The experience of surgical treatment of the patients with extended cicatricial esophageal strictures

The aim of the researce was the improvement of treatment results of patients with extended post-burn esophageal cicatricial strictures. Materials and methods: The treatment results are presented for 102 patients which were divided into two groups. In 49 patients with extended post-burn esophageal cicatricial strictures of the main group modified esophagoplasty were performed. Traditional esophagoplasty in 53 patients of the comparison group was performed. Results: A trend was observed on reduction in both short-term and long-term post-operative complications and lethality. The comparative analysis showed statistically valid reduction in number of complications caused by radical surgery: in the main group the frequency of short-term post-operative complications was 10,2 %, in the comparison group – 45,3 %, the frequency of long-term post-operative complications being in the main group 8,2 %, and in the comparison group 26,4%. A trend was observed on reduction of both local and general complications, which may be explained by both peculiarities of the operative interventions with application of improved surgical treatment methods and by more efficient pre-operation preparation of the patients. Post-operative lethality level was 2,0 % in the main group, and 3,8% in the comparison group. Life quality parameters in the main group patients in the long-term post-operation period were statistically significantly better. Conclusions: In patients with extended post-burn esophageal cicatricial stricture application of the proposed surgical tactics, modified method of single-step esophagoplasty and esophagoplasty as Step II of the surgical treatment for persons who have a formed contact gastrostomy is an efficient means for patients’ treatment improvement.

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Original method of esophagojejunal anastomosis after gastrectomy for stomach cancer, allowing post-operative complications prevention

Kazan medical journal ◽

10.17816/kmj1831 ◽

2014 ◽

Vol 95 (4) ◽

pp. 505-510

Author(s):

F Sh Akhmetzyanov ◽

V P Borisov ◽

F F Akhmetzyanova ◽

S V Borisov

Keyword(s):

Comparison Group ◽

Intestinal Anastomosis ◽

Original Method ◽

Main Group ◽

Double Row ◽

Esophagojejunal Anastomosis ◽

Single Row ◽

Operative Complications ◽

Complications And Mortality ◽

Post Operative Complications

Aim. To perform the comparative assessment of postoperative complications and mortality rate associated with two types of cuff esophagojejunal anastomosis after gastrectomy. Methods. Follow-up data of short-term post-operative complications rate in two groups of patients who underwent gastrectomy for gastric cancer, are described. Comparative results are presented on after gastrectomy in two groups of patients with gastric cancer: 193 patients were operated using the original method - single-row esophageal-intestinal anastomosis (main group), and 164 patients - using a double-row anastomosis (comparison group). Results. Among the patients who underwent an operation, 229 (64.1%) were older 60 years of age. Post-operative complications were observed in 25.4% of cases in the main group and in 36.6% of cases - in comparison group, including complications leading to unfavorable outcome - in 8.3 and 16.5% of cases, respectively. Post-surgical mortality in non-combined interventions was 5.1% in the main group and 13.7% in comparison group. After combined gastrectomy, post-surgical mortality was assessed as 10.5 and 17.7%, respectively. Early post-operative complications were subdivided into 2 groups: (1) associated with the method of anastomosis and (2) not associated with the method of anastomosis. The first group consisted of anastomosis suture failure, esophagojejunal anastomosis afferent loop obstruction syndrome, pancreatitits. Those complications were combined in one group because of pathogenesis unity. The number of such complications was lower by 2.2 times in the main group, including those with fatal outcome - by 3.2 times. Conclusion. Early post-surgical complications and mortality rate in patients who underwent gastrectomy with original method of single-row esophageal-intestinal anastomosis (main group) was significantly lower compared to patients who underwent gastrectomy with double-row anastomosis. Good reliability of the method of single-row esophageal-intestinal anastomosis allows to recommend its wide use in daily practice by surgeons and oncologists.

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Standard open operative interventions in surgical treatment of patients, suffering an acute complicated pancreatitis

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2018.07.27 ◽

2018 ◽

Vol 85 (7) ◽

pp. 27-29

Author(s):

V. P. Аndriushchenko ◽

D. V. Аndriushchenko ◽

Yu. S. Lysiuk

Keyword(s):

Surgical Treatment ◽

Comparison Group ◽

Surgical Intervention ◽

Main Group ◽

Control Group ◽

Treatment Results ◽

Surgical Interventions ◽

Second Stage ◽

Standard Operations

Objective. To determine the character and optimal volume of standard open surgical interventions in an acute complicated pancreatitis (ACP) with elaboration of the main technical elements of the operations. Маterials and methods. There were operated 96 patients, suffering ACP. The main group consisted of 47 patients, in whom open interventions were performed primarily in 19, and as the second-stage procedure after application of miniinvasive interventional technologies (МIТ) – in 28. The comparison group consisted of 49 patients, in whom standard operations were done only. Results. Application of MIТ have promoted the indications narrowing for performance of primary open operations more than twice. In the main group the arcuate-like subcostal access was applied predominantly - in 26 (55%) observations (χ²=14.287; р=002), while in a control one – a median upper laparotomy – in 37 (76%) observations (χ²=38.43, р < 0.001). The method of closed draining in accordance to procedure of Beger was used predominantly in the main group of patients – in 43% of observations, comparing with a control group - 9% of observations (χ²=12.965; р=0.003). In 23% patients of the main group and in 26% patients of a control one (χ²=0.0013; р=0.05), when the extended purulent-necrotic inflammation process have presented, a staged sanation was applied, using programmed relaparotomies. Some technical elements of the surgical intervention were improved. Conclusion. Application of standard open operations in accordance to elaborated principle is accompanied by improvement of the treatment results in patients, suffering ACP.

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A comparative study of short term results of open haemorrhoidectomy and stapler haemorrhoidopexy

International Surgery Journal ◽

10.18203/2349-2902.isj20174496 ◽

2017 ◽

Vol 4 (10) ◽

pp. 3358

Author(s):

Chandrasekhar S. Neeralagi ◽

Yogesh Kumar ◽

Surag K. R. ◽

Lakkanna Suggaiah ◽

Preetham Raj

Keyword(s):

Surgical Treatment ◽

Postoperative Pain ◽

Return To Work ◽

Hospital Stay ◽

Stapled Hemorrhoidopexy ◽

Short Term ◽

Post Operative Pain ◽

Duration Of Surgery ◽

Operative Complications ◽

Post Operative Complications

Background: Haemorrhoids are the most common benign anorectal problems worldwide. Treatments of third and fourth degree hemorrhoids include surgical haemorrhoidectomy. Milligan Morgan haemorrhoidectomy (MMH) as described in 1937 has remained the most popular among many techniques proposed. In order to avoid the postoperative drawbacks of Milligan Morgan haemorrhoidectomy, a new surgical treatment for prolapsing haemorrhoids has been described by Longo in 1995, procedure called stapled haemorrhoidopexy which is associated with less postoperative pain and a quicker recovery. The objective of this study was to compare the short-term outcome between stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy.Methods: Prospective randomized study of 120 patients with grade 3 and grade 4 haemorrhoids requiring surgical treatment either MMH or SH, 60 in each group for the period of 18 months from June 2014 to November 2015. Post-operative pain, duration of surgery, duration of hospital stays, post-operative complications and time taken to return to work were compared with mean follow up period of 6 months.Results: Duration of surgery is significantly low in stapled group with P <0.001, duration of hospital stay is significantly low in stapled group with P <0.001, post-operative pain low in staple group with P <0.05, time taken to return to work is significantly early in stapled group with P <0.001. Post-operative complications incontinence not found in the present study but recurrence of two cases in each group noted.Conclusion: Stapled hemorrhoidopexy is associated with less postoperative pain, shorter duration of surgery and hospital stay, earlier return to work as compared with Milligan-Morgan open hemorrhoidectomy. The procedure is not associated with major post-operative complications.

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EXPERIENCE OF TREATMENT OF NEWBORN CHILDREN WITH GASTROSCHISIS

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2015-174-6-46-51 ◽

2015 ◽

Vol 174 (6) ◽

pp. 46-51

Author(s):

B. N. Bisaliev ◽

N. A. Tsap

Keyword(s):

Surgical Treatment ◽

Hospital Stay ◽

Enteral Feeding ◽

Comparison Group ◽

Main Group ◽

Comparative Assessment ◽

Treatment Results ◽

Treatment Methods ◽

Primary Radical ◽

Operative Methods

The article presents an analysis of 10-year treatment results of 62 children with gastroschisis. Children were divided into two groups and it depended on the applied surgical treatment. An elimination of congenital eventration using Bianchi method was performed for children of the main group. The operative methods such as siloplasty, Gross operation, alloplasty and primary radical abdominoplasty were performed for children of comparison group. Comparative assessment of efficacy of the treatment methods of gastroschisis showed, that Bianchi method had a number of advantages: an early transition to independent breath and enteral feeding, shortening of hospital stay, decrease of the rate of lethality from 66,6% to 14,2%.

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ASSESSMENT OF EFFICACY OF THE METHOD OF PROGRAMMED IRRIGATION ASPIRATION SANATION IN COMPLEX TREATMENT OF PATIENTS WITH CHRONIC POSTTRAUMATIC OSTEOMYELITIS OF THE LONG BONES

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2016-175-3-40-43 ◽

2016 ◽

Vol 175 (3) ◽

pp. 40-43

Author(s):

A. A. Glukhov ◽

V. A. Sergeev

Keyword(s):

Comparison Group ◽

Main Group ◽

The Other ◽

Long Term Results ◽

Long Bones ◽

Treatment Results ◽

Posttraumatic Osteomyelitis ◽

Sf 36

The analysis of treatment results of 128 patients aged from 21 to 62 years old with chronic posttraumatic osteomyelitis of the long bones was made at the period from 2006 to 2013. The main group included 67 patients and the method of programmed irrigation aspiration sanation was applied for them. The comparison group consisted of 61 patients and drainage was performed for these patients using the conventional ways. The authors noted good immediate results in the main group in 56 (83,58%) out of 67 patients and in the comparison group - in 43 (70,49%) out of 61 patients. The long-term results were analyzed in 116 (90,6%) out of 128 patients in terms from two to five years after treatment. The rate of recurrences such as formation of purulent fistula were twice less in patients of the main group, than in the comparison group. According to the results of questionnaire SF-36, there was noticed, that patients of the main group got better mean indices of quality of life on all 8 scales compared with the other group.

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P-OGC10 Long-term survival is not affected by complications after oesophagectomy

British Journal of Surgery ◽

10.1093/bjs/znab430.138 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Edward J Nevins ◽

Jakub Chmelo ◽

Joshua Brown ◽

Pooja Prasad ◽

Alexander W Phillips

Keyword(s):

Survival Rates ◽

Short Term ◽

Term Survival ◽

Long Term Survival ◽

Kaplan Meier ◽

Operative Complications ◽

Short Term Mortality ◽

Index Hospital ◽

Post Operative Complications

Abstract Background Outcomes following oesophagectomy for oesophageal cancer continue to improve, but complications are common and can result in significant morbidity. Post-operative complications are known to impact upon peri-operative and short-term survival but the effect on long-term survival remains unclear. The aim of this study is to investigate the effect of post-operative complications on long-term survival following oesophagectomy. Methods A contemporaneously maintained database from a single centre was reviewed. All patients who underwent oesophagectomy between January 2010 and January 2019 were included. Patients were separated into three groups, those who experienced no or very minor complications (Clavien-Dindo 0 or 1), minor complications (Clavien-Dindo 2), and major complications (Clavien-Dindo 3-4). Those who died during the index hospital admission were excluded to correct for short-term mortality effects. Overall survival was analysed using Kaplan-Meier and log rank testing. Results Seven hundred and twenty-three patients underwent oesophagectomy during this time. Seventeen (2.4%) died during their index hospital stay, and were excluded from the survival analysis. The 30- and 90- day mortality was 1.1% (8/723) and 2.4% (17/723) respectively. There were 43.2% (305/706), 30.2% (213/706) and 26.6% (188/706) in the Clavien-Dindo 0-1, Clavien-Dindo 2, and Clavien-Dindo 3-4 group respectively. Median survival across the three groups was equivalent (50, 57 and 51 months). Across all three groups, overall long-term survival rates were equivalent at 1 (87.5%, 84.9%, 83.5%), 5 (44.2%, 48.9%, 44.7%) and 10 years (36.7%, 36.0%, 36.7%) (p = 0.730). Conclusions Long term survival is not affected by complications, irrespective of severity, following oesophagectomy.

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The benefits of early surgical treatment of deep cervical burns in children

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors16298 ◽

2020 ◽

Vol 8 (1) ◽

pp. 25-34

Author(s):

Pavel A. Gnipov ◽

Alexey G. Baindurashvili ◽

Marina A. Brazol ◽

Ekaterina V. Mitrofanova ◽

Maxim R. Melnikov ◽

...

Keyword(s):

Surgical Treatment ◽

Main Group ◽

Control Group ◽

Surgical Removal ◽

Treatment Results ◽

The Third ◽

Graft Success ◽

The Moment ◽

Early Surgical Treatment

Background. The frequency of deep cervical burns in children is four times higher than that of deep face burns. Currently, there is no consensus on the methods for surgical treatment of deep burns in cervical areas; meshed skin autografts continue to be used. Aim. To evaluate the benefits of early surgical treatment of deep сervical burns in children between the third and fifth days from the moment of injury. Materials and methods. Case-control study. Surgical treatment was performed in 81 children with deep cervical burns. The main group with early surgical treatment included 46 children and underwent surgical treatment at 3.37 0.14 days from the moment of injury; the control group received autograft during stage treatment for 35 children at 27.17 0.18 days. The treatment results were evaluated by the following indicators: the number of dressing changes, the period of skin restoration, and the area of graft success. In the long term, functional and cosmetic treatment results were evaluated. Results. In the study and control groups, 7.93 0.45 and 18.75 0.61 dressings were required to complete the treatment, respectively (p 0.001). The skin restoration periods were 16.54 0.68 and 36.94 0.89 days, respectively (p 0.001). The graft success areas were 99.50% 0.13% in the main group and 93.91% 2.68% in the control (p 0.001). During the staged surgical treatment, one patient showed a loss of 90% of the graft, which required regrafting. Other complications in the treatment process have not been noted. When assessing long-term cosmetic results using the Vancouver Scar Scale, the average score was 4.0 0.26 points in the main group and 7 0.28 points in the control (p 0.001). The presence of post-burn cicatricial contracture in the main group was noted in 12 (26%) people and the absence in 34 (74%) children. In the control group, 20 (57%) patients required surgical removal of post-burn deformity, and 15 (43%) children did not need further surgical interventions. Conclusions. Early surgical treatment of deep cervical burns in children on the third and fifth days from injury allows not only to accelerate the process of restoration of the skin but also to directly affect the cosmetic and functional results in a better way.

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Surgical treatment of patients with deep infiltrating endometriosis of the rectovaginal septum

Voprosy ginekologii akušerstva i perinatologii ◽

10.20953/1726-1678-2021-4-5-11 ◽

2021 ◽

Vol 20 (4) ◽

pp. 5-11

Author(s):

E.A. Galliamov ◽

◽

L.N. Aminova ◽

V.A. Alimov ◽

A.G. Kozub ◽

...

Keyword(s):

Surgical Treatment ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Comparison Group ◽

Chronic Pelvic Pain Syndrome ◽

Main Group ◽

Pelvic Pain Syndrome ◽

Deep Infiltrating Endometriosis ◽

Rectovaginal Septum ◽

Infiltrating Endometriosis

Objective. To optimize the tactics of surgical treatment of deep infiltrating endometriosis of the rectovaginal septum, including with bowel involvement. Patients and methods. The study included 122 patients diagnosed with deep infiltrating endometriosis of the rectovaginal septum, who underwent surgical interventions of different volumes using laparoscopy. The patients were divided into a main group and a comparison group. The main group consisted of 92 patients with deep infiltrating endometriosis of the rectovaginal septum who underwent surgical treatment using the original technique of systematic approach; the comparison group consisted of 30 patients who were operated using the generally accepted technique. Results. There was a statistically significant decrease in the operation duration, intraoperative blood loss, as well as more effective relief of dysmenorrhea and chronic pelvic pain syndrome, less complications and relapses in the main group compared to the comparison group. In addition, it was found that the combination of three symptoms such as dysmenorrhea, dyspareunia and chronic pelvic pain increase the likelihood of deep infiltrating endometriosis up to 93%. Conclusion. Based on the results obtained, the proposed method of surgical treatment of deep infiltrating endometriosis is more efficient and safer in comparison with the generally accepted technique, which can be considered as a valid reason for its wide introduction into clinical practice. Key words: deep infiltrating endometriosis, bowel endometriosis, surgical treatment of endometriosis, treatment algorithm

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