ABSTRACT
This article presents results of surgical treatment of 2963 patients with cholelithiasis. The majority of them (71.8%) had an elective surgery, though 28.2% of patients underwent an emergency operation. A comparative assessment of obligate treatment criteria was made in 2 groups. A first group consisted of 803 patients and it was before introduction of Roman selection criteria used for surgical treatment of patients. A second group included 2963 patients in the period after introduction of selection criteria. Preoperative planning of surgery with evaluation of technical complexity of all stages of intervention with prognosis for possible complications should be the base of reasonable choice of surgical method of treatment of cholelithiasis and safety protection of surgery. The study completed and results obtained allowed decrease of the rate of postoperative complications to 1.4% and lethality--to 0.3%, respectively.
Subject(s)
Cholecystectomy, Laparoscopic , Cholelithiasis , Minimally Invasive Surgical Procedures , Postoperative Complications , Cholecystectomy, Laparoscopic/adverse effects , Cholecystectomy, Laparoscopic/methods , Cholecystectomy, Laparoscopic/statistics & numerical data , Cholelithiasis/diagnosis , Cholelithiasis/etiology , Cholelithiasis/mortality , Cholelithiasis/surgery , Elective Surgical Procedures , Female , Humans , Male , Middle Aged , Minimally Invasive Surgical Procedures/methods , Minimally Invasive Surgical Procedures/statistics & numerical data , Patient Selection , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Preoperative Period , Risk Adjustment , Survival Analysis , Treatment OutcomeABSTRACT
The presented method of hernioplasty was used in 1242 patients with different types of inguinal hernias. In 428 patients plasty of the inguinal canal was performed by the classical method of Lichtenstein, in 814 patients the method was modified. The method modified by the authors is described in detail. Improved results of treatment are associated by the authors with reduced ischemization of the sutured tissues with reticulate endoprosthesis. Recurrent hernias were noted in 0.2% in the main group, and 1.8% in the control group.
Subject(s)
Abdominal Wall/surgery , Hernia, Inguinal/surgery , Herniorrhaphy , Inguinal Canal/surgery , Ischemia/prevention & control , Microvessels/physiopathology , Abdominal Wall/blood supply , Abdominal Wall/physiopathology , Adult , Female , Hernia, Inguinal/pathology , Hernia, Inguinal/physiopathology , Herniorrhaphy/adverse effects , Herniorrhaphy/methods , Herniorrhaphy/standards , Humans , Inguinal Canal/physiopathology , Ischemia/etiology , Ischemia/physiopathology , Male , Middle Aged , Practice Patterns, Physicians'/standards , Quality Improvement , Secondary Prevention , Suture Techniques/adverse effects , Suture Techniques/standards , Treatment OutcomeABSTRACT
Treatment results of 405 patients with Mallory-Weiss syndrome, X-ray gastric investigation in patients with severe bloating reflex were analyzed. Experimental part of the study involved rats and pigs, modeling esophageal and gastric rupture. Cardioesophageal and gastric cardial rupture happen in case of simultaneous sudden intragastric and intraabdominal hypertension, following the rule of Laplace.
