scholarly journals Aotric esophageal fistula: etiopathogenesis and diagnostics (review of literature)

2021 ◽  
Vol 179 (6) ◽  
pp. 89-93
Author(s):  
R. Sh. Muslimov ◽  
Sh. N. Danielyan ◽  
I. E. Popova ◽  
N. R. Chernaya
Keyword(s):  
Surgical Treatment ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Malignant Neoplasms ◽  
Esophageal Fistula ◽  
Aortic Diseases ◽  
Intravenous Contrast ◽  
Surgical Interventions ◽  
Advantages And Disadvantages ◽  
Unified Protocol

Aortic esophageal fistula (AEF) is a rare but extremely life-threatening condition requiring immediate surgical treatment. The mortality rate among such patients may exceed 60 %, including after surgical treatment. Etiological and pathogenetic mechanisms of AEF are complex and various, but in most cases, they are associated with chronic aortic diseases. The second group of etiological factors of AEF includes trauma of esophagus wall by foreign bodies, malignant neoplasms of the esophagus or mediastinum. AEF may also occur as a result of surgical interventions on the aorta and esophagus. The difficulties of early diagnosis are primarily associated with non-specific clinical manifestations of AEF and the lack of unified protocol for the examination of patients with the first-time upper gastrointestinal tract bleeding. The described reasons in some cases can lead to an inaccurate diagnosis, which entails a loss of time. Among the instrumental diagnostic methods, the most informative is the combination of esophagogastroduodenoscopy and computed tomography of the chest with intravenous contrast enhancement. Each of these methods has its advantages and disadvantages, and allows to identify a number of direct and indirect signs of pathological communication between the aorta and the esophagus.

scholarly journals Problems of diagnostics and treatment of diffuse — toxic goiter (Graves’ disease)

2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Saydiganikxodja I. Ismailov ◽  
Komila Kh. Khayitboyeva
Keyword(s):  
Surgical Treatment ◽  
Iodine Deficiency ◽  
Diagnostic Methods ◽  
Graves Disease ◽  
Minimal Risk ◽  
Familial Predisposition ◽  
Advantages And Disadvantages ◽  
Radioiodine Ablation ◽  
Treatment Indications ◽  
Toxic Goiter

The article is devoted to prevalence, contemporary diagnostic methods and treatment of Grave’s disease. Advantages and disadvantages of different treatment options are discussed. The cause of the disease can be environmental conditions, infectious diseases, severe operational intervention, drugs, trauma, especially brain traumas, iodine deficiency and radiation damage of thyroid in iodine deficiency conditions, familial predisposition. The ideal treatment of Graves’ disease should ensure a fairly rapid elimination of clinical symptoms of thyrotoxicosis, return to an euthyroid state, with minimal risk of complications. The relapse rate of the disease can reach up to 80 %, using conservative treatment. The radioiodine ablation is relatively simple, non-invasive, effective and cheap. There are special indications for surgical treatment. Indications for surgical treatment: 1) large goiter (the volume of the thyroid gland is more than 45 ml); 2) frequent recurrences of thyrotoxicosis and failure of the drug and RIT; 3)malignancy of goiter; 4) allergic and toxic (leukopenic) reactions to thyreostatics. Patients with Graves’ disease should referred to a specialized center with multidisciplinary team.

scholarly journals Modern aspects of surgical treatment of patients with adhesive small bowel obstruction

2021 ◽  
Vol 12 (4) ◽  
pp. 47-54
Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Sergey V. Petrov ◽  
Diyora H. Qalandarova
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Small Bowel ◽  
Mortality Rate ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Diagnostic Algorithm ◽  
Diagnostic Methods ◽  
Adhesive Small Bowel Obstruction ◽  
Surgical Interventions

Despite the ongoing preventive measures aimed at reducing the formation of adhesions in the abdominal cavity with an increase in the number of surgical interventions on the abdominal organs, the number of patients admitted to surgical hospitals with adhesions of the small intestine is also increasing. It should be noted that annually about 12% of previously operated patients undergo treatment in surgical departments while the exceptional fact is that 5070% are patients with acute adhesive ileus of the small intestine and the mortality rate in this group ranges from 13 to 55%. In recent years the literature has been actively discussing the advantages of minimally invasive technologies in the treatment of adhesive small bowel obstruction since the use of traditional methods often leads to the development of complications with repeated (in 60% of cases) surgical interventions. The purpose of this study was the development and implementation of an improved therapeutic and diagnostic algorithm in patients with adhesive small bowel obstruction which made it possible to improve the results of treatment. A comparative analysis of 338 patients with adhesive small bowel obstruction who were treated in the surgical departments of the St. Elizabeth Hospital in St. Petersburg in the period from 2016-2019 was carried out. All the patients were divided into 2 groups: the main (I) group (2018-2019), which consisted of 198 patients who received the improved diagnostic and treatment algorithm as well as the comparison group (II) (2016-2017) which included 140 cases these are patients examined according to the standard protocol and operated on in the traditional way. Moreover, in 98 cases, it was possible to resolve acute adhesive small intestinal obstruction in a conservative way, and 240 patients underwent surgical treatment. The developed diagnostic algorithm is based on the consistent application of the most informative diagnostic methods. At the same time the indications and the sequence of their application were established which ultimately made it possible to shorten the preoperative time interval as well as to determine the optimal treatment strategy with the choice of the type of surgical treatment (laparotomy or laparoscopy). The proposed treatment and diagnostic algorithm allowed to reduce the complication rate from 46.5% (53) to 22.2% (28) (р 0,001), and the mortality rate from 14.9% (17) to 3.9% (5) (p 0,01).

scholarly journals Alveolar Echinococcosis in Children

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Emilija Jonaitytė ◽  
Martynas Judickas ◽  
Eglė Tamulevičienė ◽  
Milda Šeškutė
Keyword(s):  
Surgical Treatment ◽  
Current Literature ◽  
Echinococcus Multilocularis ◽  
Cystic Echinococcosis ◽  
Alveolar Echinococcosis ◽  
Pediatric Patients ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Diagnostic Methods

Alveolar echinococcosis (AE) is an infectious zoonotic disease that is caused by Echinococcus multilocularis. The disease is generally identified accidentally because of the long asymptomatic period, has a malignant behaviour, and mainly occurs in the liver. Usually it is diagnosed in adults and is very rare in pediatric patients. We report two cases of AE and 1 differential case between AE and cystic echinococcosis (CE) in children: two of them had lesions in the liver and one had rare extrahepatic presentation of a cyst in the spleen. All our patients received chemotherapy with albendazole because surgical treatment was not recommended. The children were followed-up from 10 to 30 months and no significant improvement was seen. In this report we discuss the difficulties we faced in the treatment and follow-up of these patients. We also review the main clinical manifestations, general diagnostic methods, and treatment options of AE according to the current literature.

scholarly journals Lipoma of the cerebellopontine angle: case reports and literature review

1994 ◽  
Vol 52 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Marcelo P. Ferreira ◽  
Nelson P. Ferreira ◽  
Rene Lenhardt
Keyword(s):  
Surgical Treatment ◽  
Literature Review ◽  
Cerebellopontine Angle ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Diagnostic Methods ◽  
Surgical Indications ◽  
Complete Excision

Two patients with cerebellopontine angle (CPA) lipoma were studied. They were submitted to surgical treatment. Available literature was reviewed and 29 cases with same lesion were identified which had been treated by surgery. Clinical manifestations, possibility of diagnostic methods, surgical indications and treatment strategies are discussed. Attention is called to the peculiarities of CPA lipomas and the doubtful vality of attempting complete excision in all cases.

scholarly journals Specialized medical care for patients with malignant neoplasms of the maxillofacial area in the Penza region of Russia

2021 ◽  
Vol 10 (3) ◽  
pp. 23-31
Author(s):  
M. V. Lebedev ◽  
Yu. A. Abdullina ◽  
I. Yu. Zakharova
Keyword(s):  
Oral Cavity ◽  
Clinical Manifestations ◽  
Interdisciplinary Approach ◽  
Diagnostic Methods ◽  
Malignant Neoplasms ◽  
Maxillofacial Region ◽  
Lower Lip ◽  
Endoscopic Gastrostomy ◽  
Results Of Treatment ◽  
Psychological Assistance

This article analyzes domestic and foreign sources, regulatory documents of the Russian Federation, in order to determine the etiological factors of oral cancer, assess the statistical data on morbidity and mortality from malignant neoplasms of the maxillofacial region in the Penza region. The results of changing the routing, an interdisciplinary approach to treating patients with malignant neoplasms of the maxillofacial region in the Penza region are presented. The epidemiology, clinical manifestations, main diagnostic methods, routing, treatment and rehabilitation of patients with head and neck oncology are considered. The results of treatment of patients with oral cavity and lower lip cancer using photodynamic therapy (PDT), both alone and in combination with radiation and chemotherapy, are analyzed. The study showed that PDT of tumors of the lower lip and buccal mucosa in mono-mode made allowed achieving 100% efficiency. After the completed treatment, all participants in the experiment were provided with a complex of rehabilitation, including nutritional support, psychological assistance, exercise therapy, training in correct swallowing tactics, percutaneous endoscopic gastrostomy, and a course of oral cavity massage. An interdisciplinary approach to treating malignant neoplasms of the maxillofacial region is the most correct in modern practice.

Surgery of the upper departments of the digestive tract with intraoperative intra-research endoscopic assistance: review of the literature

2020 ◽  
pp. 117-124 ◽  
Author(s):  
A. L. Shestakov ◽  
M. E. Shakhbanov ◽  
M. V. Khrustaleva ◽  
N. A. Bulganina ◽  
I. A. Boeva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Gastrointestinal Tract ◽  
Negative Impact ◽  
Upper Gastrointestinal Tract ◽  
Research Centre ◽  
Malignant Neoplasms ◽  
Malignant Diseases ◽  
Surgical Interventions ◽  
Low Efficiency ◽  
Upper Gastrointestinal

This analysis is based on the study of materials from scientific electronic libraries (elibrary.ru, PubMed, scientific library of the Petrovsky National Research Centre of Surgery, Moscow, Russia). The problem of treating the pathology of the upper gastrointestinal tract is caused by the high prevalence of benign and malignant diseases of this zone, their severity, the complexity of diagnosis and often the low efficiency of conservative therapy. Intensive implementation of innovative scientific technologies in medical practice, aimed at increasing the effectiveness of treatment and diagnostic measures, minimizing their negative impact on the patient’s body and reducing the risk of complications, which, at the same time, have sufficient economic attractiveness. In full, all of the above can be attributed to endoscopy, which has been actively developing in recent years, both in the diagnostic and in the operational areas. In the treatment of various diseases of the gastrointestinal tract in recent years, combined methods based on the use of two or more minimally invasive technologies, for example, endoluminal endoscopic and thoraco or laparoscopic methods, have entered the world practice. The data of scientific articles on the problem of surgical treatment of patients with benign and malignant diseases of the upper gastrointestinal tract, carried out using intraoperative intraluminal endoscopic assistant, are analyzed. The use of intraluminal endoscopy, in particular, allows to increase the radicality of surgical interventions in patients with malignant neoplasms of the upper gastrointestinal tract, perform intraoperative topical diagnosis of non-palpable tumors, and use it in the surgical treatment of esophageal diverticulums of various localization. Also, another area of application of intraoperative intraluminal endoscopy is the assessment of tightness and anastomosis zone during surgical interventions on the organs of the gastrointestinal tract. However, this technique is in the process of implementation in clinical practice and has not been sufficiently studied both in foreign and domestic literature.

State of the problem of early diagnosis and treatment of benign ovarian tumors in postmenopausal patients (literature review)

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 294-299
Author(s):  
Nataliia M. Podzolkova ◽  
Roman E. Kuznetsov ◽  
Olga L. Glazkova ◽  
Larisa G. Sozaeva ◽  
Luiza B. Tumgoeva
Keyword(s):  
Quality Of Life ◽  
High Risk ◽  
Early Diagnosis ◽  
Clinical Manifestations ◽  
Ovarian Tumors ◽  
Diagnostic Methods ◽  
Comprehensive Treatment ◽  
Surgical Interventions ◽  
Benign Ovarian Tumors

As life expectancy increases, older people require strict individualization of management and treatment, taking into account all age and pathophysiological characteristics of a particular patient, a more attentive approach to the features of clinical manifestations of diseases, the presence of comorbid pathology. Timely diagnosis and comprehensive treatment of postmenopausal patients with benign ovarian tumors is a debatable issue, since none of the existing diagnostic methods of research in practice provides sensitivity and specificity equal to or at least approaching 100% of the indicator. The progressive aging of the population raises the question of whether it is necessary to operate on menopausal patients with benign ovarian tumors of small size (up to 5 cm), given the low percentage of malignancy of these formations and the high risk of deterioration in the patients quality of life after surgical interventions.

FIBROCYSTIC MASTOPATHY

2020 ◽  
Vol 6 (3) ◽  
pp. 19-32
Author(s):  
Arif Guseynov
Keyword(s):  
Surgical Treatment ◽  
General Practitioners ◽  
Current Data ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Differential Diagnostics ◽  
Advantages And Disadvantages ◽  
Fibrocystic Mastopathy ◽  
Conservative And Surgical Treatment

The lecture provides information for specialist doctors: oncologists, surgeons, mammologists, general practitioners on the diagnosis and treatment of fibrocystic mastopathy. The current data on the etiology and pathogenesis, classification and clinic of the disease are presented, well-known and new diagnostic methods, advantages and disadvantages of each method are described in detail. Issues of differential diagnostics are highlighted, optimal tactics, methods of conservative and surgical treatment are proposed

scholarly journals Surgical treatment of complications of Crohn’s disease

2018 ◽  
Vol 20 (1) ◽  
pp. 111-116
Author(s):  
I A Solovev ◽  
A M Pershko ◽  
D P Kurilo ◽  
M V Vasilchenko ◽  
E S Silchenko ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Surgical Treatment ◽  
Crohn's Disease ◽  
Surgical Intervention ◽  
Intestinal Anastomosis ◽  
Clinical Manifestations ◽  
Intestinal Fistula ◽  
Subtotal Resection ◽  
Surgical Interventions ◽  
Conservative And Surgical Treatment

Possibilities and options of surgical treatment of complications of Crohn’s disease in the general surgical hospital are considered. Patients underwent various surgical interventions: ileum resection with «side-to-side» anastomosis (4 patients), resection of ileocecal department with the formation of ileoascendoanastomosis (2 patients), total coloproctectomy with the formation of ileostomy (2 patients), right-sided hemicolectomy (1 patient), obstructive resection of transverse colon (1 patient), obstructive resection of sigmoid colon (2 patients). Postoperative complications developed in 3 patients (25%), among them: postoperative wound suppuration - 2, dehiscence of anastomosis in 1 patient, which led to the formation of internal intestinal fistula and death. It was found that with limited lesions of colon in Crohn’s disease (less than a third of the colon) can be limited to resection of the affected segment with formation of intestinal anastomosis in the limits of healthy tissues. In the presence of lesions in the ascending department of colon proximal border of resection should be at the level of middle colic vessels with preservation of the latter. In long Crohn’s disease of colon with severe clinical manifestations of the operation of choice is a subtotal resection of colon with the imposition of single-barrel ileostomy. Surgical treatment of complicated forms of Crohn’s disease is in all cases performed in surgical profile hospitals, taking patients by ambulance. Most often, patients have delayed indications for operations, which gives the opportunity to carry out a comprehensive preoperative preparation. In all cases, complications of Crohn’s disease requires an individual approach, which combines conservative and surgical treatment. Surgical intervention is determined by the shape and characteristics of the course of complications of Crohn’s disease.

scholarly journals COMPARISON OF DIAGNOSTIC METHODS AND TREATMENT OF ENDOMETRIOSIS OF ATYPICAL LOCATION

2018 ◽  
Vol 5 (3) ◽  
pp. 157-163
Author(s):  
D. D Shlyk ◽  
Yury E. Kitsenko ◽  
D. R Markaryan ◽  
V. I Lanchinskiy ◽  
I. A Tulina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Malignant Neoplasm ◽  
Early Postoperative Period ◽  
Diagnostic Methods ◽  
Reproductive Age ◽  
Treatment Technique ◽  
Intravenous Contrast ◽  
Preoperative Stage ◽  
Extragenital Endometriosis

Surgical treatment and subsequent management of women of reproductive age with endometriosis of extragenital localization involving intestine, whose frequency is up to 37%, currently do not have a detailed and clearly described protocol, which may be caused by the complexity of diagnosis at the preoperative stage. In most cases, extragenital localization is an intraoperative finding. The purpose of the article is to evaluate the complexity of diagnosing the atypical location of extragenital endometriosis, systematize the diagnostic protocol and present the chosen treatment tactics. Material and methods. In the clinic of coloproctology and minimally invasive surgery, 4 observations of extragenital endometriosis with intestinal lesions were noted. According to the results of diagnostic studies (multispiral computed tomography - MSCT of the abdominal cavity with intravenous contrast, irrigoscopy with double contrasting, colonoscopy with biopsy), endometriosis was confirmed in 2 patients at the preoperative stage. All patients underwent surgical interventions in the volume of resection of the affected segment of the intestine within the unchanged tissues. Results. According to the intraoperative revision, in all patients there was noted the presence of additional extragenital foci of different localization, which were destroyed by diathermocoagulation. Patients with unverified endometriosis also underwent lymphadenectomy in D2 volume due to the inability to exclude malignant neoplasm. In the early postoperative period, no complications were noted. Only 1 patient decided to take hormonal therapy for 6 months after the operation. At present, none of the relapses have been observed, the mean follow-up time is 17.3 ± 13.6 months (4-33 months). In all patients there was recovered the menstrual cycle, menstruation moderately painful, previous abdominal pains before menstruation and spotting discharges from the rectum stopped. Conclusion. Surgical treatment of extragenital endometriosis of intestinal localization in the volume of resection of the affected intestine within the unchanged tissues is the optimal treatment technique and is not accompanied by significant complications. However, in cases of unverified histologically endometriosis, principles of oncological radicalism should be kept. To select the optimal volume of surgical intervention and access, a multidisciplinary consultation with the coloproctologist, gynecologist and with the obligatory consideration of the patient’s opinion is required.

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