O'SMIR VA BALOG’AT YOSHDAGI BEMORLARDA LAPAROSKOPIK XOLESISTEKTOMIYA BILAN HAMROH JARROHLIK PATOLOGIYALARNI DAVOLASH NATIJALARI
Abstrakt
ANNOTATSIYA
Hozirgivaqtda butun dunyo, jumladan, O‘zbekiston sog‘liqni saqlash sohasida qorin bo‘shlig‘i a’zolarining qo‘shma kasalliklarini jarrohlik yo‘li bilan davolashning oltin standarti endovideojarrohlik texnologiyalari yordamida bir vaqtda amalga oshiriladigan operatsiyalar ekanligi isbotlangan. Ushbu ilmiy ishning maqsadi o'smirlik va balog’at yoshdagi bemorlarda qorin bo'shlig'i a'zolarining qo'shma jarrohlik kasalliklarida simultan endovideojarrohlik tashrixlarining samaradorligini baholash.Tadqiqot materiali va usullari:Tadqiqot qorin bo'shlig'i a'zolarining qo'shma jarrohlik kasalliklari bo’lgan ikkala jinsdagi 48 nafar o'smir va balog’at yoshidagi(12-20) bemorlar davolash natijalariga asoslangan. Surunkali toshli xoletsistit (+STX) + jigar solitar kistasi (9), STX+ exinokokk kistasi (19),STX + kindik churrasi (12) va STX + сhov churrasi (8). Barcha bemorlarga birinchi bosqichda laparoskopik xoletsistektomiya (LXE), so'ngra hamroh patologiyani tuzatish amalga oshirildi. Jarrohlik aralashuvi endovideojarrohlik tashrix xonasida “Karl Storz” (Germaniya) tomonidan ishlab chiqarilgan endovideojarrohlik stendidan foydalangan holda, o’pkani sun'iy shamollatish bilan bigalikda ko'p komponentli vena ichi anesteziya ostida amalga oshirildi.LXE dan so'ng jigar kistasi bo'lgan (9) bemorlarda jigar kistasining laparoskopik rezektsiyasi amalga oshirildi. Kista qobig'i uning tarkibini dastlabki punksiyon aspiratsiyasidan so'ng kesilgan. Jigardan laparoskopik exinokokkektomiya qilingan (19) bemorlarda torakoportlar LXE kabi nuqtalarga o'rnatildi, o'ng qovurg’alar ostiga 5 mm o'rniga 20 mm o'lchamdagi torakoport o'rnatildi. Ekinokokk kistasini olib tashlangandan so'ng, qoldiq bo’shliqni yopish maqsadida (17) bemorda katta charvi tomponada qilindi, 2 bemorda charvi tomponadasi imkonsizligi sabab ularda "mini" laparotomiya qo'llanildi va Delbe bo’yicha "kapitonaj" usuli orqali qoldiq bo'shliq yopildi. Kindik churrasi bo'lgan 12 bemorda“Meyo” usulidan foydalangan holda qorin old devorining plastik jarrohligi amalga oshirildi. Shuningdek, 8 bemorda chov churralarini bartaraf etishda, churra halqalari propilen to’rdan foydalanildi.Tadqiqot natijasi va tahlillari: Tashrix o’tkazilgan barcha bemorlar tashrixdan keyingi davrda narkotik analgetiklardan foydalanilmadi va tashrix jarohatlarining yiringlashi kuzatilmadi. Tashrixlar o'rtacha davomiyligi 60±10 minut, o'rtacha kasalxonaga yotqizilgan kun 4,5±0,5 kun, o'rtacha reabilitatsiya davri 12-14 kunni tashkil etdi. Ertasi kuni ultratovush tekshiruvidan so'ng drenaj trubkalar olib tashlandi.Xulosalar:Qorin bo'shlig'i a'zolarining qo’shma jarrohlik kasalliklarini tuzatish uchun simultan laparoskopik aralashuvlarni o'tkazish maqsadga muvofiq va asoslidir, chunki hamroh jarrohlik patologiyalari birjarrohlik aralashuvi va anesteziya doirasida bartaraf etiladi. Simultan laporoskopik tashrixlar kosmetik, estetik va iqtisodiy samaradorlik, asoratlarning minimal darajasi, bemorlarning kasalxonada bo'lish muddati va reabilitatsiya muddatining qisqarishiga erishiladi.
Mualliflar haqida
Adabiyotlar ro'yxati
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
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