The aim — to identify and evaluate simultaneous gynaecological and abdominal operations in a retrospective cohort of patients aged 55 years and older with impaired glucose tolerance.Materials and methods. All patients who underwent operative treatment at the Department of Surgery in 2016 — 2018 were included in this study. The analysis of medical records provided the identification of patients over the age 55 years, in whom simultaneous operations were performed, that is, surgical interventions on two or more anatomical zones for various diseases. A total of 3974 surgeries were performed in 3158 patients, 816 of which had simultaneous operations. Of these patients, 185 were 55 years old and older with impaired glucose tolerance. 325 simultaneous operations were performed in these ones.Results and discussion. 46 gynaecological and 279 operations on the abdominal organs and hernias were performed in the cohort. Impaired glucose tolerance was detected in all patients who underwent simultaneous gynaecological operations and in 20 (30 %) patients who did not undergo simultaneous gynaecological operations (p = 0.0001). Abdominoplasty and hernioplasty were statistically significantly more often performed simultaneously with gynaecological operations (in 16 (14.4 %) and 6 (3.6 %) and in 57 (51.4 %) and 20 (12.1 %) observations (p < 0.05), respectively). Analysis of clinical data revealed the postoperative complications in 8 (17.3 %) patients who underwent simultaneous gynaecological operations, and in 19 (29.0 %) patients without simultaneous gynaecological operations (p = 0.18).Conclusions. Patients with impaired glucose tolerance over the age of 55 years who underwent gynaecological simultaneous operations have a higher risk of hyperglycaemia, as well as a higher incidence of postoperative complications, which must be considered when planning surgical interventions in this cohort of patients.
The aim — to increase the treatment efficacy for patients with cosmetic defects of the anterior abdominal wall by introducing new simultaneous operations techniques in combination with lipoabdominoplasty.Materials and methods. The original procedure was used in 42 patients (the main group). The comparison group included 40 patients. The average age of patients in the main group was 38.2 ± 2.8 years, and 41.1 ± 2.3 years in the comparison group. 35 (83.3 %) of the patients in the main group were either obese or overweight (average BMI 34.2 ± 1.9), the maximal patient’s body weight was 113 kg. In the comparison group, the average BMI was 35.1 ± 1.7, the maximal patient’s body weight was 117 kg. The term of postoperative observation was 12 months.Results and discussion. The average duration of surgical intervention was 129 ± 15 min in the comparison group and 170.2 ± 6.5 minutes in the main group, which was caused by the additional liposuction procedure. The average volumes of liposuction were 1253.6 ± 36.2 ml and ranged 250 — 2750 ml. Volumes over 1000 ml were observed in 30 patients (71.4 %). 6 complications (13.3 %) developed in the main group and in 12 patients from the comparison group (30.0 %).Conclusions. The lower level of postoperative complications in patients with 13.3 % with a potentially high risk compared with traditional abdominoplasty — 30.0 % (p < 0.05), is an important argument in favour of lipoabdominoplasty. When evaluating the result after 12 months, the advantage of an excellent result in the main group was found to be 71.2 %, as opposed to 37.5 % in the comparison group.
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