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1

Melnichenko, M. G., and V. V. Antonyuk. "Experience of treatment of children, suffering postoperative intraabdominal infiltrates." Klinicheskaia khirurgiia 85, no. 7 (July 26, 2018): 67–70. http://dx.doi.org/10.26779/2522-1396.2018.07.67.

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Objective. Raising of the treatment efficacy for postoperative intraabdominal infiltrates (PII) in children, using the elaborated program of complex treatment. Маterials and methods. Experience of treatment of 150 children, suffering PII, was accumulated. Comparative analysis of efficacy for the elaborated program of complex treatment was conducted. Results. There was established, that the elaborated program of the PII complex stationary treatment guarantees good result in 83.0% of children. Application of intramedia potentiated antibioticotherapy together with endorectal anti-inflammatory therapy in children, suffering PII, caused the shortening of terms for the main clinical signs elimination by 5 - 8 days, аnd for the stationary stay of the patients - by 6 - 8 days. Conclusion. Introduction of the elaborated program of complex stationary treatment have lowered the abscess formation rate for PII in children in 4.4 times, аnd application of primary laparoscopy - in 1.3 – 1.7 times.
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2

Katkasova, Larisa, and Svetlana Kropotova. "Reduction of number of postoperative complications depends on quality of dressing material and wound treatment." Medsestra (Nurse), no. 4 (April 1, 2020): 61–63. http://dx.doi.org/10.33920/med-05-2004-10.

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Operated patients suffering from diabetes are at risk of developing postoperative complications. Modern technologies of postoperative wound treatment and modern dressings allow to avoid complications and speed up the process of postoperative wound healing.
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3

Eschweiler, GW, R. Rosin, P. Thier, and H. Giedke. "Postoperative psychosis in homocystinuria." European Psychiatry 12, no. 2 (1997): 98–101. http://dx.doi.org/10.1016/s0924-9338(97)89648-4.

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SummaryYoung homocystinuria patients suffering from lens dislocation frequently have to undergo eye surgery. We describe a 16-year-old girl with mild mental retardation who became psychotic-delirant immediately after the last of three lentectomia operations performed under general thiopental anaesthesia. Because methionine, homocysteine, its oxidation product homocysteate and cysteine are potent glutamate agonists, the disturbance of the sulphur containing amino acid (SCAA) metabolism in homocystinuria patients may alter the function of cerebral glutamatergic transmission. The chronic and acute neurological and psychiatric symptoms of homocystinuria patients offer a clue to studies of the neurotoxic but also antipsychotic potency of glutamate agonists like the SCAAs in humans.
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4

Erman, Tahsin, Metin Tuna, A. İskender Göçer, Faruk İdan, Erol Akgül, and Suzan Zorludemir. "Postoperative radicular neuroma." Neurosurgical Focus 11, no. 5 (November 2001): 1–3. http://dx.doi.org/10.3171/foc.2001.11.5.9.

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Lumbar discectomy is the most common surgical procedure performed in neurosurgery clinics. Such a large number of procedures underscore not only the prevalence of conditions such as intervertebral disc herniation, but also the strong belief of surgeons that the operation does provide benefits to patients suffering from sciatica. In spite of this belief, sciatic pain may continue after the surgery. The recurrence of sciatic and/or back pain after primary discectomy is called the “failed back surgery syndrome.” The rate of the complications involved in standard lumbar discectomy ranges from 5.4 to 14%. One of the complications of the lumbar disc surgery is nerve root injury. The complication rate of this injury ranges from 0.7 to 2.2%. Postoperative radicular neuroma must be considered in differential diagnosis for the patient who has failed back surgery syndrome. In this study the authors evaluate a patient who had undergone surgery for lumbar disc herniation and suffered intractable pain. A traumatic radicular neuroma is demonstrated and the pertinent literature is presented.
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5

Liesnyi, V. V., and A. S. Liesna. "Peculiarities of complicated course of postoperative period in a woman-patient, suffering an acute cholecystitis." Klinicheskaia khirurgiia 86, no. 10 (October 21, 2019): 71–74. http://dx.doi.org/10.26779/2522-1396.2019.10.71.

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6

Hanssonl, P., A. Ekblom, U. Lindblom, P. Marchettini, and M. Thomsson. "Cutaneous sensory modalities tested in patients suffering from postoperative oro-facial pain." Pain 30 (1987): S267. http://dx.doi.org/10.1016/0304-3959(87)91594-6.

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7

Jadidi, Khosrow, Seyed Aliasghar Mosavi, Farhad Nejat, and Aliagha Alishiri. "Complications of Intrastromal Corneal Ring Implantation (Keraring 355°) using a Femtosecond Laser for Channel Creation." International Journal of Keratoconus and Ectatic Corneal Diseases 3, no. 2 (2014): 53–56. http://dx.doi.org/10.5005/jp-journals-10025-1079.

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ABSTRACT Purpose To report complications after the implantation of Keraring 355° intrastromal corneal ring (ICR; Mediphacos, Belo Horizonte, Brazil) in keratoconic eyes using a Ziemer LDV femto- second laser (Ziemer AG, Switzerland) for channel creation. Materials and methods Five eyes suffering from keratoconus underwent Keraring 355° insertion using Ziemer LDV for corneal pocket creation. Intraoperative and postoperative complications were recorded. Results While intraoperatively there were no complication, postoperatively all cases showed severe side effects. Conclusion In this small case series, intracorneal ring (Keraring 355°) implantation using a femtosecond laser for channel creation was related to a number of significant postoperative problems in all cases. The most common complication was corneal melting (postoperatively). How to cite this article Jadidi K, Mosavi SA, Nejat F, Alishiri A. Complications of Intrastromal Corneal Ring Implantation (Kera- ring 355°) using a Femtosecond Laser for Channel Creation. Int J Kerat Ect Cor Dis 2014;3(2):53-56.
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8

Pulyaeva, I. S., V. A. Prasol, and Yu V. Ivanova. "Prophylaxis of complications in postoperative period in patients, suffering stenosis of carotid arteries." Klinicheskaia khirurgiia 87, no. 1-2 (May 26, 2020): 11–14. http://dx.doi.org/10.26779/2522-1396.2020.1-2.11.

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Objective. To analyze the surgical treatment results in patients, suffering carotid arteries stenosis, using endarterectomy in combination with conservative therapy. Materials and methods. Results of treatment were analyzed in 58 patients, suffering hemodynamically significant stenosis of carotid arteries and/or presence of embologenic pluck, in whom from 2017 to 2019 yrs in V. T. Zaytsev Institute of General and Urgent Surgery NAMS of Ukraine, Kharkov intraoperative supportive conservative therapy, taking into account the risk for development of the cerebral ischemia and the reperfusion syndrome, was conducted. There were 52 (89.7%) men and 6 (10.3%) women. Middle age of the patients operated on have constituted (65 ± 15) yrs. Results. Basing on the literature data analyzed as well as on investigation of the thrombocytes aggregation in patients in perioperative period the algorithm of supportive conservative therapy was elaborated: injection of 5000 IU heparin 5 min before the internal carotid artery clamping under the ICT control; injection of Citicoline 1000 mg 5 min before the internal carotid artery clamping to the patients with neurological deficiency in accordance to the neurological test data and with application of a temporary by-pass. In all the patients in postoperative period the complications were absent. Control of the carotid arteries passability and the ischemia zone state on the 14th day was conducted, the carotid arteries stenosis was not revealed. Nonsignificant complications, such as the stressed hematoma, demanding postoperative wound revision and hemostasis performance, were observed in 4 patients. In 2 patients postoperative period was complicated by the hypoglossal nerve paresis because of its squeezing by hematoma. Conclusion. Citicoline injection before the carotid artery clamping in the carotid endarterectomy with a temporary by-pass permits to lower the risk for development of neurological complications, and while development of postoperative reperfusion syndrome –to reduce its signs.
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9

Opanasenko, M. S., O. V. Tereshkovych, M. Yu Shamray, B. M. Konik, L. I. Levanda, M. I. Kalenichenko, S. M. Shalahai, and O. K. Obremska. "Surgical treatment of pulmonary tuberculosis in children." Klinicheskaia khirurgiia 86, no. 10 (October 21, 2019): 18–23. http://dx.doi.org/10.26779/2522-1396.2019.10.18.

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Objective. To estimate the results of surgical treatment in children, suffering pulmonary tuberculosis. Materials and methods. The results of surgical treatment of 83 children, suffering pulmonary tuberculosis in Jan. 2008 - June 2019 yrs are presented. Immediate and late results of performance of various operative interventions, rate of tuberculosis recurrence and postoperative morbidity are presented. Results. Efficacy of operative treatment (arrest of bacterioleak, improvement of clinical state, closure of the destruction cavity, positive roentgenological dynamics) in terms of observation up to10 yrs was observed in 81 (97.6%) patients. Postoperative complications were developed in 11 (13.3%) patients, they have healed conservatively. Tuberculosis recurrence in postoperative period have occurred in (2.4%) patients. Conclusion. It is possible to enhance the efficacy of treatment in children, suffering pulmonary tuberculosis, using various operative procedures. While selecting the method for surgical treatment of pulmonary tuberculosis in children, the advantage must be given to anatomic resection. Lobectomy constitutes the optimal variant of the operation. During performance of resection in children, in patients with multiresistant tuberculosis or tuberculosis with extended medicinal resistance, for prevention of pulmonary overstretching it is mandatory to apply the methods for the hemithorax volume correction (pneumoperitoneum, phrenicotripsy or one of thoracoplasty procedures).
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10

CIOROIU, S. G. "POSTOPERATIVE RECOVERY OF SPYROID TIBIA FRACTURE." Series IX Sciences of Human Kinetics 13(62), no. 2 (December 2, 2020): 181–86. http://dx.doi.org/10.31926/but.shk.2020.13.62.2.23.

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This paper is a topical issue among people diagnosed with spiral fracture third diaphyseal tibia, because following the survey conducted by the College of Physiokinetotherapists in Romania over 50% of athletes licensed to sports clubs are suffering from pathologies in the lower limbs, 20% of these at the tibia. In this paper are found some methods and ways of early and methodical application of kintetotherapy means and processes through which to restore as much as possible the functionality or loss of the patient diagnosed with spiral fracture middle third diaphyseal tibia. This paper aims to demonstrate that the proposed physiotherapy model helps to improve the functional capacity and quality of life in people with spiral fracture average third diaphyseal tibia.
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11

王, 红玲. "Clinical Nursing Analysis of 70 Patients Suffering Postoperative Pulmonary Infection after Liver Resection." Nursing Science 06, no. 03 (2017): 95–100. http://dx.doi.org/10.12677/ns.2017.63019.

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12

Jin, Tao, Guo-Wei Yu, and Liang Ma. "Secondary Rupture of Aorta following the Surgical Management of Aortoesophageal Fistula." Asian Cardiovascular and Thoracic Annals 13, no. 4 (December 2005): 374–76. http://dx.doi.org/10.1177/021849230501300418.

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A patient suffering from an aortoesophageal fistula (AEF) caused by a fish bone, was treated in our institute in 2000. The operation was successful and the patient had an uneventful early postoperative course. However, the patient died of frank hematemesis on the 6th postoperative day due to secondary rupture of the aorta. The lessons learnt and surgical efforts to manage AEF caused by an esophageal foreign body are discussed.
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13

Caelers, Inge J. M. H., Kim Rijkers, Sander M. J. van Kuijk, Henk van Santbrink, Rob A. de Bie, and Wouter L. W. van Hemert. "Neurological events due to pedicle screw malpositioning with lateral fluoroscopy–guided pedicle screw insertion." Journal of Neurosurgery: Spine 33, no. 6 (December 2020): 806–11. http://dx.doi.org/10.3171/2020.5.spine20550.

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OBJECTIVEThe risk of novel postoperative neurological events due to pedicle screw malpositioning in lumbar fusion surgery is minimized by using one of the several image-guided techniques for pedicle screw insertion. These techniques for guided screw insertion range from intraoperative fluoroscopy to intraoperative navigation. A practical technique consists of anatomical identification of the screw entry point followed by lateral fluoroscopy used for guidance during insertion of the screw. This technique is available in most clinics and is less expensive than intraoperative navigation. However, the safety of lateral fluoroscopy–guided pedicle screw placement with regard to novel postoperative neurological events due to screw malposition has been addressed only rarely in the literature. In this study the authors aimed to determine the rate of novel postoperative neurological events due to intraoperative and postoperatively established screw malpositioning during lateral fluoroscopy–assisted screw insertion.METHODSIncluded patients underwent lateral fluoroscopy–assisted lumbosacral screw insertion between January 2012 and August 2017. The occurrence of novel postoperative neurological events was analyzed from patient files. In case of an event, surgical reports were screened for the occurrence of intraoperative screw malposition. Furthermore, postoperative CT scans were analyzed to identify and describe possible screw malposition.RESULTSIn total, 246 patients with 1079 screws were included. Novel postoperative neurological events were present in 36 patients (14.6%). In 8 of these 36 patients (3.25% of the total study population), the neurological events could be directly attributed to screw malposition. Screw malpositioning was caused either by problematic screw insertion with immediate screw correction (4 patients) or by malpositioned screws for which the malposition was established postoperatively using CT scans (4 patients). Three patients with screw malposition underwent revision surgery without subsequent symptom relief.CONCLUSIONSLateral fluoroscopy–assisted lumbosacral screw placement results in low rates of novel postoperative neurological events caused by screw malposition. In the majority of patients suffering from novel postoperative neurological events, these events could not be attributed to screw malpositioning, but rather were due to postoperative neurapraxia of peripheral nerves, neuropathy, or intraoperative traction of nerve roots.
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14

Fredriksen, TA, R. Salvesen, A. Stolt-Nielsen, and O. Sjaastad. "Cervicogenic Headache: Long-Term Postoperative Follow-Up." Cephalalgia 19, no. 10 (December 1999): 897–900. http://dx.doi.org/10.1046/j.1468-2982.1999.1910897.x.

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The patient, a 50-year old female had been suffering from right-sided head- and neck pain since she was 31 years of age. It started in connection with an indirect neck trauma. Analgesics were of little or no avail and operative procedures, including liberation of the greater occipital nerve (GON) ( n = 2) and decompression of the C2 ganglion/root, had only a transitory effect. At 42, a magnetic resonance scan of the cervical spine demonstrated a degenerated disk C5–C6, with encroachment on the foramina and the cord. At 42 years of age, a stabilization operation at C5–C6 (Robinson-Smith) alleviated her discomfort—only some motor complaints in the ipsilateral upper extremity remaining and only in the first 12–18 months.
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15

Samalavicius, Narimantas Evaldas, Vitalija Nutautiene, Lina Butenaite, Rytis Markelis, and Audrius Dulskas. "Adynamic Graciloplasty for Faecal Incontinence in an Adult after Anal Atresia Correction in Infancy – a Case Report." Lietuvos chirurgija 19, no. 3-4 (December 29, 2020): 140–44. http://dx.doi.org/10.15388/lietchirur.2020.19.33.

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Background. Here we present a case of female patient suffering from bowel incontinence. Case report. The patient underwent unstimulated graciloplasty. Postoperative period was uneventful. After 4 weeks, a course of low frequency electric external stimulation in the area around the neurovascular bundle in the thigh was performed. Patient was evaluated 3 months postoperatively. On inspection, her anus was closed at rest. She stated moderate improvement in her continence and quality of life, her Wexner score was 10 and FISI score was 32 (prior surgery 19 and 44 accordingly). Conclusion. Adynamic graciloplasty seems to be a reasonable method of choice for faecal incontinence.
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16

Kotenko, O. G., V. A. Kondratiuk, O. O. Korshak, D. O. Fedorov, O. V. Hrynenko, A. V. Gusev, O. O. Popov, and M. S. Grygorian. "Late results of embolization of a portal hepatic vein branches in patients, suffering extended hepatic tumors." Klinicheskaia khirurgiia 85, no. 6 (July 26, 2018): 18–20. http://dx.doi.org/10.26779/2522-1396.2018.06.18.

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Objective. To analyze late results of preoperative embolization of the portal hepatic vein branches (EPHVB) in patients, suffering extended hepatic tumors and extremely border-like small calculated residual hepatic volume(CRHV). Маterials and methods. From 2004 to 2014 yr the extended hepatic resection (HER) was performed in 285 patients, to whom EPHVB was applied (the main group), аnd in 353 patients as well, but without endovascular preparation (control group). In both groups dynamics of laboratory indices, structure of complications and lethality, late survival were studied. Results. In the main group a trustworthily lower rate of an acute hepatic insufficiency and connected with a lower postoperative lethality - accordingly 2.3 and 4.6%, comparing with a control group - 9.3 and 8.8%, were suggested. The laboratory data dynamics have witnessed a lesser intensiveness of postoperative hepatocytolysis and lesser degree of the hepatic synthetic function lowering in the main group, what have confirmed a better functional adaptation of hepatic residual in patients, to whom preoperative EPHVB was applied. Conclusion. Preoperative EPHVB permits to lower the postoperative complications and lethality rate in patients, suffering hepatic tumors, due to better functional adaptation of hepatic residual.
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Mehdorn, Anne-Sophie, Thorben Möller, Frederike Franke, Florian Richter, Jan-Niclas Kersebaum, Thomas Becker, and Jan-Hendrik Egberts. "Long-Term, Health-Related Quality of Life after Open and Robot-Assisted Ivor-Lewis Procedures—A Propensity Score-Matched Study." Journal of Clinical Medicine 9, no. 11 (October 30, 2020): 3513. http://dx.doi.org/10.3390/jcm9113513.

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Esophagectomies are among the most invasive surgical procedures that highly influence health-related quality of life (HRQoL). Recent improvements have helped to achieve longer survival. Therefore, long-term postoperative HRQoL needs to be emphasized in addition to classic criterions like morbidity and mortality. We aimed to compare short and long-term HRQoL after open transthoracic esophagectomies (OTEs) and robotic-assisted minimally invasive esophagectomies (RAMIEs) in patients suffering from esophageal adenocarcinoma. Prospectively collected HRQoL-data (from the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire-C30 (EORTC QLQ-C30)) were correlated with clinical courses. Only patients suffering from minor postoperative complications (Clavien–Dindo Classification of < 2) after R0 Ivor-Lewis-procedures were included. Age, sex, body mass index (BMI), American Society of Anesthesiologists physical status-score (ASA-score), tumor stage, and perioperative therapy were used for propensity score matching (PSM). Twelve RAMIE and 29 OTE patients met the inclusion criteria. RAMIE patients reported significantly better emotional and social function while suffering from significantly less pain and less physical impairment four months after surgery. The long-term follow up confirmed the results. Long-term postoperative HRQoL and self-perception partly exceeded the levels of the healthy reference population. Minor operative trauma by robotic approaches resulted in significantly reduced physical impairments while improving HRQoL and self-perception, especially in the long-term. However, further long-term results are warranted to confirm this positive trend.
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18

Roehrborn, Friederike, Daniel-Sebastian Dohle, Indra N. Waack, Konstantinos Tsagakis, Heinz Jakob, and Johanna K. Teloh. "Postoperative Compensatory Ammonium Excretion Subsequent to Systemic Acidosis in Cardiac Patients." BioMed Research International 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/5383574.

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Background. Postoperative acid-base imbalances, usually acidosis, frequently occur after cardiac surgery. In most cases, the human body, not suffering from any severe preexisting illnesses regarding lung, liver, and kidney, is capable of transient compensation and final correction. The aim of this study was to correlate the appearance of postoperatively occurring acidosis with renal ammonium excretion.Materials and Methods. Between 07/2014 and 10/2014, a total of 25 consecutive patients scheduled for elective isolated coronary artery bypass grafting with cardiopulmonary bypass were enrolled in this prospective observational study. During the operative procedure and the first two postoperative days, blood gas analyses were carried out and urine samples collected. Urine samples were analyzed for the absolute amount of ammonium.Results. Of all patients, thirteen patients developed acidosis as an initial disturbance in the postoperative period: five of respiratory and eight of metabolic origin. Four patients with respiratory acidosis but none of those with metabolic acidosis subsequently developed a base excess > +2 mEq/L.Conclusion. Ammonium excretion correlated with the increase in base excess. The acidosis origin seems to have a large influence on renal compensation in terms of ammonium excretion and the possibility of an overcorrection.
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19

Dzygal, О. F., and І. М. Deykalo. "Miniinvasive vascular interventions as an alternative surgical method for treatment of the patients, suffering hepatic cirrhosis and portal hypertension." Klinicheskaia khirurgiia 85, no. 6 (July 26, 2018): 24–26. http://dx.doi.org/10.26779/2522-1396.2018.06.24.

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Objective. Determination of efficacy of miniinvasive surgical treatment of portal hypertension (PG) in patients, suffering hepatic cirrhosis (HC) in immediate and late postoperative periods. Маterials and methods. Results of surgical treatment of 200 patients, suffering HC, were analyzed retrospectively: in 102 of them (Group I) HC and gastro-esophageal varices were diagnosed, in 98 (Group II) - HC with PG. Results. There was established, that miniinvasive surgical treatment in volume of the gastric veins embolization, аs well as operations of selective and partial portocaval shunting with the objective to correct a portal hypertension in patients, suffering HC, constitutes effective alternative method of surgical treatment. Conclusion. The decompression operations for portal system in patients with HC prevent the esophago-gastric hemorrhage occurrence in late period of follow-up and guarantee good survival of the patients, suffering compensated and subcompensated hepatic function.
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20

Hryhorov, S. M., L. R. Krynychko, S. O. Stavytskyi, I. V. Boiko, and V. P. Trufanova. "Аnalysis of dynamics of clinical changes in cicatricially-changed tissues after surgical treatment of branchiogenic cysts in chronological aspect." Klinicheskaia khirurgiia 85, no. 6 (July 26, 2018): 33–35. http://dx.doi.org/10.26779/2522-1396.2018.06.33.

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Objective. Studying of processes of the cicatrices development after surgical treatment of the neck cysts of embryonal origin in chronological aspect. Маterials and methods. Experience of surgical treatment of 60 patients, suffering branchiogenic cysts, was analyzed. Retrospective analysis of the treatment results, including those performed in accordance to own elaborated procedures, was conducted. Results. Clinical changes in cicatricially-changed tissues depends upon the kind of intra- and postoperative prophylaxis of the cutaneous pathological cicatrices in surgical treatment of the neck cysts of embryological origin. Intraoperative application of the fibrin clot, enhanced by thrombocytes (PRF - clot), аnd postoperatively - of biocerrulin preparation, promotes a mostly expressed lowering of the course intensity for the free-radical oxidation in cicatricially-changed tissues of postoperative wound and prognosis for the pathological cutaneous cicatrices development, comparing with solely application of PRF-clot, аnd with operative intervention in accordance to classical method as well. Conclusion. Application of PRF-clot and biocerullin preparation improves significantly the healing processes in postoperative wound after surgical treatment of the neck cysts of embryonal origin, and this lead to lowering of possibility for development of pathological cutaneous cicatrices.
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Mathuram Thiyagarajan, U., A. Bagul, and M. L. Nicholson. "Pain Management in Laparoscopic Donor Nephrectomy: A Review." Pain Research and Treatment 2012 (October 23, 2012): 1–6. http://dx.doi.org/10.1155/2012/201852.

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The management of postoperative pain is a key to patient early recovery, in particular, where the surgery was performed to benefit another human being. In recent years it has been recognized that multimodal analgesic methods are superior for postoperative pain relief. It is also imperative to remember that inadequately managed acute postoperative pain opens the doorway to possible suffering from chronic postoperative pain later. Although the laparoscopic donor nephrectomy has reduced the disincentives associated with open surgery, still significant percentage of donors suffers from postoperative pain. In the UK, patient-controlled analgesic system (PCAS) using morphine for postoperative pain relief is being used in majority of the transplant centres. Though opioids provide good analgesia, they are far from being an ideal analgesic due to their adverse effects. This paper pragmatically looks in depth on different modalities of pain management in patients undergoing laparoscopic live donor nephrectomy.
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P., Arunraj, Viswanathan M. S., Anbazhagan R., and Kulwant Singh. "A prospective interventional study of postoperative pain, healing rates and incontinence rates following ligation of intersphincter fistula tract procedure." International Surgery Journal 5, no. 12 (November 28, 2018): 3976. http://dx.doi.org/10.18203/2349-2902.isj20185029.

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Background: Fistula in ano is one of the oldest ailments known to us, troublesome both to the patient and also challenging to the treating surgeon. The treatment of fistula in ano has evolved so much, to reduce complications and to improve patient’s compliance. This study was conducted to compare the age old method of open fistulectomy to that of recently developed technique of ligation of intersphincter fistula tract (LIFT), in patients suffering from low fistula in ano.Methods: A totally of 80 patients, suffering from low anal fistula was divided randomly into two groups. Group A: undergoing LIFT procedure and Group B: undergoing open fistulectomy procedure .The two groups were compared in the postoperative period for wound healing, postoperative pain (by visual analog scale) and fecal incontinence (by Wexner incontinence score).Results: Group A patients who underwent LIFT at the end of 3rd postoperative week had a pain score of 0.43 when compared to group B patients (1.33) who underwent fistulectomy. Group A patients had 100% continence preservation, whereas a 17.5% of moderate incontinence was documented in Group B patients. About 97.5% of patients under Group A had complete wound healing by the 3rd postoperative week, as compared to group B patients, where100% complete wound healing was noted at 6 weeks, postoperatively.Conclusions: It was found that LIFT was a promising procedure in reducing the postoperative pain significantly, with better wound healing rates. It was effective in maintaining good sphincter function, thereby providing better faecal continence following surgery, in low anal fistula.
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Penttilä, Matti A., Markus E. P. Rautiainen, Jussi E. Laranne, Juhani S. Pukander, and Pekka H. Karma. "Endoscopic and Caldwell-Luc Approach in Chronic Maxillary Sinusitis: Intraoperative and Early Postoperative Results." American Journal of Rhinology 7, no. 1 (January 1993): 5–9. http://dx.doi.org/10.2500/105065893781976573.

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Endoscopic and Caldwell-Luc surgical approaches in 150 consecutive patients (aged 14–88 years) suffering from chronic maxillary sinusitis were compared. The patients were randomly subjected either to functional endoscopic sinus surgery (FES) with middle meatal antrostomy (n = 75) or to the Caldwell-Luc (C-L) operation (n = 75). In the FES group intraoperative bleeding was significantly lower than in the C-L group. There were no major complications during or after surgery in either group. Moderate or marked postoperative facial swelling and fever were more common in the C-L patients and also the need of analgetics was more frequent among them. One month postoperatively the antral irrigation findings did not differ between the groups, but C-L operated patients expressed more frequently distinct complaints than FES patients (P < .001).
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Stavroula, Georganta, and Gkeka Perikleia. "Correlation of Possible Kidney Injury in the Immediate Postoperative Period of Patients Having Undergone a Cardiac Surgery." International Journal of Knowledge Society Research 5, no. 1 (January 2014): 40–59. http://dx.doi.org/10.4018/ijksr.2014010104.

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Cardiac surgeries nowadays are performing in a routine basis and most of the time with a great percentage of success. However, there are cases in operations that may appear postoperative complications such as renal dysfunction, which can endanger patient's life. Preexisting isolated systolic hypertension and wide pulse pressure increase the risk of postoperative renal dysfunction in the cardiac surgery population. New data suggest that BP lability (i.e., BP excursions outside an acceptable physiologic range) during cardiac surgery may also be an important predictor of subsequent renal dysfunction. Alongside, various clinic parameters for example, the time spent in the unit, other postoperative complications etc. related to kidney injury have negative effects for the progress of patients' suffering in the unit. The purpose of this study is the correlation between the appearance of kidney injury in patients undergoing a cardiac surgery the immediate postoperative period and other preoperative, intraoperative and postoperative parameters.
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Barbara, Ramez, and Adel Barbara. "Intacs Intracorneal Ring Segments Complications in Patients Suffering from Keratoconus." International Journal of Keratoconus and Ectatic Corneal Diseases 2, no. 3 (2013): 121–28. http://dx.doi.org/10.5005/jp-journals-10025-1064.

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ABSTRACT Intacs, intrastromal corneal rings are widely used to reduce myopia, astigmatism, keratometry readings and high order aberrations in patients suffering from keratoconus, almost 15 years have passed from the first procedure which was performed in the eye of a patient with unsatisfactory visual acuity and contact lenses intolerance. Many publications including book chapters, retrospective studies, case reports and literatures reviews have been published on this issue. In this review, we are reporting on the complications of Intacs implanted in keratoconic eyes, we are reporting on intraoperative and postoperative complications. The review although focusing on complications of the does not contradict the positive results of the procedure on the quality of life of the patients suffering from keratoconus and the its safety. How to cite this article Barbara A, Barbara R. Intacs Intracorneal Ring Segments Complications in Patients Suffering from Keratoconus. J Kerat Ect Cor Dis 2013;2(3):121-128.
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Schneider, Matthias, Muriel Heimann, Christina Schaub, Lars Eichhorn, Anna-Laura Potthoff, Frank A. Giordano, Erdem Güresir, et al. "Comorbidity Burden and Presence of Multiple Intracranial Lesions Are Associated with Adverse Events after Surgical Treatment of Patients with Brain Metastases." Cancers 12, no. 11 (October 31, 2020): 3209. http://dx.doi.org/10.3390/cancers12113209.

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Surgical resection is a key treatment modality for brain metastasis (BM). However, peri- and postoperative adverse events (PAEs) might be associated with a detrimental impact on postoperative outcome. We retrospectively analyzed our institutional database with regard to patient safety indicators (PSIs), hospital-acquired conditions (HACs) and specific cranial surgery-related complications (CSCs) as high-quality metric profiles for PAEs in patients who had undergone surgery for BM in our department between 2013 and 2018. The comorbidity burden was assessed by means of the Charlson comorbidity index (CCI). A multivariate analysis was performed to identify independent predictors for the development of PAEs after surgical resection of BM. In total, 33 patients (8.5%) suffered from PAEs after surgery for BM. Of those, 17 PSI, 5 HAC and 11 CSC events were identified. Multiple brain metastases (p = 0.02) and a higher comorbidity burden (CCI > 10; p = 0.003) were associated with PAEs. In-hospital mortality of patients suffering from a PAE was significantly higher than that of patients without a PAE (24% vs. 0.6%; p < 0.0001). Awareness of risk factors for postoperative complications enables future prevention and optimal response, particularly in vulnerable oncological patients. The present study identified the presence of multiple brain metastases and increased comorbidity burden associated with PAEs in patients suffering from BM.
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Wooldridge, Sarah, and Jonathan Branney. "Congruence between nurses' and patients' assessment of postoperative pain: a literature review." British Journal of Nursing 29, no. 4 (February 27, 2020): 212–20. http://dx.doi.org/10.12968/bjon.2020.29.4.212.

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Postoperative pain remains poorly managed for many patients. Effective pain management begins with accurate pain assessment, with patient self-reporting considered the most accurate measure of pain. This literature review aimed to identify how congruent nurses' assessments of pain were with patients' self-reporting. A search identified six observational studies and one quasi-experimental study that met the inclusion criteria. The findings from these studies were summarised under two themes: nurses' underestimation of patients' pain and nurses' knowledge and understanding of pain assessment. Some nurses' pain management knowledge was deemed inadequate, with evidence of negative attitudes towards managing pain in certain groups of patients. Educational interventions have so far had limited impact on correcting the ethical and professional problem of inadequate pain relief in many patients postoperatively. Randomised controlled trials are required to identify effective education interventions that can contribute to ending this avoidable suffering.
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Gasimova, K. F. "Malabsorption syndrome and changes in concentration of endogenous antimicrobial peptids and cytokines in hepatic echinococcosis." Klinicheskaia khirurgiia 87, no. 11-12 (December 28, 2020): 34–39. http://dx.doi.org/10.26779/2522-1396.2020.11-12.34.

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Objective. To study the levels of some cytokines (IL-6, TNF-α) and endogenous antimicrobial peptides (zonulin, calprotectin and lactoferrin) in patients, suffering hepatic echinococcosis, and to follow-up their changes in dynamics of postoperative treatment. Materials and methods. There were examined 29 patients, ageing 35 - 65 yrs old, operated for hepatic echinococcosis. In accordance to scheme of the treatment conducted after laparoscopic echinococcectomy the patients were distributed into two Groups: the first one - 13 patients, who obtained the standard treatment, and the second - 16 patients, to whom, besides the standard treatment, preparation for immunocorrection was prescribed. Antibodies towards the echinococcus IgG, concentration of endogenous antimicrobal peptides and cytokines in the blood serum were studied, using immuno-enzymal analysis in dynamics. Results. There was established, that in preoperative period in patients, suffering hepatic echinococcosis, high levels of the studied inflammation mediators are revealed, comparing with the indices in healthy persons. Conduction of postoperative treatment promotes a staged lowering of the antimicrobal peptides and cytokines concentrations. Standard treatment is less effective in lowering of the inflammation mediators levels, than combination of conventional treatment with immunocorrection. Conclusion. In the patients, suffering hepatic echinococcosis, the levels of cytokines and antimicrobal peptides are raised. Combined treatment with immunocorrection after echinococcusectomy leads to significant lowering of the inflammation mediators levels.
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Milićević, Ivana, Slobodan Janković, and Iva Grubor. "Delirium Risk Factors in Elderly Patients Suffering from Femoral Neck Fractures." Acta Facultatis Medicae Naissensis 35, no. 1 (March 1, 2018): 49–57. http://dx.doi.org/10.2478/afmnai-2018-0005.

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Summary Delirium is a common complication in hospitalized elderly patients suffering from hip fractures. Considering the growing incidence of delirium, understanding the risk factors for this condition is of great importance. The preoperative prevalence of delirium is approximately 4.4–35.6%, while postoperative prevalence is even higher - 4–53.3%. Various studies have shown the multifactorial etiology of delirium arising from a combination of predisposing and precipitating factors. The aim of this study was to explore these factors, which can contribute to delirium in patients with femoral neck fractures. This case control study included 62 patients diagnosed with femoral neck fractures, with 31 cases and 31 controls. Results have shown that the use of sedatives, especially benzodiazepines, and smoking increase the risk of delirium by five and sixteen times, respectively.
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Ivanov, Dejan, Sinisa Babovic, Dora Selesi, Mirjana Ivanov, and Radovan Cvijanovic. "Harmonic scalpel® hemorrhoidectomy: A painless procedure?" Medical review 60, no. 9-10 (2007): 421–26. http://dx.doi.org/10.2298/mpns0710421i.

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Since the surgical treatment of hemorrhoidal disease has been characterized by intense postoperative pain, recent studies have tried to modify the standard Milligan-Morgans technique. The up-to-date literature, in the experience of authors, has confirmed that the new method of Harmonic Scalpel? hemorrhoidectomy reduces postoperative pain. The aim of our study was to statistically evaluate, based on our experience, the efficacy of this surgical approach in terms of reducing postoperative pain and establishing a stable hemostasis. Seventy-seven (77) patients suffering from hemorrhoid disease, stage III and IV, underwent surgery in our clinic during the last five years. The postoperative pain was determined using the visual analog scale on the 1st, 2nd and 7th postoperative days. Patients were divided into two groups in regard to the surgical procedure applied. The data were statistically processed using the Statistica 7.0 software. We concluded that Harmonic Scalpel? hemorrhoidectomy, due to less thermal damage, statistically significantly reduced postoperative pain with better hemostasis, compared with Milligan-Morgan's method of treating hemorrhoidal disease. .
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Jorgensen, Lars, Michael Crawford, and Peer Wille-Jørgensen. "Asymptomatic postoperative deep vein thrombosis and the development of postthrombotic syndrome." Thrombosis and Haemostasis 93, no. 02 (2005): 236–41. http://dx.doi.org/10.1160/th04-09-0570.

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SummaryPerioperative antithrombotic clinical regimens have reduced the incidence of postoperative deep venous thrombosis (DVT). Long-term effects of asymptomatic postoperative DVT have been studied in a number of clinical trials and the present review describes the clinical significance of asymptomatic postoperative DVT regarding the possible development of postthrombotic syndrome (PTS).We performed a systematic review of reference databases focusing upon studies including patients suspected of having postoperative DVT and reporting subsequent cases of PTS at the end of a well-defined follow-up period. The included studies were stratified according to type of screening method and applied statistics. Over-all evaluation included metaanalyses based upon the Cochrane software package. The overall relative risk of developing PTS was 1.58 (95% confidence intervals: 1.24 – 2.02) in patients suffering from asymptomatic DVT as compared to patients without DVT ( p < 0.0005).In conclusion, asymptomatic postoperative DVT is associated with an increased risk of late development of PTS. The finding emphasizes that postoperative DVT, diagnosed by means of well-defined objective measures, remains the correct scientific endpoint in trials evaluating the efficacy of preoperative antithrombotic treatment regimens.
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Almosawi, Salam Abd El-Ameer, and Ahmed Turki Obaid. "The Role of CorrugateDrain In Decreasing Postoperative Complication Of Penile Fracture Surgery." Journal of University of Babylon 26, no. 2 (December 21, 2017): 220–32. http://dx.doi.org/10.29196/jub.v26i2.395.

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Objective:tostudy the role of corrugate drain (which is used by some urosurgeons) followed surgical correction of fractured penis in decreasing post operative complications such as penile swelling, pain and curvature. Patient and method:comparative cross sectional study was carried out at the urological department of Al-Hilla teaching hospital from March 2008 to April 2011. Twenty male patients (age between 21-40 years) admitted to the urological department in Al-Hila teaching hospital suffering from penile fracture from March 2008 to April 2011 were included in this study. Immediate surgical repair done to all those patients ,corrugate drain put post operatively for 10 patients while the remaining 10 patients without drains. All patients are fallowed for at least 3 months regarding postoperative penile swelling, deformity, pain and sexual function. Result:regarding age distribution of patients suffering from fracture penis, from twenty patients included in this study 11 patients their agerange from (20-30)years, 7 patients their age group range from (31-45)years and only 2 patients their age range from (46-60)years. Fifteen patients are married and only 5 patients are unmarried. No one develop postoperative penile swelling in patients with corrugate drain and only one patient develops swelling in patients without corrugate drain. Regarding postoperative pain, in patients surgically corrected with drain, 6 patients develop pain and only 2 patients surgically corrected without drain develops pain. Conclusion:No beneficial effect of corrugate drain in decreasing postoperative penile swelling or curvature and on the other hand it increase post operative penile pain.
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Каshtalyan, М. А., А. E. Тkachenko, О. А. Кvasnevskiy, and А. О. Коlotvin. "Prognostication of complications in patients with diseases of gallbladder after laparoscopic cholecystectomy." Klinicheskaia khirurgiia 87, no. 7-8 (September 30, 2020): 10–14. http://dx.doi.org/10.26779/2522-1396.2020.7-8.10.

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Objective. To elaborate a prognostic classification of possibilities for occurrence of іntra- and postoperative complications, basing on determination of a premorbid state and the risk factors, concerning operative intervention in patients, suffering surgical diseases of gallbladder. Маterials and methods. Retrospective analysis of treatment of 911 patients, suffering cholelithiasis disease, оperated by the laparoscopic cholecystectomy procedure, was conducted, and factors of possibility of occurrence for іntra- and postoperative complications were determined with further establishment of their criteria. Results. The factors of risk for the complications occurrence after laparoscopic cholecystectomy in patients with diseases of gallbladder (n=911) were investigated. Prognostication pattern of the complications occurrence was built, taking into account the results of correlation-regression analysis conducted, and on its base the clinic-epidemiological groups of the complications risk were formatted with determination of their frequency of confidence intervals. Conclusion. Theoretical substantiation and scientific-practical decision of the task was presented, concerning raising of efficacy of miniinvasive operative interventions in patients with diseases of gallbladder, using elaborated methods of prophylaxis and surgical treatment of complications.
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Меlnyk, V. М., Ye М. Shepetko, І. І. Polovnikov, and О. І. Poyda. "Іnnovation technologies in the gut organs surgery." Klinicheskaia khirurgiia 85, no. 6 (July 26, 2018): 5–9. http://dx.doi.org/10.26779/2522-1396.2018.06.05.

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Objective. To improve the surgical treatment results in patients, suffering the gut organs diseases, due to its sophistication and elaboration of modern innovation technologies. Маterials and methods. In the work the author’s concept and results of the modern innovative technologies while performing surgery on the gut organs for ulcerative hemorrhage, complicated postbulbar, parapapillary ulcers, gastric cancer and polyps, colorectal cancer, ulcerative colitis, Crohn’s disease of large bowel, familial adenomatous polyposis are adduced. Endoscopic operations, methods of atraumatic dissection of tissues, new restoration and reconstructive-restorative operations, using modern staplers for anastomoses formation, laparoscopic operations were applied. The innovative surgical technologies were applied in 2428 patients. Results. Using methods of endoscopic hemostasis a definitive arrest of ulcerative hemorrhage was achieved in 91.1% patients. Еndoscopic polypectomy for the large bowel polyps of significant size and for «spreading» polyps were performed in 90.5% patients. Occurrence of postoperative hemorrhage was reduced to 0.74%, а large bowel wall perforation was not observed. In patients with complicated postbulbar and parapapillary ulcers the postoperative morbidity was reduced tо 24.7%, postoperative lethality - tо 7.6%. More favorable functional results were obtained after gastroplastic operations. Postoperative complications have occurred in 15.8% patients, 1.7% patients died. Conclusion. Modern innovation surgical technologies, including endoscopic, staplers for anastomoses formation, methods of atraumatic dissection of tissues, reconstructive-restorative, laparoscopic surgical interventions are sufficiently effective in the treatment of patients, suffering diseases of the gut organs. Application of modern innovation technologies in the gut organs surgery makes possible to eliminate pathological process, its complications, to reduce significantly the surgical interventions traumaticity, time of their performance, quantity of postoperative complications, lethality, and to improve functional results and quality of life in the patients operated.
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Malynovskyi, A. V., V. V. Grubnik, and I. Z. Gladchuk. "Cytoreductive surgery and hyperthermal intraperitoneal chemoperfusion in colorectal cancer and cancer of ovaries: our experience and perspectives of a new method." Klinicheskaia khirurgiia 87, no. 9-10 (October 29, 2020): 54–58. http://dx.doi.org/10.26779/2522-1396.2020.9-10.54.

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Objective. Studying of results of the cytoreductive operations and hyperthermal intraperitoneal chemoperfusion application for treatment of canceromatosis in colorectal cancer and ovarian cancer. Materials and methods. In 10 patients, suffering colorectal cancer (6 men and 4 women) were performed peritonectomy, diathermo-ablation of implants, made from visceral peritoneum. Average value of the peritoneal canceromatosis index have constituted 18 (14 - 21). In 11 patients, suffering ovarian cancer, panhisterectomy, peritonectomy, omentectomy, and ablation of the visceral peritoneum implants was conducted. Median value of the peritoneal canceromatosis index was 16 (12 - 20). For hyperthermal intraperitoneal chemoperfusion oxaliplatin was used. Results. Complete and optimal cytoreduction (degree CC0-CC1 in accordance to classification of P. H. Sugarbaker) was achieved in 5 patients, while suboptimal one (degree CC2) - in 10, and nonoptimal (degree CC3) cytoreduction - in 6 patients. Intraoperative complications were absent. Postoperative complications have occurred in 5 (23.8%) patients: the wound infection, persisting ileus, episode of partial ileus. Of 10 patients, suffering colorectal cancer, 5 died in 9-12 mo. One-year barrier have had survived 45.5% patients. Of 11 women-patients, suffering ovarian cancer, 7 died in 6-24 mo. One-year barrier have had survived 36.4% women-patients. Conclusion. In patients, suffering colorectal cancer, the survival median was 12 mo, while in the women-patients, suffering ovarian cancer - 18 mo. Cytoreductive operations and hyperthermal intraperitoneal chemoperfusion constitute perspective method for the survival enhancement in patients, suffering canceromatosis, but only if their selection was organized.
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Wünschel, Markus, Nikolaus Wülker, and Christian Walter. "Surgical Treatment of a Young Patient with Bilaterally Destroyed First Metatarsophalangeal Joints Suffering from Gout." Journal of the American Podiatric Medical Association 102, no. 4 (July 1, 2012): 334–37. http://dx.doi.org/10.7547/1020334.

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The authors present an unusual case of untreated gout leading to major bony destructions in both metatarsophalangeal joints, leading to joints of enormous dimensions. If untreated, gout can cause disabling destructions with direct influence on both private and working life, even in young patients. In potentially noncompliant patients, simple surgical procedures and postoperative regimes are valuable treatment options resulting in acceptable clinical results. (J Am Podiatr Med Assoc 102(4): 334–337, 2012)
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Vynnychenko, О. V. "Complex estimation of the operation risk in patients, suffering morbid obesity." Klinicheskaia khirurgiia 86, no. 5 (May 5, 2019): 72–74. http://dx.doi.org/10.26779/2522-1396.2019.05.72.

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Objective. To compare theoretically obtained and real indices of the occurrence rate for postoperative complications and lethality with further determination of acceptability of the indices used in practical work. Маterials and methods. The investigation was conducted in 90 patients, suffering morbid obesity, to whom the gastric sleeve resection was done in the Institute (Group А) and biliopancreatic shunting (Group B) in 2014 - 2018 yrs. For every group of patients the P-POSSUM indices were calculated. The calculation and real indices of morbidity and lethality were compared. Results. There was no lethality in both groups. The calculated rate for the complications and lethality occurrence in patients of Group B have constituted (94.7 ± 15.5) and (2.6 ± 4.4)%, accordingly, and in patients of the Group А - (18.6 ± 6.2) and (0.7 ± 0.3)% accordingly. Levine’s test was applied for estimation of the indices used acceptability in practical work. Conclusion. P-POSSUM scale has high specificity for determination of the operation risk in patients, suffering morbid obesity.
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Hameury, Frédéric, Perrine Marec-Berard, Mathilde Eymery, Marc H. W. Wijnen, Niels van der Kaaij, Pierre-Yves Mure, François Tronc, et al. "Pleuropneumonectomy as Salvage Therapy in Children Suffering from Primary or Metastatic Sarcomas with Pleural Localizations." Cancers 13, no. 15 (July 21, 2021): 3655. http://dx.doi.org/10.3390/cancers13153655.

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Pediatric sarcoma patients with pleuropulmonary lesions have a dismal prognosis because the impossibility to obtain local control. The aim of this study was to determine if pleuropneumonectomy (PP) could be a therapeutic option. We retrospectively reviewed nine patients who underwent salvage PP for pleuropulmonary localization of primary localized sarcoma or metastatic recurrence. Surgery and complications were analyzed, pulmonary function tests were conducted, and quality of life was determined with EORTC-QLQ-C30 questionnaire. At the time of PP age was between 9–17 years. Underlying disease included metastatic osteosarcoma (n = 5), Ewing sarcoma (two metastatic, one primary), and one primary undifferentiated sarcoma. Early complications occurred in three patients. Mean postoperative hospitalization stay was 14.5 days. Pulmonary function test showed 19–66% reduction of total lung capacity which led to mild exercise intolerance but did not affect daily life. Four patients died of multi-metastatic relapse <14 months after PP, one patient had a local recurrence, and four patients are in complete remission between 1.5 and 12 years after PP. In conclusion, in this small patient group treated with a pleuropneumonectomy for primary or metastatic lesions, outcome is variable; however, this extended surgical technique was generally quite well tolerated. Postoperative lung function seems well preserved, and it seems to lead to at least an extension of life with good quality and therefor can be considered as salvage therapy.
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Haufe, Sabine, Ralph Hohenberger, Matti Hein, Clemens Kratochwil, Hendrik Rathke, Peter Plinkert, Ingo Baumann, et al. "Impact of sialendoscopy on improving health related quality of life in patients suffering from radioiodineinduced xerostomia." Nuklearmedizin 57, no. 04 (August 2018): 160–67. http://dx.doi.org/10.3413/nukmed-0964-18-03.

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Summary Introduction: Xerostomia following radioiodine therapy (RIT) in patients suffering from differentiated thyroid cancer is a common side effect in 2 % to 67 % of patients treated with radioiodine (I-131). In order to evaluate the impact of sialendoscopy on health related quality of life (HRQOL) in patients suffering from therapy induced sialadenitis and xerostomia, we analyzed findings from two dedicated questionnaires (Xerostomy Questionnaire XQ and Xerostomy Inventory XI) in patients before and three months after sialendoscopy. Procedures: In total, 12 patients suffering from differentiated thyroid carcinoma (10 women and 2 men) were evaluated. All patients had experienced conservative management. Patients were offered a sialendoscopy procedure if no major contradictions were present. Patients who denied the procedure formed the control group. Pre- and (three months) postoperative HRQOL was measured with the Patient Reported Outcome Measures (PROM) Xerostomia Questionnaire (XQ) and the Xerostomia Inventory (XI), as well as by a pre- and post-interventional salivary gland scintigram. Patients were graded according to their sialendoscopical findings. Results: Interventional group presented with significant improvements in HRQOL measurements regarding XQ and XI-scores three months postoperatively. Control group showed no significant changes in the XQ or the XI scores. Number of RIT and cumulative activity of I-131 did not correlate with higher disease grade in regards to sialendoscopical findings nor did it correlate with higher XQand XI scores. Pre- and post-interventional salivary gland scintigram stated that parotid glands are more severely damaged than submandibular glands (SMG), but no significant scintigraphically changes could be detected after sialendoscopy. Conclusion: Sialendoscopy in patients suffering from therapy induced sialadenitis and xerostomia seems to be beneficial when evaluating the impact on HRQOL. Functional parameters measured by salivary gland scintigram did not show significant changes in post-interventional scintigrams.
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Tsagozis, Panagiotis, Magnus Henriksson, and Ioannis Ioannidis. "Femoral Stem Displacement in a Patient Suffering Recurrent Dislocations After Hip Hemiarthroplasty: Case Report." Open Orthopaedics Journal 5, no. 1 (December 30, 2011): 400–402. http://dx.doi.org/10.2174/1874325001105010400.

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Displacement of the femoral component during attempt to closed reduction of a dislocated hip arthroplasty is an exceptionally rare, catastrophic event, which renders operative management obligatory. We report the proximal migration of a femoral stem during attempt to closed reduction in a patient with recurrent postoperative dislocations after hip hemiarthroplasty, and describe successful management by conversion to a standard total hip arthroplasty, retaining the same stem in the existing cement mantle. This illustrative case is reported not only as an extremely rare event, but also to highlight and discuss pitfalls and efficient measures in the management of this complex issue.
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Peters, Bjoern, Juliane Hentschel, Harald Mau, Elke Halle, Wolfgang Witte, and Michael Obladen. "Staphylococcal Scalded-Skin Syndrome Complicating Wound Infection in a Preterm Infant with Postoperative Chylothorax." Journal of Clinical Microbiology 36, no. 10 (1998): 3057–59. http://dx.doi.org/10.1128/jcm.36.10.3057-3059.1998.

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The course of infection in a 3-week-old premature newborn suffering from extensive dermatitis with flaccid blisters is described.Staphylococcus aureus was recovered from a local wound infection around a chest tube inserted to drain a postoperative chylothorax. The strain isolated tested positive for theeta gene for exfoliative toxin A, the causative agent of staphylococcal scalded-skin syndrome (SSSS). In this case, prematurity and loss of chylus with consecutive lymphopenia may have contributed to development of SSSS.
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42

Pavliak, А. Ya, and О. V. Pyptiuk. "Dynamics of the endotoxicosis indices in patients, suffering extended purulent peritonitis." Klinicheskaia khirurgiia 85, no. 7 (July 26, 2018): 56–59. http://dx.doi.org/10.26779/2522-1396.2018.07.56.

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Objective. To investigate the endotoxicosis indices dynamics in patients, suffering extended purulent peritonitis (EPP) during the treatment process. Маterials and methods. In the investigation 39 patients, suffering EPP in terminal stage, were included. Quantitative contents of endotoxin in the blood serum (the amoebacytes lysate Limulus) was determined in dynamics, using LAL-test, and the patient’s state severity was estimated, basing on clinical and laboratory indices. Hospital lethality have characterized the disease course. Results. In patients with positive clinical dynamics (Group I) the average quantitative indices of endotoxicosis have lowered trustworthily (р=0.0001). In the patients, who died (Group II), the endotoxicosis quantitative indices dynamics were trustworthily higher, comparing with average indices in patients of Group I (р < 0.05). Conclusion. Еndotoxicosis, measuring more 5 еndotoxic units in 1 ml of the blood serum, during 3 postoperative days constitutes one of indications for reoperation. LAL-test in patients, suffering EPP, has statistically significant prognostic and diagnostic value, what substantiates recommendation for its application as indicator of the pathological process course.
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43

Меlnyk, V. М., О. І. Poyda, E. М. Shepetko, and І. І. Polovnikov. "New methods of surgical operations on large bowel." Klinicheskaia khirurgiia 85, no. 7 (July 26, 2018): 16–20. http://dx.doi.org/10.26779/2522-1396.2018.07.16.

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Objective. To improve the immediate and late results of surgical treatment in patients, suffering the large bowel (LB) diseases, using improvement of standard and elaboration of new methods of radical, оrgan-preserving, restorational and reconstructive-restorational operations. Маterials and methods. New methods of radical, оrgan-preserving, restorational and reconstructive-restorational operations on LB were elaborated, taking into account peculiarities of the diseases morphogenesis, аnatomical and functional details of the LB separate parts. The operations mentioned were performed in 497 patients, suffering LB cancer, ulcerative colitis, Crohn’s disease, familial adenomatous polyposis, chronic decompensated colostasis, complicated by the LB diverticular disease. Results. Due to implementation into clinical practice of the surgical interventions elaborated, the postoperative morbidity occurrence rate have reduced down to 2.4%, postoperative lethality - to 0.2%, the functional results improved, the occurrence rate and the severity degree for pathological postoperative syndromes have lowered (reflux-ileitis, postcolectomy syndrome, syndrome of low anterior resection, secondary anal incontinence), the governing of the outflow process after rectal extirpation was guaranteed, the operated patients quality of life improved essentially due to introduction of the surgical interventions elaborated. Conclusion. Improvement of the surgical treatment results for the LB diseases is possible while applying of new methods of radical, organ-preserving , restorational and reconstructive-restorational operations, what promotes the essential reduction of the occurrence rate for the LB diseases recurrence occurrence, pathological syndromes morbidity and their severity degree, significant improvement of functional results and quality of life in the patients operated.
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Correll, Darin. "Chronic postoperative pain: recent findings in understanding and management." F1000Research 6 (July 4, 2017): 1054. http://dx.doi.org/10.12688/f1000research.11101.1.

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Chronic postoperative pain is a poorly recognized potential outcome from surgery. It affects millions of patients every year, with pain lasting for months to years, resulting in patient suffering and ensuing economic consequences. The operations with the highest incidence of chronic postoperative pain are amputations, thoracotomies, cardiac surgery, and breast surgery. Other risk factors include preoperative pain, psychological factors, demographics, and the intensity of acute postoperative pain. Attempts to prevent chronic postoperative pain have often led to debatable results. This article presents data from recently published studies examining the incidence, risk factors, mechanisms, treatment options, and preventive strategies for chronic postoperative pain in adults. In summary, many of the previously identified risk factors for chronic postoperative pain have been confirmed and some novel ones discovered, such as the importance of the trajectory of acute pain and the fact that catastrophizing may not always be predictive. The incidence of chronic postoperative pain hasn’t changed over time, and there is limited new information regarding an effective preventive therapy. For example, pregabalin may actually cause more harm in certain surgeries. Further research is needed to demonstrate whether multimodal analgesic techniques have the best chance of significantly reducing the incidence of chronic postoperative pain and to determine which combination of agents is best for given surgical types and different patient populations.
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NABHAN, A., F. AHLHELM, J. KELM, W. REITH, K. SCHWERDTFEGER, and W. I. STEUDEL. "Simple Decompression or Subcutaneous Anterior Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome." Journal of Hand Surgery 30, no. 5 (October 2005): 521–24. http://dx.doi.org/10.1016/j.jhsb.2005.05.011.

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The purpose of this prospective randomised study was to evaluate which operative technique for treatment of cubital tunnel syndrome is preferable: subcutaneous anterior transposition or nerve decompression without transposition. This study included 66 patients suffering from pain and/or neurological deficits with clinically and electromyographically proven cubital tunnel syndrome. Thirty-two patients underwent nerve decompression without transposition and 34 underwent subcutaneous transposition of the nerve. Follow-up examinations evaluating pain, motor and sensory deficits as well as motor nerve conduction velocities, were performed 3 and 9 months postoperatively. There were no significant differences between the outcomes of the two groups at either postoperative follow-up examination. We recommend simple decompression of the nerve in cases without deformity of the elbow, as this is the less invasive operative procedure.
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Al-Shakfa, Fidaa, James Moore, Lydia Mychaltchouk, Khaled Iguer, and Frédéric Lavoie. "Postoperative Stiffening after Bicruciate-Retaining Total Knee Arthroplasty." Journal of Knee Surgery 31, no. 05 (July 24, 2017): 453–58. http://dx.doi.org/10.1055/s-0037-1604145.

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AbstractBicruciate-retaining (BCR) total knee arthroplasty (TKA) has recently experienced a resurgence of popularity. It may be a good option among a younger, more active population because it restores knee kinematics better than other prosthetic designs. Results obtained in the first 100 BCR TKAs implanted with a simplified gap-balancing technique are reported, with special attention paid to knee flexion, through comparison with a cohort of 100 posterior-stabilized (PS) TKAs. We conducted a retrospective comparative cohort study of 100 BCR TKAs (90 patients) and 100 PS TKAs (88 patients). Knees with a BCR TKA lost significantly more flexion PS TKA in the early postoperative period when their preoperative flexion was less than 130 degrees (loss of 40 degrees vs. loss of 24 degrees). Postoperative range of motion was similar between BCR TKA and PS TKA when preoperative knee flexion was 130 degrees or more, and when there was no preoperative flexion contracture. Postoperative stiffening seems to be more frequent and of greater magnitude after BCR TKA, compared with PS TKA, in patients suffering from preoperative flexion stiffness. Further investigation on the causes of this phenomenon is warranted.
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47

Kollitz, Kathleen M., Nicholas Pulos, Allen T. Bishop, and Alexander Y. Shin. "Primary medial femoral condyle vascularized bone graft for scaphoid nonunions with carpal collapse and proximal pole avascular necrosis." Journal of Hand Surgery (European Volume) 44, no. 6 (July 26, 2018): 600–606. http://dx.doi.org/10.1177/1753193418789329.

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This study aimed to determine the outcome of free vascularized medial femoral condyle bone grafts in the primary treatment of scaphoid nonunions with scaphoid foreshortening or carpal collapse and intraoperatively documented avascular necrosis. Thirty-two patients (28 male, four female) met the inclusion criteria. Median time from injury to surgery was 70 weeks. Thirty of 32 patients healed at a median of 12 weeks. There was significant improvement from preoperative to postoperative lateral intrascaphoid angle, scapholunate angle, and radiolunate angle. Two scaphoids failed to unite; one patient underwent scaphoidectomy and four-corner fusion 15 months postoperatively after suffering a subsequent injury. Another patient underwent 1,2-intercompartmental supraretinacular artery-based vascularized bone grafting at 4 months postoperatively and then scaphoid excision with four-corner fusion 4 years later. The free vascularized medial femoral condyle bone graft restores scaphoid vascularity and architecture while promoting union in a subset of scaphoid nonunions that has historically been a clinical challenge. Level of evidence: IV
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48

Guo, Kang, Lijun Heng, Haihong Zhang, Lei Ma, Hui Zhang, and Dong Jia. "Risk factors for postoperative intracranial infections in patients with pituitary adenoma after endoscopic endonasal transsphenoidal surgery: pneumocephalus deserves further study." Neurosurgical Focus 47, no. 2 (August 2019): E5. http://dx.doi.org/10.3171/2019.5.focus19269.

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OBJECTIVEThe authors sought to identify the relevance between pneumocephalus and postoperative intracranial infections, as well as bacteriological characteristics and risk factors for intracranial infections, in patients with pituitary adenomas after endoscopic endonasal transsphenoidal surgery.METHODSIn total, data from 251 consecutive patients with pituitary adenomas who underwent pure endoscopic endonasal transsphenoidal surgeries from 2014 to 2018 were reviewed for preoperative comorbidities, intraoperative techniques, and postoperative care.RESULTSThis retrospective study found 18 cases of postoperative pneumocephalus (7.17%), 9 CNS infections (3.59%), and 12 CSF leaks (4.78%). Of the patients with pneumocephalus, 5 (27.8%) had CNS infections. In patients with CNS infections, the culture results were positive in 7 cases and negative in 2 cases. The statistical analysis suggested that pneumocephalus (maximum bubble diameter of ≥ 1 cm), diaphragmatic defects (intraoperative CSF leak, Kelly grade ≥ 1), and a postoperative CSF leak are risk factors for postoperative CNS infections.CONCLUSIONSIn pituitary adenoma patients who underwent pure endoscopic endonasal transsphenoidal surgeries, intraoperative saddle reconstruction has a crucial role for patients with postoperative intracranial infections. Additionally, postoperative pneumocephalus plays an important role in predicting intracranial infections that must not be neglected. Therefore, neurosurgeons should pay close attention to the discovery of postoperative intracranial pneumocephalus because this factor is as important as a postoperative CSF leak. Pneumocephalus (maximum bubble diameter of ≥ 1 cm), diaphragmatic defects (an intraoperative CSF leak, Kelly grade ≥ 1), and a postoperative CSF leak were risk factors predictive of postoperative intracranial infections. In addition, it is essential that operative procedures be carefully performed to avoid diaphragmatic defects, to reduce exposure to the external environment, and to decrease patients’ suffering.
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49

Kryvoruchko, I. A., M. S. Antonova, O. V. Yevtushenko, and S. A. Andreieshchev. "Surgical treatment of patients with abdominal sepsis taking into account the prediction of the implementation of re-operations." Klinicheskaia khirurgiia 87, no. 1-2 (May 26, 2020): 24–29. http://dx.doi.org/10.26779/2522-1396.2020.1-2.24.

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Objective. The investigation objective was improvement of the surgical treatment results in patients, suffering аbdominal sepsis, using individualized tactics of treatment, taking into account a possibility for the postoperative complications occurrence and the treatment results prognostication. Маterials and methods. The results of treatment of the adult patients, suffering abdominal sepsis in 2009 – 2019 yrs, excluding an acute cholecystitis cases, were analyzed. The patients were divided retrospectively and prospectively in accordance to the Sepsis–3 classification. Of them 130 have suffered peritoneal sepsis, 33 – intestinal one, and 38 – pancreatogenic abdominal. The results estimation was compared with application of modern systems: APACHE–II, Mannheim іndex of peritonitis (MPI), MODS and SOFA. The indices were estimated on the 1st, 2nd, 3rd and 4th postoperative days before subsequent outcomes of a primary operation. Results. The prognosis systems with a square under the ROC–curve (AUC) > 0.8 have included MPI only for determination of indications for reoperations: the ROC–curves value for the first subgroup (the closed treatment) have constituted 0.73, for the second subgroup (reoperations in accordance to indications) – 0.91, and for the third – 0.84 (the programmed reoperations). But in the patients of first subgroup this index have constituted 0,73, indicating its application restricting the decision making process, concerning the reoperations efficacy in patients with absence of the septic shock signs. Conclusion. Calculations of the occurrence possibility for postoperative complications and mortality in patients, depending on their preoperative state severity permits to select a most rational tactics of treatment. Most optimal approach for the rate reduction of postoperative complications occurrence and mortality in patients with abdominal sepsis and septic shock is performance of reoperations in accordance to indications to control the infection source, if it is possible.
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50

Meeker, Jennifer D., Eugenia Ayrian, and Edward R. Mariano. "Daring discourse – no: cannabinoids should not be used for acute postoperative pain management." Regional Anesthesia & Pain Medicine 45, no. 7 (May 28, 2020): 520–23. http://dx.doi.org/10.1136/rapm-2020-101475.

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As anesthesiologists and acute pain medicine specialists, we will care for patients in the perioperative period who use cannabinoids for chronic pain and/or marijuana recreationally. We will have to address difficult questions from patients regarding the potential applications for cannabinoids in acute pain management. While we must remain compassionate and understand our patients’ desire to find relief from suffering using available non-opioid medications, we are ethically bound to do no harm and provide them with treatment options supported by the best available evidence. Today, we cannot support cannabinoids in the management of acute postoperative pain.
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