SIMULTANEOUS OPERATIONS DURING UMBILICAL AND PARAUMBILICAL HERNIA REPAIR: POSSIBLE OR NECESSARY?

The aim of the study was to determine the possibility and effectiveness of simultaneous surgical interventions in umbilical and paraumbilical hernia repair. Material and methods: 148 case histories were analyzed concerning patients who were routinely admitted to the surgical department of the Kharkiv Regional Council’s Municipal Non-Profit Enterprise «Regional Clinical Hospital» between 2017 and 2019, and who underwent umbilical and paraumbilical hernia repair simultaneously with operations related to some other surgical pathology (group 1, n = 67) or in separate interventions (group 2, n = 81). All patients were routinely operated after a set of mandatory and additional general clinical, laboratory and instrumental research conducted in accordance with the existing guidelines. The structure and results of surgical interventions related to the underlying disease and simultaneous operations were studied. Results: Simultaneous operations were performed for comorbid cholecystolithiasis, diaphragmatic esophageal hernia with gastroesophageal reflux, inguinal hernia, white line hernia, benign diseases of the uterus and uterine appendages et al. The frequency of complications and recurrences of hernia in patients with simultaneous and isolated of umbilical hernia repair did not differ significantly. The outcome of the operation mostly depended on the method of operation (postoperative complications were most often observed in open sutures repair and were absent in laparoscopic hernia repair). Additional risk factors were weight gain and diabetes. Conclusions: Summarizing the data obtained, it can be concluded that application of modern endovideoscopic techniques in surgery makes simultaneous surgical interventions not only possible but also necessary in the presence of concomitant abdominal pathology that requires surgical treatment.

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Direct inguinal hernias in children

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic949 ◽

2021 ◽

Vol 11 (2) ◽

pp. 161-167

Author(s):

Vyacheslav G. Svarich ◽

Ilya M. Kagantsov ◽

Violetta A. Svarich

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Ultrasound Examination ◽

Laparoscopic Hernia Repair ◽

Abdominal Cavity ◽

Treatment Method ◽

Long Term Results ◽

Direct Inguinal Hernia ◽

Surgical Department ◽

Inguinal Hernias

AIM: Based on the accumulated clinical material, this study aims to show the possibilities of diagnosing and treating direct inguinal hernias in children. MATERIALS AND METHODS: During the period from 2000 to 2020, 3221 children with inguinal hernias were treated in the surgical department of the Republican Childrens Clinical Hospital in Syktyvkar. Of the above group of children with inguinal hernias, seven patients (0.22%) had direct inguinal hernias. The above was confirmed by ultrasound examination. In laparoscopic imaging, a rectal hernia was defined as a recess of the peritoneum of a stellate or rounded shape in the projection of the medial umbilical fossa. Two patients underwent the Bassini herniation procedure. Two children underwent laparoscopic hernia repair with intracorporeal suture insertion. In three patients, hernia repair was performed using the PRMS method. RESULTS: Long-term results were followed up from six months to 15 years. Immediate and postoperative complications were noted. No recurrence of hernia was reported. CONCLUSIONS: When establishing direct inguinal hernia diagnosis in children is clinically determined in the form of a rounded, soft-elastic formation localized medially and above the Pupart ligament next to the projection of the external (superficial) inguinal ring of the inguinal canal. It is easily set into the abdominal cavity with rumbling and confirmed by ultrasound examination results. The most preferred treatment method for direct inguinal hernia in children, in our opinion, is hernia repair using the percutaneous internal ring suturing (PIRS) method.

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Influence of medical and socio-psychological factors on changes in psychological status in patients after simultaneous surgical operations

HEALTH OF WOMAN ◽

10.15574/hw.2017.121.42 ◽

2017 ◽

pp. 42-45

Author(s):

V.L. Dronova ◽

◽

A.N. Mokryk ◽

R.S. Teslyuk ◽

◽

...

Keyword(s):

Psychological Factors ◽

Surgical Care ◽

Study Groups ◽

Negative Influence ◽

Surgical Pathology ◽

Psychological Status ◽

Psychological State ◽

Surgical Interventions ◽

Surgical Department ◽

Simultaneous Operations

The article presents data on the influence of medical and socio - psychological factors on changes in the psychological status of patients who underwent simultaneous surgical interventions. The objective: to determine the features of the psychological status and quality of life in the postoperative period in women who underwent simultaneous surgical interventions. Patients and methods. To solve the tasks, 110 patients were surgically assisted in the department of operative gynecology of the State Institution «IPAH of the National Academy of Medical Sciences of Ukraine». They were divided into two groups. The first group consisted of patients with isolated gynecological pathology (n=83), the second group consisted of simultaneous pathology (n=27). Patients with isolated surgical pathology (n=26) were included in the study, surgical care was provided in the surgical department of the City Clinical Hospital No. 10 in Kiev. They made up the third group. Results. According to the data received, the majority of patients underwent psychological and psychological influences on their psychological state, but the frequency and level of influence were different. Women (group II) operated on the simultaneous pathology were much more sensitive to the effect of socio - psychological factors, in relation to patients of groups I and III with isolated gynecological and surgical pathology, respectively, in whom the negative influence of medical and socio - psychological factors was revealed. Conclusion. The results of the research prove that the violations of the psychological status (in particular, anxious and depressive conditions) in the patients of the study groups who underwent operative interventions in a large percentage of cases depend not only on medical, but mainly on the socio-psychological factors of influence, which in the future will Is necessarily taken into account when developing measures for psychological correction in this patient population. Key words: simultaneous operations, psychological state, medical and socio-psychological risk factors.

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DIAGNOSIS AND TREATMENT OF MECKEL DIVERTICULUM COMPLICATIONS IN CHILDREN

"Medical & pharmaceutical journal "Pulse" ◽

10.26787/nydha-2686-6838-2020-22-12-162-168 ◽

2020 ◽

pp. 162-168

Author(s):

Barskaya M.A. ◽

Varlamov A.V. ◽

Zavyalkin V.A. ◽

Kuzmin A.I. ◽

Terekhina M.I.

Keyword(s):

Intestinal Obstruction ◽

Clinical Laboratory ◽

Abdominal Cavity ◽

Clinical Signs ◽

Intestinal Bleeding ◽

Meckel Diverticulum ◽

Average Hospital ◽

Surgical Interventions ◽

Surgical Department ◽

Results Of Treatment

Meckel diverticulum is a congenital abnormality of the intestinum appearing due to the failure of the vitelline duct closure. Meckel diverticulum may have no clinical signs however in 20-25% its complications may cause different acute surgical conditions demanding surgical interventions. These complications may appear with the symptoms of abdominal pain, intestinal hemorrhage and intestinal obstruction. The aim of the study was to analyze the results of treatment of Meckel diverticulum complications in children. We have analyzed the results of diagnostics and treatment of 69 children aged between 10 months and 13 years. All the children were admitted to the surgical department of Samara Regional Clinical Hospital named after V.D. Seredavin between 2013 and October 2020. The presented complications of Meckel diverticulum were: diverticulitis (37), intestinal bleeding (17), intestinal volvulus (9), intestinal obstruction (3), intussusception (3). Most frequently the complications were present in infants and preschool children. All the patients underwent clinical, laboratory, ultrasound, X-Ray (when necessary) and intraluminal endoscopic (when necessary) examinations. However, in most cases complications were diagnosed during laparoscopy. All the children underwent surgical treatment. Most of the surgeries were laparoscopic (54, 35 of them were video assisted mini laparotomies). Two patients presented postoperative complications: anastomotic leaks; both of the children required repeated surgeries. The reasons of complications were underestimation of the paients’ conditions at the moment of surgical interventions and significance of the inflammatory process in the abdominal cavity. We employed ileostomies to those children which we closed 3 weeks after that when the general conditions were appropriate. We had no lethal cases. The average hospital stay was 11,6 days.

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