Surgical treatment of transacetabular fractures

2021 ◽  
Vol 19 (3) ◽  
pp. 92-94
Author(s):  
I. S. BOROVOY ◽  
Keyword(s):  
Surgical Treatment ◽  
The Body ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Vital Functions ◽  
Acetabulum Fractures ◽  
External Fixation Device ◽  
Surgical Tactics ◽  
Positive Effect

The article presents an analysis of the treatment results of patients with transverse acetabulum fractures of type B1.1 according to the AO classification using various surgical tactics/ the most optimistic results were obtained when using the hip joint osteosynthesis with an external fixation device (EFD) «pelvis-hip» in urgent cases. Besides the obvious antishock action, it allows removing the femoral head from the central displacement and in many cases achieving the reposition of the acetabulum, due to ligamentotaxis. After x-ray control in the case of a further incomplete reposition in the EFD, it significantly simplifies the open stage of surgical treatment after the stabilization of the vital functions of the body, which has a positive effect on the long-term results of treatment of this complex category of patients.

scholarly journals Immediate and Long-Term Results of the Spleen-Preserved Operations in the Surgical Treatment of Gastric Cancer

2020 ◽  
Vol 13 (3) ◽  
pp. 227-232
Author(s):  
Marina I. Rogozianskaia ◽  
Alexander Nikolayevich Redkin ◽  
Ivan Petrovich Moshurov
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Total Gastrectomy ◽  
The Body ◽  
Long Term Results ◽  
D2 Lymphadenectomy ◽  
Spleen Preserving ◽  
Cardiac Region ◽  
Clinically Significant

ntroduction. Currently, total gastrectomy with D2 lymphadenectomy is the standard surgical treatment for proximal gastric cancer at the resectable stages (I-III). The issue of advisability of splenectomy as a component of lymphadenectomy remains a controversial one, especially when the tumor is localized in the region of the body or cardiac region of the stomach.The aim of the study was to compare immediate and long-term outcomes, including the quality of life, between spleen preserving and spleen removing surgeries.Methods. The study included 363 patients with gastric cancer II-III stages, localized in the upper and/or the middle third of the stomach, who underwent surgery at the Voronezh Regional Clinical Oncology Hospital and the Voronezh Clinical Hospital of the Russian Railway-Medicine in 2015-2017. All patients were conditionally divided into 2 groups for comparative retrospective analysis. All patients of the first (experimental or spleen-preserved) group (144 patients) were performed R0 total gastrectomy with D2 lymphadenectomy, including splenic hilar nodes (№ 10,11) removal without splenectomy. Patients of the second (control or splenectomy) group (219 patients) were performed R0 total gastrectomy with D2 lymphadenectomy and prophylactic splenectomy (for splenic hilar nodes removal).Results. The average duration of the operation and the volume of blood loss did not differ in both groups. The incidence of early postoperative surgical complications was lower in the spleen-preserved group. Splenectomy was associated with more severe complications of class 4 and 5 according to the Clavien-Dindo classification. Conclusion. Parameters of the 1- and 3-year overall survival rate did not differ in both groups. The results of the GSRS questionnaire were similar in both groups, excluding reflux-esophageal symptoms scale. The reflux scale demonstrated a statistically and clinically significant advantage of spleen preservation.

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 Immediate and long-term results of physiotherapeutic treatment of patients with chronic constipation in abnormal development of the colon

2020 ◽  
Vol 17 (4) ◽  
pp. 211-213
Author(s):  
Olga N. Litvinova
Keyword(s):  
Internal Medicine ◽  
Electrical Stimulation ◽  
Conservative Treatment ◽  
Chronic Constipation ◽  
Abnormal Development ◽  
Long Term Results ◽  
Developmental Abnormalities ◽  
Results Of Treatment ◽  
Positive Effect

Background. Currently, the issue of effective conservative treatment of constipation in cases of colon developmental abnormalities remains open. Aim: to study the immediate and long-term results of the treatment of chronic constipation in case of colon development abnormalities, through individualization of the physiotherapeutic methods used, depending on the type of pathology. Methods. The article presents the experience of treatment in the Department of Internal Medicine of the Lugansk Republican Clinical Hospital, from 2013 to the present, of 389 patients with chronic constipation in colon developmental abnormalities. We used types of electrical stimulation, different in the method of applying electrodes and the stimulating current parameters. In the work, we used the serial apparatus Endoton 01-B. We evaluated the immediate and long-term results of treatment in the period from 6 months to 3 years. Results. After 34 courses of rectal electrostimulation of patients with compensated and subcompensated forms of the disease, for 67 months, 346 (88.95%) patients had regular independent defecation with an interval of 2436 hours. The remaining 43 (11.05%) patients with subcompensated and decompensated forms of the disease received 56 courses of rectal electrical stimulation during the year. A persistent positive effect was obtained, namely independent defecation with an interval of 3648 hours. Conclusion. Rectal electrical stimulation for this pathology is considered the method of choice. The functional immediate and long-term results of rehabilitation of patients confirmed the correctness of the approach chosen.

scholarly journals Step by Step Extra-Focal Fixation of Unstable Pelvis with Separate Anterior and Posterior Modules

2014 ◽  
Vol 21 (4) ◽  
pp. 5-14
Author(s):  
I. V Borozda ◽  
N. A Ganzhurov ◽  
A. A Kapustyanskiy ◽  
R. V Nikolaev
Keyword(s):  
Functional Result ◽  
Pelvic Ring ◽  
Main Group ◽  
Long Term Results ◽  
Control Group ◽  
Residual Deformity ◽  
Pelvic Fixation ◽  
Vital Functions ◽  
External Fixation Device

Results of step by step treatment of 28 patients with disintegrative pelvic ring injuries are presented. In 14 patients (main group) step by step extra-focal pelvic fixation with application of anterior (antishock) and posterior modules was performed. In 14 patients (control group) osteosynthesis by external fixation device with circular support was used. Long-term results were assessed in1 year after injury. In control group residual deformity averaged 5 (4-7) mm and was noted in 10 (71.4%) patients. In the main group residual deformity was observed in 4 (28.6%) cases and averaged 2.5 (2-3) mm (p=0.0039). In the main group functional result by Majeed scale was also significantly better (p=0.000319). Excellent and good results were achieved in 9 (64.3%) and 5 (35.7%) of patients, respectively. In control group results were considered to be excellent in 3 (21.4%), good - in 6 (42.9%), satisfactory - in 4 (28.6) and poor - in 1 (7.1%) of cases. Advantage of the proposed transosseous osteosynthesis technique is the modular principle of the construction use that enables to perform separate fixation with anterior (antishock) module followed by final reposition of the pelvic ring with posterior module after stabilization of patient’s vital functions. This allows to increase the number of external pelvic fixation in patients with polytrauma.

scholarly journals RESULTS OF SURGICAL TREATMENT OF NON-PARASITIC SPLENIC CYSTS IN CHILDREN

2018 ◽  
Vol 22 (1) ◽  
pp. 32-35
Author(s):  
A. V. Myzin ◽  
Vasily G. Kuleshov ◽  
A. E. Stepanov ◽  
N. V. Gerasimova ◽  
K. Yu. Ashmanov
Keyword(s):  
Surgical Treatment ◽  
High Efficiency ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Long Term Results ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Splenic Cysts ◽  
Good Cosmetic

Introduction. Currently, there are different views on the treatment of non-parasitic spleen cysts in children. The choice of method of treatment is under discussion. The aim of our study was to evaluate and analyze the immediate and long-term results of surgical interventions performed on nonparasitic spleen cysts in children. Material and methods. There are presented results of surgical treatment of the 21 patient, who was on treatment at the Department of Abdominal Surgery of the Russian Children Clinical Hospital over the period from 2013 to 2016. Patients were examined by means of ultrasound of the abdominal cavity, CT, MRI. All patients have been operated. 22 surgical interventions were performed by using laparoscopic access, out of which 2 partial resections of the spleen, 1 splenectomy, 19 fenestrations of spleen cysts.Results. During the course of the operation and in the immediate postoperative period there were no complications. Patients were observed for the period of from 1 year to 3 years. Good results of treatment were obtained in 20 (95.2%) children. In a long-term period a relapse occurred in the one patient one year after the operation. The patient was reoperated, splenectomy was performed. Conclusion. The surgical treatment of spleen cysts is the basic one. It is indicated for cysts sized larger than 5 cm and cysts with clinical symptoms. Minimally invasive interventions in children are optimal because of their low traumatism and good cosmetic effect. Our study showed a high efficiency of laparoscopic operations in children suffered from non-parasitic spleen cysts with good long-term results.

scholarly journals Diagnostics and surgical tactics in the injury of the heart

2019 ◽  
Vol 178 (2) ◽  
pp. 15-21
Author(s):  
E. A. Tseimakh ◽  
V. A. Bombizo ◽  
P. N. Buldakov ◽  
N. Yu. Rucheykin ◽  
M. E. Tseimakh ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Cardiac Injury ◽  
Diagnostic Error ◽  
Long Term Results ◽  
Satisfactory Condition ◽  
Results Of Treatment ◽  
Clinical Observations ◽  
Cardiology Department ◽  
Surgical Tactics

The objective is to analyze own clinical observations with the purpose of optimization of diagnostics and application of the adequate medical grant to patients with wounds of heart.Material and methods. The results of treatment of 268 patients with heart wounds operated in the clinic for the last 27 years were analyzed. The majority of patients 202 (75.4 %) had penetrating and through wounds to the heart, 66 (24.6 %) had non-penetrating injuries. The diagnosis was based on clinical symptoms, the results of electrocardiographic, echocardiographic and x-ray studies. The clinical picture depended on the nature of the wound – penetrating or non-penetrating. Videothoracoscopy helped to clarify the nature of the damage of the heart in vague diagnostic cases. In most patients, heart damage was recognized in a timely manner, a diagnostic error was committed in 18 (6.7 %) patients. In 59 (22.0 %) cases, myocardial wounds were stitched with P-shaped sutures, and in 209 (78.0 %) – with nodular sutures.Results. 240 (89.6 %) patients were discharged in satisfactory condition, 11 (4.1%) patients were transferred to the cardiology department for the follow-up treatment, 17 patients died with penetrating or through cardiac injury. The mortality rate was 6.4 %.Conclusion. Emergency surgery is the only effective method of treating heart injury. Long-term results of treatment were traced in 38 patients in terms of 1 year to 10 years. All patients had a clinical recovery.

scholarly journals SURGICAL TREATMENT OF SUPERIOR THORACIC OUTLET SYNDROME

2015 ◽  
Vol 174 (1) ◽  
pp. 78-83 ◽  
Author(s):  
A. D. Gaibov΄ ◽  
A. Z. Kakhorov ◽  
O. N. Sadriev ◽  
Kh. A. Yunusov
Keyword(s):  
Surgical Treatment ◽  
Thoracic Outlet Syndrome ◽  
Cervical Vertebrae ◽  
Diagnostic Procedures ◽  
Long Term Results ◽  
Raynaud’S Syndrome ◽  
Results Of Treatment ◽  
Positive Results ◽  
Cervical Ribs

The authors present immediate and long-term results of treatment of 117 patients with superior thoracic outlet syndrome (STOS). There were different reasons for compression of neurovascular fascicle in outlet of the thorax. The costaclavicular syndrome was a reason in 48 patients, additional cervical ribs had 36 patients. Skalenus syndrome was noted in 26 cases, rudimentary cervical ribs or hypertrophy of cervical vertebrae C7 had 7 patients. Raynaud’s syndrome took place in 19 cases. The required volume of diagnostic procedures and surgical treatment of STOS were determined according to the cause of the syndrome. Differentiated approach to the different forms of STOS was used in relation to dominant symptoms of the disease and reasons for compression of neurovascular fascicle. This allowed getting positive results in majority of patients (90,4%) in long-term period.

scholarly journals Surgical treatment and rehabilitation capabilities of patients with patellar fractures

2019 ◽  
Vol 26 (1) ◽  
pp. 11-16 ◽  
Author(s):  
E. I Solod ◽  
N. V Zagorodniy ◽  
A. F Lazarev ◽  
M. B Tsykunov ◽  
M. A Abdulhabirov ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Conflict Of Interest ◽  
Long Term Results ◽  
Optimal Method ◽  
Results Of Treatment ◽  
Combination Osteosynthesis ◽  
Partial Patellectomy ◽  
Patellar Fractures

Relevance. Fractures of the patella represent about 1% of all fractures of the bones. Among surgeons there is no a single approach to the treatment of patients with many fragmentary patellar fractures. After surgical treatment of patients with patellar fractures, various complications could be observed. Aside from that, there is no consensus on the treatment of complex fractures of the patella, and in practice, trauma physicians use a variety of methods of osteosynthesis of the patella. In the light of the foregoing, the study of long-term results of patients after patellar fractures is of particular relevance. Purpose of study: to examine the results of patients after surgical treatment of patellar fractures with a view to devising best practices for its osteosynthesis. Patients and methods. A study of the results of treatment of 78 patients with patellar fractures was conducted. The following groups were identified depending on the type of surgery and the nature of the fracture: Weber osteosynthesis in fragmentary fractures; «cruciform osteosynthesis» and other identical options of osteosynthesis with spokes and wires at three or more fragmented fractures of the patella; combination osteosynthesis. A comparative analysis of the results of treatment of patients after partial patellectomy and osteosynthesis of the patella with spokes and tightening wire loops was conducted. We evaluated the results on the KOOS scale with clinical examination and x-ray examination of patients. Beyond that, we have supplemented this scale with the patients’ own opinion on the evaluation of the results of their treatment. Results. The average follow-up period was 22 months. A comparative analysis of the groups of patients after surgical treatment of patellar fractures on the KOOS scale showed the best results in osteosynthesis of transverse two-fragment patellar fractures by Weber’y - 72%. The results of treatment of patients with many fragmentary patellar fractures using 3-5 spokes and 2-3 wires was - 64%; after the rehabilitation of the lower pole was - 68%) and after partial patellectomy -51%. Conclusion. If a patient has three-fragmented patellar fractures, reasonable results could be achieved by using 3 spokes and 2 tightening wire loops. With four or more fragmentary fractures of the patella, the optimal method for its osteosynthesis is the use of a «cruciform» method with 4 or more spokes in combination with two or three wire loops. The use of patellectomy with subsequent fixation of the blocking wire loop should be avoided in all types of patellar fractures. Key words: patellar fracture, osteosynhesis, surgical treatment Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding

Advanced forms of kidney tuberculosis with fistula formation: modern views

2020 ◽  
pp. 60-69
Author(s):  
Andrey Volkov ◽  
Oleg Zuban ◽  
Galina Saenko
Keyword(s):  
Surgical Treatment ◽  
Pathological Process ◽  
Long Term Results ◽  
Fistula Formation ◽  
Results Of Treatment ◽  
Internal Fistulas ◽  
Intestinal Fistulas ◽  
Kidney Lesions

The aim of the study is to evaluate results of surgical treatment in patients with tuberculous pyonephrosis. In 2004 - 2019 12 patients underwent nephroureterectomy. The disease was complicated by involvement of nearby organs in pathological process and appearance of spontaneous external and internal fistulas in 100% of cases, it manifested with symptoms mostly not associated with kidney lesions. Reno-intestinal fistulas were found intraoperatively in 5 patients. Good long-term results of treatment were achieved mainly due to surgical debridment.

scholarly journals The surgical correction of refractory venous trophic ulcers

2021 ◽  
pp. 38-46
Author(s):  
S. E. Katorkin ◽  
M. J. Kushnarchuk ◽  
M. A. Melnikov ◽  
A. A. Zhukov ◽  
P. F. Kravtsov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Complete Healing ◽  
Long Term Results ◽  
Group Iii ◽  
Results Of Treatment ◽  
Group I ◽  
Group Ii ◽  
Shave Therapy

Objectives. To study the effectiveness of layered dermatolipectomy and endoscopic fasciotomy in the surgical treatment of refractory venous trophic ulcers.Materials and methods. Patients (n = 105) of the C6 clinical class underwent crossectomy and short stripping. In group I (n = 35), free autodermoplasty of trophic ulcers with a perforated flap was performed. In group II (n = 36), shave therapy and autodermoplasty were performed. In group IIІ (n = 34), fasciotomy, shave therapy and autodermoplasty were performed. Long-term results of treatment were studied in the period from 1 to 12 months.Results. Complete healing of venous trophic ulcers was observed in group I at 49,4 ± 7,2, in II – at 31,4 ± 4,7, in III – at 32,1 ± 3,6 days сутки (t1-2 = 2,09; p1-2 = 0,049; t1-3 = 2,24; p1-3 = 0,024; t2-3 = 0,03; p2-3 = 0,763). Full engraftment of an autograft graft was recorded in 7 (19,4 %) patients of group I, in 27 (77,1 %) cases in group II and in 27 (79,4 %) patients of comparison group III (χ21-2 = 23,674; p1-2 = 0,001; χ21-3 = 25,173; p1-3 = χ22-3 = 0,052; p2-3 = 0,826).Conclusion. Layered dermatolipectomy with autodermoplasty and endoscopic decompression fasciotomy is an effective method for the treatment of persistent refractory venous trophic ulcers.

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