scholarly journals Comparative estimation of meningiomas and neuroepithelial brain tumors surgical treatment results using standard methods and modern technologies in early postoperative period

2008 ◽  
Vol 0 (2) ◽  
pp. 27-32
Author(s):  
A. A. Yekimov ◽  
V. P. Sakovich ◽  
E. V. Kotlyarov ◽  
V. G. Shalyapin
2010 ◽  
Vol 112 (2) ◽  
pp. 455-460 ◽  
Author(s):  
Alejandro A. Rabinstein ◽  
Seung Young Chung ◽  
Leslie A. Rudzinski ◽  
Giuseppe Lanzino

Object The purpose of this study was to evaluate the incidence of seizures or epileptiform abnormalities on electroencephalography (EEG) studies in patients undergoing surgical treatment for acute subdural hematoma (SDH). Methods This was a retrospective study of 134 consecutive patients with acute or acute-on-chronic SDH who underwent surgical treatment at the authors' institution between January 2004 and July 2008. Detailed information was collected regarding baseline clinical data (including preexistent functional impairment); Glasgow Coma Scale (GCS) sum scores before and 24 hours after surgery; presence of clinical seizures; EEG findings; and functional outcome on discharge and up to the 6-month follow-up. All brain CT scans were reviewed to calculate SDH volume and midline shift. The Glasgow Outcome Scale (GOS) score was used for functional assessment, and GOS scores of 1–3 were considered indicative of poor outcome. Univariate and multivariate logistic regression analyses were performed to identify statistical associations. Results Clinical seizures or epileptiform changes on EEG were observed during the acute postoperative period in 33 patients (25%). Preexistent functional impairment and seizures/epileptiform EEG findings after surgery were independently associated with poor functional outcome upon hospital discharge (p < 0.001 for both). Preexistent functional impairment (p < 0.001), lower GCS score before surgery (p = 0.04), and lower GCS score 24 hours after surgery (p = 0.007), but not seizures/epileptiform EEG findings, were independently associated with poor functional recovery at 1- to 6-month follow-up evaluations. Seizures/epileptiform EEG findings had a strong association with lower GCS scores after surgery (p = 0.01), and they were more common in patients who underwent evacuation by craniotomy (p = 0.02). Conclusions Epileptic complications are common after acute SDH evacuation, and should be suspected in patients with an unanticipated depressed level of consciousness after surgery. Seizures worsen early functional outcome, but delayed favorable recovery is possible. Therefore, one should be cautious when discussing prognosis in the early postoperative period of patients with epileptic complications.


2020 ◽  
pp. 124-126
Author(s):  
I. S. Pulyaeva ◽  
V. A. Prasol

Summary. Goal. To analyze the results of surgical treatment of carotid stenosis in patients with coronary heart disease in order to prevent ischemic stroke. Materials and methods. The analysis included 18 patients treated in the SI «V. T. Zaitseva IGUS of NAMNU» from 2017 to 2019 in combined atherosclerotic lesions of the coronary and carotid arteries which evaluated the reserve brain. Results and discussion. All patients with two-stage treatment of the first and second groups were discharged in a stable state, one had a clinic of transient ischemic attack in the postoperative period. Conclusions. Simultaneous operations are advisable in patients with a reduced reserve of both coronary and cerebral circulation. The risk of developing cerebral and cardiac postoperative complications is comparable with the results of phased operations, reducing the length of hospital stay of the patient. The results of the hypoxic test serve as an additional criterion for the decision to impose an internal intra-arterial shunt. This allows you to reduce the time of the main stage of carotid endarterectomy and to avoid additional possible complications in the early postoperative period.


2021 ◽  
Vol 10 (4) ◽  
pp. 58-67
Author(s):  
O. V. Maleva ◽  
O. A. Trubnikova ◽  
I. V. Таrasova ◽  
S. V. Ivanov ◽  
O. L. Barbarash

Aim. To compare secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after different surgical treatment strategies (simultaneous and hybrid).Methods. Secondary neurological outcomes were evaluated in 43 patients with coronary and brachiocephalic artery disease in the early postoperative period after (1) carotid endarterectomy and on-pump coronary artery bypass surgery; (2) percutaneous coronary intervention and carotid endarterectomy. Demographic, clinical, instrumental data were collected. Neuropsychological assessment was performed using the Mini-Mental State Examination and Frontal Assessment Battery. Memory, attention and neurodynamics were measured using the “Status-PF” software at days 2–3 before the surgery and at days 5–7 after it. The presence of postoperative cognitive dysfunction was estimated on the basis of criteria defined as a 20% decline on 20% of the tests. Statistical analysis was performed using the software package “Statistica 10.0”.Results. Patients who underwent hybrid intervention demonstrated improved attention and memory in the early postoperative period. Complex visual-motor reaction significantly increased in patients after simultaneous surgery. Attention differed significantly in both groups. Thus, patients from the hybrid group processed more characters per 1 and 4 minutes while completing the Bourdon proof reading test. The total number of processed characters prevailed in the hybrid group. Cognitive processing speed was higher in the hybrid group according to the brain performance test. The incidence of early postoperative cognitive dysfunction was 60% in patients after simultaneous surgery and 11% in patients after hybrid surgery (p = 0.006, OR±SE 12.5±3.2).Conclusion. Hybrid intervention has shown its superiority over simultaneous intervention in terms of low rate of early cognitive impairment, thereby confirming the necessity to take into account the obtained results while selecting the optimal surgical treatment in patients with coronary and brachiocephalic artery disease present with cognitive deficits at baseline.


World Science ◽  
2019 ◽  
Vol 1 (7(47)) ◽  
pp. 48-50
Author(s):  
Макаров В. В. ◽  
Цивенко А. И. ◽  
Королевская А. Ю.

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.


2015 ◽  
Vol 22 (2) ◽  
pp. 50-54
Author(s):  
A. S Zolotov ◽  
M. S Feshchenko ◽  
O. I Pak

Incidence and pattern of disturbed sensitivity in the zone of surgical intervention was studied in 24 patients with clavicle fractures. Traumatic damage of supraclavicular nerve (not related to surgery) was observed only in 1 case. Disturbance of sensitivity in the zone of surgical intervention was noted in 21 (87.5%) patients. Mean area of anesthesia made up 44.5±29.3 cm2 (from 8.0 to 125.5 cm2). That complication developed at both horizontal and vertical surgical approaches. Intraoperatively supraclavicular nerves were visualized and preserved in 6 patients however disturbed sensitivity in early postoperative period was observed in 4 cases. Preventive isolation of supraclavicular nerves does not always ensure the preservation of sensitivity in early postoperative period.


2011 ◽  
Vol 18 (1) ◽  
pp. 21-27
Author(s):  
Eduard Ivanovich Solod ◽  
A F Lazarev ◽  
Ya G Gudushauri ◽  
M G Kakabadze ◽  
A S Roskidaylo ◽  
...  

Original method of stressed osteosynthesis for the treatment of proximal humerus is proposed. Primary tension of Y-shaped pin fixative and secondary tension that is created at its intramedullar insertion and blocking enable to achieve stable fixation of fragments without inflicting additional intraoperative injury in patients of any age and independently of their general condition. Preservation of blood supple in fragments, low traumatic osteosynthesis, and possibility of patients' early rehabilitation define the prospective of this technique for the treatment of patients with fractures on the background of osteoporosis. The importance of drug therapy for osteoporosis in the early postoperative period is shown. Experience in treatment of 62 patients aged from 23 to 78 years is presented. Control group included 30 patients with similar fractures who were treated using osteosynthesis. In the main group good results were achieved in 82.3% of patients, satisfactory - in 17.7%, no poor results were observed. In control group good results made up 40%, satisfactory - 56.7%, poor 0 3.3%.


2004 ◽  
Vol 3 (2) ◽  
pp. 66-73
Author(s):  
O. V. Leonov ◽  
V. T. Dolgikh ◽  
V. I. Shirocorad ◽  
Ye. I. Kopyltsov ◽  
D. V. Dolgikh

In the article 206 treatment results of generalized and disseminated renal cell carcinoma are presented. It has been found that disseminated forms of hypernephroma required a combined surgical treatment without fail; nephrectomy added by adrenalectomy is recommended insuperpolar tumour localization. Combined surgery with resection or ablation of the affected organ seems to be advisable in disseminated renal cell carcinoma. Such an active surgical approach improves the prognosis. Medicamental antineoplastic therapy including immunotherapy in postoperative period can raise patients survivability and quality of life.


Author(s):  
S. Rublenko ◽  
A. Yaremchuk ◽  
V. Vlasenko

Modern medical practice shows that the only eff ective treatment for breast cancer in dogs is surgery; current developments in chemotherapy and radiation therapy are ineff ective and too expensive. To identify the types of breast tumors and their anatomical distribution, it is necessary to have a reliable histological diagnosis. In most cases, it is used because the main treatment for breast cancer in dogs is their surgical removal. Undoubtedly decisive for this method of treatment are the phenomena of intoxication and endotoxicosis. Endotoxicosis in the early postoperative period consists of iatrogenic, tumor with tumors isolated and based on a small number of observations. However, the results of intoxication and the consequences of massive surgical tissue damage are often a determining factor for the outcome of treatment. Unfortunately, reports of studies of MSM in animals obtained by us indicate that almost all animals with breast tumors have endogenous intoxication, which we detected by the level of MSM and MDA in blood plasma. In our opinion, determination of the level of these markers of endotoxicosis before surgery and in the postoperative period can be an objective criterion for the risk of surgical treatment. Monitoring the level of MSM in the remote postoperative period, in combination with other biochemical studies can be a criterion for assessing the general clinical condition of the animal for the development of metastases. Probably lower levels of endogenous intoxication and clinically confi rmed reduction in the duration of treatment are a clear confi rmation of the eff ectiveness of high-frequency electrocoagulator EK-300M1. Dogs with breast tumors had high levels of MSM and MDA, which is a refl ection of the level of endogenous intoxication and may be an objective criterion for the risk of surgical treatment and postoperative recovery. Progressive reduction of these indicators in animals of the experimental group proves the eff ectiveness of the proposed treatment tactics. Key words: tumors, electrocoagulator EK-300M1, mastectomy, female dogs, oncology, endogenous intoxication, wound healing.


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