scholarly journals Peculiarities of complicated course of postoperative period in a woman-patient, suffering an acute cholecystitis

2019 ◽  
Vol 86 (10) ◽  
pp. 71-74
Author(s):  
V. V. Liesnyi ◽  
A. S. Liesna
Keyword(s):  
Acute Cholecystitis ◽  
Postoperative Period ◽  
Woman Patient ◽  
Complicated Course

Peculiarities of complicated course of postoperative period in a woman-patient, suffering an acute cholecystitis

scholarly journals Mathematical modeling for prediction of complicated acute appendicitis in children

2018 ◽  
Vol 1 (1) ◽  
pp. 70-80
Author(s):  
V. S. Konoplitsky ◽  
V. V. Motygin ◽  
A. G. Yakimenko ◽  
D. V. Dmytriiev ◽  
T. I. Mikhalchuk
Keyword(s):  
Mathematical Model ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Control Group ◽  
Toxic Substances ◽  
Healthy Children ◽  
Endogenous Intoxication ◽  
Complicated Course ◽  
Complicated Acute Appendicitis

Endogenous intoxication, which accompanies the complicated course of acute appendicitis in children, is one of the serious conditions, which are the main cause of complications in the postoperative period. Diverse clinical observations done by clinicians suggest that despite the use of modern technologies in operating equipment, anesthetic support, the number of complications in the postoperative period has no tendency to decrease, and the main cause of lethal outcomes with appendicular peritonitis is lightning development of severe degree of endotoxicosis, which develops as a result of resorbing toxic substances formed of many components, including pathogenic microflora and destruction metabolism. Purpose. Creation of a mathematical model for prediction of complicated acute appendicitis in children using the functions of regression analysis of EXCEL spreadsheet by approximating experimental data. Materials and methods. In the work, there is information about 59 patients with acute appendicitis treated at the clinic of pediatric surgery at the National Pirogov Memorial Medical University. The data on patients were divided into two groups: patients with not complicated course of pathology – 24 patients, and patients with complicated course of acute appendicitis – 35 children. The control group served the data of 37 healthy children. In each of the three groups, the following parameters were studied: gender, age, bed day, duration of the disease, presence of symptoms of peritoneal irritation, the nature of exudate in the abdominal cavity, the number of red blood cells, hemoglobin, leukocytosis, quantitative characteristics of white blood formula, ESR, cellogenic endogenous intoxication: leukocyte index of intoxication and hematological index of intoxication. All the data were determined directly at the time of hospitalization of a patient to the hospital. Results. Discussion. Based on multiple correlation x = f (x1 , x2 ) a two-factor mathematical model of probability of the complicated course of acute appendicitis in children was created. According to the obtained results of the study of the system of three equations with three unknowns, it was established that if the indicator of the form of the disease is y = 2.67 and above, when, in numerical terms, the result falls into the zone of complicated flow of acute appendicitis and completely coincides with data analysis of the three groups of patients. Conclusions. The components that determine the uncomplicated course of acute appendicitis in children, according to the developed two-factor model, include LII and GPI, which exceed the values intoxication of certain intervals studied at the time of hospitalization. The analyzed indices were determined by the degree of severity of the pathological process, duration of disease, virulence of microflora and age of patients against the background of the formed endogenous intoxication syndrome.

scholarly journals A Rare Case of Unrecognized and Uncommon Bladder Perforation after Transobturator Tape Procedure

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Ercüment Kılınç ◽  
Yaşam Kemal Akpak
Keyword(s):  
Case Report ◽  
Postoperative Period ◽  
Open Surgery ◽  
Rare Case ◽  
Transobturator Tape ◽  
Bladder Perforation ◽  
Woman Patient ◽  
Significant Step

The transobturator tape (TOT) procedure has become practically widespread worldwide. Complications seem to be rare, but recognizing them intraoperatively is the most significant step because some of the complications which may appear in postoperative period can be challenging for both physicians and patients. The purpose of this case, with this patient who was operated on with open surgery, is to evaluate this rarely seen unrecognized and uncommon bladder perforation after TOT procedure and thus make some contribution to the literature. Here, we present a case report about the treatment of a 48-year-old woman patient with unrecognized and uncommon bladder perforation after TOT procedure, 5 months postoperatively. Cystoscopic evaluation is not recommended routinely, but it must be performed if the patient is complicated enough to create doubt and also the surgeon's skill and ability are not sufficient enough to operate decently.

Immunity indices in patients with late localized forms of postnatal infection

1998 ◽  
Vol 79 (5) ◽  
pp. 377-378
Author(s):  
V. S. Gorin ◽  
N. N. Semenkov ◽  
N. N. Yasinskaya ◽  
L. V. Renge ◽  
S. G. Zhabin
Keyword(s):  
Immune System ◽  
Postoperative Period ◽  
Phagocytic Activity ◽  
Immune Status ◽  
Postnatal Period ◽  
System Response ◽  
Delivery Method ◽  
Complicated Course ◽  
Immune System Response ◽  
Postnatal Infection

The state of cellular and humoral components of the immune system, phagocytic activity of peri pheric blood neutrophiles in 76 puerperas in late postnatal period is studied. The changes in the immune system response depending on the delivery method, the presence of postnatal complication as endometritis are revealed in puerperas with the complicated course of postnatal period. The pronounced changes in immune status confirming the developed second immunodeficiency accompanied by the gravest course of postnatal endometritis are revealed in puerperas with the complicated course of postoperative period.

scholarly journals Complex evaluation of endothelial dysfuncion markers for prediction of outcomes in coronary surgery.

2018 ◽  
Vol 95 (11) ◽  
pp. 1026-1034
Author(s):  
Sergei L. Mikheev ◽  
I. A. Mandel ◽  
Yu. K. Podoksenov ◽  
Yu. S. Svirko ◽  
I. V. Sukhodolo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Coronary Artery Bypass ◽  
Postoperative Period ◽  
Artery Bypass ◽  
No Production ◽  
Coronary Surgery ◽  
Group I ◽  
Complicated Course ◽  
Group Ii

Objective: to evaluate the dynamics of endothelial dysfunction markers during coronary artery bypass grafting (CABG) and to estimate their significance as predictors of postoperative complications in coronary surgery. Methods. The study included 30 patients scheduled for coronary artery bypass surgery (CABG) with cardiopulmonary bypass. We determined the concentration of endothelial dysfunction markers is blood plasma, including endothelin-1 (ET-1) and nitric oxide metabolites: total content (NOx.total), nitrite (NO2-) and nitrate (NO3-) before the surgery, at the end of the surgery and 24 hours postoperatively. Results. 5 patients (16,7%) demonstrated the complicated course of postoperative period (group I). In this group there was a significantly higher level of ET-1 in all three control points: before the surgery, at the end of the surgery and 24 hours postoperatively (p = 0,012; p = 0,010; p = 0,015) comparing to group II (uncomplicated course). Concentration of NO3- at the end of the surgery was substantially lower than in group II - 3,98 (1,96-5,82) and 10,53 (7,39-14,15) µmol/l, accordingly (p = 0,041). Concentration of NO2- before the surgery was about the same in both groups, but at the end of the surgery concentration of NO2- was significantly lower in group I comparing to group II - 0,34 (0,18-0,53) and 1,12 (0,85-1,40) µmol/l, accordingly, p = 0,001. Conclusion. High level of ET-1 at all stages of the surgery, as well as decline of NO2- and NO3- levels by the end of the surgery may be regarded as predictors of complicated course of postoperative period in CABG patients. Overproduction of ET-1 and imbalance of NO production during CABG may facilitate microcirculatory dysfunction and multiple organ failure.

Acute Cholecystitis in the Postoperative Period

1963 ◽  
Vol 269 (6) ◽  
pp. 289-292 ◽  
Author(s):  
Ronald J. Knudson ◽  
William F. Zuber
Keyword(s):  
Acute Cholecystitis ◽  
Postoperative Period

scholarly journals Dexmedetomidine in anaesthesia for laparoscopic surgery for acute cholecystitis

Pain medicine ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 37-42
Author(s):  
O A Halushko ◽  
V I Mamchich ◽  
T V Savchuk ◽  
V V Donets ◽  
M O Chayka
Keyword(s):  
Laparoscopic Surgery ◽  
General Anesthesia ◽  
Acute Cholecystitis ◽  
Postoperative Period ◽  
Artificial Ventilation ◽  
Body Position ◽  
Anesthetic Care ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background. In laparoscopic cholecystectomy (LCE), general anesthesia has its own characteristics due to the creation of pneumoperitoneum, changes in body position and adsorption of insufflated gas, which causes the occurrence of perioperative complications and requires improvement of anesthesiology programs. Objective: to determine the efficacy and safety of combined low opioid anesthesia based on dexmedetomidine in complex anesthesia in patients undergoing laparoscopic surgery for acute cholecystitis. Materials and methods. In total, the study included 163 patients undergoing LCE under general anesthesia. All patients were divided into 3 groups according to the anesthetic care scheme. In Group 1 (n=56), low-opioid anesthesia (dexmedetomidine, lidocaine, fentanyl 1–2 μg/kg/h) and artificial ventilation were performed; Group 2 (n=52): propofol with fentanyl (4–6 μg/kg/h) and artificial ventilation. In Group 3 (n=55): anesthesia with sevoflurane in combination with fentanyl and artificial ventilation. Results. Hyperdynamic reactions were observed in Group 2 and Group 3 at the beginning of the operation: heart rates and BP values after induction, with intubation in the 3rd, 5th and 7th minute of pneumoperitoneum, were slightly higher in Group 2 and 3 than in Group 1. However, moderate bradycardia was observed in Group 1 more often – in 5 patients (8.92%) than in patients in Group 2 and Group 3 – 2 cases (3.84%) and 2 cases (3.64%), respectively. The total number of injected analgesics during LCE was: in Group 1 – 141.52±23.64 μg, in Group 2 – 426.92±39.41 μg, in Group 3 – 354.75±28.63 μg (p <0.01). Only one patient in Group 1 required ondansetron for the treatment of PONV compared to 5 and 4 in Group 2 and Group 3, respectively (p <0.05). None of the patients in all groups reported “feeling” intraoperative events or “awakening during surgery”. Conclusions. The use of dexmedetomidine with lidocaine infusion three times reduced the use of opioids in the intraoperative period and to refuse their use in the postoperative period. With the use of low-opioid anesthesia in the postoperative period, the frequency of hypertensive reactions and tachycardia did not increase, but in the postoperative period, these p

scholarly journals About difficulties in the examination of the quality of medical care in the complicated course of the postoperative period after cystectomy

2020 ◽  
Vol 7 (4) ◽  
pp. 164-174
Author(s):  
K. N. Movchan ◽  
K. E. Chernov ◽  
B. S. Artyushin ◽  
A. V. Zharkov ◽  
A. Yu. Chernova
Keyword(s):  
Medical Care ◽  
Postoperative Period ◽  
Large Scale ◽  
Malignant Tumors ◽  
Special Role ◽  
Urological Oncology ◽  
Bladder Diseases ◽  
Complicated Course ◽  
Quality Of Medical Care ◽  
Favorable Clinical Outcome

Cystectomy, as a type of surgical treatment, is performed for various diseases of the bladder. Most often — with malignant tumors, as well as with benign pathological conditions. Complications in the postoperative period in patients undergoing cystectomy are mainly caused by the need to ensure adequate urine derivation. One of the options for solving this problem is the implementation of ileocystoplasty, which, in turn, is associated with the performance of technically difficult and large-scale manipulations during the operation. Successful prevention of severe complications of cystectomy (or their elimination) is probably possible only in those multidisciplinary medical organizations in which the provision of medical care to patients with urological oncology is a daily programmed activity. Outpatient health care specialists play a special role in routing patients with bladder diseases, and not only their formal referral and delivery to multidisciplinary medical and prophylactic institutions in an emergency mode with “on-duty” syndromic diagnoses such as “renal colic or hematuria”. At present, in St. Petersburg, all conditions have been created for the concentration of patients with severe diseases of the bladder in a number of specialized medical organizations, in which a large number of cystectomies with intestinal plastic are routinely performed annually, which makes it possible with a high probability to guarantee a favorable clinical outcome without discrediting method of the rarity of its implementation.

scholarly journals IMPROVING THE RESULTS OF THE LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH COMPLICATED COURSE OF THE CALCULOUS CHOLECYSTITIS

2019 ◽  
Vol 72 (5) ◽  
pp. 790-794
Author(s):  
Oleg Y. Kanikovskyi ◽  
Yaroslav V. Karyi ◽  
Yura V. Babiichuk ◽  
Yevhen V. Shaprynskyi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gallstone Disease ◽  
Results Of Treatment ◽  
Bile Duct Injuries ◽  
Group I ◽  
Complicated Course ◽  
Duration Of Disease ◽  
Group Ii ◽  
Calculous Cholecystitis

Introduction: The laparoscopic cholecystectomy (LCE) has become “gold standard” in treatment of the gallstone disease (GSD). However, introduction of LCE is accompanied by increase in the frequency of the bile duct injuries by 2-5 times, and transfer to the conversion offsets main advantages of the laparoscopic access. The aim: Тo improve the results of treatment of the patients with complicated course of the calculous cholecystitis by developing new methods of the laparoscopic cholecystectomy. Materials and methods: The results of surgical treatment of 420 patients with complicated course of the calculous cholecystitis were analyzed. The patients were divided intwo groups: group I (n = 210) where the standard four-trocar LCE was used and the group II (n = 210) where the developed methods of LCE were used. The average age made up 62 ± 6.0 years. Duration of disease made up from 1 month to 35 years. Results: The patients in group I LCE with complicated course of the acute cholecystitis was performed in 108 (25.7%) cases, chronic – in 102 (24.3%) cases. The patients in group II surgical intervention with complicated course of the acute cholecystitis was performed in 112 (26.7%) cases, chronic – in 98 (23.3%) cases. The patients of group I intraoperative injuries were observed in 12 (5.7%) cases and patients of group II – in 4 (1.9%) cases. The conversion was applied in 13 (6.2%) and in 4 (1.9%) cases, respectively. 2 (0.9%) patients died. Conclusions: Introduction of the developed methods of LCE with complicated course of the calculous cholecystitis allows to reduce the frequency of intraoperative injuries by 3,8% and conversion rate – by 4,3% (p <0,001).

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