scholarly journals MODIFIED SINGLE-SIDED LAPAROSCOPIC EXTRAVESICAL ANTIREFLUX OPERATION

2018 ◽  
Vol 8 (2) ◽  
pp. 24-32 ◽  
Author(s):  
V. I. Dubrov ◽  
S. G. Bondarenko ◽  
I. M. Kagantsov
Keyword(s):  
Surgical Treatment ◽  
Vesicoureteral Reflux ◽  
Standard Technique ◽  
Control Group ◽  
Historical Cohort ◽  
Distal Ureter ◽  
Basic Group ◽  
Antireflux Operation ◽  
Laparoscopic Techniques

Introduction. Laparoscopic techniques have been applied to ensure surgical treatment of the vesicoureteral reflux (VUR) in children during the last decades. We present the experience of using the laparoscopic extravesical antireflux standard and ureter-fixed modified surgery.Materials and methods. A multi-center prospective experimental clinical historical cohort two-group study of patients with III–V stage primary VUR. The basic group consisted of 48 children who had a unilateral laparoscopic extravesical surgery when the ureter was fixed according to the developed technique. 44 children who had a surgery according to the standard technique were included into the control group.Results. Complete VUR removal was noted in 100% of patients from the basic group and 81.2% of patients from the control group (р <0.01). Preservation of the megaureter with complete reflux resolution was seen in 1 child only (2.1%) from the basic group who had V stage VUR (p=0.2).Conclusions. Laparoscopic extravesical antireflux is a safe and effective surgery. Distal ureter fixation reduces the rate of VUR recurrences.

scholarly journals Results of laparoscopic extravesical antireflux operation in vesicoureteral reflux in children

2020 ◽  
Vol 17 (4) ◽  
pp. 427-436
Author(s):  
V. I. Dubrov ◽  
A. V. Strotsky
Keyword(s):  
Surgical Treatment ◽  
Vesicoureteral Reflux ◽  
Classical Group ◽  
Perioperative Complications ◽  
Control Group ◽  
Medium Term ◽  
Modified Technique ◽  
Term Outcome ◽  
Antireflux Operation ◽  
The Mean

The objective was to improve the results of surgical treatment of vesicoureteral reflux in children, using laparoscopic access. The prospective study was performed in 111 children (137 ureters) with the primary III–IV grade vesicoureteral reflux. The mean age was 34.7 months. The modified laparoscopic antireflux technique was performed on 73 children (91 ureters). We compared the perioperative complications and the medium-term outcome with a group of 38 children (46 ureters) who underwent classical laparoscopic extravesical reimplantation.3 In the modified group, the mean surgery time was 109.8 ± 31.5 minutes for unilateral cases and 176.5 ± 47.6 minutes for bilateral cases; in the classical group, it was 118.6 ± 34.3 and 209.5 ± 51.2 minutes respectively (p > 0.05). Postoperative vesicoureteral reflux had 2 (2.7 %) patients in the main group and 8 (21.1 %) children in the control group (p  =  0.002). There was no ureteral obstruction in the both groups. The success rate for ureters was 97.8 % with modified technique versus 82.6 % after classical laparoscopic reimplantation (p = 0.003). Laparoscopic extravesical ureteral reimplantation is a safe and effective surgical procedure. The modified technique may improve the surgical treatment results.

scholarly journals COMBINATION OF DISTRACTION OSTEOSYNTHESIS AND BONE PLASTIC AT TREATMENT OF CHILDREN WITH CONGENITAL LOW LIMB-LENGTH DISCREPANCY

2010 ◽  
Vol 16 (3) ◽  
pp. 61-67
Author(s):  
A. P. Pozdeev ◽  
E. V. Bukharev
Keyword(s):  
Surgical Treatment ◽  
Bone Regeneration ◽  
Treatment Period ◽  
Lower Limb ◽  
Limb Length Discrepancy ◽  
Limb Length ◽  
Control Group ◽  
Basic Group ◽  
Length Discrepancy ◽  
Distraction Osteosynthesis

Research objective was the estimation of combination distraction osteosynthesis with bone plastic in treatment of children with congenital lower limb discrepancy. Results of surgical treatment of 26 children (17 girl and 9 boys) with congenital lower limb-length discrepancy are analyzed. The method consists in creation of superfluous osteogenesis in the field of prospective lengthening. The control group included 10 patients with whom lengthening was carried out by typical way. Results: at the analysis of roentgenograms faster formation of a new bone has been revealed in basic group (on the average for 7,8 days faster on each centimetre of lengthening). Combination of distraction osteosynthesis and combined bone plastics shortened the treatment period by accelerating new bone regeneration during distraction osteogenesis of the children with congenital low limb-length discrepancy.

scholarly journals Sphincter-preserving technologies in the surgical treatment of extrahepatic cholestasis in complicated cholelithiasis

2020 ◽  
Vol 24 (3) ◽  
pp. 433-443
Author(s):  
B.F. Shevchenko ◽  
A.V. Zelenyuk ◽  
A.M. Babiy ◽  
N.V. Prolom ◽  
O.P. Petishko
Keyword(s):  
Surgical Treatment ◽  
Balloon Dilatation ◽  
Standard Technique ◽  
Sphincter Of Oddi ◽  
Long Term Results ◽  
Control Group ◽  
Extrahepatic Cholestasis ◽  
Surgical Interventions ◽  
Intraoperative Diagnosis ◽  
X Ray

Annotation. Extrahepatic cholestasis (EHC), caused by functional or organic disorders, always plays a key role in the pathogenetic mechanisms of the development of complicated forms of cholelithiasis caused by impaired bile outflow. Purpose of the work: to improve the immediate and long-term results of surgical treatment of patients with complicated cholelithiasis by intraoperative diagnosis of EHC and determination of the optimal parameters of dosed balloon dilatation aimed at maintaining the functional and anatomical integrity of the sphincter of Oddi (SО). During the period from 2014 to 2020, 181 patients were examined, who were operated on in the department of surgery of the digestive system of the State Institution “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”. The first group of patients (n=81, 44.75%) consisted of patients who underwent sphincter-preserving interventions, both antegrade (when performing laparoscopic cholecystectomy – LHE) and retrograde (when performing retrograde cholangiopancreatography – RCPG), the second group of patients (n=79, 43.64%) consisted of patients who underwent traditional sphincter-destructive staged interventions (total and subtotal papillotomy before or after LHE). The control group consisted of 21 patients (11.6%), in whom structural and functional abnormalities of SО were not detected during manodebitometry with X-ray verification, so they underwent LHE according to the standard technique. During the operation, all patients underwent manodebitometry, the indicators of which were compared with the data of X-ray cholangioscopy. The use of the combined method of manodebitometry in the intraoperative diagnosis of the main causes of various types of of extrahepatic cholestasis in complicated cholelithiasis (CL), made it possible to diagnose an organic disorder as the cause of the development of EHC in 34 (18.78%) patients and functional disorders of SО in 38 (20.99%) patients. The indicators of the cause of EHC in complicated cholelithiasis, established before the operation and clarified during the operation by X-ray studies, were compared with the indicators of manodebitometry in both groups of patients, while the indicator of manodebitometric coefficient in the control group was within 2.35-2.60 (Ме Q25; Q75) and on average 2.51. The use of the proposed diagnostic criteria for the manodebitometric coefficient and parameters of dosed balloon dilatation of large duodenal papilla (LDP) makes it possible to reduce the need for two-stage treatment of EHC in complicated cholelithiasis, to preserve the physiological passage of bile into the duodenum, preventing the formation of postoperative biliary hypertension by preserving the integrity of the sphincter apparatus of LDP and to reduce the amount postoperative complications and the number of staged surgical interventions by 25.92%.

scholarly journals SURGICAL TREATMENT OF CHRONIC RECURRENT HEMATOGENOUS OSTEOMYELITIS

2019 ◽  
pp. 48-51
Author(s):  
А. М. Shamsiev ◽  
S. S. Zayniev
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Satisfactory Result ◽  
Inpatient Treatment ◽  
Surgical Intervention ◽  
Control Group ◽  
Basic Group ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
Duration Of Disease

SUMMARY. According to the WHO data, the acute hematogenous osteomyelitis becomes chronic in 20–60 % of patients. The aim – to improve the results of surgical treatment of chronic recurrent hematogenous osteo­myelitis (CRHO) by optimizing the surgical intervention. Material and Methods. 180 patients with CRHO were involved (from 1995 to 2016), average age was (15.5±5.9) years, the ratio of boys and girls was 2.3/1. The duration of disease in 63.3 % of patients exceeded 4 years, including 12.8 % – 10 years. All patients were divided into two clinical groups: the control group consisted of 74 (41.1 %) – patients who received traditional surgical treatment from 1995 to 2003 (local sequesternecrectomy in the zone of greatest lesion). The basic group of patients consisted of 106 (58.9 %) patients who underwent surgical treatment in the period from 2004 to 2016 according to the developed methodology (a technique of extended sequesternecrectomy with recanalization of the affected bone). Results. The proposed tactics of surgical treatment of CRHO allowed to statistically significantly reduce the frequency of wound purulent complications from 20.3 to 3.8 %, reduce the overall duration of inpatient treatment (from (31.2±2.1) to (21.9±0.6) days) and the duration of stay in the clinic in the postoperative period (from (18.3±0.9) to (14.9±0.35). Special questionnaire for assessment of the distant results of surgical treatment of CRHO, demonstrated good results in the main group in 97.7 %, in the control group – only in 34.7 % of cases. A satisfactory result in the basic group was in 1 (1.2 %) patient, while in the control group there were 32.7 %. The number of unsatisfactory results in the basic group was significantly lower (1.2 %) than in the control group (32.7 %). Conclusions. Comparative analysis of the outcomes of CRHO treatment showed that the developed tactics of surgical treatment allowed reducing the recurrence rate of the disease from 32.7 % to 1.2 % and in 98.9 % of patients getting good and satisfactory results.

scholarly journals Surgical Treatment of Vulvar HSIL: Adjuvant HPV Vaccine Reduces Recurrent Disease

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 83
Author(s):  
Alessandro Ghelardi ◽  
Roberto Marrai ◽  
Giorgio Bogani ◽  
Francesco Sopracordevole ◽  
Paola Bay ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hpv Vaccine ◽  
Recurrent Disease ◽  
Current Knowledge ◽  
Hpv Vaccination ◽  
Clinical Effectiveness ◽  
Hpv Infection ◽  
Control Group ◽  
Hpv Test ◽  
Significant Difference

Data suggest that adjuvant human papillomavirus (HPV)-vaccination in women treated for cervical HPV diseases reduces recurrent disease. This study investigates adjuvant HPV-vaccination and the rate of recurrence in women undergoing surgery for vulvar high-grade squamous intraepithelial lesions (HSIL). From January 2013 to April 2020, we enrolled 149 women in a prospective case-control study. The control group (NV-group) was treated by standard surgery alone, while the study group received adjuvant vaccination soon after surgery (V-group). A follow-up was performed by vulvoscopy and HPV test. Statistical analysis was performed by Fisher’s exact test. HSIL recurrence was observed in 24/76 (32%) patients in NV-group and in 8/42 patients (19%) of the vaccinated group. By analysing the recurrence rate related to the incident and reactivated latent HPV infection, we found a significant difference between (17/76) 22.3% in NV-group and (2/42) 4.8% in V-group (p = 0.01). A reduction of 78.5% in incident/reactivated HPV infections was demonstrated. Data results add to the current knowledge about the mechanism of post-surgical adjuvant HPV vaccination. Our prospective study is the first to document the vaccine clinical effectiveness in preventing “reactivation” of latent HPV infections. Quadrivalent HPV vaccine administered after the surgical treatment for vulvar HSIL appears to be useful in preventing recurrent disease.

Primary Surgical Treatment in Very Advanced (T4b) Oral Cavity Squamous Cell Carcinomas

2021 ◽  
pp. 019459982098435
Author(s):  
Evan J. Patel ◽  
Jamie R. Oliver ◽  
Alec Vaezi ◽  
Zujun Li ◽  
Michael Persky ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Propensity Score ◽  
Oral Cavity ◽  
Squamous Cell ◽  
Multivariable Analysis ◽  
Group Versus ◽  
Curative Treatment ◽  
National Cancer Database ◽  
Curative Intent ◽  
Historical Cohort

Objectives To describe patterns of primary surgical treatments in patients with T4b oral cavity squamous cell carcinoma (OCSCC). Study Design Historical cohort study. Setting National Cancer Database. Methods Review of the National Cancer Database between 2004 and 2017 for all T4b OCSCCs. Only patients with curative treatment methods were included in the survival analysis. Surgical and nonsurgical outcomes were compared by multivariable and propensity score matching analysis. Results A total of 1515 cases of T4b OCSCC were identified. A minority of patients (n = 363, 24.0%) underwent curative treatment; among these, 206 (56.7%) underwent primary surgery. Median length of follow-up was 24 months. The 90-day mortality of patients who underwent surgical treatment was 1.0%. The 2-year survival was higher for patients who underwent surgery + chemoradiotherapy (CRT) as compared with CRT (64.6% vs 45.2%, P < .001). On multivariable analysis, surgery + CRT was associated with longer survival. In a propensity score–matched cohort of 312 patients, 2-year survival remained higher in the surgical group versus the nonsurgical group (59.4% vs 45.5%, P = .02). Among patients who underwent surgery + CRT, there was no difference in 2-year survival between clinical T4a and T4b (59% vs 64.6%, P = .20). Conclusions A minority of patients with T4b OCSCC undergo treatments with curative intent. A subset of patients underwent primary surgical treatment, which was associated with longer survival. The T4b classification might entail a heterogenous group, and further studies in revision of this classification might be justified.

scholarly journals Unplanned hospital readmission after surgical treatment for thoracic spinal stenosis: incidence and causative factors

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hui Wang ◽  
Longjie Wang ◽  
Zhuoran Sun ◽  
Shuai Jiang ◽  
Weishi Li
Keyword(s):  
Surgical Treatment ◽  
Spinal Stenosis ◽  
Hospital Readmission ◽  
Spinal Epidural Hematoma ◽  
Control Group ◽  
Unplanned Readmission ◽  
Thoracic Spinal Stenosis ◽  
Thoracic Spinal ◽  
Causative Factors ◽  
Csf Leakage

Abstract Background To assess the incidence and causative factors of unplanned hospital readmission within 90 days after surgical treatment of thoracic spinal stenosis (TSS). Methods Hospital administrative database was queried to identify patients who underwent surgical treatment of TSS from July 2010 through December 2017. All unplanned readmissions within 90 days of discharge were reviewed for causes and the rate of unplanned readmissions was calculated. Patients of unplanned readmission were matched 1:3 to a control cohort without readmission. Results Twenty-one patients (incidence of 1.7 % in 1239 patients) presented unplanned hospital readmission within a 90-day period and enrolled as the study group, 63 non-readmission patients (a proportion of 1: 3) were randomly selected as the control group. Causes of readmission include pseudomeningocele (8 patients; 38 %), CSF leakage combined with poor incision healing (6 patients; 29 %), wound dehiscence (2 patient; 9 %), surgical site infection (2 patients; 9 %), spinal epidural hematoma (1 patient; 5 %), inadequate original surgical decompression (2 patients; 9 %). Mean duration from re-admission to the first surgery was 39.6 ± 28.2 days, most of the patients readmitted at the first 40 days (66.7 %, 14/21 patients). When compared to the non-readmitted patients, diagnosis of OPLL + OFL, circumferential decompression, dural injury, long hospital stay were more to be seen in readmitted patients. Conclusions The incidence of 90-day unplanned readmission after surgical treatment for TSS is 1.7 %, CSF leakage and pseudomeningocele were the most common causes of readmission, the peak period of readmission occurred from 10 to 40 days after surgery, patients should be closely followed up within this period.

New possibilities of the use of surgical lasers in obstetrics

1997 ◽  
Vol 78 (6) ◽  
pp. 434-438
Author(s):  
I. F. Fatkullin
Keyword(s):  
Surgical Treatment ◽  
High Risk ◽  
Postoperative Complications ◽  
Cesarean Section ◽  
Laser Welding ◽  
Comparison Group ◽  
Obstetrics And Gynecology ◽  
Septic Complications ◽  
Basic Group ◽  
Section Operation

The laser welding suture of peritoneum in pregnants and in women in labor with high risk of pyo-septic complications is used in cesarean section operation. In the basic group the postoperative complications are three times as little than in the comparison group. The promise of the use of the biological laser @welding@ in obstetrics and gynecology to improve technology and results of surgical treatment especially in delivery of women with high risk of pyo-septic complications is noted.

Experience of using the drug Glutoxim in patients with benign and borderline epithelial ovarian tumors after performing conservative surgical treatment

2018 ◽  
pp. 79-86
Author(s):  
A.A. Sukhanova ◽  
◽  
M.Yu. Yegorov ◽  
Keyword(s):  
Surgical Treatment ◽  
High Risk ◽  
Ovarian Tumors ◽  
Molecular Profile ◽  
Control Group ◽  
Profile Data ◽  
Ki 67 ◽  
Risk Of Recurrence ◽  
Relapse Therapy ◽  
E Cadherin

The objective: to increase the effectiveness of treatment of patients with benign and borderline epithelial ovarian tumors (EOT) after conservative operations performed based on the definition of a high risk group for recurrence and malignancy according to the molecular expression profile of the markers p53, Ki-67, estrogen receptors (ER), CD34 and E-cadherin and inclusion in the complex anti-relapse therapy of the immunomodulating drug Glutoxim. Materials and methods. A clinical examination of 60 patients of reproductive age with EOT was performed, which were treated with organ-sparing surgical treatment (main group). Of these 60 patients, 30 women (subgroup I) were diagnosed with benign EOT (BEOT), the remaining 30 women (subgroup II) were diagnosed with borderline EOT (BoEOT) Ia and Ib stages in FIGO. In removed tumors after routine histopathological examination, the molecular profile was determined by immunohistochemically determining the protein regulator of apoptosis p53, proliferation index (PI) by Ki-67 expression, estrogen receptors — ER, microvessel density by CD34 expression and E-cadherin intercellular adhesion protein. Based on the molecular profile determination data, the removed tumor was ranked as high or low risk of recurrence and malignancy. Patients from the high-risk group for relapse and malignancy according to the molecular profile data included the immunomodulating drug Glutoxim in the complex anti-relapse therapy - intramuscularly 10 mg daily for 2 weeks with a course repeated every six months for 3 years. The control group consisted of 64 patients with BEOT and BoEOT, who underwent conservative surgical treatment without further anti-relapse treatment. Results. During the molecular profile study, it was found that high risk of recurrence and malignancy had EOT with p53 expression (LI ≥15%), high proliferative activity of cells with Ki-67 expression (PI ≥10%), low estrogen reception (LI ER < 49.5%), high density of microvessels on the expression of CD34 (IM ≥40 mv /mm2), low level of intercellular adhesion on the expression of E-cadherin (LI <59%). Molecular profile characterizing a high risk of recurrence and malignancy, in most cases was inherent in BoEOT. The purpose of a comprehensive anti-relapse treatment with the inclusion of the immunomodulatory drug Glutoxim (intramuscularly daily at 10 mg for 2 weeks) after performing of sparing conservative surgical treatment with a repetition of the course every six months in patients at high risk of relapse and malignancy according to molecular profile data has reduced the relapse of EOT to 6.7% in patients of the main group compared with 20.3% in the control group during three years of follow-up observation of patients. The difference is statistically significant (p <0.05). Conclusion. In order to prevent cases of recurrence and malignancy in patients with EOT at high risk of relapse and malignancy according to molecular profile data after a sparing surgical treatment that preserves their reproductive function, it is recommended that Glutoxim is administered in complex anti-relapse therapy at 10 mg intramuscularly per every day for 2 weeks with a repetition of the course every six months for 3 years. Key words: benign epithelial ovarian tumors, borderline epithelial ovarian tumors, high risks of recurrence and malignancy, anti-relapse therapy, reproductive function, Glutoxim.

Medical Versus Surgical Treatment of Primary Vesicoureteral Reflux

PEDIATRICS ◽  
1981 ◽  
Vol 67 (3) ◽  
pp. 392-400 ◽  
Keyword(s):  
Surgical Treatment ◽  
Vesicoureteral Reflux ◽  
Therapeutic Intervention ◽  
Renal Damage ◽  
Rational Basis ◽  
Benefit Ratio ◽  
International Trial ◽  
Prospective Longitudinal ◽  
Primary Vesicoureteral Reflux

The role of VUR in the development and progression of renal damage in children is universally acknowledged. The risk/benefit ratio of therapeutic intervention, whether medical or surgical, continues to be debated. This carefully controlled prospective, longitudinal, multispecialty, international trial aims to establish a rational basis for the treatment of VUR.

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