scholarly journals MULTIMODAL REHABILITATION OF PATIENTS OPERATED ON FOR PANCREATIC NECROSIS

2021 ◽  
pp. 36-39
Author(s):  
I. A. Kryvoruchko ◽  
K. Yu. Parkhomenko ◽  
A. G. Drozdova ◽  
V. A. Vovk ◽  
K. E. Payunov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Fast Track ◽  
Pancreatic Necrosis ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Financial Costs ◽  
Commercial Enterprise ◽  
Bed Days

Summary. The aim of the study — to improve the results of surgical treatment of patients operated on for pancreatic necrosis. Matherials and Methods of the study. The results of treatment of 56 patients operated on for pancreatic necrosis who were treated in the surgical department of the Municipal non-commercial enterprise of the Kharkov regional council «Regional Clinical Hospital» from 2018 to 2020, aged 22 to 69, were analyzed. In the treatment of all patients, a “step-up approach” tacktics was used and the principles of the concept of “fast-track surgery” or multimodal rehabilitation of patients after surgery were implemented. Results of the study. Along with the performed surgical interventions (mostly minimally invasive), a “staged” method of managing the postoperative period in patients operated on for pancreatic necrosis is proposed and implemented. As a result, there is a decrease in the incidence of postoperative complications and a decrease in the length of stay in the surgical department (14.6 bed-days). Conclusions. This example confirms the appropriateness of applying the principles of “fast-track surgery” in everyday surgical practice in the complex treatment of patients with pancreatic necrosis, as the results of surgical treatment of this category of patients are improved and financial costs for treatment are reduced.

scholarly journals AN INTEGRATED APPROACH TO THE TREATMENT OF PATIENTS WITH ACUTE PANCREATITIS

2021 ◽  
pp. 8-11
Author(s):  
A. G. Drozdova ◽  
K. Y. Parkhomenko ◽  
N. M. Honcharova ◽  
V. A. Vovk ◽  
K. E. Payunov ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Fast Track ◽  
Comparison Group ◽  
Integrated Approach ◽  
Fast Track Surgery ◽  
Surgical Practice ◽  
Surgical Department ◽  
Financial Costs ◽  
Commercial Enterprise

Abstract. The aim of the study – to improve the results of surgical treatment of patients with acute pancreatitis. Matherials and methods of the study. The results of the treatment of 103 patients with acute pancreatitis who were treated in the surgical department of the Municipal non-commercial enterprise of the Kharkov regional council «Regional Clinical Hospital» 2015 to 2020 were analyzed. All patients were divided into two groups: the main (56 patients) and the comparison group (47 patients). In the main group, the tactics of the “step-up approach” were applied and the principles of the ERAS concept (2018-2020) were implemented. In the comparison group (2015-2017), the ERAS principles were not implemented and the open method was mainly used as the standard surgical treatment. Results of the study. Patients treated using the principles of “fast-track surgery” along with the “step-up approach” tactics, less likely to have postoperative complications and reduced the length of stay in the surgical department. Conclusions. This example confirms the appropriateness of applying the principles of “fast-track surgery” in everyday surgical practice in the complex treatment of patients with acute pancreatitis, as the results of surgical treatment of this category of patients are improved and financial costs for treatment are reduced.

scholarly journals IMPLEMENTATION OF THE CONCEPT OF «FAST-TRACK SURGERY» IN THE TREATMENT OF PATIENTS WITH ACUTE PANCREATITIS ACCORDING TO THE TACTICS «STEP-UP APPROACH»

2020 ◽  
pp. 81-84
Author(s):  
I. A. Kryvoruchko ◽  
K. Yu. Parkhomenko ◽  
A. G. Drozdova ◽  
M. V. Suplichenko
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Fast Track ◽  
Comparison Group ◽  
Complex Treatment ◽  
Fast Track Surgery ◽  
Surgical Practice ◽  
Surgical Department ◽  
Financial Costs ◽  
Commercial Enterprise

Summary. The aim of the study – to improve the results of surgical treatment of patients with acute pancreatitis using the “step-up approach” tactics, and justify the feasibility of implementing the concept of “fast-track surgery” in surgical practice using the example of these patients. Matherials and Methods of the study. The results of the treatment of 103 patients with acute pancreatitis who were treated in the surgical department of the Municipal non-commercial enterprise of the Kharkov regional council «Regional Clinical Hospital» 2015 to 2020 were analyzed. All patients were divided into two groups: the main (56 patients) and the comparison group (47 patients). In the main group, the tactics of the “step-up approach” were applied and the principles of the ERAS concept (2018-2020) were implemented. In the comparison group (2015-2017), the ERAS principles were not implemented and the open method was mainly used as the standard surgical treatment. Results of the study. Patients treated using the principles of “fast-track surgery” along with the “step-up approach” tactics, less likely to have postoperative complications and reduced the length of stay in the surgical department. Conclusions. This example confirms the appropriateness of applying the principles of “fast-track surgery” in everyday surgical practice in the complex treatment of patients with acute pancreatitis, as the results of surgical treatment of this category of patients are improved and financial costs for treatment are reduced.

scholarly journals Foundations for Molecular and Enzymatic Functional Surgery

2018 ◽  
Author(s):  
Ilya Klabukov
Keyword(s):  
Clinical Trials ◽  
Surgical Treatment ◽  
Medical Ethics ◽  
Fast Track ◽  
Modern Concept ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Personalized Approach ◽  
Functional Surgery ◽  
Further Development

This paper presents an approach of molecular and enzymatic surgery for treatment of human diseases, including opportunity for use of systemic biology methods in planning of surgical interventions, possible biological components of a “molecular scalpel”, and problems of standardization, medical ethics and clinical trials of the new pharma-surgical toolbox. In conclusions is proposed to consider of molecular and enzymatic surgery methods as realization of the principles of “functional surgery” and also further development of fast track surgery with attaining the modern concept of a personalized approach to surgical treatment of the patient.

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 Early enteral nutrition in surgical treatment of an acute complicated pancreatitis

2018 ◽  
Vol 85 (9) ◽  
pp. 8-10
Author(s):  
V. P. Andriushchenko ◽  
D. V. Andriushchenko ◽  
V. V. Kunovskyi ◽  
Yu. S. Lysiuk
Keyword(s):  
Surgical Treatment ◽  
Small Bowel ◽  
Enteral Nutrition ◽  
Fast Track ◽  
Early Enteral Nutrition ◽  
Fast Track Surgery ◽  
Blood Leukocytes ◽  
Necrotic Focus ◽  
Rapid Restoration ◽  
Effective Component

Objective. To estimate the efficacy of early enteral nutrition (EEN) in patients with an acute complicated pancreatitis, after determining of its content  and improving the realization methods. Маterials and methods. There were studied the results of EEN in 82 patients, suffering an acute complicated pancreatitis. Two groups of patients were delineated - the main (n=58), in which EEN was included into the complex of treatment in preoperative and postoperative periods, and a comparative one (n=24). For conduction of EEN the probe was put during fibrogastroscopy into jejunum (in 25 patients), while suboperative nasogastrointestinal intubation was performed (in 12), and a jejunostomy in accordance to Witzel procedure was formatted (in 21), what have appeared the most effective procedure and served for realization of the Fast track surgery principles. Results. Nutritious food blends were applied in combination with probiotics and the metabolism correctors. Application of EEN in the patients іn an acute complicated pancreatitis have promoted more rapid restoration of a motor-evacuation function of a small bowel, normalization of levels of the blood leukocytes and proteins, weakening of microstructural changes in mucosa and «clearance» of purulent-necrotic focus. Conclusion. EEN in the patients, suffering an acute complicated pancreatitis constitutes an effective component of surgical treatment in preoperative and postoperative periods.

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.

OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS WITH ACUTE PANCREATITIS USING MINIINVASIVE TECHNIQUES

2020 ◽  
pp. 16-18
Author(s):  
A. G. Drozdova
Keyword(s):  
Acute Pancreatitis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Pancreatic Necrosis ◽  
Minimal Invasive ◽  
Hospital Treatment ◽  
Bed Days ◽  
Minimal Invasive Techniques ◽  
Invasive Techniques

Summary. The aim of the study. To improve the results of surgical treatment of patients with acute pancreatitis using minimal invasive techniques. Matherials and Methods of the study. The results of surgical treatment of 75 patients with different forms of acute pancreatitis were analyzed. All patients were examined and operated on. Results of the study. Minimally invasive interventions were performed in 92 % of the analyzed patients. Intraoperatively acute pancreatic edema was observed in 43 % of patients, hemorrhagic pancreatic necrosis – in 24 %, infected pancreatic necrosis – in 33 %. The postoperative period was complicated by 13.3 %, the mortality rate was 9.3 %. Conclusions. The use of minimally invasive techniques for treating acute pancreatitis can significantly improve the results of surgical treatment of patients with this pathology. The frequency of complications and lethality decreases. Also, it is possible to significantly reduce operational trauma, and hence the number of bed-days of stay in hospital treatment. This contributes to reducing the financial cost of treatment in patients with acute pancreatitis, as well as improving the quality of life of this category of patients.

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 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.

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