AIM: evaluation of the effectiveness of the enhanced recovery protocol for stoma reversal procedures.PATIENTS AND METHODS: a single-center retrospective analysis of stoma reversal surgery in 130 ostomy patients in 2012-18 was performed. From 2012 to 2015, 56 (43.1%) patients were treated before the implementation of the Enhanced Recovery After Surgery (ERAS) protocol in clinical practice, 74(56.9%) patients were treated in accordance with the principles of fast-track.RESULTS: the introduction into clinical practice of the ERAS protocol reduced postoperative complications from 8.5% to 5.4% (p=0.002) and the hospital stay from 16,3±9,4 to 11,4±4,2 days (p=0.003).CONCLUSION: the fast-track strategy is an effective way to improve the results of stoma reversal procedures.
Objective: to analyze the diagnostic value of radiation techniques in patients with opisthorchiasis-induced obstructive jaundice and to determine the types of bile duct (BD) changes characteristic of this disease.Subjects and methods. The investigation enrolled 103 patients with chronic opisthorchiasis complicated by obstructive jaundice. For BD visualization, the investigators used radiation diagnostic methods, such as ultrasonography (USG), magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP); their efficiency was evaluated.Results. ERCP and MRCP could identify 5 types of BD architectonics in opisthorchiasis-induced obstructive jaundice. The sensitivity, specificity, and overall accuracy of MRCP in diagnosing opisthorchiasis-induced sclerotic changes were 98.1, 87.5, and 96.8%, respectively.Conclusion. Among instrumental methods for diagnosing sclerotic BD changes in prolonged opisthorchiasis invasion, it is preferable to use MRCP, which is determined by its high informative value. Five types of cholangioarchitectonics are detectable in chronic opisthorchiasis complicated by obstructive jaundice.
Esophagogastroduodenoscopy (EGDS) is the main way to diagnose bleeding from the upper gastrointestinal tract. Diagnostic accuracy of the study depends on the preparation. Aim of the study was to evaluate the preparation of the upper parts of the digestive tract in case of esophagogastroduodenal bleeding. Material and methods. The retrospective analysis of 2570 case histories was carried out. Gastric lavage through nasogastric tube was carried out in the main group (1299 patients). Preparation for the primary EGDS was not carried out in the control group (1271 patients). A comparison of the number of EGDS performed and the detection of the bleeding source in the control and the main groups as well as the period of investigation up to the detection of the bleeding source were performed. Results. EGDS without preparation of the upper gastrointestinal tract in case of acute bleeding and determination of the diagnosis is possible in 85,6 % of patients. Preparation of the upper gastrointestinal tract for EGDS prolongs the study period by 30–60 minutes, but allows establishing the diagnosis in 93.7 % of cases that is by 8.1 % more than without preparation.
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