scholarly journals Immediate and long-term results of laparoscopic hernioplasty in inguinal hernias with and without mesh endoprosthesis fixation

2020 ◽  
Vol 179 (4) ◽  
pp. 22-28
Author(s):  
O. V. Zaitsev ◽  
A. V. Koshkina ◽  
D. A. Khubezov ◽  
V. A. Yudin ◽  
V. V. Barsukov ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Mesh Fixation ◽  
Long Term Results ◽  
Control Group ◽  
Inguinal Hernioplasty ◽  
Inguinal Hernias ◽  
Laparoscopic Hernioplasty ◽  
Mesh Endoprosthesis

The objective of this study was to conduct comparative analysis of the immediate and long-term results of laparoscopic inguinal hernioplasty performed with and without fixation of the mesh endoprosthesis.Methods and materials. The base group included 77 patients who underwent laparoscopic inguinal hernioplasty without fixation of the mesh by herniostepler. The control group included 76 patients who underwent laparoscopic inguinal hernioplasty with mesh fixation by herniostepler. To assess the postoperative period, the following criteria were studied: the severity of postoperative pain on a Visual Analog Scale; postoperative complications on the Clavien-Dindo scale; an early recurrence of inguinal hernias determined by ultrasound.Results. In both groups, the severity of postoperative complications did not exceed grade I. Among the entire list of complications, there were observed: pain in the area of surgery, an increase in body temperature above 38.5 °C, acute urinary retention, swelling and hematoma of the scrotum, seroma. There were no cases of conversion, intraoperative damage to internal organs and vascular structures. Complications in both groups do not differ significantly and do not depend on the method of laparoscopic inguinal hernioplasty: with fixation of the endoprosthesis by herniostepler or without fixation. The level of pain in the early postoperative period in patients operated by laparoscopic inguinal hernioplasty with mesh fixation was significantly higher. During control examinations of patients on the day after surgery, at the time of discharge and 6 months after surgery, no cases of dislocation of mesh endoprosthesis and relapse of inguinal hernia were detected.Conclusion. The obtained data indicate the effectiveness of laparoscopic hernioplasty in inguinal hernias with polypropylene mesh without fixing with herniostepler.

scholarly journals JUSTIFICATION AND DIRECT RESULTS OF ENDOSCOPIC GYNRYOPLASTICS WITH TAPP AND TEP TECHNIQUES

2019 ◽  
Vol 21 (1) ◽  
pp. 125-129
Author(s):  
P N Romashchenko ◽  
Al A Kurygin ◽  
V V Semenov ◽  
S U Polushin ◽  
A A Mamoshin ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Economic Efficiency ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Inguinal Hernias ◽  
Laparoscopic Hernioplasty ◽  
Mesh Prosthesis ◽  
Invasive Intervention

Inguinal hernioplasty is one of the most common planned surgical interventions. With the advent of minimally invasive technologies in herniology, a new page in the field of inguinal hernia surgery has opened. The emergence of laparoscopic techniques (TAPP) and fully pre-peritoneal surgery using the TEP method allowed us to achieve good long-term results. However, there remain unresolved questions of justifying the choice of a particular method of minimally invasive intervention in patients with inguinal hernias, as well as minimal information about the comparison of long-term results of treatment of this category of patients. As a result of the study, the results of treatment of 987 patients with inguinal hernias, operated from 2014 to 2018, were evaluated. in the clinic by the endoscopic method (319 by the laparoscopic method TAPP and 668 patients operated by the TEP method). The criteria for the comparison of endoscopic techniques of hernioplasty were: the duration of the operation, the intensity of the pain syndrome, the postoperative bed-day, the economic costs for one treated herniological patient. It was established that in the absence of significant contraindications, the operation of choice was hernioplasty according to the TER method due to the lower risk of damage to internal organs and its greater economic efficiency, while maintaining all the positive qualities of minimally invasive intervention. The average bed-day after surgery according to the TAPP method was 3.8 ± 0.2, and according to the TEP method - 2.6 ± 0.3. The complications, the frequency and the cause of relapses after endoscopic hernioplasty were studied. Analyzing long-term results, in 3 cases (0.9%) after laparoscopic hernioplasty, a relapse of the disease was diagnosed. After hernioplasty using the TEP method, relapse was diagnosed in 2 cases (0.3%). In 2 patients, the hernia recurred was due to the small size of the established mesh prosthesis (less than 10x15 cm), in 3 patients it was caused by turning the lower edge of the mesh prosthesis and was observed at the stage of mastering the technique. As a result of the study, it was found that the TEP technique, in contrast to laparoscopic hernioplasty TAPP, leads to a reduction in the postoperative hospital bed, is accompanied by a significantly lower pain syndrome and recurrence rate of the disease, and also has greater economic efficiency.

scholarly journals An integrated approach to treatment of patients with complicated forms of gastroesophageal reflux disease

2020 ◽  
Vol 101 (4) ◽  
pp. 595-602
Author(s):  
A A Moroshek ◽  
M V Burmistrov
Keyword(s):  
Postoperative Complications ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Antireflux Surgery ◽  
Main Group ◽  
Long Term Results ◽  
Control Group ◽  
Peptic Stricture

Aim. To justify the appropriateness of applying the integrated algorithm of treatment, including the sequential application of conservative antireflux treatment and antireflux surgery, in patients with complicated forms of gastroesophageal reflux disease. Methods. The main group of the study included 554 patients with complicated forms of gastroesophageal reflux disease (erosive esophagitis in 301, peptic stricture in 36, Barrett's esophagus in 90 and a combination of several complications in 127 patients), and the control group included 229 patients with uncomplicated gastroesophageal reflux disease and indications for surgical treatment. At the diagnostic stage, fiberoptic esophagogastroduodenoscopy with chromoendoscopy using a double dye staining technique (Lugol and methylene blue) and biopsies of areas suspicious for metaplasia, as well as a barium contrast multi-positional radiographic examination of the esophagus and gastroesophageal junction were used. At the treatment stage, both groups received conservative antireflux treatment lasting 48 weeks, comprising lifestyle regulation, diet, antisecretory drug therapy (proton pump inhibitors omeprazole or rabeprazole 20 mg orally twice a day, antispasmodic agent domperidone 20 mg orally 3 times a day or itopride 50 mg orally 3 times a day), followed by either laparotomic or laparoscopic antireflux surgery. In the main group, antireflux surgery was supplemented with endoscopic argon plasma coagulation during the postoperative period in the patients with Barrett's esophagus and esophageal bougienage under endoscopic control during the pre- and postoperative period in the patients with a peptic stricture. Results. The frequency of intraoperative [6.3% (95% CI 1.45.8%), p=0.0462] and early postoperative complications [41.5% (95% CI 37.445.7%), p=0.0011] in the main group were statistically significantly higher than in the control group. There was no clinically important difference. Frequency of late postoperative complications in the main group [5.4% (95% CI 3.77.6%)] did not have statistically significant differences from the control (p=0.1239). The integrated algorithm of treatment has proven to be safe with provision for the need to develop measures to reduce the overall incidence of early postoperative complications. Excellent and satisfactory immediate treatment results were achieved in 91.7% (95% CI 89.193.9%), and excellent and satisfactory long-term results were achieved in 91.3% (95% CI 88.793.5%) patients of the main group, and were statistically significantly worse than in the control group, p=0.0008 and p=0.0021 for the immediate and long-term results, respectively. The difference was attributable to the extremely high efficiency of the treatment algorithm in the control group and had no clinical significance. Conclusion. The use of the integrated algorithm of treatment based on the implementation of antireflux surgery is appropriate in all patients with complicated forms of gastroesophageal reflux disease.

scholarly journals THE USE OF MESH ENDOPROSTHESIS IN SURGICAL TREATMENT OF VENTRAL HERNIA

2019 ◽  
Vol 21 (1) ◽  
pp. 122-125
Author(s):  
V A Ragimov ◽  
Sh I Ragimli
Keyword(s):  
Surgical Treatment ◽  
Polypropylene Mesh ◽  
Long Term Results ◽  
Wound Complications ◽  
Linea Alba ◽  
Inguinal Hernias ◽  
Mesh Endoprostheses ◽  
Mesh Endoprosthesis ◽  
Ventral Hernias

Surgical treatment of patients with ventral hernias remains an urgent problem in abdominal surgery. More than 20 million operations are performed annually in the world for hernias. The urgency and complexity of the problem is based on the fact that inadequately performed surgery leads to a recurrence of the disease in 14-54% of cases. The aim of the work is to study the results of surgical treatment of patients with ventral hernias using mesh endoprostheses. The results of a retrospective analysis of 437 hernioplasty performed with hernias of various localizations for the period from 2010 to 2014 were used. Patients were classified by hernia localization and divided into groups depending on the methods of alloplasty. The duration of observation of patients operated by using polypropylene mesh ranged from 6 month to 3 years. An analysis of the complications that developed after alloplasty of the inguinal, postoperative, umbilical hernias and hernias of the linea alba was carried out. Our clinical experience confirms that the operation of Liechtenstein is rightly considered to be the “gold standart” for the treatment of inguinal hernias. However, the use of polypropylene mesh in the treatment of inguinal hernias leads to the development of postsurgical wound complications. Placed next to the polypropylene mesh peritoneum flap plays the role of internal drainage, prevents the development of seromas in the wound. The use of a new inguinal alloplasty technique reduced the number of postoperative complications. Also, the best immediate and long-term results are obtained by alloplasty using a sublay method. In patients with postoperative hernias operated by sublay method, no recurrences were observed and they showed the best quality of life.

scholarly journals Immediate and long-term results of treatment of abdominal complications after gynecological operations using endoscopic technologies

2021 ◽  
Vol 2 ◽  
pp. 22-26
Author(s):  
V.I. Boyko ◽  
V.A. Terekhov
Keyword(s):  
Postoperative Complications ◽  
Inpatient Treatment ◽  
Average Duration ◽  
Early Postoperative Period ◽  
Long Term Results ◽  
Control Group ◽  
Abdominal Complications ◽  
Pelvic Organs ◽  
Group I

The objective: to give a comparative assessment of the immediate and long-term results of laparoscopic treatment of postoperative abdominal complications in patients with gynecological pathology.Materials and methods. We carried out a comparative study of the immediate results after repeated laparoscopies and relaparotomies in gynecological patients with postoperative intra-abdominal complications, during which 2 clinical groups of patients were identified. Group I (main) consisted of 62 patients (50,82%) with early postoperative complications who underwent video endoscopic interventions. Group II (control) included 60 (49,18%) patients who underwent traditional «open» laparotomy. The criteria for the course of the early postoperative period were chosen traditionally. At the same time, it was taken into account that after the repeated interventions, the patients of both the main and the control groups received similar intensive therapy aimed at correcting the main symptom complex of the disease.All patients were comprehensively examined using clinical, instrumental and laboratory research methods. The groups were homogeneous in age and structure of operations performed on the pelvic organs, and were statistically comparable.Long-term results were studied among 28 (45,1%) patients of the main group and 21 women from the comparison group (35%) in terms of one to five years after gynecological intervention.Results. In the patients of the control group, the pain syndrome persisted statistically significantly longer and required prescription of anesthetic drugs on average 2 days more. The use of laparoscopy in the treatment of postoperative complications most often (51,7%) made it possible to refuse analgesics, and non-steroidal anti-inflammatory drugs were used on demand only in the first 2–3 days. The average duration of inpatient treatment for patients of group I with postoperative intra-abdominal gynecological complications averaged 10±2,5 days versus 16±2,9 in II (control) (p>0,05). The average duration of inpatient treatment after open surgery was on average 6±1,9 days longer (p<0,05).Long-term results were assessed using a three-point system (the result is good, satisfactory, unsatisfactory) based on the data of clinical and instrumental examination. Good long-term results were found in 13 (46,4%) patients of the main group and in 6 (28,5%) patients from the control group. Satisfactory results in group I were found in 13 (46,4%) patients, in group II – in 13, which amounted to 61,9%. In 2 patients, the results were found unsatisfactory after relaparoscopic manipulations (7,2%), and in 2 (9,5%) – after relaparotomy. One patient, due to frequent, recurrent cramping pains, was operated on as planned (abdominal adhesions were dissected).The study revealed a direct relationship during the early postoperative period and long-term results in women operated traditionally and with the use of laparoscopy. Based on the study of the results of surgical treatment of early postoperative intraperitoneal complications, the high efficiency of the video-laparoscopic method was proved in comparison with the traditional one. Thus, the implementation of the proposed treatment tactics can significantly improve the quality of life of this category of patients. The study of long-term results of laparoscopic operations has shown that the use of diagnostic methods of surgical techniques in the practice of medical institutions will contribute to the improvement of the results of complex treatment of sick women with pathology of the pelvic organs.

Temporary “liquid” Implant for Congenital Glaucoma (long-term results)

2020 ◽  
pp. 49-65
Author(s):  
N Bobrova ◽  
N Trofimova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Hypotensive Effect ◽  
Congenital Glaucoma ◽  
Long Term Results ◽  
General Will ◽  
Visual Functions ◽  
Advanced Stages ◽  
Intraocular Fluid

The aim of the work was to analyze the long-term results of using a temporary “liquid” implant in the surgery of congenital glaucoma in children. The basis of the developed method of filtrative antiglaucomatous surgery (Patent of Ukraine No. 45099 of 2009) – viscosinusotrabeculotomy – has been set the task of reducing the risk of developing intra- and postoperative complications, reducing the scarring rate and maintaining the newly created ways of the intraocular fluid outflow, which in general will increase the effectiveness of surgical treatment of congenital glaucoma in children. 54 children (91 eyes) with simple congenital glaucoma at the age of 1 to 36 months were operated on average (8.7 ± 8.2) months. The persistent and long-lasting hypotensive effect achieved due to viscosinusotrabeculotomy in children with developed and far-advanced stages of congenital glaucoma stops the processes of stretching of the membranes of the eye and stabilizes their size, which in general allows preserving and visual functions improving, in infancy – creating conditions for their formation.

scholarly journals Role and effectiveness of complex and supervised rehabilitation on overall and hand function in systemic sclerosis patients—one-year follow-up study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Bożena Dziankowska-Bartkowiak ◽  
Michał Podgórski ◽  
Jarosław Fabiś ◽  
Arleta Waszczykowska
Keyword(s):  
Systemic Sclerosis ◽  
Hand Function ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Long Term Results ◽  
Home Exercise ◽  
Control Group ◽  
Study Group

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.

scholarly journals ТREATMENT OF STENOSIS OF THE PYLORIC BULBAR ZONE OF ULCERATIVE GENESIS USING MINIMALLY INVASIVE SURGERY

2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Clinical Signs ◽  
State Institution ◽  
Disease Recurrence ◽  
Control Group ◽  
Surgical Interventions ◽  
Remote Observation

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions. Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions. Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.

Rituximab Followed by Involved Fields Radiotherapy (IF-RT) in Stage I-II Follicular Lymphoma (FL): Long Term Results,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3699-3699
Author(s):  
Marco Ruella ◽  
Andrea Filippi ◽  
Anna DI Russo ◽  
Daniele Caracciolo ◽  
Paola Matteucci ◽  
...  
Keyword(s):  
Complete Remission ◽  
Stage I ◽  
Molecular Probe ◽  
Long Term Results ◽  
Control Group ◽  
Front Line ◽  
Who Grade ◽  
Long Term Outcome ◽  
Limited Stage

Abstract Abstract 3699 Background: Radiotherapy is considered the standard approach in stage I-II non bulky FL but no consensus of the required radiation field has been reached and failure-free survival (FFS) reported ranged between 41 to 49%. Published randomized trials failed to demonstrate the superiority of non adriamycin-containing regimens plus RT over RT alone and only one single arm study with COP-B plus IF-RT reported superior FFS (73%) however complicated by an high rate of treatment related toxicity. Since the monoclonal anti CD-20 antibody Rituximab has shown to be effective in systemic therapy of FL as primary treatment as well at relapse, the combination of the anti-CD20 Rituximab with IF-RT may be considered a valid approach, allowing an effective systemic disease control while sparing the toxicity of chemotherapy. We reported here the long-term outcome of a series of stage I-II FL pts treated front-line with Rituximab followed by IF-RT. Patients and Methods: From July 1999 to April 2009, 36 consecutive stage I-II FL WHO grade I-II, have been enrolled in this phase II study and treated with 4 weekly doses of Rituximab followed by IF-RT. Median age: 49 yrs (range 34–82), M/F: 20/16; FLIPI 0–1: 36; Bulky:0. BM PCR analysis to detect minimal residual disease (MRD) was carried out in 25 pts with a molecular probe: PCR+/PCR-: 10/15. Treatment consisted of 4 weekly doses of Rituximab (375 mg/sqm) followed by external bean RT on involved fields. Median radiation dose was 30.6 Gy, (range 20–40). Results: Rituximab followed by IF-RT was well tolerated without any additional toxicity. All but one pts reached a complete remission (CR). With a median follow-up of 7 years (range: 2–12), 34 pts are alive and 24 in continuous complete remission. Of the 12 relapsed pts, 6 were PCR+ versus 4 PCR- at baseline BM analysis; 2 pts had no molecular probe. Two smokers pts died of lung cancer at 3 and 4 years after immuno-radiotherapy. The OS and FFS were 94% and 67% respectively. These results compare favorably with those observed in similar historical control group treated at our Institution with IF-RT alone (OS:87%,FFS:46.8%). Conclusion: Rituximab followed by IF-RT is a well tolerated and effective front-line treatment for limited stage FL. Long-term results are comparable to those reported for non-anthracycline-containing chemo-radiotherapy and higher when compared to radiotherapy alone, making Rituximab-IF-RT a potential option as initial therapy of limited stage FL. Disclosures: No relevant conflicts of interest to declare.

Efficacy of Spine Segments Radiofrequency Denervation

2013 ◽  
Vol 20 (2) ◽  
pp. 26-31
Author(s):  
G. I Nazarenko ◽  
A. M Cherkashov ◽  
V. I Kuzmin ◽  
A. G Nazarenko ◽  
M. A Gorokhov ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Conservative Treatment ◽  
Pain Syndrome ◽  
Soft Tissue Injuries ◽  
Long Term Results ◽  
Control Group ◽  
Treatment Results ◽  
Radiofrequency Denervation ◽  
One Year

Early and long-term results of radiofrequency facet destruction for 245 patients with cervical, thoracic and lumbar spondyloarthrosis were presented. One hundred six patients (control group) were treated conservatively. Treatment results were assessed by pain syndrome intensity using pain audit. One year after operation good result was observed in 62 (32%) out of 195 patients and satisfactory results — in 117 (60%) patients. That method enabled to eliminate considerably vertebrogenic pain localized in one dermatome when conservative treatment failed. Our experience showed that radiofrequency facet nerves destruction was safe and did not result in soft tissue injuries. All that enabled patients to return to work at maximum short terms.

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