RESUMEN
OBJECTIVE: To analyze the early results of pancreatoduodenectomies with different methods of pancreatic isthmus transection. MATERIAL AND METHODS: There were 82 pancreatoduodenectomies for cancer of pancreatic head or major duodenal papilla for the period 2010-2019. The control group comprised 38 patients with pancreatic isthmus transection and no preliminary suturing of local vessels. The study group consisted of 44 patients who underwent preliminary intersection of pancreatic isthmus vessels. Inclusion/exclusion criteria were used for grouping. We evaluated total intraoperative blood loss and blood loss following pancreatic isthmus transection, incidence and structure of postoperative complications. RESULTS: Total intraoperative blood loss was 755.12±108.61 vs. 698.45±92.87 ml, respectively (p>0.05). Intraoperative blood loss following pancreatic isthmus transection was 48.21±9.11 vs. 7.83±1.72 ml, respectively (p<0.01). Incidence of postoperative complications and redo surgeries was similar. Postoperative bleeding occurred in 5 (13.15%) patients of the 1st group (class A - 2.63%; B - 5.26%; C - 5.26%) and 2 (4.54%) patients of the 2nd group (A - 4.54%; B and C - 0%). There were no significant differences in the incidence of other complications and postoperative mortality. CONCLUSION: Pre-stitching of arterial vessels of the pancreatic isthmus reduces blood loss following intersection (p<0.01), as well as the incidence of postoperative bleeding class B and C (p<0.05).
Asunto(s)
Neoplasias Pancreáticas , Pancreaticoduodenectomía , Arterias , Pérdida de Sangre Quirúrgica/prevención & control , Humanos , Páncreas/cirugía , Neoplasias Pancreáticas/cirugía , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & controlRESUMEN
OBJECTIVE: To study the effectiveness of pharmacotherapy for perforated gastric ulcer in a surgical hospital. MATERIAL AND METHODS: A retrospective analysis of the treatment of 693 patients with perforated gastric and duodenal ulcers was carried out. Laparoscopic and open surgeries were performed. Statistical analysis was performed using the Statistica and MS Excel software packages. Student t-test was applied for independent samples and Fisher's F-test was calculated. RESULTS: Combined therapy included surgical treatment (suturing of the ulcer as a rule) and medication with proton pump inhibitors, antibacterial drugs. Over the past 5 years, postoperative quality of life has been significantly improved in patients with perforated ulcers. Stomach resection and vagotomy for perforated ulcers will become historical in the near future. Laparoscopic and open procedures ensure similar periods of ulcer closure. CONCLUSION: Currently, successful treatment of perforated gastric and duodenal ulcers requires an integrated approach at all levels of specialized care and is impossible without modern pharmacotherapy.
Asunto(s)
Úlcera Duodenal , Úlcera Péptica Perforada , Úlcera Gástrica , Antibacterianos/uso terapéutico , Terapia Combinada , Úlcera Duodenal/complicaciones , Úlcera Duodenal/tratamiento farmacológico , Úlcera Duodenal/cirugía , Humanos , Úlcera Péptica Perforada/diagnóstico , Úlcera Péptica Perforada/tratamiento farmacológico , Úlcera Péptica Perforada/etiología , Úlcera Péptica Perforada/cirugía , Inhibidores de la Bomba de Protones/uso terapéutico , Calidad de Vida , Estudios Retrospectivos , Úlcera Gástrica/complicaciones , Úlcera Gástrica/tratamiento farmacológico , Úlcera Gástrica/cirugía , Resultado del TratamientoRESUMEN
Endometriosis is a functioning endometrial tissue outside the inner layer of the uterine wall. Liver endometriosis is one of the rarest forms of atypical endometriosis. In this article, we report a patient with this disease. A 59-year-old patient complained of heaviness and periodic pain in the right hypochondrium for more than a year. Previous contrast-enhanced CT revealed signs of cystic-solid hypovascular mass lesion in the right liver lobe. Histological examination revealed no reliable signs of tumor growth. According to control CT after 8 months, no significant changes were observed. Surgical treatment was indicated and atypical liver resection was performed. Histological examination revealed cystic endometrioid lesion. Liver endometrioma is a rare disease with unclear pathogenesis. Diagnosis is difficult due to uncharacteristic clinical manifestations and no specific markers. Liver endometriosis should be considered in differential diagnosis of liver lesion. Surgical treatment is preferable due to the risk of malignant transformation.
Asunto(s)
Endometriosis , Hepatopatías , Endometriosis/diagnóstico por imagen , Endometriosis/patología , Endometriosis/cirugía , Femenino , Hepatectomía , Humanos , Hepatopatías/diagnóstico por imagen , Hepatopatías/patología , Hepatopatías/cirugía , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
The results of a comparative assessment of the state of hemomicrocirculation and oxygen metabolism in the mucous membrane of the alveolar crest after contour plastics of the gums during dental implantation using a connective tissue graft from the upper jaw, a connective tissue transplant from the palate and the collagen matrix collagen matrix are presented. During contouring with the use of connective tissue graft (CTG) from the upper jaw and collagen matrix in the mucous membrane of the alveolar mandible, the level of tissue blood flow decreases, which characterizes the development of ischemia, which is stopped after 3 weeks, when using a connective tissue graft (CTG) from the palatine, the level of tissue blood flow rises, which indicates the development of hyperemia, which is stopped for more than 3 weeks. According to oximetry data after contouring with the use of various surgical techniques, the level of oxygenation and oxygen metabolism is reduced by 8-38%, which characterizes the development of hypoxia, which is stopped after 3 weeks when using CTG from the hillock of the upper jaw and collagen matrix for more than 3 weeks when applying CTG from the palatine.
Asunto(s)
Recesión Gingival , Proceso Alveolar/cirugía , Tejido Conectivo , Implantación Dental , Recesión Gingival/cirugía , Humanos , Membrana MucosaRESUMEN
AIM: To evaluate and to compare the intensity of the inflammatory response to zinc-oxide-eugenol based filling material in rabbit's soft and bone tissue. MATERIAL AND METHODS: The study employed 20 chinchilla rabbits. The artificial defects were formed in jaw and in soft tissues and filled by zinc-oxide-eugenol based filling material. After 14 or 30 days the animals were euthanized, and tissue samples were analyzed with microscope. RESULTS: Histological analysis revealed that zinc-oxide-eugenol based filling material support inflammation reaction in the tissue, but bone tissue showed statistically lower inflammatory response in comparison to soft tissue (p<0,05). CONCLUSION: Extrusion of zinc-oxide-eugenol based filling material from root canal is undesirable as it leads to complex unfavorable tissue reaction for its elimination, more pronounced in soft tissues.
Asunto(s)
Eugenol , Materiales de Obturación del Conducto Radicular , Animales , Óxidos , Conejos , Zinc , Cemento de Óxido de Zinc-EugenolRESUMEN
Pancreatoenterostomy is one of the key moments in pancreatic surgery. It was proposed invaginative pancreatojejunostomy in end-to-side fashion by using of two continuous single-row purse-string sutures. This technique may be used in pancreatoduodenectomy and Beger's procedure. This method will be useful in cases of edematous and erupting pancreatic parenchyma and hard-to-differentiate lumen of pancreatic duct. It is followed by reduced trauma of tissue and bleeding, allows to avoid sutures failure and to achieve sealed anastomosis.
Asunto(s)
Páncreas/cirugía , Pancreatectomía/métodos , Pancreatoyeyunostomía/métodos , Humanos , Páncreas/patología , Conductos Pancreáticos/patología , Conductos Pancreáticos/cirugía , Pancreaticoduodenectomía/métodos , Técnicas de SuturaRESUMEN
It reports the results of primary basal blood flow in partially edentulous bone tissue with atrophy, as well as comparative evaluation of haemomicrocirculation level of the alveolar bone mucosa after bone augmentation via tunneling and conventional methods. The results of the initial state of microcirculation in the mucous membrane of the alveolar process in the partially edentulous area show a 45% decrease of blood flow (M), its intensity (s) by 60%. Microcirculatory shifts in blood flow levels indicators, its intensity, vasomotor activity are more evident when using the conventional method, where revascularization takes more than five months. When using the tunnel method, there is an improvement in haemodynamic mechanisms of tissue blood flow regulation. Microcirculation is restored 4 months after surgery.
Asunto(s)
Proceso Alveolar/irrigación sanguínea , Aumento de la Cresta Alveolar/métodos , Arcada Parcialmente Edéntula/cirugía , Microcirculación , Atrofia , Velocidad del Flujo Sanguíneo , Hemodinámica , Humanos , Mandíbula/patología , Mandíbula/cirugía , Maxilar/patología , Maxilar/cirugía , Mucosa Bucal/irrigación sanguíneaRESUMEN
AIM: To justify ligation of vascular branches of anterior pancreateroduodenal arterial arch or gastroduodenal artery prior to bifurcation. MATERIAL AND METHODS: This method was tested on sufficient clinical material: 147 patients with recurrent chronic pancreatitis. The interventions are presented by Frey, Beger procedures and its Berne variant. RESULTS: Comparative analysis showed reliable advantages of vascular ligation during pancreatectomy.
Asunto(s)
Pérdida de Sangre Quirúrgica/prevención & control , Duodeno , Hemostasis Quirúrgica/métodos , Páncreas , Pancreaticoduodenectomía , Pancreatitis Crónica , Procedimientos Quirúrgicos Vasculares , Adulto , Duodeno/irrigación sanguínea , Duodeno/patología , Duodeno/cirugía , Femenino , Humanos , Ligadura/métodos , Masculino , Persona de Mediana Edad , Evaluación de Procesos y Resultados en Atención de Salud , Páncreas/irrigación sanguínea , Páncreas/patología , Páncreas/cirugía , Pancreaticoduodenectomía/efectos adversos , Pancreaticoduodenectomía/métodos , Pancreatitis Crónica/diagnóstico , Pancreatitis Crónica/patología , Pancreatitis Crónica/fisiopatología , Pancreatitis Crónica/cirugía , Flujo Sanguíneo Regional , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
Hemostatic disorders are typically associated with prolonged bleeding after or during surgical procedures. The aim of the study was to increase the efficiency of oral surgery in these patients using erbium laser. Selected 46 patients receiving oral surgery were randomly divided in 2 groups: 43 patients with thrombocytopenia, trombocytemia and other platelet disorders treated with erbium laser and a control group of 43 patients without concomitant pathology determined for conventional surgical treatment. No postoperative bleeding was seen in group 1. Conventional procedures were associated with significantly more postoperative pain and epithelization took 1-3 days longer. Erbium laser radiation is an up-to-date method which can be successfully used for oral surgery in patients with hemostatic disorders.
Asunto(s)
Trastornos de las Plaquetas Sanguíneas/complicaciones , Láseres de Estado Sólido , Procedimientos Quirúrgicos Orales/instrumentación , Hemorragia Posoperatoria/etiología , Hemorragia Posoperatoria/prevención & control , Trastornos de las Plaquetas Sanguíneas/patología , Humanos , Hemorragia Posoperatoria/patología , Trombocitopenia/complicacionesRESUMEN
The study presents scientific data about surgical preparation of the alveolar bone before dental implantation by applying synthetic osteoplastic materials. The review analyzed the results of experimental and clinical studies on structural features and the efficiency of these materials, the time for replacement of new-formed bone tissue and contains comparative analysis of the efficiency of synthetic bone substitutes and other types of osteoplastic materials.
Asunto(s)
Pérdida de Hueso Alveolar/terapia , Aumento de la Cresta Alveolar , Cementoplastia , Cementos Dentales , Implantación Dental , Pérdida de Hueso Alveolar/cirugía , Regeneración Ósea , HumanosRESUMEN
The article is aimed to analyze the advantages of the tunnel operative approach in dental surgery. It is shown that the application of the tunnel technique can enhance tissue regeneration and revascularization, achieve better aesthetic and functional results, offer higher treatment quality.
RESUMEN
The article presents a comparative analysis of therapeutic and diagnostic measures aimed at eliminating jaundice complicating diseases hepatopancreatoduodenal zone as tumor and benign etiology. Patients with obstructive cholestasis were represented by two groups: the main and control, including 858 and 869 patients, respectively. Therapeutic and diagnoctic tactics in the study group was based on the principles of the proposed algorithm. Using the proposed diagnostic and treatment algorithm led to better outcomes: significantly lower mortality and the incidence of postoperative complications
Asunto(s)
Algoritmos , Ictericia Obstructiva/diagnóstico , Ictericia Obstructiva/terapia , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Monitoring results of current awareness level of dispensary patients with arterial hypertension are presented in the article. Awareness-raising activities for patients with arterial hypertension were developed by information and education work and communications increasing; effective target medical and social programs developing and implementing.
Asunto(s)
Atención Ambulatoria , Conocimientos, Actitudes y Práctica en Salud , Hipertensión , Educación del Paciente como Asunto/métodos , Humanos , Hipertensión/diagnóstico , Hipertensión/etiología , Hipertensión/prevención & control , Educación del Paciente como Asunto/estadística & datos numéricos , Educación del Paciente como Asunto/tendenciasRESUMEN
In this review the modern ideas of the cell-like immune pathogenesis mechanism of Lichen planus)LP) are described. The special attention is paid to molecular diagnostics methods ( immunohistochemical and others). Communication of emergence of oral LP with infectious diseases is shown.
Asunto(s)
Liquen Plano Oral/inmunología , Linfocitos T/inmunología , Candida albicans/inmunología , Candidiasis/complicaciones , Candidiasis/inmunología , Enterobacter/inmunología , Infecciones por Enterobacteriaceae/complicaciones , Infecciones por Enterobacteriaceae/inmunología , Humanos , Liquen Plano Oral/microbiología , Boca/inmunología , Boca/microbiología , Infecciones Estafilocócicas/complicaciones , Infecciones Estafilocócicas/inmunología , Staphylococcus aureus/inmunologíaRESUMEN
The article highlights various techniques of biliodigestive anastomises, used for the treatment of high-level blockages of biliary ducts. The novel author method of tetrahepaticojejunostomy, possessing less insufficiency risk and less traumaticity was suggested. 38 patients have been operated on using the hepaticoenterostomy; 5 patients received the described method of tetrahepaticojejunostomy with positive outcome.
Asunto(s)
Colestasis/cirugía , Conducto Hepático Común/cirugía , Yeyunostomía/métodos , Anciano , Anastomosis Quirúrgica/métodos , Colestasis/diagnóstico , Colestasis/etiología , Constricción Patológica/complicaciones , Constricción Patológica/diagnóstico , Constricción Patológica/cirugía , Femenino , Estudios de Seguimiento , HumanosRESUMEN
The paper presents studies on nutritional foramina of the mandible. Some nutritional foramina located in the frontal mandibular region on the lingual surface and containing significant blood vessels and nerves are found to be more typical for teeth-bearing mandible. In retromolar area in case of third molars presence intraosseous canals were revealed leading to inferior alveolar nerve canal. One should consider intraligamental and lingual anesthesia by lower incisors extraction. Intraosseous anesthesia and retromolar area infiltration significantly increase anesthesia efficiency by third molar extraction.
Asunto(s)
Anestesia Dental/métodos , Incisivo/inervación , Incisivo/cirugía , Mandíbula , Tercer Molar/inervación , Tercer Molar/cirugía , Extracción Dental , Anciano , Femenino , Humanos , Masculino , Mandíbula/anatomía & histología , Mandíbula/diagnóstico por imagen , Mandíbula/inervación , Nervio Mandibular/anatomía & histología , Persona de Mediana Edad , RadiografíaRESUMEN
The aim of the study was to estimate the clinical efficacy of mandibular third molars anesthesia with various combinations of local anesthesia methods. Anatomical, radiological and morphological methods were used in the study. The topographic features of retromolar triangle were thoroughly examined. The neurovascular bundle revealed its relationship with retromolar area structures. According to the results of the clinical study the most effective combinations of mandibular third molars analgesia were selected.
Asunto(s)
Anestesia Dental/métodos , Anestesia Local/métodos , Mandíbula/efectos de la radiación , Tercer Molar/diagnóstico por imagen , Adulto , Anciano , Cadáver , Femenino , Humanos , Masculino , Mandíbula/anatomía & histología , Mandíbula/inervación , Persona de Mediana Edad , Tercer Molar/anatomía & histología , Tercer Molar/inervación , Tomografía Computarizada por Rayos XAsunto(s)
Procedimientos Quirúrgicos del Sistema Biliar/métodos , Quiste del Colédoco , Conducto Colédoco/cirugía , Ictericia Obstructiva/etiología , Anciano , Quiste del Colédoco/complicaciones , Quiste del Colédoco/diagnóstico , Quiste del Colédoco/fisiopatología , Quiste del Colédoco/cirugía , Conducto Colédoco/patología , Femenino , Humanos , Ictericia Obstructiva/fisiopatología , Ictericia Obstructiva/cirugía , Imagen por Resonancia Magnética , Resultado del Tratamiento , UltrasonografíaRESUMEN
Seventy patients aged 20 to 75 years with suspected parotid gland disease were examined to study the capabilities of an ultrasound study in the diagnosis of neoplasms of the major salivary glands. B-mode ultrasonography and color Doppler imaging presented a means of detecting the presence of masses in the gland, their topography and dimensions, and specific vascularization, which allowed the option and scope of treatment to be planned.