Tenorrhaphy as an Alternative to Resection in the Treatment of Horizontal Strabismus in Children

2020 ◽  
pp. 26-30
Author(s):  
Y.I. Trilyudina ◽  
◽  
V.N. Kurochkin ◽  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Modified Technique ◽  
Resection Control ◽  
Standard Resection ◽  
Alternative Method ◽  
Additional Correction

Purpose. To evaluate the effectiveness of surgical treatment of horizontal strabismus by modified tenorrhaphy in comparison with standard resection in children. Material and methods. For 3 years (2017–2019), 560 patients with horizontal strabismus at the age from 2 to 14 years were operated. Of these, 288 patients (51.4%) underwent tenorrhaphy using a modified technique (main group) as augmentation surgery, 272 patients (48.6%) underwent classical resection (control group). Results. The average age of patients in the main group was 6 (3.46) years, in the control group – 5.8 (3.34) years. In the main group of patients, orthotropy was achieved in 85.4% of cases, in the control group – in 83.5% of cases, p = 0.523. The residual strabismus angle (up to 5°) was observed in 40 patients (14%) in the main group and in 44 patients (16.5%) in the control group of patients, p = 0.449. In the main group, additional correction of the residual angle was performed on the day after the operation using adjustable suture in 8 patients (2.8%). Reoperation in the long-term period was required for 10 patients (3.7%) in the control group and 3 patients (0.7%) in the main group, p = 0.039. Significant postoperative conjunctival thickening was found in 7.2% of patients in the main group. Conclusion. The effectiveness of tenorrhaphy is not inferior to classical resection and, in combination with recession (tenomyoplasty), gives predictable stable results. The tenorrhaphy method is technically simpler, safer, more physiological, can be easily corrected in the immediate postoperative period, has no risk of «losing» muscle and can be recommended as an alternative method of resection.

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.

scholarly journals Structure, diagnosis, prevention and treatment of postoperative complications of childbirth perineal tears complicated by anal incontinence

2015 ◽  
Vol 96 (5) ◽  
pp. 779-783
Author(s):  
S G Sultanova
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Anal Canal ◽  
Anal Incontinence ◽  
Main Group ◽  
Long Term Results ◽  
Control Group ◽  
Perineal Tears ◽  
Second Degree

Aim. Improving the results of surgical treatment of complications of second and third degree perineal tears complicated by anal incontinence. Methods. The study included 248 patients aged 16 to 50 years. The patients were allocated to three groups: the first group - 40 women who underwent traditional surgery and conservative treatment; the second group - 128 women with second degree perineal tear; group III - 80 women who underwent sphincteroplasty (I option) and sphincteroplasty combined with levatorplasty (II option) in our modification (sphincter-saving surgery with precision sutures). The main group included 111 patients who additionally received conservative treatment [1 mL of 1% enoxaparin sodium intravenously and 1 ml of 30% vitamin E (alfa-tocopherol acetate) by intramuscular injection]; control group - 97 patients who underwent standard treatment. Long-term results were assessed by a survey, physical examination in the clinic, telephone and Internet surveys in 35 patients of the main group and 31 women of the control group. Results. In 91 (82%) patients of the main group, the pain intensity decreased after 7-10 days of treatment was antioxidants, 8 (7.2%) patients had pain in the perineum or anal canal, in 12 (10.8%) cases intense pain in the anal canal were still present. Long-term results were evaluated as good in 16 (51.6%) and 25 (69.4%) patients, as satisfactory - in 9 (29%) and 8 (22.2%) patients, as unsatisfactory - 6 (19.4 %), and 3 (8.3%) patients of the main and the control groups, respectively. The test group showed earlier formation of granulation tissue (3.1±0.3 days earlier compared to the control group). At sphincterometry on the 12th day, 6 patients of the control group had first degree anal incontinence, 3 - second degree anal incontinence compared with only 1 (1.8%) case in the study group (second degree sphincter incontinence). Conclusion. A proposed diagnostic strategy in women with anal incontinence due to perineal tears of II-III degrees after the labor trauma, allowed choosing the optimal method of surgical treatment and improving treatment outcomes.

The results of surgical treatment of the patients with a cochlear form of otosclerosis

2019 ◽  
Vol 18 (5) ◽  
pp. 46-53
Keyword(s):  
Surgical Treatment ◽  
Bone Conduction ◽  
Functional Results ◽  
Main Group ◽  
Differential Diagnostics ◽  
Control Group ◽  
Efficient Treatment ◽  
And Control

Despite the progress in otosurgery, the efficient treatment of patients with the cochlear form of otosclerosis (according to the classification of N.A. Preobrazhensky, 1962) remains an important task. The authors have developed and implemented an advanced stapedoplasty method, providing the improvement of hearing in this category of patients. and described the methods of differential diagnostics for selection of patients according to the developed method. The article describes in details the early and long-term functional results of surgical treatment of 60 patients with cochlear and mixed II forms of otosclerosis, divided into the main and control groups. The main group is represented by 30 patients who underwent a cartilage-on-vein stapedoplasty according to the improved method. The control group included 30 patients, in which 18 people underwent a cartilage-on-vein stapedoplasty according to the method developed by Lenin Prize winner V. F. Nikitina, and 12 people who underwent V. T. Palchun’s piston stapedoplasty. The results demonstrate a statistically significant improvement of bone conduction in the main group in average by 15–20 dB throughout the entire tone scale (except for high frequencies in some patients) and the complete closure of the bone-air interval with subsequent preservation of the results. Based on the obtained data, the authors present the expediency and perspectivity of implementation of the advanced stapedoplasty method.

scholarly journals The choice of surgical treatment method of perforated pyloroduodenal ulcer

2021 ◽  
Vol 88 (1-2) ◽  
pp. 8-13
Author(s):  
D. V. Maksymchuk ◽  
V. I. Mamchich ◽  
V. D. Maksymchuk
Keyword(s):  
Surgical Treatment ◽  
Clinical Application ◽  
Pyloric Stenosis ◽  
Postoperative Period ◽  
Physiological Function ◽  
Treatment Method ◽  
Main Group ◽  
Control Group ◽  
Surgical Tactics ◽  
Suturing Methods

Objective. To develop a method of organ-saving operation aimed at preservation of the physiological function of the pylorus and the normal physiological functioning of the pyloroduodenal area in patients with combined perforated, stenotic pyloroduodenal ulcers. Materials and methods. The study included 60 patients who faced surgery treatment in relation to complicated combined perforated, stenotic pyloroduodenal ulcers. Depending on diagnostic and surgical tactics applied, patients were conditionally divided into two groups. The control group consisted of 30 patients who underwent standard suturing methods. The main group also consisted of 30 patients in whom the developed method was applicated. Results. In the control group at the postoperative period of 30 patients operated in different ways complications occurred in 12 persons or in 40% of cases. In the main group of 30 patients operated according to the proposed method, complication in the form of anastomositis occurred in 1 patient only. Conclusions. The obtained results substantiate recommendation to clinical application the suggested method of organ-saving operation aimed to preserve the physiological function of the pyloroduodenal area, which excludes perforated ulcers suturing without pyloric stenosis elimination and gastrectomy on the background of peritonitis.

Limbal conjunctival approaches to extraocular muscles in the surgical treatment of previously operated strabismus

2021 ◽  
pp. 27-32
Author(s):  
V.N. Kurochkin ◽  
◽  
Y.I. Trilyudina ◽  
Keyword(s):  
Surgical Treatment ◽  
Strabismus Surgery ◽  
Main Group ◽  
Cosmetic Result ◽  
Control Group ◽  
Good Cosmetic Result ◽  
Tenon’S Capsule ◽  
Good Cosmetic ◽  
Tenon's Capsule

Purpose. Тo analyze clinical efficacy of the surgical treatment of previously operated strabismus using limbal incisions which are lengthening the conjunctiva and Tenon's capsule. Material and methods. The study included 440 patients (440 eyes) with previously operated strabismus at the age of 4 to 68 years old. The main group included 240 patients (240 eyes) who underwent strabismus surgery by limbal approach; the control group included 200 patients (200 eyes) who underwent surgery by paralimbal conjunctival approach. Horizontal strabismus occurred in 146 patients (60,8%) in the main group and in 158 (79%) in the control group. Horizontal strabismus in combination with vertical strabismus was found in 94 patients (39.2%) in the main group and in 42 patients (21%) in the control group respectively. The following approaches were applied: Y-shaped limbal approach, T-shaped incision of the conjunctiva, lower limbal peritomy, circular limbal approach with an additional horizontal incision towards the muscle being strengthened. Results. Good cosmetic result in the main group was achieved in 94.7% of cases, in the control group in 87% of cases, р<0.001. Re-surgery in the long term period was required for 39 patients (19.5%) in the control group and 14 patients (7%) in the main group, р<0.001. Conclusion. Limbal approaches performed to lengthening the conjunctiva and Tenon's capsule on the side of the weakened muscle and shortening on the side of the muscle being strengthened, are enhancing the effect of recession and resection, thereby contributing to the achievement of the state of orthotropy in 83% and have a good cosmetic result in 94.67% of cases. Key words: limbal conjunctival approaches, limbal conjunctival incisions, strabismus, children.

scholarly journals Tactics of surgical treatment of deep intermuscular gluteal region phlegmons

2021 ◽  
Author(s):  
E.N. Byakova ◽  
V.K. Tatyanchenko ◽  
V.L. Bogdanov ◽  
Y.V. Sukhaya ◽  
Y.V. Krasenkov
Keyword(s):  
Surgical Treatment ◽  
Soft Tissues ◽  
New Technologies ◽  
Main Group ◽  
Gluteal Region ◽  
Control Group ◽  
Tissue Pressure ◽  
Results Of Treatment ◽  
Purulent Wound

Purpose. The purpose is to improve the results of treatment of patients with phlegmon of the gluteal region soft tissues by diagnosing the stage of tissue hypertension and determining the tactics of surgical treatment depending on this indicator. Materials and methods. Clinical studies were performed on 74 patients suffering from phlegmon of the gluteal region. All the patients were divided into 2 groups: in the main group (as opposed to the control group), acute tissue hypertension syndrome was diagnosed and decompressive fasciotomy was performed in tissue hypertension (30–35 mm Hg) (patent). The authors performed ultrasound cavitation and ozone therapy of a purulent wound. Results. With phlegmon of the gluteal region of soft tissues, an increase in tissue pressure by 25% above the norm is an indication for fasciotomy in the area of fascial nodes. The time of purulent wound cleaning against the background of normal tissue pressure (8–10 mm Hg) of the surgery in patients of the main group was reduced to 5 days (8 days in the control). In the long-term (0.5–1 years), good results were obtained in 92.8% of patients in the main group (64.7% in the control group). Conclusion. The developed tactics of treatment of patients with phlegmon of the soft tissues of the gluteal region are highly effective due to the development and application of new technologies for the diagnosis and treatment of tissue hypertension.

scholarly journals Evaluation of the effectiveness of the use of functional electrical stimulation after VII-XII anastomosis in patients with facial nerve damage of various etiologies

2019 ◽  
pp. 21-27
Author(s):  
Andrej Bobrov ◽  
Oleg Borisenko ◽  
Volodimir Jus ◽  
Alexander Papp
Keyword(s):  
Electrical Stimulation ◽  
Surgical Treatment ◽  
Facial Nerve ◽  
Postoperative Period ◽  
Nerve Fibers ◽  
Main Group ◽  
Control Group ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Facial Muscles

Surgical treatment of lesions of the facial nerve by an hypoglossal-facial anastomosis takes a long time to re-sprout of the nerve fibers to the facial muscles. The recovery time of facial function after surgical treatment of patients with paralysis of the facial nerve is long enough and can start from 6-8 months after surgery and last up to 2 years. Thus, all this time the mimic muscles are in a state of denervation. The purpose of this work was to determine the effect of electrical stimulation of facial muscles in patients with lesions of the facial nerve of different etiology after hypoglossal -facial anastomosis. Materials and methods: To evaluate the results of the use of early postoperative transcutaneus electrical stimulation, a low frequency FES was used, starting from the 2nd month after performing a XII-VII anastomosis. Assessment of the recovery of facial nerve function was performed 1 year after surgery. The study included 88 patients who underwent surgery to restore facial nerve function - hypoglossal -facial anastomosis. The survey was divided into 2 groups. The first (main) group consisted of 28 patients who underwent FES of facial muscles in the postoperative period, and the second group (comparison) consisted of 60 patients who underwent XII-VII anastomosis according to the following by the same method, but no further pharmacological or physiotherapeutic agents were used that could affect facial nerve regeneration. Results and discussion: According to this scale, the surveyed control group after 12 months. After the operation of XII-VII anastomosis according to the classical method, the following distribution was observed: The 1st degree of recovery of facial nerve function was not present in any of the patients, the 2nd degree had 2 (3.33%) patients, the thirds - 28 (46, 66%), IV - 20 (33,33%), V - 6 (10%) and VI - 4 (6,66%). In patients in the main group (where FES was used), distribution by degrees of recovery of facial nerve function on the House-Brackman scale after 12 months. after surgery it had the following character: II degree had 2 (6.45%) examined, III - 17 (54.83%), IV - 5 (22.58%), V - 2 (7.4%) and VI - 2 (7.4%). Conclusions: A statistically significant difference was observed in the postoperative period when comparing the mean M-responses of mimic muscles registered at different times after surgery in control subjects compared with patients in the main group in which FES was used. In addition, in the main group, a significantly larger number of patients reported a recovery of FN function to grade III-IV on the House-Brackman scale. Therefore, based on the results of the evaluation of the function of FN on the House-Brackman scale and electromyographic examination data in patients who underwent XII-VII anastomosis, it can be argued that with the use of FES in the postoperative period of recovery of facial nerve function is significantly faster and more complete in compared to the control group.

scholarly journals Comparative clinical and functional results of implantation of «reverse – M and M1» in patients with high myopia in the long-term postoperative period

2021 ◽  
pp. 6-12
Author(s):  
G.V. Sorokoletov ◽  
◽  
E.R. Tumanyan ◽  
A.N. Bessarabov ◽  
M.A. Soboleva ◽  
...  
Keyword(s):  
Postoperative Period ◽  
High Myopia ◽  
Functional Results ◽  
Main Group ◽  
Control Group ◽  
Posterior Chamber ◽  
High Grade ◽  
Long Term Follow Up

The formation of secondary cataracts in patients with high-grade myopia remains the main cause of vision loss in the long-term postoperative period. Taking this into account, a soft model of posterior chamber «reverse» IOL was developed in the Fyodorov Eye Microsurgery Federal State Institution, Moscow, which allows reducing the development of secondary cataracts. Purpose. Comparative analysis the clinical and functional results of implantation of «reverse M and M1» IOL in patients with high myopia in the long-term follow-up. Materials and methods. Clinical studies were conducted on 140 eyes of 97 patients with high-grade myopia aged from 42 to 83 years (on average, 64.24±0.79 years) after phacoemulsification cataract (FEC) with IOL implantation in high-grade myopia. The main group consisted of 57 eyes of 40 patients who were implanted with «reverse-M1» IOL, the control group-83 eyes of 57 patients who were implanted with «reverse-M» IOL. Visual acuity before surgery without correction in any patient did not exceed 0.01, and with the maximum correction was no more than 0.2 (80%). The follow-up period was up to 5 years. Results. Visual functions in the majority of patients increased and remained stable throughout the postoperative period, amounting to 0.55+0.04 in the main group, and 0.54+0.03 in the control group. In the late postoperative period, dissection of the posterior lens capsule with «reverse-M» IOL was performed in 11 eyes of 13 patients (13.2%), in the main group, YAG laser dissection of the posterior capsule was required in 2 patients with 3 eyes (5.3%). Conclusions. Implantation of a «reverse-M1» IOL is safe, predictable and allows you getting less PCO formation compare with «reverse-M» IOL in the long-term follow-up in patients with high myopia. Keywords: phacoemulsification cataract, implantation of «reverse» IOL, high myopia.

scholarly journals Transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control in surgical treatment of hemorrhoids

2020 ◽  
Vol 87 (11-12) ◽  
pp. 62-66
Author(s):  
A. A. Nykonenko ◽  
G. I. Okhrimenko ◽  
E. I. Haidarzhi ◽  
N. G. Golovko ◽  
I. V. Zubryk ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Main Group ◽  
Control Group ◽  
Results Of Treatment

Objective. To study the immediate and late follow-up results of treatment in patients, suffering hemorrhoids, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was done, and to compare them with results of treatment in patients, operated in accordance to procedure of standard hemorrhoidectomy. Materials and methods. There were analyzed the results of treatment of 111 patients, suffering hemorrhoids. The main group have consisted of 50 patients, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was performed. Into control group 61 patients were included, who were operated in accordance to Parks procedure. Results. In the main group the average time of the operation have constituted (50.1 ± 1.4) min, the patient stationary stay - (9.9 ± 0.7) days, the pain syndrome intensity in postoperative period was estimated as 2 - 3 points, what have appeared significantly lesser, than in the control group of the patients (p < 0.01). Good late follow-up results were achieved in 100% patients of the main group and in 88% of the control group. Conclusion. There was established, that transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control permits to reduce essentially the average time of the operation, the patients’ stationary stay, to lower the pain syndrome intensity, and to improve late follow-up results of the hemorrhoids treatment.

scholarly journals The benefits of early surgical treatment of deep cervical burns in children

2020 ◽  
Vol 8 (1) ◽  
pp. 25-34
Author(s):  
Pavel A. Gnipov ◽  
Alexey G. Baindurashvili ◽  
Marina A. Brazol ◽  
Ekaterina V. Mitrofanova ◽  
Maxim R. Melnikov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Main Group ◽  
Control Group ◽  
Surgical Removal ◽  
Treatment Results ◽  
The Third ◽  
Graft Success ◽  
The Moment ◽  
Early Surgical Treatment

Background. The frequency of deep cervical burns in children is four times higher than that of deep face burns. Currently, there is no consensus on the methods for surgical treatment of deep burns in cervical areas; meshed skin autografts continue to be used. Aim. To evaluate the benefits of early surgical treatment of deep сervical burns in children between the third and fifth days from the moment of injury. Materials and methods. Case-control study. Surgical treatment was performed in 81 children with deep cervical burns. The main group with early surgical treatment included 46 children and underwent surgical treatment at 3.37 0.14 days from the moment of injury; the control group received autograft during stage treatment for 35 children at 27.17 0.18 days. The treatment results were evaluated by the following indicators: the number of dressing changes, the period of skin restoration, and the area of graft success. In the long term, functional and cosmetic treatment results were evaluated. Results. In the study and control groups, 7.93 0.45 and 18.75 0.61 dressings were required to complete the treatment, respectively (p 0.001). The skin restoration periods were 16.54 0.68 and 36.94 0.89 days, respectively (p 0.001). The graft success areas were 99.50% 0.13% in the main group and 93.91% 2.68% in the control (p 0.001). During the staged surgical treatment, one patient showed a loss of 90% of the graft, which required regrafting. Other complications in the treatment process have not been noted. When assessing long-term cosmetic results using the Vancouver Scar Scale, the average score was 4.0 0.26 points in the main group and 7 0.28 points in the control (p 0.001). The presence of post-burn cicatricial contracture in the main group was noted in 12 (26%) people and the absence in 34 (74%) children. In the control group, 20 (57%) patients required surgical removal of post-burn deformity, and 15 (43%) children did not need further surgical interventions. Conclusions. Early surgical treatment of deep cervical burns in children on the third and fifth days from injury allows not only to accelerate the process of restoration of the skin but also to directly affect the cosmetic and functional results in a better way.

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