ABSTRACT
Methods and results of treatment of 119 patients, suffering postoperative abdominal hernia, were analyzed. There was established, that application of laparoscopic miniinvasive technologies permits to improve the results of treatment in patients in comparison with those after open operative interventions, due to shortening of the operation duration, better visualization during viscerolysis conduction, shortening of rehabilitation period, the patients postoperative quality of life improvement.
Subject(s)
Abdominal Cavity/surgery , Hernia, Abdominal/surgery , Herniorrhaphy/methods , Postoperative Complications , Abdominal Cavity/pathology , Adult , Aged , Female , Hernia, Abdominal/etiology , Hernia, Abdominal/rehabilitation , Humans , Laparoscopy , Male , Middle Aged , Quality of LifeABSTRACT
The "fast track" concept in surgery provides rapid rehabilitation of postoperative patients, using the operative trauma reduction, adequate anesthesia--for reduction of the organism stress answer on surgical intervention. Results of treatment were analyzed in 118 patients, in whom for calculous cholecystitis the one-port transumbilical laparoscopic cholecystectomy (OPTLCH) was performed. Duration of the patients stationary treatment without abdominal cavity drainage have constituted at average (1.49 ± 0.05) days, after drainage--2.22 days. Intensity of the pain impulsation, which was determined in accordance to concentration of proinflammatory cytokins, including interleukin-1 (IL-1) and a tumor necrosis factor-α (TNF-α) after standard laparoscopic cholecystectomy (LCH) was in 1.2 times higher, than after OPTLCH. In subjective estimation of the pain intensity in accordance to visual analogous scale in patients after OPTLCH have constituted (3.42 ± 0.16) cm, and after a standard one--(5.98 ± 0.19) cm (p < 0.05).
Subject(s)
Cholecystectomy, Laparoscopic/methods , Cholecystitis, Acute/surgery , Gallbladder/surgery , Gallstones/surgery , Adolescent , Adult , Aged , Cholecystitis, Acute/pathology , Cholecystitis, Acute/physiopathology , Female , Gallbladder/pathology , Gallbladder/physiopathology , Gallstones/pathology , Gallstones/physiopathology , Humans , Interleukin-1/blood , Male , Middle Aged , Pain/physiopathology , Pain/psychology , Pain Measurement , Treatment Outcome , Tumor Necrosis Factor-alpha/bloodABSTRACT
Morphological changes in gastric mucosa were studied, optimal terms of bariatric operations performance after intragastric balloon (IGB) insertion were determined. Before the IGB insertion in 10 (35.7%) patients, in accordance to histological investigations, the changes in gastric mucosa were not revealed, and in 18 (64.3%) - chronic gastritis was established. In accordance to endoscopic investigation results, immediately after the IGB removal in 23 (82.1%) patients a pronounced erythematous gastropathy was noted, and in 5 (17.9%) - erosive gastropathy. While investigating the gastric mucosa biopsies in all the patients a prominent inflammatory changes were revealed, including significant edema, pronounced lymphocytic infiltration. In accordance to esophagogastroduodenoscopy data on the 14-th day of endoscopic monitoring in 6 (21.4%) patients pathological changes of gastric mucosa were not revealed, in 22 (78.6 %) - erythematous gastropathy was noted, and in accordance to histological investigation - chronic gastritis. Persistence of IGB in gastric cavity during 6 mo caused a morphological changes in gastric mucosa - a significant inflammation, what was confirmed by endoscopic and histological investigations data. The gastric mucosa structure normalization was observed in 14 days after the IGB removal, that's why a radical bariatric intervention is recommended to perform not earlier the term established.
Subject(s)
Bariatric Surgery , Gastric Balloon , Gastric Mucosa/surgery , Gastritis/surgery , Obesity, Morbid/surgery , Biopsy , Female , Gastric Mucosa/pathology , Gastritis/pathology , Gastroscopy , Histocytochemistry , Humans , Male , Obesity, Morbid/pathologyABSTRACT
The article analyzes the dynamics of postoperative pain at single-port transumbilical laparoscopic cholecystectomy compared to traditional laparoscopic cholecystectomy. It is shown that the intensity of pain in patients who have undergone laparoscopic procedures through a single transumbilical access was significantly less than in patients with traditional laparoscopic intervention. Furthermore, the use of a single-port transumbilical laparoscopic cholecystectomy accompanied by a smaller increase in the concentration of proinflammatory cytokines compared with patients who had laparoscopic procedures through four trocar accesses.
Subject(s)
Cholecystectomy, Laparoscopic/methods , Pain, Postoperative/diagnosis , Umbilicus , Cholecystectomy, Laparoscopic/adverse effects , Humans , Interleukin-1/blood , Interleukin-6/blood , Pain Threshold , Pain, Postoperative/etiology , Pain, Postoperative/immunology , Syndrome , Tumor Necrosis Factor-alpha/blood , Umbilicus/surgeryABSTRACT
Experience of laparoscopic gastric shunting application in accordance to the Fobi - Capello procedure in 15 patients, suffering morbid obesity (MO), was adduced. The surgical intervention technique was adduced, first results were analyzed, which are witnessing the effective lowering of the excessive body mass while followup to 6 mo postoperatively.
