Licensed books on medicine
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ACTUALITY OF SURGICAL TREATMENT.
I am often asked about my attitude to liposuction, as a method of treating obesity.
It seems to me that a sensible woman is unlikely to climb under the knife (or a syringe, it does not matter) without trying to eliminate the very reason for the appearance of fullness.
After all, liposuction is not a method of treating obesity. This is a surgical correction of body contours due to the removal of fat deposits using a vacuum suction! It corrects the asymmetry of the body - when, for example, one buttock is larger than the other or with local forms of obesity associated with a violation of the contours of the figure. Most often in women, there is a “galliferous” deformity of the thighs, fat deposits on the inner side of the knee joint, deposits in the thigh, anterior and lateral surfaces of the abdomen. It is impossible to remove large amounts of fat, because with an incorrect metabolism, the lost fat will recover in another place. Very often, such operations are dangerous complications leading to disability and even death. The fat in such operations on large volumes and areas is usually unevenly removed. And then it also increases unevenly. As a result, a year later, the surface of the abdomen may resemble a mountain range with numerous mounds and depressions.
As well as liposuction, lipotherapy is a means of correction, not weight loss. And it allows you to maintain the achieved results for many years - provided that a person does not gain too many extra pounds.
As you may remember, there is a type of obesity called hyperplastic. It is usually predetermined genetic and develops, as a rule, from early childhood. With this type of obesity, a large number of fat cells themselves (adipocytes) are laid down and when losing weight, only a decrease in the volume of fat cells occurs, but their total number remains almost unchanged. As a result, the fat cells, although sharply reduced in volume, form a small, but sufficiently stable fat layer that is not amenable to further conservative treatment. That is, even almost having achieved the desired weight, you do not get rid of any fat cells. They are dramatically reduced in size, but do not die, but continue to sit under your skin, waiting for favorable times to flourish again with unprecedented strength. How to destroy these cells, get rid of them once and for all.
In this case, the “final chord of the entire symphony” of getting rid of fat can and should be liposuction. Destroyed fat cells can never recover again. In adults, in general, fat cells are not able to be updated - only their size changes.
However, some patients with alimentary constitutional obesity, wishing apparently to get rid of this problem in one fell swoop without any effort, are turning to a surgeon. And if earlier the surgeon, perhaps, would dissuade such a patient from useless and dangerous surgical intervention, now money decides everything. In some clinics, these operations have already been put on stream.
I consider the feasibility of such a surgical intervention - the method of despair. In some cases, the hopelessness of the situation of patients who have lost not only their ability to work, but also the ability to self-serve themselves, to complete despair and sometimes even suicide, makes them resort to this method of correction.
Diets and physical exertion are sometimes powerless with a drooping stomach in the form of an extensive skin fold (apron). Such an apron itself can interfere with life. After all, under it with constant sweating creates an ideal environment for the reproduction of microbes. Pustular and erysipelas develop. Here, only cosmetic surgery will help (abdominoplasty).
The help of the surgeon is necessary and justified in case of local, difficult leaving fat deposits in the area of the waist, abdomen, on the back, on the hips.
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ACTUALITY OF SURGICAL TREATMENT.
More than 100 years ago, Miles first described the operation of abdominal-perineal extirpation; from then until the early 1960s. it was considered the standard method of surgical treatment of colorectal cancer. Today, this operation is also important in large low-lying tumors of the rectum with locoregional spread and low degree of differentiation, as well as in the presence of
In patients with diabetic foot syndrome, two fundamentally different groups of operations are performed: reconstructive vascular operations and surgical treatment of purulent-necrotic forms. The main indications for reconstructive surgical treatment are the ineffectiveness of conservative therapy, the preservation or progress of critical ischemia in the absence of purulent-necrotic
Surgical treatment of hcmp by ventriculomiotomy and (or) myectomy, as well as therapy with adrenergic blockers, has been used since the early 60s. For the first time the attention of surgeons to this disease attracted E. Brock (1957). The first successful operation, trans-aortic ventriculomiotomy, was performed by M. Cleland and E. Bentall in 1958, and this patient lived 25 years after the operation. In 1961, A. Morrow and D.
The lack of efficacy of DCM therapy prompted researchers to search for surgical methods of treating this disease and its complications. Based on the experimental data of R. Salisbury and co-authors (1964), J. Goodwin (1964) suggested the appropriateness of pericardectomy, which allows to improve the diastolic dilation of the left ventricle and its function. Attempted use
In some cases, the ineffectiveness of drug treatment of tachyarrhythmias, intolerance to patients with antiarrhythmic drugs, as well as frequent recurrence of seizures and the severity of hemodynamic disorders that arise, force us to turn to cardiac surgery methods. The latter are based on various damaging effects on areas of the heart muscle or the cardiac conduction system, in
In economically developed countries, cardiac surgery has become quite widespread. Revascularization improves survival of patients with severe course and / or serious prognosis of the disease. The clinic often uses two methods: percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass surgery (CABG). Indications for revascularization are
Despite the use of traditional or nonstandard antiarrhythmic drugs and implantable stimulants, in some patients, there is still disabling or life-threatening tachycardia. Surgical methods have been developed for the treatment of such patients, used in combination with EFI. As is known, atrioventricular electrical connections include the normal conductive
- Surgical treatment of heart failure
Technological advances, and with it the development of cardiac surgery, have led to the emergence of invasive techniques that can help a complex category of patients with chronic heart failure. It is necessary to honor the main possible causes of heart failure in patients with coronary artery disease: 1. Concomitant damage to the valves of the heart, the possibilities of surgical treatment of which we touched on
- CABG, surgical treatment of arrhythmias and PPR
According to a number of studies after CABG surgery, the disappearance of PPJ was noted in approximately 40–50% of patients. PSP after CABG were recorded in patients with low EF and frequent ventricular extrasystoles, however, with prospective observation for 3 years, no sudden deaths were recorded, therefore, the prognostic value of PFV in this group of patients remains unclear. Surgical
- Indications and contraindications for surgical treatment of hemorrhagic stroke
Hemorrhagic stroke: intracerebral hematoma (hematoma) - rapid development of symptoms, subarachnoid hemorrhage. Indications for surgical treatment. Surgical treatment is indicated for: 1. subcortical and putamenal hematoma with a volume of more than 30 cm3 (according to other sources - more than 20-30 cm3), accompanied by a dislocation of the brain and a pronounced neurological deficit; 2. at
- Surgical (electrosurgical, cryosurgical, etc.) treatment of tachyarrhythmias
Below are discussed mainly indications, contraindications for surgical interventions and their results. As for the surgical technique, features and options for operations, access to the heart, anesthetic management and many other specific issues of surgery, the reader will be able to get acquainted with them in detail by special editions and publications, the most important of which
Coronary revascularization In the absence of the effect of drug therapy and preservation of signs of recurrent myocardial ischemia, coronary revascularization is indicated: percutaneous transluminal coronary angioplasty (PTCA) or aorto-coronary bypass surgery (CABG). The main indications for emergency coronary revascularization are: I. Recurrent episodes of ischemia
- Hydrocephalus. Surgery
Hydrocephalus (from the Greek. Hydros - fluid + Greek. Kephale - head) - excessive accumulation of cerebrospinal fluid in the cerebrospinal fluid spaces of the brain - the ventricles, cisterns, subarachnoid crevices. The cause of hydrocephalus is a violation of the production, resorption and circulation of cerebrospinal fluid. As noted earlier, the normal amount of cerebrospinal fluid in the cerebrospinal fluid
- OPPORTUNITIES FOR SURGICAL TREATMENT OF METASTATIC LIVER CANCER
Sidorov D.V., Lozhkin M.V., Shveikin A.O. Moscow Research and Development Institute of Oncology named after Pyotr A. Gertsen Research objective: Evaluation of the immediate and long-term results of surgical treatment of liver metastatic lesions in colorectal cancer. Material and methods: From 2005 to the present, we have performed 70 resections for colorectal cancer metastases.
- Conservative and surgical treatment of stroke
Therapeutic measures for stroke should begin as early as possible, preferably in the interval of the “therapeutic window” - in the first 3–6 hours from the moment the disease develops. The adequacy of their condition of the patient and the intensity largely determine the further course and outcome of the disease. Patients are indicated hospitalization in a neurological or neurovascular hospital, in the case of the development of an extensive
- SURGICAL TREATMENT OF PATIENTS WITH KIDNEY CANCER METASTASES IN THE LUNGS
Amiraliev A.M., Pikin O.V., Alekseev B.Ya., Kolbanov K.I., Glushko V.I., Vursol D.A., Kartoschovenko A.S., Bagrov V.A. FGU MNOII im.P.A. Gertsena, Moscow Objective of the study: Metastatic lung damage in renal cancer is diagnosed in 15 - 20% of patients. The five-year survival rate in operated patients is 32–48%, and with the use of drug treatment it does not exceed 5%.
- Modern methods of conservative and surgical treatment of chronic tonsillitis
Conservative treatment Conservative treatment of patients with chronic tonsillitis outside of its exacerbation should be comprehensive and carried out in several courses. The course of treatment may include the washing of the tonsil gaps with antiseptic solutions (furacillin, rivanol, etc.) and next day physiotherapy (UHF or UHF) to the region of the regional lymph nodes and simultaneous UV irradiation on the tonsils.
- Evolution of the surgical treatment of coronary heart disease
The first attempts of surgeons to take part in the treatment of angina pectoris were made at the end of the XIX century, when Charles Francois-Franck (S.Е. Francois-Franck) made an attempt to eliminate heart pain by crossing sympathetic trunks around the neck. Since the 1930s, after the reports of Hermann Blümgart (Blumgart HL, 1933) and Peter Alexandrovich Herzen (1938), a new and more
- General principles of surgical treatment
General principles of surgical
- Epilepsy. Conservative and surgical treatment
Epilepsy is a chronic disease, manifested by repeated convulsive or other seizures, loss of consciousness and accompanied by changes in personality. The disease has been known for a very long time. His descriptions are found in Egyptian priests (about 5000 BC), doctors of Tibetan medicine, Arabic-speaking medicine, etc. Epilepsy in Russia received the name of epilepsy, or simply epilepsy