scholarly journals Therapeutic tactics in the deep forms of rectal abscesses complicated by fournie gangrene

2020 ◽  
Vol 73 (2) ◽  
pp. 293-297
Author(s):  
Oleh E. Kanikovskyi ◽  
Andrii V. Osadchyі ◽  
Sergey I. Androsov ◽  
Anatolii V. Tomashevsky ◽  
Oleh A. Yarmak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Antibacterial Therapy ◽  
Treatment Duration ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Surgical Clinic ◽  
Modern Technologies ◽  
Clinical Emergency ◽  
Early Surgical Treatment

The aim: To conduct an analysis of the complex treatment of severe forms of rectal abscesses complicated by NF. Materials and methods: The results of treatment in 471 patients with deep forms of RA was performed. In 38(8%) the spread of the process and rotten-necrotic affection of the perineal fascia. Patients were treated at the surgical clinic of the medical faculty №2, VNPMMU, and Vinnytsya Clinical Emergency Hospital in the period from 2010-2018. Results: Total lethality 8(1,7%). Mortality in GF was 8(19,5%). It is worth noting the reduction of the treatment duration against the background of the modern technologies usage in the period from 2016 to 12 days in relation to the total figure of 15 days. Conclusions: Early surgical treatment, adequate necrectomy, fasciotomy and antibacterial therapy stop the necrotic process. The active aspiration reduces the timing of wound cleansing and further ensures the accelerated implementation of reconstructive surgical interventions.

scholarly journals THE RESULTS OF SURGICAL TREATMENT IN PATIENTS WITH DIFFUSE POSTOPERATIVE PERITONITIS COMPLICATED WITH SEVERE ABDOMINAL SEPSIS

2015 ◽  
Vol 1 (1) ◽  
pp. 28-32
Author(s):  
F. V. Galimzyanov ◽  
T. M. Bogomyagkova ◽  
M. I. Prudkov ◽  
M. A. Lazareva
Keyword(s):  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Treatment Algorithm ◽  
Abdominal Sepsis ◽  
Postoperative Peritonitis ◽  
Control Group ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Clinical Indications ◽  
Surgical Methods

Aim of investigation: improvement the results of treatment in patients with diffuse postoperative peritonitis complicated with severe abdominal sepsis. Materials and methods. The present investigation is performed in 132 patients. According to the way of treatment the patients were divided into 2 groups: the first (control) group included 56 patients with diffuse postoperative peritonitis, severe abdominal sepsis who got complex treatment, sanations and abdominal cavity drainage according to “clinical indications”. The second (main) group included 76 patients with diffuse postoperative peritonitis, severe abdominal sepsis who got complex treatment and a surgical treatment algorithm which we have worked out. The patients were in severe condition with marked multiple organ failure, with equal risk of lethality in both groups. Surgical methods included laparotomy, relaparotomy, sanations, abdominal cavity drainage, mini-laparotomy. Results: application of the elaborated algorithm for surgical treatment of patients with diffuse postoperative peritonitis and severe abdominal sepsis made it possible to improve the results of treatment. Intensive ward stay was 1.4 times less accordingly, 10.0 ± 1.4 days and 14.0 ± 1.9 days (p < 0.1). Hospital stay was 3.3 days less accordingly, 29.0 ± 0.9 days and 32.3 ± 1.2 days (p < 0.05). Lethality was 2.5 times less as compared with abdominal cavity sanations according to “clinical indications”, accordingly 21.1 and 51.8 % (p < 0.01).

scholarly journals Analysis of the results of different treatment methods for patellar dislocation

2018 ◽  
Vol 99 (3) ◽  
pp. 504-507
Author(s):  
G P Kotel'nikov ◽  
P V Ryzhov ◽  
Yu V Lartsev ◽  
D S Kudashev ◽  
S D Zuev-Ratnikov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Patellar Dislocation ◽  
Surgical Techniques ◽  
Correction Method ◽  
Invasive Treatment ◽  
Surgical Interventions ◽  
Individual Approach ◽  
Results Of Treatment ◽  
Habitual Dislocation ◽  
Time Periods

The aim of the study was the analysis of domestic and foreign medical literature of different time periods, which describes the basic methods of surgical and conservative treatment of congenital or habitual dislocation of patella, as well as statistical analysis of the results of treatment. Due to the existence of a large number of options of surgical treatment for this pathology (more than 150 methods were developed) and high variability of its manifestations, it is necessary to know the basic methods and their results for planning tactics of treatment with individual approach to each patient. Based on this review, analysis was performed for the results of using different options for invasive treatment of congenital or habitual dislocation of patella. Also, the paper contains the indications and efficacy of conservative therapy for this disease. A comparative analysis was made on the results of surgical and conservative methods of treatment of patellar dislocation, which were used in different time periods, from the initial description of the first results of treatment of this pathology to modern surgical techniques that are currently used. It is shown that all methods of surgical treatment of the pathology are divided into three main groups: myofascioplastic surgeries, osteoplastic and combined surgical interventions. It is underlined that the diseases requires individual approach to the choice of correction method in each certain case to achieve positive outcomes.

scholarly journals Carbuncle - the actual problem of modern surgery (Literature review)

2019 ◽  
Vol 21 (4) ◽  
pp. 19-24
Author(s):  
K V Lipatov ◽  
Yu E Cherkasov ◽  
V I Khrupkin ◽  
M V Lysenko ◽  
E I Dekhissi
Keyword(s):  
Surgical Treatment ◽  
Literature Review ◽  
Plastic Surgery ◽  
Pathological Process ◽  
Tissue Viability ◽  
Actual Problem ◽  
Surgical Interventions ◽  
Timely Diagnosis ◽  
Results Of Treatment ◽  
Surgical Tactics

Analyzed the features of the surgical treatment of carbuncles. The severity of the purulent-necrotic process was assessed, the significance of the timely diagnosis of the inflammatory stage and the choice of the timing of surgical treatment is shown. The features of the options of surgical tactics - from gentle to radical surgical interventions, methods of intraoperative assessment of tissue viability in the inflammatory focus are described. The necessity of a differentiated approach to the treatment of carbuncles depending on the stage of the disease, the prevalence of the pathological process and its localization is substantiated. The significance of restorative skin-plastic surgery in the replacement of postnecrectomy defects of epithelial tissues in the treatment of extensive carbuncles is shown. Ways of improving the results of treatment of patients with carbuncles are outlined, including timely diagnosis, a differentiated approach to surgical treatment, rational antibacterial therapy, and adequate general treatment.

scholarly journals Epidemiology and treatment of perforated duodenal ulcer in Kemerovo Region

2020 ◽  
Vol 5 (2) ◽  
pp. 67-71
Author(s):  
V. I. Podoluzhnyi ◽  
A. B. Startsev ◽  
I. A. Radionov
Keyword(s):  
Duodenal Ulcer ◽  
Surgical Treatment ◽  
Gastric Acid ◽  
Proteolytic Activity ◽  
Pyloric Stenosis ◽  
Gastric Resection ◽  
Perforated Duodenal Ulcer ◽  
Surgical Interventions ◽  
Ulcer Complications ◽  
Clinical Emergency

Aim. To estimate the frequency of ulcerative bleeding, pyloric stenosis, need for pyloroplasty and the justification of vagotomy for perforated duodenal ulcer.Materials and Methods. We analyzed the surgical treatment of patients with perforated duodenal ulcer admitted to Podgorbunskiy Regional Clinical Emergency Hospital during 1999-2019.Results. In 2018, the number of surgical interventions due to perforated duodenal ulcer decreased by 56.4% in comparison with 1998. In 8.6% and 2.1% of patients, perforated duodenal ulcer was combined with pyloric stenosis and bleeding, respectively, requiring Judd pyloroplasty (diamond- shaped transverse excision) or gastroduodenotomy followed by Heineke-Mikulicz pyloroplasty (transversely closed longitudinal incision across the pylorus) and vagotomy. Distal gastric resection by Billroth’s operation II was required in 2.8% of patients. Repeated admission of patients with duodenal ulcer complications has been observed after isolated suturing of perforated duodenal ulcer.Conclusion. Over the last 20 years, the amount of surgical interventions because of perforated duodenal ulcer in Kemerovo Region decreased more than twofold. In > 10% patients, pyloric stenosis and bleeding require a gastric drainage. In > 8% patients, perforated duodenal ulcer is combined with pyloric stenosis; in these cases, Heineke-Mikulicz pyloroplasty may be a treatment of choice. In > 2% patients, perforated duodenal ulcer is combined with ulcerative bleeding requiring excision of the ulcer and optional distal gastric resection. Pyloroplasty may be combined with vagotomy to normalise the proteolytic activity of gastric acid.

scholarly journals ECONOMIC INDICATORS OF SURGICAL TREATMENT OF ATHEROSCLEROSIS OF THE FEMORAL-POPLITEAL SEGMENT IN PATIENTS FOR CRITICAL LIMB ISHEMIA

2021 ◽  
Vol 4 (18) ◽  
pp. 51-57
Author(s):  
O.A. Holyachenko ◽  
Y.M. Gupalo ◽  
O.I. Nabolotnuy ◽  
B.L. Kulikovskuy ◽  
A.V. Shamrai-Sas ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lower Extremity ◽  
Bypass Surgery ◽  
Transluminal Angioplasty ◽  
Economic Indicators ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Patients With Diabetes ◽  
Average Patient

Introduction: is to analyze the economic indicators of different types of surgical treatment of atherosclerosis of the femoral-popliteal segment of the lower extremity in patients for сritacal limb ishemia. Materials and methods. were analyzed 173 cases of atherosclerosis of the femoral-popliteal segment of the lower extremity in patients for сritacal limb ishemia, of which 93 underwent arterial percutaneous transluminal angioplasty and 80 bypass surgery of the affected vessels. For this an original model of determining the value of medical care was used. It included the determination of costs that was given as a payment for medical workers, material and technical costs, the surgical interventions costs, the drugs that were used, additional examinations, and etc. Results. Economic analysis of costs per average patient that underwent PTA was UAH 5025.85, and bypass surgery UAH 4351.1. However,analyzing the results of treatment showed that there are small differences between the two methods, in particular a larger number of patients with diabetes. Conclusions. Both methods of treatment gave almost the same result in terms of the cost of treatment, which requires consideration of other factors, especially the clinical course of the disease.

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 SPHINCTEROPLASTY IN THE TREATMENT OF ANAL INCONTINENCE ON THE BASIS OF NECROTIZING FASCIITIS

2019 ◽  
Vol 4 (9-10) ◽  
pp. 47-52
Author(s):  
O. E. Kanikovskyi ◽  
A. V. Osadchyi ◽  
O. A. Kotsyura ◽  
A. V. Tomashevskyi ◽  
T. P. Zarezenko
Keyword(s):  
Surgical Treatment ◽  
Anal Canal ◽  
Anal Incontinence ◽  
Social Life ◽  
Treatment Technique ◽  
Outpatient Basis ◽  
Social Self ◽  
Results Of Treatment ◽  
Serious Disease ◽  
Surgical Clinic

Incontinence of intestinal contents is a serious disease that gives patients strong emotional and psychological feelings leading to social self-isolation, unsuitability and disability of the population. From an analysis of scientific research, it is known that more than 30% of coloproctologic operations are complicated by insufficiency of the sphincter apparatus and lead to anal incontinence. The purpose of the study - to improve the results of treatment for anal incontinence. Material and methods. 44 patients with perineal NF were analyzed. Patients were treated in the surgical clinic of the Faculty of Medicine No. 2 of VNMU and Vinnitsa City Clinical Hospital of Emergency Medical Services from 2010 to 2018. The average age is 59.0±8.72 years (26-80). There are 11 women and 33 men. Age <20 - 0, 21-29 – 1 (2.27%), 30-39 – 2 (4.54%), 40-49 – 7 (15.9%), 50-59 – 10 (22.74%), >60 years old – 24 (54.5%). Results and their discussion. The development of postoperative anal incontinence was identified in 13 (29,5%) patients. An anal incontinence scale (Wexner) was used to verify the diagnosis of anal canal failure. The surgical treatment technique was performed both in patiently in 4 (9.0%) patients and on an outpatient basis in 4 (9.0%). With cicatricial changes in the anal canal, the rumen was excised, the sphincter edges were mobilized, allograft implantation and sphincteroplasty were performed. Narrowing the anal canal is a less traumatic method that can be performed on an outpatient basis and in hospitals of one day. After surgery, patients independently retain gases and feces. Conclusions. Patients with NF requiring immediate surgical treatment. Anal incontinence on the basis of the transferred NF leads to disability. The narrowing of the anal canal using a mesh transplant is minimally invasive, characterized by a mild postoperative course.Sphincteroplasty is possible to carry out stationary and on an outpatient basis under local anesthesia. Restoration of the function of the sphincter apparatus in 100% of the operated patients on the Wexner scale, which improves the level of physical and social life of patients.

scholarly journals Surgical treatment of patients with descending purulent mediastinitis

2021 ◽  
Vol 26 (4) ◽  
pp. 118-123
Author(s):  
I.M. Shevchuk ◽  
S.S. Snizhko
Keyword(s):  
Surgical Treatment ◽  
Pleural Cavity ◽  
Comparison Group ◽  
Postoperative Mortality ◽  
Complete Removal ◽  
Main Group ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Minimally Invasive Surgical ◽  
Surgical Tactics

The aim of the study was to improve the results of treatment of patients with descending purulent mediastinitis by means of individualized surgical tactics with the priority use of minimally invasive surgical interventions and developed methods of drainage of the mediastinum and pleural cavity. Examination and treatment of 73 patients with descending purulent mediastinitis receiving treatment in the department of thoracic surgery of Ivano-Frankivsk regional clinical hospital was carried out. Treatment of patients in the main group included intramediastinal administration of antibiotics, the use of the developed method of cascade drainage of the mediastinum and pleural cavity, the priority use of video-assisted thoracoscopy and surgical tactics aimed at anticipating the spread of the purulent process in the mediastinum. The rapid and reliable decrease in the indices of endogenous intoxication in the main group confirms the effectiveness of the developed tactics of surgical treatment of patients with mediastinitis, adequate sanation of purulent mediastinatis, complete removal of the purulent substrate from the mediastinum and pleural cavity. The developed tactics of surgical treatment of purulent mediastinitis allowed reducing the overall postoperative mortality from 26.3% in the comparison group to 11.4% in the main group of patients.

Outcomes of Surgical Treatment of Fractures in Concomitant and Multiple Injuries in Children

2009 ◽  
Vol 16 (2) ◽  
pp. 72-75
Author(s):  
Tokhir Sidikovich Musaev ◽  
N N Tolipov ◽  
F A Masharipov ◽  
T S Musaev ◽  
N N Tolipov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Duration ◽  
Simple Technique ◽  
Bone Fractures ◽  
Locomotor System ◽  
Surgical Interventions ◽  
Fixation Devices ◽  
Duration Of Hospitalization ◽  
Group 2 ◽  
Group 1

Outcomes of surgical treatment of 72 children with concomitant (55) and multiple (17) injuries of locomotor system were analyzed. In 53 patients (group 1) surgical interventions for bone fractures were performed in early terms (within 3 days after trauma), in 19 patients (group 2) the interventions were postponed. In group 1 good and satisfactory result was achieved in 92% of patients (63 segments), in group 2 - in 85.2% of patients (23 segments). Duration of hospitalization made up in two groups 11.5 and 14.5 days, respectively. Application of pirod external fixation devices facilitated the treatment course due to the reduction of treatment duration and traumatization, as well as use of more simple technique of long bones and pelvis osteosynthesis.

scholarly journals Trochanteric epiphysiodesis in complex treatment of children with hip pathology: analysis of preliminary results

2020 ◽  
Vol 8 (3) ◽  
pp. 249-258
Author(s):  
Ivan Y. Pozdnikin ◽  
Vladimir E. Baskov ◽  
Dmitry B. Barsukov ◽  
Pavel I. Bortulev ◽  
Ekaterina A. Kostomarova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hip Joint ◽  
Complex Treatment ◽  
Greater Trochanter ◽  
Surgical Interventions ◽  
High Position ◽  
Neck Shaft Angle ◽  
Slowing Down ◽  
Shaft Angle ◽  
Radiological Examinations

Background. The relative overgrowth of the greater trochanter is one of the most common deformities of the proximal femur in association with several disorders of the hip joint. Aim. To analyze the dynamics of proximal femoral growth after trochanteric epiphysiodesis as well as to determine the options for using this method in the complex treatment of children with hip pathology. Materials and methods. We analyzed the data of clinical and radiological examinations and surgical treatment (permanent trochanteric epiphysiodesis with metal fixation) outcomes for 43 (52 joints) patients aged 412 years with a developing high position of the greater trochanter. Results. The surgery enabled slowing down of the growth of the greater trochanter on the side of intervention by (average) 50% (p 0.05), although the values of the neck-shaft angle both on the affected side and the side opposite to it did not change (p 0.05). Conclusion. In moderate disorders of the growth plate of the femoral head epiphysis, trochanteric epiphysiodesis can prevent the progression and, in some cases, correct disturbed ratios of the hip joint, thereby avoiding the need for larger surgical interventions.

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