scholarly journals URGICAL TACTICS IN WOUNDS OF PHARYNX AND CERVICAL ESOPHAGUS

2019 ◽  
pp. 95-98
Author(s):  
M. Yu Syzyi
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Surgical Intervention ◽  
Main Group ◽  
Cervical Esophagus ◽  
Penetrating Injuries ◽  
Twofold Decrease

Summary. The results of surgical treatment of 98 patients with penetrating injuries to the pharynx and cervical esophagus are presented. The patients were divided into the main and the comparison group. In the comparison group, the traditional principles of intervention were used. In the main group, surgical intervention was performed with a mini access on the neck 3-4 cm in length using a ring-shaped retractor. In the main group there was a twofold decrease in the frequency of purulent complications after surgical treatment of penetrating injuries to the pharynx and cervical esophagus, in comparison with the comparison group.

scholarly journals Standard open operative interventions in surgical treatment of patients, suffering an acute complicated pancreatitis

2018 ◽  
Vol 85 (7) ◽  
pp. 27-29
Author(s):  
V. P. Аndriushchenko ◽  
D. V. Аndriushchenko ◽  
Yu. S. Lysiuk
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Surgical Intervention ◽  
Main Group ◽  
Control Group ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Second Stage ◽  
Standard Operations

Objective. To determine the character and optimal volume of standard open surgical interventions in an acute complicated pancreatitis (ACP) with elaboration of the main technical elements of the operations. Маterials and methods. There were operated 96 patients, suffering ACP. The main group consisted of 47 patients, in whom open interventions were performed primarily in 19, and as the second-stage procedure after application of miniinvasive interventional technologies (МIТ) – in 28. The comparison group consisted of 49 patients, in whom standard operations were done only. Results. Application of MIТ have promoted the indications narrowing for performance of primary open operations more than twice. In the main group the arcuate-like subcostal access was applied predominantly - in 26 (55%) observations (χ²=14.287; р=002), while in a control one – a median upper laparotomy – in 37 (76%) observations (χ²=38.43, р < 0.001). The method of closed draining in accordance to procedure of Beger was used predominantly in the main group of patients – in 43% of observations, comparing with a control group - 9% of observations (χ²=12.965; р=0.003). In 23% patients of the main group and in 26% patients of a control one (χ²=0.0013; р=0.05), when the extended purulent-necrotic inflammation process have presented, a staged sanation was applied, using programmed relaparotomies. Some technical elements of the surgical intervention were improved. Conclusion. Application of standard open operations in accordance to elaborated principle is accompanied by improvement of the treatment results in patients, suffering ACP.

Surgical treatment of patients with deep infiltrating endometriosis of the rectovaginal septum

2021 ◽  
Vol 20 (4) ◽  
pp. 5-11
Author(s):  
E.A. Galliamov ◽  
◽  
L.N. Aminova ◽  
V.A. Alimov ◽  
A.G. Kozub ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Comparison Group ◽  
Chronic Pelvic Pain Syndrome ◽  
Main Group ◽  
Pelvic Pain Syndrome ◽  
Deep Infiltrating Endometriosis ◽  
Rectovaginal Septum ◽  
Infiltrating Endometriosis

Objective. To optimize the tactics of surgical treatment of deep infiltrating endometriosis of the rectovaginal septum, including with bowel involvement. Patients and methods. The study included 122 patients diagnosed with deep infiltrating endometriosis of the rectovaginal septum, who underwent surgical interventions of different volumes using laparoscopy. The patients were divided into a main group and a comparison group. The main group consisted of 92 patients with deep infiltrating endometriosis of the rectovaginal septum who underwent surgical treatment using the original technique of systematic approach; the comparison group consisted of 30 patients who were operated using the generally accepted technique. Results. There was a statistically significant decrease in the operation duration, intraoperative blood loss, as well as more effective relief of dysmenorrhea and chronic pelvic pain syndrome, less complications and relapses in the main group compared to the comparison group. In addition, it was found that the combination of three symptoms such as dysmenorrhea, dyspareunia and chronic pelvic pain increase the likelihood of deep infiltrating endometriosis up to 93%. Conclusion. Based on the results obtained, the proposed method of surgical treatment of deep infiltrating endometriosis is more efficient and safer in comparison with the generally accepted technique, which can be considered as a valid reason for its wide introduction into clinical practice. Key words: deep infiltrating endometriosis, bowel endometriosis, surgical treatment of endometriosis, treatment algorithm

THE USE OF THORACOPLASTY IN THE TREATMENT OF DESTRUCTIVE PULMONARY TUBERCULOSIS

2021 ◽  
pp. 18-28
Author(s):  
Andrey V. Ivanov ◽  
Alexey A. Malov ◽  
Vadim A. Kichigin ◽  
Vasily A. Ivanov ◽  
Larisa V. Tarasova
Keyword(s):  
Drug Resistance ◽  
Body Weight ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Pulmonary Tuberculosis ◽  
Comparison Group ◽  
Main Group ◽  
Negative Reaction ◽  
Normal Body ◽  
Normal Body Weight

Despite a decrease in the incidence of pulmonary tuberculosis in the Russian Federation in recent years, among the newly diagnosed patients there remains a significant proportion of patients with bacterial excretion and destructive pulmonary tuberculosis. In patients with destructive pulmonary tuberculosis, surgical treatment is often the only possible method for saving lives. We studied the results of extrapleural posterosuperior thoracoplasty in 42 patients with destructive pulmonary tuberculosis. The comparison group consisted of 30 patients who received medicamentous therapy. The mortality rate for 3 years of follow-up in the conservative treatment group was 36.7%, in the surgical treatment group it was 23.8%, p = 0.237. Among patients with more than 2 years of disease experience, mortality was 45% in the main group, 88% in the comparison group, p = 0.070. In the absence of drug resistance, mortality in the main group was 4%, that in the comparison group – 14.2%, p = 0.283. Mortality in individuals with normal body weight was lower in the group of patients who underwent thoracoplasty than in the comparison group: 17.6% vs. 33.3% (p = 0.202). Among those who did not achieve sputum negative reaction, mortality was lower, and passing to the 3rd group of dispensary care was more common in the surgical treatment group – 41.7% vs. 71.4% (p = 0.077) and 33.3% vs. 21.4% (p = 0.426). Among patients with drug resistance or low body weight or unachieved sputum negative reaction, mortality rates were comparable in both groups. Thus, thoracoplasty, in comparison with conservative therapy, makes it possible to improve treatment results in patients regardless of the length of the disease in groups with Mycobacterium tuberculosis sensitive process, with normal body weight, with preservation of elimination of bacilli. The effectiveness of thoracoplasty decreases in patients with an increase in the disease duration.

scholarly journals Surgical tactics for victims of gunshot wounds of the diaphragm specialized stage of medical care in conditions of a modern armed conflict

2019 ◽  
Keyword(s):  
Surgical Treatment ◽  
Medical Care ◽  
Comparison Group ◽  
Care Delivery ◽  
Abdominal Cavity ◽  
Surgical Care ◽  
Gunshot Wounds ◽  
Main Group ◽  
Lung Capacity ◽  
Combat Injuries

Introduction. The diaphragm gunshot wounds are serious combat injuries. The main functions of the diaphragm are to change the intra-abdominal pressure and the outflow of lymph and blood from the abdominal cavity due to the constant contraction and relaxation. Therefore, when it is injured at the same time with a powerful painful impulse, cardiopulmonary disorders quickly arise. Purpose: To improve the results of surgical treatment of patients with gunshot wounds through the introduction of new video endoscopic technologies at the stage of specialized surgical care. Materials and methods. The article analyzes the features of specialized surgical care in 64 patients with gunshot wounds who were treated at the surgical clinic of the Military Medical Clinical Center of the Northern Region (III level of medical care). New minimally invasive methods are proposed to improve the outcomes of surgical treatment of victims with diaphragm gunshot wounds at level III of health care delivery. Results. Thus, the use of video thoracoscopic technique in the surgical treatment of the diaphragm wound and its suturing in the proposed method allowed to improve the results of treatment by increasing the average value of diaphragmatic excursion in deep breath in the main group to 3.73 ± 0.31 cm, whereas in the comparison group 2.21 ± 0.38 cm. The severity of the pain syndrome on the of Visual Аnalogue Scale 5 days after surgical treatment was 5.2 ± 2.3 points in the injured main group, 6.7 ± 2.1 points in the comparison group. The ratio of vital lung capacity to the required vital lung capacity in the main group was 75.3 ± 2.2%, in the comparison group 64.1 ± 1.7%. Conclusions. The use of video thoracoscopy increases the efficiency of the diagnosis of gunshot wounds of the diaphragm. The use of laser imaging and fluorescence diagnosis of diaphragm wounds ensure the adequacy of the removal of paravulary necrotic tissues. The suturing of the wounds in accordance with the anatomical and functional structure of the diaphragm with the use of plaques improves the immediate postoperative results of surgical treatment.

scholarly journals Dynamics of quality of life in patients with morbid obesity after biliopancreatic diversion and sleeve gastrectomy

2018 ◽  
Vol 22 (3) ◽  
pp. 548-552
Author(s):  
O.V. Perekhrestenko
Keyword(s):  
Quality Of Life ◽  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Sleeve Gastrectomy ◽  
Surgical Treatment ◽  
Biliopancreatic Diversion ◽  
Comparison Group ◽  
Main Group ◽  
The Impact

The rapid progress of obesity surgery dictates the necessity to study the quality of life of patients after bariatric procedures. The aim of the study is to assess the dynamics of quality of life of patients with morbid obesity after biliopancreatic diversion in the modification of Hess-Marceau and the sleeve gastrectomy in order to improve the results of surgical treatment of the specified category of patients. The results of surgical treatment of 205 patients with morbid obesity who performed sleeve gastrectomy (main group — 105 patients) or biliopancreatic diversion by Hess-Marceau (comparison group — 100 patients) were analyzed. The study of the dynamics of quality of life of patients was performed in according the Moorehead-Ardelt II method. Statistical data processing was performed using the methods of variational and descriptive statistic using Statistica 6.0 statistical analysis package. Installed that biliopancreatic diversion by Hess-Marceau and sleeve gastrectomy allowed to significantly improve the quality of life of patients with an increase of the quality of life index with -1.5±0.7 in the comparison group and -1.6±0,6 in the main group up to 1.8±0.3 and 2.0±0.4 respectively (p<0.05 compared to pre-operative data) 60 months after surgery. A more pronounced positive dynamics of quality of life in patients of the main group in the time interval of 12–24 months after the operation was achieved due to the absence of severe late metabolic complications and undesirable side effects of biliopancreatic diversion and laparoscopic access for sleeve gastrectomy in 54.3% of patients. Thus, the quality of life of patients with morbid obesity before performing bariatric surgery is critically low and significantly improved after biliopancreatic diversion by Hess-Marceau as well as sleeve gastrectomy. The impact of bariatric surgery on the duration and quality of life of patients requires further multicenter randomized trials.

scholarly journals Surgical treatment of patients with osteoarthritis of the ankle joint

2012 ◽  
Vol 93 (1) ◽  
pp. 38-43
Author(s):  
Yu A Plakseychuk ◽  
R Z Salikhov ◽  
V V Soloviev
Keyword(s):  
Surgical Treatment ◽  
Ankle Joint ◽  
Bone Grafting ◽  
Comparison Group ◽  
Functional Results ◽  
Main Group ◽  
Radiographic Evaluation ◽  
Results Of Treatment ◽  
Ilizarov Apparatus

Aim. To evaluate the results of treatment using the authors’ proposed method of arthrodesis of the ankle and subtalar joints, based on the combination of bone grafting with compression in the Ilizarov apparatus. Methods. Conducted was a clinical and radiographic evaluation of the results of arthrodesis in the Ilizarov apparatus in 286 patients with osteoarthritis of the ankle and subtalar joints (during the last 15 years). 36 (12.6%) patients (the main group) were operated on using the authors’ proposed technique. Results. Bone adhesion as a result of arthrodesis was achieved in all patients of the main group. Excellent functional results were achieved in 11 out of 36 patients (30.5%), good results - in 22 (61.1%) patients, satisfactory results - in 3 (8.4%) patients. Bone adhesion as a result of arthrodesis in 250 patients of the comparison group was achieved in 243 patients (97.2%). In this group excellent functional results were achieved in 76 out of 250 patients (30.4%), good results - in 145 (58%) patients, satisfactory results - in 21 (8.4%) patients, poor results - in 8 (3.2%) patients. Conclusion. The proposed method of biarticular arthrodesis makes it possible to improve the trophism of the arthrodesis zone, to conduct the correction of posttraumatic deformities in the region of the ankle and subtalar joints, provides a durable and solid bone ankylosis of the ankle and subtalar joints, and makes it possible to achieve adhesion even in severe forms of osteoarthritis of the ankle and subtalar joints.

OPTIMIZATION OF SURGICAL TACTICS FOR TREATING PATIENTS WITH GASTRIC CANCER IN CASE OF VARIANT ANATOMY OF THE CELIAC-MESENTERIC BASIN

2019 ◽  
Vol 65 (4) ◽  
pp. 537-545
Author(s):  
Aleksandr Zakharenko ◽  
Kirill Vovin ◽  
Mikhail Belyaev ◽  
Anton Trushin ◽  
T. Kupenskaya ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Surgical Treatment ◽  
Lymph Node Dissection ◽  
Comparison Group ◽  
Perioperative Complications ◽  
Treatment Algorithm ◽  
Main Group ◽  
Node Dissection ◽  
D2 Lymph Node Dissection

Relevance: The variability of the visceral vessels occurs from 10 to 30%. There are anatomical options in which the main arteries of the stomach depart from the aorta or superior mesenteric artery. The recommended standardized surgical technique for radical treatment of gastric cancer is defined for typical vascular anatomy. Objective: To improve the results of surgical treatment of patients with gastric cancer (GC) by optimizing the diagnostic algorithm and correcting surgical techniques. Material and Methods: The results of surgical treatment of 296 patients with gastric cancer cT1-4N1-2M0, who were treated at I.P. Pavlov First St. Petersburg State Medical University from 2012-2017. In the main group of patients (n = 176), the proposed diagnostic and treatment algorithm was applied (spiral computed tomography in the angiographic mode (SCTA) + with the discharge of the vessel participating in the blood supply to the stomach from the aorta (AO) and / or the superior mesenteric artery (SMA) extended lymph node dissection D2 + № 16a2, № 16b1). All patients were radically operated. The evaluation of the diagnostic characteristics of SCTA was performed. The results of treatment were evaluated in 108 patients of the main group. The comparison group (n = 120) consisted of patients in whom vascular anatomy was not studied. Estimated blood loss, time of operation, the frequency of perioperative complications and long-term survival. Results: In 32,9 % (n = 58) patients, variant anatomy of the visceral vessels of the upper abdominal cavity was detected. Additional arteries with typical trifurcation were found in 21,6 % (n = 38) of cases; celiac trunk bifurcation was determined in 10,2 % (n = 18) of patients; the absence of the celiac trunk and a single celiac-mesenteric trunk were found in 1,1 % (n = 2) of patients. The sensitivity of SCTA was 95,7 %, specificity 94,4 %, total accuracy 95,4 %. As a result of the applied diagnostic and treatment algorithm, the standard volume of D2 lymph node dissection was performed in 124 (70,4 %) patients during the surgical treatment of the main group of patients. Expansion of lymphadenectomy to D2 + was required in 52 (29,5 %) patients. Metastases to lymph nodes of groups № 16a2 and № 16b1 in patients who underwent extended D2 + lymph node dissection were detected in 16 (30,8 %) cases. The average blood loss in the main group was 1,95 times less and amounted to 126,5±22 ml, and in the comparison group - 246,7±34 ml (M ± m, p = 0,0276). A comparison of the average duration of the operation did not show any significant differences: in the comparison group it was 188,2 ± 16,4 minutes, while the main group was slightly lower - 172,3 ± 21,5 minutes. In the main group, the total number of complications was 14 cases (13,5 %) and was significantly lower than in the comparison group - 29 cases (25,9 %). Survival for 1-2-3 years in patients of the main group was higher than the comparison group and amounted to 92,6, 75,0, 53,7 % and 90,8, 71,8, 47,5 %, respectively. The relapsefree 1-2-3-year survival of the group of patients to whom the diagnostic and treatment algorithm was applied was also higher than in the comparison group and amounted to 90,7, 73,1, 48,1 % and 90,8, 68, 3, 44,2 %, respectively. The median survival was significantly better in the main group of patients - 31,4 months, in the comparison group - 28,5 months. Conclusions: Performing SCTA at the preoperative stage is an effective way to visualize the great vessels, allowing to plan the volume of the operation, to avoid perioperative complications. Expanding the volume of lymph node dissection to D2 + № 16a2, № 16b1 when the vessel participating in the blood supply to the stomach from the AO and / or SMA is released, as it allows to improve the long-term results of treatment of patients with gastric cancer, by increasing radical surgery.

Experience of the usage of nabumetone in oncogynecologic patients

2017 ◽  
pp. 118-122
Author(s):  
S.M. Kartashov ◽  
◽  
E.M. Oleshko ◽  
Keyword(s):  
Antioxidant Activity ◽  
Postoperative Period ◽  
Comparison Group ◽  
Surgical Intervention ◽  
Malonic Dialdehyde ◽  
Pain Syndrome ◽  
Main Group ◽  
Narcotic Analgesics ◽  
Diene Conjugates ◽  
Results Of Treatment

Objective: to study the effect of nabumetone in oncogynecologic patients in the postoperative period. Materials and methods. There were examined 98 patients of 40-78 years old, who were divided into two groups: the main group - 58 patients, of which 37 - patients with endometrial cancer I-III and 21 - with ovarian cancer of II-IV stage (FIGO); The comparison group included 40 patients (17 and 23 patients respectively). All patients underwent surgical treatment. In the postoperative period, were used NSAIDs - nabumeton. Before the operation and on the 10th day of the postoperative period, the following parameters were studied: a clinical blood test, TNF-a, ceruloplasmin, diene conjugates (DC), malonic dialdehyde (MDA), antioxidant activity (AOA). The content of TNF-a, in the blood serum was determined by radioimmunological, and DC, MDA, AOA by biochemical method. Results. Established: the content of the leukocyte formula before the start of treatment in the compared groups did not reveal any significant differences. After surgical intervention, both groups showed an increase in the absolute values of all leukocyte fractions. The level of ceruloplasmin in the patients of the comparison group increased significantly in the postoperative period, and in the main group the parameters of ceruloplasmin did not differ significantly. The level of TNF-a in the pre- and postoperative period in the compared groups did not differ. On the 10th day of the postoperative period, it significantly increased in the comparison group, and when nabumetone was used during the postoperative period, the level of TNF-a did not increase. The initial indicators characterizing the processes of LPO and AOA in both groups did not differ significantly. Assessing the dynamics of indicators before and after the operation, it was noted that in patients in the blood, the level of DC in both the baseline and in the comparison group increased. The use of nabumethon led to a slight increase in DC. The maintenance MDA in the postoperative period has increased in both groups, however it is unreliable in comparison with parameters before surgical intervention. In the comparison group, after the treatment, the antioxidant defense was reliably reduced. In the main group, the use of nabumetone contributed to a smaller decrease in AOA. The use of nabumeton allowed abandoning of narcotic analgesics in earlier periods of the postoperative period. Conclusion. Use of nabumeton in the postoperative period allows to reduce the pain syndrome, the number of inflammatory complications; contributes to the normalization of LPO processes, inhibits the inhibition of the antioxidant system, which contributes to the reduction of endogenous intoxication and improves the results of treatment of oncogynecologic patients. Key words: nabumeton, oncogynecologic patients, anti-inflammatory action, tumor necrosis factor, ceruloplasmin, diene conjugates, malanialdehyde, antioxidant activity.

Physiotherapeutic support of patients with dysplastic coxarthrosis after total hip prosthetics

2020 ◽  
pp. 7-16
Author(s):  
Oleg N. YAMSHCHIKOV ◽  
Nikita I. VORONIN ◽  
Dmitry A. MARKOV ◽  
Ksenia P. Zvereva
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Health Indicators ◽  
Main Group ◽  
Long Term Results ◽  
Average Score ◽  
Treatment Technique ◽  
Total Hip ◽  
Sf 36 ◽  
Hip Prosthetics

Today, the main method of surgical treatment of dysplastic coxarthrosis among adults is total hip prosthetics. Distant positive results according to foreign authors are 76–89%. One method of rehabilitation is physiotherapeutic treatment. The absence of standardized physiotherapeutic treatment protocols leads to a sharp reduction in the prescription of this type of rehabilitation measures. The aim of the study is to assess the long-term results of hip joint endoprosthetics among patients with dysplastic coxarthrosis using the developed physiotherapeutic treatment technique. Research materials and methods. For the period from 2010 to 2014, 205 patients were performed an operation with dysplastic coxarthrosis 1, 2, 3 degrees of Crowe. In the pre- and postoperative periods, patients of the main group were prescribed physiotherapeutic treatment according to the developed methodology. Evaluation of the results was carried out 12 months after surgical treatment using clinical and radiological methods, questionnaires using the Harris scale, SF-36. The obtained data were processed using statistical methods: Student coefficient, Pearson coefficient, correlation method. Results. When analyzing distant results, the average Harris score in the main group 85.82 (84.93–86.71) was significantly higher than in the comparison group 83.01 (82.02–84.00). The average score of the SF-36 questionnaire in the main group was significantly higher than in the comparison group (p < 0.001). Mental health indicators of patients were not significantly different from those of the postoperative period and were at a high level. Conclusions. Prescription of physiotherapeutic treatment promotes rapid healing of postoperative wounds and improves results of surgical treatment.

scholarly journals "FAST-TRACK" IN SIMULTANEOUS OPERATIONS AGAINST THE BACKGROUND OF WIDESPREAD PERITONITIS

2018 ◽  
Vol 25 (5) ◽  
pp. 141-146
Author(s):  
V. Yu. Mykhaylichenko ◽  
O. Yu. Gerbali ◽  
U. I. Basnaev ◽  
N. E. Karakursakov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Fast Track ◽  
Comparison Group ◽  
Clinical Laboratory ◽  
Average Duration ◽  
Main Group ◽  
Simultaneous Operations ◽  
Duration Of Hospitalization ◽  
Recovery Program

Aim. This research was conducted to study the possibility and effectiveness of the "Fast-track" fast recovery program application when performing simultaneous operations against the background of widespread peritonitis.Materials and methods. In the course of the study were examined 66 patients, the ratio of woman/man was 45:21. The main group – 32 (48,5%) patients with the major disease of constricted postoperative hernia complicated by the widespread peritonitis and chronic calculous cholecystitis (a prospective analysis of surgical treatment). The comparison group – 34 (51,5%) patients with the identical pathology – the retrospective analysis of surgical treatment. The treatment of patients of the main group was supplemented with the application of the elements of the «Fast-track» program. Whereas, the treatment of patients of the comparison group was performed exclusively according to the standard scheme of the patient management with widespread peritonitis.Results. Clinical, laboratory and instrumental data indicate the positive effect of the "Fast-track" program on the process of rehabilitation of patients in the postoperative period. There was a significant acceleration in the recovery of motorevacuation function of the intestine in patients of the main group in relation to the comparison group and a smaller number of complications in the main group in relation to the comparison group against the background of the application of this technique. As a result, the average duration of hospitalization of patients from the comparison group was 10- 5 days (average 12±2,4 days). While the average duration of hospitalization of patients from the comparison group was 17-20 days (on average 18±1,2 days).Conclusion. The use of the "Fast-track" program in simultaneous operations does not increase the effectiveness of surgical treatment, thereby accelerating the process of rehabilitation of patients in the postoperative period. 

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