scholarly journals EFFECTS OF HYPERBARIC OXYGEN THERAPY ON THE POST-OPERATIVE PERIOD IN PATIENTS WITH A DIFFERENT FUNCTIONAL STATUS

2019 ◽  
Vol 26 (2) ◽  
pp. 93-105
Author(s):  
Andrey V. Stakanov ◽  
Vladislav V. Golubtsov ◽  
Alexey E. Muronov
Keyword(s):  
General Population ◽  
Functional Status ◽  
Postoperative Period ◽  
Perioperative Complications ◽  
Colonic Obstruction ◽  
Combined Treatment ◽  
Risk Groups ◽  
Early Postoperative Period ◽  
Surgical Interventions ◽  
Complications And Mortality

Aim. To evaluate the effi cacy of hyperbaric oxygenation (HBO) in patients with a different functional status (FS) after the elimination of acute colonic obstruction (ACO).Materials and methods. A retrospective analysis of 210 medical records of patients who had undergone emergency surgical interventions aimed at ACO elimination was carried out. Based on the value of the direct current potential (DCP), the patients were divided into three groups: 1st (n = 96) with the DCP value from –30 mV and below — FS subcompensation; 2nd (n = 60) with average negative DCP values from –15 to –29.9 mV — FS compensation; 3rd (n = 54) with low negative and positive DCP values from –14.9 mV and higher — FS decompensation. The correlation between patients’ FS and the incidence of postoperative complications was studied, and independent predictors of fatal outcomes were identifi ed. Subsequently, a quantitative analysis of complications and mortality was carried out in each group depending on the use of HBO sessions in the postoperative period, followed by an assessment of their effi cacy.Results. According to the number of perioperative complications and mortality, risk groups in terms of the unfavourable course of the postoperative period were identifi ed: patients with high negative DCP values, for whom the arterial hypotension and acute kidney injury (AKI) could serve as the independent predictors of death; and patients with low negative and positive DCP values, for whom the statistically signifi cant predictors of mortality were shown to be the DCP level, hypotension, AKI and pneumonia. HBO sessions in the postoperative period allow the number of complications in the general population to be reduced: pneumonia by 7%, delirium by 8.8%, AKI by 6.3%, intestinal dysfunction for more than 3 days by 7.3%. In addition, HBO contributed to a 2.9% decrease in suppurative diseases. The analysis of the data on the HBO application in the general population and FS information showed HBO to have a positive effect on the general somatic status of ACO patients. In addition, HBO treatment is shown to decrease the incidence of complications in the early postoperative period. The effi cacy of HBO is found to be higher in the cohort of the most severe patients with decompensated FS, where such complications as delirium, pneumonia and gastrointestinal paresis were decreased by 22.2%, 13% and 18.5%, respectively. As a result, in this group of patients, a signifi cant decrease of 11.1% in 30-day mortality was achieved.Conclusion. The postoperative period depends on the actual FS. The conducted analysis of HBO therapy has convincingly confi rmed its effi cacy in the combined treatment of patients after the elimination of ACO. 

scholarly journals Photodynamic therapy in the treatment of stomach cancer

2018 ◽  
Keyword(s):  
Photodynamic Therapy ◽  
Postoperative Period ◽  
Intestinal Anastomosis ◽  
Effective Means ◽  
Combined Treatment ◽  
Early Postoperative Period ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Biopsy Channel ◽  
Small Intestinal

The analysis of the results of treatment of 10 patients with gastric cancer with high surgical risk, who in the treatment complex used photodynamic therapy with photosensitizer Photolon and further irradiation with a semiconductor laser with a wavelength of λ = 0.67 μm cross-irradiation fields introduced through the biopsy channel of the endoscope. Endoscopic PDT can be used at the stage of combined treatment in combination with drug therapy and surgical interventions and is an effective means of preventing the development of esopha- geal-small intestinal anastomosis failures in the early postoperative period. Endoscopic PDT can also be used in the postoperative period as a prophylaxis of early postoperative complications in cases of detection of tumor cells in the margins of resection.

scholarly journals РЕЗУЛЬТАТЫ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ПАЦИЕНТОК С ПЕРВИЧНЫМ РАКОМ ГРУДНОЙ ЖЕЛЕЗЫ

World Science ◽  
2019 ◽  
Vol 1 (7(47)) ◽  
pp. 48-50
Author(s):  
Макаров В. В. ◽  
Цивенко А. И. ◽  
Королевская А. Ю.
Keyword(s):  
Breast Cancer ◽  
Postoperative Period ◽  
Radical Surgery ◽  
Postoperative Mortality ◽  
Disease Recurrence ◽  
Early Postoperative Period ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Postoperative Wound ◽  
Primary Radical

The treatment results of 172 patients with breast cancer, who underwent radical surgery on the breast, were analyzed. During the last 4 years, the implementation of combined surgical interventions — radical surgery with removal of the tumor with D2 lymphnode dissection and the simultaneous installation of a silicone implant (in 17 patients — 17.4%) takes attention. In most cases, the early postoperative period proceeded safely. During the early postoperative period, complications occurred in 30 (17.4%) patients: long postoperative lymphorrhea - 25 (14.5%) cases, which in 6 (3.6%) patients leaded to the development of seroma, and in two (1.2 %) of them - suppuration of the postoperative wound. Diastasis of wound edges was noted in 4 (2.3%) patients. In 1 (0.6%) case, bleeding was observed on the first day after surgery. Postoperative mortality rate was 0%. 10 (5.8%) patients were admitted for the surgery during the period from 1 to 3 years after the primary radical surgery due to a local recurrence of breast cancer. Despite the arsenal of modern diagnostic, anesthetic and surgical support, the issue of postoperative complications prevention and the disease recurrence prevention of the patients with breast cancer remains relevant.

scholarly journals Perioperative management of patients with hypertension. Guidelines

2020 ◽  
pp. 7-33
Author(s):  
I. B Zabolotskikh ◽  
A. E Bautin ◽  
E. V Grigoryev ◽  
A. I Gritsan ◽  
K. M Lebedinskii ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Perioperative Management ◽  
Perioperative Complications ◽  
Preoperative Assessment ◽  
Perioperative Period ◽  
Laboratory Diagnosis ◽  
Early Postoperative Period ◽  
Critical Conditions ◽  
Surgical Interventions ◽  
Based Medicine

This article described the main theses of clinical guidelines of the Russian Federation of Anesthesiologists and Reanimatologists on the perioperative management of patients with arterial hypertension. The classification of hypertension, the principles of stratification of the risk of perioperative complications associated with the patients hypertension in the perioperative period are presented. The principles of clinical, instrumental and laboratory diagnosis of the condition of such patients are described. The principles and approaches to the treatment of emergency and critical conditions associated with hypertension are given. An algorithm for the preoperative assessment of the patient and recommendations for planning surgical interventions in patients with arterial hypertension are given. The principles and algorithms of preoperative preparation are described in detail, including antihypertensive therapy, premedication, especially the choice and management of anesthesia, and management of the early postoperative period. All information presented in the article is based on evidence-based medicine data obtained by domestic and foreign researchers.

scholarly journals Experience of the use of anti-adhesive barrier based on sodium hyaluronate and carboxymethylcellulose in gynecological surgery

2019 ◽  
pp. 149-153
Author(s):  
A. S. Molotkov ◽  
E. N. Popov ◽  
A. O. Ivanova ◽  
E. V. Kazantseva
Keyword(s):  
Postoperative Period ◽  
Abdominal Cavity ◽  
Uterine Fibroids ◽  
Sodium Hyaluronate ◽  
Uterine Cavity ◽  
Early Postoperative Period ◽  
Gynecological Surgery ◽  
Surgical Interventions ◽  
And Control

The article presents our experience in the use of anti-adhesive barrier based on hyaluronic acid and carboxymethylcellulose in gynecological surgery. The study included 63 patients who underwent removal of polyps, uterine fibroids, intrauterine synechiae, removal of ovarian cysts. At the end of operations an anti-adhesive gel was introduced into the uterine cavity and into the abdominal cavity to prevent adhesions. Efficacy and safety were assessed in the early postoperative period and with a further sixmonth follow-up of patients. It is noted that the introduction of the gel does not lead to the development of hyperthermic reactions, and in the postoperative period in patients there is no increase in the level of leukocytes (6.3 ± 0.2 x 109/L before the operation and 5.8 ± 0.5 x 109/L in postoperative period). In 89.7% of patients after surgical interventions, normalization of the menstrual cycle was noted, in 23% of patients with infertility, pregnancy was noted. When carrying out ultrasound of the pelvic organs and control hysteroscopy (in 7 cases), no evidence of the occurrence of adhesions was obtained.

scholarly journals Repair of Saphenofemoral Transition: Reşat Operation for Patients With Venous Reflux

2018 ◽  
Vol 102 (9-10) ◽  
pp. 446-458
Author(s):  
Ilker Alat
Keyword(s):  
Postoperative Period ◽  
Valsalva Maneuver ◽  
Color Doppler ◽  
Early Postoperative Period ◽  
Venous Reflux ◽  
Surgical Interventions ◽  
First Choice ◽  
Physical Examinations ◽  
Late Postoperative Period

Objective: To develop a new solution superior to the current surgical interventions in patients with venous reflux in the great saphenous vein (GSV). Materials and Methods: Patients with the symptoms of venous incompetence in their legs like pain, edema, and cramp were also examined with color Doppler ultrasonography (CDU). One hundred ninety-one extremities with venous reflux at the saphenofemoral transition (SFT) were subjected to surgery over 8 years. A newly designed operation, the Reşat operation, was performed in all of the patients. The Reşat Operation was performed only in the patients with continuous reflux at their saphenofemoral transition during the entire Valsalva maneuver. The follow-up time spanned more than 8 years. The patients' complaints, physical examinations, and CDU findings were evaluated. Results: All of the patients had continuous reflux at the SFT for the duration of the entire Valsalva maneuver preoperatively. However, 67.88% of the patients had no reflux postoperatively (P < 0.001). Additionally, 95.76% of the patients recovered to different degrees in the early postoperative period ultrasonographically (P < 0.001). All of the patients reported being satisfied with the result in the early postoperative period (P < 0.001). In the late postoperative period, although the CDU reports of some patients showed reflux at the GSV, no patient complained about their condition. Conclusion: The Reşat operation is a well-tolerated operation and reconstitutes the saphenofemoral transitions successfully. Its early and late postoperative results are satisfactory. The Reşat operation should be the first-choice surgical treatment in patients with venous reflux at the saphenofemoral transition.

scholarly journals Protocol of intravenous lidocaine infusion in the postoperative period in children operated on abdominal organs

2021 ◽  
Vol 15 (1) ◽  
pp. 41-47
Author(s):  
Evgeny Y. Felker ◽  
Dmitry V. Zabolotskii
Keyword(s):  
Postoperative Period ◽  
Pediatric Anesthesia ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Standards Of Care ◽  
World Federation ◽  
Intravenous Lidocaine ◽  
Surgical Interventions ◽  
Perioperative Analgesia ◽  
Abdominal Organs

BACKGROUND: Many studies indicate the effectiveness of intravenous lidocaine infusion for perioperative analgesia and treatment of intestinal paresis in adults. In the scientific literature, only a few publications focus on the intravenous infusion of lidocaine in pediatric practice. The purpose of the work is to increase the effectiveness of the treatment of pain syndrome after operations on abdominal organs in children by creating a protocol for intravenous lidocaine infusion. MATERIALS AND METHODS: In the development of the clinical protocol, publications included in the databases PubMed, Cochrane, American Society of Anesthesiologists, World Federation of Pediatric Intensive and Critical Care Societies, and American Academy of Pediatrics were considered. The recommendations and standards of care for this problem from the Committee on Pediatric Anesthesiology (Statement on Practice Recommendations for Pediatric Anesthesia, 2016), Society for Paediatric Anesthesia Anaesthesiology, and our own materials for our research performed at the St. Petersburg State Pediatric Medical University. RESULTS: The developed protocol includes 11 provisions, including indications and contraindications to the use of lidocaine infusion, preoperative examination, a list of necessary equipment, the method of infusion, methods of evaluation, and control of postoperative pain syndrome. CONCLUSIONS: A protocol for the management of children in the early postoperative period using intravenous lidocaine infusion, as an alternative to prolonged epidural blockade and systemic anesthesia, is developed. The authors express confidence that further implementation of the protocol in clinical practice will improve the quality of medical care for children after abdominal surgical interventions.

scholarly journals Effectiveness of the concept of fast-trak surgery for simultaneous laparoscopic hernioplastics and cholecistectomy

2021 ◽  
Keyword(s):  
Postoperative Period ◽  
Inpatient Treatment ◽  
Fast Track ◽  
Early Postoperative Period ◽  
Wound Complications ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Group I ◽  
Laparoscopic Hernioplasty ◽  
Group Ii

The aim of the research was to study the feasibility and effectiveness of simultaneous laparoscopic hernioplasty and cholecystectomy in patients with combined abdominal pathology. Material and methods. Simultaneous laparoscopic hernioplasty and cholecystectomy during 2015–2019 performed on 70 patients, including 49 (70 %) women, mean age 57.3 ± 6.5 g. In 37 patients the principles of Fast-track surgery were applied (group I), including thorough examination for diagnostics of combined abdominal pathology and clinically significant general somatic pathology; if necessary a course of therapy for full compensation of general somatic pathology was prescribed; during the operation of epidural prolonged anesthesia; choice in favor of laparoscopic technology; at the end of the operation – irrigation of the subdiaphragmatic space with local anesthetic; postoperatively: early drainage removal; withdrawal from opioids by prescribing parenteral paracetomol; activation of the patient 6-8 hours after surgery; on the day of surgery – use of chewing gum and fluid intake. In 33 patients the standard complex of perioperative management (group II) is applied. The immediate results of surgical interventions have been studied. Results. There were no significant complications during the operation and in the early postoperative period. In the first group, seroma (after open alloplasty) was detected in 2 (5 %) cases, and in the second group, small wound complications were detected in 4 (12 %) cases (p > 0.05 according to the χ2 criterion). The duration of inpatient treatment in patients of group I is 4.4 ± 1.2 months, in group II – 7.0 ± 1.3 days (р < 0.001 by Student’s test). Conclusion. Application of the principles of Fast-track surgery and accelerated recovery at all stages of simultaneous laparoscopic hernioplasty and cholecystectomy (preparation for surgery, during the operation and in the postoperative period) does not increase the number of postoperative complications and decreased duration of inpatient treatment from 7,0 ± 1,3 in patients with traditional postoperative management to 4,4 ± 1,2 days.

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