scholarly journals COMPLICATION OF LAPAROSCOPIC PLASTIC OF VENTRAL HERNIAS

2020 ◽  
pp. 185-188
Author(s):  
A. V. Sivogelezo ◽  
М. O. Sykal ◽  
V. V. Chugai ◽  
O. A. Tonkoglas
Keyword(s):  
Early Recognition ◽  
Test Time ◽  
Surgical Infection ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Abdominal Organs ◽  
Laparoscopic Hernioplasty ◽  
Surgery Department ◽  
Ventral Hernias ◽  
Timely Treatment

Summary. LGP passed test time, and its popularity grows. Today more and more surgeons readily accept it. Thanks to standardization of methods we can minimize quantity of postoperative complications and improve results of treatment of patients with ventral hernias. Materials and methods. In clinic of surgery department No. 2 on the basis of surgical department of Regional Hospital from 2017 performed 1231 operations of ventral hernias. At 411 (33 %) patients the laparoscopic hernioplasty is executed. Results and discussion. Intraoperative bleedings, intestines injuries, a surgical infection, an infection of a mesh, seroma and others belong to specific intraoperative and extra operational complications of laparoscopic hernioplasty of ventral hernias. We observed bleedings from an abdominal wall in 6 cases and from abdominal organs at 2 patients from 411 patients that made 1,9 %. In 3 cases it is noted infection of a mesh after laparoscopic hernioplasty (0,8 %). At 2 patients the inflammation managed to be liquidated in the conservative way, at 1 patient were forced to remove abscess with the part of a mesh. The most widespread complication after laparoscopic hernioplasty, according to our data - the seroma is noted at 34 of 411 patients (8,2 %). Conclusion. Laparoscopic interventions concerning ventral hernias demand care in time and after operation, early recognition of complications and their timely treatment, important for reduction of the risks.

scholarly journals Features of laparoscopic hernioplasty of paracolostomy hernias in patients with combined abdominal pathology

2020 ◽  
Vol 24 (4) ◽  
pp. 600-603
Author(s):  
K. Yu. Parkhomenko
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Average Length ◽  
Abdominal Cavity ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Inguinal Hernias ◽  
Laparoscopic Hernioplasty ◽  
Commercial Enterprise ◽  
Laparoscopic Techniques ◽  
Ventral Hernias

Annotation. The aim of the study is to study the technological features and results of simultaneous laparoscopic hernioplasty of paracolostomy hernias in the presence of combined abdominal pathology. We analyzed the results of surgical treatment of 11 patients with paracolostomy hernias who were treated in the surgical department of the Municipal non-commercial enterprise of the Kharkov regional council “Regional Clinical Hospital” from 2016 to 2020, of whom – women – 4 (36%), men – 7 (64%), aged from 42 to 69 years old. Clinical, anamnestical and instrumental data for the prolongation of cancer were not identified in all patients. Out of 11 patients, in addition to paracolostomy hernia, 3 (27%) had inguinal hernias, 8 (73%) had postoperative ventral hernias. 3 (27%) patients with hernias also had cholecystolithiasis. All patients underwent laparoscopic hernioalloplasty of paracolostomy hernia. 3 patients underwent simultaneous TAPP for inguinal hernias, and 1 patient underwent laparoscopic cholecystectomy and TAPP. 6 patients with incisional ventral hernias underwent simultaneous IPOM according to the standard method, and 2 – according to the own method. Of the above, 2 patients suffering from cholecystolithiasis, in addition to hernioalloplasty, underwent laparoscopic cholecystectomy. In 4 (36%) patients, viscerolysis was additionally performed due to the presence of an adhesive process in the abdominal cavity. Simultaneous hernioalloplasty TAPP and IPOM, as well as laparoscopic cholecystectomy, had no significant effect on the development of complications and the duration of hospitalization. The average length of inpatient treatment was 9.2 bed-days. The study proves the expediency of widespread simultaneous surgical interventions for hernias of the anterior abdominal wall, as well as the preference for laparoscopic techniques.

scholarly journals Laparoscopy in the Treatment of Children with Intussusception

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
A A Pereyaslov ◽  
A O Dvorakevych ◽  
O M Nykyforuk
Keyword(s):  
Ileocecal Valve ◽  
Intestinal Loop ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Laparoscopic Equipment ◽  
Intussusception Reduction ◽  
Open Laparotomy ◽  
Selection Of Patients ◽  
Timely Treatment ◽  
Selection Of

Intussusception is one of the main causes of intestinal obstruction in children that requires timely treatment. Despite the high efficacy of therapeutic methods of intussusception reduction, some patients need the surgery. The question of the surgery method choice, namely open laparotomy or laparoscopy, is still under debate.The objective of the research was to summarize own experience of laparoscopy in children with an intussusception.The research was grounded on the results of treatment of 28 children operated in the first surgical department of the Lviv Regional Children’s Clinical Hospital «OHMATDYT» during 2008-2015. Optical system Strayker 1088 HD (Germany) with the 3-, 5-mm laparoscopic equipment was used for laparoscopy. The reduction of intussusception was performed by the retrograde traction of small intestine with the sliding catches.Laparoscopic intussusception reduction was successful in 67.9% of patients, conversion was conducted in 32.1% of patients. The main reasons for the conversion were the necrosis of intestinal loop needing resection, presence of the complex intussusception, and the presence of polyp clear to the ileocecal valve. In 10.7% patients the laparoscopic reduction was supplemented by per rectum pneumoreduction with the help of Richardons’ system. During the last year, in cases of intestine resection need, the video-assisted operations were applied, when the intestine mobilization was performed laparoscopically and anastomosis was applied extraperitonealy. Complications during laparoscopic reduction and in the postoperative period were not observed.Laparoscopy is the safe and effective method of patients with the intussusception treatment. Thorough selection of patients for the laparoscopic intussusception reduction makes it possible to decrease the rate of conversion.

scholarly journals Modern technology in the treatment of patients with postoperative ventral hernias

2018 ◽  
Vol 10 (1) ◽  
pp. 37-42
Author(s):  
B. V. Sigua ◽  
V. P. Zemlyanoy ◽  
A. S. Sokolova ◽  
D. F. Cherepanov ◽  
S. A. Vinichuk ◽  
...  
Keyword(s):  
Diagnostic Algorithm ◽  
Modern Technology ◽  
Control Group ◽  
Spiral Computed ◽  
X Ray ◽  
Flow Energy ◽  
Results Of Treatment ◽  
Abdominal Organs ◽  
Analysis Of Results ◽  
Ventral Hernias

The analysis of results of treatment of 113 patients with postoperative ventral hernias was carried out patients divided into two groups. 74 patients have received treatment (II (control) group) from 2013 to 2014 year. Patients of the control group were examined according to the accepted diagnostic algorithms, in addition to physical examination algorithm include chest and abdominal x-ray examination, ultrasound diagnosis of abdominal organs and fibro-esophagogastroduodenoscopy. Plastic by reticular endoprostheses was carried out in various methods. Methods have been chosen directly by surgeon during the operation. The draining of the postoperative wound was mandatory. Main (I) group included 39 patients who received treatment from 2015 to 2016. The diagnostic algorithm was supplemented with fibrocolonoscopy and spiral computed tomography, and the plastic method was predominantly sub-lay. Hypoderma treatment by high-temperature oscillating plasma flow energy according to the original technique for the prevention of lymphorrhea was provided to all patients. Maims were mostly sutured tightly. This approach allowed to reliably reduce frequency complications from 13.4% (14) to 1.8% (2) and, as a consequence, the length of stay of the patient in the hospital.

scholarly journals MODERN TRENDS IN THE TREATMENT OF ACUTE ADHESION IN INTESTINAL OBSTRUCTION

2020 ◽  
pp. 58-61
Author(s):  
V. V. Lesnoy ◽  
A. S. Lesnay
Keyword(s):  
Intestinal Obstruction ◽  
Inpatient Treatment ◽  
Conservative Therapy ◽  
Postoperative Treatment ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Restoration Time ◽  
Days Open ◽  
Adhesive Obstruction

Summary. Aim. To perform the modern tactics of acute adhesive obstruction (AAO) treatment. Materials and methods. The basis of the work is the analysis of the results of treatment of 38 patients hospitalized in an urgent order to the surgical department with the clinic AAO. Results. 20 (52.6 %) patients with the background of conservative therapy, the phenomenon of intestinal obstruction was regressed. Repeated hospitalization during the year with the hospital was required by AAO 2 (5.3 %) patients. Laparoscopic adhesion was performed 4 (10.5 %) patients whose average intestinal restoration time was (1.8±1.2) days, and the duration of postoperative inpatient treatment was (5.1±1.3) days. Open surgical interventions were performed 14 (36.8 %) patients, in whom the period of restoration of the intestine function was (3.8±1.5) days, and the duration of postoperative treatment was (10.1±1.2) days. Conclusion. Conservative therapy is effective in 52.6 % of patients. Laparoscopic adhesion is indicated in the absence of peritoneal symptoms, if ≤ 2 laparotomies were noted in the history, with a peritoneal index of adhesion ≤ 9 points.

scholarly journals The rheumatology/hematology interface: CAPS and MAS diagnosis and management

Hematology ◽  
2018 ◽  
Vol 2018 (1) ◽  
pp. 313-317 ◽  
Author(s):  
John M. Gansner ◽  
Nancy Berliner
Keyword(s):  
Lupus Erythematosus ◽  
Macrophage Activation ◽  
Early Recognition ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Rheumatologic Disease ◽  
Rheumatologic Diseases ◽  
Life Threatening ◽  
Vessel Thrombosis ◽  
Timely Treatment

Abstract Catastrophic antiphospholipid antibody syndrome (CAPS) and macrophage activation syndrome (MAS) are both life-threatening hematologic disorders that infrequently afflict patients with rheumatologic disease. CAPS is characterized by fulminant multiorgan damage related to small vessel thrombosis in the setting of persistent antiphospholipid antibodies. It can occur in patients with rheumatologic diseases such as systemic lupus erythematosus but can also affect patients who do not have rheumatologic disease. By contrast, the term MAS is applied when patients with rheumatologic disease develop hemophagocytic lymphohistiocytosis (HLH); therefore, patients with MAS have an underlying rheumatologic disease by definition. Similar to CAPS, HLH/MAS can have a fulminant presentation, but the pathogenesis and manifestations are different. In both CAPS and MAS, management generally includes but is not limited to immunosuppression with steroids. Fatalities are relatively common and morbidity is often significant. Early recognition of these disorders and initiation of timely treatment are important. More effective therapies for both syndromes are urgently needed.

Results of treatment of surgical infection by the method of photodynamic therapy

2016 ◽  
Vol 22 (3) ◽  
pp. 28
Author(s):  
G. M. Ismailov ◽  
E. K. Slovokhodov ◽  
V. I. Yarema ◽  
V. I. Polsachev ◽  
N. M. Nikolaev ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Surgical Infection ◽  
Results Of Treatment

scholarly journals Pulmonary Gangrene - Severe And Rare Complication Of Pneumonia

2014 ◽  
Vol 7 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Guergana Petrova ◽  
Penka I. Perenovska ◽  
Dimitrinka Miteva ◽  
Radost T. Kabakchieva ◽  
Ognyan G. Brankov ◽  
...  
Keyword(s):  
Rare Complication ◽  
Left Lung ◽  
Lower Lobe ◽  
Good Health ◽  
Surgical Department ◽  
Intravenous Antibiotics ◽  
Histology Result ◽  
Severe Infections ◽  
The Right ◽  
Surgery Department

SummaryPneumonia is an inflammatory lung disorder characterized by consolidation due to presence of exudates in the alveolar spaces. Most pneumonias can be effectively treated with appropriate oral antibiotics, with intravenous antibiotics being reserved for those with severe infections. We present two cases of girls admitted in our clinic with pneumonia where our conventional therapy was not sufficient. Case 1: A 15-year-old girl with cystic fibrosis, with left lobular pneumonia, for which an aggressive conservative treatment was initiated. After significant improvement, sudden detorioration and pneumothorax of the left lung occurred. She was transferred to the surgical department for intervention. Due to failure to respond to initial drainage she underwent thoracotomy and resection of the left lower lobe of the lung. The histology result confirmed gangrene. Case 2: A four-year old girl was treated for pneumonia in the right lung with aggressive intravenous antibiotic. After temporary improvement sudden deterioration was observed. The patient was transferred to the surgery department, where pulmonary gangrene was confirmed. After the lower lobe of the right lung was resected, she was discharged in good health. The careful follow up, accurate diagnosis and correct medication choice are crucial for reducing the complications of “common” pneumonia.

scholarly journals JUSTIFICATION AND DIRECT RESULTS OF ENDOSCOPIC GYNRYOPLASTICS WITH TAPP AND TEP TECHNIQUES

2019 ◽  
Vol 21 (1) ◽  
pp. 125-129
Author(s):  
P N Romashchenko ◽  
Al A Kurygin ◽  
V V Semenov ◽  
S U Polushin ◽  
A A Mamoshin ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Economic Efficiency ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Inguinal Hernias ◽  
Laparoscopic Hernioplasty ◽  
Mesh Prosthesis ◽  
Invasive Intervention

Inguinal hernioplasty is one of the most common planned surgical interventions. With the advent of minimally invasive technologies in herniology, a new page in the field of inguinal hernia surgery has opened. The emergence of laparoscopic techniques (TAPP) and fully pre-peritoneal surgery using the TEP method allowed us to achieve good long-term results. However, there remain unresolved questions of justifying the choice of a particular method of minimally invasive intervention in patients with inguinal hernias, as well as minimal information about the comparison of long-term results of treatment of this category of patients. As a result of the study, the results of treatment of 987 patients with inguinal hernias, operated from 2014 to 2018, were evaluated. in the clinic by the endoscopic method (319 by the laparoscopic method TAPP and 668 patients operated by the TEP method). The criteria for the comparison of endoscopic techniques of hernioplasty were: the duration of the operation, the intensity of the pain syndrome, the postoperative bed-day, the economic costs for one treated herniological patient. It was established that in the absence of significant contraindications, the operation of choice was hernioplasty according to the TER method due to the lower risk of damage to internal organs and its greater economic efficiency, while maintaining all the positive qualities of minimally invasive intervention. The average bed-day after surgery according to the TAPP method was 3.8 ± 0.2, and according to the TEP method - 2.6 ± 0.3. The complications, the frequency and the cause of relapses after endoscopic hernioplasty were studied. Analyzing long-term results, in 3 cases (0.9%) after laparoscopic hernioplasty, a relapse of the disease was diagnosed. After hernioplasty using the TEP method, relapse was diagnosed in 2 cases (0.3%). In 2 patients, the hernia recurred was due to the small size of the established mesh prosthesis (less than 10x15 cm), in 3 patients it was caused by turning the lower edge of the mesh prosthesis and was observed at the stage of mastering the technique. As a result of the study, it was found that the TEP technique, in contrast to laparoscopic hernioplasty TAPP, leads to a reduction in the postoperative hospital bed, is accompanied by a significantly lower pain syndrome and recurrence rate of the disease, and also has greater economic efficiency.

scholarly journals Acute appendicitis in children in the context of the new coronavirus infection (COVID-19)

2021 ◽  
Vol 25 (1) ◽  
pp. 25-28
Author(s):  
V. G. Svarich ◽  
I. M. Kagantsov ◽  
V. A. Svarich ◽  
E. G. Perevozchikov
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Medical Care ◽  
Surgical Care ◽  
Komi Republic ◽  
Complicated Appendicitis ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Significant Difference ◽  
Coronavirus Infection

Introduction. The first publications about acute appendicitis in the conditions of the new COVID-19 coronavirus infection have appeared. Most authors point to the increased time of seeking medical help in such patients and an increase in the level of postoperative complications.Material and methods. A retrospective study of 192 case histories of patients aged 3 to 17 years with various forms of acute appendicitis who were treated in the surgical Department of the Republican children’s clinical hospital in the period from 2019 to November 2020 was conducted. Children operated on during 2019 before the start of the new coronavirus pandemic were included in the first group (n = 114). Children operated on in 2020 after the development of a new coronavirus pandemic were included in the second group (n = 78).Results. The age of patients in both groups compared did not differ significantly. The course of the disease was within the average accumulated indicators and the terms of hospitalization did not change significantly. According to our observations, the time of admission to the surgical hospital from the time of the disease in the pre-coronavirus period and during it also did not differ significantly, which indicates that the same availability of medical care remains even during the epidemic. Our study also showed that the number of requests for complicated appendicitis in children during the COVID-19 epidemic even decreased, which ultimately led to a decrease in the level of postoperative complications. The study did not establish a significant difference between the main results of treatment of children with acute appendicitis before and during the new COVID-19 coronavirus infection. Only the level of postoperative complications significantly decreased in patients operated during the COVID-19 epidemic, which is associated with a lower admission of children with complicated appendicitis.Conclusion. With the onset of the pandemic, the organization of medical care for the child population with acute pathology in the Komi Republic did not change and did not have any restrictions, which made it possible to maintain the timely provision of surgical care to children with acute appendicitis at the proper level.

scholarly journals Advancing convergent mixed methods design using the Diamond Approach for clinical multiple case studies: an example using data on time to treatment in aneurysmal subarachnoid haemorrhage

2021 ◽  
Author(s):  
Thuy P Nguyen ◽  
Christine Stirling ◽  
Gemma Kitsos ◽  
Kim Jose ◽  
Linda Nichols ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Quantitative Data ◽  
Early Recognition ◽  
Hospital Treatment ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Time To Treatment ◽  
Study Approach ◽  
Multiple Case ◽  
Timely Treatment

Backgrounds and aims: Delays in treatment of aSAH appear common but the causes are not well understood. We explored facilitators and barriers to timely treatment of aSAH. Methods: We used a mixed-methods multiple case study approach including in-depth interviews with stakeholders involved in individual aSAH cases, focusing on events from onset to treatment. Quantitative data were extracted from medical records including date and times. Within-case analysis identified barriers and facilitators in 4 phases (pre-hospital, presentation, transfer, in-hospital), which then being triangulated with the quantified time in each phase to determine significant influencing factors. Finally, we conducted thematic analysis across cases in early (<12h) and delayed (>12h) treatment group using a case-study matrix. Results: Twenty-seven cases (74.1% female) with 89 interviewees were included. Median (IQR) time to treatment was 15.1 (9.0, 24.1) hours. Only 37% of cases had treatment within 12 hours of onset. Qualitative and quantitative data triangulation identified key themes influencing timely treatment of aSAH. Early recognition of aSAH and good coordination during pre-hospital and diagnosis phases, and availability of resources for treatment during in-hospital period were main facilitators for treatment within 12 hours from onset. Lack of recognition of aSAH at onset and lack of resources for immediate in-hospital treatment were major barriers for more delayed treatment. Conclusions: Using a robust mixed-methods approach, we identified the most significant factors affecting more timely treatment within 12 hours from onset of aSAH. The factors are potentially modifiable and may improve timely treatment of aSAH.

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