scholarly journals Results of Colostomy Use in Children with Anorectal Malformation

2021 ◽  
Vol 11 (2) ◽  
pp. 17-28
Author(s):  
Temur T. Narbaev ◽  
Mahmud M. Aliev ◽  
Shovkat T. Bozorov ◽  
Jasmin T. Turaeva ◽  
Muzaffar A. Yuldashev ◽  
...  
Keyword(s):  
Anorectal Malformation ◽  
Abdominal Cavity ◽  
Anorectal Malformations ◽  
Excretory Urography ◽  
Early Postoperative Period ◽  
Social Adaptation ◽  
Screening Tests ◽  
Medical Institute ◽  
Results Of Treatment ◽  
Technical Errors

Introduction. Anorectal malformations in children are still one of the most challenging problems in pediatric coloproctology. The incidence of anorectal malformations in recent years has no tendency to decrease and, according to various authors, ranges from 1 in 4000-5000 live births. Most pediatric surgeons continue to adhere to the opinion about the advisability of preliminary colostomy and delayed proctoplasty at the age of 6-18 months or when the child reaches a certain body weight (8-10 kg.). They are motivating this tactic with the possibility of creating an optimal condition for performing a complex intervention, reducing anesthetic risk, avoiding technical errors. Objective is to improve treatment outcomes for anorectal malformations in children with prior colostomy. Materials and methods. The work is based on the results of treatment of 154 children with anorectal malformation, with preliminary colostomy in the clinic of the Tashkent Pediatric Medical Institute for the period from 2000 to 2020. Along with routine and general clinical examination methods, all children underwent: X-ray of the abdominal cavity, colostography, fistuloirrigography, excretory urography, cystography, ultrasound of the perineum (small pelvis), neurosonography (NSG) screening tests. Results. 154 (10*0%) children had colostomy as a palliative stage of treatment. Of these 117 (76%) children developed colostomy on the first day of life, with the development of intestinal obstruction. In 37 (24%) children, the formation of a colostomy was performed directly by us. 9 (5.8%) children as the first stage before primary radical correction with a high form of the defect and 10 (6.5%) children previously operated on and requiring re-corrective operations, 5 (3.2%) patients underwent colostomy after the development of complications in the early postoperative period. In 13 (8.5%) cases, colostomies were formed with identified concomitant anomalies and defects that clinically "dominated" over anorectal malformation. In 2 (5.4%), a double sigmastoma was imposed, in 2 (5.4%) a distal single-barreled sigmastoma, in 5 (13.5%) the Hartmann type terminal sigmastoma. Conclusion. The use of colostomy in children with anorectal malformation made it possible to carry out the necessary surgical tactics in a timely and differentiated manner. To reduce the frequency, nature of complications and early disability, to improve the quality of life and social adaptation of patients.

scholarly journals The standardisation of minimally invasive methods approaches in treatment of post-laparoscopic cholecystectomy bile leakage

2018 ◽  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Minimally Invasive ◽  
Abdominal Cavity ◽  
Bile Leakage ◽  
Early Postoperative Period ◽  
Endoscopic Retrograde ◽  
Septic Complications ◽  
Endoscopic Techniques ◽  
Results Of Treatment ◽  
Ultrasound Guided Puncture

The paper analyses the results of surgical treatment of 10243 patients with cholelithiasis who underwent laparoscopic cholecystectomy. In the early postoperative period 60 patients (0.59%) had bile leakage. Developed surgical technique based on ultrasound data and endoscopic retrograde cholangiopancreatography can improve the results of treatment and avoid septic complications and lethal outcomes. Conservative treatment, minimally invasive endoscopic techniques, ultrasound guided puncture methods and relaparoscopy were effective in 52 patients (86,7%). Postoperative bile leakage is currently one of the most frequent complications of LCE, routine drainage of the subhepatic space facilitates early diagnosis of postoperative complications. When choleo-excretion is more than 200 ml per day, endoscopic retrograde cholangiography is necessary to diagnose damage to the main bile ducts, while confirming the injury of the hepaticocholedochus, a reconstructive surgery with laparotomy is indicated. Drainage bile bleeding, accompanied by symptoms of biliary peritonitis or a significant accumulation of bile in the abdominal cavity in the absence of an injury to the hepaticocholedochus, requires a relaparoscopy for diagnostic and therapeutic purposes. Standardization of the complex application of relaparoscopy, transduodenal endoscopic interventions and puncture techniques can significantly reduce the number of laparotomic operations to correct the complications that have arisen.

scholarly journals CURRENT ASPECTS OF DIAGNOSTICS AND TREATMENT OF ACUTE BILLARIAN PANCREATITIS

2018 ◽  
Vol 14 (3-4) ◽  
pp. 74-79
Author(s):  
I.V. Kolosovych ◽  
B.H. Bezrodnyi ◽  
I.V. Hanol
Keyword(s):  
Acute Pancreatitis ◽  
Length Of Stay ◽  
Comparison Group ◽  
Abdominal Cavity ◽  
Main Group ◽  
Duct System ◽  
Results Of Treatment ◽  
Positive Clinical Effect ◽  
Number Of Patients ◽  
Comparative Group

Relevance. The article is devoted to the problem of diagnosis and treatment of acute biliary pancreatitis, which remains one of the most common surgical diseases of the abdominal cavity and accounts for 33.2% of the total number of patients with acute pancreatitis. Objective of the work is to improve the diagnosis and results of surgical treatment of patients with acute pancreatitis of biliary etiology. Materials and methods. The results of treatment of 264 patients with acute pancreatitis of biliary etiology are analyzed. Operative treatment was applied in 92 (34,8 %) patients: endoscopic operations were performed in 44 patients (16,7 %). Thus, in 10 (3,8 %) patients, endoscopic papilloprotectomy was performed with the auditory of the duct system and the extraction of concrements. In other cases, organo-preserving intervention was performed without disturbing the morphofunctional integrity of the sphincter apparatus of the duct system: the cannulation in 6 (2,3%) patients, mechanical (balloon) in 5 (1,9 %) cases, pharmacological (myogenic antispasmodic) dilatation of distal duct and a large duodenal papilla in 11 (4,2 %) patients. In residual choledocholithiasis, a technique of papillotomy under the control of choledochoscopy was proposed – 12 (4,54 %) patients. A comparative analysis of the effectiveness of the treatment of patients who used the "open" (comparative group) and noninvasive endoscopic interventions in the early disease (the main group) was performed. Results. So in the main group the length of stay in the hospital was 12±3,2 days, respectively, in the comparison group – 26±4,3 days. In 42 (95,4 %) patients who had undergone endoscopic surgery, a positive clinical effect, a rapid regress of the symptoms of acute pancreatitis was achieved. In two (4,5 %) patients in the main group, the course was complicated by the development of the abscess of the stuffing box, and puncture under ultrasound control was performed. In patients of the comparison group complications arose in 5 (41,6 %) patients, it is noteworthy that all of them had undergone operative interventions, which were limited only to the rehabilitation and drainage of the abdominal cavity, a stuffing box bag. The mortality rate among unopposed was 1,2 % (2 patients), and among the operated – 11,9 % (11 patients). Among prooperated patients who died, 81,8 % (9 people) were elderly patients. Conclusions. The use of minimally invasive endoscopic interventions in the early phase of the disease reduces the length of stay of patients in the hospital from 26±4,3 days (comparison group) to 12 3,2 days (main group) and the number of complications occurring by 37,1 % (P <0, 05). Application of the proposed method of papillotomy under the control of choledochoscopy makes it possible to reduce the risk of perforation of the wall of the duodenum with the development of peritonitis or retroperitoneal phlegmon by 1,2 % (P <0,05).

scholarly journals Changes in Indicators of Microcirculation in the Early Postoperative Period in the Treatment of Diaphyseal Fractures of the Shin Bones Using a Plate with Limited Contact

2019 ◽  
Vol 4 (3) ◽  
pp. 58-62
Author(s):  
A. I. Plakhov ◽  
L. I. Kolesnikova ◽  
L. I. Korytov ◽  
V. G. Vinogradov ◽  
M. A. Darenskaya
Keyword(s):  
Postoperative Period ◽  
Lower Limb ◽  
Blood Circulation ◽  
Early Period ◽  
Metal Plate ◽  
Early Postoperative Period ◽  
Control Group ◽  
Doppler Flowmetry ◽  
Results Of Treatment ◽  
Diaphyseal Fractures

Background. Unsatisfactory results of treatment, such as delayed consolidation and non-fusion of fractures, the formation of false joints and limb bone defects, have no tendency to decrease. We can assume that one of the leading factors of complications in traumatology is a violation of microcirculation in the affected segment of the limb.Aims. To identify patterns of changes in the parameters of the microcirculatory bed of the damaged segment of the lower limb when fixing bone fragments with a plate with limited contact in the early period after surgery.Materials and methods. In 25 patients, we studied four parameters of microcirculation of the lower limb segment with application of laser Doppler flowmetry. The control group consisted of 25 healthy volunteers, comparable in age and sex with the study group.Results. We found that in the early postoperative period (from the first to the 10th day after the surgery) in patients with diaphyseal fractures of the tibia operated with metal plate with limited contact there was an increase in microcirculation by 75.69 %, an increase in the proportion of the nutritive component of microcirculation compared to the shunt fraction by 24.64 %, as well as an increase in more than one ratio of the amplitude of the heart and respiratory range. All of that indicates a local circulatory disorder in the nutritive arterial hyperemia. We note that the increase in the amplitude of the respiratory component by 17.22 % and the equality of the amplitude of the cardiac range compared with the control group indicate violations of local blood circulation by the type of venous stagnation.Conclusion. On the basis of the results obtained, we note that patients with diaphyseal fractures of the shin bones treated with metal osteosynthesis with a plate with limited contact in the early postoperative period develop a violation of local blood circulation in the stagnant-hyperemic type.

scholarly journals Results Of Treatment Of Acute Diffuse Purulent Peritonitis Using Laparostomy

2020 ◽  
Vol 02 (11) ◽  
pp. 66-71
Author(s):  
S. A. Ruziboev ◽  
◽  
A. A. Avazov ◽  
Sh. Kh. Sattarov ◽  
A. N. Elmuradov ◽  
...  
Keyword(s):  
Bacterial Translocation ◽  
Abdominal Cavity ◽  
Multiple Organ ◽  
The Body ◽  
Abdominal Pressure ◽  
Results Of Treatment ◽  
Abdominal Hypertension ◽  
Purulent Peritonitis ◽  
Intractable Problems ◽  
Cause Of Deaths

Currently, despite significant achievements in the field of surgery, anesthesiology and resuscitation, the results of treatment of patients with advanced purulent peritonitis remain one of the most intractable problems, almost every sixth patient with acute surgical diseases and injuries of the abdominal cavity is admitted to medical institutions with peritonitis [1,3] Common peritonitis in 17-29% complicates the course of most acute surgical diseases and is the main cause of deaths in surgical hospitals [3,7]. Lethality in advanced peritonitis remains extremely high and reaches 20-39% [1,2,4,5]. In recent decades, great importance has been attached to recording intra-abdominal pressure in purulent pathology of the abdominal cavity. It was found that intra-abdominal hypertension occurs in every third patient with acute surgical pathology and negatively affects the functioning of all organs and systems of the body [1,6,8]. Pathological changes that occur with acute and excessive increase in intra-abdominal pressure (IAP) are manifestations of abdominal compartment syndrome (ACS) with disorders of the cardiovascular system; urinary disorders, disorders of perfusion of internal organs and the development of intestinal ischemia, which contributes to bacterial translocation and endogenous infection [2,7,8]. Ischemic blood flow disorders of the splanchnic zone are fraught with the development of bacterial translocation and the development of systemic inflammatory response syndrome and multiple organ failure (PON). Unsatisfactoriness with such results gave rise to a fundamentally different approach to the surgical treatment of common forms of peritonitis-the introduction of an open abdominal management method based on the ideas of I. Mikulich (1881), Jean-Louis Faure (1928), N. S. Makoch (1984) and D. Steinberg (1979).

scholarly journals Diagnosis and surgical treatment of liver echinococcosis

2021 ◽  
Vol 26 (4) ◽  
pp. 113-117
Author(s):  
V.O. Shaprinskyi  ◽  
O.O. Vorovskyi ◽  
O.A. Kaminskyi ◽  
Ya.M. Pashynskyi
Keyword(s):  
Blood Loss ◽  
Pleural Cavity ◽  
Abdominal Cavity ◽  
Diagnostic Value ◽  
Results Of Treatment ◽  
Before And After ◽  
Residual Cavity ◽  
Right Lobe ◽  
The Right ◽  
Duration Of Operation

The results of treatment of 72 patients with echinococcosis of the liver were analyzed, women – 62 (86.2%), men – 10 (13.8%). Primary echinococcosis was detected in 69 (95.8%) patients, secondary – in 3 (4.2%). Among instrumental research methods, ultrasound and computed tomography examination were of diagnostic value. Single liver cysts were found in 63 (87.5%) patients, multiple – in 9 (12.5%). Among patients with solitary cysts, the right lobe was more often affected than the left – 48 (66.7%) vs 24 (33.3%) cases. Echinococcosis of central localization was less common and was noted in 8 (11.1%) cases. Echinococcosis complications were observed in 16 (22.2%) patients. Among them, most often there were suppurations of the cyst – in 13 (18.1%); a bursting of the cyst into the free abdominal cavity – in 1 (1.4%), in the pleural cavity – 1 (1.4%), in the biliary tract – in 1 (1.4%). Partial or complete liming of the hand was observed in 12 (16.7%) patients. In 20 (27.8%) cases, the operation was performed from the upper median access, in 42 (58.3%) – from oblique hypochondria accesses by Kocher or by Fedorov. Pericystectomy was performed in 48 (66.7%) patients, in 8 (11.1%) patients underwent resections of liver segments with an echinococcal cyst, in 4 (5.6%) – cyst opening with removal of contents and treatment of its cavity. Laparoscopic echinococectomy was used in 12 (16.7%) patients. In the postoperative period complications were observed in 16 (22.2%) patients. The use of the welding electrocoagulator EK-300M "Swarmed" in the thermal rehabilitation of the walls of the residual cavity after echinococectomy allowed to reduce blood loss from 2200±210 ml to 250±50 ml. With the use of laparoscopic echinococectomy, intraoperative blood loss was reduced by 9 times (р=0.0001); duration of operation – 2 times (р<0.05), stay in hospital – 3.3 times (р=0.002). There were no fatal outcomes. Before and after operation antirelapse antiparasitic therapy with albendazole (Vormil) was performed in two cycles of 28 days, separated by a 14-day break. The dose at body weight over 60 kg was 400 mg 2 times a day, and for less than 60 kg the drug was calculated at a rate of 15 mg/kg/day. There were 2 (2.8%) cases of relapse, there was no mortality.

scholarly journals Outcomes of the minimally invasive aortic valve replacement

2019 ◽  
Vol 178 (3) ◽  
pp. 16-20
Author(s):  
M. A. Snegirev ◽  
A. A. Paivin ◽  
D. O. Denisyuk ◽  
N. E. Khvan ◽  
L. B. Sichinava ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Early Postoperative Period ◽  
Red Blood Cell Transfusion ◽  
Postoperative Blood Loss ◽  
Transfusion Rate ◽  
Results Of Treatment ◽  
Risk Patients

The OBJECTIVE was to demonstrate clinical outcomes of minimally invasive aortic valve replacement (MIAVR).MATERIAL AND METHODS. We retrospectively analyzed surgical results of treatment of patients underwent isolated AVR in our Institution between 2006 and 2018. Overall number of operations was 122; 56 of patient were operated via upper ministernotomy approach. Preoperative characteristics were similar in both groups.RESULTS. In our series MIAVR procedures had prolonged CPB and aortic cross clamping time, what significantly contributed to the increase in manifestations of heart failure in the early postoperative period, but didn’t affect the perioperative mortality and major morbidity rates. MIAVR led to reduction in postoperative blood loss and perioperative red blood cell transfusion rate. Most severe complications occurred in frail patients older than 75 years, and in those with extensive aortic annular calcification.CONCLUSION. MIAVR was the safe and reproducible surgical intervention and rarely led to significant complications in low-risk patients. Prolonged CPB time adversely affected the frequency of significant complications, especially in elderly patients. Although, selected high risk patients might benefit with MIAVR.

scholarly journals Rectal Atresia and Congenital Hypothyroidism: An Association or Coincidence?

2018 ◽  
Vol 06 (01) ◽  
pp. e7-e10
Author(s):  
Feride Mehmetoğlu
Keyword(s):  
Surgical Treatment ◽  
Thyroid Hormones ◽  
Newborn Screening ◽  
Congenital Hypothyroidism ◽  
Anorectal Malformation ◽  
Screening Tests ◽  
Unique Case ◽  
Rectal Atresia ◽  
Three Stages

AbstractRectal atresia is a rare anorectal malformation, and its association with other anomalies is even more rare. This study presents a unique case of co-twin in which the surviving newborn male underwent surgery due to rectal atresia. Newborn screening tests identified congenital hypothyroidism. The surgical treatment consisted of three stages and thyroid hormones were replaced.

scholarly journals Troublesome Tinnitus in Children: Epidemiology, Audiological Profile, and Preliminary Results of Treatment

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
G. Bartnik ◽  
A. Stępień ◽  
D. Raj-Koziak ◽  
A. Fabijańska ◽  
I. Niedziałek ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Normal Hearing ◽  
Hearing Screening ◽  
Screening Tests ◽  
Tinnitus Retraining Therapy ◽  
Preliminary Results ◽  
Results Of Treatment ◽  
Retraining Therapy

Introduction. Although tinnitus often has a significant impact on individual's life, there are still few reports relating to tinnitus in children. In our tinnitus clinic, children with distressing tinnitus constitute about 0,5% of all our patients.Objectives. The aim of this study was to analyse children with troublesome tinnitus as regards epidemiology, audiological profile, and preliminary effects of the therapy.Methods. A retrospective study was carried out involving the cases of 143 children consulted in our Tinnitus Clinic in 2009. The selected group with troublesome tinnitus was evaluated and classified for proper category of Tinnitus Retraining Therapy (TRT).Results. The study showed that 41.3% of the children suffered from bothersome tinnitus. In this group 44.1% of the patients demonstrated normal hearing. The success of the therapy after 6 months was estimated on 81.4% of significant improvement.Conclusions. It is recommended that a questionnaire include an inquiry about the presence of tinnitus during hearing screening tests.

scholarly journals Structure of abdominal injury and its consequences

2021 ◽  
Keyword(s):  
Abdominal Trauma ◽  
Road Traffic ◽  
Abdominal Cavity ◽  
Craniocerebral Trauma ◽  
Premature Death ◽  
City Council ◽  
Hospital Treatment ◽  
Non Profit ◽  
Results Of Treatment ◽  
Working Age

Introduction. Mechanical injuries are a leading cause of disability and premature death among the working-age population in most countries worldwide. Injuries to the abdominal and retroperitoneal organs (abdominal trauma) significantly aggravate the course of trauma and are a frequent cause of death. The aim of the study was to analyse the structure and outcome of the treatment of abdominal trauma victims. Materials and methods. On the basis of the polytrauma department of the municipal non-profit enterprise «Municipal clinical hospital of emergency and urgent medical care named after A. I. Meshchaninov» of Kharkiv City Council councilаnalysis damage structure and the results of treatment of 240 patients with abdominal trauma were carried out, the main causes of lethal outcomes were determined. Results. Most of the patients with abdominal trauma were male (78,7%), and they were young (18 to 44 years old) (72,5 %). The cause of injury in 95 (39.6 %) victims was road traffic accident, in 58 (24.2 %) – catatrauma; in 65 (27.1 %) – domestic injury. In the abdominal cavity, parenchymatous organs (spleen and/or liver) were injured most frequently, identified in 66.7 % of victims. In 26.3 % of patients revealed damage to the small or large intestine, in some cases, trauma to the stomach and gallbladder was detected. In 37 (15.4 %), mesenteric injury was detected, and in 32 (13.3 %), omental injury was detected. Among retroperitoneal organs the renal trauma was frequent – 46 (19.2 %), pancreatic and urinary bladder injuries were revealed in 27 (11.2%) and in 13 (5.4%) cases, retroperitoneal haematoma was revealed in 63 (26.7 % ) victims. In 178 (74.2 %) victims a combined trauma was diagnosed: thoracic in 129 (53.8%) cases, skeletal in 96 (40 %), craniocerebral in 84 (35 %). Combined injuries of one anatomofunctional region were diagnosed in 80 (33.3 %), two in 67 (27.9 %), and three in 31 (12.9 %) victims. During in-hospital treatment, 34 (14.2 %) victims died, of which 12 (35 %) during the first week after injury. The duration of inpatient treatment for the victims who were discharged was 15.0 [12.0; 25.0] beds/day. The causes of mortality and prolonged hospitalization (more than 14 days) in most cases were cardiovascular, respiratory, purulent-septic and renal complications. Conclusion. Abdominal parenchymal injuries predominate in the structure of abdominal trauma, occurring in 66.7 % of victims. Combined (thoracic, skeletal and/or craniocerebral) trauma occurs in 74.2 % of victims. The fatality rate for isolated abdominal trauma was 4.8 %, with a significant increase in cases of combined trauma, up to 41.9 % for combined thoracic, skeletal and craniocerebral trauma.

scholarly journals The Results of Duodenum-Preserving Resections of the Pancreas in Chronic Pancreatitis Using the Technology of Sealing the Pancreatic-Intestinal Anastomosis

2019 ◽  
Vol 4 (2) ◽  
pp. 122-126
Author(s):  
V. G. Lubyanskiy ◽  
V. V. Seroshtanov
Keyword(s):  
Chronic Pancreatitis ◽  
Intestinal Anastomosis ◽  
Abdominal Cavity ◽  
Main Group ◽  
Control Group ◽  
Cervical Anastomosis ◽  
Pancreatic Anastomosis ◽  
Drainage Fluid ◽  
Results Of Treatment ◽  
Cause Of Deaths

Background. The problem of chronic pancreatitis in recent years is acute, primarily due to the occurrence of complications and pain that forces you to turn to a surgeon. The main cause of deaths is the failure of the pancreatic anastomosis and the occurrence of bleeding into the cavity of the pancreatic intestinal anastomosis (40 %).Aims: to improve the results of duodenum-preserving resections by introducing the technology of sealing the pancreaticintestinal anastomosis.Materials and methods. The clinic operated 225 patients with chronic pancreatitis. All patients before the operation and in the postoperative period were carried out clinical and biochemical studies, the Frey operation was performed. Patients were divided into two groups. The first group, the group of comparison, included 184 (81.8 %) patients with pancreatoenteroanastomosis formed without additional sealing methods. The second group – the main one – consisted of 41 (18.2 %)patients in which the suture of the pancreatic anastomosis was strengthened with an adhesive composite or with the loop of the small intestine.Results. After the surgery, complications in the control group were recorded in 19 (8.4 %) patients: failure – in 6 (3 %), bleeding into the lumen of pancreatoenteroanastomosis – in 9 (4 %), mortality was 1.8 % (4 persons). There were no complications in the main group. The analysis of the amylase content in the drainage fluid revealed high values in the control group on the 3rd day – 916 ± 15 U/l, in comparison with the main group – 437 ± 16 U/l (p < 0.05). The data obtained indicate that the cause of insolvency of the pancreatic-intestinal anastomosis is the penetration of enzymes through the pancreatic-cervical anastomosis zone into the abdominal cavity. When analyzing the results, it turned out that the failure of the pancreatic-intestinal anastomosis was not detected in any case in patients with sealing.Conclusion. The escape of enzymes destroys the tightness of the superimposed fistula and is characterized by an increase in the level of amylase in the drainage fluid. The proposed sealing technologies decrease the number of postoperative complications and improve the results of treatment.

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