scholarly journals SPHINCTEROPLASTY IN THE TREATMENT OF ANAL INCONTINENCE ON THE BASIS OF NECROTIZING FASCIITIS

2019 ◽  
Vol 4 (9-10) ◽  
pp. 47-52
Author(s):  
O. E. Kanikovskyi ◽  
A. V. Osadchyi ◽  
O. A. Kotsyura ◽  
A. V. Tomashevskyi ◽  
T. P. Zarezenko
Keyword(s):  
Surgical Treatment ◽  
Anal Canal ◽  
Anal Incontinence ◽  
Social Life ◽  
Treatment Technique ◽  
Outpatient Basis ◽  
Social Self ◽  
Results Of Treatment ◽  
Serious Disease ◽  
Surgical Clinic

Incontinence of intestinal contents is a serious disease that gives patients strong emotional and psychological feelings leading to social self-isolation, unsuitability and disability of the population. From an analysis of scientific research, it is known that more than 30% of coloproctologic operations are complicated by insufficiency of the sphincter apparatus and lead to anal incontinence. The purpose of the study - to improve the results of treatment for anal incontinence. Material and methods. 44 patients with perineal NF were analyzed. Patients were treated in the surgical clinic of the Faculty of Medicine No. 2 of VNMU and Vinnitsa City Clinical Hospital of Emergency Medical Services from 2010 to 2018. The average age is 59.0±8.72 years (26-80). There are 11 women and 33 men. Age <20 - 0, 21-29 – 1 (2.27%), 30-39 – 2 (4.54%), 40-49 – 7 (15.9%), 50-59 – 10 (22.74%), >60 years old – 24 (54.5%). Results and their discussion. The development of postoperative anal incontinence was identified in 13 (29,5%) patients. An anal incontinence scale (Wexner) was used to verify the diagnosis of anal canal failure. The surgical treatment technique was performed both in patiently in 4 (9.0%) patients and on an outpatient basis in 4 (9.0%). With cicatricial changes in the anal canal, the rumen was excised, the sphincter edges were mobilized, allograft implantation and sphincteroplasty were performed. Narrowing the anal canal is a less traumatic method that can be performed on an outpatient basis and in hospitals of one day. After surgery, patients independently retain gases and feces. Conclusions. Patients with NF requiring immediate surgical treatment. Anal incontinence on the basis of the transferred NF leads to disability. The narrowing of the anal canal using a mesh transplant is minimally invasive, characterized by a mild postoperative course.Sphincteroplasty is possible to carry out stationary and on an outpatient basis under local anesthesia. Restoration of the function of the sphincter apparatus in 100% of the operated patients on the Wexner scale, which improves the level of physical and social life of patients.

scholarly journals SURGICAL TREATMENT OF CHRONIC VENOUS DEFICIENCY OF LOWER EXTREMITIES

2020 ◽  
pp. 68-73
Author(s):  
I. B. Babynkina ◽  
A. A. Novikova ◽  
G. P. Babynkina
Keyword(s):  
Surgical Treatment ◽  
Lower Extremities ◽  
Outpatient Basis ◽  
Perforating Veins ◽  
Results Of Treatment ◽  
Cosmetic Effect ◽  
Modern Economic ◽  
Surgical Tactics ◽  
Tissue Trauma ◽  
Standard Operations

Summary. The aim. Improving the results of treatment of patients with decompensated forms of chronic venous insufficiency in post-thrombophlebitic and varicose diseases based on the use of differentiated pathogenetically substantiated surgical tactics. Materials and methods. The basis of the work is the study of the results of surgical treatment of 102 patients not previously operated on with postthrombophlebitic disease of the lower extremities in the decompensated stage of CVI. All patients underwent combined surgical treatment, including the elimination of perforating insufficiency and various modifications of the operation on the superficial veins to eliminate vertical reflux. Results and discussion. The combined operation for clipping perforating veins allows the operation to interrupt blood circulation through insolvent perforating veins, including on an outpatient basis, minimizing tissue trauma during puncture rather than sectional access to a vein. The cosmetic effect of the operation is significantly increased, which is especially important in the treatment of women. Since the operation can be performed on an outpatient basis, the number of days of incapacity for work is significantly reduced compared to standard operations on perforating veins, which is a particularly important circumstance in modern economic conditions. Conclusion. Using the proposed method allows to achieve optimal conditions for the restoration of trophism of affected tissues, leading to a decrease in the number of complications and a reduction in hospitalization.

scholarly journals Therapeutic tactics in the deep forms of rectal abscesses complicated by fournie gangrene

2020 ◽  
Vol 73 (2) ◽  
pp. 293-297
Author(s):  
Oleh E. Kanikovskyi ◽  
Andrii V. Osadchyі ◽  
Sergey I. Androsov ◽  
Anatolii V. Tomashevsky ◽  
Oleh A. Yarmak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Antibacterial Therapy ◽  
Treatment Duration ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Surgical Clinic ◽  
Modern Technologies ◽  
Clinical Emergency ◽  
Early Surgical Treatment

The aim: To conduct an analysis of the complex treatment of severe forms of rectal abscesses complicated by NF. Materials and methods: The results of treatment in 471 patients with deep forms of RA was performed. In 38(8%) the spread of the process and rotten-necrotic affection of the perineal fascia. Patients were treated at the surgical clinic of the medical faculty №2, VNPMMU, and Vinnytsya Clinical Emergency Hospital in the period from 2010-2018. Results: Total lethality 8(1,7%). Mortality in GF was 8(19,5%). It is worth noting the reduction of the treatment duration against the background of the modern technologies usage in the period from 2016 to 12 days in relation to the total figure of 15 days. Conclusions: Early surgical treatment, adequate necrectomy, fasciotomy and antibacterial therapy stop the necrotic process. The active aspiration reduces the timing of wound cleansing and further ensures the accelerated implementation of reconstructive surgical interventions.

scholarly journals The use of daptomycin for the treatment of infectious endocarditis: results of a multicenter study

2017 ◽  
Vol 95 (4) ◽  
pp. 328-332
Author(s):  
Yu. L. Shevchenko ◽  
V. P. Tyurin ◽  
L. V. Popov ◽  
V. G. Gudymovich ◽  
E. P. Pavlikova ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Treatment ◽  
Blood Cultures ◽  
Average Dose ◽  
Surgical Mortality ◽  
Cardioverter Defibrillator ◽  
Duration Of Therapy ◽  
Results Of Treatment ◽  
Serious Disease ◽  
Emergency Echocardiography

Analysis of the results of daptomycin antibiotic therapy and surgical treatment of 37 patients with infective endocarditis (IE) admitted to three Moscow hospitals during 2012 to 2016 is presented. Primary endocarditis was diagnosed in 32.4% of the cases. The secondary forms of the disease dominated by endocarditis following cardiac surgery (29.7%) including valve prosthetics and implantation of pacemaker/cardioverter-defibrillator (PM/CVD). Positive reaction in 2 or more blood cultures was observed in 73% of the patients with the prevalence of Staphylococcus aureus (27%). Vegetation at TT and emergency echocardiography was documented in 89.2% of the patients, fibrous ring or leaflet abscesses in 24.3%). All patients were treated with daptomycin at an average dose of 6,7 ± 0,7 mg/kg b w. The duration of therapy was 26,7 ± 9,8 days. Surgical treatment was given to 48.6% of the patients including PM/CVD replacement in 5.4%. Surgical mortality was absent. Hospital mortality amounted to 13.5%. The use of daptomycin in combination with surgical treatment can significantly improve the results of treatment of this serious disease.

scholarly journals Structure, diagnosis, prevention and treatment of postoperative complications of childbirth perineal tears complicated by anal incontinence

2015 ◽  
Vol 96 (5) ◽  
pp. 779-783
Author(s):  
S G Sultanova
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Anal Canal ◽  
Anal Incontinence ◽  
Main Group ◽  
Long Term Results ◽  
Control Group ◽  
Perineal Tears ◽  
Second Degree

Aim. Improving the results of surgical treatment of complications of second and third degree perineal tears complicated by anal incontinence. Methods. The study included 248 patients aged 16 to 50 years. The patients were allocated to three groups: the first group - 40 women who underwent traditional surgery and conservative treatment; the second group - 128 women with second degree perineal tear; group III - 80 women who underwent sphincteroplasty (I option) and sphincteroplasty combined with levatorplasty (II option) in our modification (sphincter-saving surgery with precision sutures). The main group included 111 patients who additionally received conservative treatment [1 mL of 1% enoxaparin sodium intravenously and 1 ml of 30% vitamin E (alfa-tocopherol acetate) by intramuscular injection]; control group - 97 patients who underwent standard treatment. Long-term results were assessed by a survey, physical examination in the clinic, telephone and Internet surveys in 35 patients of the main group and 31 women of the control group. Results. In 91 (82%) patients of the main group, the pain intensity decreased after 7-10 days of treatment was antioxidants, 8 (7.2%) patients had pain in the perineum or anal canal, in 12 (10.8%) cases intense pain in the anal canal were still present. Long-term results were evaluated as good in 16 (51.6%) and 25 (69.4%) patients, as satisfactory - in 9 (29%) and 8 (22.2%) patients, as unsatisfactory - 6 (19.4 %), and 3 (8.3%) patients of the main and the control groups, respectively. The test group showed earlier formation of granulation tissue (3.1±0.3 days earlier compared to the control group). At sphincterometry on the 12th day, 6 patients of the control group had first degree anal incontinence, 3 - second degree anal incontinence compared with only 1 (1.8%) case in the study group (second degree sphincter incontinence). Conclusion. A proposed diagnostic strategy in women with anal incontinence due to perineal tears of II-III degrees after the labor trauma, allowed choosing the optimal method of surgical treatment and improving treatment outcomes.

Treatment of anal incontinence with “Noltrex” bulking gel

2021 ◽  
Vol 11 (06) ◽  
pp. 11-17
Author(s):  
М. М.Алиев ◽  
◽  
Билим Алдамуратович Теребаев ◽  
Keyword(s):  
Body Weight ◽  
Anal Canal ◽  
Plastic Surgery ◽  
Anal Incontinence ◽  
Single Injection ◽  
Polyacrylamide Gel ◽  
Results Of Treatment ◽  
Morphological Studies ◽  
Reconstructive Plastic Surgery ◽  
Reconstructive Plastic

The article presents the results of treatment of 27 patients aged 3 to 18 years with a diagnosis of postoperative anal incontinence. Who performed the operation of gel plastic surgery of the anal canal with polyacrylamide gel "Noltrex". Morphological studies were carried out on 10 labarotor mice, body weight 20-22 grams, in the department of experimental biomodelling. The analysis of the conducted studies showed that in 22 (78.3%) patients, after a single injection of the bulking polyacrylamide gel "Noltrex", complete closure of the anus was noted and normal continence was achieved. When choosing a tactic for the treatment of postoperative anal incontinence in children, an individual approach is required, taking into account the cause leading to this condition. Gel plasty of the anal canal in patients with postoperative anal incontinence is the method of choice and is an alternative to reconstructive plastic surgery. However, it should be noted that it is appropriate and effective in cases where there is no cicatricial change in the anal canal. Key words: anal incontinence, volume forming gel, proctoplasty, treatment

scholarly journals Analysis of surgical treatment of liver hemangiomas

2021 ◽  
Vol 38 (4) ◽  
pp. 129-141
Author(s):  
I. N. Mugatarov ◽  
M. F. Zarivchatsky ◽  
V. A. Samartsev ◽  
L. A. Bankovskaya ◽  
E. D. Kamenskikh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Outpatient Basis ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Abdominal Organs ◽  
Right Lobe ◽  
Perioperative Safety ◽  
Surgical Tactics ◽  
The Right ◽  
Ct And Mri

Objective. Development of criteria for optimal tactics of surgical treatment of liver hemangiomas of various sizes and localizations. Materials and methods. A retrospective analysis of 247 patients with hepatic hemangiomas observed on an outpatient basis and in a hospital was carried out; 59 of them (23.89 %) were operated including 12 men and 47 women over the period of 19992019. Liver resection with hemangioma was performed in 30 patients, hemangioma enucleation in 21, X-ray endovascular occlusion in 8 patients. The diagnosis was established on the basis of ultrasound of the abdominal organs, CT and MRI with contrast as well as angiographic research methods. Results. The postoperative complications developed in 4 (6.78 %) cases: reactive pleurisy was detected in 2 patients after the right-sided hemihepatectomy, hematomas in the resection zone of segments of the right lobe of the liver with a tumor were diagnosed in 2 patients. All complications were eliminated by conservative measures. There were no lethal outcomes. Conclusions. Surgical treatment of patients with hemangiomas includes resection of the liver with a tumor, enucleation of the hemangioma, and various types of local destruction. In order to reduce the blood circulation of the tumor and decrease the risk of intraoperative blood loss, the ECA of the branches of the hepatic artery was indicated. A comparative analysis of the results of treatment of patients with liver hemangiomas using various methods of surgical interventions made it possible to develop optimal surgical tactics, a system of intra- and perioperative safety in this category of patients.

scholarly journals Retrorectal Mucinous Adenocarcinoma Arising from a Tailgut Cyst: A Case Report

2021 ◽  
pp. 147-151
Author(s):  
Manon Baverez ◽  
Emilie Thibaudeau ◽  
Vincent Libois ◽  
Olivier Kerdraon ◽  
Hélène Senellart ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Anal Canal ◽  
Malignant Transformation ◽  
Mucinous Adenocarcinoma ◽  
Tailgut Cyst ◽  
Local Invasion

We report the case of a 57-year-old woman who presented with local invasion of the anal canal by mucinous adenocarcinoma, the malignant transformation of a long-term preexisting retrorectal tailgut cyst. This progression is infrequent and justifies preemptive surgical treatment of retrorectal cysts.

scholarly journals Treatment of Injuries of the Lumbar Spine

2019 ◽  
Vol 5 (12) ◽  
pp. 156-162
Author(s):  
M. Sabyraliev
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Spinal Canal ◽  
Thoracolumbar Spine ◽  
Spinal Injuries ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Post Traumatic

Surgical treatment of patients with spinal injuries, accompanied by traumatic stenosis of the spinal canal, is an urgent and discussed problem of modern vertebrology. Surgical treatment of 111 patients with various injuries of the thoracolumbar spine was performed. In 40 patients, post-traumatic stenosis was eliminated using ligamentotaxis using transpedicular osteosynthesis. The immediate results of treatment were followed up in all patients: good results were obtained in 33 (82.5%) cases; satisfactory — in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term results with a follow-up of more than 1 year were followed up in 27 (67.5%) patients; good results were obtained in 20 (74.0%), satisfactory in 7 (25.0%).

scholarly journals Dr the efficacy of karpoor ghrith in the management of parikartika.

2020 ◽  
Vol 8 (05) ◽  
Author(s):  
Om Dhote
Keyword(s):  
Surgical Treatment ◽  
Anal Canal ◽  
Faecal Incontinence ◽  
Squamous Epithelium ◽  
Burning Sensation ◽  
Local Application ◽  
Ancient Text ◽  
Fissure In Ano ◽  
Longitudinal Ulcer ◽  
Stratified Squamous Epithelium

Fissure in Ano ( Parikartika) is a vertical tear or an elongated longitudinal ulcer in the long axis of stratified squamous epithelium of the lower anal canal. Ancient text couldn’t give a brief idea about this condition. Mainly it has been described as complication of Bastikarma and Atisar. It is so named in which sharp cutting pain is felt in the anus. For that Modern surgical treatment of choice is again has limitations such as faecal incontinence. Hence, karpoor Ghrita having effective Vranaropan & vedanashamak, tridoshaghna  property i.e. it relieves burning sensation quickly. So we modified a method of Local Application is conceived for this study.   

scholarly journals PALLIATIVE RESECTIONS OF A LIVER USING CRYODESTRUCTION FOR THE PATIENTS WHO HAVE BEEN REPEATEDLY OPERATED FOR ALVEOCOCCOSIS

2014 ◽  
Vol 13 (3) ◽  
pp. 25-31
Author(s):  
B. I. Alperovich ◽  
I. S. Zaytsev
Keyword(s):  
Surgical Treatment ◽  
Liver Resection ◽  
Compensatory Hypertrophy ◽  
Palliative Resection ◽  
Hepatic Insufficiency ◽  
Hepatoduodenal Ligament ◽  
Safe Method ◽  
Tissue Sections ◽  
Results Of Treatment ◽  
Vascular Structures

The purpose of work was the assessment of influence of a palliative resection of a liver with application of cryodestruction and without cryodestruction application on the remote results of treatment of the patients who have been repeatedly operated for alveococcosis.The analysis of surgical treatment of 14 patients operated repeatedly for alveococcosis of a liver is carried out. Patients were operated in the complicated stage of a disease in the presence of germination of a parasite in caval and/or portal gate of organ. Primary interventions were various – a diagnostic laparotomy, a cytoreduction and a marsupialization of a parasite, a liver resection. All patient at repetition intervention executed palliative resections of a liver. Resections were carried out by a clinic technique with imposing the ginglymoid of ligatures on remaining tissue of a liver at distance of 2–3 cm from the deleted parasitic knot taking into account a segmentary structure of organ. At all patients on "dangerous zones" (a zones of gate of a liver, a hepatoduodenal ligament) plates of parasitic fabric of various sizes from 1  2 cm to 2  4 cm were left. At 10 patients they were exposed to cryodestruction. The exposition in one point made from 1 to 2 minutes at a temperature –196 С. Postoperatively, patients received a dose of 10 mg/kg albendazole.Development of hepatic insufficiency after palliative resections of a liver is noted in one case. Lethal outcomes weren't.All patients for convenience of the analysis were divided into two groups: group of patients without application of cryotechnologies (n = 4) and group of the patients operated with application of cryodestruction (n = 10). Efficiency of palliative resections estimated on a median of survival of patients. Calculation of survival carried out Kaplan–Meier's method. The survival median in groups made 12 and 17 years respectively.When comparing survival of patients by Gehan's test with Yates's correction distinction of survival in two selections are statistically significant (z = 2,94; p < 0,005).Among patients repeatedly operated for alveococcosis when involving in parasitic process of gate of a liver, lack of possibility of prosthetics of vascular structures and developments of a compensatory hypertrophy of not struck departments of body the palliative resection allows to achieve survival of 50% of patients more than 16,8 years.Cryodestruction is the effective and safe method, allowing to increase survival of patients after a p alliative resection of a liver, through the destruction left in the area of the liver gate parasitic tissue sections.

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