scholarly journals CURRENT VIEW ON PATHOGENETIC APPROACH IN SURGICAL TREATMENT OF PATIENTS WITH DIABETIC FOOT SYNDROME

2018 ◽  
Vol 35 (1) ◽  
pp. 12-20
Author(s):  
V P Okroyan ◽  
T R Ibragimov ◽  
O V Galimov ◽  
V O Khanov

Aim. To improve the immediate and long-term results of diabetic foot syndrome treatment, using modern surgical techniques. Materials and methods. The results of treatment of 264 patients were analyzed. For these patients with purulo-necrotic affection of extremities against the background of diabetes mellitus, complex treatment, including the techniques of extremity revascularization as well as modern hydrocolloid bandage materials, depending on the stage of wound process, was used; different variants of foot unloading at the clinical and ambulatory stages were offered. The method of treatment of purulo-necrotic wounds against the background of diabetes mellitus, based on differentiated use of ozonotherapy combined with application of biomaterials for closing ulcerous defects, was developed and introduced by the authors. Results. The systemic approach and criteria for choosing surgical strategy of diabetic foot syndrome treatment were worked out and presented. The immediate and long-term results of using the introduced scheme of the management of patients were studied. Conclusions. The developed complex approach is aimed at preservation of the foot and supporting function of the lower extremity; its clinical use permits to decrease the percent of amputations and lethality, improving patients’ quality of life indices.

Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.


2020 ◽  
Vol 64 (1) ◽  
pp. 28-33
Author(s):  
T. Morgoshiya

When comparing the results of surgical interventions in the modifications of Billroth-I and Billroth-II concerning carcinoma there are no significant differences both in immediate and in long-term results of treatment. At the same time the functional results of interventions and quality of life of patients are better after reconstruction of the digestive tract with the help of gastroduodenal anastomosis. Gastric stump cancer is more often occur after Billroth-II surgery. The main cause of the development of carcinoma in this case is the appearance of atrophic gastritis as a result of denervation of the organ and the transfer of bile to the operated stomach.


2018 ◽  
Vol 177 (6) ◽  
pp. 63-68 ◽  
Author(s):  
A. A. Glukhov ◽  
V. V. Sergeev ◽  
G. A. Semyonova

Objective.To assess the outcomes of the treatment of patients with suppurative necrotic complications of diabetic foot syndrome (DFS) without critical ischemia with the use of programmed rehabilitation technologies (PRT).Materialand methods.The study included 82 patients. 40 patients (reference group) underwent conventional rehabilitation, while 42 patients (study group) were treated with PRT with the use of the original equipment AMP-01.Results.Use of PRT has been established to significantly improve the quality of rehabilitation, which helps to reduce the duration of inpatient treatment. The number of suppurative complications in the study group proved to be significantly less (p=0.014), and postoperative mortality was lower. The long-term outcomes of the treatment (number of late suppurative complications, ischemia progression, maintenance of foot support ability) in the study group was also found to be significantly better compared to the reference group.Conclusion.The use of PST promotes the improvement of short-term and long-term outcomes of the treatment of the patients with DFS suppurative necrotic complications.


2018 ◽  
Vol 25 (3) ◽  
pp. 129-132
Author(s):  
L. V. SHAGAL ◽  
V. V. TKACHEV ◽  
V. V. SHAGAL ◽  
I. S. BLUMENAU ◽  
N. V. ZABOLOTSKIKH ◽  
...  

Aim. To study the severity of cognitive and psychoemotional disorders in the outcome of treatment of the patients with cerebral aneurysms ruptures, who were admitted in a compensated condition.Materials and methods. 57 cases are analyzed in the article. These are the cases of patients who were operated on in an acute state of aneurysmal subarachnoid hemorrhage. The severity of their state when they were admitted was 1-3 according to the Hunt-Hess scale. Depending on the results of treatment, the patients were divided into 2 groups: the first included 37 patients with excellent immediate results of treatment on the inverted Glasgow outcome scale (GOS 1), the second included 20 patients with moderate and severe disability (GOS 2-3).Results. The patients with moderate and severe disability as immediate results of treatment have a lower quality of life than patients with excellent results, due to the presence of severe headache, anxiety and depression disorders.Conclusion. The decline in the quality of life of patients with moderate and severe disability as immediate results of treatment of the cerebral aneurysms ruptures requires a rehabilitation therapy.


2020 ◽  
pp. 5-9
Author(s):  
O. V. Galimov ◽  
V. O. Khanov ◽  
M. R. Bakirov ◽  
R. R. Saifullin ◽  
D. O. Galimov

Aim. To improve the method of Heller cardiomyotomy for best immediate and long-term results of treatment of esophageal achalasia.Materials and methods. Analyzing the results of surgical treatment of 280 patients with esophageal achalasia who were treated in the Department of Surgical Diseases and New Technologies of the Bashkir State Medical University (Ufa) and the Department of Surgery and Stomach of the Republican Clinical Oncology Center (Kazan) for a period from 2000 to 2019. We conducted a cohort retrospective study in 2 groups (laparoscopic esophagocardiomyotomy according to Heller, supplemented by anterior modified hemifundoplication according to Dor (n = 74) and traditional laparoscopic interventions (n = 206).Results. The authors have developed an original method of laparoscopic esophagocardiomyotomy, including the use of devices that facilitate the mobilization of cardia and the formation of fundoplication cuffs. Patients were examined by performing esophagogastroduodenoscopy, contrast X-ray scopy of the esophagus and stomach, esophagomanometry, pH-measurement in distal part of esophagus. Long-term results of up to 2 years were tracked. Surgically treated patients were tested by special application forms. Received results showed the restoration of quality of life in most of the subjects.Conclusion The developed technique of laparoscopic esophagocardiomyotomy, including the use of intra-esophageal transillumination and a device for measuring the esophagus, prevents damage to the esophagus wall and postoperative complications associated with insufficient or excessive narrowing of the esophagus. Of the 74 patients, 66 (89.2 %) rated the result as excellent and good, 6 (8.1 %) as satisfactory, and 2 (2.7 %) as unsatisfactory.


Introduction. One of the complications of diabetes mellitus (DM) is diabetic foot syndrome (DFS), which develops in 6–11 % of patients and requires surgical treatment in 40–70 % of them. Various types of amputations and large necrectomies lead to a redistribution of the load on the foot with the development of violations of its support function and deformity. As a result, the soil arises for the development of purulent-necrotic processes, the quality of life of patients decreases. Rehabilitation is an important part of postoperative care. It should be carried out both in the hospital and at the outpatient stage of treatment and is an important measure in preventing complications and improving the quality of life of patients. Aim. To analyze the results of treatment of patients with purulent-necrotic complications (PNC) of DFS, for whom postoperative rehabilitation measures were included in the treatment complex. Materials and methods. The results of treatment of 128 patients operated on for PNC of DFS were studied. The examination and treatment were carried out according to the standards. At the outpatient stage, 45 patients underwent complex rehabilitation using a set of physical exercises in combination with physiotherapy methods of treatment. Determination of the degree of foot deformity was performed using plantography and X-ray of the foot bones. The dynamics of life quality indicators were studied using the Manchester-Oxford foot questionnaire (MOXFQ). Results and discussion. The obtained results showed that in conditions of rehabilitation treatment, after 6 months the number of complications in the main group was less than in the comparison group by 12.6 %, and after a year – by 25 %. The study of the quality of life using the MOXFQ questionnaire 6 months after rehabilitation showed a significant difference in indicators (p < 0.05) between the comparison and the main groups on pain and social interaction scales and the MOXFQ index in general, which indicates a positive effect of the used rehabilitation treatment on the quality life of patients. At the same time, after a year, the reliability of the difference in indicators on all scales and the MOXFQ-index of the main and comparison groups was not revealed, despite the best absolute figures. The result obtained indicates the need for repeated courses of rehabilitation measures in the complex of treatment. Conclusions. Treatment of patients with complications of DFS should be organ-preserving and complex. Treatment should include a set of rehabilitation measures aimed at restoring the motor function and support ability of the foot to prevent its deformation. The use of rehabilitation treatment can reduce the number of complications in the postoperative period and improve the quality of life of patients.


2021 ◽  
Vol 11 (1) ◽  
pp. 7-16
Author(s):  
Anastasiia A. Skopetc ◽  
Svetlana A. Karavaeva ◽  
Tatiana K. Nemilova

INTRODUCTION: Necrosis and perforation of the stomach and /or duodenum in newborns and infants is a rare but severe disease with high mortality. There are many theories about the etiology and pathogenesis of the necrosis and perforation of the stomach and duodenum in children of this age. Various treatment options are described, but neither foreign nor Russian publications have assessed the long-term results of the treatment of patients with perforation of the stomach and duodenum during the first year of life and the quality of their life. AIM: This study aimed to analyze the results of treatment of newborns and infants with perforation of the stomach and duodenum and to assess their long-term quality of life. MATERIALS AND METHODS: The study analyzes the long-term results of treatment of 21 children, aged 212 yrs, with perforation of the stomach and duodenum. The volumetric evacuation function of the stomach and duodenum and the childs nutritional status were assessed. A survey of patients and their parents was also carried out to assess the quality of life of the child using questionnaires from the EuroQol Research Foundation version EQ5D-Y. RESULTS: The volumetric evacuation function of the stomach and duodenum recovered completely. The nutritional status of 16 (76%) children corresponds to their age. According to the results of the analysis of the questionnaire of the quality of life, eight patients aged 8 yrs and 15 parents consider the health profile of children as the best (71%), the parents of one patient assess the health profile of their child as satisfactory, and five mothers of children with neurological deficits rated as unsatisfactory. CONCLUSION: Owing to the high adaptation capacity of the newborn and infants of the first year of life, most of the examined patients have a good quality of life and a normal nutritional status. The volumetric evacuation function of the stomach and duodenum recovered in all patients within 13 yrs after surgery.


2011 ◽  
Vol 152 (29) ◽  
pp. 1171-1177 ◽  
Author(s):  
Gábor Szabad

Diabetes mellitus contributes to a number of disorders that can affect the quality of life. Amongst this diabetic foot syndrome and diabetic foot ulceration are serious secondary complications of diabetes mellitus. Persons with diabetic foot ulceration have an increased risk of amputation. In the first part of this review the author focuses on the pathophysiology of diabetic foot ulceration. The second part covers the topics of current and future therapies. The reader will understand the need and modes for preventive measures, the importance of multi level education in this topic, and the need for specialized wound care centers. As emphasized by the author, diabetic foot syndrome and ulceration are serious complications of diabetes mellitus, which can lead to devastating lower-extremity amputations and possible death. Specialized wound care centers, multi level education and proper adherence to standard treatment regimes can potentially prevent the need for amputation. Orv. Hetil., 2011, 152, 1171–1177.[Formula: see text]


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