ON THE ISSUE OF SURGICAL TREATMENT OF DOLICHOSIGMA

Vestnik ◽  
2021 ◽  
pp. 210-214
Author(s):  
А.М. Мадаминов ◽  
Ы.А. Бектенов ◽  
А.Ю. Айсаев ◽  
С.И. Турдалиев
Keyword(s):  
Surgical Treatment ◽  
Sigmoid Colon ◽  
Colon Resection ◽  
Long Term Results ◽  
Kyrgyz Republic ◽  
Results Of Treatment ◽  
Barium Suspension ◽  
Comparative Aspect ◽  
Bowel Movements

До настоящего времени результаты лечения больных долихосигмой с длительными запорами остаются неудовлетворительными. Так при консервативном лечении долихосигмы неудовлетворительные результаты наблюдаются у 20-30% больных, а прихирургическом лечении доходит до 35-45%. Целью настоящего исследования является изучение результатов хиркргического лечения долихосигмы с длительностью запоров 7 и более дней. Материалом данного исследования являются результаты обследования и хирургического лечения 98 больных долихосигмой с длительными запорами, находившихся в отделении проктологии Национального Госпиталя при Министерстве здравоохранения Кыргызской Республики с 2001 года по 2020 год. Для уточнения диагноза кроме общеклинических методов исследования применены: пальцевое исследование прямой кишки, ректороманоскопия, сфинктерометрия, колоноскапия, ирригоскапия, пассаж бариевой взвеси по толстой кишке. Результаты хирургического лечения больных долихосигмой с длительными запорами в зависимости от вида оперативного вмешательства изучены в сравнительном аспекте. Из 98 больных 50 (51%) пациентам произведена резекция сигмовидной кишки, а 48 (49%) пациентам левосторонняя гемиколэктомия. Изучены отдаленные результаты хирургического лечения долихосигмы с длительными запорами у 79 больных. Так из 79 больных у 38 (48%) пациентов ранее была произведена левосторонняя гемиколэктомия, а у 41 (52%) - резекция сигмовидной кишки. У всех 38 больных перенесших левосторонную гемоколэктомию результаты хирургического лечения были хорошими. У этих пациентов отмечалось самостоятельный стул 1 раз в два дня, исчезли боли в левой половине живота и метиоризм. Из 41 пациента, перенесших резекцию сигмовидной кишки, у 29 (70,7%) больных результаты хирургического лечения оценены кака удовлетворительные. У этих больных улучшилось общее состояние, периодически наблюдался самостоятельный стул. А у 12(29,3%) больных, так же перенесших резекцию сигмовидной кишки, в последующем вновь отмечалось отсутствие самостоятельного стула, возникли боли в левой половине живота и метиоризм. У этих 12 больных результаты хирургического расценены как неудовлетворительные. Таким образом, сравнительный анализ результатов хирургического лечения долихосигмы с длительностью запора 7 и более дней показал преимущества левосторонней гемоколэктомии при этой патологии. Until now, the results of treatment of patients with dolichosigma with prolonged constipation remain unsatisfactory. So with the conservative treatment of dolichosigma, unsatisfactory results are observed in 20-30% of patients, and with surgical treatment it reaches 35-45%. The aim of this research is to study the results of surgical treatment of dolichosigma with constipation duration of 7 or more days. The material of this research is the results of examination and surgical treatment of 98 patients with dolichosigma with prolonged constipation, who were in the proctology department of the National Hospital under the Ministry of Health of the Kyrgyz Republic since 2001 till 2020. To clarify the diagnosis, in addition to general clinical research methods applied: digital examination of the rectum, sigmoidoscopy, sphincterometry, colonoscopy, irrigoscapia, passage of barium suspension through the colon. The results of surgical treatment of patients with dolichosigma with prolonged constipation, depending on the type of surgical intervention, were studied in a comparative aspect. From 98 patients, 50 (51%) patients underwent resection of the sigmoid colon, and 48 (49%) patients underwent left-sided hemicolectomy. The long-term results of surgical treatment of dolichosigma with prolonged constipation were studied in 79 patients. Thus, out of 79 patients, 38 (48%) patients had previously undergone left-sided hemicolectomy, and of 41 (52%) had sigmoid colon resection. In all 38 patients who underwent left-sided hemocolectomy, the results of surgical treatment were good. These patients had independent bowel movements once every two days, pain in the left abdomen and methiorism disappeared. From 41 patients who underwent resection of the sigmoid colon, in 29 (70.7%) patients, the results of surgical treatment were assessed as satisfactory. These patients have improved their general condition, periodically there was an independent bowel movements. And in 12 (29.3%) patients who also underwent resection of the sigmoid colon, subsequently, there was again a lack of independent bowel movements, and pain in the left side of abdomen and methiorism. In these 12 patients, the results of the surgical procedure were assessed as unsatisfactory. Therefore, a comparative analysis of surgical treatment results of dolichosigma with constipation duration of 7 or more days showed the advantages of left-sided hemocolectomy in this pathology.

scholarly journals Treatment of Injuries of the Lumbar Spine

2019 ◽  
Vol 5 (12) ◽  
pp. 156-162
Author(s):  
M. Sabyraliev
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Spinal Canal ◽  
Thoracolumbar Spine ◽  
Spinal Injuries ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Post Traumatic

Surgical treatment of patients with spinal injuries, accompanied by traumatic stenosis of the spinal canal, is an urgent and discussed problem of modern vertebrology. Surgical treatment of 111 patients with various injuries of the thoracolumbar spine was performed. In 40 patients, post-traumatic stenosis was eliminated using ligamentotaxis using transpedicular osteosynthesis. The immediate results of treatment were followed up in all patients: good results were obtained in 33 (82.5%) cases; satisfactory — in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term results with a follow-up of more than 1 year were followed up in 27 (67.5%) patients; good results were obtained in 20 (74.0%), satisfactory in 7 (25.0%).

scholarly journals RESULTS OF SURGICAL TREATMENT OF NON-PARASITIC SPLENIC CYSTS IN CHILDREN

2018 ◽  
Vol 22 (1) ◽  
pp. 32-35
Author(s):  
A. V. Myzin ◽  
Vasily G. Kuleshov ◽  
A. E. Stepanov ◽  
N. V. Gerasimova ◽  
K. Yu. Ashmanov
Keyword(s):  
Surgical Treatment ◽  
High Efficiency ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Long Term Results ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Splenic Cysts ◽  
Good Cosmetic

Introduction. Currently, there are different views on the treatment of non-parasitic spleen cysts in children. The choice of method of treatment is under discussion. The aim of our study was to evaluate and analyze the immediate and long-term results of surgical interventions performed on nonparasitic spleen cysts in children. Material and methods. There are presented results of surgical treatment of the 21 patient, who was on treatment at the Department of Abdominal Surgery of the Russian Children Clinical Hospital over the period from 2013 to 2016. Patients were examined by means of ultrasound of the abdominal cavity, CT, MRI. All patients have been operated. 22 surgical interventions were performed by using laparoscopic access, out of which 2 partial resections of the spleen, 1 splenectomy, 19 fenestrations of spleen cysts.Results. During the course of the operation and in the immediate postoperative period there were no complications. Patients were observed for the period of from 1 year to 3 years. Good results of treatment were obtained in 20 (95.2%) children. In a long-term period a relapse occurred in the one patient one year after the operation. The patient was reoperated, splenectomy was performed. Conclusion. The surgical treatment of spleen cysts is the basic one. It is indicated for cysts sized larger than 5 cm and cysts with clinical symptoms. Minimally invasive interventions in children are optimal because of their low traumatism and good cosmetic effect. Our study showed a high efficiency of laparoscopic operations in children suffered from non-parasitic spleen cysts with good long-term results.

scholarly journals SURGICAL TREATMENT OF SUPERIOR THORACIC OUTLET SYNDROME

2015 ◽  
Vol 174 (1) ◽  
pp. 78-83 ◽  
Author(s):  
A. D. Gaibov΄ ◽  
A. Z. Kakhorov ◽  
O. N. Sadriev ◽  
Kh. A. Yunusov
Keyword(s):  
Surgical Treatment ◽  
Thoracic Outlet Syndrome ◽  
Cervical Vertebrae ◽  
Diagnostic Procedures ◽  
Long Term Results ◽  
Raynaud’S Syndrome ◽  
Results Of Treatment ◽  
Positive Results ◽  
Cervical Ribs

The authors present immediate and long-term results of treatment of 117 patients with superior thoracic outlet syndrome (STOS). There were different reasons for compression of neurovascular fascicle in outlet of the thorax. The costaclavicular syndrome was a reason in 48 patients, additional cervical ribs had 36 patients. Skalenus syndrome was noted in 26 cases, rudimentary cervical ribs or hypertrophy of cervical vertebrae C7 had 7 patients. Raynaud’s syndrome took place in 19 cases. The required volume of diagnostic procedures and surgical treatment of STOS were determined according to the cause of the syndrome. Differentiated approach to the different forms of STOS was used in relation to dominant symptoms of the disease and reasons for compression of neurovascular fascicle. This allowed getting positive results in majority of patients (90,4%) in long-term period.

scholarly journals Surgical treatment and rehabilitation capabilities of patients with patellar fractures

2019 ◽  
Vol 26 (1) ◽  
pp. 11-16 ◽  
Author(s):  
E. I Solod ◽  
N. V Zagorodniy ◽  
A. F Lazarev ◽  
M. B Tsykunov ◽  
M. A Abdulhabirov ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Conflict Of Interest ◽  
Long Term Results ◽  
Optimal Method ◽  
Results Of Treatment ◽  
Combination Osteosynthesis ◽  
Partial Patellectomy ◽  
Patellar Fractures

Relevance. Fractures of the patella represent about 1% of all fractures of the bones. Among surgeons there is no a single approach to the treatment of patients with many fragmentary patellar fractures. After surgical treatment of patients with patellar fractures, various complications could be observed. Aside from that, there is no consensus on the treatment of complex fractures of the patella, and in practice, trauma physicians use a variety of methods of osteosynthesis of the patella. In the light of the foregoing, the study of long-term results of patients after patellar fractures is of particular relevance. Purpose of study: to examine the results of patients after surgical treatment of patellar fractures with a view to devising best practices for its osteosynthesis. Patients and methods. A study of the results of treatment of 78 patients with patellar fractures was conducted. The following groups were identified depending on the type of surgery and the nature of the fracture: Weber osteosynthesis in fragmentary fractures; «cruciform osteosynthesis» and other identical options of osteosynthesis with spokes and wires at three or more fragmented fractures of the patella; combination osteosynthesis. A comparative analysis of the results of treatment of patients after partial patellectomy and osteosynthesis of the patella with spokes and tightening wire loops was conducted. We evaluated the results on the KOOS scale with clinical examination and x-ray examination of patients. Beyond that, we have supplemented this scale with the patients’ own opinion on the evaluation of the results of their treatment. Results. The average follow-up period was 22 months. A comparative analysis of the groups of patients after surgical treatment of patellar fractures on the KOOS scale showed the best results in osteosynthesis of transverse two-fragment patellar fractures by Weber’y - 72%. The results of treatment of patients with many fragmentary patellar fractures using 3-5 spokes and 2-3 wires was - 64%; after the rehabilitation of the lower pole was - 68%) and after partial patellectomy -51%. Conclusion. If a patient has three-fragmented patellar fractures, reasonable results could be achieved by using 3 spokes and 2 tightening wire loops. With four or more fragmentary fractures of the patella, the optimal method for its osteosynthesis is the use of a «cruciform» method with 4 or more spokes in combination with two or three wire loops. The use of patellectomy with subsequent fixation of the blocking wire loop should be avoided in all types of patellar fractures. Key words: patellar fracture, osteosynhesis, surgical treatment Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding

Justification of the diagnostic algorithm and treatment strategies in patients with severe chronic slow-transit constipation

2021 ◽  
Vol 23 (3) ◽  
pp. 75-82
Author(s):  
Vadim B. Samedov ◽  
Pavel N. Romashchenko ◽  
Gennady O. Revin
Keyword(s):  
Surgical Treatment ◽  
Sigmoid Colon ◽  
Diagnostic Algorithm ◽  
Long Term Results ◽  
Subtotal Resection ◽  
Slow Transit Constipation ◽  
X Ray ◽  
Slow Transit ◽  
Transit Constipation

Surgical treatment of patients with chronic slow-transit constipation leads to unsatisfactory results in almost a third of cases. It appears relevant to the search for the causes of unsatisfactory results of surgical interventions in such patients and the need to develop a rational diagnostic algorithm; its implementation will allow us to determine the indications for surgical treatment and justify the volume of colon resection. For this purpose, the results of the examination and treatment of 53 patients with constipation were analyzed. The median disease duration was 15 years, and the median duration of constipation was 6.2 1.6 days. Patients were divided into a group with a positive effect of conservative treatment and a group without the expected effect. The symptoms, results of laboratory tests of blood and feces, and instrumental studies of the colon were analyzed. A balloon expulsion test was used to exclude proctogenic constipation. The evacuation function of the colon was studied by X-ray examination, while the transit time of barium sulfate or X-ray contrast markers through the gastrointestinal tract was estimated. Twenty-four patients underwent surgery for chronic slow-transit constipation, while the sigmoid colon was removed in one patient, including 7-left-sided hemicolectomy and 16-subtotal resection of the colon. Long-term results were examined in the period from 3 to 6 months after surgery. In the total examination of the semiotics of chronic slow-transit constipation, the results did not show significant differences between the groups of patients and did not allow us to justify the stratification into severe and non-severe disease course by its specific symptoms. The use of X-ray contrast markers for the assessment of the state of the evacuation function of the colon makes it possible to quantify the severity of various motor disorders and justify the choice of the volume of its resection. The analysis of the long-term results of the treatment of patients with chronic slow-transit constipation allows us to conclude that segmental resections of the colon (left-sided hemicolectomy, resection of the sigmoid colon) have a good therapeutic effect if the preoperative examination revealed a segmental type of failure of the evacuation function of the colon, and subtotal resection of the colon is appropriate for the common type. The absence of negative results of surgical treatment of patients with chronic slow-transit constipation, in which the formation of a colonic anastomosis was performed with a short stump of the sigmoid colon, indicates the possibility of using this option to complete the surgical intervention.

Advanced forms of kidney tuberculosis with fistula formation: modern views

2020 ◽  
pp. 60-69
Author(s):  
Andrey Volkov ◽  
Oleg Zuban ◽  
Galina Saenko
Keyword(s):  
Surgical Treatment ◽  
Pathological Process ◽  
Long Term Results ◽  
Fistula Formation ◽  
Results Of Treatment ◽  
Internal Fistulas ◽  
Intestinal Fistulas ◽  
Kidney Lesions

The aim of the study is to evaluate results of surgical treatment in patients with tuberculous pyonephrosis. In 2004 - 2019 12 patients underwent nephroureterectomy. The disease was complicated by involvement of nearby organs in pathological process and appearance of spontaneous external and internal fistulas in 100% of cases, it manifested with symptoms mostly not associated with kidney lesions. Reno-intestinal fistulas were found intraoperatively in 5 patients. Good long-term results of treatment were achieved mainly due to surgical debridment.

scholarly journals The surgical correction of refractory venous trophic ulcers

2021 ◽  
pp. 38-46
Author(s):  
S. E. Katorkin ◽  
M. J. Kushnarchuk ◽  
M. A. Melnikov ◽  
A. A. Zhukov ◽  
P. F. Kravtsov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Complete Healing ◽  
Long Term Results ◽  
Group Iii ◽  
Results Of Treatment ◽  
Group I ◽  
Group Ii ◽  
Shave Therapy

Objectives. To study the effectiveness of layered dermatolipectomy and endoscopic fasciotomy in the surgical treatment of refractory venous trophic ulcers.Materials and methods. Patients (n = 105) of the C6 clinical class underwent crossectomy and short stripping. In group I (n = 35), free autodermoplasty of trophic ulcers with a perforated flap was performed. In group II (n = 36), shave therapy and autodermoplasty were performed. In group IIІ (n = 34), fasciotomy, shave therapy and autodermoplasty were performed. Long-term results of treatment were studied in the period from 1 to 12 months.Results. Complete healing of venous trophic ulcers was observed in group I at 49,4 ± 7,2, in II – at 31,4 ± 4,7, in III – at 32,1 ± 3,6 days сутки (t1-2 = 2,09; p1-2 = 0,049; t1-3 = 2,24; p1-3 = 0,024; t2-3 = 0,03; p2-3 = 0,763). Full engraftment of an autograft graft was recorded in 7 (19,4 %) patients of group I, in 27 (77,1 %) cases in group II and in 27 (79,4 %) patients of comparison group III (χ21-2 = 23,674; p1-2 = 0,001; χ21-3 = 25,173; p1-3 = χ22-3 = 0,052; p2-3 = 0,826).Conclusion. Layered dermatolipectomy with autodermoplasty and endoscopic decompression fasciotomy is an effective method for the treatment of persistent refractory venous trophic ulcers.

scholarly journals Immediate and Long-Term Results of Treatment of Aneurysms of Ascending Aorta and Aortic Arch and Substantiation of Tactical Approaches to the Treatment Based on the Obtained Results

2021 ◽  
pp. 69-75
Author(s):  
Vitalii І. Kravchenko
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Hospital Mortality ◽  
Aortic Arch ◽  
Ascending Aorta ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Long Term Follow Up

Acute aortic dissection is a formidable disease. Its prevalence increases due to the population aging, as well as wider awareness of physicians about this pathology. The aim. To analyze immediate and long-term results of surgical treatment of aneurysms of ascending aorta and aortic arch and to determine optimal methods of correction of these lesions in order to improve the results of surgical treatment. Materials and methods. This was a comparative analysis of immediate and long-term treatment outcomes in 419 patients with aneurysms of ascending aorta and aortic arch. A comparative analysis of the results of treatment of two groups of patients was performed: the comparison group of 157 people operated before 2013, and the main group of 262 patients operated since 2013 using modified methods of aortic surgery. Results. The study showed significant reduction in the left ventricular dilatation according to echocardiography and satisfactory postoperative course in patients of both groups. Patients with valve-sparing aortic prosthetics had better results than those who underwent valve replacement surgery. Hospital mortality decreased from 17.2% to 5.3%. Analysis of long-term results showed that supracoronary aortic prosthetics with aortic valve plasty and elimination of the intimal tear zone make it possible to carry out effective aortic reconstruction. Due to events in the long run, regular lifelong monitoring is required. The analysis also showed that individualized approach to the choice of surgical tactics for the correction of aortic insufficiency in patients with aortic root and ascending aortic pathology allows to achieve comparable results in the immediate and long-term follow-up. Despite the complexity of the applied correction methods, the developed methods of surgical treatment of ascending aortic aneurysm (AAA) and aortic arch aneurysm and methods of protection of brain and visceral organs allowed to keep hospital mortality and the number of complications at the same level corresponding to one of the best world results. This gives hope for a good result in the long-term follow-up. Conclusions. Aneurysm of ascending aorta and aortic arch is a formidable life-threatening disease, and its only non-alternative treatment option is surgery. The optimized approach to the treatment of patients in the main group allowed to obtain better immediate and long-term results of surgical treatment and reduce postoperative complications from 34.4% to 8.4% and hospital mortality from 17.2% to 5.3%. Comparative analysis of long-term results in the studied groups showed more encouraging indicators of quality of life and life expectancy in patients when using modified surgical techniques, protection of the brain and visceral organs. We hope to get a final assessment of these data in the further study of the condition of these patients in the long-term follow-up.

scholarly journals Surgical treatment for femur neck pseudoarthrosis

1996 ◽  
Vol 3 (2) ◽  
pp. 25-27
Author(s):  
V. I. Zoray ◽  
M. V. Parshikov ◽  
A. G. Matveev
Keyword(s):  
Surgical Treatment ◽  
Proximal Femur ◽  
Long Term Results ◽  
Coxa Vara ◽  
Femur Head ◽  
Femur Neck ◽  
Results Of Treatment ◽  
Methods Of Reconstruction

The results of treatment of 56 patients with femur neck pseudoarthrosis associated with different degree of degenerative dystrophic damage of femur head are presented. In femur neck pseudoarthrosis with coxa vara intra-articular extraosseous autoplasty by displacement of figured segment from intertrochanteric region under pseudoarthrosis zone is used. The method of intraosseous autoplasty consisted of subcortical cylingrical drilling of spongy neck bone through pseudoarthrosis zone with rotation of autograft by 180 is applied. The long-term results are retraced in 48 patients in the period up to 6 years. The preference is given methods of reconstruction of proximal femur end with combination of its autoplasty interchangeability.

Surgical treatment of transacetabular fractures

2021 ◽  
Vol 19 (3) ◽  
pp. 92-94
Author(s):  
I. S. BOROVOY ◽  
Keyword(s):  
Surgical Treatment ◽  
The Body ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Vital Functions ◽  
Acetabulum Fractures ◽  
External Fixation Device ◽  
Surgical Tactics ◽  
Positive Effect

The article presents an analysis of the treatment results of patients with transverse acetabulum fractures of type B1.1 according to the AO classification using various surgical tactics/ the most optimistic results were obtained when using the hip joint osteosynthesis with an external fixation device (EFD) «pelvis-hip» in urgent cases. Besides the obvious antishock action, it allows removing the femoral head from the central displacement and in many cases achieving the reposition of the acetabulum, due to ligamentotaxis. After x-ray control in the case of a further incomplete reposition in the EFD, it significantly simplifies the open stage of surgical treatment after the stabilization of the vital functions of the body, which has a positive effect on the long-term results of treatment of this complex category of patients.

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