Iatrogenic hepatic damage as a problem of modern surgery (literature review)

2021 ◽  
Vol 22 (3) ◽  
pp. 94-101
Author(s):  
Ya. A. Chakhchakhov ◽  
◽  
B. K. Gibert ◽  
◽  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Bile Ducts ◽  
Diagnostic Algorithm ◽  
Controversial Issues ◽  
Surgical Interventions ◽  
Iatrogenic Damage ◽  
Extrahepatic Bile Ducts ◽  
The Russian Federation

Iatrogenic damage to the extrahepatic bile ducts occurs in a fairly large number of observations, despite constant work aimed at improving surgical interventions. The most optimal chosen therapeutic tactics, as well as the timing of the revealed damage to the bile ducts, determine the effectiveness and quality of care provided to this category of patients. We also have to state that, to date, in the Russian Federation there is no unambiguously generally accepted and approved therapeutic and diagnostic algorithm for iatrogenic damage to the extrahepatic bile ducts. One of the main aspects of the effectiveness of the applied treatment tactics is the level of quality of life of patients who underwent surgical treatment. Treatment and management of patients with iatrogenic damage to the extrahepatic bile ducts still have a fairly large number of controversial issues, the solution of which should improve the immediate results of surgical treatment of this category of patients.

scholarly journals For the 30th anniversary of laparoscopic cholecystectomy: problems remain

2019 ◽  
Vol 100 (3) ◽  
pp. 537-541
Author(s):  
I V Fedorov ◽  
A N Chugunov ◽  
L E Slavin ◽  
D A Slavin ◽  
V I Fedorov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Ducts ◽  
Perioperative Complications ◽  
Open Cholecystectomy ◽  
Intrahepatic Bile Ducts ◽  
Negative Effect ◽  
Iatrogenic Damage ◽  
Extrahepatic Bile Ducts ◽  
Legal Costs

The review describes perioperative complications of laparoscopic cholecystectomy. Over the past 30 years, laparoscopy has become the «gold standard» for cholecystectomy and one of the most frequently performed procedures in abdominal surgery. Nevertheless, despite the advantages of the method, it has an «Achilles heel» - the frequency of iatrogenic damage to the extrahepatic bile ducts is 3-5 times higher than with an open cholecystectomy. This complication has a negative effect on the survival of patients after surgery, leads to deterioration in the quality of life and is a major source of legal costs in many countries. In general, the total range for any damage to the biliary tract during laparoscopic cholecystectomy is 0.32-0.52%, while the complication rate and mortality rate are 1.6-5.3% and 0.08-0.14%, respectively. Patients who have undergone a complete intersection of the hepaticoholedochus, become «bile cripples» for life. Recurrent cholangitis, strictures of anastomoses with a possible outcome in liver cirrhosis are quite likely in later periods after damage to the intrahepatic bile ducts. Technological efforts to improve the results of laparoscopic cholecystectomy reside. These include the routine use of intraoperative cholangiography, infrared fluorescent cholangiography, etc. Nevertheless, despite the growing number of methods designed to reduce these complications, evidence of their effectiveness remains limited. The most important factors ensuring the safety of laparoscopic cholecystectomy are recognized: understanding of anatomy, adequate exposure when using electrosurgery, psychological readiness to invite a senior colleague in time for help, the ability to recognize a situation that requires conversion and rejection of laparoscopy.

Concept «quality of life» and method of its assessment in patients after surgical treatment of the aortal valve faults

2019 ◽  
pp. 46-50
Author(s):  
A. N. Molchanov
Keyword(s):  
Quality Of Life ◽  
Heart Disease ◽  
Surgical Treatment ◽  
The Elderly ◽  
Underlying Disease ◽  
Point Of View ◽  
Optimal Method ◽  
Surgical Interventions ◽  
Age Related

The review of the literature examines the study of the quality of life of patients in the older age group after cardiac surgery for heart disease. In recent years, the number of elderly people has increased significantly in many countries. As a result of this phenomenon, cardiologists and cardiac surgeons are increasingly confronted in their practice with elderly patients. There are features of the management of cardiac and cardiac surgical patients of advanced age, caused both by the specifics of the underlying disease and by concomitant diseases. With the emergence of new options for evaluating the effectiveness of various methods of surgical correction of heart disease in age patients, new questions arise that require evidentiary consideration and an optimal answer. Opinions of experts about the feasibility of surgical interventions in the elderly are often different. The urgency of the problem is due to the recent increase in the number of heart operations in the group of age-related patients. The study of the quality of life of patients in the postoperative period helps to determine the most rational and optimal method of surgical treatment, not only from the point of view of the cardiac surgeon, but also from the standpoint of assessing the patient himself. In addition, frequent postoperative complications and recurrences of diseases force specialists to focus on the quality of life of patients after surgery, which makes the problem extremely urgent.

scholarly journals SIMULATION MODEL OF OPERATIONAL INTERVENTIONS TAKING INTO ACCOUNT NEW NECK TOPOGRAPHIC–ANATOMICAL DATA

2020 ◽  
Vol 23 (2) ◽  
pp. 124-132
Author(s):  
Yu. V. Maleev ◽  
P. N. Romashchenko ◽  
N. F. Fomin ◽  
A. V. Chernykh ◽  
D. S. Krivolapov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Gland ◽  
Simulation Model ◽  
Diagnostic Algorithm ◽  
Structural Features ◽  
Optimal Method ◽  
Anatomical Studies ◽  
Surgical Interventions ◽  
Cervical Trachea

Considerable difficulties and serious complications during operations on the thyroid (thyroid gland) and parathyroid gland (OSG), larynx, cervical trachea and esophagus are caused primarily by their large anatomicalvariability. Purpose of the study. To develop a simulation model of surgical interventions on the neck, taking into account new data on its typical anatomy to improve the quality of life of patients. Material and methods: Somatometry of the neck: 300 men aged 17 to 47 years (22 ± 4 years) and 475 women from 16 to 66 years (21.9 ± 5 years). Topographic-anatomical studies - 426 non-fixed corpses of persons who died suddenly: 290 males who died aged 18 - 83 years (47 ± 12) and 136 - females aged 17 - 85 years (52 ± 16). Clinical studies - in the clinic of faculty surgery S.P. Fedorova VMA from 2013 to 2017: 470 operated patients with thyroid pathology. Results and conclusion. The optimal method of neck somatometry was tested; systematized topographic – anatomical structural features of the thyroid gland and the thyroid gland, VGN, esophagus, trachea, larynx; made anatomical discoveries; proposed new principles for developing a simulation model of operations, taking into account extreme types of variability. A treatment and diagnostic algorithm is proposed for thyroid and thyroid surgery, which minimizes intraoperative and postoperative complications and improves the quality of life of patients.

scholarly journals Comparative evaluation of the effect of different methods of surgical treatment of chronic pancreatitis on the quality of life of patients

2012 ◽  
Vol 93 (1) ◽  
pp. 34-38
Author(s):  
A A Karpachev ◽  
I P Parfenov ◽  
A Yu Khlynin ◽  
A L Yarosh ◽  
A V Soloshenko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Psychological Health ◽  
Comparative Evaluation ◽  
General Health Questionnaire ◽  
Life Quality ◽  
Surgical Interventions ◽  
Physical And Psychological Health

Aim. To conduct a comparative evaluation of the effectiveness of surgical treatment of chronic pancreatitis and define the quality of life of patients depending on the methods of surgical treatment. Methods. The study included 81 of the 165 patients with chronic pancreatitis, who underwent the following operations: endoscopic transmural interventions through the wall of the stomach and duodenum, endoscopic transpapillary surgery, percutaneous interventions for sanitation and drainage of the cystic cavity, laparotomic operations of internal drainage, resection interventions. The quality of life of patients was assessed using the general health questionnaire SF-36. Results. The lowest level of life quality was established in the group of patients after endoscopic transpapillary interventions. Statistically significant differences in the level of physical and psychological health were established when comparing patients after endoscopic transpapillary interventions and after endoscopic transmural surgical interventions, which were carried out through the wall of the stomach and duodenum; differences only in the level of physical health were noted when comparing with the group of resection interventions. Conclusion. The quality of life of patients with chronic pancreatitis depends on the type of surgical intervention, age and sex of the patients.

Influence of endometriosis and some methods of its treatment on the quality of life of women of reproductive age

2021 ◽  
Vol 50 (3) ◽  
pp. 100-102
Author(s):  
V. I. Konovalov ◽  
M. A. Zvychayny
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Operative Treatment ◽  
Hormonal Therapy ◽  
Life Quality ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Surgical Interventions

The aim of the study was to investigate the effect of endometriosis and somewide-spread contemporary methods of its conservative hormonal and operative treatment on the life quality of women of reproductive age. 546 women, aged 20-40, were examined: 371 patients with initially diagnosed endometriosis, 64 after conservative hormonal therapy, 111 after efficient surgical interventions and 30 healthy women (a control group). The following conclusion has been made: endometriosis arising at the reproductive age greatly deteriorates the life quality of women as compared to the healthy ones but none of the studied methods of its conservative hormonal therapy and efficient surgical treatment enables its rehabilitation.

scholarly journals Carbohydrate metabolism and quality of life in patients after surgical treatment of insulinoma

2014 ◽  
Vol 11 (3) ◽  
pp. 18-22
Author(s):  
Ivan Ivanovich Dedov ◽  
Galina Afanas'evna Melnichenko ◽  
Alena Anatol'yevna Krivko ◽  
Nikolay Sergeevich Kuznetsov ◽  
Ekaterina Anatol'evna Troshina
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Carbohydrate Metabolism ◽  
Russian Federation ◽  
Term Treatment ◽  
Psychological Status ◽  
Anthropometric Parameters ◽  
Long Term Treatment ◽  
The Russian Federation

Objectives. T study the quality of life and status of carbohydrate metabolism in patients after surgical treatment insulinoma. Methods: The study involved 20 patients divided in two groups: the first group with a catamnesis duration of up to five years; the second group with a catamnesis duration of more than five years. We studied anthropometric parameters and carbohydrate metabolism as well as psychological questioning of patients using SF-36 questionnaire, the data was considered statistically significant at p0.05. Results. severe combined postoperative complications were more frequent in the first group (63.6% vs. 22.2%, p=0.07), due to extend of the performed surgery. Adrenergic symptoms prior to the surgery were detected in 90.9% of cases in the first group and in 77.7% of cases in the second group. After treatment these numbers decreased to 36.4% and 11.1% respectively (p=0.039 and 0.026). Neuroglycopeniс symptoms before treatment were detected in 90.9% of cases in the first group and for all patients in the second, while after treatment persisted only in 45.5% and 33.3% of cases respectively (p=0.045 and 0.036). Carbohydrate metabolism have normalized for the majority of patients. Two patients (18.2%) of the first group showed impaired glucose tolerance. Improved carbohydrate metabolism was associated with a decrease in body weight in both groups. Results of psychological questionnaires were comparable with the survey data obtained in general population in the Russian Federation. Conclusion. Surgical treatment of insulinomas is highly effective. Physical and psychological status of patients in most cases corresponds with those typical for this age-sex group of the population of the Russian Federation. Long-term treatment results do not depend on duration of the catamnesis. Complications that developed from surgical treatment have the main influence on the health of patients.

scholarly journals QUALITY OF LIFE AS AN INDICATOR OF THE EFFECTIVENESS OF THE CHOICE OF THE METHOD OF TREATING ULCER DISEASES

2019 ◽  
pp. 52-58
Author(s):  
Виктор Куница ◽  
V. Kunitsa ◽  
Татьяна Полищук ◽  
Tatyana Polishchuk ◽  
Сергей Чернуха ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peptic Ulcer ◽  
Surgical Treatment ◽  
Peptic Ulcer Disease ◽  
Surgical Interventions ◽  
Ulcer Disease ◽  
New Methods ◽  
Methods Of Treatment ◽  
Non Surgical Treatment

Progress in clarifying the etiology, pathogenesis of peptic ulcer disease and the development of new methods of treatment did not lead to a decrease in surgical interventions for urgent and urgent reasons. At the same time, the quality of life of patients is the lowest after gastrectomy. Vagotomy to a lesser extent affects the quality of life, comparable to non-surgical treatment

scholarly journals ASSESSMENT OF THE QUALITY OF LIFE OF PATIENTS AFTER CHOLECYSTECTOMY, DEPENDING ON THE TYPE OF SURGICAL ACCESS AND THE NATURE OF THE DISEASE

2020 ◽  
Vol 75 (3) ◽  
pp. 50-55
Author(s):  
Yu.A. Sobolev ◽  
◽  
A.I. Belyaeva ◽  
V.I. Davydkin ◽  
R.I. Fedulov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Syndrome ◽  
Surgical Interventions ◽  
Surgical Access ◽  
Medical Institutions ◽  
Patient Groups ◽  
The Russian Federation ◽  
Access Surgery ◽  
Main Factor

The prevalence of cholelithiasis among the working population ranges from 10 to 20 %. Cholecystectomy ranks first in frequency among surgical interventions. The purpose of this work is to assess the quality of life in patients with cholelithiasis 6 month after cholecystectomy. The study was conducted on the basis of three medical institutions in the Russian Federation. The patient groups were homogeneous in their composition, and the quality of life was assessed using the Gallstone Impact Checklist. The groups were compared depending on the type of operative access (laparoscopic, mini-access), and depending on the nature of the disease (symptomatic and asymptomatic variants). The results were calculated as the average calculated value ± standard deviation. The following results were obtained, which show that cholecystectomy significantly reduces the quality of life of patients. Laparoscopic access is more preferable in the presence of pain syndrome, as the main factor in reducing the quality of life. Mini-access surgery is not accompanied by a deterioration in the quality of life in patients with pain and dyspeptic syndromes, but it improves the emotional and volitional sphere of human activity.

scholarly journals New methods of surgical operations on large bowel

2018 ◽  
Vol 85 (7) ◽  
pp. 16-20
Author(s):  
V. М. Меlnyk ◽  
О. І. Poyda ◽  
E. М. Shepetko ◽  
І. І. Polovnikov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Large Bowel ◽  
Functional Results ◽  
Late Results ◽  
Occurrence Rate ◽  
Surgical Interventions ◽  
New Methods ◽  
Severity Degree

Objective. To improve the immediate and late results of surgical treatment in patients, suffering the large bowel (LB) diseases, using improvement of standard and elaboration of new methods of radical, оrgan-preserving, restorational and reconstructive-restorational operations. Маterials and methods. New methods of radical, оrgan-preserving, restorational and reconstructive-restorational operations on LB were elaborated, taking into account peculiarities of the diseases morphogenesis, аnatomical and functional details of the LB separate parts. The operations mentioned were performed in 497 patients, suffering LB cancer, ulcerative colitis, Crohn’s disease, familial adenomatous polyposis, chronic decompensated colostasis, complicated by the LB diverticular disease. Results. Due to implementation into clinical practice of the surgical interventions elaborated, the postoperative morbidity occurrence rate have reduced down to 2.4%, postoperative lethality - to 0.2%, the functional results improved, the occurrence rate and the severity degree for pathological postoperative syndromes have lowered (reflux-ileitis, postcolectomy syndrome, syndrome of low anterior resection, secondary anal incontinence), the governing of the outflow process after rectal extirpation was guaranteed, the operated patients quality of life improved essentially due to introduction of the surgical interventions elaborated. Conclusion. Improvement of the surgical treatment results for the LB diseases is possible while applying of new methods of radical, organ-preserving , restorational and reconstructive-restorational operations, what promotes the essential reduction of the occurrence rate for the LB diseases recurrence occurrence, pathological syndromes morbidity and their severity degree, significant improvement of functional results and quality of life in the patients operated.

scholarly journals DYNAMICS IN CHANGES OF FREE-RADIAL OXIDATION PROTEINS, REGENERATOR PROCESSES, MICROBIAL DISTRIBUTION AND NON-SPECIFIC IMMUNITY IN THE HOMOGENATES OF SCAR TISSUES AT DIFFERENT STAGES OF THE POSTOPERATIVE PERIOD

2018 ◽  
Vol 22 (3-4) ◽  
pp. 3-6
Author(s):  
L.R. Krinichko ◽  
S.M. Grigorov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Biochemical Parameters ◽  
Surgical Interventions ◽  
Aesthetic Result ◽  
Microbial Distribution ◽  
Combined Use ◽  
Biochemical Mechanisms

The problem of excessive scar formation deserves a particular attention, primarily in the open areas of the human body, because the biochemical mechanisms of the regulation of collagenosynthesis processes after planned surgical interventions of the skin are not well-substantiated. The aim of the study was to optimize the prevention of pathological scars after surgical treatment of congenital neck cysts by determination of the dynamics of changes in biochemical parameters occurring in the neck skin at various stages of healing. It was proved that the combined use of PRF-clot at the intraoperative stage of prophylaxis and ceruloplasmin at the post-operative, in contrast to monotherapy with fibrin membranes, obtained from platelets-rich plasma caused a better functional and aesthetic result, which significantly improved the quality of life of patients in the early and late postoperative periods.

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