RESUMO
The results of miniinvasive transcutaneous interventions for purulentseptic complications of pancreonecrosis are presented. The computeric tomography (CT) and the ultrasound investigation data where compared while choosing of transcutaneous access towards purulent focus. Peculiar attention was drawn to searching of extraperitoneal trajectory for the drain conduction way. The drains were installed, using a onestaged method with a stylet catheters, owing 10 12 Fr in diameter, or a twostaged one. While comparing various methods of treatment of the pancreonecrosis purulentseptic complications there was established efficacy of miniinvasive interventions, performed for pancreatogenic abscesses and relatively delimited purulent foci in retroperitoneal cellular tissue.
Assuntos
Abscesso/cirurgia , Drenagem/métodos , Pancreatite Necrosante Aguda/cirurgia , Punções/métodos , Sepse/cirurgia , Abscesso/diagnóstico por imagem , Abscesso/etiologia , Abscesso/mortalidade , Adulto , Drenagem/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Pancreatite Necrosante Aguda/complicações , Pancreatite Necrosante Aguda/diagnóstico por imagem , Pancreatite Necrosante Aguda/mortalidade , Punções/instrumentação , Espaço Retroperitoneal/diagnóstico por imagem , Espaço Retroperitoneal/cirurgia , Sepse/diagnóstico por imagem , Sepse/etiologia , Sepse/mortalidade , Análise de Sobrevida , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
The method of magnet resonance tomography was applied for early diagnosis of the burn depth and dynamics of processes in the tissues in the course of its treatment and verification of occurring complications. Application of the method proposed for diagnosis and control of therapy have permitted to estimate expediency and determination of volume of early surgical treatment objectively.
Assuntos
Queimaduras/diagnóstico por imagem , Queimaduras/cirurgia , Imageamento por Ressonância Magnética/métodos , Transplante de Pele/métodos , Pele/diagnóstico por imagem , Adulto , Queimaduras/patologia , Queimaduras/terapia , Meios de Contraste/administração & dosagem , Procedimentos Cirúrgicos Dermatológicos/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Compostos Organometálicos/administração & dosagem , Reepitelização/fisiologia , Pele/lesões , Pele/patologia , Transplante AutólogoAssuntos
Gerenciamento Clínico , Laparoscopia/métodos , Pâncreas/cirurgia , Pancreatite Necrosante Aguda/cirurgia , Tomada de Decisão Clínica/métodos , Humanos , Laparoscopia/instrumentação , Pâncreas/diagnóstico por imagem , Pâncreas/patologia , Pancreatite Necrosante Aguda/diagnóstico por imagem , Pancreatite Necrosante Aguda/patologia , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Literature data and own experience of the treatment complications, occurring after tho- racic operations, using sternotomy access, were presented. Special attention was drawn to postoperative sternomediastinitis - most frequent infectious complication. Measures for the sternomediastinitis prophylaxis, methods of its diagnosis and treat- ment were presented.
Assuntos
Anti-Infecciosos Locais/uso terapêutico , Mediastinite/tratamento farmacológico , Mediastino/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Esternotomia/métodos , Esterno/cirurgia , Humanos , Mediastinite/etiologia , Mediastinite/patologia , Mediastinite/cirurgia , Complicações Pós-Operatórias , Período Pós-Operatório , Esterno/efeitos dos fármacos , Telas Cirúrgicas , Grampeadores CirúrgicosAssuntos
Fibrinolíticos/uso terapêutico , Trombectomia/métodos , Terapia Trombolítica/métodos , Veia Cava Inferior/cirurgia , Trombose Venosa/tratamento farmacológico , Doença Aguda , Ablação por Cateter/instrumentação , Ablação por Cateter/métodos , Humanos , Trombectomia/instrumentação , Filtros de Veia Cava , Veia Cava Inferior/patologia , Trombose Venosa/sangue , Trombose Venosa/patologia , Trombose Venosa/cirurgiaRESUMO
Experience of performance of 160 operations for injuries and stricture of biliary ducts, was analyzed. In 36 patients before admittance to hospital there were performed interventions, which provide correction of injuries or their consequences. In majority (141) of patients hepaticojejunoanastomosis in accordance to Roux method or its reconstruction were performed. Other interventions (right-sided hemihepatectomy) were rarely performed. The procedure of anastomosis formation, permitting to connect the mucosae of joining organs in precision, was proposed. Clinical observations of correction of the biliary ducts stricture were presented.
Assuntos
Anastomose em-Y de Roux/métodos , Ductos Biliares/cirurgia , Colestase/cirurgia , Ductos Biliares/patologia , Colestase/patologia , Constrição Patológica/patologia , Constrição Patológica/cirurgia , Hepatectomia , Humanos , Jejuno/cirurgia , Fígado/cirurgiaRESUMO
BACKGROUND: There is a great variety of liver parenchyma transection techniques. The objective of this research lies in developing a new method of liver transection and comparing it to the existing ones. METHODS: The original gas jet transection method of biological tissues and the apparatus for its realization "Pneumojet" were developed in our institute. Efficiency comparison of gas jet,water jet, ultrasonic methods of liver transection and clamp crushing technique were carried out on 24 mini-pigs. We did not use Pringle manoeuver. RESULTS: The mean blood loss was the smallest in the group of animals that had a gas jet transection (3.5+-0.15 ml/cm²) and the highest in the clamp crushing technique group (5.5+-0.46ml/cm²). Indicators present statistically authentic differences(p 0.001). The transection speed was the highest in the Clamp crushing technique group (2.9+-0.25 cm²/min) and was credibly higher than in the gas jet (2.4+-0.16 cm²/min), ultrasonic(2.4+-0.13 cm²/min) and water jet (2.5+-0.14 cm²/min) transection groups. Compared to the water jet and ultrasonic methods of liver transection the original method does not have statistically reliable distinctions on the basic indexes of work. CONCLUSIONS: The research conducted proves high efficiency and safety of the gas jet transection method. Gas jet transection,therefore, can be recommended for further improvement and clinical application.