms with conservative treatment. The aim of this study is to present a surgical technique as a treatment option for resection of calcaneonavicular coalition associated with abnormal cuboid-navicular joint. Level of Evidence V; Therapeutic Studies; Expert Opinion.

scholarly journals Results obtained after the surgical treatment of Graves’ disease depending on the levels of anti-thyroid antibodies

2021 ◽  
Author(s):  
S. L. Shliakhtych ◽  
V. R. Antoniv
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Surgical Technique ◽  
Hormone Receptors ◽  
Thyroid Stimulating Hormone ◽  
Endocrine Surgery ◽  
Graves Disease ◽  
Autoimmune Thyroid ◽  
Early Postoperative Complications ◽  
Surgery Duration

Graves' disease (GD) is a hereditary autoimmune disease which is characterized by persistent abnormal hypersecretion of thyroid hormones and thyrotoxicosis syndrome development. GD affects from 0.5 % to 2.0 % of population in different regions. 46 % of these patients develop ophthalmopathy. GD is a common cause of disabilities in patients under 60 years of age. In recent years, the incidence of GD in Ukraine has increased by 9.9 % — from 106.2 to 117.9 per 100,000 individuals. This can be connected with the improved diagnostic possibilities and active disease detection as well as with the increased number of autoimmune thyroid disorders. The recent studies focus on prevention of specific complications and recurrences of GD after surgery. Objective — to compare the levels of antibodies to the thyroid‑stimulating hormone receptors (TSHR‑Ab) during different postoperative periods as well as the incidence of early and late complications depending on the surgical technique used for the treatment of GD. Materials and methods. The results of surgical treatment of 130 patients, with GD were compared. 29 male patients and 101 female patients aged from 19 to 76 (average — 44.1 ± 3.2 years), receiving their treatment for GD in Kyiv Center of Endocrine Surgery during 2010—2018, were randomly selected and divided into two groups. At the time of operation the duration of disease was from 1 to 30 years (average — 4.6 ± 1.2 years). Group  1 included 65 patients that underwent total thyreoidectomy (TT) and group 2 included 65 patients that underwent subtotal thyreoidectomy (ST). The following parameters were compared: surgery duration, the incidence of early postoperative complications, including bleedings and damage to the recurrent laryngeal nerves, and late outcomes of surgical treatment (persistent hypoparathyreoidism disorder and disorder recurrences) depending on the method of surgery (ST or TT). Furthermore, the patterns of the TSHR‑Ab level reduction were studied for different postoperative periods. Results. The comparison of surgical outcomes following TТ and ST didn’t reveal any statistically significant differences in such evaluation criteria as the average surgery duration, the average volume of intraoperative blood loss and the average duration of the postoperative inpatient treatment. The comparative assessment of the thyroid stump volume and the average amount of drained discharge showed statistically significant differences for TТ. It allows considering TТ as a surgery which causes less complications than ST. The studied parameters of early postoperative complications had no significant differences for ST and TТ. The long‑term (5 years) postoperative level of TSHR‑Ab was statistically significantly lower in patients after TT and made up 1.15 ± 0.13 IU/L (thus corresponding to the normal level). Conclusions. Total thyroidectomy is an optimal surgical technique and is more appropriate compared with subtotal thyroid gland resection. It should be noted that TT provides lower risk of complications due to significantly lower level of TSHR‑Ab in late postoperative period.  

scholarly journals Menstrual and reproductive function repair in patients with polycystic ovary syndrome and obesity by correcting of glucose intolerance

2008 ◽  
Vol 5 (2) ◽  
pp. 38-41 ◽  
Author(s):  
O I Lineva ◽  
M V Glukhova
Keyword(s):  
Reproductive System ◽  
Negative Impact ◽  
Positive Impact ◽  
Polycystic Ovary ◽  
Reproductive Function ◽  
Endocrine Function ◽  
Anthropometric Parameters ◽  
Ovary Syndrome ◽  
High Incidence ◽  
Total Treatment

The aim of the study was to investigate the effect of sibutramine on metabolic and hormonal parameters in women with PCOS and obesity. Materials and methods. The study included 53 women aged 18 to 35 years (mean age 31,3 ± 1,1 years) with PCOS and obesity. All patients received therapy with sibutramine. The total treatment duration was 6 months. The treatment was evaluated monthly nature of the menstrual cycle, anthropometric parameters (body weight, BMI, ON, ON, ON / OF). The Results. The studies found that after 3 months of treatment with weight loss was 8,1 ± 0,31 kg, after 6 months - 13,1 ± 0,78 kg (p 0,05). Results of the survey of women included in this study strongly support the negative impact of obesity on the functional state of the reproductive system, evidenced by the high incidence of anovulation, rhythm disturbances of menstruation (amenorrhea up to), infertility. Conclusions. The obtained results once again confirm the high efficacy and safety of sibutramine to reduce body mass, suggest correction of metabolic, hormonal disorders and positive impact on women's reproductive health. This allows us to consider the use of sibutramine in women with PCOS and obesity as a way to restore the endocrine function of the reproductive system.

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