ABSTRACT
The rupture of infrarenal segment of aorta is the severe pathology in spite of modem diagnostics and the operation. This case is accompanied by negative results of treatment (lethality consists of 56,3%). The article presents the experience of treatment of 157 patients with the rupture of infrarenal segment of aorta in conditions of multifield hospital (Municipal hospital No 26). The authors highlighted the postoperative complications, their influence on negative outcome. It was shown, that the main reasons of negative outcome of such patients with abdominal aortic aneurism, complicated by the rupture, were an advanced age of patients, who had the complex of concomitant diseases and postoperative complications such as nosocomial pneumonia, cardiac problems and multiple organ failure due to massive acute hemorrhage.
Subject(s)
Aorta, Abdominal/surgery , Aortic Aneurysm, Abdominal/complications , Aortic Rupture , Blood Vessel Prosthesis Implantation , Postoperative Complications , Aged , Aged, 80 and over , Aorta, Abdominal/diagnostic imaging , Aortic Aneurysm, Abdominal/mortality , Aortic Rupture/diagnosis , Aortic Rupture/etiology , Aortic Rupture/physiopathology , Aortic Rupture/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/methods , Blood Vessel Prosthesis Implantation/statistics & numerical data , Emergencies , Female , Humans , Male , Middle Aged , Postoperative Complications/classification , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Postoperative Complications/mortality , Radiography , Survival Analysis , Treatment Outcome , UltrasonographySubject(s)
Anastomotic Leak , Cardia , Gastrectomy , Stomach Diseases/surgery , Subphrenic Abscess , Adult , Anastomotic Leak/etiology , Anastomotic Leak/physiopathology , Anastomotic Leak/surgery , Cardia/pathology , Cardia/surgery , Female , Gastrectomy/adverse effects , Gastrectomy/methods , Humans , Necrosis , Reoperation , Severity of Illness Index , Stomach Diseases/diagnosis , Stomach Diseases/physiopathology , Subphrenic Abscess/etiology , Subphrenic Abscess/physiopathology , Subphrenic Abscess/surgery , Treatment OutcomeABSTRACT
Direct and long-term results of surgical interventions for differentiated cancer of the thyroid gland supplemented with lymphadenectomy on the tumor side were studied on the material of 1136 patients. As a group of comparison there was a group of 303 patients with similar histological diagnoses, gender and age and distribution of carcinomas by stages in which the ablation of para- and pretracheal lymph nodes was not fulfilled by any reasons. The investigation gives proofs of the necessity to perform central lymphadenectomy simultaneously in all primary operations for differentiated cancer of the thyroid gland.
Subject(s)
Carcinoma , Lymph Nodes/surgery , Lymphatic Metastasis/pathology , Neck Dissection/methods , Sentinel Lymph Node Biopsy/methods , Thyroid Gland/surgery , Thyroid Neoplasms , Carcinoma/pathology , Carcinoma/surgery , Disease-Free Survival , Female , Humans , Lymph Nodes/pathology , Male , Middle Aged , Neck Dissection/adverse effects , Neoplasm Staging , Neoplasm, Residual/prevention & control , Outcome Assessment, Health Care , Paresis/etiology , Thyroid Gland/pathology , Thyroid Neoplasms/pathology , Thyroid Neoplasms/surgery , Thyroidectomy/methodsABSTRACT
On the basis of anatomical (30 observations) and clinical material (160 patients with different diseases of the thyroid gland) the topography of connective-tissue fixing apparatus of the thyroid gland was defined more precisely. Its classification is proposed and the relationship with the surrounding structures is described. The character of changes in the connective-tissue fixing elements is shown in different variants of its pathology. The best places for dissection of the connective-tissue structures are well-founded with special reference to the topography of the thyroid vessel branches, recurrent and superior laryngeal nerves. The sequence of surgeon's actions in mobilization of the thyroid gland lobe is proposed and substantiated.
Subject(s)
Suture Techniques , Thyroid Diseases/surgery , Thyroid Gland/anatomy & histology , Thyroidectomy/methods , Adult , Aged , Aged, 80 and over , Humans , Middle Aged , Thyroid Diseases/pathology , Thyroid Gland/surgery , Treatment OutcomeABSTRACT
On the basis of an anatomical (60 observations) and clinical material (160 patients with different diseases of the thyroid gland) the authors specified topography of the external branch of the superior laryngeal nerve, proposed supplements to the classification of variants of its passage, estimated the risk of traumatizing this structure during operation, determined the zone of most probable injury. Anatomical substantiation is given to the places of most convenient ligation of the main branches of the superior thyroid vessels.
