scholarly journals Іnnovation technologies in the gut organs surgery

2018 ◽  
Vol 85 (6) ◽  
pp. 5-9
Author(s):  
V. М. Меlnyk ◽  
Ye. М. Shepetko ◽  
І. І. Polovnikov ◽  
О. І. Poyda
Keyword(s):  
Postoperative Complications ◽  
Large Bowel ◽  
Postoperative Morbidity ◽  
Functional Results ◽  
Postoperative Hemorrhage ◽  
Pathological Process ◽  
Surgical Interventions ◽  
Wall Perforation ◽  
Significant Size

Objective. To improve the surgical treatment results in patients, suffering the gut organs diseases, due to its sophistication and elaboration of modern innovation technologies. Маterials and methods. In the work the author’s concept and results of the modern innovative technologies while performing surgery on the gut organs for ulcerative hemorrhage, complicated postbulbar, parapapillary ulcers, gastric cancer and polyps, colorectal cancer, ulcerative colitis, Crohn’s disease of large bowel, familial adenomatous polyposis are adduced. Endoscopic operations, methods of atraumatic dissection of tissues, new restoration and reconstructive-restorative operations, using modern staplers for anastomoses formation, laparoscopic operations were applied. The innovative surgical technologies were applied in 2428 patients. Results. Using methods of endoscopic hemostasis a definitive arrest of ulcerative hemorrhage was achieved in 91.1% patients. Еndoscopic polypectomy for the large bowel polyps of significant size and for «spreading» polyps were performed in 90.5% patients. Occurrence of postoperative hemorrhage was reduced to 0.74%, а large bowel wall perforation was not observed. In patients with complicated postbulbar and parapapillary ulcers the postoperative morbidity was reduced tо 24.7%, postoperative lethality - tо 7.6%. More favorable functional results were obtained after gastroplastic operations. Postoperative complications have occurred in 15.8% patients, 1.7% patients died. Conclusion. Modern innovation surgical technologies, including endoscopic, staplers for anastomoses formation, methods of atraumatic dissection of tissues, reconstructive-restorative, laparoscopic surgical interventions are sufficiently effective in the treatment of patients, suffering diseases of the gut organs. Application of modern innovation technologies in the gut organs surgery makes possible to eliminate pathological process, its complications, to reduce significantly the surgical interventions traumaticity, time of their performance, quantity of postoperative complications, lethality, and to improve functional results and quality of life in the patients operated.

scholarly journals New methods of surgical operations on large bowel

2018 ◽  
Vol 85 (7) ◽  
pp. 16-20
Author(s):  
V. М. Меlnyk ◽  
О. І. Poyda ◽  
E. М. Shepetko ◽  
І. І. Polovnikov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Large Bowel ◽  
Functional Results ◽  
Late Results ◽  
Occurrence Rate ◽  
Surgical Interventions ◽  
New Methods ◽  
Severity Degree

Objective. To improve the immediate and late results of surgical treatment in patients, suffering the large bowel (LB) diseases, using improvement of standard and elaboration of new methods of radical, оrgan-preserving, restorational and reconstructive-restorational operations. Маterials and methods. New methods of radical, оrgan-preserving, restorational and reconstructive-restorational operations on LB were elaborated, taking into account peculiarities of the diseases morphogenesis, аnatomical and functional details of the LB separate parts. The operations mentioned were performed in 497 patients, suffering LB cancer, ulcerative colitis, Crohn’s disease, familial adenomatous polyposis, chronic decompensated colostasis, complicated by the LB diverticular disease. Results. Due to implementation into clinical practice of the surgical interventions elaborated, the postoperative morbidity occurrence rate have reduced down to 2.4%, postoperative lethality - to 0.2%, the functional results improved, the occurrence rate and the severity degree for pathological postoperative syndromes have lowered (reflux-ileitis, postcolectomy syndrome, syndrome of low anterior resection, secondary anal incontinence), the governing of the outflow process after rectal extirpation was guaranteed, the operated patients quality of life improved essentially due to introduction of the surgical interventions elaborated. Conclusion. Improvement of the surgical treatment results for the LB diseases is possible while applying of new methods of radical, organ-preserving , restorational and reconstructive-restorational operations, what promotes the essential reduction of the occurrence rate for the LB diseases recurrence occurrence, pathological syndromes morbidity and their severity degree, significant improvement of functional results and quality of life in the patients operated.

scholarly journals EFFICACY OF GASTRODUODENAL ANASTOMOSIS IN SURGERY OF DISTAL STOMACH CANCER: FROM PAST TO PRESENT

2020 ◽  
Vol 64 (1) ◽  
pp. 28-33
Author(s):  
T. Morgoshiya
Keyword(s):  
Functional Results ◽  
Long Term Results ◽  
Billroth Ii ◽  
Distal Stomach ◽  
Surgical Interventions ◽  
Billroth I ◽  
Results Of Treatment ◽  
Operated Stomach

When comparing the results of surgical interventions in the modifications of Billroth-I and Billroth-II concerning carcinoma there are no significant differences both in immediate and in long-term results of treatment. At the same time the functional results of interventions and quality of life of patients are better after reconstruction of the digestive tract with the help of gastroduodenal anastomosis. Gastric stump cancer is more often occur after Billroth-II surgery. The main cause of the development of carcinoma in this case is the appearance of atrophic gastritis as a result of denervation of the organ and the transfer of bile to the operated stomach.

Functional outcome and quality of life in patients undergoing salvage radical prostatectomy (SRPE).

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 212-212 ◽  
Author(s):  
David Pfister ◽  
Jasmin Pullankavumkal ◽  
Friederike Haidl ◽  
Vahudin Zugor ◽  
Tobias Kohl ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radical Prostatectomy ◽  
Functional Outcome ◽  
Functional Results ◽  
High Rate ◽  
Surgical Interventions ◽  
Eortc Qlq ◽  
Salvage Radical Prostatectomy

212 Background: Salvage radical prostatectomy is one option for patients with locally recurrent disease with proven long term oncologic control. There are concerns about worse functional results due to fibrotic tissue after radiotherapy and patients are treated with palliative systemic androgendreptivation. We retrospectively analyzed continence and quality of life in patients undergoing SRPE. Methods: After biopsy proven local recurrent prostate cancer 138 patients were offered SRPE and extended lymphadenectomy. Continence and quality of life had been collected before 6 and 12 months after surgery. Validated questionaires with ICIQ and EORTC qlq 30 had been used. Results: Präoperatively at 6 monts and 12 months the feed back was available in 93, 84 and 82 patients respectively. Präoperatively there was no or mild incontinence in 38(40.8%), moderate in 33 (35.5%) and strong incontinence in 22 (23.7%) of the patients. There is a significant decrease in the rate of continence after 6 and 12 months to no or mild in 19 (23.1%), moderate in 19 (23.2%) and strong incontinence in 44 (53.7%) of the patients. In 5 patients an artifitial sphinkter was implanted. Quality of life did not change significantly before and 12 months after surgery. Median value of Question 30 was 6 and five respectively. Conclusions: Patients need to be informed about a worse functional outcome and the potential need for further surgical interventions as artificial sphinkter implantion compared to primary radical prostatectomy. Quality of life seems to be affected only moderatly. Nevertheless there is already a rather high rate of any incontinence before surgery that needs to be taken into account.

scholarly journals Сучасні підходи до хірургічного лікування хворих на генералізова- ний пародонтит із використанням дентальних імплантатів

2017 ◽  
Author(s):  
H. B. Prots ◽  
V. P. Piuryk
Keyword(s):  
Postoperative Complications ◽  
Bone Tissue ◽  
Surgical Intervention ◽  
Positive Development ◽  
Duration Of Treatment ◽  
Surgical Interventions ◽  
Periodontal Tissues ◽  
Dental Implantation ◽  
Simultaneous Surgery

The main postulate of periodontal treatment is the elimination of factors injuring periodontal disease, creating conditions for the normalization of its properties. Structures with additional supports on the intraosseous implants are optimal for orthopaedic treatment. The possibilities and conditions for surgical intervention on periodontal tissues and implantation in patients with varying severity of chronic GP were generally poorly understood.The aim of the study – to improve the treatment of patients with partial edentia and chronic generalized periodontitis by including dental implantation to the complex of therapeutic measures.Materials and Methods. There are presented the results of 360 patients with varying severity degrees of generalized periodontitis who underwent surgery on periodontal tissues with dental implantation.Results and Discussion. Our research showed that implantation in patients with mild generalized periodontitis can achieve consistently good results regardless the method of treatment. Simultaneous surgery on periodontal tissues and the dental implantation shortens treatment duration in 1.5–2 times without compromising its quality. It is shown that in patients with moderate and severe degrees of generalized periodontitis it is appropriate to perform periodontal surgery separately followed by dental implantation to prevent postoperative complications and implant loss. When planning for dental implants and periodontal surgical intervention it is necessary to determine the quality of bone remodeling to assess the structural and functional state of bone tissue and differentiated destination osteotropic drugs that promote positive postoperative period.Conclusions. Therefore, in order to increase the effectiveness of dental implantation and surgical periodontal intervention, bone remodelling markers should be determined to assess the structural and functional status of bone tissue and for the differentiated use of osteotropic drugs, which will contribute to the positive development of the postoperative period. Simultaneous surgical intervention on periodontal tissues and dental implantation in 1.5–2 times reduces the duration of treatment without reducing its quality. In patients with moderate to severe degrees, it is expedient to carry out surgical interventions with subsequent dental implantation in order to prevent postoperative complications and loss of implants.

scholarly journals Long-term oncological and functional results of robot-assisted radical prostatectomy

2021 ◽  
Vol 17 (3) ◽  
pp. 121-128
Author(s):  
K. K. Ramazanov ◽  
K. B. Kolontarev ◽  
G. P. Gens ◽  
A. V. Govorov ◽  
A. O. Vasilyev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Radical Prostatectomy ◽  
Length Of Hospital Stay ◽  
Functional Results ◽  
State University ◽  
Robot Assisted ◽  
Surgical Interventions ◽  
Long Term Follow Up

Prostate cancer (РСа), being one of the leading causes of cancer mortality in men in Russia and in a number of other countries of the world, remains an urgent problem for modern oncourology, and the choice of surgical method is an important task for a surgeon. Such a pronounced interest in robot-assisted radical prostatectomy (RARP) in patients is driven by good tolerance and effectiveness of these surgical interventions, despite the fact that radical prostatectomy is considered to be the "gold standard" for treatment of patients with clinically localized РСа with regard to European Association of Urology data. The long-term oncological and functional results and the quality of life of patients after RARP deserve close attention and thorough study. According to the data presented in this article, it is obvious that RARP is the preferred method for surgical treatment of РСа, since oncological and functional results in the long-term follow-up are comparable to the results after radical prostatectomy, and according to some authors, these results are superior to the results of radical prostatectomy. The results of the study will allow to continue further introduction of RARP into clinical practice and its popularization as a method of surgical treatment of patients with localized PCa, which will reduce the length of hospital stay of patients, accelerate their medical and social rehabilitation, and improve the quality of medical care.The amount of data on the study of distant oncological and functional results of RARP as well as its superiority over other treatment methods is limited in medical literature, which prompted us to conduct our own research. Currently the urological clinic of the A.I. Evdokimov Moscow State University of Medicine and Dentistry continues work aimed at studying the longterm results of RARP in the first patients in Russia.

729 RELATION OF POSTOPERATIVE MORBIDITY WITH QUALITY OF LIFE FOLLOWING ESOPHAGEAL SURGERY FOR CANCER: A EUROPEAN MULTICENTER STUDY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Nannet Schuring ◽  
Sheraz R Markar ◽  
Egle Jezerskyte ◽  
Mirjam A G Sprangers ◽  
Asif Johar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
General Population ◽  
Subgroup Analysis ◽  
Postoperative Morbidity ◽  
Multivariable Logistic Regression Analysis ◽  
One Year ◽  
Eortc Qlq ◽  
Esophagectomy For Cancer

Abstract   Despite improvements in perioperative esophageal cancer care, severe postoperative complications occur in 17.2% of the patients. Postoperative complications are associated with reduced health-related quality of life (HR-QoL), and severe complications may have a profound negative effect on the HR-QoL.The aim of this study was to investigate the relation between postoperative morbidity and reported HR-QoL in patients following esophagectomy for cancer. Methods Disease-free patients at least one year following esophagectomy for cancer in one of the participating LASER study centers between 2010 and 2016 were included. Patients completed the LASER, EORTC-QLQ-C30 and QLQ-OG25 questionnaires at least one year following surgery. The primary outcome was the relation between reported HR-QoL and occurrence of postoperative complications and to compare the HR-QoL in the study population with the reference values of the general population. Subgroup analysis was performed in patients with ‘no’ or ‘minor’ (Clavien-Dindo grade I-IIIa) and ‘severe’ (Clavien-Dindo grade ≥ IIIb) complications, using univariable and multivariable logistic regression analysis. Results Among 645 included patients, 283 patients with ‘no’, 207 patients with ‘minor’ and 155 patients with ‘severe’ postoperative complications were included. The mean age of the patients was 64 years (SD 9), with a mean time since surgery of 4.4 years (SD 1.7). Neither significant or clinically relevant differences were found in the HR-QoL scores between patients with and without complications, nor were differences observed in subgroup analysis for severity of postoperative complications. Compared to the general population, patients reported worse HR-QoL in all domains except ‘Global Health’ and ‘Emotional Functioning’, and more symptomatology in all symptom domains except ‘Pain'. Conclusion HR-QoL between patients at a median of 4.4 years after esophagectomy for cancer did not differ. Differences were neither significant nor clinically relevant and furthermore, no differences were observed in subgroup analysis for severity of postoperative complications according to Clavien-Dindo.

Postoperative morbidity, functional results and quality of life of patients following orthotopic neobladder reconstruction

2003 ◽  
Vol 10 (3) ◽  
pp. 119-125 ◽  
Author(s):  
Tatsuaki Yoneda ◽  
Mikio Igawa ◽  
Hiroaki Shiina ◽  
Kazushi Shigeno ◽  
Shinji Urakami
Keyword(s):  
Quality Of Life ◽  
Postoperative Morbidity ◽  
Functional Results ◽  
Orthotopic Neobladder

scholarly journals SURGICAL COMPLICATIONS AFTER MODULAR ENDOPROSTHETICS IN PATIENTS WITH ACETABULAR TUMOR

2019 ◽  
Vol 6 (3) ◽  
pp. 98-107
Author(s):  
G. D. Iluridze ◽  
V. Yu. Karpenko ◽  
V. A. Derzhavin ◽  
A. V. Bukharov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
World Literature ◽  
Malignant Tumors ◽  
Pelvic Ring ◽  
Functional Results ◽  
Surgical Interventions ◽  
Metal Structures ◽  
Pelvic Bones ◽  
Conservation Treatment

There are various methods of restoring the integrity of the pelvic ring, after surgery in patients with tumor lesions of the pelvic bones, allowing to keep the limb with good oncological and functional results. A new stage in the development of organ conservation treatment in this group of patients is the use of modular endoprostheses based on the conical leg. The development of postoperative complications leads to an unsatisfactory result of treatment, despite the radical surgery and technically correct endoprosthesis. This, in turn, leads to repeated surgical interventions, namely to remove metal structures, or to perform a crippling operation. Purpose. To analyze postoperative complications and methods of their treatment in patients after modular endoprosthesis replacement of the acetabulum. Patients and methods. From 2011 to 2018, surgical treatment of endoprosthesis using modular metal structures based on a conical leg was performed in 30 patients. There were 13 men (43%) and 17 women (57%). The median age was 45 years (23–63 years). Primary malignant tumors of pelvic bones were in 19 (63%) patients, 5 (17%) had a giant cell tumor. Two (7%) patients had solitary metastases of kidney cancer and one (3%) with synovial sarcoma, and 3 (7%) had relapses after previous surgical treatment. Results. The average follow-up period was 36 months. Progression of the disease in terms of 6 to 40 months was revealed in 10 patients (33%), 8 (27%) of which died, the remaining 22 (67%) are alive with no signs of progression. In the postoperative period, 11 (37%) patients developed complications with predominance (up to 30%) of infectious. The average functional result on the MSTS scale was 59%. Conclusion. The use of modular prostheses on the basis of a conical leg in patients with tumors of the pelvic bones allow to perform safe operations with a satisfactory functional and oncological result. The result obtained in our study is comparable with the data of world literature. 

scholarly journals Uticaj obima hirurske resekcije kod totalne laringektomije na uspostavljanje ezofagusnog glasa i govora

2004 ◽  
Vol 51 (1) ◽  
pp. 37-41 ◽  
Author(s):  
P. Stankovic ◽  
Vojko Djukic ◽  
M. Vukasinovic ◽  
Ljiljana Janosevic
Keyword(s):  
Total Laryngectomy ◽  
Surgical Intervention ◽  
Functional Results ◽  
Surgical Interventions ◽  
Term Adverse Effect ◽  
Anatomic Results ◽  
Base Of The Tongue ◽  
Voice And Speech

The study of functional results of total laryngectomy carmot be separated from articulation of esophageal voice and speech. To achieve success of phoniatric rehabilitation in laringectomized patients, it is necessary to be well aware of pathological sequelae of the veiy operation, long-term adverse effect of oncological risk factors as well as postoperative anatomo-physiological changes. Anatomic results of total laryngectomy depend on the type of surgical intervention and probable radiotherapy. The extent of surgical procedure, primary dictated by oncological indications, has the essential effect to articulation of esophageal voice and speech. If possible for oncological reasons, hyoid bone should be particularly left intact. Extensive surgical interventions of hypopharynx and the base of the tongue during laryngectomy, neck dissection - especially the radical one, and subsequent radiotherapy, all of them significantly reduce the possibility to produce esophageal voice and speech. Total laryngectomy eliminates the creator of voice and vibrations, which are acoustically perceived as esophageal voice, proceeding at the level of pharyngoesophageal junction. For this reason, the quality of newly created vibrating narrowing is especially important.

Sign in / Sign up

Export Citation Format

Share Document