scholarly journals Transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control in surgical treatment of hemorrhoids

2020 ◽  
Vol 87 (11-12) ◽  
pp. 62-66
Author(s):  
A. A. Nykonenko ◽  
G. I. Okhrimenko ◽  
E. I. Haidarzhi ◽  
N. G. Golovko ◽  
I. V. Zubryk ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Main Group ◽  
Control Group ◽  
Results Of Treatment

Objective. To study the immediate and late follow-up results of treatment in patients, suffering hemorrhoids, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was done, and to compare them with results of treatment in patients, operated in accordance to procedure of standard hemorrhoidectomy. Materials and methods. There were analyzed the results of treatment of 111 patients, suffering hemorrhoids. The main group have consisted of 50 patients, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was performed. Into control group 61 patients were included, who were operated in accordance to Parks procedure. Results. In the main group the average time of the operation have constituted (50.1 ± 1.4) min, the patient stationary stay - (9.9 ± 0.7) days, the pain syndrome intensity in postoperative period was estimated as 2 - 3 points, what have appeared significantly lesser, than in the control group of the patients (p < 0.01). Good late follow-up results were achieved in 100% patients of the main group and in 88% of the control group. Conclusion. There was established, that transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control permits to reduce essentially the average time of the operation, the patients’ stationary stay, to lower the pain syndrome intensity, and to improve late follow-up results of the hemorrhoids treatment.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

scholarly journals IMPROVING THE RESULTS OF TREATMENT OF PATIENTS WITH URETERAL CONCREMENTS AFTER CONTACT URETEROLITHOTRIPSY

2017 ◽  
Vol 4 (2) ◽  
pp. 8-12
Author(s):  
R. M. Solh ◽  
M. I. Andrukhin ◽  
O. V. Makarov ◽  
V. V. Fedchenkov
Keyword(s):  
Laser Therapy ◽  
Postoperative Period ◽  
Acute Pyelonephritis ◽  
Main Group ◽  
Ureteral Stones ◽  
Control Group ◽  
Results Of Treatment ◽  
Group 6 ◽  
Beta 2 ◽  
Beta 2 Microglobulin

Purpose. Im proving the results of treatment of patients with ureteral stones and reducing the dam aging effects of contact lithotripsy.Materials and methods. In this study, 48 patients were examined aged 20 to 63 years. All patients admitted to the urology department with diagnoses: urolithiasis, calculus of the ureter. In all cases contact ureterolithotripsy with stenting of the upper urinary tract were performed. The patients were divided into two groups: main and control. 25 patients (52 .1%) were included into the main group, which in the postoperative period, we used low-level laser therapy (L-therapy). 23 patients were included in a control group (47.9%) who did not receive low-laser therapy. Laboratory tests and ultrasound with Doppler renal blood vessels scan were performed on admission, on the first day after the operation and on the 5-th day of hospitalization. Low-intensity laser therapy was performed within 5 days after contact ureterolithotripsy on projection of placement of stone and kidney projection by series for 5 minutes.Results. All patients admitted to the hospital, were spared from ureteral stones. In the main group during the treatment with L-therapy a decrease in the level of beta-2 microglobulin to normal was observed. (4.8 ± 0.1 mg/l on the first day. On the 5th day 2 .3 + 0.1 mg/l). In the control group during the treatment without the use of L-therapy, the average level of beta-2 microglobulin decreased but did not reach normal levels. (5.5 ± 0.1 mg/l on the first day. On the 5th day 3,2 ±0, l mg/l).Resistance index in the study group decreased compared to the control. In the control group, cases of acute pyelonephritis were observed. The average hospital stay for patients of the main group (6 days) was less than in the control group (6 .5 + days).Conclusion. The use of laser therapy in the treatment of patients who did undergo ureterolithotripsy can reduce the length of stay of the patient in the hospital and reduce the risk of acute pyelonephritis in the postoperative period. Also it can reduce the damaging effect of lithotripsy on the renal tissues.

Experience of the usage of nabumetone in oncogynecologic patients

2017 ◽  
pp. 118-122
Author(s):  
S.M. Kartashov ◽  
◽  
E.M. Oleshko ◽  
Keyword(s):  
Antioxidant Activity ◽  
Postoperative Period ◽  
Comparison Group ◽  
Surgical Intervention ◽  
Malonic Dialdehyde ◽  
Pain Syndrome ◽  
Main Group ◽  
Narcotic Analgesics ◽  
Diene Conjugates ◽  
Results Of Treatment

Objective: to study the effect of nabumetone in oncogynecologic patients in the postoperative period. Materials and methods. There were examined 98 patients of 40-78 years old, who were divided into two groups: the main group - 58 patients, of which 37 - patients with endometrial cancer I-III and 21 - with ovarian cancer of II-IV stage (FIGO); The comparison group included 40 patients (17 and 23 patients respectively). All patients underwent surgical treatment. In the postoperative period, were used NSAIDs - nabumeton. Before the operation and on the 10th day of the postoperative period, the following parameters were studied: a clinical blood test, TNF-a, ceruloplasmin, diene conjugates (DC), malonic dialdehyde (MDA), antioxidant activity (AOA). The content of TNF-a, in the blood serum was determined by radioimmunological, and DC, MDA, AOA by biochemical method. Results. Established: the content of the leukocyte formula before the start of treatment in the compared groups did not reveal any significant differences. After surgical intervention, both groups showed an increase in the absolute values of all leukocyte fractions. The level of ceruloplasmin in the patients of the comparison group increased significantly in the postoperative period, and in the main group the parameters of ceruloplasmin did not differ significantly. The level of TNF-a in the pre- and postoperative period in the compared groups did not differ. On the 10th day of the postoperative period, it significantly increased in the comparison group, and when nabumetone was used during the postoperative period, the level of TNF-a did not increase. The initial indicators characterizing the processes of LPO and AOA in both groups did not differ significantly. Assessing the dynamics of indicators before and after the operation, it was noted that in patients in the blood, the level of DC in both the baseline and in the comparison group increased. The use of nabumethon led to a slight increase in DC. The maintenance MDA in the postoperative period has increased in both groups, however it is unreliable in comparison with parameters before surgical intervention. In the comparison group, after the treatment, the antioxidant defense was reliably reduced. In the main group, the use of nabumetone contributed to a smaller decrease in AOA. The use of nabumeton allowed abandoning of narcotic analgesics in earlier periods of the postoperative period. Conclusion. Use of nabumeton in the postoperative period allows to reduce the pain syndrome, the number of inflammatory complications; contributes to the normalization of LPO processes, inhibits the inhibition of the antioxidant system, which contributes to the reduction of endogenous intoxication and improves the results of treatment of oncogynecologic patients. Key words: nabumeton, oncogynecologic patients, anti-inflammatory action, tumor necrosis factor, ceruloplasmin, diene conjugates, malanialdehyde, antioxidant activity.

scholarly journals Use of PlateletRich Autoplasma in Complex Therapy of Knee Osteoarthrosis

2016 ◽  
pp. 40-45 ◽  
Author(s):  
A. I. Gorbatenko ◽  
N. O. Kostyanaya
Keyword(s):  
Pain Syndrome ◽  
Main Group ◽  
Control Group ◽  
Joint Function ◽  
Analog Scale ◽  
Number Of Patients ◽  
Pain Visual Analog Scale ◽  
Inflammatory Drugs ◽  
Efficacy Of Treatment

Efficacy of platelet-rich autoplasma (PRA) in treatment of osteoarthrosis was evaluated. Prospective study included 120 patients (83 females, 37 males, mean age 52.8±4.5 years) with clinical and roentgenologic diagnosis of II-IV stage osteoarthrosis by Kellgren-Lawrence classification. The patients from the main group (n=60) were on courses of PRA intraarticular injections (3 injections with 1-2 weeks interval). In the control group the patients received nonsteroidal anti-inflammatory drugs (NSAIDs) and periodically injections of glucocorticoids when indicated. Results were assessed by the verbal efficacy scale, Lequesne index and the pain visual analog scale. Follow up period made up 6 months. Use of PRA enabled to eliminate pain syndrome and improve knee joint function without adverse effects. In 6 months the number of patients who noted the efficacy of treatment was 31% higher in the main group than in the control one. The obtained results allow recommending PRA use for knee osteoarthrosis treatment as an alternative to NSAIDs especially in contraindications to the latter.

scholarly journals The choice of surgical treatment method of perforated pyloroduodenal ulcer

2021 ◽  
Vol 88 (1-2) ◽  
pp. 8-13
Author(s):  
D. V. Maksymchuk ◽  
V. I. Mamchich ◽  
V. D. Maksymchuk
Keyword(s):  
Surgical Treatment ◽  
Clinical Application ◽  
Pyloric Stenosis ◽  
Postoperative Period ◽  
Physiological Function ◽  
Treatment Method ◽  
Main Group ◽  
Control Group ◽  
Surgical Tactics ◽  
Suturing Methods

Objective. To develop a method of organ-saving operation aimed at preservation of the physiological function of the pylorus and the normal physiological functioning of the pyloroduodenal area in patients with combined perforated, stenotic pyloroduodenal ulcers. Materials and methods. The study included 60 patients who faced surgery treatment in relation to complicated combined perforated, stenotic pyloroduodenal ulcers. Depending on diagnostic and surgical tactics applied, patients were conditionally divided into two groups. The control group consisted of 30 patients who underwent standard suturing methods. The main group also consisted of 30 patients in whom the developed method was applicated. Results. In the control group at the postoperative period of 30 patients operated in different ways complications occurred in 12 persons or in 40% of cases. In the main group of 30 patients operated according to the proposed method, complication in the form of anastomositis occurred in 1 patient only. Conclusions. The obtained results substantiate recommendation to clinical application the suggested method of organ-saving operation aimed to preserve the physiological function of the pyloroduodenal area, which excludes perforated ulcers suturing without pyloric stenosis elimination and gastrectomy on the background of peritonitis.

Tenorrhaphy as an Alternative to Resection in the Treatment of Horizontal Strabismus in Children

2020 ◽  
pp. 26-30
Author(s):  
Y.I. Trilyudina ◽  
◽  
V.N. Kurochkin ◽  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Modified Technique ◽  
Resection Control ◽  
Standard Resection ◽  
Alternative Method ◽  
Additional Correction

Purpose. To evaluate the effectiveness of surgical treatment of horizontal strabismus by modified tenorrhaphy in comparison with standard resection in children. Material and methods. For 3 years (2017–2019), 560 patients with horizontal strabismus at the age from 2 to 14 years were operated. Of these, 288 patients (51.4%) underwent tenorrhaphy using a modified technique (main group) as augmentation surgery, 272 patients (48.6%) underwent classical resection (control group). Results. The average age of patients in the main group was 6 (3.46) years, in the control group – 5.8 (3.34) years. In the main group of patients, orthotropy was achieved in 85.4% of cases, in the control group – in 83.5% of cases, p = 0.523. The residual strabismus angle (up to 5°) was observed in 40 patients (14%) in the main group and in 44 patients (16.5%) in the control group of patients, p = 0.449. In the main group, additional correction of the residual angle was performed on the day after the operation using adjustable suture in 8 patients (2.8%). Reoperation in the long-term period was required for 10 patients (3.7%) in the control group and 3 patients (0.7%) in the main group, p = 0.039. Significant postoperative conjunctival thickening was found in 7.2% of patients in the main group. Conclusion. The effectiveness of tenorrhaphy is not inferior to classical resection and, in combination with recession (tenomyoplasty), gives predictable stable results. The tenorrhaphy method is technically simpler, safer, more physiological, can be easily corrected in the immediate postoperative period, has no risk of «losing» muscle and can be recommended as an alternative method of resection.

scholarly journals Immediate results of surgical treatment of peripheral hepatic cholangiocarcinoma in elderly and senile patients

2020 ◽  
Vol 87 (9-10) ◽  
pp. 48-53
Author(s):  
O. Yu. Usenko ◽  
O. V. Hrynenko ◽  
A. І. Zhylenko ◽  
O. O. Popov ◽  
A. V. Husiev
Keyword(s):  
Surgical Treatment ◽  
International Study ◽  
Main Group ◽  
Control Group ◽  
Results Of Treatment ◽  
Peripheral Cholangiocarcinoma ◽  
Acute Pulmonary Thromboembolism ◽  
Clinically Significant ◽  
Selection Of

Objective. To estimate immediate results of surgical treatment of peripheral cholangiocarcinoma in elderly and senile patients. Materials and methods. In 2004-2018 yrs period in the Department of Transplantation and Surgery of the Liver of the Shalimov National Institute of Surgery and Transplantology 84 patients, suffering peripheral cholangiocarcinoma, were radically operated: 31 (36.9%) patients older than 60 yrs (the main Group), and 53 (63.1%) patients, younger than 60 yrs (control Group). Results. Postoperative clinically significant (IIIa-IV degree in accordance to classification of Clavien-Dindo) complications during 90-days of postoperative period were noted in 29.1% patients of the main Group and in 32.1% patients of a control Group (p=0.262), postoperative hepatic insufficiency, in accordance to The International Study Group of Liver Surgery criteria, - in 16.1 and 22.6% accordingly (p=0.473); reoperation was performed in 9.6 and 9.4% patients, accordingly (p=0.973). The causes of postoperative lethality in 2 patients of the main Group were an acute myocardial infarction (1) and an acute pulmonary thromboembolism (1). Conclusion. Hepatic resection is characterized by satisfactory immediate results of treatment of peripheral cholangiocarcinoma in elderly and senile patients, if performed in highly-specialized multidisciplinary centre and thorough selection of patients.

scholarly journals Tactics of surgical treatment of deep intermuscular gluteal region phlegmons

2021 ◽  
Author(s):  
E.N. Byakova ◽  
V.K. Tatyanchenko ◽  
V.L. Bogdanov ◽  
Y.V. Sukhaya ◽  
Y.V. Krasenkov
Keyword(s):  
Surgical Treatment ◽  
Soft Tissues ◽  
New Technologies ◽  
Main Group ◽  
Gluteal Region ◽  
Control Group ◽  
Tissue Pressure ◽  
Results Of Treatment ◽  
Purulent Wound

Purpose. The purpose is to improve the results of treatment of patients with phlegmon of the gluteal region soft tissues by diagnosing the stage of tissue hypertension and determining the tactics of surgical treatment depending on this indicator. Materials and methods. Clinical studies were performed on 74 patients suffering from phlegmon of the gluteal region. All the patients were divided into 2 groups: in the main group (as opposed to the control group), acute tissue hypertension syndrome was diagnosed and decompressive fasciotomy was performed in tissue hypertension (30–35 mm Hg) (patent). The authors performed ultrasound cavitation and ozone therapy of a purulent wound. Results. With phlegmon of the gluteal region of soft tissues, an increase in tissue pressure by 25% above the norm is an indication for fasciotomy in the area of fascial nodes. The time of purulent wound cleaning against the background of normal tissue pressure (8–10 mm Hg) of the surgery in patients of the main group was reduced to 5 days (8 days in the control). In the long-term (0.5–1 years), good results were obtained in 92.8% of patients in the main group (64.7% in the control group). Conclusion. The developed tactics of treatment of patients with phlegmon of the soft tissues of the gluteal region are highly effective due to the development and application of new technologies for the diagnosis and treatment of tissue hypertension.

scholarly journals Comparative estimation of a pain syndrome in patients after combined operations for coexistent pathology of anal channel and rectum with application of modern and standard surgical technologies

2021 ◽  
Vol 88 (5-6) ◽  
pp. 36-41
Author(s):  
V. V. Balytskyy
Keyword(s):  
Surgical Treatment ◽  
Thin Layer ◽  
Radio Wave ◽  
Postoperative Period ◽  
High Frequency ◽  
Pain Syndrome ◽  
Coagulation Necrosis ◽  
Control Group ◽  
Combined Operations ◽  
Frequency Apparatus

Objective. Comparative estimation of the pain syndrome in patients with concomitant pathology of anal channel and rectum after performance of combined operations, using modern high-frequency electro-surgical and radio-surgical apparatuses, as well as conventional scalpel. Materials and methods. The results of surgical treatment of 689 patients with concomitant pathology of anal channel and rectum, using apparatuses of a high-frequency electro-surgery and radio-wave surgery, were analyzed, using the pain syndrome estimation on 1-7th postoperative day. The patients were distributed into 4 investigation groups and a control group, consisting of 112 patients, operated on using metallic conventional surgical scalpel. Results. The pain syndrome on the first postoperative day was mostly expressed in patients of control group, for anesthesia they needed (4 ± 1) ml of 2% solution of promedol, while the patients of the first, third and fourth groups investigated, in which, accordingly, apparatus of radio-wave surgery «Surgitron» and high-frequency electro-surgical apparatuses «EFA» and «KLS Martin» were used, needed for anesthesia (2 ± 1) ml of 2% solution of promedol. While application of the electro-surgical high-frequency apparatus «ERBE ICC 200» the necessity for the 2% solution of promedol for anesthesia have constituted (3 ± 1) ml. Conclusion. Combined operations, using modern apparatuses of high-frequency electro-surgery and radio-wave surgery give significantly better results, than application of conventional surgical metallic scalpel, because it produces significantly reduced pain syndrome due to thin layer of coagulation necrosis, promoting formation of delicate elastic cicatrix and preventing development of cicatricial strictures of anal channel in postoperative period.

scholarly journals Evaluation of the effectiveness of the use of functional electrical stimulation after VII-XII anastomosis in patients with facial nerve damage of various etiologies

2019 ◽  
pp. 21-27
Author(s):  
Andrej Bobrov ◽  
Oleg Borisenko ◽  
Volodimir Jus ◽  
Alexander Papp
Keyword(s):  
Electrical Stimulation ◽  
Surgical Treatment ◽  
Facial Nerve ◽  
Postoperative Period ◽  
Nerve Fibers ◽  
Main Group ◽  
Control Group ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Facial Muscles

Surgical treatment of lesions of the facial nerve by an hypoglossal-facial anastomosis takes a long time to re-sprout of the nerve fibers to the facial muscles. The recovery time of facial function after surgical treatment of patients with paralysis of the facial nerve is long enough and can start from 6-8 months after surgery and last up to 2 years. Thus, all this time the mimic muscles are in a state of denervation. The purpose of this work was to determine the effect of electrical stimulation of facial muscles in patients with lesions of the facial nerve of different etiology after hypoglossal -facial anastomosis. Materials and methods: To evaluate the results of the use of early postoperative transcutaneus electrical stimulation, a low frequency FES was used, starting from the 2nd month after performing a XII-VII anastomosis. Assessment of the recovery of facial nerve function was performed 1 year after surgery. The study included 88 patients who underwent surgery to restore facial nerve function - hypoglossal -facial anastomosis. The survey was divided into 2 groups. The first (main) group consisted of 28 patients who underwent FES of facial muscles in the postoperative period, and the second group (comparison) consisted of 60 patients who underwent XII-VII anastomosis according to the following by the same method, but no further pharmacological or physiotherapeutic agents were used that could affect facial nerve regeneration. Results and discussion: According to this scale, the surveyed control group after 12 months. After the operation of XII-VII anastomosis according to the classical method, the following distribution was observed: The 1st degree of recovery of facial nerve function was not present in any of the patients, the 2nd degree had 2 (3.33%) patients, the thirds - 28 (46, 66%), IV - 20 (33,33%), V - 6 (10%) and VI - 4 (6,66%). In patients in the main group (where FES was used), distribution by degrees of recovery of facial nerve function on the House-Brackman scale after 12 months. after surgery it had the following character: II degree had 2 (6.45%) examined, III - 17 (54.83%), IV - 5 (22.58%), V - 2 (7.4%) and VI - 2 (7.4%). Conclusions: A statistically significant difference was observed in the postoperative period when comparing the mean M-responses of mimic muscles registered at different times after surgery in control subjects compared with patients in the main group in which FES was used. In addition, in the main group, a significantly larger number of patients reported a recovery of FN function to grade III-IV on the House-Brackman scale. Therefore, based on the results of the evaluation of the function of FN on the House-Brackman scale and electromyographic examination data in patients who underwent XII-VII anastomosis, it can be argued that with the use of FES in the postoperative period of recovery of facial nerve function is significantly faster and more complete in compared to the control group.

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