RESUMEN
It was done comparative analysis the results of different treatment options using of laparoscopic treatment of 331 patients with perforated ulcers. It was defined that postoperative complications frequency is increased to 1.6% in case of perforated ulcers suturing with diameter to 0.7 cm. This indication is increased to 7.1% in case of perforated ulcers suturing and plugging by greater omentum with holes diameter to 1.0 cm. The complications are absent in case of perforated ulcer excision with subsequent vagotomy and pyloroplasty.
Asunto(s)
Úlcera Duodenal/complicaciones , Laparoscopía , Úlcera Péptica Perforada , Complicaciones Posoperatorias , Úlcera Gástrica/complicaciones , Técnicas de Sutura , Adulto , Investigación sobre la Eficacia Comparativa , Úlcera Duodenal/mortalidad , Femenino , Humanos , Laparoscopía/efectos adversos , Laparoscopía/clasificación , Laparoscopía/métodos , Laparoscopía/estadística & datos numéricos , Masculino , Úlcera Péptica Perforada/etiología , Úlcera Péptica Perforada/cirugía , Atención Perioperativa , Complicaciones Posoperatorias/clasificación , Complicaciones Posoperatorias/etiología , Píloro/cirugía , Recurrencia , Úlcera Gástrica/mortalidad , Análisis de Supervivencia , Técnicas de Sutura/clasificación , Técnicas de Sutura/estadística & datos numéricos , Resultado del TratamientoRESUMEN
654 patients with ulcerative gastroduodenal bleeding from duodenum were under observation. It was done the meta-analysis of treatment results of 111 patients with hard scarring duodenal ulcers. It was discovered high efficiency of organ-preserving operations such aslaparoscopic vagotomy and proton pump inhibitors in these observations.
Asunto(s)
Cicatriz , Úlcera Duodenal/cirugía , Laparoscopía/métodos , Úlcera Péptica Hemorrágica/cirugía , Complicaciones Posoperatorias , Inhibidores de la Bomba de Protones/uso terapéutico , Vagotomía/métodos , Cicatriz/etiología , Cicatriz/fisiopatología , Cicatriz/cirugía , Terapia Combinada/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tratamientos Conservadores del Órgano/métodos , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/cirugía , Factores de Tiempo , Resultado del Tratamiento , Cicatrización de HeridasRESUMEN
Of 1102 patients with gastrointestinal ulcer bleeding, 143 developed the recurrence during the hospital stay. 9 critical risk factors of the recurrence were distinguished. The optimal treatment strategies of gastrointestinal ulcer bleeding were worked out, which allowed to decrease the mortality rate from 6.4 to 2.4%.
Asunto(s)
Úlcera Duodenal , Hemostasis Quirúrgica/métodos , Hemostáticos/uso terapéutico , Pacientes Internos , Úlcera Péptica Hemorrágica/terapia , Endoscopía Gastrointestinal , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Úlcera Péptica Hemorrágica/diagnóstico , Úlcera Péptica Hemorrágica/epidemiología , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Federación de Rusia/epidemiología , Prevención Secundaria , Tasa de Supervivencia/tendencias , Resultado del TratamientoRESUMEN
The results of the complex prophylaxis and treatment of 33 458 patients with gastric or duodenal ulcer were analyzed. Of the analyzed group, 1002 (2,99%) patients experienced ulcer bleeding. The complex out-patient and stationary treatment of the ulcer disease allowed of bleeding frequency from 8,6 to 2,1%; the decrease of recurrent bleedings from 13,0% to 0; allowed to avoid major surgery (the previous frequency was as high as 14,5%) and decreased lethality rate from 9 to 1%.
Asunto(s)
Úlcera Péptica Hemorrágica/terapia , Úlcera Péptica/complicaciones , Profilaxis Antibiótica , Humanos , Úlcera Péptica/cirugía , Úlcera Péptica/terapia , Úlcera Péptica Hemorrágica/prevención & control , Úlcera Péptica Hemorrágica/cirugíaRESUMEN
The results of investigations the hepato-pancreatico-duodenal organs are analysed. High diagnostic effectiveness of the ultrasound examination in acute cholecystitis (95.5%) is demonstrated. In chronic calculous cholecystitis and in choledocholithiasis the ultrasound examination appeared to be accurate in 97.0% and 84.2% of cases respectively. Retrograde cholangiopancreatography was the most informative method for detection of the concrements in choledochus (effective in 94.4% of the cases). The diagnostic effectiveness of the ultrasound examination and laparoscopy in detection of mechanical jaundice and acute pancreatitis are considered to be equal. Ultrasound examination, retrograde cholangiopancreatography, laparoscopy appeared to be the most accurate and informative methods in diagnosis of the diseases of the organs of hepato-pancreatico-duodenal zone. The role of the X-ray examination decreased. At the same time the significance and reliability of intraoperative cholangiography has been stressed.
Asunto(s)
Enfermedades de las Vías Biliares/diagnóstico , Hepatopatías/diagnóstico , Pancreatitis/diagnóstico , Enfermedad Aguda , Enfermedades de las Vías Biliares/diagnóstico por imagen , Colangiopancreatografia Retrógrada Endoscópica , Colecistitis/diagnóstico , Colecistitis/diagnóstico por imagen , Colelitiasis/diagnóstico , Colelitiasis/diagnóstico por imagen , Colestasis/diagnóstico , Colestasis/diagnóstico por imagen , Diagnóstico Diferencial , Cálculos Biliares/diagnóstico , Cálculos Biliares/diagnóstico por imagen , Humanos , Laparoscopía , Hepatopatías/diagnóstico por imagen , Pancreatitis/diagnóstico por imagen , UltrasonografíaRESUMEN
A comparative analysis of the performance of 51 operations for resection of various parts of the colon, among which were 24 operations conducted by laparoscopy, was undertaken. Certain advantages of laparoscopic resection of the colon, as well as the possibility of lymph dissection, which meets the principles of oncological surgery, were revealed.
Asunto(s)
Enfermedades del Colon/cirugía , Laparoscopía , Enfermedades del Recto/cirugía , Neoplasias del Colon/cirugía , Estudios de Evaluación como Asunto , Humanos , Escisión del Ganglio Linfático , Neoplasias del Recto/cirugíaRESUMEN
In 75 patients with a phasic development of endogenous psychoses the course of the disease before lithium treatment was characterized by statistically valid and successively increasing from attack to attack phenomena such as lengthening of attacks (phases) with a stable duration of the remissions and more frequent double phases. All of these phenomena were regarded by the authors as an unfavourable medicative pathomorphosis. The influence of lithium was expressed in the following symptoms: 1) prevention of hospitalization (56% of the cases); 2) significant shortening of the attacks (phases) and in some of the cases (19%)--their arrest; 3) transition from psychotic syndromes to cyclothymic; 4) a significant drop of double phases and a corresponding rise in the number of "pure" subdepressive states.