The VAL technique can be confidently used as a main tool to expedite evaluation and treatment of patients with abdominal trauma in cases of both stable and unstable hemodynamic status.
Aim. To analyse and generalize available literature data on the problem of colorectal anastomotic leakage after rectal resection. Key findings. Over the last decade, there has been an increasing trend towards sphincter-preserving operations in modern colorectal surgery. The widespread use of suturing devices of various diameters allows the formation of ultra-low anastomoses (at the level of the pelvic floor). One of the menacing complications after rectal resection is anastomotic leakage, which frequency can reach 21%. The mortality from anastomotic leakage can reach 40%. The analysed literature sources discuss a variety of risk factors, both preoperative and intraoperative, affecting the healing of the inter-intestinal anastomosis. In almost all studies, the height of the tumour and the anastomosis from the anus, preoperative radiotherapy and male sex are independent risk factors for the development of colorectal anastomotic leakage. Concerning other factors, there are conflicting opinions. The timely use of preventive measures and early diagnosis of colorectal anastomotic leakage can reduce the number and severity of postoperative complications.Conclusion. Individual consideration of risk factors and their adequate assessment in terms of possible complications are decisive in the choice of the extent of surgical intervention, which will undoubtedly improve the immediate and long-term results of the surgical treatment of colorectal cancer.
A hernia of the esophageal aperture of the diaphragm is considered as one of the factors contributing to the development of gastroesophageal reflux disease and requires a complete and comprehensive examination of the patient. Routine esophagogastroduodenoscopy does not give a complete picture of the disease, and therefore patients receive symptomatic treatment for a long time. Paraesophageal hernia of the esophageal aperture of the diaphragm are not well understood yet due to their relatively low frequency of occurrence, may be asymptomatic or manifest as chest pain of noncardiac origin. A patient with a long history of gastroesophageal reflux disease associated with a giant paraesophageal hernia of the esophageal aperture of the diaphragm is presented as a clinical case.
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