scholarly journals Influence of intraoperative rupture of brain aneurysm on results of surgical treatment in the early postoperative period

2018 ◽  
Vol 23 (1) ◽  
pp. 24-32
Author(s):  
A.V. Byndiu ◽  
◽  
M.Yu. Orlov ◽  
V.V. Cheburachin ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Brain Aneurysm ◽  
Intraoperative Rupture

Seizures after evacuation of subdural hematomas: incidence, risk factors, and functional impact

2010 ◽  
Vol 112 (2) ◽  
pp. 455-460 ◽  
Author(s):  
Alejandro A. Rabinstein ◽  
Seung Young Chung ◽  
Leslie A. Rudzinski ◽  
Giuseppe Lanzino
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Functional Impairment ◽  
Postoperative Period ◽  
Strong Association ◽  
Early Postoperative Period ◽  
Acute Subdural Hematoma ◽  
Early Functional Outcome ◽  
Gcs Score

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.

scholarly journals SURGICAL TREATMENT OF CAROTID STENOSIS IN PATIENTS WITH CORONARY HEAR+T DISEASE IN ORDER TO PREVENT ISCHEMIC STROKE

2020 ◽  
pp. 124-126
Author(s):  
I. S. Pulyaeva ◽  
V. A. Prasol
Keyword(s):  
Ischemic Stroke ◽  
Surgical Treatment ◽  
Carotid Stenosis ◽  
Postoperative Period ◽  
Stable State ◽  
Length Of Hospital Stay ◽  
Early Postoperative Period ◽  
Main Stage ◽  
Simultaneous Operations ◽  
Ischemic Attack

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.

scholarly journals Secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after simultaneous and hybrid surgical treatment

2021 ◽  
Vol 10 (4) ◽  
pp. 58-67
Author(s):  
O. V. Maleva ◽  
O. A. Trubnikova ◽  
I. V. Таrasova ◽  
S. V. Ivanov ◽  
O. L. Barbarash
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Postoperative Cognitive Dysfunction ◽  
Early Postoperative Period ◽  
Brachiocephalic Artery ◽  
Neurological Outcomes ◽  
Simultaneous Surgery ◽  
Artery Disease ◽  
Hybrid Group

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.

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.

New Potentialities in Surgical Treatment of Proximal Humerus

2011 ◽  
Vol 18 (1) ◽  
pp. 21-27
Author(s):  
Eduard Ivanovich Solod ◽  
A F Lazarev ◽  
Ya G Gudushauri ◽  
M G Kakabadze ◽  
A S Roskidaylo ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Surgical Treatment ◽  
General Condition ◽  
Postoperative Period ◽  
Proximal Humerus ◽  
Original Method ◽  
Early Postoperative Period ◽  
Early Rehabilitation ◽  
Control Group ◽  
Stable Fixation

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%.

scholarly journals Clinical and experimental justifi cation for the use of high-frequency electrocoagulator EK-300M1 for the surgical treatment of breast tumors in female dogs

2020 ◽  
pp. 129-139
Author(s):  
S. Rublenko ◽  
A. Yaremchuk ◽  
V. Vlasenko
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
High Frequency ◽  
Breast Tumors ◽  
Early Postoperative Period ◽  
Surgical Removal ◽  
Duration Of Treatment ◽  
Objective Criterion ◽  
Endogenous Intoxication

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.

scholarly journals Surgical treatment of benign tumors of parapharyngeal space

2019 ◽  
pp. 35-40
Author(s):  
Dmitry Zabolotny ◽  
Erwin Lukach ◽  
Diana Zabolotnaya ◽  
Fedor Yevchev ◽  
Irina Tsvirinko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Parapharyngeal Space ◽  
Vascular Complications ◽  
State Institution ◽  
Early Postoperative Period ◽  
Transoral Approach ◽  
Vascular Lesions ◽  
Vascular Tumors ◽  
Benign Tumors

Background: Neoplasms of the oropharynx and parapharyngeal space are quite rare, characterized by nonspecific development of the disease, and the involvement of important anatomical structures in the pathological process. Problems of diagnosis and choice of tactics of surgical treatment are relevant today. Aim: To evaluate the effectiveness of transoral approach when removing benign tumors of the parapharyngeal space. Materials and methods: In State Institution “O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Sciences of Ukraine” in recent years, 92 patients underwent surgical treatment with benign tumors of the parapharyngeal space. Men – 39 (42.4%), women – 53 (57.6%). All patients underwent total removal of the tumor in the parapharyngeal space by transoral approach. Results: In patients evaluated the postoperative period, the type of postoperative wound healing, the presence of complications and the quality of life. The following postoperative complications were observed: in 13 (14.1%) patients lockjaw was observed, which regressed on average for 2-3 days, bleeding from the postoperative site in the early postoperative period – 4 (4.3%) and acute cerebrovascular accident in the early postoperative period in 1 patient (1.1%). Conclusions: Given the good blood supply to the parapharyngeal space, bleeding is one of the most common complications. Vascular complications are more common when neurogenic or vascular tumors are removed. Angiography is useful in evaluating post-styloid lesions in order to demonstrate their connection with large vessels and differentiate neurogenic and vascular lesions. The advantages of transoral removal of the tumors of the parapharyngeal space are the absence of cosmetic defects, the rapid healing of postoperative wounds and the rapid restoration of the patient’s working capacity.

scholarly journals Stationary replacement technologies in the surgical treatment of simultaneous pathology in gynecological patients

2018 ◽  
pp. 64-71
Author(s):  
A. N. Shikhmetov ◽  
L. A. Osin ◽  
A. M. Zadikyan ◽  
A. A. Pazichev
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Subsequent Treatment ◽  
The Body ◽  
Operating Table ◽  
Operating Team ◽  
Simultaneous Operations ◽  
Repeated Surgery

The authors analyzed the results of simultaneous operations in 238 patients with regard to the combined surgical and gynecological pathology performed in the hospital-replacing environment of the ВСDС of PAO «Gazprom». Previously, all patients were assigned to the sequence of stages, the location of trocars, taking into account the additional stages of the operation, the position of the monitor, the location of the operating team, the position of the patient on the operating table during each stage. Performing simultaneous laparoscopic operations does not lead to an increase in the number of intra- and postoperative complications in comparison with isolated interventions and is not accompanied by great technical difficulties, but causes a somewhat longer duration (on average, 20.6 ± 1.5 min), which, in our opinion , is not critical for anesthesia. There were no significant differences in the course of the early postoperative period and the intensity of the functional systems of the body. Advantages of simultaneous operations are undeniable: two or three surgical diseases are cured simultaneously, progression or serious complication of the disease is prevented, operative treatment of which would be postponed for a later period, the risk of repeated surgery and anesthesia is eliminated, the time of total stay of the patient in the hospital and subsequent treatment is reduced, economic efficiency of treatment is increased.

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