ABSTRACT
It was done the analysis of the results of 625 open and endoscopic prosthetic and autoplastic hernia repairs made in a planned and emergency basis during the period from 2005 to 2012. The autoplastic group was divided into three subgroups: the plastic by Bassini, Shouldays and Postempski. The prosthesis group was divided into open and endoscopic subgroups. The open prosthesis group was also divided into subgroups in accordance with the options of hernia sac preparation (excised, reseted, untouched) and the reconstruction of the posterior wall of the inguinal canal (without reconstruction, with a single-layer and double-layer plastic). It was noted hematocele scrotum - 19 (3.04%), hematoma of the spermatic cord - 16 (2.56%), wound infiltration with a hemorrhagic component - 13 (2.08%). It was not noted the hemorrhagic complications in the subgroups of open prosthesis without hernia sac preparation. Reducing surgical aggression against inguinal hernias during the operation can reduce the frequency of hematomas. The absence of a clear classification of hematomas brings to difficulties in assessment of the role of specific surgical techniques in the development of postoperative complications after surgery for inguinal hernias.
Subject(s)
Hematoma/etiology , Hernia, Inguinal/surgery , Herniorrhaphy/adverse effects , Postoperative Hemorrhage/etiology , Follow-Up Studies , Hematoma/epidemiology , Herniorrhaphy/methods , Humans , Incidence , Laparoscopy/methods , Male , Postoperative Hemorrhage/epidemiology , Retrospective Studies , Russia/epidemiology , Surgical MeshSubject(s)
Biliary Fistula/complications , Gastric Fistula/complications , Gastrointestinal Hemorrhage/etiology , Hemostasis, Endoscopic/methods , Splenic Vein/abnormalities , Vascular Malformations/complications , Biliary Fistula/diagnosis , Diagnosis, Differential , Endoscopy, Gastrointestinal , Follow-Up Studies , Gastric Fistula/diagnosis , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/surgery , Humans , Male , Middle Aged , Severity of Illness Index , Splenic Vein/surgery , Vascular Malformations/diagnosis , Vascular Malformations/surgeryABSTRACT
Treatment of ulcerative gastroduodenal bleedings remains one of the most pressing problems in urgent surgery. Available methods of endoscopic hemostasis are not fully eligible to safety requirements, effectiveness and reliability. In this connection persist high levels of general and postoperative mortality in our country and around the world. The aim of this study is to identify the advantages and disadvantages of endoscopic radiofrequency effects in comparison with standard techniques of hemostasis, used in the treatment of ulcer bleeding in the world practice.
Subject(s)
Electrocoagulation/methods , Endoscopy, Gastrointestinal/methods , Hemostasis, Endoscopic/methods , Peptic Ulcer Hemorrhage/therapy , Animals , Disease Models, Animal , Epinephrine/administration & dosage , Epinephrine/therapeutic use , Male , Peptic Ulcer Hemorrhage/pathology , Rats , Rats, Wistar , Treatment Outcome , Vasoconstrictor Agents/administration & dosage , Vasoconstrictor Agents/therapeutic useABSTRACT
Experimental and clinical results of use of fibrin glue for strengthening "high risk" sutures of anastomoses in elective surgery of the esophagus, stomach and urgent abdominal surgery are presented. In experimental studies this glue permitted to increase mechanical strength and containment of anastomosis, to accelerate microbial elimination, activated reparative processes. In clinical practice fibrin glue permitted to avoid suture insufficiency of gastrointestinal anastomoses in the most unfavorable conditions (peritonitis, acute intestinal obstruction, oncological process, etc). It is concluded that fibrin glue is the high effective protective agent for gastrointestinal anastomoses.
