RESULTS OF LAPAROSCOPIC CHOLECYSTECTOMY WITH CORRECTION OF COMBINED SURGICAL PATHOLOGY IN PATIENTS OF ADOLESCENCE AND YOUNG AGE
Abstract
Abstract: Currently, in healthcare around the world, including Uzbekistan, the gold standard for surgical treatment of combined diseases of the abdominal organ proved to be simultaneous operations using endovideosurgical technologies. The purpose of this scientific work was to evaluate the effectiveness of simultaneous endovideosurgical operations in patients with combined diseases of the abdominal organs in adolescence and young adulthood. Material and methods: Work based on 48 adolescents and young men of both genders aged 12-20 years with combined surgical diseases of the abdominal organs: Chronic calculous cholecystitis (CCСH) + solitary liver cyst (SLC) -9, CCCH + echinococcal cyst (EC)-19, CCCH + umbilical hernia (UH)-12andCCCH +inguinal hernia (IH) -8. All patients underwent laparoscopic cholecystectomy (LCC) at the first stage, followed by correction of combined pathology. The surgical intervention was performed in an endovideosurgical surgical room using an endovideosurgical stand manufactured by Karl Storz (Germany), under multicomponent balanced intravenous anesthesia in the condition of artificial ventilation. In (9) patients with a solitary liver cyst after LCE, laparoscopic resection of the liver cyst was performed. The protruding part of the cyst shell was excised after preliminary puncture aspiration of its contents. We install thoracoports as with LCE in (19) patients undergoing laparoscopic echinococcectomy from the liver; in the right hypochondrium in place of 5 mm we install thoracoport of 20 mm in size. After removal of the echinococcal cyst, treatment of the residual cavity in (17) patients with a greater omentum, and a “mini” laparotomy was used in 2 patients in the projection of the residual cavity using the “capitonage” method according to Delbe due to the impossibility of packing with an omentum. Herniotomy with plastic surgery of the anterior abdominal wall using the Mayo method from a “mini” access was applied in 12 patients with an umbilical hernia and inguinal ring repair was performed using a swaddle mesh and a two-composite mesh in 8 patients with inguinal hernias.Results and discussions: All operated patients did not require narcotic analgesics in the postoperative period. No suppuration of postoperative wounds was observed. The average duration of the operation was 60±10 minutes, the average hospital bed day was 4.5±05 days, the average rehabilitation period was 12-14 days. The drainage tubes were removed the next day after ultrasound control. Conclusions: Performing simultaneous laparoscopic operations for correction the combined surgical diseases of the abdominal organs is appropriate and justified, since combined surgical pathology is eliminated within the framework of one surgical intervention and anesthesia. SLO is accompanied by a cosmetic, aesthetic and economic effect, a minimal incidence of complications, a short period of stay for patients in the hospital and a short period of rehabilitation.
About the Authors
List of references
Galimov O.V. Treatment of patients with combined pathology of the pelvic organs using laparoscopic technologies. Endoscopic surgery 2012:25–8.
Rakhmatullaev A. R., Khasanov S. M. Possibilities and feasibility of performing simultaneous laparoscopic operations for combined surgical diseases of the abdominal organs. Eurasian Union of Scientists 2015;10:113–6.
Golbrah V. A. Modern approaches to simultaneous operations (indications, execution algorithms, complications). Journal of Volgograd State Medical University 2021;18:28–36. DOI: https://doi.org/10.19163/1994-9480-2021-2(78)-28-36
Istamkulovich GF, Baltaevich NB. Simultaneous laparoscopic surgery in gynaecology and surgery. Eur Sci Rev 2015:44–44.
Akhrameev V.B. et al. Simultaneous operations in emergency abdominal surgery. Bulletin of emergency and reconstructive surgery 2021;6:20–6.
Fedorov A.V., Krieger A.G., Kolygin A.V., Kochatkov A.V. One-step operations. Terminology (literature review and own proposal). Surgery 2011:72–6.
Chernookov A.I. Experience of using simultaneous operations in patients with varicose veins and hernias of the anterior abdominal wall. 2022.
Surico D, Gentilli S, Vigone A, Paulli E, Leo L, Surico N. Laparoendoscopic single-site surgery for treatment of concomitant ovarian cystectomy and cholecystectomy. J Minim Invasive Gynecol 2010;17:656–9. https://doi.org/10.1016/j.jmig.2010.05.005. DOI: https://doi.org/10.1016/j.jmig.2010.05.005
Ibragimov Sh. U. Results of surgical treatment of patients with abdominal hernias and concomitant abdominal pathology. Problems of Science 2022:69–73.
Galimov O.V., Khanov V.O.,Aminova A.N., Ziganshin D.M. Simultaneous laparoscopic operations on the pelvic. Endoscopic surgery 2010:51–6.
Chen Y., Bai J., Guo Y, Zhang G. The simultaneous repair of an irreducible diaphragmatic hernia while carrying out a cesarean section. Int J Surg Case Rep 2013;4:771–2. DOI: https://doi.org/10.1016/j.ijscr.2013.06.002
Reiffersceid M. Der simultaneingziff in der Bayychhohle-ChirurgischeAspekte. Zent Bl Chir 1971.
Ganiev F. Medical and surgical measures carried out for simultaneous pathologies (a combination of gynecological and surgical pathologies) in women. Journal of the Doctor’s Bulletin 2015;1:15–9.
Mishalov V. G. Simultaneous laparoscopic interventions on the abdominal organs in obese patients during the correction of ptosis of the anterior abdominal wall. Surgery of Ukraine 2017:30–4.
Talaibekova A. T. Simultaneous endoscopic operations in gynecology, modern problems (literature review). Healthcare of Kyrgyzstan 2021:134–40. DOI: https://doi.org/10.51350/zdravkg2021311134
Hart S, Ross S, Rosemurgy A. Laparoendoscopic single-site combined cholecystectomy and hysterectomy. J Minim Invasive Gynecol 2010;17:798–801. https://doi.org/10.1016/j.jmig.2010.07.006. DOI: https://doi.org/10.1016/j.jmig.2010.07.006
Hayakawa S, Hayakawa T, Inukai K, Miyai H, Yamamoto M, Kitagami H, et al. Simultaneous transabdominal preperitoneal hernia repair and laparoscopic cholecystectomy: A report of 17 cases. Asian J Endosc Surg 2019;12:396–400. https://doi.org/10.1111/ases.12667. DOI: https://doi.org/10.1111/ases.12667
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
