Video laparoscopic diagnostics and surgical tactics for acute diseases of abdominal organs
https://doi.org/10.33667/2078-5631-2021-4-17-24
Abstract
The article presents the results of video laparoscopy (VLS) performed in 2008–2019 in 5,599 patients in order to diagnose acute diseases of the abdominal organs requiring emergency surgery, identify competing and concomitant diseases, and determine treatment tactics. 2,442 (43.6 %) of them made up group I, with no doubt; 2,656 (47.4 %) – II group, with presumptive reliability; and 501 (9.0 %) – group III, with an unclear clinical diagnosis of the disease. In 2,326 (95.2 %) patients of group I with VLS, the clinical diagnosis was confirmed, in 100 (4.1 %) other diseases were revealed, and in 16 (0.7 %) the diagnosis was not established. Competing diseases were found in 8 patients and concomitant diseases in 4. In 1,641 (61.8 %) patients of group II, VLS made it possible to clarify and differentiate the clinical diagnosis of diseases, in 929 (35.0 %) – to identify other diseases, and in 86 (3.2 %) the diagnosis was not possible. When performing differential diagnosis, 126 other diseases were identified more than the number of patients. Competing diseases were found in 6 patients and concomitant diseases in 6 patients. 356 (71.0 %) patients of group III with VLS were diagnosed with major diseases, 75 (15.0 %) had other diseases, and 70 (14.0 %) were not diagnosed. In 4 patients, competing diseases were found, and in 1 – concomitant disease. Of the 5,427 (96.9 %) patients with the definitive diagnosis of the disease established with VLS, 3,828 (70.5 %) were found to be able to perform VLS operations, in 10 (0.3 %) of them – simultaneous with competing diseases.
About the Authors
A. S. Ermolov
Scientific Research Institute of Emergency Medicine n.a. N.V. Sklifosovsky; Russian Medical Academy for Postgraduate Continuous Education
Russian Federation
Russian Federation
Ermolov Alexander S.
Moscow
V. T. Samsonov
Scientific Research Institute of Emergency Medicine n.a. N.V. Sklifosovsky
Russian Federation
Russian Federation
Samsonov Vladimir T.
Moscow
P. A. Yartsev
Scientific Research Institute of Emergency Medicine n.a. N.V. Sklifosovsky; Russian Medical Academy for Postgraduate Continuous Education
Russian Federation
Russian Federation
Yartsev Peter A.
Moscow
A. A. Gulyaev
Scientific Research Institute of Emergency Medicine n.a. N.V. Sklifosovsky; Russian Medical Academy for Postgraduate Continuous Education
Russian Federation
Russian Federation
Gulyaev Andrey A.
Moscow
References
1. Савельев В.С., Гельфанд Б.Р. Абдоминальная хирургическая инфекция. Российские национальные рекомендации. М. 2011. Savelyev V.S., Gelfand B.R. Abdominal surgical infection. Russian national recommendations. M. 2011.
2. Самсонов В.Т., Ермолов А.С., Гуляев А.А. и др. Видеолапароскопия в экстренной хирургии редко встречающихся, атипичных заболеваний. Хирургия. 2020. 11. С. 25–31 Samsonov V.T., Ermolov A.S., Gulyaev A.A., et al. Videolaparoscopy in emergency surgery of rare, atypical diseases. Surgery. 2020. 11. pp. 25–31.
3. Турбин М.В., Черкасов М.Ф., Черкасов Д.М., Устименко И.В., Меликова С.Г. Возможности эндовидеохирургии в диагностике и лечении острого аппендицита. Современные проблемы науки и образования. 2018. 3. С. 71. Turbin M.V., Cherkasov M.F., Cherkasov D.M., Ustimenko I.V., Melikova S.G. Possibilities of endovideosurgery in the diagnosis and treatment of acute appendicitis. Modern problems of science and education. 2018. 3. p. 71.
4. Горелик С.Г., Поляков П.И., Литынский А.В. Диагностика и лечение острой абдоминальной патологии у пациентов старших возрастных групп. Научные ведомости Белгородского государственного университета. Серия: Медицина. Фармация. 2012. Т. 20. № 22–2 (141). С. 117–122. Gorelik S.G., Polyakov P.I., Litynsky A.V. Diagnostics and treatment of acute abdominal pathology in patients of older age groups. Scientific vedomosti of the Belgorod State University. Series: Medicine. Pharmacy. 2012. Vol. 20. no. 22–2 (141). p. 117–122.
5. Диагностика и лечение острых хирургических заболеваний органов брюшной полости. Опыт московского здравоохранения 1993–2014 гг. Под ред. А.С. Ермолова. М.: ВИДАР-М; 2015. Diagnosis and treatment of acute surgical diseases of the abdominal cavity. Experience of Moscow healthcare 1993–2014 Edited by A.S. Ermolov. Moscow: VIDAR-M; 2015.
6. Касимов Р.Р., Мухин А.С. Современное состояние диагностики острого аппендицита. Современные технологии в медицине, 2013, Т. 5, № 4, С. 112–117. Kasimov R.R., Mukhin A.S. Modern state of diagnostics of acute appendicitis. Modern technologies in medicine, 2013, vol. 5, no. 4, pp. 112–117.
7. Мещеряков В. Л., Слесаренко С. С., Коссович М. А. и др. Видеолапароскопия в экстренной абдоминальной хирургии. Альманах Института хирургии им. А.В. Вишневского, 2010, Т. 5, № 1, С. 63. Meshcheryakov V. L., Slesarenko S. S., Kossovich M. A., et al. Videolaparoscopy in emergency abdominal surgery. Almanac of the Vishnevsky Institute of Surgery, 2010, vol. 5, no. 1, p. 63.
8. Баймаков С.Р., Жамилов У.Р., Юнусов С.Ш., Аширметов А.Х. Сочетание острого аппендицита с перекрутом и некрозом жирового подвеска толстой кишки при транспозиции внутренних органов. Вестник хирургии им. И. И. Грекова. 2020. Т. 179, № 1. С. 74–77. Baymakov S.R., Zhamilov U.R., Yunusov S. Sh., Ashirmetov A.H. The combination of acute appendicitis with torsion and necrosis of the fat suspension of the colon in the transposition of internal organs. Bulletin of Surgery named after I.I. Grekov. 2020. Vol. 179, No. 1. pp. 74–77.
9. Тимербулатов В. М., Тимербулатов М. В. К дискуссии о лечебной тактике при остром аппендиците. Хирургия. 2014. № 4. С. 20–22. Timerbulatov V.M., Timerbulatov M.V. On the discussion of therapeutic tactics in acute appendicitis Surgery. 2014. No. 4. pp. 20–22.
10. Тимофеев М.Е., Шаповальянц С.Г., Федоров Е.Д., Полушкин В.Г. Применение лапароскопических вмешательств в диагностике и лечении острой спаечной тонкокишечной непроходимости у больных без перенесенных операций на органах брюшной полости. Хирург, 2013, № 9, С. 25–36. Timofeev M.E., Shapovalyants S.G., Fedorov E.D., Polushkin V.G. The use of laparoscopic interventions in the diagnosis and treatment of acute adhesive small bowel obstruction in patients without surgery on the abdominal organs. Surgeon, 2013, No. 9, pp. 25–36.
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For citations:
Ermolov A.S., Samsonov V.T., Yartsev P.A., Gulyaev A.A. Video laparoscopic diagnostics and surgical tactics for acute diseases of abdominal organs. Medical alphabet. 2021;(4):17-24. (In Russ.) https://doi.org/10.33667/2078-5631-2021-4-17-24
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