Different Methods Of Surgical Treatment Research Articles

Functional outcomes of bowel resection versus shaving or disc excision of colorectal endometriosis: a systematic review protocol

IntroductionEndometriosis is a prevalent gynaecological condition for women of reproductive age worldwide. While endometriosis primarily involves the reproductive system, it can also infiltrate additional viscera such as the gastrointestinal tract....

Prevention of complications of surgical treatment of stage III-IV cystocele using light polypropylene mesh.

The purpose of study was to report the subjective and objective results of different methods of surgical treatment of cystocele using the transvaginal Mesh-system. A prospective study was conducted from January 2017 to December 2020 comparing anterior colporrhaphy with vaginal mesh and two distinct types of vaginal wall repair sutures in the surgical treatment of cystocele. The primary endpoint was the incidence rate of vaginal wall erosion complications 12 months after surgery. Secondary endpoints were anatomic outcomes, TVM-related morbidity, and patient satisfaction measured using validated questionnaires. In total, 102 patients with stage III-IV cystocele and the average age of 67.2 ± 3.1 years (age range of 47-79 years old) took part in the study. Of the 102 women initially enrolled, 102 (100%) were successfully followed up 12 months after primary surgery. The primary result, the objective erosion development, was radically different in the comparison groups (1.6% against 23.5%, respectively). Analysis of the improved method of operative treatment showed a prominent level of positive, uncomplicated, surgery results of 98.4% (60/61). The anatomic success rate of recovery from cystocele was 99.9% (101/102) 12 months after surgery. The suggested method of restoring the anterior vaginal wall in stage III-IV isolated cystocele without signs of incomplete and complete prolapse of the uterus showed a radically positive result. The number of complications was relatively high in the comparison group, but no difference was observed in satisfaction with the anatomical results of the surgery. The percentage of the vaginal wall erosion when using a single-layer suture is 23.5%, when using a two-layer suture is 1.6.

Хирургическое лечение Hallux extensus

Introduction This study is a comparative assessment of early and long-term results of two different methods of surgical treatment of hallux extensus. Materials and methods The results of surgical treatment of 22 patients with Hallux extensus at the orthopedic department of the Moscow Yudin City Hospital from 2017 to 2019 were studied. The patients were divided into 2 groups depending on the tactics of surgical treatment. The main goal of this study is a comparative assessment of the functional results of two surgical techniques. The first group of patients, which included 11 subjects, underwent needle percutaneous tenotomy of the extensor tendon of the big toe, the second group, which also consisted of 11 people, underwent tenodesis of the tendon-muscular part of the short flexor of the big toe according to the proposed by us technique. Results The study results are based on the assessment of subjective patient satisfaction and radiography images, as well as on the ACFAS score. In the group of patients who underwent percutaneous tenotomy of the extensor tendon of the big toe, there was a recurrence of deformity in 4 patients (36 %) and insufficient correction of the deformity in 2 patients (18 %). In the group of patients who underwent tenodesis of the tendon-muscle part of the short flexor of the big toe, 100 % showed good functional results, pain relief and esthetic effect. Good treatment results were observed in 73.3 % of the patients. Conclusions Analysis of the clinical results of surgical treatment showed a high efficacy of tenodesis of the tendon-muscle part of the short flexor of the big toe in comparison with percutaneous tenotomy of the extensor tendon of the big toe. Positive results were achieved in 100 % of cases. No recurrence of deformity was observed. The patients did not complain of pain, and there were no problems with footwear in the postoperative period.

Determination of CCL2 / MCP-1 levels in the serum of children with melanocytic nevus in the postoperative period after using different methods of surgical treatment.

To date, there are many methods and ways to remove pigmented skin tumors, which have their own indications and contraindications for use, early or late complications.The aim of the studywas to determine the level of CCL2 / MCP-1 in the serum of patients with melanocyte skin nevi in the postoperative period with different methods of their removal.Materials and methods of research.The study involved 60 children with melanocyte skin nevi of different localization, who were hospitalized in the pediatric surgery clinic in the period from 2018 to 2020. All patients were divided into 3 groups : I group - the excision of the formation took place with a scalpel, group II - excision of the formation was performed using a high-intensity surgical laser, group III - excision of the formation using a high-frequency electrosurgical device «BOWA-ARC 350.Results and discussion.The results of our study showed an increase in the level of CCL2 / MCP-1 plasma level in the patients of group I in 2,6 times in 12 hours after surgery and in 3,15 times in 24 hours after surgery. A similar but more pronounced dynamics of CCL2 / MCP-1 plasma level was observed in patients of group II. The largest increase in CCL2 / MCP-1 levels was observed in the comparison group III.Conclusions.High CCL2 / MCP-1 plasma level in patients of groups II and III in 12 and 24 hours after surgery convincingly indicate the presence of a pronounced inflammatory reaction under the influence of thermal damaging factor on skin tissues. (www.actabiomedica.it)

Surgical treatment of complicated duodenal ulcers with different variants of their localization

Purpose: To analyze and highlight the most effective methods of surgical treatment of complicated duodenal ulcer (DU) depending on its location. Material and methods. 86 patients underwent surgery for complicated combined pyloroduodenal ulcers. All patients with signs of gastrointestinal bleeding and perforation were examined according to clinical protocols. Patients were operated on by various surgical techniques depending on the location of DU. Further the analysis of different methods of surgical treatment of the pathology under study at its various localizations was carried out. Results. It has been established that in complicated combined pyloroduodenal ulcers with localization in the pyloric canal antrumectomy is the method of priority. If duodenum ulcer is complicated by bleeding, excision with pyloroplasty is the method of priority. Suture ulceration with pyloroplasty can be considered as an alternative method of treatment. It has been verified that in complicated duodenal ulcers, exteriorization and suturing of the ulcer have the lowest efficiency. The most frequently used method of duodenal ulcers of any localization treatment was excision of the ulcer with pyloroplasty. 6 (41.8 ± 0.053%).patients had been operated on by this method. In the second place in terms of universality was ulcer’s suturing with pyloroplasty - 22 patients or (25.5 ± 0.047%). The third was the method of exteriorization and suturing of ulcers, which accounted for 10 patients (11.6 ± 0.034%).

Direct medical costs of interprosthetic femoral fracture treatment: A cohort analysis

IntroductionPeriprosthetic femoral fractures (PPFs) represent a challenging clinical problem with a fast-rising incidence. Interprosthetic fractures (IPFs) represent one of its most difficult variants. There is a paucity of data regarding the financial burden of PPFs, and none for IPFs. This study aims to estimate the direct medical cost of the surgical treatment of IPFs in NHS, and analyse the factors influencing this when using different methods of surgical treatment. MethodsA cohort of patients with IPFs treated in a single academic unit over a period of 8-years with different surgical methods was studied. In-hospital details, as well as outpatient follow-up data, were gathered relevant to their clinical and radiological outcome until discharge. Local and national NHS data were acquired from the financial department, as well as industry-related resources. The economic analysis was structured as a cost identification analysis (CIA) of the overall cohort, but also as a comparative best-case scenario (uncomplicated course till discharge) comparison between the 3 main different management strategies (a) revision arthroplasty (RTHA), b) plate fixation (ORIF), c) combination of implants (COMBO). ResultsData from 28 patients (22 females) with IPFs were analysed with a median age of 78.4 years. The overall direct medical cost of treating this cohort of patients was £468,330, with a median of £15.625 (range £10,128 to 33,060). Comparing the three different surgical modalities, the median cost in groups a, b, and c was £20,793 (range £12,110 to £24,116), £12,979 (range £10,128 to £20,555), and £22,316 (range £10,938 to £23,081) respectively. In all groups, the 2/3 of the identified costs were relevant to the inpatient stay. Transfusions were the highest (3 units of cRBC on average) to the patients that received a revision THA vs the other two groups (p=0.022). There was statistically significant higher mean overall cost between the RTHA and the ORIF groups (£19,453 vs. £14,201, p=0.0242), but not when compared with the COMBO cases (£19,453 vs. £18,788, p=0.86). ConclusionThe first cost identification study and “best case scenario” comparative analysis for IPFs demonstrated a significant overall direct medical cost, when managing these complex fractures with variable contemporary techniques. Evidence based reimbursement strategies should be developed to allow the sustainability of the clinical service we offer in this challenging patient population.

Обзор современных методов оперативного лечения малых диафрагмальных грыж и гастроэзофагеальной рефлюксной болезни

The article presents a review of literature dated 2011-2020 devoted to results of surgical treatment of small diaphragmatic hernias and gastroesophageal reflux disease. Small hernias are encountered with the frequency of 90%. The study discusses modern problems in application of different surgical methods for treatment of this pathology. Based on the review of domestic and foreign literature, we aimed to determine advantages of laparoscopic ant-reflux surgery versus conservative treatment and open surgery methods. Search for the materials was carried out in Scopus, Web of science, PubMed, e-library, Ulrich’s Periodicals Directory, Google Scholar and AGRIS databases. The keywords used were “small diaphragmatic hernias”, “operative treatment” and “gastroesophageal reflux disease”. The purpose of search for literature was to reveal main indications and selection criteria for laparoscopic ant-reflux surgery as well as to draw a comparison between results of cruroraphia and Nissen fundoplication by the frequency of relapse and complications. Additionally, we aimed to compare different operative techniques for fundoplication and to determine the most optimal one for improvement of the patients’ quality of life. Advantages of laparoscopic anti-reflux surgery in comparison with conservative treatment and open surgery methods have been revealed.

Treatment of hyperplasia of the coronoid process of the mandible in adults: analysis of 42 literature reports and illustrative case

ABSTRACT Objective: The objective of this research was to review the literature, compare different methods of surgical treatment for coronoid hyperplasia and report a clinical case of unilateral coronoid hyperplasia treated by coronoidectomy with intraoral access. Methods: A critical review of the literature was performed by selection of papers published in the last 20 years on the treatment of coronoid in adults in the PubMed, Medline, Scielo and Lilacs databases, with the terms coronoid hyperplasia OR coronoid elongation AND treatment OR management. The data was extracted for analysis. Results: twenty-four articles were selected. It included 42 patients, among them 69% were male patients and 81% were bilaterally affected. The age group with the highest prevalence was the people in the 20's and 30's. Sixty-nine percent of the patients were treated with coronoidectomy and 26.2% with coronoidotomy. The majority (83.3%) with intraoral access. No cases had surgical complications reported, and 71.4% underwent physiotherapy after surgery. Regarding the results, 83.3% were considered satisfactory, 11.9% were unsatisfactory. Conclusion: The great majority of the cases that brought significant results in the improvement of the pre and postoperative mouth opening were treated by coronoidectomy, proving to be an efficient and safe surgical treatment for the coronoid hyperplasia.

CLINICAL OUTCOME OF OPERATIVE TREATMENT IN 18 CASES OF GIANT CELL TUMORS OF BONES

Background: Giant Cell Tumor of the bone (GCTB) has got variable outcome after the different methods of surgical treatment depending upon the site and grade of lesion and extent of tumor removal. This retrospective prospective analysis of operatively treated cases of GCTB of different sites aimed to highlight the clinical outcome.
 Methods: This was a prospective observational study of 18 cases of GCTB; proximal tibia (n=6), distal femur (n=5), distal radius (n=4), proximal femur (n=1), proximal fibula (n=1) and anterior arc of first rib (n=1) treated with different operative management with mean follow up of 53.61 months. Functional outcome with Musculoskeletal Tumor Society Score (MSTS), recurrence and complications were analyzed with at least 24 months of follow up.
 Results: There were 10 females and 8 males with average age at presentation 27.3 years (range 15-38). Average duration of symptom was 4.72 months. 2 were cases of recurrence previously op­erated and 16 were de novo cases. Mean MSTS was 84.27% with good to excellent result in 88%. There were no non-union, graft failure, metastasis, prosthetic failure or wound infection till at least 24 months of follow up in any of the cases.
 Conclusions: Extended curettage or reconstruction with auto graft in grade I and II tumor or en­doprosthesis in higher grade or recurrence of GCTB can give good to excellent functional result in majority of the cases.

Clinical outcome of operative treatment in 18 cases of giant cell tumors of bones

Background: Giant Cell Tumor of the bone (GCTB) has got variable outcome after the different methods of surgical treatment depending upon the site and grade of lesion and extent of tumor removal. This retrospective prospective analysis of operatively treated cases of GCTB of different sites aimed to highlight the clinical outcome.
 Methods: This was a prospective observational study of 18 cases of GCTB; proximal tibia (n=6), distal femur (n=5), distal radius (n=4), proximal femur (n=1), proximal fibula (n=1) and anterior arc of first rib (n=1) treated with different operative management with mean follow up of 53.61 months. Functional outcome with Musculoskeletal Tumor Society Score (MSTS), recurrence and complications were analyzed with at least 24 months of follow up.
 Results: There were 10 females and 8 males with average age at presentation 27.3 years (range 15-38). Average duration of symptom was 4.72 months. 2 were cases of recurrence previously op­erated and 16 were de novo cases. Mean MSTS was 84.27% with good to excellent result in 88%. There were no non-union, graft failure, metastasis, prosthetic failure or wound infection till at least 24 months of follow up in any of the cases.
 Conclusions: Extended curettage or reconstruction with auto graft in grade I and II tumor or en­doprosthesis in higher grade or recurrence of GCTB can give good to excellent functional result in majority of the cases.

Options for surgical treatment of cicatrical stenosis of the middle (folded) larynx

Aim of the study: to develop a tactic of surgical treatment of cicatrical lesion of the middle larynx depending on the localization and length of stenosis.Materials and methods: from 2014 to 2019, 43 patients with cicatrical stenosis of the folded larynx underwent surgery. The average age of the patients was 39 years and ranged from 18 to 78 years. Depending on the clinical situation, patients were divided into 4 groups, in which different methods of surgical treatment were applied – removal of scars of the middle larynx using CO2-laser and additional application of keel-shaped implant (n = 21), microflaps in the area of commissure (n = 10) and intraretynoid region (n = 4), endoprosthesis covered with xenopericord (n = 8).Results: in the postoperative period endoscopic examination of the larynx was carried out in dynamics during the period up to 1 year. Patients were examined daily while in hospital, then monthly. In addition to endoscopic examination, the study of voice function was carried out by the method of determining the time of maximum fonation. The estimation of respiratory and voice rehabilitation was carried out and stable positive effect was received in 90% in the first group, 70% - in the second, 75% - in the third, 75% – in the fourth. The obtained data allow to develop an individual approach to surgical treatment of cicatrical stenosis of the larynx depending on the localization and extent of cicatrical lesion.Discussion: the optimal method of treating cicatrical lesion of the middle larynx is to create conditions that prevent the contact of wound surfaces and their separation. For this purpose, methods that are individually addressed to the main clinical situations in this problem have been developed. In addition, the use of CO2-laser in the surgical treatment of cicatrical lesions of the middle larynx significantly expands operational capabilities due to high accuracy and low level of damage to surrounding tissues.Conclusions: in case of cicatrical lesion of the middle larynx up to 4 mm in length, in the absence of a tracheostoma an effective method of restoration of respiratory and vocal function of the larynx is the use of microflaps formed by microsurgery with th e help of CO2-laser; stenoses in the area of middle larynx commissure of more than 4 mm require additional stenting for the period of epithelization of the wound surface and remodeling of the scar, which is 3–4 weeks. In the presence of a tracheostoma in patients with prolonged stenosis of the middle laryngeal commissiure, an implant coated with xenopericardium and chlorhexidine ionic-covalent immobilization, which helps to avoid inflammatory changes during the period of stenting, has proved to be a good choice.

Puncture methods of treatment of patients with fluid formations of the pancreas and liver

Summary. Diagnosis and treatment fluid formations of the liver and pancreas non-parasitic genesis remains a controversial issue, despite current advances in minimally invasive surgery. The aim of the study is to improve the results of surgical treatment of patients with fluid formations of the liver and pancreas non-parasitic genesis through the integrated use of mini-invasive methods of diagnosis and surgical treatment. Patients were carried out clinical, instrumental, laboratory methods of examination, in the course of which liquid formations were revealed. With the help of ultrasound of the apparatus the liquid structure was elucidated, then dopplerography determined the non-vascular zone for passing the puncture needle. For punctures we used special nozzles on the ultrasonic sensor. The puncture was performed under local anesthesia. Chiba-type needles were used for the puncture, and Pig tail catheters from 6 to 9 F were used for drainage. The timing of the puncture was determined individually, taking into account clinical and sonographic signs, with the average time of drainage of pancreatic cysts being 24 ± 4,3 days, and drainage of liver cysts – 32 ± 1,6 days. Indications for puncture under the control of sonography and laparoscopic treatment were determined. Puncture-draining interventions were performed in 53 patients with non-parasitic liver cysts, of which 30 patients were drained under ultrasound control, and 23 patients underwent video laparoscopic drainage. Also punctuation-drainage interventions were performed in 72 patients with pseudo-pancreatic cysts, of which ultrasonic drainage was performed in 48 patients, 24 patients had video laparoscopic drainage. In the case of puncture treatment of liver cysts and pancreas, narcotic analgesics were not used for pain relief. The postoperative period was more favorable in patients where percutaneous puncture interventions were used. Immediately after percutaneous interventions under ultrasound control and from the second day after videolaparoscopic operations, patients returned to their usual diet and volume of physical activity. Thus, comparing different methods of surgical treatment of non-parasitic fluid formations of the liver and pancreas it was established that application of puncture-draining methods allowed to improve significantly medical and social indices of this group of patients.

Comparative assessment of the efficiency of different methods of surgical treatment for varicose veins

Topicality. In some regions about ¼ of the population suffers from venous disease (VD), and the main methods of treatment are endovascular laser coagulation (EVLC) and a traditional phlebectomy using Babcock technique though the optimization of such surgical measures demands perfection. Objective: to assess the results of EVLC and phlebectomy in VD at different stages after the performed surgical procedure and to distinguish the factors defining the efficiency of the operation. Material and methods. There were 302 patients with VD of the lower extremities (¼ of men and ¾ of women aged from 29 to 72 years) under the survey. C2, C3, C4, C5 and C6 classes of VD are established in 10%, 14%, 37%, 16% and 23% of the cases, respectively. EVLC was carried out by means of the device “Fotonika-Lika-Surgeon” (Ukraine). The patients were observed 2, 4 and 24 weeks later after the operation. Results. EVLC in the patients with VD of shins statistically authentically exceeds the efficiency of phlebectomy both 2–4 and 24 weeks later after the performed operation, and, the presence of comorbide gonarthrosis has a negative effect on the first method of surgical treatment, while the results of the second one depend on the severity of the disease, laser ablation is closely connected with the initial indicators of prostacyclinemia and the level of superficial viscous properties of venous blood serum whereas the efficiency of phlebectomy defines the module of viscoelasticity, at the same time both groups of the patients didn't differ on parallel using of the medications, but they differed considerably on the character of the complications (the development of phlebitis, paresthesias, thrombosis of deep veins after the exposure to laser beams and the appearance of seromas, hematomas and a hyperpigmentation of the skin in other cases), besides the administration of rivaroxaban and low-molecular heparins was prescribed for the representatives of the first group within the month from the moment of the operation, and for the second group — cyclo-3-fort. Conclusion. The preference should be given to EVLC in the choice of the method of surgical treatment of VD.

Многоэтапное лечение оскольчатого внутрисуставного перелома дистального метаэпифиза лучевой кости с применением спицевого аппарата наружной фиксации

Introduction. Distal radius fracture is the most frequent fracture in humans. Most authors recommend surgical treatment for intraarticular fracture. A large number of different methods of surgical treatment have been proposed. However, in the long-term treatment no significant superiority of any one method over others has been statistically revealed. Objectives. To study the results of using of Ilizarov external fixation as primary fixation (first step treatment) for the period from injury to final ORIF with a volar locked plate. Patients and methods. The study is based on the analysis of the results of surgical treatment of 81 patients with multifragmentary intraarticular distal radius fractures. These fractures are considered unstable and conservative treatment is not preferred. Patients were divided into 2 groups of 41 and 40 people. In patients of the first group (control group), at the first stage, a closed reduction was applied followed by preoperative immobilization with a classical cast bandage. Patients of the second group (study group) as the first stage of treatment performed fixation of the wrist joint with its distraction in the bridge Ilisarov external fixator. In a few days after reducing swelling all patient had ORIF with volar locked plate. To assess the function of the upper limb in the postoperative period, a DASH questionnaire was used. The results were evaluated at 3,6,12 and 18 months. Results and discussion. In 3 months after surgery revealed a significant improvement in the function of the upper limb (estimated by DASH). After 1.5 years after surgical treatment, no statistically significant difference in the result of treatment was revealed. We suppose that distraction of the wrist joint with Ilizarov external fixator accelerates reducing swelling in preoperative period of time and can improve reduction during ORIF.

Comparison of Shape Memory Staple and Gelled Platelet-Rich Plasma versus Shape Memory Staple alone for the Treatment of Waist Scaphoid Nonunion: A Single-Center Experience.

Purpose The aim of this study was to analyze the results of two different methods of surgical treatment of waist scaphoid nonunions (SNUs). We retrospectively analyzed data from 87 patients referred to our department from January 2010 to December 2017 who were surgically treated for waist SNU. Methods The mean period of time passed from trauma was 11.2 (±5.6) months. Patients were divided into two groups based on surgical treatment received: volar exposure osteosynthesis with shape memory staple (SMS) (group A) and volar exposure osteosynthesis with SMS and gelled platelet-rich plasma (GPRP) application at the bone defect level (group B). A cast (thumb excluded) was maintained for 4 weeks. Healing was checked clinically (pain, QuickDASH [Disabilities of the Arm, Shoulder, and Hand] score, Mayo Wrist Score) and radiologically (standard X-ray). Results Union was achieved in 40 patients in group A (95.2%) and in all patients in group B (45 patients; 100%). A statistically significant difference was observed in the improvement of the Mayo Wrist Score, QuickDASH score, and pain (measured through the visual analog scale) after 3 months from surgery ( p = 0.02). Conclusion SMS is effective in treating waist SNU at more than 6 months from trauma. GPRP application can improve bone healing and upper limb function. Level of Evidence This is a retrospective observational Level III study.

Comparative study between excision with lay open and excision with primary closure in treatment of pilonidal sinus

Background: Pilonidal sinus is a common anorectal condition affecting young adults with various etiological factors. Various surgical methods have been described, but treatment failure and recurrence are frequent, causing considerable morbidity. This study was undertaken to study the different surgical methods in treatment of pilonidal sinus.Methods: This study was done between January 2017 and June 2018. 20 cases underwent excision with open healing and 10 cases underwent excision with primary closure. The surgeries for primary closure included Limberg flap, Karydakis technique and Z plasty. Patients were analyzed with respect to post operative complications, duration of hospital stay, duration of getting back to work and duration of wound healing.Results: Spectrum of clinical presentation included pain, discharge, sinus and swelling. No recurrences were observed in the present study. Wound infection occurred in only three cases. Duration of wound healing was found to be an average of 51.6 days in Excision with open healing method and 14.2 days in excision with primary closure method. The average length of hospital stay in excision and lay open group was 4.35 days and 5.4 days in the excision and primary closure group. The average duration to return to work was 34 days in excision and lay open group, while it was 8 days in excision and primary closure group.Conclusions: Excision with primary closure is a better modality than excision with lay open technique in treatment of pilonidal sinus.

Incision and Drainage with Daily Irrigation for the Treatment of Auricular Pseudocyst.

Introduction Pseudocyst of the pinna is a rare condition that occurs when fluid accumulates in the intercartilagenous space of the auricle. The main goal when treating this condition is to keep acceptable cosmetic results with no recurrence rate. Objective To demonstrate the superior impact of incision and drainage of auricular pseudocysts with the insertion of a catheter drain and daily irrigation as the treatment of this condition. Methods A total of 42 patients with auricular pseudocysts were enrolled in the present study in the period between May 2011 and May 2017. All of the patients were treated with incision and drainage with compression. The average follow-up time reached ∼ 6 months in all of the cases. Results All of the patients had satisfactory cosmetic results with no recurrence and no complications. Conclusion Among the different methods of surgical treatment of pseudocyst of the pinna, incision and drainage with daily irrigation is a significantly efficient method both for the eradication of auricular pseudocysts and for good cosmetic results.

A comparative analysis of four different surgical methods for treatment of sacrococcygeal pilonidal sinus

Although many surgical methods have been described for sacrococcygeal pilonidal sinus treatment, the best option is still controversial. We aimed to compare postoperative outcomes of these different methods in terms of advantages and disadvantages. The records of 320 patients undergone surgery for primary or recurrent pilonidal sinus between May 2013 and May 2017 were retrospectively analyzed. Demographical data, pre operative stories, wound site infection, seroma development, wound dehiscence, time of healing, duration of return to work, and if there is any recurrence of 303 patients included in the study were recorded. Upon wide local excision, the first surgeon performed marsupialisation and the lay open technique, second surgeon performed vertical excision and primary closure, third surgeon performed Limberg flap transposition and fourth surgeon performed Karydakis' flap transposition. There was no significant difference between the patients in terms of demographical characteristics. The duration of surgery was statistically significantly higher in primary closure method (p=0.001). The mean duration of return-to-work was statistically significantly lower in primary closure method (p=0.002). In primary closure method, the recurrence rate was found to be statistically significantly higher than the other methods (p=0.009). We do not suggest the use of primary closure method in treatment of pilonidal sinus. Because of lower rates of recurrence and shorter durations of return to work, the Karydakis and Limberg methods are seen as safer methods when compared to lay-open and marsupialization method.

Кохлеарная имплантация при отосклерозе с IV степенью тугоухости и глухотой

The article presents a literature review devoted to such pathology as otosclerosis with severe hearing loss and deafness. The article describes in details this pathology, research methods, analysis of statistical data and different methods of surgical treatment of otosclerosis with degree IV hearing loss, as well as their results. The article describes the present-day methods of diagnostics and differential diagnostics with other pathologies in the preoperative period in otosclerosis with severe hearing loss and deafness. The experience of various authors in preoperative preparation of patients with otosclerosis with severe hearing loss in cochlear implantation (CI). The detailed analysis of each CI technique, complexity and complications (intraoperative and postoperative), which significantly affects the results of rehabilitation in cochlear implantation in patients with otosclerosis with degree IV hearing loss and deafness. The problem of intraoperative diagnosis of this pathology remains unsolved. The authors suggest various ways of registration of reflexes, however, they are not effective in stapes ankylosis or after stapedoplasty. The article points out the unsolved problems in this pathology that need further development to improve the results of rehabilitation after CI.

The choice of surgical treatment in patients with infected pancreonecrosis

The objectiveis to study the results of different methods of surgical treatment of patients with infected pancreonecrosis and to conduct a comparative analysis of minimally invasive and traditional surgical interventions.Material and methods.The results of treatment of 206 patients with infected pancreonecrosis were analyzed. In accordance with the used method of surgical treatment, the patients were divided into 2 groups: 105 (51.0%) patients with “traditional” open interventions were included in the first group (comparison), and 101 (49.0%) patients treated with various miniinvasive technologies, or a combination of minimally invasive and “open” interventions were included in the second group.Results.It was found that the mortality rate in the second group was less than in the first group by 12.8% (p<0.05).Conclusion.Minimally invasive surgical techniques are the method of choice for delimited pancreatogenic ulcers. The use of combined surgical interventions leads to a significant reduction of postoperative mortality and duration of inpatient treatment.