scholarly journals Differentiated treatment tactics in surgery of liver echinococcosis

2020 ◽  
Vol 174 (5) ◽  
pp. 72-77
Author(s):  
A. M. Shamsiev ◽  
J. A. Shamsiev ◽  
K. E. Rakhmanov ◽  
S. S. Davlatov
Keyword(s):  
Postoperative Complications ◽  
Integrated Approach ◽  
Disease Recurrence ◽  
Medical Institute ◽  
Preventive Chemotherapy ◽  
Residual Cavity ◽  
Laparotomy Wound ◽  
Surgical Tactics ◽  
Surgery Department

Purpose of the study. Improving the quality of treatment for liver echinococcosis by improving surgical tactics and developing eff ective methods to reduce disease recurrence. Materials and methods: 371 patients with echinococcosis of the liver, who were admitted to the surgery department of the 2nd clinic of Samarkand State Medical Institute, were examined. Of the 371 patients in 311 (83.8%) patients, the disease was detected for the fi rst time and in 60 (16.2%) patients, echinococcosis was recurrent. The results of the study: compared with 2005–2008. the incidence of postoperative complications decreased from 13.1 to 4.3%. Complications such as suppuration of the residual cavity (6 times), suppuration of the laparotomy wound (2 times), the formation of bile fi stulas (3 times), and no subphrenic abscesses began to occur much less frequently. The duration of inpatient treatment after surgery decreased by 2 times compared with the control — from 21.2 ± 1.2 to 10.9 ± 0.3 days. Conclusions: the developed algorithm for choosing the tactics of surgical treatment of liver echinococcosis, taking into account the integrated approach to choosing access, the method of treatment and elimination of the residual cavity, as well as preventive chemotherapy, has improved the quality of care by reducing the frequency of immediate postoperative complications from 12.5% to 4, 3% (p = 0.027 according to the χ2 criterion) and relapse of the disease from 11.9% to 2.6% (p = 0.031 according to the χ2 criterion).

scholarly journals Improvement of surgical tactics in acute destructive cholecystitis

2021 ◽  
pp. 17-22
Author(s):  
Z. Y. Saydullaev ◽  
S. S. Davlatov ◽  
K. E. Rakhmanov
Keyword(s):  
Surgical Treatment ◽  
Integrated Approach ◽  
World Health ◽  
Medical Institute ◽  
State Medical Institute ◽  
Number Of Patients ◽  
The World ◽  
Surgical Tactics ◽  
Health Organization

Abstract. Relevance. According to the World Health Organization, in the world due to the increase in the incidence of cholelithiasis, there is an increase in the number of patients with destructive forms of this pathology. The aim of the study is to improve the quality of treatment of patients with acute destructive cholecystitis by improving surgical tactics. Materials and research methods. The work is based on the assessment of the results of surgical treatment of patients with acute destructive cholecystitis who were treated in the surgical departments of the 1st clinic of the Samarkand State Medical Institute (clinical base of the departments of surgical diseases No. 1 and general surgery of the Samarkand State Medical Institute) for the period from 2016 to 2020. Conclusions. The tactics of surgical treatment of patients with destructive cholecystitis, taking into account an integrated approach to the choice of access, made it possible to improve the quality of care by reducing the frequency of immediate postoperative complications from 13.4% (11 patients in the comparison group) to 1.7% (2 patients in the main group).

Prediction of perioperative parameters of laparoscopic organ-sparing interventions on the kidney taking into account the surgeon's "learning curve"

2021 ◽  
Author(s):  
V.N. Gridin ◽  
I.A. Kuznetsov ◽  
A.I. Gazov ◽  
E.S. Sirota
Keyword(s):  
Logistic Regression ◽  
Comparative Analysis ◽  
Learning Curve ◽  
Multilayer Perceptron ◽  
Regression Line ◽  
Integrated Approach ◽  
Duration Of Surgery ◽  
Surgical Tactics ◽  
The Impact

The paper considers an integrated approach for constructing models for predicting the perioperative parameters of laparoscopic kidney resections, which include the duration of the operation, the time of thermal ischemia, and the glomerular filtration rate 24 hours after the operation. The approach is based on the principle of expanding the feature space, extracted from the analysis of the surgeon's "learning curve" data when mastering laparoscopic kidney resections. The aim of this work is to predict the main perioperative parameters that have the most significant impact on the surgical tactics of treatment at the stage of planning surgery. New methods have been developed for identifying significant parameters that take into account the complexity of the operation and the qualifications of the surgeon based on his “learning curve”. The parameters to be distinguished include: “complexity of the operation” based on nephrometric indices (RENAL, PADUA and C-index); the average value of the predicted perioperative parameters of surgical interventions depending on the complexity; slope and standard error based on the regression line of predicted perioperative parameters. Models were developed for predicting the perioperative parameters of laparoscopic organ-preserving kidney interventions using modern approaches based on machine learning, which are based on the algorithms “decision trees”, “multilayer perceptron”, “Naïve Bayes”, “logistic regression”. A comparative analysis of the quality of the developed models was carried out, as a result of which the best result was obtained using the “logistic regression” algorithm. The F-measure was used as a metric. A comparative analysis of the developed models was carried out to assess the impact on the final quality of the new selected features. For the predicted parameter “time of thermal ischemia” the increase was from 9.68% to 16.68%; for the predicted parameter “duration of surgery” the increase was from 2.76% to 4.08%. At the same time, for the predicted parameter “GFR in 24 hours” there was no significant increase, and for the “multilayer perceptron” algorithm it turned out to be negative. The obtained forecasting models can be used in applied software solutions that act as decision support systems in determining the surgical tactics of treating patients with localized formations of the renal parenchyma. Such software solutions can be implemented as a web service or as a separate program.

scholarly journals Diagnostics and surgical tactics in case of combined complications of colon cancer in elderly and senile patients

2018 ◽  
Vol 10 (2) ◽  
pp. 79-86
Author(s):  
N I Glushkov ◽  
T L Gorshenin ◽  
S K Dulaeva
Keyword(s):  
Colon Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Traditional Methods ◽  
Western State ◽  
Surgical Tactics ◽  
Medical University ◽  
Ray Methods ◽  
North Western

The results of diagnostics and surgical treatment of the combined complications of colon cancer in elderly and senile patients are presented. It is established that modern ray methods of research, along with traditional methods, allow to improve the quality of diagnostics of combined complications. The introduction of endovideosurgical technologies helps to reduce the number of postoperative complications and lethality. (For citation: Glushkov NI, Gorshenin TL, Dulaeva SK. Diagnostics and surgical tactics in case of combined complications of colon cancer in elderly and senile patients. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):79-86. doi: 10.17816/mechnikov201810279-86).

Reduction of number of postoperative complications depends on quality of dressing material and wound treatment

2020 ◽  
pp. 61-63
Author(s):  
Larisa Katkasova ◽  
Svetlana Kropotova
Keyword(s):  
At Risk ◽  
Wound Healing ◽  
Postoperative Complications ◽  
Wound Treatment ◽  
Postoperative Wound ◽  
Speed Up ◽  
Modern Technologies

Operated patients suffering from diabetes are at risk of developing postoperative complications. Modern technologies of postoperative wound treatment and modern dressings allow to avoid complications and speed up the process of postoperative wound healing.

About Using the Complex Method in Studies of the Quality of Life of the Population of the North Ossetia

2020 ◽  
pp. 36-48
Author(s):  
I. M. Loskutova ◽  
N. G. Romanova
Keyword(s):  
Quality Of Life ◽  
Integrated Approach ◽  
Standard Of Living ◽  
Complex Method ◽  
The North ◽  
Social Wellbeing ◽  
The Social ◽  
Sociological Studies ◽  
North Ossetia

This article is devoted to the application of an integrated approach in the study of the quality of life of the population of the North Ossetia. Aspects of the specifity of objective and subjective approaches are substantiated. The increasing importance of the concept of “quality of life” in the XXI century is indicated. A review of sociological studies of the level and quality of life in Russia, as well as a range of monographic works on the analyzed issues. The results of empirical sociological studies in 2014 and 2018 (a study of the quality and standard of living of the population of North Ossetia and a study of the social wellbeing of the population of North Ossetia using the methodology developed by Lapin N. I. and Belyaeva L. A.) are presented.

The Use of Fibrin-based Tissue Adhesives for Breast in Reconstructive and Plastic Surgery

2020 ◽  
Vol 19 (32) ◽  
pp. 2985-2990 ◽  
Author(s):  
Kuo Chen ◽  
Mikhail Y. Sinelnikov ◽  
Vladimir N. Nikolenko ◽  
Igor V. Reshetov ◽  
Yu Cao ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Plastic Surgery ◽  
Fibrin Glue ◽  
Reconstructive Surgery ◽  
Tissue Adhesives ◽  
Tissue Adhesion ◽  
Advanced Technologies ◽  
Breast Plastic Surgery

Background: Breast plastic surgery is a rapidly evolving field of medicine. The modern view of surgical trends reflects the desire to minimize complications and introduce advanced technologies. These always will be priorities for surgeons. Reconstructive surgery, a branch of plastic surgery focusing on restoration of lost functional and aesthetic component, seeks to enhance psychological rehabilitation and improves the quality of life, as well as aesthetic recovery. Objective: This review addresses the action of fibrin agents and their effect on the quality of surgical hemostasis. Discussion and Conclusion: The fundamental goals for the surgeon are to perform a minimally traumatic intervention and to prevent any form of complication. Achieving complete hemostasis is an intraoperative necessity. Timely prevention of bleeding and hemorrhagic phenomena can affect not only the outcome of the operation, but also the incidence of postoperative complications. Topics include the integrity of microvascular anastomoses, tissue adhesion, and the incidence of seromas and hematomas associated with fibrin glue usage. The literature on fibrin adhesives with respect to prevention of postoperative complications, and the effectiveness with active drainage also are analyzed.

scholarly journals Impact of Diabetes Mellitus on Cervical Spine Surgery for Ossification of the Posterior Longitudinal Ligament

2021 ◽  
Vol 10 (15) ◽  
pp. 3375
Author(s):  
Atsushi Kimura ◽  
Katsushi Takeshita ◽  
Toshitaka Yoshii ◽  
Satoru Egawa ◽  
Takashi Hirai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cervical Spine ◽  
Postoperative Complications ◽  
Spine Surgery ◽  
Posterior Longitudinal Ligament ◽  
Lower Extremity Function ◽  
Cervical Spine Surgery ◽  
The Impact

Ossification of the posterior longitudinal ligament (OPLL) is commonly associated with diabetes mellitus (DM); however, the impact of DM on cervical spine surgery for OPLL remains unclear. This study was performed to evaluate the influence of diabetes DM on the outcomes following cervical spine surgery for OPLL. In total, 478 patients with cervical OPLL who underwent surgical treatment were prospectively recruited from April 2015 to July 2017. Functional measurements were conducted at baseline and at 6 months, 1 year, and 2 years after surgery using JOA and JOACMEQ scores. The incidence of postoperative complications was categorized into early (≤30 days) and late (>30 days), depending on the time from surgery. From the initial group of 478 patients, 402 completed the 2-year follow-up and were included in the analysis. Of the 402 patients, 127 (32%) had DM as a comorbid disease. The overall incidence of postoperative complications was significantly higher in patients with DM than in patients without DM in both the early and late postoperative periods. The patients with DM had a significantly lower JOA score and JOACMEQ scores in the domains of lower extremity function and quality of life than those without DM at the 2-year follow-up.

scholarly journals Perceived quality of surgical care in association with patient-related factors and correlation to reported postoperative complications in Finland: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037708
Author(s):  
Ira Helena Saarinen ◽  
Jaana-Maija Koivisto ◽  
Antti Kaipia ◽  
Elina Haavisto
Keyword(s):  
Quality Of Care ◽  
Postoperative Complications ◽  
Cross Sectional Study ◽  
Perceived Quality ◽  
Living Alone ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Perceived Quality Of Care

ObjectiveTo study if patient-related factors are associated with patient-evaluated quality of care in surgery. To examine if there is an association with postoperative complications and patient-evaluated low quality of care.DesignA correlation cross-sectional study, in addition, a phone call interview at 30 days postoperatively to examine complications.SettingThe data on patients admitted for non-cardiac general and orthopaedic surgery at a central hospital in Southwestern Finland were collected in two phases during an 8-month period.Participants436 consecutive consenting and eligible in-ward non-cardiac general surgery and orthopaedic surgery adult patients. Ambulatory, paediatric and memory disorder patients were excluded. 378 patients completed the questionnaire (Good Nursing Care Scale for Patients (GNCS-P)).MethodsPerceived quality of care was examined by the GNCS-P questionnaire. Patient-related factors were obtained from electronic patient records and questionnaire. A telephone interview related to postdischarge complications was conducted 30 days after discharge.Main outcome measuresPatient evaluation of quality of care at discharge, its association with patient-related factors and patient-reported postdischarge complications.ResultsThe overall quality was evaluated high or very high by the patients. The lowest overall quality of care rate was assessed by surgical patients living alone (p=0.0088) and patients who evaluated their state of health moderate or poor (p=0.0047). Surgical patients reporting postoperative complications after discharge evaluated lower overall quality of care (p=0.0105) than patients with no complications.ConclusionPatient demographic factors do not seem to influence the perceptions of the quality of care. Instead, subjective state of health and living conditions (living alone) may have an influence on the patient experience of quality of care. The perceived quality of care in healthcare staff technical and communication skills may have an association with reported postoperative complications.

scholarly journals GCT-61. CORRELATION OF PATTERNS OF DISEASE RECURRENCE WITH RADIOTHERAPY TECHNIQUES AND DOSE IN INTRACRANIAL GERM CELL TUMOURS (icGCT): LESSONS FROM THE UK COHORT OF SIOP GCT96 STUDY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii340-iii340
Author(s):  
Thankamma Ajithkumar ◽  
Henry Mandeville ◽  
Fernando Carceller ◽  
Milind Ronghe ◽  
Tina Foord ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Disease Recurrence ◽  
Germ Cell Tumours ◽  
Prospective Data ◽  
Data Collection And Analysis ◽  
Radiotherapy Techniques ◽  
The Uk ◽  
A Prospective Study ◽  
Patterns Of Recurrence

Abstract BACKGROUND There are global variations in radiotherapy approaches for icGCT. An understanding of patterns of disease recurrence correlated with radiation techniques and doses is important in standardising and improving the quality of radiotherapy using high-precision techniques. METHODS AND RESULTS Data from 20 patients with tumour recurrence after treatment within the SIOP GCT96 study in the UK were analysed. Seven (35%) patients had germinoma and 13 (65%) had non-germinoma. Twelve patients had local recurrence, 5 had metastatic and 3 had local and metastatic disease. Radiotherapy details were retrieved in only 8 patients (40%). Six patients had received focal radiotherapy and two craniospinal radiotherapy. Of the patients who received focal radiotherapy, 4 had recurrence within the radiation portal, one had periventricular recurrence and one had marker-positive recurrence with no radiological lesions. Both patients who received CSI recurred within the CSF space. The main reasons for poor retrieval of treatment details were difficulty in retrieving archived information and that the study was conducted during a period before PACS or electronic radiotherapy records. CONCLUSION This study highlights the importance prospective data collection and analysis to understand the patterns of recurrence in icGCT. Even within a prospective study, radiotherapy techniques varied between centres. There is therefore an urgent need for centralised radiological review and prospective radiotherapy quality assurance measures in future clinical trials.

Would integrating women's professional care of pelvic organ prolapse improve the symptoms and quality of life: an integrative literature review

2020 ◽  
Vol 28 (2) ◽  
pp. 119-133
Author(s):  
Nicola Davies ◽  
Teresa Burdett
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Integrated Approach ◽  
Pelvic Organ ◽  
Social Implications ◽  
Content Type ◽  
Practical Implications

PurposeIntegrated healthcare is a central tenant of the NHS Long Term Plan (NHS, 2019). NICE in 2019 published guidelines; advising the integration of multidisciplinary professionals which may lead to an improvement in conservative treatment methods of pelvic organ prolapse. Therefore, current literature on the conservative treatments for pelvic organ prolapse needs to be reviewed to ascertain if an integrated approach would improve the symptoms and quality of life for women.Design/methodology/approachA systematic review of the literature between 2013 and 2018 was implemented. Papers included were written in English, peer-reviewed and consisted of treatments of pelvic organ prolapse in women. Papers containing surgical interventions, postpartum participants, reviews, evaluations, guidelines, follow-up studies, focusing on cost effectiveness, sexual function were excluded.FindingsSeven studies in total were included, and two overarching themes were identified: quality of life after treatment and the effect of conservative treatment on pelvic organ prolapse symptoms. The literature suggested that integrating care had a more positive outcome on pelvic organ symptoms and quality of life.Research limitations/implicationsTo develop a robust enhanced model of care for conservative treatment of pelvic organ prolapse through more mixed method or qualitative research, that incorporates integrative treatment methods with collaboration from multidisciplinary professionals.Practical implicationsThe practical implications of integrating the conservative management of pelvic organ prolapse is the communication between the multidisciplinary team must be exceptional to ensure everyone understands and agrees the treatment that is being provided to patient. Also, effective teamwork is important to ensure the patient receives the best care with input from the correct disciplines. The multi-professional team will need to have regular meetings to discuss and implement care plans for patients that might prove difficult to schedule due to differing commitments and priorities. This must be overcome to insure a successful and effective integrated approach to pelvic organ prolapse is delivered.Social implicationsThe social implications of integrating the professional approach to women's care of pelvic organ prolapse involves reducing the severity of the symptoms therefore, increasing the quality of life. This may result in the reduction of surgical intervention due to the patient being satisfied with the conservative management. Through integrating the management of the prolapse the patient will receive an accessible individualised care plan pathway that focuses on treating or reducing the impact of the symptoms that are bothersome to the patient whilst managing patient expectations. Patients will also, be reassured by the number of multi-disciplinary professionals involved in their care.Originality/valueGlobal integration of conservative treatments and multidisciplinary-professionals specialising in pelvic organ prolapse and pelvic floor dysfunction is needed.

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