PREOPERATIVE DIAGNOSIS OF THE FUNCTIONAL STATE OF THE SPHINCTER COMPLEX IN THE TREATMENT OF RECTAL FISTULAS

2021 ◽  
pp. 31-35
Author(s):  
T. M. Firsyk ◽  
I. A. Kryvoruchko ◽  
O. P. Bozhko
Keyword(s):  
Anal Sphincter ◽  
Functional State ◽  
Postoperative Period ◽  
Contractile Function ◽  
Normative Values ◽  
Bioelectrical Activity ◽  
Surgical Department ◽  
Sphincter Complex ◽  
Standard Values ◽  
Sphincter Insufficiency

Abstract. Introduction. Preoperative determination of the functional state of the sphincter apparatus of the rectum is an important part of the treatment of patients. Assessment and analysis of the functional viability of the anal sphincter are necessary for the choice of tactics for surgical correction of rectal fistulas. This approach makes it possible to assess the effectiveness of a specific surgical method and determine the degree of sphincter insufficiency in the postoperative period. The aim of the study: to assess the normative values of neurophysiologicsl parameters of the sphincter apparatus of the rectum and pelvic floor muscles by using the method of electrosphincteromyography. Materials and methods. The study included 93 patients who were treated in the surgical department of the Kharkiv Regional Hospital for rectal fistulas. Indicators of the contractile function of the sphincter apparatus were determined by the method of interference electrosphincteromyography in the preoperative period. The comparison group consisted of 28 volunteers who did not have rectal diseases associated with impaired intestinal retention function (0 points on the Wexner incontinence scale). Results. The standard values of the bioelectrical activity of the sphincter apparatus were obtained by examining a group of volunteers by the method of interference electrosphincteromyography. The analysis of the results obtained demonstrates a slight decrease in the initial indicators of the bioelectric activity of the sphincter complex in the postoperative period. Conclusions. Minimally invasive methods of surgical treatment of rectal fistulas are preferred, because during the study, patients showed a decrease in the initial parameters of the contractile viability of the anal sphincter.

scholarly journals THE STATE OF CHANGES IN THE BIOELECTRICAL ACTIVITY OF THE BRAIN IN PATIENTS UNDERGOING SURGERY USING GENERAL ANESTHESIA WITH STANDART MANAGEMENT OF THE POSTOPERATIVE PERIOD

2019 ◽  
pp. 95-101
Author(s):  
O. L. Tovazhyanskaya ◽  
S. S. Dubivska ◽  
Yu. B. Grigorov ◽  
E. T. Solovyova
Keyword(s):  
General Anesthesia ◽  
Functional State ◽  
Postoperative Period ◽  
Surgical Stress ◽  
Bioelectrical Activity ◽  
Emergency Medical Care ◽  
Standard Management ◽  
Number Of Patients ◽  
Two Stages ◽  
The Brain

The purpose of this work is to determine the functional state of the brain of patients on the basis of the electroencephalogram, which were operated under general anesthesia against the background of the standard management of the postoperative period. The study was conducted in the surgical departments of various profiles on the basis of the Kharkov City Clinical Hospital of Emergency and Emergency Medical Care. prof. A.I. Meshchaninov. The study was conducted with the total number of patients in 86 young, middle-aged and elderly patients with surgical pathology who underwent surgery under general anesthesia. The study of the functional state of the brain by determining the bioelectrical activity of the brain, by conducting an electroencephalogram, was determined in two stages: before surgery and 3-5 days after surgery with general anesthesia. Based on the data obtained, it is possible to recommend an electroencephalogram to assess the functional state of the brain of patients undergoing surgery under general anesthesia. Marked electroencephalographic changes in the period after the operation indicate a deterioration in the functional state of the brain, which are a consequence of the effects of anesthesia, surgical stress, and effects on cognitive function.

scholarly journals ДИНАМИКА ИЗМЕНЕНИЙ БИОЭЛЕКТРИЧЕСКОЙ АКТИВНОСТИ ГОЛОВНОГО МОЗГА У ПАЦИЕНТОВ, КОТОРЫМ ПРОВОДИТСЯ ХИРУРГИЧЕСКОЕ ВМЕШАТЕЛЬСТВО С ИСПОЛЬЗОВАНИЕМ ОБЩЕЙ АНЕСТЕЗИИ

World Science ◽  
2019 ◽  
Vol 2 (2(42)) ◽  
pp. 15-18
Author(s):  
Дубовская С. С. ◽  
Товажнянская Е. Л. ◽  
Григоров Ю. Б. ◽  
Соловйова Е. Т. ◽  
Долженко М. А.
Keyword(s):  
Comparative Analysis ◽  
General Anesthesia ◽  
Functional State ◽  
Postoperative Period ◽  
Bioelectrical Activity ◽  
Emergency Medical Care ◽  
Bioelectric Activity ◽  
Regulatory Changes ◽  
Two Stages ◽  
The Brain

The purpose of this work is to determine the functional state of the brain of patients on the basis of the EEG, who underwent surgery under general anesthesia.The study was conducted in the surgical departments of various profiles on the basis of the Kharkov City Clinical Hospital of Emergency and Emergency Medical Care. prof. A. I. Meshchaninov.The study of the functional state of the brain by determining the bioelectrical activity of the brain, by conducting an EEG, was determined in two stages: before surgery and 3-5 days after surgery with general anesthesia.In a comparative analysis of the results obtained, a strong direct correlation is determined between the degree of regulatory changes in the bioelectric activity of the brain in the postoperative period and the age of the patients. Also, in a comparative analysis of the results, a strong direct correlation is determined between the degree of regulatory changes in the bioelectric activity of the brain in the postoperative period and the duration of anesthesia support. Given the above, we can recommend an EEG to assess the functional state of the brain of patients undergoing surgery under general anesthesia.

scholarly journals THE STATE OF CHANGES IN THE BIOELECTRICAL ACTIVITY OF THE BRAIN IN PATIENTS UNDERGOING SURGERY USING GENERAL ANESTHESIA WITH STANDART MANAGEMENT OF THE POSTOPERATIVE PERIOD

2019 ◽  
pp. 95-101
Author(s):  
O. L. Tovazhyanskaya ◽  
S. S. Dubivska ◽  
Yu. B. Grigorov ◽  
E. T. Solovyova
Keyword(s):  
General Anesthesia ◽  
Functional State ◽  
Postoperative Period ◽  
Surgical Stress ◽  
Bioelectrical Activity ◽  
Emergency Medical Care ◽  
Standard Management ◽  
Number Of Patients ◽  
Two Stages ◽  
The Brain

The purpose of this work is to determine the functional state of the brain of patients on the basis of the electroencephalogram, which were operated under general anesthesia against the background of the standard management of the postoperative period. The study was conducted in the surgical departments of various profiles on the basis of the Kharkov City Clinical Hospital of Emergency and Emergency Medical Care. prof. A.I. Meshchaninov. The study was conducted with the total number of patients in 86 young, middle-aged and elderly patients with surgical pathology who underwent surgery under general anesthesia. The study of the functional state of the brain by determining the bioelectrical activity of the brain, by conducting an electroencephalogram, was determined in two stages: before surgery and 3-5 days after surgery with general anesthesia. Based on the data obtained, it is possible to recommend an electroencephalogram to assess the functional state of the brain of patients undergoing surgery under general anesthesia. Marked electroencephalographic changes in the period after the operation indicate a deterioration in the functional state of the brain, which are a consequence of the effects of anesthesia, surgical stress, and effects on cognitive function.

scholarly journals Functional state of the brain bioelectric activity in treatment of diaphyseal lesions of the radius using the transosseous osteosynthesis of the wire and rod arrangement

2021 ◽  
Vol 6 (4) ◽  
pp. 213-219
Author(s):  
I. N. Kinash ◽  
M. E. Puseva ◽  
Ch. Z. Butaev ◽  
T. K. Verkhozina ◽  
E. G. Ippolitova
Keyword(s):  
External Fixation ◽  
Functional State ◽  
Postoperative Period ◽  
Bioelectrical Activity ◽  
Bioelectric Activity ◽  
Zonal Distribution ◽  
The Central Nervous System ◽  
The Stability ◽  
High Degree ◽  
The Brain

Radial fracture is the most common trauma to the musculoskeletal system and accounts for 50 % of traumatic injuries to the bones of the upper limb. Disability in patients with fractures of the forearm bones ranges from 6 to 8 months, so the choice of the most effective method of treatment is very relevant. Currently, an important point is the tendency of optimizing the transosseous method by eliminating the disadvantages and looking for new advantages of external fixation. Bone fracture and associated surgical intervention are always accompanied by varying degrees of changes in the links of the central nervous system, hemodynamics and metabolism. In order to study the bioelectrical activity of the brain in 47 patients with a fracture of the radial diaphysis treated in the Traumatology Department of the Irkutsk Scientific Centre of Surgery and Traumatology, in the pre- and postoperative period we compared EEG indicators of two variants of the layout of the external fixation apparatus (EF): wire and rod. Analysis of the rhythms of bioelectrical activity of the brain in both groups in the preoperative period revealed a normal zonal distribution with the dominance of the alpha rhythm on the EEG, which generally reflects a rather high degree of organization of neuroactivity and indicates the stability of cerebral homeostasis. At the same time, in the group of patients with a wire-mounted EF device in the postoperative period, EEG indices significantly differed from the values of the norm and ndicators in the group with a rod-shaped arrangement. A decrease in the amplitude of alpha and beta rhythms was noted, as well as a shift in the frequency of bioelectric activity towards slow waves, which is a sign characteristic of discirculatory encephalopathy. An EEG study using the method of transosseous osteosynthesis with EF devise of a rod assembly showed its greater efficiency compared to the use of an EF device of a wire assembly during treatment and rehabilitation. Thus, the study of the bioelectric activity of the brain is a reliable method for assessing its functional state after an injury, as well as the effectiveness of the treatment.

scholarly journals The results of sphincterometry in patients after sorgion treatment of extrasphintery anal fistula

2021 ◽  
Vol 11 (10) ◽  
pp. 311-319
Author(s):  
R. Paliyenko ◽  
Z. Mishura
Keyword(s):  
Surgical Treatment ◽  
Anal Sphincter ◽  
Functional State ◽  
Postoperative Period ◽  
External Anal Sphincter ◽  
Control Group ◽  
Compression Force ◽  
Maximum Compression ◽  
Basal Tone ◽  
Late Postoperative Period

More than 30% of patients with chronic paraproctitis have complex forms. They are most often complicated by external sphincter insufficiency due to deformation of the anal canal and scarring of the sphincters. The main principle of substantiation of surgical treatment of extrasphincteric pararectal fistulas is the individual choice of method in each particular patient. It is based on a comprehensive assessment of such factors as the etiology of the fistula, its distance from the edge of the anus, the relationship of the defect or fistula with the sphincter muscles apparatus, the severity of the scarring process, the functional state of the rectum. Aim. Evaluation of the functional state of the sphincter apparatus of the rectum in patients with extrasphincteric pararectal fistulas in the preoperative, early and late postoperative periods. Materials and methods. To determine the average indicators of anal sphincter function, basal tone and maximal compression force were measured using a sphincterometer "Sphinctometer STM-0164-SM" in 114 healthy individuals (68 men and 46 women) of different ages (16 to 80 years) who objectively had no signs of anal incontinence. In all patients, sphincterometry was preceded by a thorough proctological examination, and proctological pathology was excluded. Therefore, hemorrhoids or anal fissures, which lead to increased basal tone at rest, were excluded so as not to lead to falsified values. Results. Indicators of the maximum compression force in the early postoperative period, ie the compression force of the external anal sphincter, in both groups were significantly lower than preoperative and ranged from 55 to 154 mm Hg, respectively. and from 63 to 137 mm Hg. This can be explained by the presence of a granulating wound in the pararectal tissue, edema and partial injury of the external anal sphincter during surgery. In the late postoperative period, 6-12 months after surgery, the indicators of basal tone in both groups approached the preoperative indicators. In the main group, the study was performed in 22 patients. In these 22 patients, the tone of the internal anal sphincter did not differ significantly from the preoperative and ranged from 20 to 37 mm Hg. In the control group, in all 32 patients, the basal tone of the anal sphincter was significantly lower than before surgery - from 17 to 28 mm Hg. There were no clinical manifestations of incontinence at rest in either main or control groups. In the late postoperative period in both groups a decrease in the maximum compression force of the external anal sphincter was revealed. In the main group the maximum compression force of the external anal sphincter varied from 71 to 186 mm Hg, and in the control group from 77 to 135 mm Hg, respectively. Conclusion. Surgical treatment of patients with extrasphincteric pararectal fistulas significantly reduces the contractile function of the external anal sphincter in the postoperative period, regardless of the choice of surgery.

Inflammatory Pseudotumor of the Anal Sphincter Complex: A Case Report

1999 ◽  
Vol 40 (4) ◽  
pp. 733
Author(s):  
Sang Hoon Lee ◽  
So Lyung Jung ◽  
Myeong Im Ahn ◽  
Jee Young Kim ◽  
Young Ha Park
Keyword(s):  
Case Report ◽  
Anal Sphincter ◽  
Inflammatory Pseudotumor ◽  
Sphincter Complex ◽  
Anal Sphincter Complex

Possibility of osteopathic correction inclusion in the complex treatment of anal incontinence in teenagers

2021 ◽  
pp. 31-40
Author(s):  
T. S. Kovalchuk ◽  
R. R. Enaleev ◽  
Yu. O. Kuzmina
Keyword(s):  
Anal Sphincter ◽  
Anal Incontinence ◽  
Standard Treatment ◽  
Control Group ◽  
Lumbar Region ◽  
Complex Treatment ◽  
Group 16 ◽  
Sphincter Insufficiency ◽  
Severity Of The Disease ◽  
Socially Maladjusted

Introduction. Anal incontinence (insufficiency of the anal sphincter) is a disease in which there is an uncontrolled discharge of intestinal contents through the anal canal when it is impossible to keep the episode of defecation to an acceptable place, which is a socially significant problem. Patients suffering from anal incontinence experience a feeling of psychoemotional inferiority and are often socially maladjusted. Insufficiency of the anal sphincter is a widespread pathology. The course of therapy is, as a rule, complex, and usually includes the use of medications, cleansing enemas, as well as non-drug methods of treatment (exercise therapy, massage, physiotherapy). At the same time, information on the possibility of including such a method of non-drug treatment as osteopathic correction in the complex therapy of anal incontinence in the available literature has not been found.The aim of the research was to study the possibility of including osteopathic correction in the complex treatment of anal sphincter insufficiency in teenagers.Materials and methods. The study involved 32 teenagers with functional anal sphincter incontinence, aged 14–17 years, undergoing treatment in the department of surgery. The patients were divided into 2 groups by the method of simple randomization — the main group (16 people, they received osteopathic correction in addition to the standard treatment) and the control group (16 people, they received only the standard treatment). At the beginning and at the end of the study there were assessed the osteopathic status and the disease severity using the Wexner scale and the Browning–Parks scale. The obtained results were analyzed by methods of nonparametric statistics. Results. It was found that the inclusion of osteopathic correction in the complex treatment of teenagers with anal sphincter insufficiency is accompanied by a statistically significant (p<0,05) decrease in the severity of the disease. It was revealed that children suffering from anal sphincter insufficiency are characterized by a high frequency of detection of regional (pelvic region, lumbar region) and local (some skull sutures, rectum, ascending and descending colon) somatic dysfunctions. After osteopathic correction, the frequency of detecting regional and local dysfunctions in teenagers is statistically significantly lower (p<0,05) compared with children who did not receive osteopathic correction.Conclusion. The obtained results demonstrated the ability to include the osteopathic correction in the complex treatment of teenagers with anal sphincter insufficiency.

ASSESSMENT OF SEGMENTAL MYOCARDIAL STRAIN OF THE LEFT VENTRICULAR MYOCARDIUM IN CHILDREN WITH HYPERTROPHIC CARDIOMYOPATHY

2021 ◽  
Vol 100 (5) ◽  
pp. 46-52
Author(s):  
N.Yu. Chernykh ◽  
◽  
А.А. Tarasova ◽  
O.S. Groznova ◽  
I.M. Shigabeev ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Longitudinal Strain ◽  
Contractile Function ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Normative Values ◽  
Left Ventricular Myocardium ◽  
Open Label ◽  
Timely Initiation ◽  
Compensatory Increase

Assessment of segmental myocardial strain is a promising and relevant direction in the diagnosis of early impairments of left ventricular (LV) contractility in children with hypertrophic cardiomyopathy (HCM). Objective of the study: to assess the indicators of segmental myocardial strain in children with HCM. Materials and methods of research: prospective, open-label, nonrandomized, controlled. 61 patients with asymmetric HCM aged 7 to 17 years (median 9 [7,6; 13,2]) underwent echocardiography according to the standard technique with the determination of segmental longitudinal, radial, circular LV myocardium in 2D speckle tracking mode. 45 (74%) children had a non-obstructive form (NF) of HCM, 16 (26%) children had an obstructive form (OF). Obstruction was detected at the level of the LV outflow tract with a pressure gradient of 30-50 mm Hg. Results: when assessing segmental myocardial strain, a decrease in longitudinal strain was found less than the normative values in the antero-septal, anterior, antero-lateral segments in children with NF HCM with a compensatory increase in strain values in the contralateral segments (inferior septal, inferior lateral and lower ). In similar segments in children with OF, there was a significant decrease in deformity, while in the contralateral segments a less pronounced compensatory increase in deformity was determined, as well as a decrease in the minimum values of strain indicators. Assessment of segmental radial and circular strain, a statistically significant predominance of indicators in all segments, except for anterolateral, in the group with NF compared to the OF HCM was determined. A decrease in strain in the antero-septal, anterior, antero-lateral segments was found, but less pronounced compared to the indicators of longitudinal strain, as well as a compensatory increase in strain in the antero-septal values in the contralateral segments (inferior septal, inferior lateral and inferior). It has been found that the assessment of global strain values widely used in clinical practice might not be optimal enough, since too many segmental strain values are discarded and averaged, which are unevenly distributed, and therefore the assessment of strain in each segment of the myocardium in children with an asymmetric form of HCM acquires important diagnostic value. Conclusion: changes in the indicators of segmental myocardial strain reflect violations of LV contractile function and are most pronounced in OF compared with NF HCM. Their study in children is important for the timely initiation of therapy and improving the prognosis of the disease.

scholarly journals Recurrent goitrous transformation and postoperative hypothyroidism — the arguments to execution of organ-preserving thyroid sergery

2010 ◽  
Vol 9 (5) ◽  
pp. 160-164
Author(s):  
A. N. Galyan ◽  
O. S. Popov ◽  
V. I. Tikhonov ◽  
V. D. Zavadovskaya ◽  
S. N. Gasparyan ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Functional State ◽  
Postoperative Period ◽  
Thyroid Tissue ◽  
Surgical Methods

The study included 557 patients with diffuse nodular colloidal goiter and different functional state of thyroid gland after routine surgeries. In the postoperative period was diagnosed hypothyroidism and in its presence the relapse nodulation in thyroid residue. In order to prevent the development of postoperative hypothyroidism, organopreserve surgical methods of the local cryodestruction of pathologic area thyroid gland and autotransplantation of intact thyroid tissue were suggested.

ULTRASOUND DIAGNOSTICS OF CHRONIC CONSTIPATION IN CHILDREN: RESULTS OF A CLINICAL STUDY

2021 ◽  
Vol 100 (6) ◽  
pp. 59-65
Author(s):  
L.N. Tsvetkova ◽  
◽  
M.M. Kolisnichenko ◽  
O.A. Goryacheva ◽  
◽  
...  
Keyword(s):  
Clinical Study ◽  
Anal Sphincter ◽  
Chronic Constipation ◽  
Diagnostic Method ◽  
Age Distribution ◽  
Age Groups ◽  
Pathological Process ◽  
Number Of Patients ◽  
Ultrasound Diagnostics ◽  
Sphincter Insufficiency

Chronic constipation (CC) is an important medical and social problem, as it can lead to the development of complications, fecal intoxication, social disadaptation and self-isolation of a child, as well as significantly reduce the quality of life. The article presents the results of a clinical study of CC in children using a new diagnostic method - transabdominal and transperianal ultrasound examination (US) of the colon and anorectal zone. The objective of the study was to analyze the course of CC in children depending on the mechanism of its formation according to US of the colon and anorectal zone. Materials and methods of research: the prospective cohort study included 470 children with an established diagnosis of CC at the age of 1 month to 17 years old. The patients were divided into 3 age groups: 1 month. – 3 years (n=166), 4–10 years (n=102), 11–17 years (n=202). The median follow-up was 48 months. The age distribution of children with CC was carried out on the basis of the frequency of visits, against the background of the beginning of attending kindergarten and/or elementary school groups, and the emergence of psychological problems due to the difficulty of going to a public toilet. An evaluation of analysis of the dynamics of US changes in the colon and anorectal zone was carried out by the method of ultrasound diagnosis of Hirschsprung's disease in children (patent № 2547614, authors M.I. Pykov, M.M. Kolisnichenko, I.V. Poddubny). Results: in children aged 1 month to 3 years, 66.9% of cases are statistically significantly dominated by proctogenic constipation type of constipation with US signs of anus spasm and anal sphincter insufficiency. In children aged 4 to 10 years, the mixed mechanism of CC formation prevails (41.1%), and in patients aged 11 to 17 years – cologenic (77.7%), for which the most typical ultrasound signs are dolichocolon (22.8%), anus spasm (8.7%), anal sphincter insufficiency (4.7%). It has been established that despite adequate therapy, the number of patients with the above-described mechanisms of formation of CC increases, which indicates the recurrence and progression of pathological process in children of different age groups. Conclusion: the proposed diagnostic method – transabdominal and transperianal US of the colon and anorectal zone is a highly informative, pathogenetically substantiated method for examining the state of the colon and anorectal zone in children with CC, built on precise objective criteria that are available at any age.

Sign in / Sign up

Export Citation Format

Share Document