6 research outputs found
Особенности диагностики и хирургического лечения промежностной грыжи больших размеров
USMF Nicolae Testemiţanu, Conferinţa consacrată aniversării celor 40 de ani de la fondarea SCM Sfânta Treime 17 iunie 2016 Chișinău, Republica MoldovaThe study analyzes the etiopathogenesis, clinical picture, diagnosis and surgical treatment of perineal hernia. The study contains and characterizes the own clinical case of large recurrent posterior perineal hernia. Hernia occurred after childbirth, exercise and surgery – herniotomy and hernia repair with own tissues of perineal hernia. The patient was re-operated on 17 years after the first operation with a combined biosynthetic plastic – with autoderma and synthetic mesh with satisfactory results. The were no complications in 18 years.В работе проанализированы этиопатогенез, клиника, диагностика и хирургическое лечение промежностной грыжи. Работа содержит и характеризует собственный клинический случай задней рецидивной промежностной грыжи больших размеров. Грыжа появилась после родов, физической разгрузки и операции – грыжесечения и герниопластики собственными тканями промежностной грыжи. Пациентка перенесла повторную операцию через 17 лет после первой операции с комбинированной пластикой – биосинтетической из аутодермы и синтетической сетки с благоприятным результатом. Через 18 лет осложнений не наблюдалось
Peculiarities of diagnostic and surgical treatment of external lateral abdominal hernia (Spiegel)
Catedra Chirurgie nr. 2, USMF „Nicolae Testemiţanu”Studiul include 29 cazuri de hernii ventrale laterale (Spiegel) ce alcătuiesc 1,01% din 1908 bolnavi cu hernii abdominale externe. Vârsta bolnavilor a variat
între 34-84 ani, majoritatea taraţi de sex feminin.
Cauza herniilor a fost efortul fizic, operaţiile suportate la peretele abdominal anterior – cât şi patologie colorectală.
La majoritatea bolnavilor au fost depistate maladii concomitente – obezitate, maladii pulmonare, diabet zaharat, boala hipertonică.
Tabloul clinic deseori poate simula apendicita acută sau cronică, colecistita cronică, patologie renală şi colonică în deosebi la pacienţii cu hernii mici şi
mijlocii. Aceste hernii sunt mai frecvent întâlnite decât diagnosticate până la operaţie, deoarece nu întotdeauna se ţine cont de ele.
Diagnosticul a fost complex şi a inclus examenul clinic, radiologic, ultrasonografia, tomografia computerizată şi examenul endoscopic la necesitate.
În herniile voluminoase cu atrofia ţesutului musculo-aponeurotic în jurul porţii herniare cu pierderea de substanţă s-a efectuat plastia combinată
biosintetică din autodermă perforată, localizată intraabdominal şi plasa sintetică deasupra fixate împreună sub tensiune, iar pe plasa sintetică lambourile
formaţiunii herniare. Morfologic la distanţă s-a constatat că lamboul autodermal se concreşte intim cu plasa de propilen, formează un ţesut conjunctiv
fibros cu colagenizare în care elementele celulare se reabsorb şi în sfârşit lamboul autodermal împreună cu plasa sintetică formează un strat bine adaptat şi
rezistent. La distanţa complicaţii nu s-au înregistratThe study includes 29 external lateral abdominal hernia (Spiegel) representing 1.01% of 1908 patients with external abdominal hernias. Age of the patients
was from 34 to 84 years, most of them were women.
The causes of hernias were physical activities, surgeries on the anterior abdominal wall as well as colorectal pathology.
Most patients had concomitant diseases - obesity, lung diseases, diabetes, and hypertension.
The clinical picture can often simulate acute and chronic appendicitis, renal and large intestine pathology, especially in patients with small and mediumsized hernias. These hernias are more common than diagnosed before surgery because they do not always take into account.
Diagnostics was comprehensive and included clinical and radiographic examination, ultrasound, CT and endoscopic examination if necessary.
In the case of voluminous hernias with atrophy of muscle-aponeurotic tissues around the hernial gate and loss of substance, was performed a combined
biosynthetic plastic from perforated autoderma located intraperitoneal and on top of it synthetic mesh connected under pressure, and on top of synthetic
mesh - flaps of hernia formation. Morphologically in the distant period was noted the intimate adnation of autodermal flap with synthetic mesh, the
formation of fibrous connective tissue with collagenization at which cellular elements are reabsorbed and eventually autodermal flap formed the resistant
layer with synthetic mesh. There were no complications in the distant period
Causal factors and surgical treatment in ventral postoperative hernias
Catedra Chirurgie 2, clinica 2, SCM „Sfânta Treime”Here are presented the results of operations on 154 patients with postoperative ventral hernia after conventional cholecystectomy, appendectomy, as well as gynecological operations on which was performed the plastic of hernia gates with own tissue – 91 cases, with synthetic mesh – 56 cases, and combined techniques – 7 patients. The results were good, except in five cases, two patients with postoperative lethality due to concomitant diseases.
Sunt prezentate rezultatele operaţiilor la 154 bolnavi cu hernii ventrale postoperatorii după colecistectomia clasică, apendicectomie, cât şi operaţii ginecologice la care s-a efectuat plastia porţilor herniare cu ţesuturi proprii – 91 cazuri, cu plasă sintetică – 56 cazuri, şi combinată la 7 bolnavi. Rezultatele au fost bune, cu excepţia în 5 cazuri, cu letalitatea postoperatorie la 2 bolnavi din cauza maladiilor concomitente
The analysis of repeated operations at hydatid hepatic cysts
Catedra chirurgie 2,Clinica chirurgie 2,USMF” N.Testemiţanu”, SCM „Sf. Treime”,
Chişinău, R.MoldovaRepeated operations were performed in 54 patients with residual cavity, purulent fistula,
the open bilious channel, the rest of the hydatid cyst, sequesters of the fibrous environment and
suture material, residual hydatid cysts and cysts due to the relapse of disease.
Improvement of the diagnosis, modernization of surgical techniques and prevention of
intraoperative dissemination by the content of the cysts can reduce the number of repeated
operations.
Reintervenţii chirurgicale la 54 bolnavi au fost efectuate pentru cavitate restanta, fistule
purulente, cale biliară deschisă, reziduu elementelor chistului hidatic, sechestre a membranei
fibroase şi materialul de sutură, chist hidatic rezidual si recidivant.
Reintervenţiile chirurgicale pot fi reduse prin diagnosticul în complex, modernizarea
tehnicii chirurgicale şi profilaxia desiminării intraoperatorie cu conţinut hidatic
Modern diagnosis and treatment of thoraco-abdominal injuries in everyday life
Catedra chirurgie 2,clinica 2, USMF “Nicolae Testemitanu “We analyzed the thoraco-abdominal trauma in 135 men and 36 women aged 17 - 71
years. Stab wounds were in 157 cases and gunshot wounds in 14 patients, most were located on
the left with injuries to the lung, heart, diaphragm, spleen and colon.
We used clinical, laboratory and instrumental (radiography review, sonography of the
chest and abdomen, pleural puncture, thoracoscopy and laparoscopy) examinations. The type of
surgery depended on the type of injury and the priority had the injuries with vital risk. The
evaluation in the postoperative period was complicated in 51 cases. 24 patients died from
pleural-pulmonary shock, multiple organ failure and purulent-septic complications.
Au fost analizate traumatismele toracic-abdominale la 135 barbaţi şi 36 femei în vîrsta
17-71 ani. Traume cu obiecte albe au fost în 157 cazuri, prin arme de foc la 14 pacienţi,
majoritatea localizate pe stînga cu lezarea plamînului, cordului, diafragmei, splinei, colonului.
Metoda de examenare au servit examenul clinic, de laborator şi instrumental (radiografia de
ansamblu, ecografia toracelui şi abdomenului, puncţia pleurală, toracoscopia şi laparoscopia.
Tipul intervenţiei a fost efectuat în dependenţă de traumatism, prioritate au avut cele cu risc vital.
Perioada postoperatorie a evoluat cu complicaţii în 51 cazuri cu 24 decese din cauza şocului
pleuropulmonar, insuficienţa poliorganică şi complicaţii septicopurulente