scholarly journals Multistage Surgical Treatment of Multisystem Closed Abdominal Trauma: Standardization of the Approach

2021 ◽  
Vol 9 (4) ◽  
pp. 626-638
Author(s):  
S. S. Maskin ◽  
V. V. Aleksandrov ◽  
V. V. Matyukhin ◽  
M. I. Parovatkin

Introduction. The multisystem closed abdominal trauma is accompanied by a high mortality rate, and exceeding the minimum required volume of surgery in an extremely difficult patient’s condition often leads to an unfavorable outcome.Aim of study. Standardization of staged treatment of patients with severe concomitant closed abdominal trauma.Material and methods. This review presents the latest information obtained as a result of studying domestic and foreign literature on the issue of multistage surgical treatment of severe multisystem closed abdominal trauma. The concept of damage control, its stages are described step by step, indications for types of surgical interventions are specified. The literature data on the results of clinical application of the technique from the standpoint of evidence-based medicine are presented.Conclusion. A clear knowledge of the required volume of surgical intervention at each stage of treatment of patients with severe concomitant closed abdominal trauma, the main points of intensive care, the criteria for patient stabilization and indications for relaparotomy improve the treatment results for this category of victims.

2016 ◽  
Vol 23 (1) ◽  
pp. 40-47
Author(s):  
D. B Barsukov ◽  
A. I Krasnov ◽  
M. M Kamosko ◽  
V. E Baskov ◽  
I. Yu Pozdnikin ◽  
...  

To optimize the anatomical and functional surgical treatment results in patients with early (I-II) stages of juvenile femoral head epiphysiolysis both pre- and postoperative data of clinical, x-ray and magnetic-resonance examinations were analyzed for 120 patients aged 11 - 15 years. Maximum follow up period after surgical interventions, i.e. femoral head epiphysiodesis (n=60) and femoral head epiphysis fixation (n=60) made up 23 and 3 years, respectively. It was shown that surgical intervention for the fixation of femoral head epiphysis ensured reliable stability of the epiphysis preventing the latter from displacement development and progression, and did not exert significant influence upon either femoral neck and head endochondral growth or the length of the upper extremity.


2018 ◽  
Vol 85 (7) ◽  
pp. 27-29
Author(s):  
V. P. Аndriushchenko ◽  
D. V. Аndriushchenko ◽  
Yu. S. Lysiuk

Objective. To determine the character and optimal volume of standard open surgical interventions in an acute complicated pancreatitis (ACP) with elaboration of the main technical elements of the operations. Маterials and methods. There were operated 96 patients, suffering ACP. The main group consisted of 47 patients, in whom open interventions were performed primarily in 19, and as the second-stage procedure after application of miniinvasive interventional technologies (МIТ) – in 28. The comparison group consisted of 49 patients, in whom standard operations were done only. Results. Application of MIТ have promoted the indications narrowing for performance of primary open operations more than twice. In the main group the arcuate-like subcostal access was applied predominantly - in 26 (55%) observations (χ²=14.287; р=002), while in a control one – a median upper laparotomy – in 37 (76%) observations (χ²=38.43, р < 0.001). The method of closed draining in accordance to procedure of Beger was used predominantly in the main group of patients – in 43% of observations, comparing with a control group - 9% of observations (χ²=12.965; р=0.003). In 23% patients of the main group and in 26% patients of a control one (χ²=0.0013; р=0.05), when the extended purulent-necrotic inflammation process have presented, a staged sanation was applied, using programmed relaparotomies. Some technical elements of the surgical intervention were improved. Conclusion. Application of standard open operations in accordance to elaborated principle is accompanied by improvement of the treatment results in patients, suffering ACP.


Author(s):  
D. B. Barsukov ◽  
A. I. Krasnov ◽  
M. M. Kamosko ◽  
V. E. Baskov ◽  
I. Yu. Pozdnikin ◽  
...  

To optimize the anatomical and functional surgical treatment results in patients with early (I-II) stages of juvenile femoral head epiphysiolysis both pre- and postoperative data of clinical, x-ray and magnetic-resonance examinations were analyzed for 120 patients aged 11 - 15 years. Maximum follow up period after surgical interventions, i.e. femoral head epiphysiodesis (n=60) and femoral head epiphysis fixation (n=60) made up 23 and 3 years, respectively. It was shown that surgical intervention for the fixation of femoral head epiphysis ensured reliable stability of the epiphysis preventing the latter from displacement development and progression, and did not exert significant influence upon either femoral neck and head endochondral growth or the length of the upper extremity.


2020 ◽  
pp. 11-72

This chapter covers the general considerations in safely and effectively performing paediatric surgery. It starts with the ethical and legal requirements, including withdrawal of treatment, treating children in the Jehovah’s Witness faith, and safeguarding. It then outlines evidence-based medicine, including meta-analysis, statistics, and reporting trials. Transport of the sick child, anaesthesia, analgesia, intensive care, sepsis, and the use of antibiotics in children are all covered. Day-case surgery, from its history to indications, pre- and postoperative care, and proper documentation, is described. Pre-assessment, care of the neurologically impaired child, basics of vascular access and radiology, and nutrition in the surgical patient are all covered.


2013 ◽  
Vol 20 (3) ◽  
pp. 42-45
Author(s):  
S. Yu Berezhnoy ◽  
A. I Protsenko ◽  
V. V Kostyukov

Surgical treatment results for 27 patients with interdigital keratosis of the foot were analyzed. To determine the predisposing factors for keratosis development data of clinical and roentgenologic examination were used. In all cases transcutaneous technique that enabled to avoid surgical intervention directly on a pathologic focus was applied. Mean follow up period made up 6 months. It was shown that transcutaneous surgical intervention was an effective and reproducible method for interdigital keratosis treatment. That technique provided positive results with minimum risk of postoperative complications in the majority of cases and could be used at outpatient department.


2001 ◽  
Vol 166 (11) ◽  
pp. 952-954 ◽  
Author(s):  
H. Payravi ◽  
S.S. Sayed Mortaz ◽  
I. Fazel

2019 ◽  
Vol 15 (4) ◽  
pp. 405-410 ◽  
Author(s):  
K. B. Pershin ◽  
N. F. Pashinova ◽  
M. E. Konovalov ◽  
E. P. Gurmizov ◽  
O. Yu. Zubenko ◽  
...  

Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.


Sign in / Sign up

Export Citation Format

Share Document