TREATMENT ADVANTAGES OF PATIENTS WITH URETEROLITHIASIS BY LITHOTRIPSY CONTACT METHODS IN COMPARISON WITH OPEN SURGERY

2020 ◽  
pp. 40-43
Author(s):  
Bogdan-Boris Olegovich Biloruskyi
Keyword(s):  
Open Surgery ◽  
High Efficiency ◽  
Average Duration ◽  
Average Length ◽  
Holmium Laser ◽  
Ureteral Stricture ◽  
Results Of Treatment ◽  
Duration Of Surgery ◽  
Endoscopic Methods ◽  
Methods Of Treatment

One of the most effective methods of treatment of ureteral concretions is ureteroscopy with contact lithotripsy. The study analyzed the results of treatment of 96 patients with urolithiasis they were as follows: 44 patients underwent laser ureterolithotripsy, 52 persons had an open ureterolithotomy. When comparing different treatments for patients with ureterolithiasis, it has been found that the average duration of surgery when performing laser ureterolithotripsy was shorter and averaged 53 minutes. As for open ureterolithotomy it lasted in average 102 minutes. The average length of patients staying in clinic when performing laser ureterolithotripsy in average was 2.5 days, during open ureterolithotomy that index was 20 days. This is a significant advantage of endoscopic treatment of ureterolithiasis versus an open surgery (especially when a holmium laser is used in lithotripsy). By using endoscopic methods of treatment of ureteral concretions instead of an open surgery (ureterolithotomy), it has been possible to reduce the in−patient staying 8 times. Lithotripsy with a holmium laser occurred to be an effective method of destroying the ureteral concretions of any mineral composition, if the dimensions of these calculi did not exceed 2 cm. It should be emphasized that under these conditions, the localization of a stone and the duration of its stay in the ureter are also not important. In addition, the use of a holmium laser minimizes an injury to the ureter wall. The advantages of lithotripsy when it used with a holmium laser consist in its high efficiency in destruction of solid fixed and the ingrown stones. In case of combination of both a stone and ureteral stricture and in the presence of ligature calculi, the treatment with a holmium laser is also prescribed. Key words: ureterolithiasis, laser ureterolithotripsy, open ureterolithotomy, holmium laser.

scholarly journals COMPARATIVE ANALYSIS OF INTERNATIONAL STANDARDS AND OUR EXPERIENCE IN TREATMENT OF PATIENTS WITH CHRONIC HEMORRHOID A BASE FOR EVIDENTIAL MEDICINE

2020 ◽  
pp. 90-93
Author(s):  
V. V. Bojko ◽  
V. V. Makarov ◽  
V. V. Tsodikov ◽  
L. G. Tarasenko
Keyword(s):  
Clinical Experience ◽  
High Efficiency ◽  
International Standards ◽  
Clinical Protocols ◽  
Clinical Protocol ◽  
Surgical Decision ◽  
Results Of Treatment ◽  
Methods Of Treatment ◽  
Single Approach

Summary. Aim. Decrease the amount of postoperative complications and improve quality of life for patients by a chronic hemorrhoid (CH). Materials and methods. Both international and national foreign clinical protocols are analysed. The obtained data are confronted with our clinical experience. Results and their discussion. Materials and methods. In the looks of foreign colleagues to tactics of treatment of patients with CH are analysed. The obtained data are confronted from positions of the best medical practice of providing of medicaid to the patients with a CH. Results and their discussion. In spite of insignificant differences in the volume of operative treatment of patients of CH, international practice adheres to single approach on tactics of surgical decision of this problem. Among the radical methods of treatment recommend next methodologies as an operation of choice: hemorrhoidectomy Milligan - Morgan, Ferguson and Parks, that in all researches were marked as high-efficiency. Clinical experience of our clinic, that Milligan–Morgan hemorrhoidectomy is the operation of choice for patients with 3-4 degrees of fall of knots, and applications of modern methodologies allows to bring down lacks of this operation and to attain the level of complications less than 1 %. Conclusions. The necessity of development of compatible clinical protocol of medicare to the patients takes place with CH. Introduction of single home standards of providing of medicare to the patients with CH will allow to bring down the risk of development of complications and improve the results of treatment. The got results of own researches on providing of medicare to the patients with CH are comparable with the results of foreign colleagues.

scholarly journals Experience of the laparoscopic-assisted stoma creation use in patients with colorectal cancer

2020 ◽  
Vol 101 (3) ◽  
pp. 441-445
Author(s):  
D G Brezhnev ◽  
V V Khvostovoi ◽  
O G Frolova ◽  
A S Moskalev ◽  
O Yu Makhova
Keyword(s):  
Colorectal Cancer ◽  
Blood Loss ◽  
Surgical Intervention ◽  
Average Duration ◽  
Average Length ◽  
Laparoscopic Group ◽  
Control Group ◽  
Stoma Creation ◽  
Duration Of Surgery ◽  
Laparoscopic Assisted

Aim. To demonstrate the advantages of laparoscopic surgery in patients with colorectal cancer compared to traditional surgical intervention. Methods. A retrospective analysis of 40 patients treatment (the main group) in the Department of abdominal Oncology of the Kursk Regional Oncology Center for the period 20172019, who had a pronounced violation of the passage through the intestine due to stenosing by the tumour, was conducted. As a control group, 30 people who underwent open surgery in the volume of a colostomy for the period 20172019 was taken. Results. According to the average duration of surgical intervention, the groups significantly differed (p 0.05), the average duration of surgery in the laparoscopic group was less 40.513.6 min, with laparotomy 54.518.5 min. The volume of blood loss during the operation was greater in the control group and reached 7540 ml against, 10.55.5 ml the differences were statistically significant (p 0.05). The average length of stay in hospital in the laparoscopic group was 41 days, which is significantly less than in patients who underwent laparotomy 114 days (p 0.05). Postoperative complications occurred in 10% of patients in the control group: seroma of the median wound in 2 patients, ligature fistula in 1 patient. There were no postoperative fatalities in both groups. Conclusion. The comparison of methods of surgical intervention showed that the results of laparoscopic operations are much better than traditional open operations in patients with colorectal cancer since they significantly reduce the duration of the rehabilitation period, accompanied by minor blood loss.

Experience of performing laparoscopic organ-preserving operations in treatment of kidney tumors

2020 ◽  
pp. 11-18
Author(s):  
N. V. Kovalenko ◽  
V. V. Javoronkova ◽  
A. I. Ivanov ◽  
A. G. Chuhnin ◽  
V. B. Venskel ◽  
...  
Keyword(s):  
Blood Loss ◽  
Average Duration ◽  
Operation Time ◽  
Malignant Neoplasms ◽  
Intraoperative Blood Loss ◽  
Kidney Tumors ◽  
Results Of Treatment ◽  
Duration Of Surgery ◽  
Direct Results ◽  
Kidney Resection

Purpose: to conduct a comparative assessment of the effectiveness and safety of laparoscopic kidney resections for benign and malignant neoplasms with and without vascular isolation of the organ. Materials and methods: the research presents a comparative analysis of the direct results of treatment of 182 patients who underwent laparoscopic kidney resection. Among them there were 94 men (51,7 %) and 88 women (48,3 %). The average age was 61,6 ± 6,2 years. Two main methods were used: kidney resection with vascular isolation and without vascular ischemia. Surgical treatment was performed for malignant neoplasms in 152 cases (86,5 %) and for benign neoplasms in 24 cases (13,6 %). We used the methods of laparoscopic resection of the kidney with total vascular ischemia in 44 cases (24,2 %) and without vascular ischemia in 138 patients (75,8 %). Results: the average duration of surgery was 80 ± 18,5 minutes. The average duration of the operation with the use of vascular ischemia was 122,1 ± 17,5 minutes, without ischemia — 81,7 ± 10,6 minutes. The volume of intraoperative blood loss averaged 174,4 ± 20,1 ml, while this indicator when using the ischemic-free technique was 154,2 ± 15,7 ml, which is 32,9 % less (p> 0,05) than in cases with the use of vascular isolation (230,1 ± 20,8 ml). When using the technique of vascular isolation, the serum creatinine has increased for 16,2 ± 1,7 μmol / L (16,7 %), without vascular isolation 6,5 ± 1,5 μmol / L (6,7 %). Conclusion: laparoscopic kidney resections without vascular isolation are characterized by a lower volume of intraoperative blood loss, a shorter operation time and are not accompanied by an increase in the number of postoperative complications.

scholarly journals Surgical treatment of liver echinococcosis

2021 ◽  
Vol 38 (3) ◽  
pp. 32-40
Author(s):  
M. F. Zarivchatskiy ◽  
I. N. Mugatarov ◽  
E. D. Kamenskikh ◽  
M. V. Kolyvanova ◽  
N. S. Teplykh
Keyword(s):  
Surgical Treatment ◽  
Liver Resection ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Average Length ◽  
Enzyme Linked Immunosorbent Assay ◽  
Percutaneous Puncture ◽  
Echinococcal Cyst ◽  
Duration Of Surgery ◽  
Methods Of Treatment

Objective. To improve the results of treatment of patients with liver echinococcosis and carry out a comparative assessment of techniques of surgical treatment depending on the nature of postoperative complications, hospital stay and antirecurrent efficacy. Materials and methods. The experience of complex examination and treatment of 65 patients with liver echinococcosis for the period of 1999-2019 was analyzed. Open echinococectomy was performed in 21 patients, atypical liver resection in 18 patients, anatomical liver resection in 14 patients, pericystectomy in 10, laparoscopic echinococectomy in 1, percutaneous puncture of an echinococcal cyst under ultrasound control in 1 patient. Results. The time of inpatient treatment of patients after open echinococectomy was 23.5 4.3 days, after pericystectomy 19.8 1.4 days, after liver resection 14.4 2.7 days, after laparoscopic echinococcectomy 6, after percutaneous puncture echinococcal cyst 7 days. Postoperative complications were observed in 52.4 % of patients who underwent open echinococectomy, in 20 % of patients after pericystectomy, and in 15.6 % after liver resection. There were no relapses of liver echinococcosis in all the groups. Mortality was 1.5 % and was recorded after open echinococectomy. Conclusions. The most effective techniques for preventing postoperative complications are pericystectomy and liver resection. The duration of surgery and the average length of hospital stay with minimally invasive methods of treatment are shorter. However, the use of these methods of treatment remains controversial due to the possibility of intra-abdominal spread of the parasite. Patients with parasitic liver cysts after surgical treatment are subjected to dynamic follow-up observation (ultrasound examination of the liver, enzyme-linked immunosorbent assay, computed tomography of the abdominal organs) after 3-6 months for at least 5 years.

Method of high frequency therapy at cows' mastitis during machine milking

2020 ◽  
pp. 9-12
Author(s):  
Viktor E. Lyubimov ◽  
Keyword(s):  
Dairy Cows ◽  
Electromagnetic Fields ◽  
High Frequency ◽  
High Efficiency ◽  
Environmentally Friendly ◽  
Ultrahigh Frequency ◽  
Machine Milking ◽  
High Frequency Electromagnetic Field ◽  
Milking Machine ◽  
Methods Of Treatment

Health of dairy cows ensures human health, so it is important that dairy products do not contain antibiotics that are used to treat any inflammation, including mastitis. In Russia at present, the problem of mastitis in cows exists with both attached and loose housing of cows. Mastitis of dairy cows are the great problem in milking husbandry. Losses from mastitis in milk yield can reach 15-20%. The main reasons for the occurrence of nonspecific mastitis of cows are the shortcomings of the working components of the milking machine: the degree of deterioration of the nipple rubber and the violation of machine milking technology (the reduction in pre-milking time and vacuum fluctuations account for 70% of all causes). Treatment of mastitis with antibiotics is effective, but not environmentally friendly and unacceptable. For the treatment of inflammation of the udder, it is necessary to use more environmentally friendly methods of treatment, one of which is the exposure to ultra-high frequency electromagnetic field tested by medicine. Use of three types of medical-mobile milking machines with the same method of exposure to ultrahigh-frequency electromagnetic fields on cow's nipples through electrodes in milking cups: LPDA-1-UHF, LPDA-2-UHF and LPDA-UHF-30 M, is described in the article. Author proved that cows with subclinical forms of mastitis recovered faster during milking with exposure to the ultrahigh frequency than when treated by antibiotics, and milking with the ultrahigh frequency device helps to recover 82% of the affected quarters with clinical forms and 100% of cows with subclinical forms of mastitis or with udder irritation. The high efficiency of the method of exposure to electromagnetic fields of the ultrahigh frequency during machine milking by means of medical-mobile milking machines LPDA-UHF for the prevention and treatment of mastitis of cows was shown.

The value of endoscopic examination methods in infertile marriage

2021 ◽  
Vol 50 (3) ◽  
pp. 52-56
Author(s):  
I. E. Korneeva
Keyword(s):  
Medical Care ◽  
Retrospective Analysis ◽  
Reproductive Function ◽  
Endoscopic Examination ◽  
Female Infertility ◽  
Infertile Women ◽  
Important Stage ◽  
Examination Methods ◽  
Endoscopic Methods ◽  
Methods Of Treatment

To optimize the management of infertile women the estimation of efficacy of endoscopic methods of treatment (laparoscopy and hysteroscopy) in this category of patients was undertaken. With the method of retrospective analysis clinico- laboratory and endoscopic examination of2785 sterile pairs was carried out. The results of the study showed that endoscopic methods are not only the most important stage of diagnostics but also the first pathogenetically substantiated stage in treating female infertility. It became clear that half of the patients demonstrated from 2 till 5 factors in pathogenesis of reproductive function abnormalities that brings on the necessity of elaboratingthe algorithm of treatingparticular patients considering the disturbances revealed.So, to increase the effectiveness of treating the patients in question, distinct standards of medical care should be put into practice.

Retrieval and Radiographic Analysis of the Contour Antiprotrusio Cage

2017 ◽  
Vol 27 (4) ◽  
pp. 378-381 ◽  
Author(s):  
Jonathan M. Vigdorchik ◽  
Richard S. Yoon ◽  
Susannah L. Gilbert ◽  
Joseph D. Lipman ◽  
Mathias P. Bostrom
Keyword(s):  
Average Length ◽  
Biomechanical Analysis ◽  
Acetabular Reconstruction ◽  
Pelvic Discontinuity ◽  
Intact Group ◽  
Future Design ◽  
Severe Bone Loss ◽  
Macroscopic Findings ◽  
Centre Of Rotation ◽  
Methods Of Treatment

Introduction Acetabular reconstruction in the setting of severe bone loss or pelvic discontinuity remains a challenging problem. Multiple methods of treatment have been described including antiprotrusio cages (APCs). The objective of this study is to combine biomechanical analysis of retrieved APCs with radiographic and clinical data to determine which factors influence or predict APC failure. Methods 41 APCs were identified. Sequential radiographs were examined for cage and polyethylene cup abduction angles, change in centre of rotation, screw placement, progression of cage failure, and failure mechanism. Cages were manually examined for gross macroscopic findings, breakage, and the location of breakage. High-resolution microscopy was used for further analysis. Results 24 cages were included in the analysis. Mean age of patients was 64.5 years (range 43-85 years); average length of implantation was 42.5 months (range 3-108 months). Average cage abduction angles were 56°; abduction for the cemented polyethylene cup was 44°. 14 of 24 cages were broken; 10 were intact. Of the broken cages, 10/14 broke through a screw hole in the ischial flange or just superior to the ischial flange. In the intact group, 6/10 failed due to pullout of the ischial screws. Discussion All cages had superior and lateralised centres of rotation. The majority of cages failed due to breakage or pullout at the ischial flange. Pelvic discontinuity was a large risk factor for a broken cage. Future design and technique modifications may result in superior outcomes in these complex acetabular reconstructions.

scholarly journals COMPARATIVE EFFICACY OF COMBINATION CONTACT AND TRANSURETHRAL PERCUTANEOUS LITHOTRIPSY WITH REMOTE LITHOTRIPSY IN CORALLOID NEPHROLITHIASIS TREATMENT

2011 ◽  
Vol 2 (1) ◽  
pp. 31-34
Author(s):  
V A Perepechai ◽  
A V Zozulya ◽  
I I Skorikov ◽  
S N Dimitriadi ◽  
V N Gornostaev
Keyword(s):  
Retrospective Analysis ◽  
Open Surgery ◽  
High Efficiency ◽  
Complete Elimination ◽  
Comparative Efficacy ◽  
Postoperative Rehabilitation ◽  
Rehabilitation Period ◽  
Analysis Of Results ◽  
Percutaneous Nephrolithotripsy ◽  
Choice Method

A retrospective analysis of results of percutaneous nephrolithotripsy (PNLT) for corallike nephrolithiasis in lithotripter "Swiss LithoClast ® Master" and transurethral nephrolithotripsy (TUNLT). In the period 20072010 167 PNLT and 11 TUNLT were performed. Complete elimination at PNLL was achieved in 83.2% of patients, residual concretions – in 16,8% of cases, with complete elimination TUNLT – 36,4%, residual concretions – 63,6%. In 3% of patients needed for the complete elimination of the implementation of additional percutaneous accesses, while 12.6% of the patients was necessary to repeat PNLT. Complications from PNLT + DLT developed in 30,2% of cases, and when the TUNLT + DLT – in 18,2%. Percutaneous technology in comparison to open surgery with corallike nephrolithiasis can significantly shorten the postoperative rehabilitation period and be choice method of the treatment due to its high efficiency and less traumatic.

scholarly journals Modern approaches to the treatment of retrosternal goiter

2021 ◽  
Vol 88 (1-2) ◽  
pp. 45-49
Author(s):  
V. V. Grubnik ◽  
R. S. Parfentiev ◽  
V. M. Kosovan ◽  
N. D. Parfentieva
Keyword(s):  
Massive Bleeding ◽  
Parathyroid Glands ◽  
Recurrent Nerve ◽  
Endoscopic Techniques ◽  
Results Of Treatment ◽  
Retrosternal Goiter ◽  
Duration Of Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Standard Techniques

Objective. To analyze the results of treatment of patients with retrosternal goiter. Materials and methods. During the period from 2010 to 2019, 62 patients with thoracic goiter were operated on, which was 6.2% of all patients operated in relation to goiter. There were 48 women (77.4%) and 14 men (22.6%). Age of patients varied from 21 to 87 years (average age - 47 years). Computed tomography was mandatory in terms of research. The size of the sternal goiter and the degree of operative risk were determined by G. Mercante (2011). Results. In 39 patients (1st group) the operation was performed by cervicotomy according to standard techniques. Video endoscopic support was used in 23 patients, thanks to which in 15 patients (group 2) it was able to cross all blood vessels with the help of an electro coagulator and isolate nerve structures and parathyroid glands. In 8 patients (group 3) there was a massive bleeding after attempts of finger dissection. They underwent tamponade and temporarily stopped bleeding. After that, a video endoscope was inserted into the wound and hemostasis was performed with the help of an electrocoagulation. Bleeding from the surgical wound, which required revision, was not observed. Temporary tracheostomy in the postoperative period was imposed in 3 patients, later it was closed. Hypocalcemia occurred in 12 (19.3%) patients (in 11 it was transient). Transient paresis of the recurrent nerves was observed in 3 patients of the 1st, 2 of the 2nd and 2 of the 3rd groups. Permanent paresis of the recurrent nerve occurred in only 1 patient of the 3rd group. According to histological examination, 21 patients were diagnosed with cancer (19 - papillary, 2 - follicular). They subsequently underwent standard treatment for highly differentiated thyroid cancer. Conclusions. The use of cervical access with video endoscopic support during surgery for thoracic goiter avoids performing a sternotomy, reduces blood loss and operational trauma, improves the nerve structures and parathyroid glands identification, and reduces the duration of surgery. The use of modern methods of electrocoagulation significantly expands the capabilities of endoscopic techniques.

A STUDY ON OUTCOME OF MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS (MIPO) IN EXTRA ARTICULAR FRACTURE OF DISTAL 1/3RD TIBIA.

2021 ◽  
pp. 106-111
Author(s):  
Vaibhav Vaibhav
Keyword(s):  
Soft Tissue ◽  
Average Duration ◽  
Tibial Fractures ◽  
Categorical Variables ◽  
Minimal Risk ◽  
Distal Tibial Fractures ◽  
Non Union ◽  
Articular Fractures ◽  
Number Of Patients ◽  
Duration Of Surgery

BACKGROUND: Fractures of the distal tibia can be challenging to treat because of the limited soft tissue, the subcutaneous location, and poor vascularity. There is a considerable debate regarding the best method for treating distal tibial fractures. In present study we have treated distal tibial fractures using MIPPO technique OBJECTIVES: To evaluate the functional outcome following use of MIPO technique in lower 1/3rd fractures of tibia. MATERIAL AND METHODS: This is a longitudinal follow up study. In this study a total of 30 patients with fracture distal 1/3rd tibia admitted to CMRI hospital will be selected for treatment with MIPO technique according to inclusion and exclusion criteria. All patients were reviewed in CMRI Hospital and radiographs (Tibia AP and lateral views) obtained after surgery and then at 1 month, 3 months and nally at 6 months. From 5 weeks onwards symptoms and functions will be assessed using the scoring system of Olerud and Molander(1984). Statistical analysis of categorical variables was expressed as number of patients and percentage of patients and continuous variables are expressed as descriptive statistics. The statistical software SPSS version 20 has been used for the analysis. RESULTS: The age of patients ranged from 22-65 years. Fracture was most common in 4th and 5th decade of life. Average mean age was 44.03±10.74yrs. In this study majority of 17(56.7%) patients were male and there were 13(43.3%) were female. Road Trafc accident (RTA) was the main cause to produce lower end tibia fractures (83.3%) in our study. In this study right side (60%) was involved more than left (40%). In this study only 3 (10%) patients had open grade 1 injury. Majority of patients 27 (90%) had closed injury. In our study 66.67% (20) of patients had associated injuries and 33.33% patients had no associated injury. Average injury operation interval in this study was 3.27±1.53 days. Average no. of plate holes were 10.50±1.72. Average duration of hospital stay in this study was 10.07±2.75 days. Average duration of surgery in this study was 88.03±16.36 minutes. In this study 26 patients (86.7%) had no early post-op complications and 4 (13.3%) had complications. 3 patients (10%) had delayed wound healing and 1patient (3.3%) had supercial infection of suture lines. There was 1 non-union and majority of patients 21(70%) took 20-25 weeks for union. 7(23.4%) patients took less than 20 weeks and 1(3.33%) patient took more than 25 weeks. Average time of union in this study was 21.17±2.17 weeks. Average time of weight bearing was 17.72±1.91 weeks in this study. Most frequent late complication seen was swelling with frequency of 7 followed by stiffness and pain. 1 patient had malunion and 1 patient had non-union. In this study there were 28(93.3%) patients which showed union, 1 (3.3%) patient showed coronal malunion and 1(3.3%) had non-union. There were 21 patients (70 %) with excellent result, 7 patients (23.3%) with good result and 2 patients (6.7%) with fair result in our cases of study. Average clinical Olerud & Molander score was 81.17±16.07 in this study. CONCLUSION: The satisfactory functional results and lack of soft tissue complications suggest that this method should be considered in peri-articular fractures. Biological xation of complex fractures gives stable as well as optimal internal xation and complete recovery of limb function at an early stage with minimal risk of complications.

Sign in / Sign up

Export Citation Format

Share Document