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Surgical Tactics In Treatment Of Patients With Hydatid Liver Disease  [PDF]
A.S. Tolstokorov,Yu.S. Gergenreter
Saratov Journal of Medical Scientific Research , 2009,
Abstract: The analysis of 327 case histories of patients with hydatid liver disease has been performed to find out the optimal surgical access according to the cyst location. Indications for biliary tracts decompression with the use of endoscopic technique have been determined
LIVER CONTUSIONS. DECISIONS AT ARRIVALS: THE RESUSCITATION AND EVALUATION OR LAPAROTOMY  [PDF]
C. Letoublon,Catherine Arvieux
Jurnalul de Chirurgie , 2005,
Abstract: The liver is the largest solid abdominal organ with a relatively fixed position, which makes it prone to injury. The liver is the second most commonly injured organ in abdominal trauma, but damage to the liver is the most common cause of death after abdominal injury. The most common cause of liver injury is blunt abdominal trauma, which is secondary to motor vehicle accidents in most instances. In the past, most of these injuries were treated surgically. However, surgical literature confirms that many of liver injuries have stopped bleeding by the time surgical exploration is performed, and some operations performed for blunt abdominal trauma are nontherapeutic. Imaging techniques and non-operative management, have made a great impact on the treatment of patients with liver trauma, and use of these techniques has resulted in marked reduction in the number of patients requiring surgery and nontherapeutic operations
LIVER CONTUSIONS: INDICATIONS FOR NON OPERATIVE APPROACH  [PDF]
C. Letoublon,Catherine Arvieux
Jurnalul de Chirurgie , 2005,
Abstract: The most important condition for a conservative treatment of the liver trauma is a stable patient. Ultrasound and computerized tomography (CT) examinations are essential for the investigation of abdominal trauma. These explorations allow visualization of solid organ anatomy and have the ability to grade and quantify the livers' injuries (Mirvis classification). After the first exploration and the decision for initial non-operative approach, the patients will be followed in the intensive care unit (hemodynamic status, biological exploration, CT or ultrasonography). In this second survey period it is possible to appear complications (hemorrhage, peritonitis, intra-abdominal hyper-pressure syndrome etc.) and emergency laparotomy can be necessary. The overall mortality for non operative approach is about 9%, and direct mortality is under 1%. Secondary operations are necessary in 7-10% from these patients. Interventional radiology techniques and endoscopic procedures (such as endoscopic retrograde cholangio-pancreatography) allowed the reduction of the secondary surgical interventions. Hospital stay depends by the grade of the liver injury. Long term follow-up it is necessary; some cystic image can appear in the liver parenchyma at CT exam after months or years from the trauma, but without clinical significance.
Combined Cerebrocranial Trauma. Report 2. Emergency and Surgical Tactics  [PDF]
A.P. Fraerman,N.V. Syrkina,O.V. Zhelezin,G.I. Gomozov
Sovremennye Tehnologii v Medicine , 2010,
Abstract: An algorithm of the emergency measures at a combined craniocerebral trauma elaborated on a basis of the proper investigation results and literary modern data is presented in the second part. The basic principles of the combined trauma diagnosis and treatment are stated.The main statements, defining a surgical tactics at the brain damage different combinations (at the craniocephal and cranioverteral traumas, traumas of breast, abdomen, the extremity fractures and etc.), are regarded in detail.
Differentiated surgical tactics in patients with colic polyps and polyposis  [cached]
Dilshod Sapaev,Sarimbek Navruzov,Shukur Mamatkulov,Sharafat Sapaeva
Medical and Health Science Journal , 2010,
Abstract: Choice of tactics and method of surgical treatment in colic polyps and polyposis (CPP) remains the issue of the day. Surgical tactics has to be differentiated and individual, depending on the character of the disease and the level of involvement of colon. Timely diagnostic and prognosis of course of CPP is a prerequisite for development and choosing the most effective differentiated surgical tactics. In 102 patients, there were applied newly developed methods of complex diagnostics and differentiated surgical tactics developed by us. Differentiated surgical tactics should be applied using both endoscopic and radical operations, taking into account the extent and character of involvement, as well as the risk of malignization. Application of the developed algorithm of differentiated surgical tactics allows significant improving the treatment outcomes. Particularly this approach helps to increase several times the recovery rate and reduce the rate of relapses.
Surgical treatment for liver cancer  [cached]
Nicole C Tsim, Adam E Frampton, Nagy A Habib, Long R Jiao
World Journal of Gastroenterology , 2010,
Abstract: Primary liver cancer is amongst the commonest tumors worldwide, particularly in parts of the developing world, and is increasing in incidence. Over the past three decades, surgical hepatic resection has evolved from a high risk, resource intensive procedure with limited application, to a safe and commonly performed operation with a range of indications. This article reviews the approach to surgical resection for malignancies such as hepatocellular cancer, metastatic liver deposits and neuroendocrine tumors. Survival data after resection is also reviewed, as well as indications for curative resection.
FEATURES OF SURGICAL TACTICS AND TREATMENT OF ACUTE APPENDICITIS AT PRESENT STAGE  [PDF]
S.S. Slesarenko,A.Yu. Lisunov
Saratov Journal of Medical Scientific Research , 2008,
Abstract: This research is dedicated to the problem of choosing treatment tactics in catarrhal form of acute appendicitis. The results of investigation and treatment of 1468 patients with acute appendicitis of our region were analyzed. Large specific gravity (26%) of patients who had been operated with regard to acute appendicitis was exposed. With the purpose of improvement of surgical treatment results of patients with acute appendicitis we have worked out and instilled a diagnostic system, which is a totality of invasive and uninvasive methods of investigation that allows to divide clinical material into two categories: one of them is with existence of inflamed process and the other is without it.
Up-to-date surgical tactics in echinococcosis of the lungs  [cached]
Zafar Murtazaev,Sobirjon Mamarajabov,Bakhodir Sabirov,Olmos Elbabaev
Medical and Health Science Journal , 2010,
Abstract: The paper provides analysis of surgical treatment of 132 patients with echinococcosis or hydatid disease (86 patients with uncomplicated and 46 with complicated echinococcosis) of the lungs. It was possible to perform echinococcectomy of the lungs through mini-invasive approaches in more than 2/3 patients and employment of endovisual technology made it possible to shorten the number of postoperative complications from 35.71 % to 4% and the terms of treatment from 14.2 to 6.4 days.In our opinion, echinococcectomy of the lungs through mini-invasive approach requires further technical improvement. It is easier and more effective to perform echinococcectomy through minithoracotomy approach. At the same time it should be acknowledged that echinococcectomy via thoracotomy approach is more often recommended in recurrent echinococcosis of the thoracic cavity and sometimes in complicated course of the disease. Simultaneous operations using mini-approaches in bilateral echinococcosis of the lungs or in combination with the liver are the operations of the choice and can be performed in patients with good functional indexes of the cardiovascular and the respiratory systems.
Surgical Treatment of Neuroendocrine Liver Metastases  [PDF]
Ser Yee Lee,Peng Chung Cheow,Jin Yao Teo,London L. P. J. Ooi
International Journal of Hepatology , 2012, DOI: 10.1155/2012/146590
Abstract: Management of Neuroendocrine liver metastases (NELM) is challenging. The presence of NELM worsens survival outcome and almost 10% of all liver metastases are neuroendocrine in origin. There is no firm consensus on the optimal treatment strategy for NELM. A systematic search of the PubMed database was performed from 1995–2010, to collate the current evidence and formulate a sound management algorithm. There are 22 case series with a total of 793 patients who had undergone surgery for NELM. The overall survival ranges from 46–86% at 5 years, 35–79% at 10 years, and the median survival ranges from 52–123 months. After successful cytoreductive surgery, the mean duration of symptom reduction is between 16–26 months, and the 5-year recurrence/progression rate ranges from 59–76%. Five studies evaluated the efficacy of a combination cytoreductive strategy reporting survival rate of ranging from 83% at 3 years to 50% at 10 years. To date, there is no level 1 evidence comparing surgery versus other liver-directed treatment options for NELM. An aggressive surgical approach, including combination with additional liver-directed procedures is recommended as it leads to long-term survival, significant long-term palliation, and a good quality of life. A multidisciplinary approach should be established as the platform for decision making.
Surgical Treatment of Neuroendocrine Liver Metastases  [PDF]
Ser Yee Lee,Peng Chung Cheow,Jin Yao Teo,London L. P. J. Ooi
International Journal of Hepatology , 2012, DOI: 10.1155/2012/146590
Abstract: Management of Neuroendocrine liver metastases (NELM) is challenging. The presence of NELM worsens survival outcome and almost 10% of all liver metastases are neuroendocrine in origin. There is no firm consensus on the optimal treatment strategy for NELM. A systematic search of the PubMed database was performed from 1995–2010, to collate the current evidence and formulate a sound management algorithm. There are 22 case series with a total of 793 patients who had undergone surgery for NELM. The overall survival ranges from 46–86% at 5 years, 35–79% at 10 years, and the median survival ranges from 52–123 months. After successful cytoreductive surgery, the mean duration of symptom reduction is between 16–26 months, and the 5-year recurrence/progression rate ranges from 59–76%. Five studies evaluated the efficacy of a combination cytoreductive strategy reporting survival rate of ranging from 83% at 3 years to 50% at 10 years. To date, there is no level 1 evidence comparing surgery versus other liver-directed treatment options for NELM. An aggressive surgical approach, including combination with additional liver-directed procedures is recommended as it leads to long-term survival, significant long-term palliation, and a good quality of life. A multidisciplinary approach should be established as the platform for decision making. 1. Introduction Neuroendocrine tumors (NETs) are a varied group of neoplasms characterized by a relatively slow growth rate and the potential to produce and secrete a variety of hormones along with other vasoactive substances, giving rise to a variety of clinical syndromes. Neuroendocrine tumors are relatively uncommon with an approximate incidence of 1 to 5 per 100,000, but there has been a slow but steady rise in its incidence and prevalence [1, 2]. In the USA, the Surveillance, Epidemiology, and End Results (SEER) database showed a significant increase in reported incidence from about 1 in 100,000 in 1973 to 5 in 100,000 in 2004 [3]. Overall, the incidence is increasing at a rate of 3% to 10% per year [4]. This increase was likely caused in part by improvements in classification of these tumors, and the widespread use of endoscopy for cancer screening likely also contributed to the increase in reported incidence of gastrointestinal NETs [3]. Neuroendocrine tumors include carcinoid tumours, gastrinomas, insulinomas, glucagonomas, somatostatinomas, and vipomas [5]. Histopathologically, NETs are tumours of cells, which originate from the neuroectoderm and possess secretory granules. They can occur as part of multiple endocrine
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