The aim of the study is to improving the quality of treatment of ventral hernias in patients with morbid obesity by improving the tactical and technical aspects and optimizing the choice of hernioplasty method.
The object of the study were 121 patients with ventral hernias and morbid obesity who were hospitalized in the surgical department of the 1st clinic of the Samarkand State Medical University in the period from 2012 to 2021.
The scientific novelty of the study is as follows: a method was developed for preoperative preparation of patients with ventral hernia and morbid obesity using a modified pneumatic belt-bandage to adapt the cardiovascular and respiratory systems to intra-abdominal hypertension after hernioplasty; improved technical aspects of the reconstruction of the anterior abdominal wall in patients with morbid obesity; the surgical instrument "retractor" has been improved for technical optimization of the stage of suturing the anterior abdominal wall for fixing the prosthesis in patients with concomitant obesity and abdominal ptosis; clarified clinical and instrumental criteria for the specific unification of the scale for assessing the quality of life of patients after hernioplasty and abdominoplasty for ventral hernias and morbid obesity with differentiation of the value of physical, mental and social daily activity. The practical results of the study are as follows: According to the results of a scientific study to improve the diagnosis and surgical treatment of patients with ventral hernias and morbid obesity: improved "retractor". The use of the proposed tool made it possible to level the technical difficulties in fixing the prosthesis against the background of severe overweight with a reduction in the operation time; developed guidelines "Technical aspects of hernioplasty for ventral hernias in patients with morbid obesity" (certificate of the Ministry of Health 8n-r / 905 dated October 12, 2021), "Criteria for the choice of surgical treatment of patients with ventral hernias and obesity" (certificate of the Ministry of Health 8n-r /906 dated October 12, 2021). The proposed recommendations made it possible to optimize the choice of tactics for surgical treatment of patients with ventral hernias and morbid obesity; the obtained scientific results on improving the quality of diagnosis and surgical treatment of patients with ventral hernias and morbid obesity have been introduced into the practice of health care, in particular, in the departments of surgery of the 1st clinic of the Samarkand State Medical Institute, the Jizzakh Regional Multidisciplinary Medical Center and the Sh. Rashidov District Medical Association of the Jizzakh region (certificate of the Ministry of Health 8n-z / 368 dated October 22, 2021). The implementation of research results by improving the tactical and technical aspects of the surgical treatment of patients with ventral hernias and morbid obesity made it possible to reduce the overall incidence of postoperative complications from 14.8% to 8.9%, including wound complications from 11.1% to 4.5% and extra-abdominal from 7.4% to 4.5%, as well as significantly reduce the duration of surgical treatment and rehabilitation periods after various types of hernioplasty and abdominoplasty. The structure and scope of the dissertation. The dissertation consists of an introduction, five chapters, a conclusion, conclusions, practical recommendations and a list of cited literature. The volume of the text material is 107 pages.
Any operation is a stressful situation, which causes the psychological state of patients to deteriorate. Psychological assistance to patients before and after surgery is considered the most necessary direction of a medical nurse. In inpatient treatment facilities, the patient is faced with unaccustomed situations, which causes a feeling of discomfort. The purpose of our study of the above issues is to study the psychological state and satisfaction of patients with treatment
Хозирга кунда юқори ва пастки жағларда мавжуд иккиламчи адентияларни протезлаш стоматологлар олдидаги долзарб муаммолардан биридир. Ушбу муаммони яьни тиш каторлари нуқсонларини бартараф этишнинг замонавий усулларидан бири бу дентал имплантологиядир.Узоқ муддат эстетик нуқсон билан юриш беморларни психоэмоционал ўзгаришлар ва юз жағ тизимининг анатомик функционал бузулишларига сабаб бўлади. Дентал имплантологиянинг ривожланишига карамай имплантларни урнатиш хали-хамон кушимча операция муолажаларини талаб килади. Шу жумладан, юкори жаг бўшлиғида киста мавжуд беморларда дентал имплантация учун суяк миқдори етишмаслигида синус лифтинг операциясидан олдин беморлар ЛОР шифокорда цистоэктомия операциясини ўтказишлари зарур эди. Бу эса беморлар учун кўшимча стресс, вақт ва харажатларни келтириб чикарарди. Шуларни олдини олиш учун бирвактлама киста суюклигини олиб ташлаш ва синус лифтингни утказишни самарадорлигини урганиш бизнинг максадимиз булди.
Subjects of the inquiry: the patients with nonspecific ulcerative colitis
Aim of the inquiry: an improvement of the results of the treatment of patients with nonspecific ulcerative colitis by the perfection of diagnosis and a choice of the scope of surgical intervention.
Method of inquiry: clinical, laboratory, instrumental, surgical and statistical.
The results achieved and their novelty: algorhythm of diagnosis and choice of the method of treatment of the patients with non-specific ulcerative colitis has been developed. Indications to intraoperative colonofibroscopy for the choice of the method and scope of the operation in complicated forms of non-specific ulcerative colitis have been formulated for the first time. Its efficiency has been proven. Intraoperative colonofibroscopy gives a possibility to determine borders of the inflammatory-ulcerative process exactly and provides threefold decrease of the postoperative complications and significantly more often positive outcomes of the operation (88,5% of the cases). A quantitative scale for evaluation of the severity of various forms of non-specific ulcerative colitis was offered. It permits to obtain more objective information.
Practical value: the developed algorhythm of diagnosis of nonspecific ulcerative colitis, including intraoperative colonofibroscopy, considerably improves results of surgical treatment, decreasing the number of postoperative complications and resulting in good outcomes more frequently. Use of quantitative scale for evaluation of the severity of various clinical forms of nonspecific ulcerative colitis provides an adequate estimation of the patient’s state
Degree of embed: the developed scheme of diagnosis in the form of algorhythm and an offered method of a choice of a scope of operation -intraoperative colonofibroscopy - in nonspecific ulccrus colitis is introduced into practice of work of the Research Center of Coloproctology of the Ministry of Public Health of the Republic of Uzbekistan. Results of the research arc included in the course of lectures at the department of surgery for doctors of general practice of Tashkent Medical Academy.
Sphere of usage: coloproctology and gastroenterology.
In spite of the fact that the first operation for funneled deformation of a thorax is executed more than 100 years ago, the problem of treatment of this disease cannot be considered finally solved. Points the fact that for correction of FDCh more than hundred ways and modifications of surgery are used to it.