Hernia tissues morphology in patients with chronic inguinal hernias

Кафедра загальної хірургі

Biochemical disorders in patients with strangulated abdominal hernias, complicatedby acute intestinal obstruction

Existing literature sources related to the problem of strangulated hernias are contradictory. Specific attention is paid to intestinal obstruction as a complication of strangulated hernias. There is no clear answer concerning changes of different links of metabolism in patients with strangulated hernia and intestinal obstruction. The aim of the study was to evaluate the changes of metabolism in patients with strangulated abdominal wall hernias complicated and non-complicated by intestinal obstruction.Totally 120 patients participated in the study, among them 78 patients were operated for strangulated hernia of anterior abdominal wall with no signs of acute intestinal obstruction (I group) and 42 patients who were operated for complicated acute intestinal obstruction (II group). Groups were equivalent according to age and sex parameters. Bioethics was strictly obeyed. Metabolic changes evaluated according the literature recommendations. Methods of variation statistics applied through MS Excel® software. In the Igroup patients we noted the favorable course of the disease in the postoperative period. Decompensation of comorbidities in this group of patients was not identified. In patients with strangulated hernia complicated by acute intestinal obstruction (II group), significant disruption of homeostasis were revealed at admission that grew further postope-ratively and were most pronounced on the third postoperative day. Statistically significant deviations from the normal values in protein, carbohydrate and water-electrolyte metabolisms have been identified in this group of patients. Strangulated abdominal wall hernias without intestinal obstruction lead to minor changes in different metabolic processes. Complicated hernias with intestinal obstruction cause serious disruption of all forms of metabolism with residual violations even at the time of 3-7 days after surgery

Severity Scoring Systems Use In Surgery: An Experimental Update

By means of experimental modeling in acute model of abdominal sepsis, the efficacy of using of individual scoring systems for estimating the severity of surgical patients’ state (APACHE, APACHE II, MIP) has been studied in a comparative aspect. The prognostic value and the effectiveness of scoring pathologic conditions was studied by simulating an acute pathological process in experiment. The object of the study were 19 inbreed dogs weighing 8-15 kg (12.39±1.47 kg). To assess the functional state changes of the organism we determined heart rate, respiratory rate, arterial blood oxygenation indices, arterial blood pH, ionogramme indicators, hematocrit, creatinine, peripheral blood WBC count and formula, conducted a macroscopic assessment of the pathological process development. It was found that application of such systems with a prognostic purpose is advisable for using under clinical conditions. However, several factors are missing in all of the single scores. This lead to inaccurate data obtained when using only one separate system for the prognostic purpose. Thus, it is expedient to combine different evaluation systems with the aim of enhancing prognostic reliability and optimizing the treatment tactics. The combined use of several scoring system in each particular case provide efficiency and accuracy in prognosis of the patients' outcome

DEVELOPMENT OF ACUTE RESPIRATORY DISTRESS SYNDROME UNDER ABDOMINAL SEPSIS

By means of experimental modeling in acute model of abdominal sepsis, the efficacy of using of individual scoring systems for estimating the severity of surgical patients’ state (APACHE, APACHE II, MIP) has been studied in a comparative aspect. The prognostic value and the effectiveness of scoring pathologic conditions was studied by simulating an acute pathological process in experiment. The object of the study were 19 inbreed dogs weighing 8-15 kg (12.39±1.47 kg). To assess the functional state changes of the organism we determined heart rate, respiratory rate, arterial blood oxygenation indices, arterial blood pH, ionogramme indicators, hematocrit, creatinine, peripheral blood WBC count and formula, conducted a macroscopic assessment of the pathological process development. It was found that application of such systems with a prognostic purpose is advisable for using under clinical conditions. However, several factors are missing in all of the single scores. This lead to inaccurate data obtained when using only one separate system for the prognostic purpose. Thus, it is expedient to combine different evaluation systems with the aim of enhancing prognostic reliability and optimizing the treatment tactics. The combined use of several scoring system in each particular case provide efficiency and accuracy in prognosis of the patients' outcome