scholarly journals Experience of application of interventional sonography in treatment of patients with bacterial hepatic abscesses

2020 ◽  
Vol 87 (3-4) ◽  
pp. 31-34
Author(s):  
M. V. Bezruchko ◽  
S. I. Panasenko ◽  
O. S. Osipov ◽  
V. S. Drabovskyi ◽  
Ya. V. Rybalka
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Bile Leakage ◽  
Complex Configuration ◽  
Abscess Cavity ◽  
Hepatic Parenchyma ◽  
Sonographic Guidance ◽  
Results Of Treatment ◽  
Bed Days ◽  
Dynamical Control

Objective. To analyze the possibilities and efficacy of application of the intervention sonography in complex surgical treatment of patients with bacterial hepatic abscesses. Materials and methods. Results of treatment of 39 patients with hepatic abscesses in Department of Surgery № 3 through period from 2012 till June 2019 yr was presented. The patients were treated, using the puncture aspiration or drainage of abscesses under sonographic guidance. In hepatic abscesses with diameter up to 40 mm a puncture sanation was applied. In all the patients transcutaneous drainage was performed, not depending from the abscesses dimensions and localization. Results. Treatment and application of the intervention sonography was effective in 37 (94.9%) patients. Postoperative complications have occurred in 4 (10.3%) patients: hemorrhage inside the abscess cavity (in 2), durable bile leakage via the drain (in 1), migration of the drain from the abscess cavity (in 1). Average stationary stay of the patients was (19,2 ± 1,6) bed-days. Conclusion. Application of the puncture-draining procedures under sonographic control in treatment of patients, suffering hepatic abscesses constitutes a method of choice, what is caused by their small traumaticity, availability of dynamical control and efficacy in 94.9% patients. But these procedures owe some limitations, connected by the abscesses quantity, their localization, as well as complex configuration and big possibility of presence of large sequesters of necrotized hepatic parenchyma.

Surgical management of synchronous colorectal liver metastases: Simultaneous versus staged resections.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 616-616
Author(s):  
Igor Shchepotin ◽  
Andrii Lukashenko ◽  
Olena Kolesnik ◽  
Anton Burlaka
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Liver Metastases ◽  
Metastatic Cancer ◽  
Economic Effect ◽  
Hepatic Metastases ◽  
Group A ◽  
Bed Days ◽  
Group B

616 Background: Surgical treatment of metastatic colorectal cancer remains the only method that improves overall 5-year survival. This study aimed to compare the surgical outcome and survival benefit between synchronous and staged resection of liver metastases from colorectal cancer. Methods: Clinicopathologic data, treatments, and postoperative outcomes from 110 patients who underwent simultaneous (48 patients, group A) or staged (62 patients, group B) colorectal and hepatic resections at clinic of National cancer institute in period of 2008-2013 were reviewed. Results: Postoperative complications in patients with simultaneous resections (group A) were observed in 13 cases (27.1%), including 5, 1, 4, 2, 0, and 1 of grades I, II, IIIa, IIIb, IV, and V, respectively. Similar results have been reported in group B after staged resections, where overall postoperative complications registered in 16 patients (25.8 %), including 4, 3, 6, 3, 0 of grades I, II, IIIa, IIIb, and IV respectively. Overall level of post-operative complications in the groups A and B after surgical stages finishing did not differ statistically (p=0.96). Shorter operative intervention duration was registered in the group A – (311±10.1) min, whereas in the group B it was (496.6±16.2) min (р<0.001). Patients after staged resection stayed in clinic for a longer time – 23.9±0.8 bed-days, when simultaneous resections provided with shorter recovery terms in post-operative period – 9.8±0.5 bed-days (p<0.001). Overall 3-year survival in the group of patients with simultaneous resections (group А) was 42 % and in the group B 55 % (р=0.22). Conclusions: Analysis of our research indicated necessity of the development of differentiated approach in management of synchronous colorectal liver metastatic cancer. Simultaneous resections of colorectal cancer primary lesions and hepatic metastases were safe and could serve as a primary option for selected patients. Subsequent research should be directed towards study of prognosis factors and criteria for patients’ selection for surgical treatment groups, assessment of economic effect, and patients life quality.

scholarly journals Surgical treatment of patients with abdominal sepsis taking into account the prediction of the implementation of re-operations

2020 ◽  
Vol 87 (1-2) ◽  
pp. 24-29
Author(s):  
I. A. Kryvoruchko ◽  
M. S. Antonova ◽  
O. V. Yevtushenko ◽  
S. A. Andreieshchev
Keyword(s):  
Septic Shock ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Roc Curves ◽  
Abdominal Sepsis ◽  
Treatment Results ◽  
Results Of Treatment ◽  
Closed Treatment ◽  
Optimal Approach ◽  
Sepsis And Septic Shock

Objective. The investigation objective was improvement of the surgical treatment results in patients, suffering аbdominal sepsis, using individualized tactics of treatment, taking into account a possibility for the postoperative complications occurrence and the treatment results prognostication. Маterials and methods. The results of treatment of the adult patients, suffering abdominal sepsis in 2009 – 2019 yrs, excluding an acute cholecystitis cases, were analyzed. The patients were divided retrospectively and prospectively in accordance to the Sepsis–3 classification. Of them 130 have suffered peritoneal sepsis, 33 – intestinal one, and 38 – pancreatogenic abdominal. The results estimation was compared with application of modern systems: APACHE–II, Mannheim іndex of peritonitis (MPI), MODS and SOFA. The indices were estimated on the 1st, 2nd, 3rd and 4th postoperative days before subsequent outcomes of a primary operation. Results. The prognosis systems with a square under the ROC–curve (AUC) > 0.8 have included MPI only for determination of indications for reoperations: the ROC–curves value for the first subgroup (the closed treatment) have constituted 0.73, for the second subgroup (reoperations in accordance to indications) – 0.91, and for the third – 0.84 (the programmed reoperations). But in the patients of first subgroup this index have constituted 0,73, indicating its application restricting the decision making process, concerning the reoperations efficacy in patients with absence of the septic shock signs. Conclusion. Calculations of the occurrence possibility for postoperative complications and mortality in patients, depending on their preoperative state severity permits to select a most rational tactics of treatment. Most optimal approach for the rate reduction of postoperative complications occurrence and mortality in patients with abdominal sepsis and septic shock is performance of reoperations in accordance to indications to control the infection source, if it is possible.

scholarly journals The choice of surgical treatment method of patients with bacterial liver abscesses

2012 ◽  
Vol 93 (2) ◽  
pp. 265-269 ◽  
Author(s):  
A P Tolstikov
Keyword(s):  
Postoperative Complications ◽  
Ultrasound Guidance ◽  
Comparison Group ◽  
Average Duration ◽  
Abdominal Cavity ◽  
Bile Leakage ◽  
Main Group ◽  
Early Postoperative Complications ◽  
Liver Abscesses ◽  
Bed Days

Aim. To improve the results of surgical treatment of patients with bacterial abscesses of the liver. Methods. During the period from 2000 to 2010 treated were 118 patients with bacterial liver abscesses, 75 men and 43 women aged from 18 to 80 years (mean age 52.1 years). Management of the patients was based on the developed algorithm of diagnosis and treatment of liver abscesses. Two groups of patients were formed: the main group (treatment consisted of percutaneous puncture and drainage of the abscesses under ultrasound guidance) - 94 patients, the comparison group - 24 patients. In the comparison group surgical interventions were performed using the transabdominal access: laparotomy, opening and drainage of the abscess (18 patients), hepatic resection (3 patients), left-sided hemihepatectomy (2 patients), right-sided hemihepatectomy (1 patient). Results. In the patients of the comparison group the following early postoperative complications developed: wound infection - 4, intra-abdominal hemorrhage - 1, bile leakage - 1, abscesses of the abdominal cavity - 2, exudative pleuritis - 2, pneumonia - 3 cases. The average duration of patient hospitalization was 19.5±1.6 bed-days. In the main group the average duration of patient hospitalization was 9.2±±0.6 bed-days. Early postoperative complications in patients of the main group included: intra-abdominal hemorrhage - 1, bile leakage - 1, abscesses of the abdominal cavity - 1, exudative pleuritis - 2, pneumonia - 2 cases. There were no deaths in either of the groups. Conclusion. Puncture and drainage of bacterial liver abscesses under ultrasound guidance is an effective method of treatment that makes it possible to reduce the number of abdominal operations, reduce the number of postoperative complications and shorten the hospital stay.

scholarly journals Treatment Tactics and Complications After Surgical Treatment of HIV-Infected Patients With Extra-Articular Fractures of the Long Bones of Extremities

2020 ◽  
Vol 9 (3) ◽  
pp. 369-376
Author(s):  
N. G. Doronin ◽  
S. N. Khoroshkov ◽  
M. V. Naumenko
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Aseptic Loosening ◽  
Infectious Complications ◽  
Long Term Results ◽  
Long Bones ◽  
Results Of Treatment ◽  
Articular Fractures ◽  
Fracture Consolidation

The aim of the study is the comparative analysis of the long-term results of treatment of extra-articular fractures of the long bones in HIV-infected and non-HIV-infected patients.Material and methods. In the presented study, a comparative analysis of the results of surgical treatment of 90 HIV-infected and 112 HIV-uninfected patients with extra-articular fractures of the long bones of the extremities aged from 23 to 54 years was performed.Results. HIV-infected patients are mainly characterized by non-infectious complications from the postoperative wound (formation of seromas, hematomas, dehiscence of the edges of wounds, delayed healing), aseptic loosening and migration of fixators, and delayed consolidation of fractures. The presence of statistically significant relationships between the factors characterizing the course of HIV infection (stage of the disease, the number of CD4 + lymphocytes, the ratio of CD4/CD8 + lymphocytes, viral load) and the risk of postoperative complications was revealed.Conclusion. Thus, the use of standard algorithms for determining the tactics and method of treatment of extra-articular fractures of the long bones of the extremities in HIV-infected patients leads to a significant number of unsatisfactory treatment results (up to 31.1%). For HIV-infected patients, the most typical complications are postoperative wounds, impaired fracture consolidation processes and aseptic loosening of metal fixators, which can lead to the development of infectious complications without proper attention. Expansion of research in this area with an increase in the number of observed contingents will make it possible to develop a scientifically based scale for predicting the development of possible postoperative complications in this category of patients.

scholarly journals Results of surgical treatment of patients of elderly and senile age with complicated forms of locally advanced colon cancer

2019 ◽  
Vol 11 (2) ◽  
pp. 35-42
Author(s):  
N. I. Glushkov ◽  
T. L. Gorshenin ◽  
M. Ya. Belikova ◽  
S. K. Dulaeva ◽  
I. K. Borovik
Keyword(s):  
Colon Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Locally Advanced ◽  
Results Of Treatment ◽  
Advanced Colon Cancer

The paper analyzes the results of treatment of 74 elderly and senile patients with complicated forms of locally advanced colon cancer. The article demonstrates the prevalence of symptomatic operations due to the severity of the condition advanced oncological process. The use of endovideosurgical technologies in treating patients with complications of locally advanced colon cancer reduces the number of postoperative complications.

scholarly journals Pneumonectomy in the treatment of tuberculosis relapse in a previously resected lung

2020 ◽  
Vol 179 (2) ◽  
pp. 11-19
Author(s):  
D. B. Giller ◽  
A. A. Glotov ◽  
O. Sh. Kesaev ◽  
E. M. Glotov ◽  
Ya. G. Imagogev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Clinical Effect ◽  
High Efficiency ◽  
Radical Surgery ◽  
Surgical Techniques ◽  
Results Of Treatment ◽  
Completion Pneumonectomy ◽  
Medical Indications ◽  
Tuberculosis Relapse

THE OBJECTIVE of our study was to increase the efficiency of treatment of tuberculosis postoperative reactivations in a previously operated lung, by clarifying the medical indications, improving surgical techniques and tactics when removing a previously resected lung.METHODS AND MATERIALS. We analyzed the results of treatment of 220 patients who, in the 2004–2017 timeframe in our institution, had pneumonectomies (76 cases) and pleuropneumonectomies (144 cases) for tuberculosis relapse in a previously operated lung. For more objective planning of surgical treatment and evaluation of its results, we identified three degrees of treatment radicalism: radical, conditionally radical, and palliative.RESULTS. 32 patients, who had carried a radical surgery, were diagnosed as having a complete clinical effect at the time of discharge (absence of destruction cavities in a single lung, bacterial excretion and illiquid complications) in 100 % of cases; in the group of patients operated conditionally radical, there were diagnosed 161 out of 168 (95.8 %) and in the group of patients operated palliative, there were distinguished only 3 cases out of 20 (15.0 %).CONCLUSION. The implementation of the completion pneumonectomy and pleurapneumonectomy is accompanied by high technical complexity and more frequent development of intraoperative and postoperative complications. At the same time, the high efficiency of treatment of tuberculosis relapses in a previously operated lung can be achieved using the recommended tactics and techniques of surgical treatment when performing radical and conditionally radical interventions.

scholarly journals MODERN VIEWS ON THE TREATMENT OF PERFORATED PYLORODUODENAL ULCERS

2021 ◽  
pp. 33-36
Author(s):  
D. O. Smetskov ◽  
N. M. Нoncharova ◽  
S. M. Teslenko ◽  
P. V. Svirepo ◽  
A. V. Sivozhelizov ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Traditional Method ◽  
Early Postoperative Period ◽  
Perforated Ulcer ◽  
Laparoscopic Suturing ◽  
Ulcer Disease ◽  
Surgical Department ◽  
Results Of Treatment

Summary. Purpose: to improve the results of surgical treatment of patients with perforated pyloroduodenal ulcer. Materials and methods. The results of treatment of 101 patients operated on for perforated pyloroduodenal ulcer, which were treated in the surgical department for the period from 2015 to 2020, were analyzed. Results and discussion. Laparoscopic interventions were performed in 56 (55.4 %) patients with perforated ulcer. Excision of perforated ulcer by traditional laparotomy without vagotomy was used in 26 (25.7 %) patients. Suturing of perforated ulcer by traditional method without vagotomy was performed in 19 (18.8 %) patients. Complications of the early postoperative period in 8 (7.9 %) patients were surgical in nature. In 27 (26.7 %) patients postoperative complications were specific associated with the performance of dilated pyloroduodenoplasty. The largest number of postoperative complications was observed in patients who underwent suturing of the ulcer using traditional laparotomy access – 17 (16.8 %), of which general surgery – 6 (5.9 %), specific – 11 (10.9 %). Conclusions. Laparoscopic suturing of perforated ulcers is accompanied by less pronounced pain, a decrease in the number of postoperative complications, which requires greater use of endovideo-surgical technologies in this complication of peptic ulcer disease.

scholarly journals Staged surgical treatment of cholangiogenic abscesses of the liver

2020 ◽  
pp. 20-23
Author(s):  
V. V. Boyko ◽  
V. M. Lykhman ◽  
D. A. Miroshnichenko ◽  
A. A. Merkulov ◽  
S. V. Tkach ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Mortality ◽  
Treatment Method ◽  
Stage Ii ◽  
Abscess Cavity ◽  
Controlled Drainage ◽  
Results Of Treatment ◽  
Liver Abscesses ◽  
Single Lumen

The aim of the work: to improve the results of treatment of patients with cholangiogenic liver abscesses by means of staged treatment methods using minimally invasive interventions. Materials and Methods. 82 patients with cholangiogenic liver abscesses aged 21 to 80 years who underwent 130 operations were examined and treated. The main group consisted of 40 (48.4 %) patients who underwent ultrasound-controlled drainage of abscess cavities (stage I), followed by removal of the source of cholangiogenic abscesses (stage II). The comparison group consisted of 42 (51.6 %) patients who underwent rehabilitation and drainage only with laparotomy access. Results and Discussion. Minimally invasive methods of surgical treatment included ultrasound-controlled drainage with simultaneous rehabilitation of abscess cavities. The dimensions of the cavities averaged (150±23.3) cm³. One drainage was used to drain the liver abscess with a diameter of up to 10.0 cm. When the diameter of the abscess was more than 5.0 cm, drainage was carried out by two single-lumen tubes followed by suction-flow washing of the abscess cavity. Monitoring the standing of the drainage and reducing the cavity of abscesses was carried out on 3, 7, 14 days after setting. The drainage tube was removed after the disappearance of the cavity according to ultrasound and control fistulography, which coincided with the normalization of the general condition and body temperature, the disappearance of signs of purulent intoxication. Duration of drainage averaged from 7 to 30 days (an average of 15.2). The proposed treatment method is not very traumatic, the ability to control the effectiveness of the treatment, and most importantly – positive results in 87 % of patients. Second stage in 38 (95 %) was performed laparoscopic cholecystectomy of technical features. The optimal duration of stage II was considered (13±3) days after extraction of the drainage. In the diagnosis and treatment of cholangiogenic liver abscesses, it is necessary to use puncture ultrasound-controlled drainage methods. The stage-by-stage treatment of cholangiogenic liver abscesses with rehabilitation of the abscess cavity made it possible to reduce the incidence of sepsis from 9.5 to 2.5 %, reduce postoperative mortality in extremely severe patients to 2.4 %, and develop complications by 7.3 %.

scholarly journals Medical treatment of hernia of abdomen wall with the use of different plastic materials

2019 ◽  
Vol 23 (2) ◽  
pp. 263-266
Author(s):  
S. D. Khimich ◽  
M. D. Zheliba ◽  
A. I. Reva ◽  
A. V. Funikov ◽  
A. P. Prevar ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Skin Flap ◽  
Postoperative Wound ◽  
Satisfactory Condition ◽  
Results Of Treatment ◽  
Plastic Materials ◽  
Significant Difference ◽  
Antimicrobial Film ◽  
Bed Days ◽  
The Cost

The purpose of the work is to analyze the results of surgical treatment of hernias using different methods of hernioplasty. The results of treatment of 176 patients with abdominal hernias, which were monitored from 1995 to 2008, were analyzed. Patients were divided into 2 groups. The first group (85 patients) included patients who underwent surgical treatment with autodermal plasty. Second group (91 patients) consisted of patients who underwent hernioplasty using mesh allografts. All patients were comprehensively examined. In obese patients, an antimicrobial film was used to glue the skin under the mammary glands and “folds of the abdomen” to prevent microbial contamination of the wound. All operated patients had a normal postoperative condition, and the postoperative period in both groups was almost the same. We did not observe complications from the side of the postoperative wound in patients of the 1st group. The wounds healed by primary intention. All patients were discharged on the 8–10 day in satisfactory condition. 2 relapses were noted: in one patient 1 month after surgery, in the second — 10 years after surgery. In the 2nd group, suppuration of the postoperative wound was observed in a patient with a II degree of obesity. The average number of bed-days in the 2nd group was approximately the same as in the 1st group. The number of bed-days statistically significantly increased with an increase in the degree of obesity in these patients. Thus, the use of mesh allografts is an effective method of treating hernias and they should be used strictly according to indications. Autodermal plastic surgery using a skin flap is also a reliable surgical method for the treatment of hernias. A significant difference in the indices in the treatment of patients of both groups (with the exception of the cost of mesh allografts) was not found.

scholarly journals Laparascopic Hernia Repair with the Use of TiNi-based alloy

2017 ◽  
Vol 2 (1) ◽  
pp. 193 ◽  
Author(s):  
G.Ts. Dambaev ◽  
V.E. Gunther ◽  
A.V. Menschikov ◽  
M.M. Solovyov ◽  
E.A. Avdoshina ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
World Literature ◽  
Injury Rate ◽  
Everyday Practice ◽  
Results Of Treatment ◽  
The Everyday ◽  
Endoscopic Methods

The reduction of the endoscopic methods of the inguinal hernia surgical treatment to the everyday practice of the surgery departments led to the better results of treatment. However, the recurrence rate remain sat the level of 2.2-4.4%, and the rate of the intraoperative and postoperative complications is 8%. The paper describes treating 78 patients (59 pations underwent the reduction of the endoscopic methods of the inguinal hernia surgical treatment to the everyday practice of the surgery departments led to the better results of treatment and 19 patients underwent the laparoscopic transabdominal hernia repair with the usage of porous nickelid titanium. in the period from 2000 to 2016. It shows a procedure of installing porous nickelid titanium, gives the obtained results of the procedure and analizes the experience of world literature. The procedure of the laparoscopic hernia repair allows to lessen the injury rate of the surgery, to lessen the possibility of the postoperative complications and to simplify the medical staff work.

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