Assessment of postoperative complications of transurethral contact pyelocalycоlithotripsy in patients with high-density stones according to the Clavien – Dindo classification

2020 ◽  
Vol 10 (4) ◽  
pp. 309-316
Author(s):  
Toirkhon Kh. Nazarov ◽  
Anisjon I. Tursunov ◽  
Ivan V. Rychkov ◽  
Magomed A. Ahmedov ◽  
Kseniya E. Trubnikova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Retrospective Analysis ◽  
Kidney Stones ◽  
Postoperative Period ◽  
Topical Issue ◽  
Unified Algorithm ◽  
Cavity System ◽  
Treatment Of Urolithiasis

Improving the effectiveness of treatment of urolithiasis is a topical issue in modern urology. Despite a large number of studies on this problem, there is currently no unified algorithm for assessing postoperative complications of removal of calculi of the renal cavity system by transurethral access. Purpose of the study: based on a retrospective analysis to adapt the classification of postoperative complications according to Clavien Dind from 2004 to describe the complications of transurethral contact pyelocalicolithotripsy. Materials and methods. A retrospective analysis of the results of surgical treatment of 211 patients with kidney stones with a density of 960 HU to 1840 HU was performed. Ultrasonic energy was used for lithotripsy. Criteria for the normal course of the postoperative period in patients have been formulated. Results. The number of postoperative complications was calculated. The obtained data are distributed according to the corresponding gradations of the adapted Clavien Dindо classification. Conclusion. The improved Clavien Dindo classification, taking into account the adaptation, can be used as an up-to-date, accessible and logical template for assessing the postoperative complications of transurethral contact pyelocalicolithotripsy.

FEATURES OF OPHTHALMIC CARE FOR PATIENTS WITH COMPLICATED CATARACTS

2020 ◽  
pp. 84-89
Author(s):  
Inna Ivanovna Lapkina
Keyword(s):  
Health Care ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Key Words ◽  
Outpatient Treatment ◽  
Practical Application ◽  
Unified Approach ◽  
Case Histories ◽  
High Prevalence

Today, around 50 million people worldwide suffer from cataracts, more than a half of them need surgical treatment. High prevalence of this pathology in Ukraine, the need to improve the provision of ophthalmic care to patients, and the reform of the health care system have made the research relevant. Concomitant diseases and special conditions of the eye increase the risk of intra− and postoperative complications, worsen the functional parameters of patients after surgery. In order to develop a unified approach to the treatment of complicated cataracts based on diagnostically related groups of patients, a retrospective analysis of case histories of patients with different variants of complications related to the condition of the lens itself, its ligament apparatus and other structures of the eye was conducted. In each case, the surgeon has to choose the appropriate modification of cataract phacoemulsification surgery. The study proposed the classification of cataract phacoemulsification modifications on the basis of the techniques and the sequence of operation stages, taking into account the classification of the degrees of turbidity of the lens, proposed by L. Buratto. It has been noted that in complicated cases, according to the indications of the patient, surgery may be performed on several modifications of cataract phacoemulsification. The developed classification made it possible to generalize the various variants of pathology and greatly facilitate the choice of tactics of surgical treatment in complicated cataracts. It can be used not only for practical application, but also for improving the qualification of trained professionals. The prospect of further research is to identify contraindications for outpatient treatment of the patients with complicated cataracts. Key words: cataract complication, classification of phacoemulsification modifications, diagnostically related groups.

PREDICTIVE FACTORS IN THE CHOICE OF SURGICAL TREATMENT FOR COLORECTAL CANCER WITH LAPAROSCOPIC OR "OPEN" ACCESS

2017 ◽  
Vol 63 (3) ◽  
pp. 470-474
Author(s):  
Rustem Topuzov ◽  
Georgiy Manikhas ◽  
Eskender Topuzov ◽  
Mikhail Khanevich ◽  
Magomed Abdulaev ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Open Access ◽  
Comparative Study ◽  
Retrospective Analysis ◽  
Predictive Factors

There are presented results of surgical treatment of 347 patients with colorectal cancer. Based on the retrospective analysis a comparative study of results of surgical treatment for colorectal cancer using laparoscopic technologies and “open” access was carried out. Predictive factors that correlate with the risk of postoperative complications with laparoscopic and “open” access at the surgical stage of treatment for colorectal cancer were determined.

scholarly journals Duplex scanning as an alternative to computer tomography with contrast enhancement for the control of complications after endovascular aneurysm repair

2018 ◽  
Vol 9 (1) ◽  
pp. 44-49
Author(s):  
D. I. Korshunov ◽  
R. I. Khabazov ◽  
N. V. Ustiantseva ◽  
A. V. Chupin ◽  
S. V. Deryabin
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Early Detection ◽  
Computer Tomography ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Endovascular Aneurysm Repair ◽  
Duplex Scanning ◽  
Non Invasive ◽  
Aneurysm Repair

EVAR (endovascular aneurism repair) is the preferred method for the surgical treatment of ananeurysm. The advantage of this type of surgical intervention is that a smaller number of postoperative complications will occur. The main diagnostic tasks for patients after EVAR are to determine the size of the aneurysmal sac, detection of an endoleak, detection of the endoprosthesis migration and the deformation of the stent graft itself. Conclusion: early detection of complications in the postoperative period remains the main problem for monitoring patients after EVAR. Duplex scanning is a safe, non-invasive and effective method of measuring the size of an aneurysmal sac and detecting possible complications after EVAR.

Improving the efficiency of the postoperative period in the surgical treatment cancer patients with metastatic bone fractures upper and lower extremities using elixir altai ("vitavis") in combination with ion-activated water resources

10.12737/6454 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Антонов ◽  
A. Antonov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Postoperative Period ◽  
Bone Fractures ◽  
Infectious Complications ◽  
Lower Limbs ◽  
Oncologic Patients

Use elixir Altai ("Vitavis") in combination with ion-activated with water by means of such a complex contingent cancer patients as patients with metastatic bone fractures of the upper and lower limbs can reduce the early postoperative period, and to reduce to a minimum infectious complications and improve quality of life. The problem of postoperative complications, until now, is not solved. In oncologic patients, and those more in by III and As IV stages occurs it immunnodefitsit, which is caused not only by basic disease, but also by conse-quences of khimio- beam therapy. In connection with this appears the difficulty in the surgical treatment, caused by postoperative complications. As a result surgical treatment appears surgical injury, oxidizing stress, disturbance of homeostasis and oppression of immunity, which leads to an even larger disturbance of immunity in oncologic patients, which decreases the unspecific resistibility of organism. The application of adaptogena of the elixir of Altai (“Vitavis”) in combination with the ionic- activated aqueous means makes it possible to level and to reduce on no oxidizing stress, to increase the unspecific resistibility of the organism of oncologic patient and to increase immuni-ty. Moreover, powerful antioxidant - the ionic- activated aqueous means strengthens the action of adaptogena of the elixer of Altai (“Vitavis”), which leads to the decrease of postoperative infectious complications, reduces postoperative period, improves the quality of life and enlarges indications to the surgical treatment in oncologic patients with III it and IV by the stages of diseases.

scholarly journals Clinical case of surgical treatment of giant central anastomosis aneurysm after autovenous femoropopliteal bypass

2021 ◽  
Vol 38 (1) ◽  
pp. 144-150
Author(s):  
Vladimir A. Samartsev ◽  
Dmitry S. Vaganov ◽  
Andrey Yu. Oparin ◽  
Ilya A. Karasov ◽  
Eugeny V. Kruglov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Efficient Method ◽  
Postoperative Period ◽  
Clinical Case ◽  
Lower Extremities ◽  
Femoropopliteal Bypass ◽  
Proximal Anastomosis ◽  
Surgical Revascularization ◽  
Aneurysm Development

Ahterosclerosis of vessels of the lower extremities is widely distributed in the population. Open surgical revascularization is an efficient method for treatment of this pathology. One of the rare postoperative complications is an anastomosis aneurysm development. We report about a clinical case of a 74-year-old male with a giant (25 cm in diameter) aneurysm of the proximal anastomosis after femoropopliteal bypass. Open aneurysmectomy was performed, and the postoperative period was uneventful.

scholarly journals Surgical treatment of relapsed megaesophagus

2020 ◽  
Vol 47 ◽  
Author(s):  
LUIGI CARLO DA SILVA COSTA ◽  
JOÃO GABRIEL ROMERO BRAGA ◽  
VALDIR TERCIOTI JUNIOR ◽  
JOÃO DE SOUZA COELHO NETO ◽  
JOSÉ ANTÔNIO POSSATTO FERRER ◽  
...  
Keyword(s):  
Weight Loss ◽  
Retrospective Study ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Chagas Disease ◽  
Surgical Procedures ◽  
Postoperative Period ◽  
Outpatient Clinic ◽  
Surgical Result ◽  
Stage 1

ABSTRACT Objective: to analyze the surgical treatment of patients with recurrent megaesophagus followed at the esophageal-stomach-duodenal outpatient clinic of the Hospital de Clínicas - UNICAMP. Methods: a retrospective study, from 2011 to 2017, with 26 patients with Chagas or idiopathic megaesophagus, surgically treated, and who recurred with dysphagia. Clinical, endoscopic and radiographic aspects were assessed and correlated with the performed surgical procedures. Results: 50% had dysphagia for liquids, 69% regurgitation, 65.3% heartburn, 69.2% weight loss and 69.2% had Chagas disease. In addition, 38.4% had megaesophagus stage 1 and 2 and 61.5% stage 3 and 4. Regarding the reoperations, 53% of them underwent Heller-Pinotti surgery by laparoscopy, Serra-Dória in 30.7% and esophageal mucosectomy in 7.9%. In 72% of the reoperations there were no postoperative complications, and 80% of the patients had a good outcome, with reduction or elimination of dysphagia. Among the reoperated patients undergoing the laparoscopic Heller-Pinotti technique, three reported little improvement of dysphagia in the postoperative period and among those who underwent Serra-Dória surgery, 100% had no dysphagia. It was observed that, when the time between the first procedure and the reoperation was longer, the better the surgical result was, with statistical significant decreased dysphagia (p=0.0013, p<0.05). Conclusions: there was a preference to perform laparoscopic re-miotomy and, as a second option, Serra-Dória surgery, for patients with recurrent megaesophagus. Esophagectomy or esophageal mucosectomy were reserved for more severe patients.

scholarly journals Percutaneous nephrolithotripsy in children of the young age

2021 ◽  
Vol 14 (1) ◽  
pp. 144-150
Author(s):  
Yu.E. Rudin ◽  
◽  
D.S. Merinov ◽  
A.B. Vardak ◽  
L.D. Arustamov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Kidney Stones ◽  
Postoperative Period ◽  
Single Case ◽  
Problem Solution ◽  
Stone Size ◽  
Kidney Size ◽  
Extracorporeal Shock Wave ◽  
Percutaneous Nephrolithotripsy ◽  
Residual Stones

Introduction. Urolithiasis remains one of the most common diseases in the pediatric urology practice. A special category is made up of children weighing up to 15 kg with large and coral-like kidney stones, which require a smaller instrument to remove. Aim. The aim of the study was to evaluate the effectiveness of percutaneous nephrolithotripsy, used for urolithiasis treatment in children aged 1 to 3 years. Materials and methods. Between 2008 and 2019 in the pediatric uroandrology department of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation 93 children aged 1 to 3 years (69 (74.2%) boys and 24 (25.8%) girls) had nephrolithotripsy. The average patients age was 1 year and 9 months. Fifty-one (54.8%) patients had coral-like kidney stones, while the remaining 42 (45.2%) had kidney pelvic stones. The average stone size was 25.8mm. (15 – 56 mm). Nephrolithotripsy was performed according to the standard technique, all patients underwent cystoscopy and ureteral catheterization. In the prone position, under ultrasound and X-ray guidance, a puncture of the renal collecting system was performed. In 59 cases (63.5.1%) the puncture was performed through the lower calyx, in 31 cases (33.3%) – through the middle one, and in nine children two approaches were performed. In 93 children the intervention was performed using a mini-nephroscope with tubes of 12, 15 and 16.5 Ch. To disintegrate the stone, a pneumatic lithotripter and a holmium laser "Auriga" with a fiber of 365 and 600 μm in diameter were used. Only in 31 cases, when the kidney size allowed, a standard 24 Ch nephroscope and combined lithotripsy (ultrasound and pneumatic) were used. The duration of the procedure varied from 32 to 145 minutes, with an average of 43.5 minutes. In the postoperative period, all patients underwent infusion and antibiotic therapy based on the results of urine bacteriological examination. After the patients’ activation on days 1 – 3, a survey urography and antegrade pyeloureterography were performed. In the absence of residual stones and urinary passage disorders, nephrostomy drainage was removed. Results. The effectiveness of nephrolithotripsy in our cohort of patients was 87.1% (81 patients). Four children (4.3%) required second percutaneous intervention. The remaining 8 (8.6%) patients with residual stones underwent distance lithotripsy in the short postoperative period. Significant bleeding occurred in 2 patients who then required transfusion of blood products. Fever was noted in 5 (5.4%) patients. We have not observed a single case of septic and bacteriotoxic shock. Discussion. As a first-line surgical treatment in pediatric practice, it is recommended to use extracorporeal shock wave lithotripsy (ESWL). This treatment is ideal for stones ≤ 15 mm in size, with SFR of 68-95%. However, the need for repeated ESWL sessions occurs in 14-54% cases. Complications rate, frequency of retreatment, as well as a decrease in SFR, increase when a stone size is greater than 1.5 cm. Since all types of surgical treatment in children require anesthesia, and the treatment approach may not provide a complete problem solution, it is preferable to choose a procedure with the greatest possible success in one session. Primary SFR was significantly lower in children with stones ≥ 30 mm in size and multiple kidney stones. Mini– percutaneous nephrolithotripsy is an effective (87.1%) method for nephrolithiasis treatment in children aged 1 to 3 years. Conclusion. Mini-percutaneous nephrolithotripsy in children aged 1 to 3 years is an effective treatment for nephrolithiasis. However, in a small percentage of cases, it becomes necessary to combine the procedure with extracorporeal lithotripsy. Paying attention to the small size of the organ, to reduce the number of hemorrhagic complications, it is preferable to perform this intervention with one approach. The occurrence of even a small amount of bleeding during the operation is a formidable complication, given the small volume of circulating blood in children.

scholarly journals Prevention of complications of transvesical adenomectomy with a blind suture of the urinary bladder

2012 ◽  
Vol 93 (1) ◽  
pp. 56-61
Author(s):  
E A Zubkov ◽  
M E Sitdykova
Keyword(s):  
Urinary Tract ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Urinary Bladder ◽  
Postoperative Period ◽  
Early Recovery ◽  
One Stage ◽  
Analysis Of Results ◽  
Transvesical Adenomectomy ◽  
Prostate Adenoma

Aim. To determine the frequency and develop methods for prevention of possible complications of transvesical adenomectomy. Methods. Conducted was an analysis of results of surgical treatment of 492 patients with prostate adenoma. One-stage suprapubic transvesical adenomectomy with a primary blind suture of the urinary bladder and hemostasis of the adenoma bed was performed in 347 patients. Results. In the postoperative period inflammatory complications of the urinary tract were observed in 5 (1.4%) out of 347 operated patients. It was established that the frequency and nature of both early and late pyo-inflammatory and obstructive postoperative complications of the suprapubic adenomectomy depend on the method of hemostasis of the bed of the adenoma and on the time of urination recovery. Conclusion. The main measures of prevention of complications during suprapubic adenomectomy are hemostasis of the bed of the adenoma by temporary retriganization with removable hemostatic ligatures, early recovery of urethral voiding (2-4 days) and application of antibiotics to the bed of the adenoma via the drainages of the deference ducts.

scholarly journals APPENDICULAR PERITONITIS IN CHILDREN: AN EFFICIENT SURGICAL APPROACH AND INTENSIVE CARE

2020 ◽  
Vol 24 (2) ◽  
pp. 62-70
Author(s):  
O. V. Karaseva ◽  
Kseniia E. Utkina ◽  
A. L. Gorelik ◽  
A. V. Timofeeva ◽  
D. E. Golikov ◽  
...  
Keyword(s):  
Intensive Care ◽  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Intestinal Obstruction ◽  
Postoperative Period ◽  
Diffuse Peritonitis ◽  
Surgical Tactics ◽  
Adhesive Intestinal Obstruction ◽  
Local Protocol

Introduction. Currently, there is no any unified approach to the treatment of complicated forms of acute appendicitis in children. The purpose of our study is to evaluate the effectiveness of the local Protocol for diagnostics and treatment of appendicular peritonitis (AP) in children. Material and methods. 149 children with AP, aged 2 - 17 (11 ± 3.5 ), were included into the study. All of them were treated at the Clinical and Research Institute Emergency Pediatric Surgery and Trauma (CRIEPST) in 2015-2018. In the gender structure, boys (104; 69.8%) prevailed over girls (45; 30.2%). The following parameters were evaluated: AP structure, surgical tactics, postoperative course (incidence of postoperative intestinal failure syndrome (IFS), postoperative complications, length of hospital stay). A tactics for surgical treatment and volume of intensive care in the postoperative period were defined depending on AP severity and according to the local Protocol. Laparoscopic appendectomy was performed in 145 (97.3%) patients. There were no intraoperative complications and conversions in the studied group. In case of periappendiular abscess (PA) 3 (2.7%), patients had puncture and abscess drainage under ultrasound control. Results. While analyzing the AP structure by forms , the following picture was shown: free and abscessed forms were approximately equal - 72 (48.3%) and 77 (51.7%), respectively (p > 0.05). Diffuse peritonitis - 31.5%; generalized - 16.8%; combined - 17.4%; periappendicular abscess (PA) stage 1-14.8%; PA 2-16.8%; PA 3-2.7%. Postoperative complications - 4 (2.7%): postoperative abdominal abscesses - 3 (2.0%); early adhesive intestinal obstruction - 1 (0.7%). In postoperative abscesses, puncture and drainage were performed under ultrasound control; in early adhesive intestinal obstruction - laparoscopic adhesiolysis. All the children recovered. Length of intensive care was 2.9 ± 1.8 days; hospitalization - 12.0 ± 5.2 days. Conclusion. The local Protocol developed by the researchers helps to define a surgical tactics and volume of intensive care in the postoperative period. Laparoscopic surgery, in the vast majority of cases, is an optimal and effective technique for AP surgical treatment in children. Contraindications to laparoscopic surgery are PA 3 and total abscessing peritonitis.

scholarly journals Stationary replacement technologies in the surgical treatment of simultaneous pathology in gynecological patients

2018 ◽  
pp. 64-71
Author(s):  
A. N. Shikhmetov ◽  
L. A. Osin ◽  
A. M. Zadikyan ◽  
A. A. Pazichev
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Subsequent Treatment ◽  
The Body ◽  
Operating Table ◽  
Operating Team ◽  
Simultaneous Operations ◽  
Repeated Surgery

The authors analyzed the results of simultaneous operations in 238 patients with regard to the combined surgical and gynecological pathology performed in the hospital-replacing environment of the ВСDС of PAO «Gazprom». Previously, all patients were assigned to the sequence of stages, the location of trocars, taking into account the additional stages of the operation, the position of the monitor, the location of the operating team, the position of the patient on the operating table during each stage. Performing simultaneous laparoscopic operations does not lead to an increase in the number of intra- and postoperative complications in comparison with isolated interventions and is not accompanied by great technical difficulties, but causes a somewhat longer duration (on average, 20.6 ± 1.5 min), which, in our opinion , is not critical for anesthesia. There were no significant differences in the course of the early postoperative period and the intensity of the functional systems of the body. Advantages of simultaneous operations are undeniable: two or three surgical diseases are cured simultaneously, progression or serious complication of the disease is prevented, operative treatment of which would be postponed for a later period, the risk of repeated surgery and anesthesia is eliminated, the time of total stay of the patient in the hospital and subsequent treatment is reduced, economic efficiency of treatment is increased.

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