scholarly journals «FAST-TRACK» SURGERY OF ACUTE DESTRUCTIVE CHOLECYSTITIS

2020 ◽  
pp. 27-30
Author(s):  
A. N. Veligotsky ◽  
A. S. Chebotaryov ◽  
V. S. Strakhovetsky ◽  
S. G. Fedorovskyi ◽  
A. S. Fomina
Keyword(s):  
Experimental Study ◽  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Fast Track ◽  
Control Group ◽  
Study Group ◽  
Fast Track Surgery ◽  
Results Of Treatment ◽  
The Right

Summary. Aim. Introduction of «FAST-TRACK» principles in laparoscopic surgery of acute destructive cholecystitis. Materials and methods. The paper presents the results of an experimental study of the treatment of 210 patients with acute destructive cholecystitis, 104 patients in the control group and 106 comparative patients who were hospitalized and operated on in the clinic for the period from 2012 to 2019. Results and their discussion. In the control group, conversion and cholecystectomy were performed by lateral mini-access in the right hypochondrium. In the study group of patients performed laparoscopic cholecystectomy in similar conditions, but using original methods. Conclusions. As a result of the study it was possible to improve the results of treatment by 3.2 % and reduce the patient’s stay in the hospital from 6.5 days to 5.4 and reduce the number of postoperative complications by 80 % from 5 to 1 complication.

scholarly journals The change of endotracheal tube cuff pressure during laparoscopic surgery

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 431-436 ◽  
Author(s):  
Youngsuk Kwon ◽  
Ji Su Jang ◽  
Sung Mi Hwang ◽  
Jae Jun Lee ◽  
Seok Jun Hong ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Control Group ◽  
Study Group ◽  
Endotracheal Tube Cuff ◽  
Tube Cuff ◽  
Significant Difference ◽  
Endotracheal Tube Cuff Pressure

AbstractBackgroundWe evaluated the endotracheal tube cuff pressure (Pcuff) changes during pneumoperitoneum for laparoscopic cholecystectomy and the correlations between body mass index (BMI), pneumoperitoneum time, and Pcuff changes.MethodsTotal 60 patients undergoing laparoscopic cholecystectomy were allocated to either a study group (BMI ≥ 25 kg/m2) or a control group (BMI < 25 kg/m2). The endotracheal intubation was performed with a high-volume low-pressure cuffed oral endotracheal tube. A manometer was connected to the pilot balloon using a 3-way stopcock and the cuff was inflated. The change in Pcuff was defined as the difference between the pressure just before intra-abdominal CO2 insufflation and the pressure before CO2 desufflation.ResultsPcuff increased to 5.3 ± 3.6 cmH2O in the study group and 5.7 ± 5.4 cmH2O in the control group. There was no significant difference between two groups. While BMI was not correlated with change in Pcuff (r = 0.022, p = 0.867), there was a significant correlation between change in Pcuff and the duration of pneumoperitoneum (r = 0.309, p = 0.016).ConclusionThe change in Pcuff was not affected by BMI and was significantly correlated with pneumoperitoneum time. We recommend regular measurement and adjustment of Pcuff during laparoscopic surgery.

scholarly journals Effect of operation technic on development of postoperative complications after appendectomy

2018 ◽  
Vol 9 (4) ◽  
pp. 63-66
Author(s):  
P. M. Lavreshin ◽  
V. K. Gobedgishvili ◽  
V. V. Gobedgishvili ◽  
E. V. Kochkarov ◽  
O. V. Vladimirova
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Fast Track ◽  
Test System ◽  
Abdominal Adhesions ◽  
Fast Track Surgery ◽  
Results Of Treatment ◽  
Connective Tissue Dysplasia ◽  
Instrumental Methods

Objective: to improve the results of treatment of patients with acute appendicitis. Te results of surgical treatment of 360 patients with acute appendicitis were presented.Materials and methods: in predicting of development of intra-abdominal adhesions in patients afer appendectomy and of effectiveness of anti-adhesion therapy in postoperative period was used clinical, laboratorial (phenotype signs of connective tissue dysplasia syndrome, activity of the enzyme N-acetyltransferase, a test system based on sorbents with magnetic properties with immobilized granular antigen from adhesive tissue), instrumental methods of research. Te frst group included 120 (50%) patients who underwent standard appendectomy. In 120 patients with acute appendicitis (the second group) the elements of “Fast-Track” surgery was used in performing classical laparotomy appendectomy. Te third group consisted of 120 patients who underwent laparoscopic appendectomy.Results: all patients with diagnosed adhesive process in the early stages of its development in postoperative period were provided with anti-adhesion therapy. Te least number of postoperative complications was observed in cases of multimodal approach to treatment of acute appendicitis.Conclusions: application of “Fast-Track” surgery principles allowed to reduce development of intra-abdominal adhesion afer surgery compared with traditional appendectomy on 6.6 %, and with laparoscopic — on 2.8 %.

scholarly journals Differentiated approach to radical surgical treatment of elderly patients with tumor diseases of the pancreatoduodenal zone

2021 ◽  
Vol 13 (2) ◽  
pp. 49-56
Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Alexey V. Gulyaev ◽  
Malkhaz Yu. Tsikoridze ◽  
Evgeny A. Zakharov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Comparison Group ◽  
Main Group ◽  
Control Group ◽  
Study Group ◽  
Tumor Diseases ◽  
Results Of Treatment ◽  
Repeated Surgery ◽  
Pancreatic Fistulas

BACKGROUND: In recent years, there has been a widespread increase in the incidence of tumors of the pancreatoduodenal zone, especially noticeable in the older age group. A decrease in the incidence of postoperative complications and mortality after pancreatoduodenal resection made it possible to expand the indications for surgical treatment of elderly and senile patients. AIM: Improvement of the immediate results of pancreatoduodenal resection in the treatment of elderly and senile patients suffering from tumor diseases of the pancreatoduodenal zone. MATERIALS AND METHODS: Pancreatoduodenal resection was performed in 61 elderly and senile patients with tumors of the pancreatoduodenal zone. The main group consisted of 32 patients, whose treatment was carried out in accordance with the developed algorithm for choosing a method for forming a pancreatodigestive anastomosis based on a scale for assessing the risk of developing pancreatic fistulas. The comparison group consisted of 29 patients in whom the method of forming a pancreatodigestive anastomosis was carried out in accordance with the preferences of the operator without taking into account the risk of developing a pancreatic fistula. RESULTS: In the main group, compared with the control group, pylorus-saving interventions were performed significantly more often 27 (84.4%) and 14 (48.3%) (p 0.01). There was also a decrease in the frequency of performing pancreaticojejunostomy 16 (50%) and 22 (75.9%) (p 0.05), due to the use of reservoir terminolateral pancreatojejunostomy 8 (25%) and 0, respectively (p 0.01). Postoperative complications were observed in 14 (43.8%) of the study group and in 21 (72.4%) patients of the comparison group (p 0.05). There was also a decrease in the incidence of postoperative pancreatic fistulas from 8 (27.6%) to 2 (6.2%) (p 0.05) in the study group. Repeated surgery was required in 5 (15.6%) patients of the main group and 11 (37.9%) in the comparison group (p 0.05). The lethal outcome was recorded in 3 (9.4%) patients of the main group and in 7 (24.1%) in the comparison group (p 0.05). CONCLUSIONS: The results of performing pancreatoduodenal resection in the treatment of elderly and senile patients can be comparable with the results of treatment of the general population. The use of the developed algorithm made it possible to reliably reduce the incidence of complications from 72.4 to 43.8% (p 0.05), postoperative pancreatic fistulas from 27.6 to 6.2% (p 0.05), as well as the frequency of repeated interventions. from 37.9 to 15.6 % (p 0.05). In addition, a downward trend in mortality was achieved from 24.1% to 9.4%.

scholarly journals Frequency-Following Response (FFR) in Military Pilots

2020 ◽  
Author(s):  
Graziela Maria Martins-Moreira ◽  
Alessandra Spada Durante
Keyword(s):  
Pure Tone Audiometry ◽  
Control Group ◽  
Study Group ◽  
Aircraft Accidents ◽  
Frequency Following Response ◽  
Significant Difference ◽  
Qualitative Variables ◽  
Chi Squared ◽  
The Right ◽  
Military Pilots

Abstract Introduction Good hearing in pilots, including central auditory skills, is critical for flight safety and the prevention of aircraft accidents. Pure tone audiometry alone may not be enough to assess hearing in the members of this population who, in addition to high noise levels, routinely face speech recognition tasks in non-ideal conditions. Objective To characterize the frequency-following response (FFR) of a group of military pilots compared with a control group. Methods Twenty military pilots in the Study Group and 20 non-pilot military personnel, not exposed to noise in their work, in the Control Group, all with normal hearing, aged between 30 and 40 years old, completed a questionnaire to assess their hearing habits, and their FFRs were measured with a /da/ syllable (duration 40 milliseconds, speed 10.9/s), at 80 dB NA in the right ear. All procedures were approved by the ethical committee of the institution. Statistical analysis was performed using the t-Student or Mann-Whitney tests for quantitative variables, and the Fisher or chi-squared tests for qualitative variables, and a value of p < 0.05 was considered to be statistically significant. Results There was no significant difference between the groups regarding auditory habits. In the FFR, wave amplitudes A (p = 0.01) and C (p = 0.04) were significantly lower in the Study Group. Conclusion Working as a military pilot can be a crucial factor in determining an individual's typical FFR pattern, demonstrated in the present study by statistically significant reductions in the amplitudes of the A and C waves.

scholarly journals Sonographic Signs of Adenomyosis in Women with Endometriosis Are Associated with Infertility

2021 ◽  
Vol 10 (11) ◽  
pp. 2355
Author(s):  
Dean Decter ◽  
Nissim Arbib ◽  
Hila Markovitz ◽  
Daniel S. Seidman ◽  
Vered H. Eisenberg
Keyword(s):  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Statistical Analysis ◽  
Conservative Management ◽  
Transvaginal Ultrasound ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Increased Risk ◽  
And Control

We compared the prevalence of ultrasound signs of adenomyosis in women with endometriosis who underwent surgery to those who were managed conservatively. This was a retrospective study of women evaluated at a tertiary endometriosis referral center who underwent 2D/3D transvaginal ultrasound. Adenomyosis diagnosis was based on the presence of at least three sonographic signs. The study group subsequently underwent laparoscopic surgery while the control group continued conservative management. Statistical analysis compared the two groups for demographics, symptoms, clinical data, and sonographic findings. The study and control groups included 244 and 158 women, respectively. The presence of any, 3+, or 5+ sonographic signs of adenomyosis was significantly more prevalent in the study group (OR = 1.93–2.7, p < 0.004, 95% CI; 1.24–4.09). After controlling for age, for all findings but linear striations, the OR for having a specific feature was higher in the study group. Women in the study group with ≥ 5 sonographic signs of adenomyosis had more than twice the risk of experiencing infertility (OR = 2.31, p = 0.012, 95% CI; 1.20–4.45). Sonographic signs of adenomyosis are more prevalent in women with symptomatic endometriosis who underwent surgery compared with those who continued conservative management. Women with 5+ findings have a significantly increased risk of infertility. Adenomyosis on ultrasound should be considered in the management decisions regarding these patients.

scholarly journals Comparative study of the areas of osteochondral defects produced in the femoral condyles of rabbits treated with gel of sugarcane biopolymer

2011 ◽  
Vol 26 (5) ◽  
pp. 383-386 ◽  
Author(s):  
Paulo Cezar Vidal Carneiro de Albuquerque ◽  
José Lamartine de Andrade Aguiar ◽  
Saulo Monteiro dos Santos ◽  
Nicodemus Pontes Filho ◽  
Roberto José Vieira de Mello ◽  
...  
Keyword(s):  
Sugar Cane ◽  
Digital Camera ◽  
Control Group ◽  
Study Group ◽  
Osteochondral Defects ◽  
Control Groups ◽  
The Right ◽  
And Control ◽  
Natural Healing ◽  
Femoral Condyles

PURPOSE: To measure the healed areas of osteochondral defects produced in femoral condyles of rabbits filled with biopolymer sugar cane gel and to compare these with those of the control group at 90, 120 and 180 days. METHODS: A study was made of 16 New Zealand rabbits, 6 and 7 months old, weighing between 2 and 2.5 kg. Defects of 3.2 x 4 mm were made, with trephine, in the femoral condyles of the right and left knees. As to the study group defects of the medial and lateral condyles of the right knee were used which were filled with Biopolymer Sugar Cane Gel; as to the Control Group defects of the medial and lateral condyles of the left t knees were used which were left open for natural healing. The defects were analyzed at 90, 120 and 180 days after surgery. After euthanasia, the knees were removed and fixed in Bouin's solution for later digital photographic documentation with a digital camera. The areas healed were measured in both the study and control groups using the images obtained from an Image-J® program. Statistical analysis was conducted using the non-parametric Mann-Whitney test. RESULTS: There were no significant differences between the means of the healed areas in the study and control groups at 90, 120 and 180 days after surgery. CONCLUSION: The dimension of the healed areas of the defects treated with the biopolymer sugar-cane gel in the study group was similar to those of the control group, which healed naturally.

scholarly journals Glisson’s capsule cauterisation is associated with increased postoperative pain after laparoscopic cholecystectomy: a prospective case–control study

2017 ◽  
Vol 99 (6) ◽  
pp. 485-489 ◽  
Author(s):  
F Basak ◽  
M Hasbahceci ◽  
A Sisik ◽  
A Acar ◽  
Y Ozel ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Case Control Study ◽  
Gallbladder Disease ◽  
Case Control ◽  
Control Group ◽  
Study Group ◽  
Pain Scores ◽  
Standard Laparoscopic Cholecystectomy ◽  
Control Study

INTRODUCTION Postoperative pain after laparoscopic cholecystectomy has three components: parietal, visceral and referred pain felt at the shoulder. Visceral peritoneal injury on the liver (Glisson’s capsule) during cauterisation sometimes occurs as an unavoidable complication of the operation. Its effect on postoperative pain has not been quantified. In this study, we aimed to evaluate the association between Glisson’s capsule injury and postoperative pain following laparoscopic cholecystectomy. METHODS The study was a prospective case–control of planned standard laparoscopic cholecystectomy with standardized anaesthesia protocol in patients with benign gallbladder disease. Visual analogue scale (VAS) abdominal pain scores were noted at 2 and 24 hours after the operation. One surgical team performed the operations. Operative videos were recorded and examined later by another team to detect presence of Glisson’s capsule cauterisation. Eighty-one patients were enrolled into the study. After examination of the operative videos, 46 patients with visceral peritoneal injury were included in the study group, and the remaining 35 formed the control group. RESULTS VAS pain score at postoperative 2 and 24 hours was significantly higher in the study group than control (P = 0.027 and 0.017, respectively). CONCLUSIONS Glisson’s capsule cauterisation in laparoscopic cholecystectomy is associated with increased postoperative pain. Additional efforts are recommended to prevent unintentional cauterisation.

scholarly journals Comparison of laparoscopic surgery versus traditional laparotomy for the treatment of emergency patients

2019 ◽  
Vol 48 (3) ◽  
pp. 030006051988919
Author(s):  
Ning Cui ◽  
Jun Liu ◽  
Haiyan Tan
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Gastrointestinal Surgery ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Observation Group ◽  
Duration Of Surgery ◽  
Clinical Benefits ◽  
Gastrointestinal Emergency ◽  
And Control

Objective To investigate the clinical efficacy of laparoscopic gastrointestinal emergency surgery and postoperative complications. Methods Data for 604 patients undergoing emergency gastrointestinal surgery between January 2013 and December 2018 were analyzed retrospectively. Treatment efficacy and postoperative complications were compared between 300 patients (control group) undergoing traditional laparotomy and 304 patients (observation group) undergoing laparoscopic surgery. Results Clinical features were significantly better in the observation group than in the control group, including duration of surgery (59.12 ± 10.31 minutes vs. 70.34 ± 12.83 minutes), intraoperative blood loss (41.21 ± 10.45 mL vs. 61.38 ± 9.97 mL), postoperative pain score (1.25 ± 0.25 points. vs. 5.13 ± 0.43 points), length of hospital stay (5.13 ± 0.24 days vs. 7.05 ± 0.13 days), and time to free activity (13 ± 2.96 hours vs. 22 ± 3.02 hours). The total complication incidence in the observation group was 3.9%, compared with 16% in the control group (16%). No significant differences in direct medical costs were recorded between the observation and control groups. Conclusions For patients undergoing emergency gastrointestinal surgery, laparoscopic surgery resulted in better clinical outcomes than traditional laparotomy without incurring additional costs. The potential clinical benefits of emergency laparoscopic gastrointestinal surgery warrant further study.

Role of Ultrasound Screening for Gallbladder Disease in Pretransplant Patients

2008 ◽  
Vol 74 (9) ◽  
pp. 832-833
Author(s):  
Madhavi Meka ◽  
Santosh Potdar ◽  
Peter Benotti ◽  
J. Edward Hartle ◽  
Christopher Senkowski
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gallbladder Disease ◽  
Graft Loss ◽  
Day Surgery ◽  
Control Group ◽  
Study Group ◽  
Gallstone Pancreatitis ◽  
Safe Procedure ◽  
Ultrasound Screening ◽  
Clinical Value

There is no uniform data regarding prophylactic cholecystectomy in patients undergoing renal transplantation with gallbladder disease. Data analyses suggest that posttransplant patients on cyclosporine have a higher incidence of gallbladder calcifications compared with nonimmunosuppressed patients. Laparoscopic cholecystectomy is a relatively safe procedure in modern-day surgery. Taking these facts into consideration, we attempted to compare risks and complications associated with gallbladder disease and eventual cholecystectomy in pretransplant versus post-transplant patients. Between June 1999 and December 2005, 210 renal transplants were performed at our institution. One hundred four patients who had transplants before April 2003 were not screened for gallbladder disease and nine of these patients developed gallbladder disease. These patients form our control group. One hundred six patients who had transplants after April 2003 had pretransplant screening for gallbladder disease and 11 patients were identified with gallbladder disease. These patients form our study group. Nine patients who developed gallbladder disease after renal transplant underwent laparoscopic cholecystectomy with three resulting morbidities (33%), two graft losses (22%), and one mortality (11%). There was one mortality (11%) in this group. One patient in the study group died of acute gallstone pancreatitis. Of the 11 patients who were found to have gallbladder disease on screening, nine patients underwent laparoscopic cholecystectomy with one morbidity and no mortality or graft loss. Given the relative rarity of the critical events in this study (morbidity, mortality, and graft loss), the definitive statistical value of prescreening for gallbladder disease cannot be established. However, our results are suggestive of clinical value and thus we tentatively recommend ultrasound screening for gallbladder disease for all pretransplant patients and laparoscopic cholecystectomy for those identified to have gallbladder disease.

Effect of Auditory Evoked Potential Index Monitoring on Anesthetic Drug Requirements and Recovery Profile after Laparoscopic Surgery

2003 ◽  
Vol 99 (4) ◽  
pp. 813-818 ◽  
Author(s):  
Alejandro Recart ◽  
Paul F. White ◽  
Agnes Wang ◽  
Irina Gasanova ◽  
Stephanie Byerly ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Fast Track ◽  
Evoked Potential ◽  
Rating Scale ◽  
Auditory Evoked Potential ◽  
Control Group ◽  
Early Recovery ◽  
Anesthetic Drugs ◽  
Desflurane Concentration ◽  
Pacu Stay

Background The auditory evoked potential (AEP) monitor provides an electroencephalogram-derived index (AAI) that has been reported to correlate with the central nervous system depressant effects of anesthetic drugs. This clinical utility study was designed to test the hypothesis that AAI-guided administration of the maintenance anesthetics and analgesics would improve their titration and thereby provide a faster recovery from general anesthesia. Methods Seventy consenting patients undergoing elective general surgery procedures were randomly assigned to either a control (standard clinical practice) or AEP-monitored group. Although the AEP monitor was connected to all patients, the information from the monitor was only made available to the anesthesiologists assigned to patients in the AEP-monitored group. In the AEP-monitored group, the inspired desflurane concentration was titrated to maintain an AAI value of 15-20. In the control group, the inspired desflurane concentration was varied based on standard clinical signs. The AAI values and hemodynamic variables, as well as end-tidal desflurane concentrations, were recorded at 3- to 5-min intervals. The recovery times to achieve a White fast-track score greater than 12 and an Aldrete score of 10, as well as the actual duration of the PACU stay, were evaluated at 5- to 10-min intervals. Patient satisfaction with recovery from anesthesia was assessed using a 100-point verbal rating scale at 24 h after surgery. Results The average intraoperative AAI value in the AEP-monitored group was significantly higher than in the control group (16 +/- 5 vs. 11 +/- 8, P &lt; 0.05). Use of the AEP monitor reduced the desflurane requirement by 26% compared to the control group (P &lt; 0.01). In addition, the AEP-monitored group received less intraoperative fentanyl (270 +/- 120 vs. 390 +/- 203 microg, P &lt; 0.05) and more rapidly achieved fast-track eligibility (29 +/- 19 vs. 56 +/- 41 min, P &lt; 0.05). The time required to achieve an Aldrete score of 10 (60 +/- 31 vs. 98 +/- 55 min) and the duration of stay in the recovery room (78 +/- 32 vs. 106 +/- 54 min) were also significantly reduced in the AEP-monitored (vs. control) group (P &lt; 0.05). Conclusion Use of AEP monitoring as an adjunct to standard clinical monitors improved titration of anesthetic drugs, thereby facilitating the early recovery process after laparoscopic surgery.

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