Clinical and functional features of rectal sphincter in patients with rectovaginal fistulas before and after split vaginal-rectal flap application

Dysfunction of the rectal sphincter is noted in more than 70 % of patients with rectovaginal fistulas (RVF), which require an extremely careful evaluation of the rectal sphincter function both by clinical and instrumental methods. Objective: to study the state of rectal sphincter in patients with rectovaginal fistulas before and after surgical treatment. Materials and methods: in the period from 2012 to 2021 198 patients (age from 20 to 73 years, Me = 35 (30; 45)) were included in the comprehensive study of the rectal sphincter functional state before and after surgical treatment. 106 (53,5 %) cases were recurrent. Traumatic childbirth was the most common cause of RVF (43,9 %). Results: dysfunction of the rectal sphincter is revealed in 154 (77,8 %) patients with rectovaginal fistulas. The etiology of the disease and the recurrent course do not affect the severity of the rectal sphincter functional disorders. Using of a split rectal-vaginal flap do not lead to a worsening of the rectal sphincter function. Conclusion: A significant mismatch between the obtained objective (sphincterometry) and subjective (Wexner scale) data of the rectal sphincter function in patients with rectovaginal fistulas proves the need for sphincterometry in this category of patients. Elimination of rectovaginal fistulas by using a split vaginal-rectal flap is a safe and low-traumatic surgical method.

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Comparison of the State of Sleep in Patients with Sleep-disordered Breathing Before and After Surgical Treatment

Acta Oto-Laryngologica ◽

10.1080/0365523031000054 ◽

2003 ◽

Vol 123 (0) ◽

pp. 51-55

Author(s):

Munenori Hayakawa ◽

Tadao Nishimura ◽

Kenji Suzuki ◽

Natsuki Morishima ◽

Nobuhiro Shibata ◽

...

Keyword(s):

Surgical Treatment ◽

Sleep Disordered Breathing ◽

The State ◽

Before And After ◽

Disordered Breathing

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The influence of osteopathic correction on the viscoelastic characteristics of the lower leg muscles

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-1-2-93-98 ◽

2019 ◽

pp. 93-98

Author(s):

E. M. Timanin ◽

N. S. Sydneva ◽

A. A. Zakharova

Keyword(s):

Viscoelastic Properties ◽

Gastrocnemius Muscle ◽

Soft Tissues ◽

Subjective Assessment ◽

Lymphatic Drainage ◽

Intercellular Substance ◽

Leg Muscles ◽

Before And After ◽

Viscoelastic Characteristics ◽

Instrumental Methods

Introduction. To date there is a lack of studies dedicated to the objectification of the palpation data obtained by a specialist during the osteopathic examination. The issue of the evidence of the results of osteopathic correction still remains important. Search for instrumental methods allowing to register and to measure various palpation phenomena and manifestations of somatic dysfunctions is very relevant for the development of osteopathy as a science. It is also very important to find objective characteristics of these methods.Goal of research — to study viscoelastic characteristics of the soft tissues of the lower legs by palpation and instrumental methods before and after osteopathic correction.Materials and methods. 22 volunteers (12 women and 10 men) aged 18–23 years without complaints of the musculoskeletal system were examined. Osteopathic diagnostics and measurement of the viscoelastic properties of muscles were carried out by the method of vibration viscoelastometry before and after osteopathic correction.Results. Correlation analysis by Spearman showed that the subjective assessment of an osteopath positively correlated with both elasticity (r=0,43, p<0,05) and viscosity of soft issues (r=0,29, p<0,05). For the gastrocnemius muscle, this pattern was even more pronounced — for elasticity r=0,51, p<0,05, for viscosity =0,34, p<0,05. After osteopathic correction no changes in the elasticity of the soft tissues were observed. The viscosity of the tissues reduced, but in the projection of the gastrocnemius muscle, these changes were not statistically significant (p=0,12), whereas in the projection of the soleus muscle statistically significant changes (p=0,034) were observed.Conclusion. Changes in the viscoelastic properties of tissues demonstrated that the effects of osteopathic correction with the use of myofascial mobilization techniques, articulation mobilization techniques, and lymphatic drainage techniques were not obvious. The elasticity of soft tissues of the lower legs did not change, while the viscosity decreased, especially in the projection of the soleus muscles. This effect of the osteopathic correction can be associated with the effect of thixotropy — the transformation of gel-like intercellular substance into sol. Thus, the research showed that vibration viscoelastometry can be used for the objectifi cation of the condition of soft tissues and of the effects of osteopathic correction.

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Gustatory Function after Radiofrequency Tongue Base Reduction in Patients with Obstructive Sleep Apnea

Otolaryngology ◽

10.1177/0194599811413680 ◽

2011 ◽

Vol 145 (5) ◽

pp. 853-857 ◽

Cited By ~ 4

Author(s):

Young Gyu Eun ◽

Seung Youp Shin ◽

Jae Yong Byun ◽

Myung Gu Kim ◽

Kun Hee Lee ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Surgical Treatment ◽

Sleep Apnea ◽

Medical Center ◽

Tongue Base ◽

Safe Procedure ◽

Gustatory Function ◽

Obstructive Sleep ◽

Before And After ◽

Tongue Base Reduction

Objectives. To investigate the changes in gustatory function as a complication after radiofrequency tongue base reduction (RTBR) in patients with obstructive sleep apnea (OSA). Study Design. Before-and-after study. Setting. Academic tertiary medical center. Subjects and Methods. Thirty-four patients with suspected velopharyngeal collapse only underwent uvulopalatopharyngoplasty (UPPP group). Twenty-five patients with velopharyngeal and retrolingual collapse underwent concurrent UPPP with RTBR (RTBR group). All patients were evaluated before surgery and at 1 and 4 weeks after surgical treatment. A questionnaire was given to assess symptoms of hypogeusia, dysgeusia, hyposmia, and sensation of the tongue. Electrogustometry (EGM) in 4 areas was used to determine gustatory function. Results. Postoperative values for subjective symptoms did not significantly change following surgical treatment in either group. EGM thresholds of all tested in both groups did not significantly change 1 week and 4 weeks after surgery. Conclusions. Gustatory function remained unchanged after RTBR in patients with OSA. The authors suggest that RTBR is a safe procedure in terms of taste sensation in OSA patients.

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Stereopsis before and after surgical treatment for constant versus intermittent exotropia

Oftalmologicheskii Zhurnal ◽

10.31288/oftalmolzh202132327 ◽

2021 ◽

Vol 92 (3) ◽

pp. 23-27

Author(s):

I. M. Boichuk ◽

◽

Alui Tarak ◽

◽

Keyword(s):

Surgical Treatment ◽

Intermittent Exotropia ◽

Before And After ◽

Constant Versus

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Classifications for Proliferative Vitreoretinopathy (PVR): An Analysis of Their Use in Publications over the Last 15 Years

Journal of Ophthalmology ◽

10.1155/2016/7807596 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 11

Author(s):

Salvatore Di Lauro ◽

Mustafa R. Kadhim ◽

David G. Charteris ◽

J. Carlos Pastor

Keyword(s):

Clinical Practice ◽

Surgical Treatment ◽

Proliferative Vitreoretinopathy ◽

Original Description ◽

Therapy Outcome ◽

Outcome Parameters ◽

Classification Errors ◽

Before And After ◽

Pubmed Search ◽

The Way

Purpose. To evaluate the current and suitable use of current proliferative vitreoretinopathy (PVR) classifications in clinical publications related to treatment.Methods. A PubMed search was undertaken using the term “proliferative vitreoretinopathy therapy”. Outcome parameters were the reported PVR classification and PVR grades. The way the classifications were used in comparison to the original description was analyzed. Classification errors were also included. It was also noted whether classifications were used for comparison before and after pharmacological or surgical treatment.Results. 138 papers were included. 35 of them (25.4%) presented no classification reference or did not use any one. 103 publications (74.6%) used a standardized classification. The updated Retina Society Classification, the first Retina Society Classification, and the Silicone Study Classification were cited in 56.3%, 33.9%, and 3.8% papers, respectively. Furthermore, 3 authors (2.9%) used modified-customized classifications and 4 (3.8%) classification errors were identified. When the updated Retina Society Classification was used, only 10.4% of authors used a full C grade description. Finally, only 2 authors reported PVR grade before and after treatment.Conclusions. Our findings suggest that current classifications are of limited value in clinical practice due to the inconsistent and limited use and that it may be of benefit to produce a revised classification.

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Surgical treatment of tandem stenosis of the internal carotid artery

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2021-3-20-26 ◽

2021 ◽

Vol 25 (3) ◽

pp. 20

Author(s):

A. D. Pryamikov ◽

A. B. Mironkov ◽

A. I. Khripun

Keyword(s):

Surgical Treatment ◽

Carotid Artery ◽

Internal Carotid Artery ◽

World Literature ◽

Large Scale ◽

Internal Carotid ◽

Review Article ◽

Conflicts Of Interests ◽

Tandem Stenosis ◽

Instrumental Methods

This review article presents an analysis of the world literature devoted to treating patients with tandem stenosis of the intra- and extra-cranial parts of the internal carotid artery. We indicate the frequency of tandem lesion occurrence and describe the applied instrumental methods of its diagnosis. The review demonstrates the results of tandem stenosis surgical treatment in both early and more modern studies and describes the possibilities of endovascular correction of extra- and intra-cranial stenosis of the internal carotid artery. The authors emphasise the lack of large-scale studies — including randomised studies — regarding combined, tandem carotid stenosis and the need for further studies.Received 30 March 2021. Revised 8 May 2021. Accepted 11 May 2021.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflicts of interests.Contribution of the authors: The authors contributed equally to this article.

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Correction of gastrocardial syndrome in patients with hernias of the esophageal orifice of the diaphragm during antireflux operations

Medical Council ◽

10.21518/2079-701x-2021-21-2-62-71 ◽

2022 ◽

pp. 62-71

Author(s):

T. V. Khorobrykh ◽

A. A. Voevodina ◽

D. A. Efremov ◽

V. I. Korotkiy ◽

N. R. Khusainova ◽

...

Keyword(s):

Surgical Treatment ◽

Angina Pectoris ◽

Hiatal Hernia ◽

Reflux Esophagitis ◽

Antireflux Surgery ◽

Pain Syndrome ◽

Ecg Monitoring ◽

Younger Age ◽

Before And After ◽

Antireflux Operations

Introduction. Hernia of the esophageal opening of the diaphragm in 90% of cases is the main cause of the development of reflux esophagitis. The doctrine highlighted a large group of extraesophageal manifestations of reflux esophagitis, including gastrocardiac syndrome.Аim. The purpose of this publication is to evaluate the effectiveness of antireflux surgery in patients with hiatal hernia through the prism of its effectiveness in the dynamics of gastrocardial syndrome regression.Material and мethods. The paper presents the results of diagnostics and surgical treatment of 101 patients with hiatal hernia.Results. According to the data of instrumental research methods, cardiac hernias of the esophageal opening of the diaphragm were detected in 45 (44.5%) patients, cardiofundal in 40 (39.6%), subtotal in 15 (14.8%), total in 1 (0.9%). The main place in the clinical picture of gastrocardial syndrome was occupied by the pain syndrome behind the breastbone (83.1%). Thus, arrhythmias were found in 16 (40.0%) patients with cardiofundal, in 10 (66.6%) subtotal and in 1 (100.0%) total hiatal hernia, and angina pectoris is characteristic of cardiac hernias and was observed in 20 (44.4%) patients. The clinical manifestation of reflex angina pectoris and arrhythmias depended on the degree of shortening of the esophagus. Thus, arrhythmias were more common in patients with cardiofundal (50.0%), subtotal (71.4%), total (100.0%) hiatal hernia with II degree of shortening of the esophagus, and angina pectoris characteristic of cardiac (75.0%) hiatal hernia. with II degree of shortening of the esophagus. Reflex angina is typical for patients of the older age group, and manifestations of arrhythmia are recorded at a younger age. Heart rate variability was considered, according to electrocardiogram and Holter ECG monitoring before and after surgical treatment, where the parameters significantly (p> 0.05) decreased.Conclusions. The phenomena of gastrocardial syndrome regressed after antireflux surgery in 44 (43.5%) patients. Surgical treatment from the endovideosurgical approach did not worsen the results of surgical treatment.

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PREVENTION AND TREATMENT OF VENOUS THROMBOSIS AND THROMBOEMBOLISM IN SURGICAL TREATMENT PELVIC NEOPLASMS

Kharkiv Surgical School ◽

10.37699/2308-7005.3.2020.15 ◽

2020 ◽

pp. 74-80

Author(s):

A. V. Chikin

Keyword(s):

Surgical Treatment ◽

Venous Thrombosis ◽

Vena Cava ◽

Fold Increase ◽

Initial State ◽

Pelvic Neoplasms ◽

Surgical Interventions ◽

Vein Thrombosis ◽

Prevention And Treatment ◽

Before And After

Summary. Venous thromboembolic complications — a collective concept that combines thrombosis of the saphenous and deep veins, as well as pulmonary thromboembolism. In the clinical practice of a doctor of any specialty, especially surgical, the possibility of timely diagnosis, treatment and preventive measures for deep vein thrombosis and pulmonary embolism are extremely important. Purpose. To study the most informative measures for the prevention and treatment of venous thrombosis and thromboembolism in the surgical treatment of pelvic neoplasms. Materials and methods. The analysis of the results of the examination and treatment of 112 patients observed for tumors of the pelvic organs and tumors of the retroperitoneal space is presented. Results and discussion. When studying the initial state of the hemostasis system in 48 patients, a significant shortening of activated partial thromboplastin time (APTT), a 1.5-fold increase in the concentration of fibrinogen, which indicates activation of the procoagulant link, as well as an increase in platelet aggregation by 20.0 %, were established. Studies of the hemostatic system showed that surgical interventions and injuries contribute to increased hypercoagulation. Conclusions. The most informative methods for determining thrombosis in the system of the inferior vena cava and the optimal examination algorithm are: ultrasonic dynamic angioscanning, determination of the amount of D-dimer, computer, magnetic resonance bolus venography and retrograde ileocavagography. The use of unfractionated and low molecular weight heparins effectively prevents the development of thrombosis and thromboembolism before and after surgery and does not cause bleeding. Nonspecific and specific prophylaxis of venous thrombosis and embolism allowed a 2.8-fold reduction in their number in patients of the main group.

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