Introduction: Hemorrhoids is the most common disease among diseases of the anorectal zone. This disease can be attributed to diseases of civilization and its lifestyle.
Objective: review the most important studies of the incidence of hemorrhoids in foreign literature, determine the apparent prevalence of hemorrhoids in Kazakhstan based on an analysis of the available statistical data..
Materials and methods. We conducted an analysis of of-ficial statistics on the activities of medical organizations of the Republic of Kazakhstan for 2014-2019. The analysis does not include information about patients who received medical care in private medical organizationsbecause they did not record patients with hemorrhoids in official and accessible information resources during the indi-cated period of our research..
Results. North-Kazakhstan region, East-Kazakhstan region, Nur-Sultan city - are the leaders in terms of the proportion of OD treatment for hemorrhoids. This trend is observed from year to year without significant changes in indicators (based on the results of 2015, 2016, 2017) and reaches 16.2% in the South-Kazakhstan region, 11.1% in the East-Kazakhstan region and 10.4% in the Nur-Sultan city respectively ac-cording to the results of 2017. At the same time, it should be noted that in such a large metropolis of the country as Almaty, the number of patients referred to polyclinics for hemorrhoids takes only 2.3% in 2017, which does not fit into the overall picture explaining the higher proportionof appeals with the number of people living in the area..
Conclusion. In the Republic of Kazakhstan, a large-scale epidemiological study is necessary to determine the true incidence of Hemorrhoids. In the OD: to develop methods of prevention, to increase detection in the early stages of hemorrhoids, to introduce the position of coloproctologist (general surgeons who have specialized in coloproctology) at the level of urban clinics.
Introduction. Hypertrophic cardiomyopathy (HC) is a structural and functional pathology characterized by a significantly thickened ventricular myocardial wall. The prevalence of HC is 1: 500. Up to 60% of cases in adults is an autosomal dominant disease in which there are mutations in the genes encoding sarcomere protein. Medical history and clinical picture. Manifestation of the disease is diverse and depends on the penetrance of the genes involved in this pathology. Most patients have no complaints. The most com-mon symptoms are shortness of breath, fatigue, swelling in the ankles, feet, abdomen, and neck veins. Often accompanied by obstruction of the left ventricle and is manifested by symptoms such as shortness of breath, chest pain and loss of consciousness. Diagnostics. An important role in the diagnosis of HC is played by ECG, echocardiography, MRI and CT. In adults, hypertrophic cardiomyopathy is diagnosed with an increase in the wall of the left ventricle over 15 mm in one or more segments of the left ventricle, which are established using any conventional diagnostic method. Treatment. In the medical treatment of HC the main role is played by B-blockers and calcium channel blockers. With the ineffectiveness of drug therapy, surgical tactics are used. There are two main invasive treatments for HC: myectomy and alcohol ablation. Myectomy has been used since the early 1960s and is an open operation, which is accompanied by more frequent complications. At the moment, myectomy is the “gold standard” which gives relatively better instru-mental and symptomatic indicators compared to alcohol ablation..
Conclusion. The fundamental method in the diagnosis of HC is echocardiography. For differential diagnosis and stratification of patient risk, MRI is better suited. It is currently reported that there is no randomized clinical trial to compare myectomy and alcohol ablation, but several meta-analyzes have shown that both methods reduce symptoms and have the same mortality. The choice of treatment tactics should be decided by a multidisciplinary team. n. a. A. N. Syzganov n. a. A. N. Syzganov mutation, myectomy
Hepatocellular carcinoma, a malignant neoplasm originating from hepatocytes, is the most common type of primary liver cancer. In recent years, there has been an increase in the incidence rate of hepatocel-lular carcinoma worldwide, including in Kazakhstan. Currently, diagnostic issues are still important. The article describes the analysis of the expression of alpha-fetoprotein in comparison with the stage and grade of hepatocellular carcinoma. try, stage, grade
Anatomical abnormalities of the intra- and extrahepatic bile ducts are common. Adequate examination of the bile ducts and preparation of a preoperative plan for the course of endoscopic, percutaneous, and open operations helps to prevent biliary complications. We describe a case where the patient had severe mechanical jaundice and a careful examination, an intraoperative finding, showed a low confluence of the cystic duct into the common bile duct. (CBD)
Keywords
mechanical jaundice, low inser-tion of cystic duct
In the period from January 2016 to November 2019 in the Department of surgical Coloproctology of the Scientific center of surgery M. A. Topchibasheva performed primary recovery operations for the incidence of rectosigmoid rectum with the imposition of colorectal anastomosis with the removal of temporary ileostomy in 51 patients. There were 20 males (39.2%) and 31 females (60.8%). The age of the patients ranged from 34 to 75 years and averaged 63.7±1.5 years. More than 54% of patients are elderly and senile Patients. the effect of temporary ileostomy prevents the failure of the primary colorectal anastomosis for rectal cancer. In our opinion, a preventive ileostomy should be formed in cases where the risk of anastomosis failure is high. Preventive stomas reduce the incidence of colorectal (coloanal) anastomosis failure and play an important role in preventing complications associated with failure, which significantly expands the possibilities of primary restoration of colonic continuity.
For 30 patients with extensive drug resistance (main group) performed surgical intervention, including thoracoplasty with extrapleural filling with silicone implant and with preliminary valve bronchoblocation of the draining bronchus of the injured lung segment (lobe), the remaining 30 patients (the control group) performed surgical intervention including only extrapleural thoracomyoplasty. An analysis of the results found that the performed collapse surgical interventions in various studies showed almost equal effectiveness: in the main group it constituted 63,3%,and in the control, it was achieved in 60% of patients. Despite of the equal treatment effectiveness, there were determined the advantages of the collapsosurgical method with use of silicone implant against traditional methods of thoracoplasty: a) absence of the cosmetic defect of the chest wall in patients after operation (p<0.000) b) no impairment of motor function in the shoulder joint (p<0.000); c) the patient’s posture is not disturbed(p<0,000 ); ria, resistance
Keywords
Tuberculosis with extensive drug resistance, collapsosurgical intervention, thoracomyoplasty, silicone implant, valve bronchob-locator, tuberculosis mycobacte-ria
A retrospective analysis of surgeons’ laparoscopic cholestectomy with acute cholecystitis is presented. A rare form of diagnostic complication has been described: limited pus (abscess) over the liver which was removed by relaroscopy
Keywords
laparoscopic cholecystec-tomy, complications, the transition to the traditional method
In this review we want to report a case of human fascioliasis in a 19-year-old patient who was undergoing treatment in the National Scientific Center of Surgery named after A. N. Syzganov.
Objective: to study the clinical and hemodynamic effectiveness of revascularizing osteotrepanation with intracosteal laser irradiation (ICLI) in patients with critical lower limb ischemia (CILL) on the background of distal steno-occlusion of the arteries. Research material and methods: studies were conducted in 73 patients with CILL on the background of distal steno-occlusiarteria. Standard ROT surgery was performed in 42 patients, and 31 patients had ROT surgery with intracosteal laser irradiation. Clinical results of treatment were evaluated on the Rutherford R. B. et al. (1997). The following indicators of arterial and venous blood flow were determined: rheographic index (RI), linear blood velocity (LBV) in the popliteal artery, regional systolic pressure (RSP) standing and lying down, regional systolic pressure gradient (RSPG), post-occlusive venous pressure (POVP) standing and lying down, post-occlusive venous pressure gradient (GPOVP), venous-arterial index (VAI) standing and lying. Oxygen saturation of the skin (SOS) in the distal part of the foot was also studied. Parameters of regional arterial and venous blood circulation were compared with identical parameters of 48 practically healthy individuals («reference group»).
Results: when patients were admitted to the clinic, a sharp violation of the arterial and venous links of regional microcirculation was revealed. ROT and ROT surgery with ICLI significantly improves regional blood circulation, reduces the degree of chronic ischemia, and increases the number of patients with significant and moderate improvement in the clinical status of patients. These positive results were most pronounced in patients who underwent ROT surgery with ICLI.
Keywords
distal occlusion of the artery, critical ischemia of lower limb, regional blood flow, revascu-larizating osteotrepanation, intracosteal laser irradiation
