All articles - Surgery
Number of articles: 716
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The basis for the study consisted of 217 patients with postoperative ventral hernias of comparable age who were under observation and admitted to the department of the surgical departments of the 1st and 2nd clinics of Samarkand state medical institute in the periods from 2009 to 2017. After the application of the proposed development and innovative approaches, the quality of life of patients with postoperative ventral hernias undergoing hernioplasty in the main group improved in contrast to the patients in the comparison group.
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The cases (144) of forensic examination of victims were analyzed with the aim of clarifying the mechanism of injury in various types of nasal bone fractures. It has been revealed that fractures of the bones of the nose arise mainly from the impact of a blunt instrument by the mechanism of impact and pressure, less often from the impact, pressure and slip of a blunt solid instrument. In assessing the mechanism of bone fractures, along with the nature and circumstance of the injury, a change in the shape of the nose should be investigated and assessed. It is also necessary to take into account the individual anatomical structure of the skull, such as the structure of the face and external nose, as well as the design of the nose itself. -
Generalized 173 cases results of forensic medicine expertise (inspect) associated with mechanical trauma of nose. It is established, that expert approach to forensic medical evaluation trauma following fracture of nose bones have to differentiated and individualized. On the severity damaging nose need to take into consideration, that occurring complication at the moment of trauma and delayed effect (nose deformation, nasal septum, disorders function of internal organs and brain). It is possible to carry on complex examination of substantiation stage severity of nose trauma as: functional-clinical, x-ray, and also CT. MSCT observations. -
Factorial analysis of tactic-diagnostic aspects, which impact on results of surgical treatment of mirizzi syndromeIn this work conducted different factors, which one or the other stage impact on outcome of surgical treatment of Mirizzi syndrome. Accounting rare number of this complication, also it is occurred studying statis-tical indication of spreading MS in the structure of CBD and frequency of occurrence depending on variety type of operative intervention. Separately investigated versions of intraoperative technical complexity and ac-cordingly frequency of postoperative complications. It is divided into 4 groups among the different clinical-diagnostical and tactical-technical factors impact on outcome of surgical treatment: statistical, anamnestical, diagnostical, tactical and intraoperative
Journal problems of biology and medicine -
Dynamics of surgical operations of the node shapes in the conditions iodine potency and iodine deficiencyThe article studied the dynamics of the number and volume of surgeries nodal forms of goiter and iodine deficiency conditions iodine security in Uzbekistan on archival data branch of the Research Institute of Endocrine Surgery Endocrinology Ministry of Health of Uzbekistan. Under the conditions of iodine deficiency increases the number of nodal forms of goiter. Moreover, the sharp increases malignant forms of nodular goiter that dictates a more radical surgery on the thyroid gland.
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Our experience of surgical treatment of idiopathic scoliosis of thoracic localizationTo analyze results of surgical treatment of patients with thoracic idiopathic scoliosis. Materi- al and methods. Fifty-two patients with Lenke type 1 idiopathic scoliosis were operated on. Follow-up periods ranged from 2 weeks to 8 years (mean 1.8 years). Surgical treatment included four types of operation: spine deformity correction with CD instrumentation; supramalleolar-and-skull traction and CDI correction; discec-tomy and interbody fusion with bone autograft and CDI correction; supramalleolar-and-skull traction, discec- tomy and underbody fusion with bone auto graft, and CDI correction. Patients were interrogated with pre-and postoperative SRS-24 questionnaires. Results. Scoliosis was corrected from a mean of 67.7° to 26.6°, with a mean deformity value being 30.3° at the last follow-up. Thus, postoperative progression of the thoracic curve with a mean follow-up 1.8 years was 3.7° (9 % from the achieved correction). Anterior fusion provided a three- fold decrease in postoperative progression. Sagittal shape of the thoracic and lumbar spine remained within norm limits. The location of the lowest instrumented vertebra (LIV) relative to a neutral vertebra, lower stable vertebra and neutralized disc did not reliably influence on the postoperative course. Postoperative deformity progression was associated only with increase in LIV tilt. SRS-24 data showed a high rate of patients' satisfac-tion with the obtained effect of treatment, the rate growing with the extension of follow-up terms. Severe com-plications were not observed. Conclusion. Modern 3rd generation segmental instrumentation allows to obtain stable and high results of treatment for single curve thoracic idiopathic deformities, while all regularities of postoperative course are not fully understood yet
Journal problems of biology and medicine -
Optimization methods for diagnosis and treatment acute abscess and gangrene of the lungs in patients with diabetesAn effective treatment for acute suppurative destructive lung diseases and diabetes mellitus is a topical application of antibacterial drugs in large doses by prolonged selective intraarterial catheter therapy
Journal problems of biology and medicine -
In recent years, in the Department of gynecology, often performed extirpation of the uterus. This is due to the fact that drug therapy does not give the desired effect. Only according to the first clinic of Sammi only in 2017, constituent part of extirpation of the all 136 laparotomic operations, uterine fibroids accounts about for 46.3%. Purpose: was to study the effectiveness and safety of the method of anesthesia. Method: was to carry out various types of anesthetic support for identical operations and determine the most effective method of anesthesia. As a result: all methods ofanesthesiological support had an effective level of anesthesia. There was no special differentiation between different methods.Conclusion: The best parameter was the method of combined spinal-epidural anesthesia, which provides a good during of the anesthesia and protects the body of patients from surgical aggression. In addition, this method has a more stable hemodynamics, relative to the other two groups (total intravenous anesthesia and spinal anesthesia), which favorably affects the course of the operation. -
Choice of primary surgical help with kidney form оf primary hyperparathyroidism in childrenThe primary hyperparathyroidism (PHPT) was diagnosed in 52 children with urolithiasis aged from 12 months to 15 years on the basis of use of clinical-biochemical and instrumental examinations. PHPT was manifested as severe forms of nephrolithiasis: bilateral single (32.6%), bilateral multiple (36,5%), and recurrent (59,6%) form. The staghorn calculi were noted in 45 (51,1%) kidneys. Hypcrparathyrincmia-hypcrparacalccmia occurred after lithotomy was successfully treated with conservative approach, in cases of lithotomy inefficacy there were identified indications for he-modyalisis and parathyroidectomy. The authors believed that in the patients with obturation uropathy the preliminary formation of the percutaneous puncture nephrostomy seems to be advantageous that is justified by less injury of this method and pathogenic approach to the choice of the primary intervention in nephrolithiasis of hyperparathyroid genesis.
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The basis for the study was 371 patients with liver echinococcosis, admitted to the departments of surgery of the 1st and 2nd clinic of the Samarkand State Medical Institute. The optimal complex of medical-diagnostic and prophylactic measures developed has changed the quality of life of patients: excellent from 5.9% to 83.0%, good from 64.7% to 15.1%, satisfactory from 17.6% to 1, 9% and unsatisfactory - from 11.8% to 0%. -
Improvement of methods of pre-operational preparation of scoliotic disease in ChildrenThe indications for the use of an optimized preoperative treatment and diagnostic complex for the preparation of paravertebral tissues and the contents of the spinal canal for radical correction in children with scoliotic disease of grade IV were determined. The proposed method extends the capabilities of a practical orthopedic-vertebrologist in assisting sick children with this disease.
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Surgical treatment of non-consolidated fractures of the humeral condyle head in childrenThe experience of operative treatment in 116 children with incomplete fractures and pseudoarthrosis of the condyle of the humeral head is presented. The reasons for nonunion are errors of diagnosis and treatment of patients. Also important is the intraarticular nature of the fracture, the condition of the broken fragment from cartilage tissue and bone tissue, the contact of heterogeneous tissues in the presence of a lateral proximal small (4-5mm) displacement of the bone fragment, which is the cause of the extended period of bone-cartilage callus beyond the redistribution the accepted period of immobilization of the joint. A method for fixing a bone fragment, proposed by the authors, and a method of operation for treating pseudoarthrosis of the humeral condyle of the humerus by bone grafting, taken from the diaphysis of the fibula of the patient himself, is described. Excellent results were obtained in 43.3%. good results were observed in 46.2%, satisfactory - in 5.3%, and unsatisfactory - in 5.3% of patients.
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Place of cerebroprotection in the prevention and correction of postoperative cognitive dysfunction during surgical interventions in elderly patientsThe article presents the results of a study of 120 patients aged 60-75 years, prepared for a planned surgical intervention. Depending on the method of drug preparation, all patients were divided into 2 groups: patients of the I-st (main) group received medical preparation as follows: 3 days before the operation, 500 mg of citicoline was administered i.v. in a jet in the morning and evening, 10 ml of thiocetam, previously diluted in a 0.9% solution of sodium chloride intravenously driply, once a day; cerebroprotection was not performed in patients of the second (control) group. The results of the study suggest that prcopcrativc ccrcbroprotcction docs not affect the need for anesthetic, significantly improves the period of post-anesthetic rehabilitation and prevents the development of cognitive deficit in the early postoperative period in elderly patients operated on in conditions of ketamine and fentanyl with ALV.
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Laser enuсleation of the prostate - new approach in operative treatment of benign prostatic hyperplasiaIn recent years, new methods of surgical treatment of benign prostatic hyperplasia (BPH) have become increasingly widespread. Transurethral endourological operations are widely developed and became common. The concept of "endoscopic enucleation of the prostate” comes to the fore in operative treatment of BPH. which is ensured by modern laser enucleation techniques such as holmium laser enucleation and thulium laser enucleation of the prostate. Laser techniques are characterized with high clinical safety and effectivity, minimal postoperative complications rates.
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Improvement results overlapping and liquidation colostomy at the obstruction of the sigmoid colon in the experimentExperimental investigate of upgrade methods of suture of overlapping and liquidation colostomy. Exper-imental investigate was fulfilled on the 32 mongrels. Application of improved methods of suture of large over-lapping and liquidation colostomy has improved results of treatment acute obstruction of sigmoid colon
Journal problems of biology and medicine -
Evaluating the effectiveness of treatment of purulent-inflammatory diseases in the experiment by using laser (co2 laser and photodynamic therapy) treatment methodsObjective: Improve the treatment of purulent destructive wounds by topical application of CO2 laser and photodynamic therapy in the experiment. Materials and methods: purulent wound model reproduced in 80 male rats by MP Thick (2002) with some modification. Animals from the third day were divided into 4 groups: 1) 20 rats with physiological regeneration, 2) 20 rats with standard therapy, and 3) 20 rats PDT 4) rats 20 inclusion complex treatment with conventional methods, the CO2 laser (JZ- 3A) 3 times daily until the wound cleansing from necrotic raids and PDT. Studied plane geometry, healing time, peripheral blood counts and morphology of biopsies from the wound bed and the wall on the 1st, 3rd, 7th and 10th day of the experiment. Results. Photodynamic therapy in a CO2 laser complex was not sufficiently effective invasive treatment of purulent wounds and allows to recommend its use in clinical practice for the treatment of local purulent-destructive diseases of soft tissues. Complex application of PDT and CO2 laser leads to an earlier cleansing from the pus, the active formation of granulation tissue and shortening deadlines complete epithelialization of the wound surface. Conclusions: Complex treatment with CO2 laser and photodynamic therapy is the most effective, as compared to other methods studied separately
Journal problems of biology and medicine -
Repeated operations in chronic recommending hematogenic osteomyelitisThe results of surgical treatment of patients with chronic recurrent hematogenous osteomyelitis are ana-lyzed. The proposed method of surgical treatment of patients with chronic recurrent hematogenous osteomyeli-tis - longitudinal osteotomy, enlarged sequestralectomy with recanalization of the affected bone, provides the most radical sanation of the osteomyelitis and improves the results of treatment in this severe pathology
Journal problems of biology and medicine -
Perfection of technology of extracorporeal detoxification at the stages of surgical treatment of patients with mechanical jaundiceThe work was based on clinical studies of 72 patients with mechanical jaundice of benign genesis and with various malignant tumors of the hepatopancreatoduodenal zone operated in the surgical department of the 1 - city hospital in Samarkand for the period 2014-2017. In 64 patients, the cause of mechanical jaundice was cholelithiasis and stricture of bile ducts, liver echinococcosis. In 8 patients, mechanical jaundice was caused by pancreatic cancer, a large duodenal papilla, and hepatitis choledoch cancer. All patients underwent surgical interventions to eliminate MF and its complications
Journal problems of biology and medicine -
The article summarizes and studies the results of surgical treatment of 396 patients with inguinal herni-as. Patients with oblique inguinal hernia was 194 people, direct inguinal hernia 174 patients and 36 patients with recurrent form of inguinal hernia (Nyhus L.) applied different methodically. Autoplasty was performed in 90 patients with direct hernias (L. Nyhus III a, b type), in 110 patients of this group the operation of Liechten-stein was performed in the classic version of 36 patients with recurrent inguinal hernias. The study of the re-sults of hernia repair in the near and distant postoperative view that the most effective method of herniation was a modified method of allogernioplasty according to Liechtenstein. In particular, when using the above method, "good" results were obtained in 93.4% of cases, "unsatisfactory" in 1.7% of cases, which indicates a higher efficiency than when using stretched hernioplasty methods -
Results of treatment after the operational spondilodistsit at injuries of a backboneThe research is based on studying of a tunelization at diagnostics and treatment of the post-operational spondilodistsit. At the time of inspection and treatment the Samarkand regional hospital of an orthopedics and a consequence of a trauma were in unit of a vertebrologiya 31 patients. From the total number of patients was 9 (29%) women, there were 22 men (71%). The age of patients was intensified from 18 to 63 years with lesions of lumbar vertebrae and disks, adjacent to them, - spondilodistsity. And with the medical purpose we carried out by the purpose of confirmation of the diagnosis low-invasive interventions - a tunnelization of a body of a vertebra and a disk through an arch root with a biopsy and the subsequent sanation of the center (A way of treatment of the spondilodistsit No. IAP 05393). Good results are received at 22 (71%) patients - full retrogress of a pain syndrome at rest and turn of a bed, decrease of feeling of fatigue at vertical position, improvement of clinical laboratory indicators. Satisfactory results are received at 8 (25,8%) patients, the unsatisfactory result is noted at 1 patient (3,2%). Thus, the tunnelization and sanations of the center antibiotics at a limited or initial spondilodistsit is a low-traumatic and effective method of single-step pressure decrease in a zone of pathology and providing local etiologies and pathogenetic treatment. The material intake for a bacteriological and histological research allows to reduce time of verification of process and to quickly provide positive clinical effect
Journal problems of biology and medicine -
Now the main task of obstetrics is decrease in maternal and perinatal incidence and mortality that promotes improvement of health of future generations. The solution of this problem first of all is connected with development of rational tactics of maintaining pregnant women with various obstetric and perinatal pathology and optimization of conducting childbirth. -
A case of postoperative fulminant septic shock caused by An anaerobic infection in a woman with autoimmune hepatitisThe article presents a clinical case of maternal mortality from liver disease complicated by sepsis. The stages of pregnancy and childbirth are analyzed from the perspective of current data on sepsis and liver diseases.
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The article draws attention to the relevance and complexity of surgical treatment of patients with acute obstruction of the small intestine and the need to create an algorithm for the selection of surgical operations in patients. As a result of the analysis of data obtained from 221 operated patients and a retrospective study of 32 medical records, an algorithm was proposed for the surgical treatment of patients with acute small bowel obstruction, depending on the period of the disease and the functional state of each patient.The use of sound tactics for the surgical treatment of patients with acute small bowel obstruction can improve the results of their treatment. -
Algorithm for modeling an individual implant to eliminate bone defects of the medium face zoneThe method of elimination of bone defects in the midface, by virtual computer modeling of an individual endoprosthesis, allows installation of an individual endoprosthesis for a lost bone segment in one stage of a surgical intervention, while reducing the period of functional and social adaptation of patients. 3D planning allows planning and determining the volume of the operation, the selection of the implant, determining the size and type of the implant, as well as its fixation. Due to the 3D model, it is possible to determine the indication and contraindication to the operation, low-impact access to the damaged area, in addition, it also allows avoiding postoperative complications, such as enophthalmos, diplopia, exophthalmos and others.
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Over the 2008-2018 HS in SFRICAN the study intraabdominal pressure in 76 patients with combined abdominal trauma. The age of the examined victims ranged from 18 to 70 years (30,5±8,9), while the majority of the victims were of working age (up to 50 years), mostly men (n=61). In 37 (48,6%) injured associated injuries of the abdomen was accompanied by head injury. The cause of the injury in most cases was road traffic accident (n=61 to 80,2%), 10 (13.1%) of wrongful injury, 7 (9.2%) of Calatrauma. Alcoholic intoxication was observed in 41 (53.9%). In those patients, in whose cases the operation is completed by suturing the abdominal wound tightly, there is a high risk of developing IAD and a high probability of developing intraabdominal hypertension syndrome (S1AG). In the same group of patients, signs of multi-organ failure arc significantly expressed, one of the causes of which may be increased intraabdominal hypertension. SIAG is quite-such an adverse complication in terms of prognosis.
