Since the beginning of the new coronavirus infection pandemia over 57.9 million people have been infected and over 1.3 million have died. The world statistics on COVID-19 rates Kazakhstan as 49 with revealed cases of COVID-19 and 53 with deaths cases. In 80% of patients with COVID-19, COVID-19 have mild or moderate disease, about 15% have severe disease requires oxygen support, and 5% have a critical illness requires stay in intensive care units. The average duration of ICU stay is 10.8 days. In 22.7% of patients, ICU length of stay is over 30 days. The mortality rate of patients in intensive care units was 40-61% during the first wave, but in most affected regions it was as high as 90%. In order to improve the results of intensive care, a team-based way introduced in many hospitals. These teams do most labor-consuming and potentially dangerous manipulations. This approach requires a sufficient number of engaged and well-trained staff. In in an acute shortage of ICU staff, some actions assumed to train medical personnel of other specialties to become doctors and nurses in intensive care units. Short and superficial courses, designed to prepare the maxi-mum number of intensive care specialists in the shortest time, as a rule, leads to a deterioration in the quality of the provided intensive care and does not improve results and mortality.
Today, in the field of modern technologies, despite successes in the field of reproductology and ad-vanced assisted reproductive technologies (ART), the frequency of infertile marriage has not only not sta-bilized, but also increased over the year, reaching 25-30% in the population. Tubal peritoneal infertility is one of the leading places in the frequency of occurrence of various factors leading to the absence of an oncoming pregnancy.
Keywords
infertility, tubal-peritoneal factor, proxy obstruction of the fallopian tubes, selective hysterosalpingog-raphy
Timely diagnosis of liver echinococcosis remains relevant to present. In order to improve the diagnosis and treatment of cystic echinococcosis of the liver, the WHO classification (2003) has been developed and introduced into practical medicine, which is used to make a diagnosis and choose a treatment. Ultrasound is a screening method that determines the further tactics of patient management. The ultrasound accuracy reaches 90%. The patients underwent various types of operations, depending on the stage of parasite de-velopment and the size of the cysts, and conservative treatment with albendazole was carried out.
With the development of innovative technologies of liver resection and partial transplantation, the intra-vital assessment of organ volume is of great interest. This review presents the main methods of CT volumetry in the preoperative assessment of donor liver volume, provides an analysis of the available literature data, identifies the advantages and disadvantages of each method. Liver transplantation in terms of frequency is on the 2nd place in the world after kidney transplan-tation. According to the WHO, up to 20 thousand liver transplants are performed annually in the world (14.6% of the donor during his lifetime). Liver transplantation from a related donor has been carried out in Kazakhstan since 2011. As of December 2018, 283 liver transplant procedures were performed at 5 transplant centers in Kazakh-stan.
Gastroesophageal reflux disease (GERD) is a common pathology among benign diseases of the upper gastrointestinal tract. Lifestyle adjustments and conservative treatments are effective in most patients and are the main treatment for GERD. But despite this, some patients require surgery - antireflux surgery. The article analyzes the results of surgical treatment of patients from 2010 to October 2020 who underwent sur-gical treatment for GERD in the conditions of the department of surgery of the gastrointestinal tract of the National Scientific Center of Surgery named after A. N. Syzganov.
Keywords
gastroesophageal reflux disease, Nissen’s fundoplication, antireflux surgery
A 39-year-old man presented with a large mass on her left hand that was progressively enlarging over a period of a few years. He had pain syndrome, cosmetic concerns about the enlarging mass, and experi-enced interference with routine activity. Physical examination revealed a soft, mobile, non-tender, lobulated mass with well-defined margins. Ultrasound diagnostic showed the soft lump to be a lipomatous mass in the deep palmar space of the hand, which was subsequently surgically resected. The imaging features of deep palmar lipomas of the hand and other common benign lesions at this location are discussed.
Rubufin was applied in patients of the National Scientific Center of Surgery named after A. N. Syzganov in the postoperative period. Studied 150 patients aged 22 to 65 years. The effectiveness of anesthesia was assessed by changing the following criteria: blood pressure, pulse, heart rate, oxygen saturation in periph-eral blood, gas composition and acid-base state of the blood, and a visual analogue pain rating scale. The effect of rubufin on changes in blood biochemical parameters was studied. A decrease in pain syndrome was revealed by 1.5 times, a decrease in heart rate from 95.6 ± 8.8 to 83.2 ± 11.7 per minute, and respira-tory rate from 22.4 ± 2.7 to 16.3 ± 2.1 in minute, a decrease in mean arterial pressure is proportional to a decrease in pain, absence of respiratory depression, an increase in oxygen tension in the blood from 109.5 ± 23.4 mm Hg. up to 112.4 ± 16.6 mm Hg, no changes in blood biochemical parameters when using rubufin. Thus, it has been proven to be highly effective in anesthetizing patients with moderate and severe pain syn-drome after extensive surgical interventions, and to improve the indicators of blood oxygenation and stroke volume associated with the elimination of pain syndrome.
The study was carried out on the basis of the Scientific Center of Surgery named after M. A. Topchiba-shev in the Department of Surgical Coloproctology and Surgical Clinic of the Azerbaijan Medical University (AMU), 37 patients were inpatient. All hospitalized patients underwent general clinical (collection of com-plaints, study of anamnesis, physical examination data), laboratory, as well as endoscopic, morphological and radiological examinations.
Analyzed the results of the collapse-surgical method of treatment using a mini-access in 10 patients with fibrous-cavernous tuberculosis with extensive drug resistance. The effectiveness of surgical treatment in the main group was achieved in 9 (90.0%) patients versus 19 (63.3%) patients in the control group. Performed accesses did not affect the effectiveness of surgical treatment. There is a difference in cosmetic effect: advantage in length of access from 6 to 8 cm versus large incision bordering the scapula.
Operational treatment of recurrent shoulder dislocation is present as a most difficult problem in modern orthopedics. This pathology is prevalent, the result of treatment is not usually gratifies the orthopedists and the patients. That’s why the search of new methods of curing the given injury is always common. In last 5 years 22 patients with recurrent shoulder dislocation injury were operated in City Hospital of Emergency (Almaty city). The usual aid of patients is from 20 to 50 years old. 12 patients were operated by Bancart methodic and 10 patients were operated with new methodic. The results of treatment by new methodic had a better result than a methodic of Ban cart and are recommended for curing in hospitals.
The problem of choosing tactics for treating patients with peripheral artery aneurysm of various etiology and localization. Probably, it will be relevant for vascular surgeons who periodically face non-trivial clinical situations requiring non-standard solutions. Surgical intervention on aneurysmically dilated vessels should be carried out using preoperative diagnostic training, including instrumental examination, in order to deter-mine the volume of intervention, access, and stratification of operational risk.
Benign biliary strictures can occur as a result of large variety of causes, but approximately more than 80% are iatrogenic after direct or vascular injury during laparoscopic or open cholecystectomy. Especiallyy after widespread application of laparoscopic cholecystectomy the incidence of iatrogenic bile duct injuries has increased two-four times higher than recorded in open cholecystectomy. Iatrogenic bile duct strictures (IBDS) can present with heteregenous clinical signs. The severity of clinical symptoms depends on stricture localization, the time of injury and septic condition. There are broad spectrum non- invasive (US, CT, MRI) and invasive (ERCP, IDUS) imaging techniques for confirming diagnosis and clarifying the etiologies of bili-ary strictures. At the moment MRCP is the “gold standart “ for the complete evaluation of the biliary tree. Successful treatment requires a correct assessment of current patients condition with iatrogenic biliary strictures because, most of patients have a history of multiple interventions and complication. Despite dif-ferent treatment tactics available for iatrogenic bile duct strictures the gold standard method is still not de-fined. The management of iatrogenic bile duct strictures after cholecystectomy are challenging and requires multidisciplinary approach comprising hepatobiliary surgeons, endosopists and interventional radiologists. Endoscopic stenting with multiple plastic stents should be chosen as first-line therapy for most cases of iatrogenic bile duct strictures. Fully covered self-expandable metal stents may be a good alternative to plastic stents, in some cases. Surgery is indicated in patients with complicated biliary and anastomotic strictures and in whom non-surgical treatments have failed. Patients with complex injuries ( vasculo-biliar injuries), secondary biliary cirrhosis and portal hypertension are good candidat to the liver transplantation. Implementation of novel technologies increases expectations for improved treatment options in future.
Keywords
iatrogenic bile duct strictures, cholecystectomy, endoscopic treatment, Roux-en Y hepaticojeju-nostomy
