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Item type:Publication, Position and Stability of the Prosthesis in Severely Deformed DDH Artificial Total Hip Replacement(Mongolian National University of Medical Sciences, 2020-12-29); Objectives: To analyze the correlation of prosthesis position selection during total hip replacement with clinical short and middle-term effects of Crowe III and Crowe IV hip dislocation. Methods: Clinical data of 28 cases of dysplasia and dislocation of the hip joint combined with severe osteoarthritis were retrospectively analyzed. During 2-year follow-up, patients were rechecked by imaging regularly to analyze the imaging changes of acetabulum prosthesis position and bone graft fusion. Harris hip score was used to assess the recovery of hip function. The correlation of prosthesis position and short and middle-term effects was analyzed. Results: The filling rate of medullary cavity of prosthesis was above 75%. The initial position was fixed and stable. The stability rate of femur-prosthesis interface reached 100%. Compared with pre-replacement, hip function was significantly improved at 6 months post surgery (p < 0.05). Conclusion: These results indicate that total hip replacement for Crowe III and Crowe IV hip dislocation can effectively reconstruct the acetabulum, recover hip function, and stabilize prosthesis. Total hip replacement is characterized by good filling rate, high stability of femoral prosthesis interface, and stable initial fixation. The clinical repair effect is strongly associated with the position of the prosthesis. - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, Post Liver Transplantation Renal Impairment: Experience With the First 100 Cases in a Single Center in Mongolia(2022); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Results of the Total Hip Arthroplasty Using 3D Printing Technology(Mongolian National University of Medical Sciences, 2020-04-01); ; Objectives: To study the value of 3D printing of custom THA femoral prostheses with conventional femoral prostheses in total hip arthroplasty for severe hip deformity. Methods: Total hip arthroplasty was used in the treatment of 107 severe hip joint deformity cases from June 2018 to June 2019. Fifty-six patients received conventional hip replacement stems and 51 patients received a custom 3D printed hip replacement stem designed to address their proximal deformity and leg length discrepancy. The operation time, intraoperative blood loss, postoperative weight-bearing time, Harris score before and after the operation, complications after surgery and the main angle measurement of compared to their contralateral hip were evaluated to determine the short-term efficacy of 3D printed total hip replacement femoral prosthesis compared to the common total hip replacement femoral prosthesis. Results: A total of 107 patients were followed up for an average of 12 months. The use of 3D printing technology in the preoperative design and custom prosthesis fabrication was associated with shortened operation time, less intraoperative blood loss, quicker time to postoperative full weight-bearing, and improved the Harris score in 1 year after the operation compared to conventional total hip replacement stem (p<.05). Our results revealed that there was a significant reduction in the femoral anteversion with a value of 13.06 ± 1.93 degrees (mean ± SD) in the custom prosthesis group compared to the conventional hip replacement group. However, there was no significant difference in neck-shaft angle, acetabular angle, and Sharp angle between both groups (p>.05). Conclusion: 3D printing technology created a virtual and realistic simulation, and personalized operation plan for patients with severe hip deformity, which was helpful for surgical treatment. The anatomical characteristics of patients with complex deformities were better addressed using the 3D printed femoral component and resulting in better patient outcomes and provided a new option for surgeons to manage these difficult cases. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ilioinguinal and Iliohypogastric Nerve Localization in Children: Our Initial Ultrasound Investigation(2022-02-26); ; Objective: The purpose of our study is to examine the localization of the Ilioinguinal and Iliohypogastric (ILIH) nerves by using ultrasound and its relationship to age, BW in children. Methods: Children between 1-16 years of age, ASA I-II class, admitted to the surgical department for inguinal hernia, orchidopexy, and hydrocele repair were included in this prospective, randomized study at the National Center for Maternal and Child Health of Mongolia. We divided these children into three age groups: 1-4 years, 5-8 years, and more than 9 years old. The transducer was placed longitudinally at the line drawing from the ASIS to the umbilicus and after identifying the ILIH nerves we measured the distances of the anatomical structures: depth or thickness of the abdominal anterior wall structures and distance of ILIH nerves from the ASIS. When we identified the ILIH nerves we saved the pictures in the US machine. Identification and visibility scores of nerves and muscles were made by using a Likert scale and Vienna score and showed in the median. We recalled the data and analyzed it with repeated measurements, followed by ANOVA for a single factor. The correlation was calculated using the Pearson’s correlation coefficient. The tables show a mean ±SD and number (%) of subjects. A p-value<0.05 was considered statistically significant. Results: A total of 55 pictures were analyzed. The current study showed that the distance and depth of some anatomical structures, such as the mean distance of skin-peritoneum was 1.43±0.37 cm (CI 95% 0.76-2.37, p=0.0023), the thickness of internal oblique muscle was 0.33±0.14 cm (CI 95% 0.11-0.75, p=0.0022), the target point of ILIH nerve which was equal to the skin to TAM distance 1.06±0.3 cm (CI 95% 0.56-1.82, p=0.0093) were increasing regarding the age. For other measurements of depth not seen age-related statistically significant differences. According to the location of the ILIH nerves to the ASIS, in younger children they locate more close than in bigger children, however, only the distance of ASIS-IHN was statistically significant. The ILIH nerves localize more close to the iliac bone in the younger children and when age is increasing the nerve locates more medially and it correlates to the BW and ages. Conclusion: ILIHN were visible by ultrasound in children. ILHN location correlates to age, BW, and BMI. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Expansion of laparoscopic cholecystectomy in a resource limited setting, Mongolia: a 9-year cross-sectional retrospective reviewBACKGROUND: The benefits of laparoscopic cholecystectomy have been largely unavailable to most people in developing countries. Mongolia has an extremely high incidence of gallbladder disease. In 2005, only 2% of cholecystectomies were being done laparoscopically. Open cholecystectomies were associated with high rates of wound infections, complications, and increased recovery time. Because of the unacceptable complications associated with open cholecystectomies, and nearly 50% of the nomadic population needing faster post-operative recovery times, a national project for the development of laparoscopic surgery was organised. Multi-institutional collaboration between the Mongolia Health Sciences University, the Dr W C Swanson Family Foundation (SFF), the University of Utah, Intermountain Healthcare, and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) led to the promulgation of a formalised countrywide laparoscopic training programme during the past 9 years. This is a retrospective review of the transition from open to laparoscopic cholecystectomy throughout Mongolia. METHODS: Demographic patient data, diagnosis, and operation preformed-laparoscopic versus open cholecystectomy, between January, 2005, and September, 2013, were collected and trends were analysed from seven regional diagnostic referral and treatment centres, and two tertiary academic medical centres from six of the 21 provinces (Aimags) throughout Mongolia. Data were analysed by individual training centre, by year, and then compared between rural and urban centres. FINDINGS: Nearly 16 000 cholecystectomies were analysed and compared (4417 [28·2%] men; 11 244 [71·8%] women). Men and women underwent laparoscopic cholecystectomy with the same frequency (41·2% men, 43·2% women) and had similar age (men, mean 52·2 years [SD 14·8]; women, mean 49·4 years [SD 15·7]). By 2013, 62% of gallbladders were removed laparoscopically countrywide as opposed to only 2% in 2005. More than 315 Mongolian practitioners have received laparoscopic training in 19 of 21 Aimags. On average 60% of cholecystectomies are done laparoscopically in urban surgical centres, up from 2%, versus 55% in rural surgical centres, up from 0%, in 2005. Laparoscopic cholecystectomy surpassed open cholecystectomy as the primary method for gallbladder removal countrywide in 2011. INTERPRETATION: By 2013, 62% of cholecystectomies countrywide were done laparoscopically, a great increase from 9 years ago. Despite being a resource limited country, the expansion of laparoscopic cholecystectomy has transformed the care of biliary tract disease in Mongolia. FUNDING: The University of Utah Center for Global Surgery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Efficacy and Safety of Radiofrequency Ablation Versus Surgery for Thyroid Nodules(Mongolian National University of Medical Sciences, 2022-09-30); Objectives: To assess the efficacy and safety of radiofrequency (RF) ablation versus surgery for benign thyroid nodules for 24 months period. Methods: From January 2019 to January 2021, 200 patients with nodular goiters who underwent surgery (group A) and 183 patients treated by radiofrequency ablation (group B) were enrolled in this study. Inclusion criteria were the following: 1) cosmetic problem, 2) nodule-related symptoms, 3) refusal of surgery (for group B). An internally cooled radiofrequency ablation system and an 18 g internally cooled electrode were used. We compared the 2 groups in terms of efficacy, and safety during a 2-year follow-up. Results: Nodule type did not differ between groups, although in total 60.1 % were solid, 31.3 % were mixed, and 8.6 % were cystic. However, the number of nodules, median volume before surgery, and diameter of the nodule differed significantly. The median volume reduction was 34.6 % at 1 month, 56.1 % at 3 months, 70.6 % at 6 months, 73.9 % at 12 months, and 74.9 % at 24 months. Any volume reduction between follow-up intervals was statistically significant (p < 0.000). The most patients had no complications. However, surgical patients were more likely to have complications such as bleeding, hoarseness, and infection (14.5 %) than the RFA group (1.6 %). Conclusion: Surgical resection and radiofrequency ablation are both effective treatments of nodular goiter. Compared with surgery, the advantages of radiofrequency ablation include fewer complications, preservation of thyroid function, and fewer hospitalization days. Therefore, radiofrequency ablation should be considered a first-line treatment for benign thyroid nodules. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Research Progress of Limb Preservation Methods: A Review(2024-08-01); ; The effects of the survival rate of replanted limbs and postoperative functional recovery is closely related to the correctness and rationality of the limb preservation methods. However, the limb preservation methods can extend the activity of tissues and cells in different levels, reduce ischemia-reperfusion injury and improve the replant survival rate and functional recovery. Is it important to consider the injury situation, the environment and the requirements of replanting of limbs, how to preserve it organically and replant reasonably, and to develop strengths and avoid weaknesses of various methods and techniques that are most suitable for limb preservation? This review describes the research progress and analyzes the effects of different methods of limb preservation. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Status of Human Echinococcosis in Western Mongolia(Mongolian National University of Medical Sciences, 2019-03-31); ; ; Sumiya, GanzorigObjective: The purpose of this study was to identify cases of human echinococcosis in the Bayan-Ulgii, Khovd provinces, to determine their WHO classification by ultrasound and to identify the haplotype in surgically cysts removed. Methods: A total of 1063 people participated in ultrasound screening. Patients who had a positive echinococcosis by ultrasound underwent serologic testing for detection of antibodies for echinococcosis. Results: Ninety people were positive for the liver cystic lesions by ultrasound screening of which 12 cases were newly diagnosed cystic echinococcosis. Four were cystic echinococcosis stages 1-2, five were stage 3, while three were cystic echinococcosis stage 4. Thirty-three patients with previously known echinococcosis stage 2 and alveolar echinococcosis stage 4 were also examined. Out of 29 cystic echinococcosis cases, 24 underwent treatment. Of 24 who underwent treatment, only one was cured. The haplotypes E. canadensis G6/7 and E. granulossus s.s. G1 were confirmed by evaluating the cytochrome c oxidase subunit I gene of mitochondrial DNA in two patients in Bayan-Ulgii. Conclusion: Ninety people were positive for cystic echinococcosis in western Mongolia of which 12 cases were newly diagnosed cases. Of the 12 new cystic echinococcosis cases, 4 were stages 1-2, 5 were stage 3 and 3 were stage 4 by WHO classification. The haplotype in Bayan-Ulgii population were E. canadensis and s.s.