Determination of indications and contraindications for simultaneous operative interventions in patients with a combination of endocrine and other surgical pathology
DOI:
https://doi.org/10.11603/2414-4533.2019.2.10265Keywords:
endocrine diseases, concomitant diseases, surgery, indications, contraindicationsAbstract
The aim of the work: to develop indications and contraindications for the implementation of simultaneous surgical interventions on the example of patients with combined pathology of the thyroid gland (TG) and cholelithiasis (CL) / gallbladder polyposis, using the scale of the functional state of P-POSSUM.
Materials and Methods. During the period from January 2015 to September 2018, 35 patients with combined pathology of the TG and CL / gallbladder polyposis were examined and operated. At the preoperative stage, as well as on the first day of the postoperative period, all patients evaluated on the P-POSSUM scale.
Results and Discussion. In 22 (62.9 %) patients, whose functional state before the intervention was assessed by physiological subscale (FS) ≤ 17 points, there were postoperative changes in health with an average difference of 0.13 points, T (Z) = 1.21, p = 0.225. In all these patients, the complexity of surgical intervention on the surgical sub-scale (SS) on the P-POSSUM scale was estimated ≤ 14 points. In 13 (37.1 %) patients, whose condition was estimated at 17 points by FS, significant changes in functional health before and after surgery were revealed, with a difference of average 1.15 points, T (Z) = 2.67; p = 0.0077. The complexity of their operations ranged from 14 to 16 points for SS.
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