scholarly journals EMERGENCY SURGERY IN COMPLEX INCISIONAL HERNIAS MANAGEMENT

2021 ◽  
Vol 68 (2) ◽  
pp. 232-240
Author(s):  
Roxana-Florina Ristea ◽  
◽  
Nicoleta-Aurelia Sanda ◽  
Daniel Ion ◽  
Marius-Răzvan Ristea ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Emergency Surgery ◽  
Economic Problem ◽  
Study Group ◽  
Emergency Operations ◽  
Incisional Hernias ◽  
Operating Field ◽  
A Current

Introduction. Complex incisional hernias are a surgical challenge and a current socio-economic problem. In the emergency surgery of this pathology, the surgeon faces the need to obtain a "tension-free" hernia repair being limited in the use of parietal prosthesis due to the frequent needs of opening the gastrointestinal tract and thus contamination of the operating field. Purpose. The aim of this study is to evaluate and adapt emergency surgical treatment in order to reduce the risk of postoperative complications. Material and methods. The present study has a retrospective character and evaluates a group of 390 patients with complex incisional hernias admitted and operated in the General and Emergency Surgery III section of the Bucharest University Emergency Hospital during 2008-2018. Results. We identified 390 patients diagnosed with complex incisional hernias, of whom 95 were presented to the hospital as an emergency.The prosthetic hernioraphy was used in 51 of these patients, and complications were found in 18 patients in the total study group, ranging from wound infection to death. Discussions. The occurrence of postoperative complications was not statistically significantly associated with emergency surgical treatment. Instead, vital complications were much more common in this group. Conclusions. Increasing the degree of information and education of the patient, increasing addressability and avoiding emergency operations for this pathology are long-term objectives in the treatment of complex incisional hernia pathology.

Temporary “liquid” Implant for Congenital Glaucoma (long-term results)

2020 ◽  
pp. 49-65
Author(s):  
N Bobrova ◽  
N Trofimova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Hypotensive Effect ◽  
Congenital Glaucoma ◽  
Long Term Results ◽  
General Will ◽  
Visual Functions ◽  
Advanced Stages ◽  
Intraocular Fluid

The aim of the work was to analyze the long-term results of using a temporary “liquid” implant in the surgery of congenital glaucoma in children. The basis of the developed method of filtrative antiglaucomatous surgery (Patent of Ukraine No. 45099 of 2009) – viscosinusotrabeculotomy – has been set the task of reducing the risk of developing intra- and postoperative complications, reducing the scarring rate and maintaining the newly created ways of the intraocular fluid outflow, which in general will increase the effectiveness of surgical treatment of congenital glaucoma in children. 54 children (91 eyes) with simple congenital glaucoma at the age of 1 to 36 months were operated on average (8.7 ± 8.2) months. The persistent and long-lasting hypotensive effect achieved due to viscosinusotrabeculotomy in children with developed and far-advanced stages of congenital glaucoma stops the processes of stretching of the membranes of the eye and stabilizes their size, which in general allows preserving and visual functions improving, in infancy – creating conditions for their formation.

scholarly journals Long-Term Survival in Octogenarians After Surgical Treatment for Colorectal Cancer: Prevention of Postoperative Complications is Key

2018 ◽  
Vol 25 (13) ◽  
pp. 3874-3882 ◽  
Author(s):  
Linda B. M. Weerink ◽  
Christina M. Gant ◽  
Barbara L. van Leeuwen ◽  
Geertruida H. de Bock ◽  
Ewout A. Kouwenhoven ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Cancer Prevention ◽  
Term Survival ◽  
Long Term Survival ◽  
Colorectal Cancer Prevention

scholarly journals Surgical treatment for antiplatelet intracerebral hemorrhage (SAP-ICH): protocol for a prospective cohort study of emergency surgery for severe spontaneous intracerebral hemorrhage patients on long-term oral antiplatelet treatment

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jun Wu ◽  
Xinguo Sun ◽  
Qingyuan Liu ◽  
Maogui Li ◽  
Shanwen Chen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Surgical Treatment ◽  
Intracerebral Hemorrhage ◽  
Prospective Cohort Study ◽  
Emergency Surgery ◽  
Prospective Cohort ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Antiplatelet Treatment ◽  
Spontaneous Intracranial Hemorrhage

Abstract Background Despite the capability of emergency surgery to reduce the mortality of severe spontaneous intracranial hemorrhage (SSICH) patients, the effect and safety of surgical treatment for severe spontaneous intracranial hemorrhage (SSICH) patients receiving long-term oral antiplatelet treatment (LOAPT) remains unclear. In consideration of this, the cohort study is aimed at figuring out the effect and safety of emergency surgery for SSICH patients on LOAPT. Methods As a multicenter and prospective cohort study, it will be conducted across 7 representative clinical centers. Starting in September 2019, the observation is scheduled to be completed by December 2022, with a total of 450 SSICH patients recruited. The information on clinical, radiological, and laboratory practices will be recorded objectively. All of the patients will be monitored until death or 6 months after the occurrence of primary hemorrhage. Results In this study, two comparative cohorts and an observational cohort will be set up. The primary outcome is the effect of emergency surgery, which is subject to assessment using the total mortality and comparison in the survival rate of SSICH patients on LOAPT between surgical treatment and conservative treatment. The second outcome is the safety of surgery, with the postoperative hemorrhagic complication which is compared between the operated SSICH patients on and not on LOAPT. Based on the observation of the characteristics and outcome of SSICH patients on LOAPT, the ischemic events after discontinuing LOAPT will be further addressed, and the coagulation function assessment system for operated SSICH patients on LOAPT will be established. Conclusions In this study, we will investigate the effect and safety of emergency surgery for SSICH patients on LOAPT, which will provide an evidence for management in the future. Ethics and dissemination The research protocol and informed consent in this study were approved by the Institutional Review Board of Beijing Tiantan Hospital (KY2019-096-02). The results of this study are expected to be disseminated in peer-reviewed journals in 2023. Trial registration Name: Effect and safety of surgical intervention for severe spontaneous intracerebral hemorrhage patients on long-term oral antiplatelet treatment. ChiCTR1900024406. Date of registration is July 10, 2019.

Prognosis of Long-term Postoperative Complications after Surgical Treatment of Dupuytren's Disease (Contracture)

2019 ◽  
Vol 12 (3) ◽  
pp. 1055
Author(s):  
Gleb I. Mikusev ◽  
Rustem F. Baikeev ◽  
Ruslan O. Magomedov ◽  
Ivan E. Mikusev ◽  
Timur S. Mishakin
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease

scholarly journals Colorectal cancer metastases to the lungs: outcomes of surgical treatment and prognostic factors

2020 ◽  
Vol 10 (2) ◽  
pp. 33-41
Author(s):  
B. B. Akhmedov ◽  
P. V. Kononets ◽  
M. Yu. Fedyanin ◽  
Z. Z. Mamedli ◽  
S. S. Gordeev ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Surgical Treatment ◽  
Survival Rate ◽  
Postoperative Complications ◽  
Progression Free Survival ◽  
Free Survival ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases

Objective: to evaluate short-term and long-term outcomes of surgical treatment for colorectal cancer metastases to the lungs and to analyze factors affecting the efficacy of surgery. Materials and methods. This study included 211 patients with colorectal cancer metastases to the lungs treated between 1994 and 2014. We enrolled patients with resectable or conventionally resectable metastases (according to chest computed tomography evaluated by a thoracic surgeon); the exclusion criteria were as follows: multiple primary tumors and age more than 85 years. We assessed the type of surgeries, frequency of R0 resections, incidence of postoperative complications, overall survival, and progression-free survival. Results. One hundred and sixty-two patients out of 211 (76.8 %) have undergone atypical lung resection. Forty-nine patients (23.2 %) have undergone pneumonectomy, bilobectomy, or lobectomy. The majority of patients (96.2 %) have had R0 resection, whereas 2.9 % of study participants have had R1 or R2 resections. One patient has undergone a trial surgery. Clinically significant postoperative complications were observed in 4 (2 %) patients; postoperative mortality was 0.5 % (1 case). The five-year overall survival rate was 52.7 %; the 5-year progression-free survival rate was 45.8 %. Development of metastases within 24 months after primary surgery was found to be a significant factor negatively affecting overall survival (hazard ratio 0.347; 95 % confidence interval 0.227–0.53; р <0.0001). Conclusions. Surgical treatment is currently the only truly effective treatment, which can improve long-term survival of patients with colorectal cancer metastases to the lungs; the best treatment results are achieved in patients with a relapse-free interval of more than 24 months. 

scholarly journals Emergency surgery for splenic flexure cancer: results of the SFC Study Group database

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nicola de’Angelis ◽  
◽  
Eloy Espin ◽  
Frederic Ris ◽  
Filippo Landi ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Splenic Flexure ◽  
Disease Free Survival ◽  
R0 Resection ◽  
Study Group ◽  
Emergency Setting ◽  
Open Approach ◽  
Long Term Outcomes ◽  
Left Colectomy

Abstract Background The effectiveness of surgical treatment for splenic flexure carcinomas (SFCs) in emergency settings remains unexplored. This study aims to compare the perioperative and long-term outcomes of different alternatives for emergency SFC resection. Method This multicenter retrospective study was based on the SFC Study Group database. For the present analysis, SFC patients were selected if they had received emergency surgical resection with curative intent between 2000 and 2018. Extended right colectomy (ERC), left colectomy (LC), and segmental left colectomy (SLC) were evaluated and compared. Results The study sample was composed of 90 SFC patients who underwent emergency ERC (n = 55, 61.1%), LC (n = 18, 20%), or SLC (n = 17, 18.9%). Bowel obstruction was the most frequent indication for surgery (n = 75, 83.3%), and an open approach was chosen in 81.1% of the patients. A higher incidence of postoperative complications was observed in the ERC group (70.9%) than in the LC (44.4%) and SLC groups (47.1%), with a significant procedure-related difference for severe postoperative complications (Dindo-Clavien ≥ III; adjusted odds ratio for ERC vs. LC:7.23; 95% CI 1.51-34.66; p = 0.013). Anastomotic leakage occurred in 8 (11.2%) patients, with no differences between the groups (p = 0.902). R0 resection was achieved in 98.9% of the procedures, and ≥ 12 lymph nodes were retrieved in 92.2% of patients. Overall and disease-free survival rates at 5 years were similar between the groups and were significantly associated with stage pT4 and the presence of synchronous metastases. Conclusion In the emergency setting, ERC and open surgery are the most frequently performed procedures. ERC is associated with increased odds of severe postoperative complications when compared to more conservative SFC resections. Nonetheless, all the alternatives seem to provide similar pathologic and long-term outcomes, supporting the oncological safety of more conservative resections for emergency SFCs.

scholarly journals Intraoperative photodynamic therapy and hyperthermic intraperitoneal chemotherapy in cytoreductive treatment of patients with disseminated mucinous carcinoma of appendix

2021 ◽  
Vol 9 (4) ◽  
pp. 23-30
Author(s):  
D. V. Sidorov ◽  
N. A. Grishin ◽  
M. V. Lozhkin ◽  
A. A. Troitsky ◽  
R. I. Moshurov ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Intraperitoneal Chemotherapy ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Mucinous Carcinoma ◽  
Peritoneal Carcinomatosis Index ◽  
Treat Ment ◽  
Cytoreductive Treatment

The article presents the experience of surgical treatment of 57 patients with peritoneal pseudomyxoma of appendicular genesis. In 32 (56.1%) patients, the operation was supplemented with intraoperative photodynamic therapy (IOPDT). In the other 25 (43.9%) patients, hyperthermic intraperitoneal chemotherapy (HIPEC) was performed. The analysis according to the value of the peritoneal carcinomatosis index, completeness of cytoreduction, the volume of operations performed, postoperative complications and hospital mortality, as well as long-term treat- ment results in two groups is presented. It was shown that with significantly worse results in terms of cytoreduction completeness obtained in the IOPDT group compared to the HIPEC group, the 5-year survival rate in the HIPEC group was 86.6%, with IOPDT - 65.2%. At the same time, in the IOPDT group, the rate of postoperative complications was significantly lower (11.1%), and there was no mortality; in the HIPEC group, these indicators were 23.8% and 12.0%, respectively. The results obtained indicate that the IOPDT method is an effective and promising direction in the surgical treatment of peritoneal pseudomyxoma.

scholarly journals Milligan–Morgan hemoroidektomijos: Vilniaus universiteto ligoninės "Santariškių klinikos" Centro filialo patirtis

2004 ◽  
Vol 2 (4) ◽  
pp. 0-0
Author(s):  
Žymantas Jagelavičius ◽  
Narimantas Evaldas Samalavičius ◽  
Tomas Poškus ◽  
Liudvikas Kervys ◽  
Romanas Kęstutis Drąsutis
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
General Anesthesia ◽  
Retrospective Analysis ◽  
Faecal Incontinence ◽  
Early Recurrence ◽  
Long Term Results ◽  
Anal Region ◽  
Age And Sex

Žymantas Jagelavičius, Narimantas Evaldas Samalavičius, Tomas Poškus, Liudvikas Kervys, Romanas Kęstutis DrąsutisKoloproktologijos poskyris, Pilvo chirurgijos III skyrius,Vilniaus universiteto ligoninės "Santariškių klinikos"Centro filialas, Žygimantų g. 3, LT-01102 VilniusEl. paštas: [email protected] Tikslas Retrospektyviai išnagrinėti Milligan–Morgan hemoroidektomijų patirtį, įvertinti vėlyvuosius rezultatus. Ligoniai ir metodai Išnagrinėtos 270 ligonių, 1985–1999 m. VUL „Santariškių klinikos“ Centro filiale operuotų nuo hemorojaus, ligos istorijos. Iš jų 252 operuoti Milligan–Morgan metodu. Registruotas ligonių amžius, lytis, ligos trukmė iki operacijos, hospitalizavimo trukmė, hemorojaus laipsnis. Antro laipsnio hemorojumi sirgo 20 (7,9%), trečio – 185 (73,4%), ketvirto – 47 (18,7%) ligoniai. Bendrinė nejautra taikyta 144 (57,1%), spinalinė – 64 (25,4%), vietinė – 44 (17,5%) ligoniams. Siekiant įvertinti vėlyvuosius rezultatus, nuo 2001 m. spalio iki 2002 m. spalio visi ligoniai buvo apklausti paštu ar telefonu pagal iš anksto paruoštą klausimyną. Į klausimus atsakė 150 (59,5%) ligonių. Rezultatai Iš 252 ligonių pooperacinė eiga komplikavosi 16 (6,3%) ligonių: devyniems (3,6%) – šlapinimosi sutrikimu, septyniems (2,8%) – kraujavimu; trys ligoniai operuoti dar kartą. Išangės sritis sugijo per 2–16, vidutiniškai per 4,6 savaites. Iš 150 apklaustųjų pakartotinai nuo recidyvo operuoti trys (2,0%) ligoniai. Jie operacinį gydymą įvertino: labai gerai – 69 (46,0%), gerai 68 – (45,3%), patenkinamai – 12 (8,0%), blogai – vienas (0,7%) ligonis. Sutrikusia išangės raukų funkcija skundėsi 25 (16,7%) ligoniai, ją vertinome pagal Klivlendo išmatų nelaikymo klasifikaciją: 1 balas – vienas (0,7%) ligonis, 2 balai – trys (2%), 3 balai – šeši (4%), 4 balai – šeši (4%), 5 balai – nebuvo, 6 balai – trys (2,0%), 7 balai – nebuvo, 8 balai – du (1,3%), 9 balai – nebuvo, 10 balų – vienas (0,7%). Išvados Hemoroidektomija Milligan–Morgan būdu yra saugi ir veiksminga. Dauguma ligonių chirurginiu gydymu buvo patenkinti. Tačiau nereikia pamiršti, kad ir nedidelei daliai ligonių gali sutrikti išangės raukų funkcija. Reikšminiai žodžiai: hemorojus, Milligan–Morgan hemoroidektomija, rezultatai, išmatų nelaikymas Milligan–Morgan hemorrhoidectomies: experience of the Center Branch of Vilnius Univerity "Santariškių klinikos" Hospital Žymantas Jagelavičius, Narimantas Evaldas Samalavičius, Tomas Poškus, Liudvikas Kervys, Romanas Kęstutis Drąsutis Objective Retrospective analysis of the experience and long-term results after Milligan–Morgan hemorrhoidectomy. Patients and methods During the period 1985–1999, 270 patients underwent hemorrhoidectomy in our hospital, of them 252 by using the Milligan–Morgan technique. We registered the age and sex of patients, time of illness and of hospitalization, degree of hemorrhoids: 20 (7.9%) had II°, 185 (73.4%) – III°, 47 (18.7%) – IV°. General anesthesia was used in 144 (57.1%), regional (spinal or epidural) in 64 (25.4%), local in 44 (17.5%) patients. To evaluate long-term results, all patients were interviewed by telephone or mail under a special questionnaire; 150 (59,5%) patients replied. Results Of 252 patients, 16 (6.3%) developed postoperative complications: nine (3.6%) troubles of urination, six (2.4%) bleeding, one (0.4%) early recurrence; three patients were reoperated on. The anal region healed over 2–16 (average 4.6) weeks. Three patients (2.0%) of the 150 interviewed were operated on repeatedly because of recurrence. They evaluated our surgical treatment: very good 69 (46.0%), good 68 (45.3%), satisfactory 12 (8.0%), bad one (0.7%) patient. Faecal incontinence was mentioned by 25 (16.7%) patients. We ranked it using Cleveland’s feacal incontinence classification: 1 point – one (0.7%) patient, 2b. – three (2%), 3b. – six (4%), 4b. – six (4%), 5b. – zero, 6b. – three (2.0%), 7b. – zero, 8b. – two (1.3%), 9b. – zero, 10b. – one (0.7%) patient. Conclusions Milligan–Morgan hemorrhoidectomy in our experience is a rather safe and effective method of treatment of hemorrhoides. The majority of the patients were satisfied with our treatment. However, we should have in mind that for a small part of patients mild faecal incontinence is possible. Keywords: hemorrhoids, Milligan–Morgan hemorrhoidectomy, results, incontinece

scholarly journals Management of Geriatric Anesthesia on Emergency Surgery

2021 ◽  
Vol 2 (2) ◽  
pp. 70-75
Author(s):  
Achmad Hariyanto ◽  
◽  
Isngadi Isngadi ◽  
Keyword(s):  
Postoperative Complications ◽  
Emergency Surgery ◽  
Geriatric Patients ◽  
Elective Surgery ◽  
Medical Complications ◽  
Short Term ◽  
Term Survival ◽  
Speed Up ◽  
Geriatric Anesthesia

In geriatric patients, emergency surgery is more common than elective surgery. The incidence of medical complications increases along with aging while the rate of surgical complications remains constant. Postoperative complications escalates short-term morbidity and mortality and also associated with decreasing long-term survival. The main purposes of geriatric patients' care were to maintain hemodynamics, speed up recovery, and perform an assessment to avoid any further decline in functional capacity. The choice of anesthesia and how to administer anesthesia agents should be adjusted for the geriatric patient.

scholarly journals Drainage devices in refractory glaucoma surgery

2019 ◽  
Vol 12 (3) ◽  
pp. 85-93
Author(s):  
S. I. Anisimov ◽  
S. Yu. Anisimova ◽  
L. L. Arutyunyan ◽  
A. P. Voznyuk
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Glaucoma Surgery ◽  
Long Term Results ◽  
Refractory Glaucoma ◽  
Eye Tissues ◽  
Surgical Methods ◽  
Methods Of Treatment ◽  
Fibroblastic Activity

Glaucoma is a socially sensitive disease, being one of the leading causes of irreversible visual impairment and blindness. Refractory glaucoma is one of the most severe forms of the disease as it is resistant to conservative and surgical methods of treatment. Because of pronounced postoperative fibroblastic activity of eye tissues, leading to gross scarring and obliteration of outflow paths, modern materials and methods of drainage surgery are needed. The review presents a variety of drains used today and considers in detail their main characteristics and the biocompatibility of the material used with eye tissues. Various groups of implants are presented, whose effectiveness and safety are compared and assessed. The statistics of postoperative complications and long-term results of surgical treatment are given.

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