SHORT-TERM OUTCOMES OF LAPAROSCOPIC ELECTIVE COLONIC RESECTIONS FOR DIVERTICULAR DISEASE

AIM: to assess the feasibility and safety of laparoscopic elective colon resections for diverticular disease.PATIENTS AND METHODS: a retrospective non-randomized study included 38 patients with elective colon resection for diverticular disease. Twentysix underwent laparoscopic resections (main group), 12 – open resections (controls). The indications for surgery were: chronic diverticulitis, pericolic abdominal mass, external and internal colon fistulas and stricture of the colon. RESULTS: operation time was the same in the control group (167.1±73.3 vs 129.9±43.7 min,p=0.06). Thirty-three (86.8%) resections were performed with a colorectal anastomosis and 5 (13.2%) obstructive resections of the sigmoid colon. In the main group, the inferior mesenteric artery (IMA) was divided at the origin in 4 (15.4%) cases, in the control group – in 6 (50%) (p=0.045). The anastomotic leakage in the main group was in 3 (11.5%) patients, in the control group – in 1 (8.3%)(p=1.0). The postoperative period was significantly shorter in the main group compared with the controls(9.3±2.8 vs 13.4±5.1 days, p=0.003). After laparoscopic procedures, narcotic analgesics were used in 3 (11.5%) cases, after conventional – in 8 (66.7%) (p=0.001).CONCLUSION: laparoscopic approach is comparable to the conventional onein operative timeand postoperative morbidity. Laparoscopic approach is associated with a significantly less postoperative pain syndrome and a shorter postoperative period, more often allows to preserve the IMA as well.

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SIDE-TO-END ANASTOMOSIS IN LOW ANTERIOR RECTAL RESECTION

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2015-174-2-42-46 ◽

2015 ◽

Vol 174 (2) ◽

pp. 42-46

Author(s):

Yu. A. Shelygin ◽

A. S. Budtuev ◽

D. Yu. Pikunov ◽

E. G. Rybakov ◽

O. Yu. Fomenko ◽

...

Keyword(s):

Rectal Cancer ◽

Postoperative Period ◽

Rectal Resection ◽

Randomized Study ◽

Functional Results ◽

Main Group ◽

Stool Frequency ◽

Prospective Randomized Study ◽

Control Group ◽

Anterior Rectal Resection

The authors have launched a prospective randomized study aimed to make a comparison of functional results of formation of straight coloanal (control group) and side-to end (main group) anastomosis in case of low anterior rectal resection since 2012. Each group consisted of 40 patients undergoing operation concerning uncomplicated rectal cancer of medium-ampullar section of rectum. It was noted that patients of the main group had lower stool frequency in postoperative period. A function of the interior sphincter was less damaged and the rate of compliance of rectum was high.

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Clinical efficacy of osteopathic correction in the complex treatment of patients with unoperated open-angle glaucoma

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-3-4-97-105 ◽

2020 ◽

pp. 97-105

Author(s):

E. N. Simakova ◽

O. V. Stenkova

Keyword(s):

Intraocular Pressure ◽

Drug Therapy ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Randomized Study ◽

Main Group ◽

Control Group ◽

Open Angle ◽

Complex Treatment ◽

Hypotensive Drug

Introduction. Glaucoma is one of the most significant eye diseases. It is often diagnosed, not always amenable to therapy, and can lead to a complete loss of visual functions. In recent years, the method of osteopathic correction has become widespread as one of the effective methods of treatment and rehabilitation of patients with pathologies of various body systems. In the pathogenesis of glaucoma, it is customary to distinguish a dystrophic concept, which considers primary open-angle glaucoma as a result of dystrophic changes in the connective tissue, as well as in the endothelial lining of the trabeculae and Schlemm′s canal, especially destructive changes in mitochondria and the alteration of their functional activity. A vascular concept is also distinguished. According to this concept, the central link in the pathogenesis of glaucoma is circulatory disorder in the ciliary vessels, ocular artery, and major vessels of the head and neck, it can be assumed that osteopathic correction in the treatment of patients with open-angle glaucoma will be pathogenetically substantiated and will have a positive effect on intraocular pressure and trophicity of the optic nerve. The goal of research — to study the influence of in osteopathic correction on the nature of unoperated glaucoma (stage IIA) and to substantiate the possibility of using osteopathic correction in the complex treatment of patients with this pathology.Materials and methods. A prospective controlled randomized study was conducted at 52 city polyclinics, branch 3, Moscow, from January 2018 to January 2019. 40 patients (70 eyes) aged 50 to 75 years with primary open-angle glaucoma IIA stage were examined. At this stage of the disease, patients most often seek medical care and the issue of conservative management is primarily considered. All patients were divided into two groups of 20 people: the main group and the control group. The treatment in the main group included hypotensive drug therapy and osteopathic correction. Patients of the control group received only drug therapy. All patients underwent ophthalmic (visometry, tonometry, perimetry) and osteopathic examination twice: before the treatment and after 3 months.Results. For patients with primary open-angle IIA non-operated glaucoma, regional (most often regions of the head, neck, dura mater) and local (abdominal diaphragm, iliac bones, hip and knee joints) somatic dysfunctions were the most typical. In the main group a statistically significant decrease in the frequency and severity of dysfunctions at all levels was stated. Also, in patients receiving osteopathic correction, a significant decrease in the level of intraocular pressure and perimetric indices was noted. In patients of the control group, no reliable changes in these indicators were obtained.Conclusion. The results obtained indicate that osteopathic correction is clinically effective in the complex treatment of patients with primary open-angle II A glaucoma.

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Application of Nasomer in surgical treatment of patients with polyposis rhinosinusitis

OTORHINOLARYNGOLOGY 2-3(2) 2019 - OTORHINOLARYNGOLOGY ◽

10.37219/2528-8253-2018-2-39 ◽

2018 ◽

pp. 39-42

Author(s):

Vladimir Bereznyuk ◽

Alexander Chernokur ◽

Oleg Gospod

Keyword(s):

Nasal Cavity ◽

Postoperative Period ◽

Paranasal Sinuses ◽

Standard Treatment ◽

Surgical Intervention ◽

Sodium Hyaluronate ◽

Main Group ◽

Control Group ◽

Nasal Breathing ◽

Minimal Invasiveness

Relevance: Modern endonasal surgery allows to remove polyps from all affected paranasal sinuses, following the principles of minimal invasiveness. Minimal traumatic of surgical intervention gives the best results, accompanied by less progression of the disease. Minimal invasiveness of surgical intervention and its obligatory combination with postoperative medical treatment are common practice in many countries. One of the drugs that actively effect the restoration of the mucous membrane of the nasal cavity and paranasal sinuses in the early postoperative period is Nazomer, which includes sodium hyaluronate and dexpanthenol in saline solution. The purpose of the study is to investigate the effectiveness of the drug Nazomer in patients with polyposis rhinosinusitis after endoscopic polyposynosotomy. Results and discussion: The main group consisted of 30 patients with polyposis rhinosinusitis, who were prescribed Nasomer in addition to standard treatment in the postoperative period. The control group included 30 patients who underwent standard treatment in the postoperative period. As criteria for clinical efficacy, data from endoscopic examination of the nasal cavity and indicators of anterior rhinomatometry, measured by the «Optimus» device, were selected. In the main group, the index of nasal breathing according to rhinomatometry was better than the results of patients in the control group on the 3rd and 5th day of the postoperative period by 26% and 24%, respectively. Conclusion: The use of the drug Nazomer in the postoperative period in patients with polyposis rhinosinusitis contributes to more active restoration of respiratory function of the nasal cavity compared with the control group, according to rhinomatometry, up to 26%. Based on the results obtained, the drug Nazomer is an effective anti-inflammatory and regenerative agent in the postoperative period in patients with polyposis rhinosinusitis.

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Evaluation of the effectiveness of ARVI treatment regimen including etiotropic (enisamium iodide) and symptomatic treatment

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.03.000572 ◽

2020 ◽

Vol 92 (3) ◽

pp. 50-55

Author(s):

D. A. Lioznov ◽

E. J. Karnaukhova ◽

T. G. Zubkova ◽

E. V. Shakhlanskaya

Keyword(s):

Influenza A ◽

Viral Infections ◽

Clinical Symptoms ◽

Randomized Study ◽

Antiviral Drug ◽

Main Group ◽

Average Score ◽

Control Group ◽

Symptomatic Therapy ◽

Respiratory Viral Infections

Aim. To assess the effectiveness of the use of the antiviral drug enisamium iodide in the complex treatment of acute respiratory viral infections (ARVI) caused by various pathogens in routine clinical practice. Materials and methods. А prospective randomized study included 134 patients who were treated in the epidemic season of influenza and ARVI in 20182019. All patients were examined for the presence of influenza A and B viruses, respiratory syncytial virus, human metapneumovirus, parainfluenza virus, coronaviruses, rhinoviruses, adenoviruses in nasopharyngeal swabs by PCR. Patients of the main group received enisamium iodide along with symptomatic therapy, the control group received only symptomatic therapy. The primary parameter of the effectiveness of therapy was evaluated on the scale of the general severity of the manifestations of ARVI (Total Symptom Score TSS) from the 2nd to the 4th day and by the secondary criteria of effectiveness: assessment of the duration of ARVI, the severity of fever, the proportion of patients with normal body temperature, the duration of the main clinical symptoms of acute respiratory viral infections, the proportion of patients in whom complications requiring antibiotics were noted, the dynamics of interferon status on the 6th day. To conduct a statistical analysis, depending on the efficiency parameter, the ANCOVA method with a fixed group factor and an initial score on the TSS severity scale was used as covariates, a criterion for comparing quantitative indicators in two independent groups. Results. According to the results of the analysis of the primary efficacy parameter, the median (interquartile range) of the average score on the scale of the general severity of ARVI manifestations in the main group was 4.33 (3.675.83), in the comparison group 6.00 (4.677.25; p0.001). The duration of systemic and local manifestations of acute respiratory viral infections was statistically significantly less in the main group (p=0.002 and p=0.019, respectively). Prescription of additional therapy was required in 2 (2.9%) patients of the main group (patients taking enisamium iodide), compared with 8 (11.9%) patients in the control group. Serum levels of interferon  and interferon  on the last day of treatment were statistically significantly higher in patients of the main group compared with the control group (p0.001). Treatment (excellent) was evaluated by 42 (62.7%) patients, while in the control group only 17 (25.8%) patients gave similar ratings. Both patients (p0.001) and doctors (p0.002) rated therapy tolerance better in the study group. Conclusion. The results confirmed the safety and effectiveness of enisamium iodide as a treatment for ARVI and influenza. The antiviral, interferonogenic and anti-inflammatory properties of the drug are involved in the formation of an antiviral response and reduce the risk of complications, which makes it possible to reduce the number of symptomatic agents used.

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IMPROVING THE RESULTS OF TREATMENT OF PATIENTS WITH URETERAL CONCREMENTS AFTER CONTACT URETEROLITHOTRIPSY

Research n Practical Medicine Journal ◽

10.17709/2409-2231-2017-4-2-1 ◽

2017 ◽

Vol 4 (2) ◽

pp. 8-12

Author(s):

R. M. Solh ◽

M. I. Andrukhin ◽

O. V. Makarov ◽

V. V. Fedchenkov

Keyword(s):

Laser Therapy ◽

Postoperative Period ◽

Acute Pyelonephritis ◽

Main Group ◽

Ureteral Stones ◽

Control Group ◽

Results Of Treatment ◽

Group 6 ◽

Beta 2 ◽

Beta 2 Microglobulin

Purpose. Im proving the results of treatment of patients with ureteral stones and reducing the dam aging effects of contact lithotripsy.Materials and methods. In this study, 48 patients were examined aged 20 to 63 years. All patients admitted to the urology department with diagnoses: urolithiasis, calculus of the ureter. In all cases contact ureterolithotripsy with stenting of the upper urinary tract were performed. The patients were divided into two groups: main and control. 25 patients (52 .1%) were included into the main group, which in the postoperative period, we used low-level laser therapy (L-therapy). 23 patients were included in a control group (47.9%) who did not receive low-laser therapy. Laboratory tests and ultrasound with Doppler renal blood vessels scan were performed on admission, on the first day after the operation and on the 5-th day of hospitalization. Low-intensity laser therapy was performed within 5 days after contact ureterolithotripsy on projection of placement of stone and kidney projection by series for 5 minutes.Results. All patients admitted to the hospital, were spared from ureteral stones. In the main group during the treatment with L-therapy a decrease in the level of beta-2 microglobulin to normal was observed. (4.8 ± 0.1 mg/l on the first day. On the 5th day 2 .3 + 0.1 mg/l). In the control group during the treatment without the use of L-therapy, the average level of beta-2 microglobulin decreased but did not reach normal levels. (5.5 ± 0.1 mg/l on the first day. On the 5th day 3,2 ±0, l mg/l).Resistance index in the study group decreased compared to the control. In the control group, cases of acute pyelonephritis were observed. The average hospital stay for patients of the main group (6 days) was less than in the control group (6 .5 + days).Conclusion. The use of laser therapy in the treatment of patients who did undergo ureterolithotripsy can reduce the length of stay of the patient in the hospital and reduce the risk of acute pyelonephritis in the postoperative period. Also it can reduce the damaging effect of lithotripsy on the renal tissues.

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Optimization of rehabilitation measures after artificial abortion as the result of immunomodulator aminodihydrophthalasindione sodium apply in comprehensive therapy

Medical Council ◽

10.21518/2079-701x-2018-21-156-161 ◽

2019 ◽

pp. 156-161

Author(s):

E. A. Voroshilova

Keyword(s):

Marked Reduction ◽

Clinical Effect ◽

Comparison Group ◽

Clinical Symptoms ◽

Randomized Study ◽

Main Group ◽

Control Group ◽

Comprehensive Therapy ◽

Effect Of Treatment ◽

Artificial Abortion

The article presents the results of a comparative randomized study, the purpose of which was to evaluate the effectiveness of the use of aminodihydrophthalasindione sodium (Galavit, LLC SELVIM, Russia) in the treatment of patients undergoing an abortion. Included in the study, 48 women were divided into two groups, 24 patients of the main group in addition to the standard rehabilitation were treated with aminodihydrophthalasindione sodium in the comparison group – 24 patients underwent only standard rehabilitation. In this study, all patients (100%) of the main group who were treated with aminodihydrophthalasindione sodium in addition to the standard therapy marked reduction of the clinical symptoms of the disease and positive dynamics was observed at ultrasound. In the control group, the full clinical effect of treatment was observed only in 10 patients (52.6%). 9 women (47,4%) required repeated therapy. Ultrasound studies in 12 patients (63.2%) showed changes equivalent to endometritis.

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Diagnostics and treatment of abdominal complications after gynecological endoscopic operations

Reproductive health of woman ◽

10.30841/2708-8731.1.2021.229720 ◽

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.

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Laparoscopic-assisted reversal of Hartmann's procedure

Acta chirurgica iugoslavica ◽

10.2298/aci1003059a ◽

2010 ◽

Vol 57 (3) ◽

pp. 59-65 ◽

Cited By ~ 6

Author(s):

S. Achkasov ◽

G. Vorobiev ◽

A. Zhuchenko ◽

M. Rinchinov

Keyword(s):

Wound Infection ◽

Operation Time ◽

Main Group ◽

Hartmann’S Procedure ◽

Control Group ◽

Open Approach ◽

Hartmann's Procedure ◽

Comparable Control ◽

Hospital Stays ◽

Laparoscopic Assisted

BACKGROUND: Postoperative morbidity after reversal of Hartmann's procedure remains high. AIM: to evaluate efficacy of laparoscopic-assisted approach. PATIENTS AND METHODS: 36 patients (19 men, aged 55.71+1.5 years) underwent laparoscopic-assisted reversal procedures in May 2008 - June 2010. The comparable control group consisted of 35 patients (16 men, aged 51.5+13.9 years). RESULTS: operation time was 179.5+65.1 min, 266.9+71.8 min in controls. Blood loss was 64.7+33.7 ml, 181.8+120.4 ml in controls. No conversions occurred in the main group. In three patients of the main group preventive ileostomy was performed. There were 11 diverting stomas in the control group. Postoperative hospital stays were 9.1+2.7 days (12.9+3.4 days in controls). There were 2 (5.9%) postoperative complications in the main group: one wound infection and one parastomal fistula. No mortality occurred. In the control group 3 (9.1%) complications (wound infection and haematoma) were detected. CONCLUSION: laparoscopic-assisted reversal of Hartmann's procedure promotes faster rehabilitation, its results are not worse than after open approach.

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Evaluation of the clinical efficacy and safety of nitric oxide synthesized from room air in the postoperative period of cardiac surgery

Translational Medicine ◽

10.18705/2311-4495-2021-8-1-38-50 ◽

2021 ◽

Vol 8 (1) ◽

pp. 38-50

Author(s):

A. E. Bautin ◽

V. D. Selemir ◽

A. I. Shafikova ◽

K. Yu. Afanasyeva ◽

E. S. Kurskova ◽

...

Keyword(s):

Nitric Oxide ◽

Cardiac Surgery ◽

Side Effects ◽

Pulmonary Artery ◽

Clinical Efficacy ◽

Median Duration ◽

Postoperative Period ◽

Main Group ◽

Control Group ◽

Efficacy And Safety

Background. Inhaled nitric oxide is a highly selective pulmonary vasodilator, the potential benefits of which include reduced resistance and pressure in the pulmonary artery without systemic arterial hypotension, vasodilation in well-ventilated areas of the lungs, rapid onset of action, and a fairly low incidence of side effects in the therapeutic dose range. Objective. Тс estimate the clinical efficacy and safety of the method for synthesizing nitric oxide from room air in the postoperative period of cardiac surgery. Design and methods. A total of 110 patients were enrolled in the study: 55 patients were included in the main group (nitric oxide was synthesized from room air by AIT-NO-01 device), 55 patients were enrolled in the retrospective control group (nitric oxide was inhaled from the balloon). Inclusion criteria were: undergone heart surgery, mean pulmonary artery pressure (PAPm) ≥ 25 mm Hg., pulmonary artery wedge pressure (PAWP) ≤ 15 mm Hg. Results. After one hour of nitric oxide inhalation in the main group, there were a 35 % decrease in PVR and a 16 % decrease in PAPm. In the control group, there were a decrease in PVR by 40 % and decrease in PAPm by 19 %. Inhalation of nitric oxide did not affect the systemic circulation hemodynamics both in the main and in the control groups. The median duration of the mechanical ventilation (MV) was 7.3 (4.5; 13.8) h and the median length of stay (LOS) in the ICU was 23.2 (21.3; 46) h in the main group. In the retrospective control group, the median duration of MV was 8.2 (5; 14.1) h, and the length of ICU stay was 24 (22; 45.3) h; found no differences between the groups. Conclusion. Nitric oxide synthesized from room air significantly reduces PVR and PAPm in patients with precapillary pulmonary hypertension after cardiac surgery. There were no significant differences in the effect on a pulmonary circulation, clinical data and side effects between the methods of synthesis of nitric oxide from room air and dosing from balloons.

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Use of Alendronate in Postoperative Period for Prevention of Hip Implant Aseptic Instability

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto200916336-44 ◽

2009 ◽

Vol 16 (3) ◽

pp. 36-44

Author(s):

Svetlana Semenovna Rodionova ◽

T N Turgumbaev ◽

S S Rodionova ◽

T N Turgumbaev

Keyword(s):

Calcium Carbonate ◽

Bone Density ◽

Bone Tissue ◽

Postoperative Period ◽

Main Group ◽

Control Group ◽

Study Group ◽

Surgical Team ◽

Tissue Mass ◽

Mineral Bone Density

Assessment of the alendronate influence upon the course of adaptive remodeling of bone tissue adjacent to the implant was performed. Dynamics of mineral bone density (BMD) changes in Gruen zones was compared for 2 groups of female patients. The groups were similar by age, nosology. All operations were performed by the same surgical team with application of one type of implant (Zweymuller). During the first post-operative year patients from the study group (n=38) were taken alendronate (Fosamax-70) once a week and at least 1200 mg of calcium carbonate daily (either as calcium containing food products or calcium carbonate preparations). Patients from control group (n=94) were taken only calcium carbonate by the same scheme within the first postoperative year. It was detected that although by 6th postoperative month alendronate did not decraese BMD loss as compared to controls, within the interval of 6-15 months it significantly increased bone tissue mass accretion. In group of alendronate patients monthly accretion of bone tissue in some Gruen zones (except for R4) was twice and more higher than in control group. Fifteen months later patients from the main group showed BMD deficit only in R4 zone. In the rest of zones bone tissue mass exceeded the basic values and in the majority of zones that increase was trustworthy. In control group BMD deficit was preserved in two proximal zones (R6 and R7) and in zone R6 it even increased as compared to the results of the previous study (12 months after operation).

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