scholarly journals PECULIARITIES OF SURGICAL TREATMENT OF BENIGN FORMATION OF MAMMARY GLAND

2018 ◽  
Keyword(s):  
Mammary Gland ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Remote Access ◽  
Surgical Approaches ◽  
Surgical Interventions ◽  
Good Cosmetic ◽  
Cosmetic Effect ◽  
Standard Set

The effectiveness of the use of remote surgical approaches in patients with benign formation of mammary gland was studied in this paper,. Before surgery, all patients underwent a standard set of instrumental examinations: mammography, ultrasound examination of the mammary gland, puncture biopsy of the formation with subsequent cytology, which was also performed in the postoperative period. The use of remote access, taking into account the localization of formations of the mammary gland is a radical surgical intervention. The duration of surgical intervention among these accesses, the severity of pain in the postoperative period are identical, as with the use of traditional accesses. In these patients, a good cosmetic effect was observed in the early and late periods of surgical intervention, which makes it possible to recommend these surgical interventions for a broader introduction of surgical treatment of patients with benign formation of mammary gland to the technology.

scholarly journals Iatrogenic Supraclavicular Nerve Injuries in Surgical Treatment of Clavicle Fractures

2015 ◽  
Vol 22 (2) ◽  
pp. 50-54
Author(s):  
A. S Zolotov ◽  
M. S Feshchenko ◽  
O. I Pak
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Early Postoperative Period ◽  
Surgical Approaches ◽  
Nerve Injuries ◽  
Clavicle Fractures ◽  
Traumatic Damage

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.

scholarly journals Clinical and Anatomical Rationale for the use of Fronto-Orbito-Zygomatic (foz) approach for the Surgical Treatment of Tumors of the Orbit and Cranioorbital Region

2020 ◽  
Vol 7 (1) ◽  
pp. 01-08
Author(s):  
O.I. Lystratenko
Keyword(s):  
Postoperative Period ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Apical Part ◽  
Diagnostic Methods ◽  
Surgical Approaches ◽  
Orbital Tumors ◽  
Good Cosmetic ◽  
Cosmetic Effect ◽  
Radical Removal

The article discusses and analyzes the results of the treatment of 56 patients with tumors of the orbit, cranioorbital region, operated at the neurosurgery clinic DCTMA in Donetsk from 2015 to February 2020, with various surgical approaches. Goals and objectives: coverage of clinical signs and symptoms, histology, diagnostic methods and treatment of patients operated on with tumors of the orbit and cranioorbital region for the period 2015-2020. The rationale for the use of front-orbit-zygomatic access as the optimal surgical access to tumors of the orbit and cranioorbital region of various localization, to perform radical organ-preserving surgery, with the maximum preservation of visual function, minimizing oculomotor disturbances, patient disability, good cosmetic effect in the postoperative period. Materials and methods: we analyzed the clinical cases of 56 patients who underwent treatment in DCTMA with tumors of the orbit, cranioorbital region for the period from 2015 to March 2020. Patients were operated on with different approaches - transcutaneous, subconjunctival, front-orbit-zygomatic, pterional, subfrontal. Surgical approaches were determined individually, depending on the location, size of the tumor, involvement in the process of the underlying structures of the orbit, adjacent anatomical areas (frontal, maxillary sinuses, cranial cavity, bones of the base of the skull). In 2 cases of lesions of the orbit by the tumor process a relapse of the tumor growth was obtained: one patient with aggressive adenocarcinoma, after 18 months, leading to orbital exenteration, and a 9-year-old child with rhabdomyosarcoma after non-radical removal of the tumor by subconjunctival approach. In all other cases, no relapses were noted; the operations were organ-preserving. Conclusions: the results of treatment of patients with orbital tumors directly depend on the radical removal of the neoplasm, which is associated with the choice of surgical approach, the use of chemo-, radiation therapy in the postoperative period, depending on the histological response. Advantages and versatility of FOZ - approach: ─ gives good visibility of all structures of the orbit, paraorbital regions, including the cranial region; ─ allows to perform organ-sparing operations to remove tumors of cranioorbital localization of any size; ─ provides radical removal of the neoplasm; ─ maximum preservation of vision function; ─ minimization of oculomotor disorders, patient disability; ─ good cosmetic effect. Indications for front-orbit-zygomatic access: ─ large formations of orbit (more than 2.5-3 cm in diameter), with diffuse growth in the capsule, including a metastatic one; ─ osteomas of the walls of the orbit, meningiomas with intracranial, intraorbital growth, fibrous dysplasia of the bones of the skull base, causing compression of blood vessels and nerves, functional disorders of the eye; ─ tumors of the apical part of the orbit, including the optic nerve. The disadvantages of the method are the technical complexity for ophthalmologist surgeons, by the routinism of the manipulation for neurosurgeon. In this regard, surgery of orbital tumors, cranioorbital localization, is subject to the competence of doctors of related specialties, including neurosurgeons.

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 Duplex scanning as an alternative to computer tomography with contrast enhancement for the control of complications after endovascular aneurysm repair

2018 ◽  
Vol 9 (1) ◽  
pp. 44-49
Author(s):  
D. I. Korshunov ◽  
R. I. Khabazov ◽  
N. V. Ustiantseva ◽  
A. V. Chupin ◽  
S. V. Deryabin
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Early Detection ◽  
Computer Tomography ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Endovascular Aneurysm Repair ◽  
Duplex Scanning ◽  
Non Invasive ◽  
Aneurysm Repair

EVAR (endovascular aneurism repair) is the preferred method for the surgical treatment of ananeurysm. The advantage of this type of surgical intervention is that a smaller number of postoperative complications will occur. The main diagnostic tasks for patients after EVAR are to determine the size of the aneurysmal sac, detection of an endoleak, detection of the endoprosthesis migration and the deformation of the stent graft itself. Conclusion: early detection of complications in the postoperative period remains the main problem for monitoring patients after EVAR. Duplex scanning is a safe, non-invasive and effective method of measuring the size of an aneurysmal sac and detecting possible complications after EVAR.

Different surgical treatments for nasal septal perforation and their outcomes

2007 ◽  
Vol 121 (5) ◽  
pp. 419-426 ◽  
Author(s):  
A Y Goh ◽  
S S M Hussain
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Journal Club ◽  
Treatment Options ◽  
Surgical Approaches ◽  
Septal Perforation ◽  
Inclusion Criteria ◽  
Hand Search ◽  
Nasal Septal Perforation ◽  
The Subject

Objective: To critically evaluate the literature on surgical treatment options for nasal septal perforations and to analyse the outcomes of these treatment options.Design: A systematic review of studies of nasal septal perforation closure using surgical intervention, published from January 1975 to March 2006.Data sources: Forty-nine papers were identified from electronic databases (all Evidence Based Medicine reviews (Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effectiveness and Cochrane Controlled Trials Register), EMBASE, Ovid (Medline) and British Medical Journal publications) and from a hand search of the reference lists of retrieved papers. Textbooks pertinent to the subject were referred to for background reading. Twenty-three studies met the inclusion criteria.Main outcome measure: Effectiveness of the surgical intervention to completely close the perforation.Results: Five studies examined the sole use of intranasal mucosal flaps to close the perforation, i.e. inferior turbinate flaps, quadrangular cartilage flap and mucoperiosteal flap. Eighteen studies reported the use of a combination of intranasal mucosal flap and interposition graft. Graft materials included temporalis fascia, mastoid periosteum, nasal septal material, acellular human dermal graft, conchal cartilage and porcine small intestine mucosa. Studies utilising interposition grafts generally produced higher closure rates. The surgical approaches documented include closed endonasal, unilateral hemitransfixion, external rhinoplasty and midfacial degloving techniques. A range of surgical treatment methods was reported in the literature, but some papers were excluded from this review as they did not meet the inclusion criteria. It was difficult to infer the true effectiveness of each study as the subject numbers were small, patient selection criteria were often unspecified and the follow-up period was brief. However, factors leading to an increased chance of success were identified.Conclusion: The review found an extensive range of surgical treatment techniques, but reported results were rarely statistically significant. It is difficult to be categorical about the effectiveness of a surgical treatment method; nonetheless, each technique has its own advantages and drawbacks.

scholarly journals MODERN SURGICAL INTERVENTIONS IN PATIENTS WITH THYROID DISEASES

2019 ◽  
Vol 21 (1) ◽  
pp. 69-72
Author(s):  
D D Dolidze ◽  
A V Shabunin ◽  
R B Mumladze ◽  
A V Vardanyan ◽  
I N Lebedinskiy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Stress Test ◽  
Thyroid Diseases ◽  
Endocrine Surgery ◽  
Surgical Interventions ◽  
Postoperative Hypoparathyroidism ◽  
Operative Complications ◽  
Cosmetic Effect ◽  
Methodological Approaches ◽  
Group Ii

The study is based on the analysis of the results of surgical treatment of 298 patients with various diseases of the thyroid gland, who were examined and treated in the department of endocrine surgery of the City Clinical Hospital named after S. P. Botkin from 2012 to 2016. 147 (49.3%) patients of the I group were operated on using extrafascial technique with intersection of the prelaryngeal muscles and visualization of the recurrent laryngeal nerve. 151 (51.7%) patients of group II underwent extrafascial surgical interventions from reduced migratory approaches using modern, including original, methodological approaches. For the prevention of paresis of the larynx in the allocation of recurrent laryngeal nerves, microsurgical instruments and magnifying devices were used. For the prevention of postoperative hypoparathyroidism, in addition to carefully accounting for anatomical and topographic-anatomical features, a «stress-test» and a method of double visual-instrumental recording of the parathyroid gland-induced fluorescence were used. In the first group of patients with surgical treatment, the following complications were recorded: in 2 (1.4%) patients developed permanent, in 8 (5.4%) transient postoperative hypoparathyroidism, and in 3 (2.0%) - temporary unilateral laryngeal paresis. The overall incidence of operative complications was 8.8% (13 patients). In the postoperative period, the following complications were recorded in group II: 2 (1.3%) patients developed transient hypocalcemia, and 1 (0.7%) patient had unilateral laryngeal paresis. The overall incidence of operative complications was 1.99% (3 patients). Analysis of the cosmetic result of the intervention, assessed on the POSAS scale, showed that cosmetic effect was better in group II (p 0.05). Thus, modern surgical interventions in patients with thyroid diseases, including new methodological approaches, have improved the results of surgical treatment with a decrease of the number of complications and achieving a better cosmetic effect of the surgical intervention.

scholarly journals Correction of High Corneal Astigmatism during Cataract Surgery

2019 ◽  
Vol 15 (4) ◽  
pp. 405-410 ◽  
Author(s):  
K. B. Pershin ◽  
N. F. Pashinova ◽  
M. E. Konovalov ◽  
E. P. Gurmizov ◽  
O. Yu. Zubenko ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Clinical Experience ◽  
Intraocular Lens ◽  
Surgical Intervention ◽  
Corneal Astigmatism ◽  
Intraocular Lenses ◽  
Toric Intraocular Lens ◽  
Surgical Interventions ◽  
Uncorrected Visual Acuity

Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.

scholarly journals Surgical Treatment of Juvenile Femoral Head Epiphysiolysis in Children

2016 ◽  
Vol 23 (1) ◽  
pp. 40-47
Author(s):  
D. B Barsukov ◽  
A. I Krasnov ◽  
M. M Kamosko ◽  
V. E Baskov ◽  
I. Yu Pozdnikin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Femoral Head ◽  
Femoral Neck ◽  
Surgical Intervention ◽  
Treatment Results ◽  
Surgical Interventions ◽  
X Ray ◽  
Endochondral Growth

To optimize the anatomical and functional surgical treatment results in patients with early (I-II) stages of juvenile femoral head epiphysiolysis both pre- and postoperative data of clinical, x-ray and magnetic-resonance examinations were analyzed for 120 patients aged 11 - 15 years. Maximum follow up period after surgical interventions, i.e. femoral head epiphysiodesis (n=60) and femoral head epiphysis fixation (n=60) made up 23 and 3 years, respectively. It was shown that surgical intervention for the fixation of femoral head epiphysis ensured reliable stability of the epiphysis preventing the latter from displacement development and progression, and did not exert significant influence upon either femoral neck and head endochondral growth or the length of the upper extremity.

scholarly journals NEW APPROACHES IN THE TREATMENT OF ACUTE INFLAMMATION OF THE EPITHELIAL PILONIDAL SINUS

2016 ◽  
Vol 7 (4) ◽  
pp. 49-57
Author(s):  
N K Gigin ◽  
N I Chernyi ◽  
Yu V Ivanov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Pilonidal Sinus ◽  
Patient Management ◽  
Acute Inflammation ◽  
Wound Closure ◽  
Surgical Interventions ◽  
New Approaches ◽  
Surgical Access ◽  
Conservative And Surgical Treatment

Presents an overview of russian and foreign publications, devoted to contemporary methods of conservative and surgical treatment of acute inflammation of the epithelial pilonidal sinus. Details of surgical interventions, techniques, indications and contraindications. Special attention is paid to pre-operative preparation for surgery, wound closure after surgical access, patient management in the postoperative period.

scholarly journals Standard open operative interventions in surgical treatment of patients, suffering an acute complicated pancreatitis

2018 ◽  
Vol 85 (7) ◽  
pp. 27-29
Author(s):  
V. P. Аndriushchenko ◽  
D. V. Аndriushchenko ◽  
Yu. S. Lysiuk
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Surgical Intervention ◽  
Main Group ◽  
Control Group ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Second Stage ◽  
Standard Operations

Objective. To determine the character and optimal volume of standard open surgical interventions in an acute complicated pancreatitis (ACP) with elaboration of the main technical elements of the operations. Маterials and methods. There were operated 96 patients, suffering ACP. The main group consisted of 47 patients, in whom open interventions were performed primarily in 19, and as the second-stage procedure after application of miniinvasive interventional technologies (МIТ) – in 28. The comparison group consisted of 49 patients, in whom standard operations were done only. Results. Application of MIТ have promoted the indications narrowing for performance of primary open operations more than twice. In the main group the arcuate-like subcostal access was applied predominantly - in 26 (55%) observations (χ²=14.287; р=002), while in a control one – a median upper laparotomy – in 37 (76%) observations (χ²=38.43, р < 0.001). The method of closed draining in accordance to procedure of Beger was used predominantly in the main group of patients – in 43% of observations, comparing with a control group - 9% of observations (χ²=12.965; р=0.003). In 23% patients of the main group and in 26% patients of a control one (χ²=0.0013; р=0.05), when the extended purulent-necrotic inflammation process have presented, a staged sanation was applied, using programmed relaparotomies. Some technical elements of the surgical intervention were improved. Conclusion. Application of standard open operations in accordance to elaborated principle is accompanied by improvement of the treatment results in patients, suffering ACP.

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