Saratov JOURNAL of Medical and Scientific Research

Potakhin S.N.

Saratov State Medical University n.a. VI. Razumovsky, Department of General Surgery, Assistant Professor, Candidate of Medical Science

Comparative analysis of assessment methods for operational and anesthetic risks in ulcerative gastroduodenal bleeding

Year: 2015, volume 11 Issue: №3 Pages: 323-327
Heading: Surgery Article type: Original article
Authors: Potakhin S.N., Shapkin Yu.G., Vlasova M.A., Nikitin V.A.
Organization: Saratov State Medical University
Summary:

Aim of the investigation: to conduct a comparative analysis of methods of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding. Materials and methods. A retrospective analysis ofthe extent of the surgical and anesthetic risks and results of treatment of 71 patients with peptic ulcer bleeding has been conducted in the study. To evaluate the surgical and anesthetic risks classification trees are used, scale ТА. Rockall and prognosis System of rebleeding (SPRK), proposed by N. V. Lebedev et al. in 2009, enabling to evaluate the probability of a fatal outcome. To compare the efficacy ofthe methods the following indicators are used: sensitivity, specificity and prediction of positive result. Results. The study compared the results ofthe risk assessment emergency operation by using these methods with the outcome ofthe operation. The comparison ofthe prognosis results in sensitivity leads to the conclusion that the scales ТА. Rockall and SPRK are worse than the developed method of classification trees in recognizing patients with poor outcome of surgery. Conclusion. The method of classification trees can be considered as the most accurate method of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding.

Evaluation of the operative and anesthetic risk for patients with ulcerative gastroduodenal bleedings

Year: 2014, volume 10 Issue: №4 Pages: 663-669
Heading: Surgery Article type: Original article
Authors: Potakhin S.N., Shapkin Yu.G.
Organization: Saratov State Medical University
Summary:

Aim: to specify operative and anesthetic risk during urgent and preventive operations for patients with ulcerative gastroduodenal bleedings, develop algorithm for prognosis of unfavorable outcomes after operations and point out possible ways to control risks in given pathology. Material and Methods. To specify factors of operative and anesthetic risk during urgent and preventive operations a comparative analysis of two groups of patients suffering from gastroduodenal bleedings, who were treated in the surgery department of "Saratov city clinical hospital Nr.6" was done. The first group consisted of 39 patients, who died after the surgery, the second group of 274 patients with a favorable outcome after the operation. The statistical analysis was done by use of the program Statistica 6.0. Results. The operative and anesthetic risk factors where determined with the help of parametric and non-parametric methods of statistical analysis. An algorithm of evaluation operative and anesthetic risk factors by a tree classification was devised through the use of multidimensional analysis. With the help of this one can predict the outcome of urgent and preventive operations and highlight the risk group with an expected lethality of about 40%. Conclusion. The division of patients according to degree of risk of bleeding relapses as a whole with complex evaluation of patient's condition severity and operative and anesthetic risk allows choosing the right treatment plan and by this as a result increases the chance for a favorable treatment outcome.

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The dynamics of main indicators for the treatment of ulcerative gastroduodenal bleedings — the analysis of several years studies

Year: 2014, volume 10 Issue: №3 Pages: 456-460
Heading: Surgery Article type: Original article
Authors: Shapkin Y.G., Potahin S.N.
Organization: Saratov State Medical University
Summary:

The research goal is evaluation of influence of changes in diagnostic & treatment possibilities and surgical approach on the results of treatment of patients with ulcerative gastro-duodenal bleedings (GDB). Material and methods: An analysis of the treatment results of 1885 patients suffering from ulcerative GDB, which have been treated in the surgery department of the "State clinical hospital No.6" in Saratov has been done. The information about the patients suffering from GDB has been retrieved from the digital archives, which were filed from 1991 to 2009. The patients have been divided into five groups according to five periods of work, each one differ by its own diagnostic & treatment possibilities and approaches. The evaluation was based the amount of operations, the number of different types of operations, the efficiency of endohemostasis, the amount of bleeding relapses and the lethality. Results: The introduction of computer prognosis for bleeding relapse, the increase in the number of endoscopic hemostatic methods, the application of Laser Doppler Flowmetry (LDF) for the evaluation of reliability of hemostasis, the use of dynamic endoscopy and testing probe for bleeding relapse in the state of prerelapse syndrome with the combination of preventive measures on the source of bleeding and antisecretory therapy have led to the decrease of overall lethality from 6,5% to 1,9%, and the postoperative lethality from 9,1% to 1,7%. Conclusion: The analysis of treatment results by periods made it possible to have an overview on different factors as they undergo changes during these periods, evaluate weak points in the current treatment tactic and set a direction for further investigations.

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Evaluation of severity and prognosis of the disease course in ulcerative gastroduodenal bleeding

Year: 2014, volume 10 Issue: №2 Pages: 301-307
Heading: Surgery Article type: Review
Authors: Potakhin S.N., Shapkin Yu.G., Chalyk Yu.V., Zevyakina V.A.
Organization: Saratov Clinical Hospital № 8, Saratov State Medical University
Summary:

The systems of evaluation for severity and prognosis of the disease course constitute an important resource for the improvement of treatment parameters in patients with gastroduodenal bleeding. Although in practice more common methods with limited accuracy and high percentage of subjectivity are often used. The work shows the analysis of the situation and possible ways of resolution.

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Evaluation of severity and prognosis of the disease course in ulcerative gastroduodenal bleeding

Year: 2014, volume 10 Issue: №2 Pages: 301-307
Heading: Surgery Article type: Review
Authors: Potakhin S.N., Shapkin Yu.G., Chalyk Yu.V., Zevyakina V.A.
Organization: Saratov State Medical University, Saratov Clinical Hospital N 8
Summary:

The systems of evaluation for severity and prognosis of the disease course constitute an important resource for the improvement of treatment parameters in patients with gastroduodenal bleeding. Although in practice more common methods with limited accuracy and high percentage of subjectivity are often used. The work shows the analysis of the situation and possible ways of resolution.

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Modern issues on the treatment of peptic ulcer bleedings

Year: 2014, volume 10 Issue: №1 Pages: 132-138
Heading: Surgery Article type: Review
Authors: Potakhin S.N., Shapkin Y.G., Klimashevich V.Y., Belikov A.V., Zevyakina V.A.
Organization: Saratov State Medical University
Summary:

Despite the success of therapeutic treatment of peptic ulcer and the introduction of endoscopic technologies, the problem of peptic ulcer hemorrhage remains valid. A large number of publications in foreign literature are dedicated to epidemiology and prevention of bleeding, evaluation of modern tactics and search for new methods of treatment. The works relating to organization of aid to patients with peptic ulcer bleeding are of particular interest. According to the recent data not all clinics even in economically developed countries manage to follow the recommendations of an international consensus-2010 for non-variceal bleeding treatment of upper gastrointestinal tract. Among the causes of non-compliance of international recommendations there are subjective and objective factors, the understanding of which can significantly affect the optimization of aid to patients with peptic ulcer bleeding.

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Monitoring of gastric secretion and early diagnostics of gastroduodenal ulcerative bleeding recurrences

Year: 2011, volume 7 Issue: №4 Pages: 957-962
Heading: Surgery Article type: Original article
Authors: Potakhin S.N., Shapkin Yu.G., Reshetov P.V., Kapralov S.V., Klimashevich V.Yu., Belikov A.V.
Organization: Saratov State Medical University
Summary:

The research goal is to develop a universal method of monitoring of intragastric medium dynamics. It allows diagnosing of bleeding recurrences and monitoring the effectiveness of gastric secretion suppression. In Saratov clinic of General Surgery use of probe-detector, dynamic endoscopy, laser Doppler flowmetry and methods of endoscopic hemostasis has reduced mortality: postoperative mortality has been decreased from 7,4 to 1,6%, while the general mortality — from 3,5 to 1,5%. The proposed devices can be used separately, and do not allow parallel assessment of pH of gastric juice, the microcirculation in the stomach wall and bleeding recurrences. 47 patients have been under the study. The changes in electroconductivity of intragastric medium have been proved in the suppression of intragastric secretion and the appearance of blood in gastric lumen. The received data have considered impedancemetry as the method of monitoring of intragastric medium in gastroduodenal bleedings

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Hundred years of helping people

Year: 2011, volume 7 Issue: №3 Pages: 740-743
Heading: Scientific schools Article type:
Authors: Shapkin J.G., Chalyk J.V., Potakhin S.N., Yefimov E.V.
Organization: Saratov State Medical University
Summary:

The article stated the history of department of general surgery since its foundation. It pointed out the actual issues of the present work of department, the main directions in research interests and development prospects

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Endoscopic recanalization of colon at tumour impassability

Year: 2010, volume 6 Issue: №3 Pages: 727-729
Heading: Surgery Article type: Original article
Authors: Shapkin Yu.G., Uryadov S.E., Chalyk Yu.V., Potakhin S.N.
Organization: Saratov State Medical University, Saratov Clinical Hospital N 8
Summary:

In article value of a full or partial endoscopic recanalization of colon stenosing tumours in preoperative decompression and performance of delayed operative measure with applying a primary colic anastomosis is established

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