scholarly journals RESULTS OF ENDOSCOPIC DIAGNOSIS OF BLEEDING AFTER ABDOMINAL SURGICAL OPERATIONS

2021 ◽  
Vol 21 (3) ◽  
pp. 129-134
Author(s):  
I. A. Yusubov ◽  
N. A. Gasimov ◽  
E. Y. Sharifov
Keyword(s):  
Blood Pressure ◽  
Gastrointestinal Bleeding ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Postoperative Bleeding ◽  
Clinical Signs ◽  
Control Group ◽  
Laboratory Findings ◽  
Abdominal Bleeding ◽  
Surgical Methods

The aim of the study is to conduct a comparative analysis of the effectiveness of endovidiosurgical diagnosis techniques to detect gastrointestinal and intra-abdominal bleeding, which may occur after abdominal operations. Materials and methods. The main group included patients (n=408), whose condition was controlled by the endovideosurgical techniques. The control group included patients (n=102) who were controlled by using conventional surgical methods to correct bleeding that may occurred after similar surgical interventions. Gastrointestinal bleeding was observed in 323 patients, and intra-abdominal bleeding was observed in 85 patients. In all cases, endoscopic haemostasis was performed by clipping (n=57), submucosal infiltration (n=32), electrocoagulation (n=29), argon-plasma coagulation (n=74), and combined techniques (n=54). Results and discussion. 408 patients with clinical signs of bleeding in the early postoperative period were examined by endoscopic techniques. Patients with alarming clinical and laboratory findings underwent ultrasound examination, which revealed the presence of free fluid in one or more parts of the abdominal cavity. Laparoscopy was performed in the first hours of the postoperative period in 17 cases (n=17); on the first day of the postoperative period (n=36), on the second day (n=19), on the third (n=8), on the fifth (n=3), and on the sixth day (n=2). Complications were excluded in 7 (16.0%) patients, despite a decrease in blood pressure and haemoglobin levels. The volume of blood found in the abdominal cavity, including clots, ranged from 30 ml to 2000 ml. Signs of ongoing bleeding (the predominance of a large amount of liquid blood with a small number of clots) were found in 49 (57.6%) cases, and signs of arrested bleeding (the presence of a large number of clots with a small amount of liquid blood) was detected in 29 (34.1%) cases. Haemostasis was provided by electrocoagulation (n=35), clipping (n=15), suturing (n=12) and tamponade from a mini-laporatomic incision (n=9). Gastrointestinal bleeding was observed in 323 patients, and intra-abdominal bleeding in 85 patients. In 8.4% (n=27) of cases, the suspicious cases of postoperative complication were excluded by endoscopic examinations. In 91.6% (n=296) of clinical cases, early postoperative bleeding or signs of unstable haemostasis with the risk of repeated bleeding were confirmed. In cases of alarming clinical and laboratory findings indicating intra-abdominal bleeding, diagnostic laparoscopy enables to exclude complications in 16.0% of patients, despite a decrease in blood pressure and haemoglobin levels.

scholarly journals Mathematical modeling for prediction of complicated acute appendicitis in children

2018 ◽  
Vol 1 (1) ◽  
pp. 70-80
Author(s):  
V. S. Konoplitsky ◽  
V. V. Motygin ◽  
A. G. Yakimenko ◽  
D. V. Dmytriiev ◽  
T. I. Mikhalchuk
Keyword(s):  
Mathematical Model ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Control Group ◽  
Toxic Substances ◽  
Healthy Children ◽  
Endogenous Intoxication ◽  
Complicated Course ◽  
Complicated Acute Appendicitis

Endogenous intoxication, which accompanies the complicated course of acute appendicitis in children, is one of the serious conditions, which are the main cause of complications in the postoperative period. Diverse clinical observations done by clinicians suggest that despite the use of modern technologies in operating equipment, anesthetic support, the number of complications in the postoperative period has no tendency to decrease, and the main cause of lethal outcomes with appendicular peritonitis is lightning development of severe degree of endotoxicosis, which develops as a result of resorbing toxic substances formed of many components, including pathogenic microflora and destruction metabolism. Purpose. Creation of a mathematical model for prediction of complicated acute appendicitis in children using the functions of regression analysis of EXCEL spreadsheet by approximating experimental data. Materials and methods. In the work, there is information about 59 patients with acute appendicitis treated at the clinic of pediatric surgery at the National Pirogov Memorial Medical University. The data on patients were divided into two groups: patients with not complicated course of pathology – 24 patients, and patients with complicated course of acute appendicitis – 35 children. The control group served the data of 37 healthy children. In each of the three groups, the following parameters were studied: gender, age, bed day, duration of the disease, presence of symptoms of peritoneal irritation, the nature of exudate in the abdominal cavity, the number of red blood cells, hemoglobin, leukocytosis, quantitative characteristics of white blood formula, ESR, cellogenic endogenous intoxication: leukocyte index of intoxication and hematological index of intoxication. All the data were determined directly at the time of hospitalization of a patient to the hospital. Results. Discussion. Based on multiple correlation x = f (x1 , x2 ) a two-factor mathematical model of probability of the complicated course of acute appendicitis in children was created. According to the obtained results of the study of the system of three equations with three unknowns, it was established that if the indicator of the form of the disease is y = 2.67 and above, when, in numerical terms, the result falls into the zone of complicated flow of acute appendicitis and completely coincides with data analysis of the three groups of patients. Conclusions. The components that determine the uncomplicated course of acute appendicitis in children, according to the developed two-factor model, include LII and GPI, which exceed the values intoxication of certain intervals studied at the time of hospitalization. The analyzed indices were determined by the degree of severity of the pathological process, duration of disease, virulence of microflora and age of patients against the background of the formed endogenous intoxication syndrome.

scholarly journals ТREATMENT OF STENOSIS OF THE PYLORIC BULBAR ZONE OF ULCERATIVE GENESIS USING MINIMALLY INVASIVE SURGERY

2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Clinical Signs ◽  
State Institution ◽  
Disease Recurrence ◽  
Control Group ◽  
Surgical Interventions ◽  
Remote Observation

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions. Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions. Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.

A case of spontaneous splenic rupture in pregnancy

2014 ◽  
Vol 63 (4) ◽  
pp. 69-73
Author(s):  
Yevgeniy Sergeyevich Mikhaylin ◽  
Lada Anatolyevna Ivanova ◽  
Aleksey Gennadyevich Savitskiy ◽  
Sergey Georgiyevich Kucheryavyy ◽  
Roman Anatolyevich Krasnolobov ◽  
...  
Keyword(s):  
Splenic Rupture ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Expectant Management ◽  
Well Being ◽  
Spontaneous Splenic Rupture ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Abdominal Bleeding ◽  
In Pregnancy

The article provides an observation case of spontaneous splenic rupture in 33/34 weeks of pregnancy. The patient was under active-expectant management, because of premature rupture of membranes at term of 33 weeks. Suddenly, against a background of well-being, emerged clinical signs of massive intra-abdominal bleeding. During the revision of the abdominal cavity the rupture of the capsule of the spleen was detect. Cesarean section and splenectomy were performed. The postoperative period was uncomplicated, the patient was discharged home with the baby.

scholarly journals PO-235 Endurance training increased the expression of myocardin in thoracic aorta of T2DM rats

2018 ◽  
Vol 1 (5) ◽  
Author(s):  
Derun Gao
Keyword(s):  
Blood Pressure ◽  
Smooth Muscle ◽  
Endurance Training ◽  
Abdominal Cavity ◽  
Fasting Blood Glucose ◽  
Experimental Studies ◽  
Training Group ◽  
Control Group ◽  
And Migration ◽  
Proliferation And Migration

Objective In recent years, a large number of experimental studies have shown that the proliferation and migration of VSMC are the pathological basis of various vascular diseases, including AS, hypertension, and restenosis after angioplasty. It’s rather remarkable that Phenotypic Modulation of VSMC plays an important role in their proliferation and migration. Myocardin is a key transcription factor for the differentiation of VSMC by far, which can effectively activate the differentiation process of SMC. Many studies have shown that endurance training is an effective way to improve glucose and lipid metabolism. This study attempted to explore the effects of long-term external stress (endurance training) on arterial smooth muscle phenotype modulation and myocardin through secondary vascular disease, in order to provide theoretical support and practical basis for sports therapy in T2DM secondary diseases. Methods Male SD rats were randomly divided into the general feed group (pC) and the high-sugar and high-fat feed group (pD). After 7 weeks, rats in pD were injected a small doses of streptozotocin through abdominal cavity. Those Non-fasting Blood Glucose (NFBG) ≥16.7mmol/L after 72h and with insulin resistance were diagnosed as diabetes. Thereafter, the pC group was randomly divided into a blank control group (C), an endurance training group (E), a diabetes model group (D), and a diabetic+endurance training group (DE). No load platform training was conducted in E&DE group, 5 days per week for 8 weeks. 8 weeks after, BP was measured through left common carotid artery intubation, blood sugar was test by enzyme chemical assay, α-SM-actin, SM-MHC , SM22α,Myocardin and KLF4 were measured through ELISA.  Results 1. Compared with C, MCP (carotid blood pressure) of D increased significantly, FBG and FINS decreased significantly, expression of α-SM-actin, SM-MHC, SM22α and Myocardin Significantly dropped, KLF4 rose significantly. Compared with D, the expression of FBG in E was significantly down-regulated, FINS was significantly up-regulated, and the expression of α-SM-actin, SM22α and Myocardin was significantly up-regulated. Conclusions 8 weeks of endurance training significantly increased the expression level of contractile protein in the aorta smooth muscle of diabetic rats, making the smooth muscle phenotype changed from synthetic to contractile type, which effectively inhibited the excessive proliferation and migration of smooth muscle cells.Myocardin is one of the hot spots in the study of vascular differentiation in recent years. This study shows that the role of endurance training in improving plaque formation and lowering blood pressure may be produced by regulating myocardin.

scholarly journals Changes in the sizes of the kidney after contralateral nephrectomy in the experiment

2018 ◽  
Vol 24 (3) ◽  
pp. 52-57
Author(s):  
V.M. Monastyrskyi
Keyword(s):  
Postoperative Period ◽  
Left Kidney ◽  
Abdominal Cavity ◽  
White Male ◽  
Male Rats ◽  
Control Group ◽  
Close Relationship ◽  
Length Width ◽  
Sexually Mature ◽  
Experimental Group

The evaluation of renal measurements such as length, width and thickness, volume is important in the diagnosis and treatment of many renal disorders, since there is a close relationship between the sizes of the kidneys and its function. The purpose of the study was to establish and compare during the postoperative period changes in the mass and sizes of the kidney left after nephrectomy in the sexually mature male rats. An experimental study was carried out on 84 sexually mature white male rats weighing 178-194 grams. Animals were divided into two groups: control (42 rats) and experimental (42 rats). In the control group, the animals under ketamine anesthesia were followed by an abdominal cavity dilution, after which the abdominal wall was applied in a row. All animals of the experimental group performed surgical intervention – nephrectomy of the left kidney. The animals were withdrawn from the trial by intra-pleural administration of thiopental-sodium 50 mg/kg after 7, 14, 21, 30, 90 days after nephrectomy. Macroscopic evaluation and description of the kidneys of animals was performed after their removal. Their weight was determined on the laboratory scale of HLR-200 up to 0.1 mg, and the length, width and thickness of the organ were measured with the help of a caliper to an accuracy of 0.05 mm. Calculated the volume of the kidney. The statistical analysis of the obtained results was carried out using the program STATISTICA 5.5 using parametric methods for evaluating the results. It was established that the mass, length, width, thickness and volume of the kidney of animals in the experimental group, as compared with the control group, were statistically significantly higher in all terms of observation. The fraction of the growth of the width and thickness of the single kidney of animals in the experimental group compared with the control animals in the animals was statistically significantly greater than the proportion of kidney growth during the postoperative period. It was found that the largest increase in the mass and thickness of the kidney, as compared with the control group, was observed after 30 days of the postoperative period, and the greatest increase in the length and width of the kidney, as compared with the control group, was observed after 14 days of the postoperative period.

scholarly journals THE RESULTS OF SURGICAL TREATMENT IN PATIENTS WITH DIFFUSE POSTOPERATIVE PERITONITIS COMPLICATED WITH SEVERE ABDOMINAL SEPSIS

2015 ◽  
Vol 1 (1) ◽  
pp. 28-32
Author(s):  
F. V. Galimzyanov ◽  
T. M. Bogomyagkova ◽  
M. I. Prudkov ◽  
M. A. Lazareva
Keyword(s):  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Treatment Algorithm ◽  
Abdominal Sepsis ◽  
Postoperative Peritonitis ◽  
Control Group ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Clinical Indications ◽  
Surgical Methods

Aim of investigation: improvement the results of treatment in patients with diffuse postoperative peritonitis complicated with severe abdominal sepsis. Materials and methods. The present investigation is performed in 132 patients. According to the way of treatment the patients were divided into 2 groups: the first (control) group included 56 patients with diffuse postoperative peritonitis, severe abdominal sepsis who got complex treatment, sanations and abdominal cavity drainage according to “clinical indications”. The second (main) group included 76 patients with diffuse postoperative peritonitis, severe abdominal sepsis who got complex treatment and a surgical treatment algorithm which we have worked out. The patients were in severe condition with marked multiple organ failure, with equal risk of lethality in both groups. Surgical methods included laparotomy, relaparotomy, sanations, abdominal cavity drainage, mini-laparotomy. Results: application of the elaborated algorithm for surgical treatment of patients with diffuse postoperative peritonitis and severe abdominal sepsis made it possible to improve the results of treatment. Intensive ward stay was 1.4 times less accordingly, 10.0 ± 1.4 days and 14.0 ± 1.9 days (p < 0.1). Hospital stay was 3.3 days less accordingly, 29.0 ± 0.9 days and 32.3 ± 1.2 days (p < 0.05). Lethality was 2.5 times less as compared with abdominal cavity sanations according to “clinical indications”, accordingly 21.1 and 51.8 % (p < 0.01).

scholarly journals Diagnostics and treatment of abdominal complications after gynecological endoscopic operations

2021 ◽  
Vol 1 ◽  
pp. 75-79
Author(s):  
Yu.P.  Vdovichenko ◽  
V.I.  Boyko ◽  
V.A.  Terehov
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Main Group ◽  
Laparoscopic Technique ◽  
Control Group ◽  
Diffuse Peritonitis ◽  
Abdominal Complications

The objective: to analyze the results of repeated laparoscopy in gynecological patients with suspected intraperitoneal postoperative complications.Materials and methods. The study involved 42 patients (mean age 46±11,3 years), in whom postoperative abdominal complications after surgical treatment of various gynecological diseases required repeated operations. Depending on the method of re-intervention, the patients were divided into 2 groups: the main group (n=20) – women who only used laparoscopy to correct postoperative complications; control (n=22) – women who were given indications for relaparotomy to correct postoperative complications during diagnostic laparoscopy. Relaparotomy was performed in 8 patients of the control group. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in terms of age and structure of operations performed on the pelvic organs, and statistically comparable.Results. During the study, the results of repeated laparoscopy of 34 gynecological patients with suspected intraperitoneal postoperative complications were analyzed. In all patients of the main group (47,6%), laparoscopy was revealed as the only and final method of treatment of postoperative complications, while in 7 women repeated relaparoscopy was used from 2 to 4 times, and in 13 women laparoscopy was performed once. In the control group (53,3%), 10 patients during diagnostic laparoscopy were exposed to indications for relaparotomy, in 4 patients the capabilities of the operating team and laparoscopic technique allowed performing some elements of the operation and completing it with a minilaparotomy approach, and 8 patients underwent relaparotomy immediately.Peritonitis and intraperitoneal bleeding prevail in the structure of early abdominal complications. The use of the video laparoscopic technique made it possible in 28,6% of patients with diffuse peritonitis to successfully eliminate the developed complication, eliminate its source and sanitize the abdominal cavity. Laparoscopic hemostasis was successfully performed in 7 patients.Compared with the standard, the use of video endoscopic technique allowed improving the indicators of diagnostic value: to increase the sensitivity level by 1,07 times, specificity by 1,39 times and diagnostic accuracy by 1,11 times.Conclusion. In general, in the early postoperative period, 47 relaparoscopies were performed for suspected complications, which is explained by programmed abdominal sanitization and the use of dynamic laparoscopy to control the course of intraperitoneal complications. Based on the analysis of the material under study, we proposed general indications and contraindications for relaparoscopy in the early postoperative period in order to diagnose and treat postoperative complications. Justifying each of the points, we were guided by the real possibilities of the method in general clinical practice, which in some cases are inferior in their effectiveness to relaparotomy.

scholarly journals THE EVALUATION OF THE EFFECTIVENESS OF LOCAL APPLICATION OF OZONE THERAPY FOLLOWING CRYOTHERAPY OF LESIONS OF VERRUCOUS LEUKOPLAKIA OF THE ORAL MUCOUS MEMBRANE

2017 ◽  
Vol 22 (4) ◽  
pp. 184-187
Author(s):  
Svetlana I. Tokmakova ◽  
O. V Bondarenko ◽  
J. N Shilova
Keyword(s):  
Mucous Membrane ◽  
Postoperative Period ◽  
Local Treatment ◽  
Clinical Signs ◽  
Laboratory Animals ◽  
Control Group ◽  
Ozone Therapy ◽  
Mucosal Membrane ◽  
Traditional Scheme ◽  
Clinical Changes

There are presented results of the study morphological and clinical changes of the oral mucosal membrane. In the experiment on laboratory animals the use of ozone therapy following the destruction of the mucous membrane of the mouth was proved to appear earlier with the more complete epithelization of the defect, compared to the treatment implemented according to the traditional scheme. There was performed a clinical examination of 32 patients with verrucous leukoplakia of the oral mucosal membrane, the treatment of which was carried out according to the traditional scheme (cryotherapy and topical anti-inflammatory treatment - group comparison) and with the use of the ozonized solution of olive oil with a known peroxide during the postoperative period (control group). To assess the effectiveness of the proposed method of the management of the postoperative wound there was used a point scoring system of clinical signs at stages of the postoperative period. There was revealed a more earlier onset of the complete epithelization in cases of the application of the local ozone therapy in comparison with traditional local treatment.

Hypotension produced by vagal block in primates

1988 ◽  
Vol 254 (6) ◽  
pp. R857-R862
Author(s):  
K. G. Cornish ◽  
M. Barazanji ◽  
A. Ryberg ◽  
J. P. Gilmore
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Left Atrial ◽  
Volume Expansion ◽  
Water Immersion ◽  
Abdominal Cavity ◽  
Sympathetic Tone ◽  
Control Group ◽  
Blood Volume Expansion ◽  
Cardiopulmonary Receptors

In many species, the vagus has been reported to contain afferents that inhibit sympathetic tone. Vagal block (VB) increases blood pressure in both the intact and sinoaortic-denervated (SAD) dog. In the present study, VB was produced in intact and SAD monkeys by infiltrating the vagi with a local anesthetic. This was done in conjunction with blood volume expansion or head-out water immersion. The cardiovascular parameters monitored were heart rate (HR), blood pressure (BP), and left atrial pressure (LAP). VB decreased BP (-13 +/- 2.8 mmHg) in the control group and the SAD animals (-47 +/- 6.7 mmHg) without changing HR. Volume expansion decreased BP in the SAD animals (-6 +/- 3.4) but not in the intact monkeys (1.8 +/- 2.27), whereas HR did not change. Volume expansion after VB increased BP in both the SAD and the intact animals while producing a decrease in HR. Volume expansion caused LAP to increase in all groups (SAD 13.9 +/- 6.3; control VB 11.6 +/- 1.8, control 9.3 +/- 0.89, SAD VB 7.66 +/- 3.46). Immersion in the VB SAD animals increased BP to a greater extent than volume expansion. VB in the monkey must be removing input from peripheral receptors, which maintain sympathetic tone. Because immersion with VB increases BP more than volume expansion with VB, it is concluded that VB causes predominantly venous pooling. Because cardiopulmonary receptors generally inhibit sympathetic tone, it is concluded that those receptors responsible for the observed hypotension are located in the venous system, probably in the chest or the abdominal cavity.

Experience with dexmedetomidine for sedanalgesia during rhinosurgery

2021 ◽  
Vol 20 (3) ◽  
pp. 102-107
Author(s):  
E. S. Grigor’kina ◽  
◽  
N. M. Vingovatova ◽  
N. G. Emelina ◽  
V. G. Nedovarov ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pain Relief ◽  
Local Anesthetic ◽  
Postoperative Period ◽  
Optimal Level ◽  
Control Group ◽  
Hemodynamic Parameters ◽  
Pain Level ◽  
Respiratory Parameters ◽  
Endotracheal Anesthesia

The aim of this work was to study the possibility of rhinosurgical interventions using the drug dexmedetomidine for controlled sedoanalgesia. Materials and methods: 118 rhinological interventions (polysinusotomy, pansinusotomy, septoplasty) were performed under combined sedation: 56 with dexmedetomidine and 62 with sibazone. Intraoperatively, the amount of narcotic analgesic and local anesthetic, pain level and depth of sedation, hemodynamic and respiratory parameters, bleeding intensity and operating visibility were considered; in the postoperative period - the level of pain, bleeding when removing tampons from the nose, satisfaction of the surgeon and the patient. Results: during sedanalgesia with dexmedetomidine, the optimal level of sedation was achieved, the amount of narcotic and local anesthetic was reduced, hemodynamic parameters were comfortable for the surgeon (lower than in the control group, blood pressure), which, first of all, provided good operational visibility. In the postoperative period, there was a higher satisfaction of the patient and the surgeon with the performed anesthetic aid. Conclusions: sedoanalgesia with the drug dexmedetomidine can be used in uncomplicated cases during rhinosurgical interventions as an alternative to endotracheal anesthesia, providing optimal pain relief and comfortable work of the surgeon.

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