Valve defects or congenital/acquired heart defects are damage to the valve and/or subvalvular structures, which leads to impaired hemodynamics and the development of heart failure. Asymptomatic valvular heart disease is present in 2.5% of the population; with age, this figure rises to 13%. In the absence of permanent treatment, lesions of the heart valves significantly reduce the quality and duration of life. The European Society of Cardiology (ESC) and the American Heart Association (AHA) regularly review the effectiveness of new surgical treatments and reflect their findings in international guidelines. Today, minimally invasive surgery is the most effective and safe way to treat patients with valvular heart disease. The article presents two new methods for the treatment of valvular heart disease. Transapical mitral valve repair on a beating heart with neochord implantation (TOP-MINI) is a new MVP option that has been approved for patients with severe mitral regurgitation due to prolapse of the leaflet (s) or chord (grades 2-4). The new procedure with the NeoChord DS1000 device results in a significant reduction in mitral regurgitation and in reverse remodeling of the left ventricle and left atrium after 6 months of follow-up. Also reviewed is Minimally Invasive Aortic Valve Replacement (MAVR), which has been shown to be beneficial in improving patient satisfaction by minimizing pain and earlier recovery. Sutureless valves are preferred over traditional aortic valve replacement (AVR) due to the reduced operation time and the need for blood transfusion. The Perceval valve (Sorin, Sallugia, Italy) is a self-expanding bovine pericardial prosthesis placed in a nitinol stent designed to facilitate aortic valve implantation. A systematic review and meta-analysis demonstrated that the early clinical and hemodynamic characteristics of the Perceval valve are satisfactory and comparable to those of conventional AVRs. This literature review was carried out in accordance with the PRISM statement. The databases searched in this review included Pubmed, Web of Science, Scopus and Cochrane databases for systematic reviews
瓣膜缺损或先天性/获得性心脏缺损是对瓣膜和/或瓣下结构的损害，导致血流动力学受损和心力衰竭的发展。2.5%的人口存在无症状的瓣膜性心脏病;随着年龄的增长，这个数字上升到13%。在没有永久性治疗的情况下，心脏瓣膜病变会显著降低生活质量和持续时间。欧洲心脏病学会(ESC)和美国心脏协会(AHA)定期审查新手术治疗的有效性，并将他们的发现反映在国际指南中。如今，微创手术是治疗瓣膜性心脏病患者最有效、最安全的方法。本文介绍了治疗瓣膜性心脏病的两种新方法。经尖顶二尖瓣修复与新脐带植入跳动的心脏(TOP-MINI)是一个新的MVP选择，已被批准用于严重的二尖瓣反流患者由于小叶(s)或弦脱垂(2-4级)。在6个月的随访后，使用NeoChord DS1000装置的新手术显著减少了二尖瓣反流，并使左心室和左心房的反向重塑。此外，微创主动脉瓣置换术(MAVR)已被证明可以通过减少疼痛和早期恢复来提高患者满意度。无缝线瓣膜比传统的主动脉瓣置换术(AVR)更受欢迎，因为它减少了手术时间和输血的需要。Perceval瓣膜(Sorin, salugia, Italy)是一种自膨胀的牛心包假体，放置在镍钛合金支架中，旨在促进主动脉瓣植入。一项系统回顾和荟萃分析表明，Perceval瓣膜的早期临床和血流动力学特征是令人满意的，与传统的avr相当。本文献综述按照PRISM声明进行。本综述检索的数据库包括Pubmed、Web of Science、Scopus和Cochrane等系统综述数据库
{"title":"SOME INNOVATIVE TECHNOLOGIES FOR THE CORRECTION OF VALVULAR HEART DISEASES. REVIEW","authors":"I. Sagatov, A. Kudaibergen, B. Momynov","doi":"10.35805/bsk2021iv022","DOIUrl":"https://doi.org/10.35805/bsk2021iv022","url":null,"abstract":"Valve defects or congenital/acquired heart defects are damage to the valve and/or subvalvular structures, which leads to impaired hemodynamics and the development of heart failure. Asymptomatic valvular heart disease is present in 2.5% of the population; with age, this figure rises to 13%. In the absence of permanent treatment, lesions of the heart valves significantly reduce the quality and duration of life. The European Society of Cardiology (ESC) and the American Heart Association (AHA) regularly review the effectiveness of new surgical treatments and reflect their findings in international guidelines. Today, minimally invasive surgery is the most effective and safe way to treat patients with valvular heart disease. The article presents two new methods for the treatment of valvular heart disease. Transapical mitral valve repair on a beating heart with neochord implantation (TOP-MINI) is a new MVP option that has been approved for patients with severe mitral regurgitation due to prolapse of the leaflet (s) or chord (grades 2-4). The new procedure with the NeoChord DS1000 device results in a significant reduction in mitral regurgitation and in reverse remodeling of the left ventricle and left atrium after 6 months of follow-up. Also reviewed is Minimally Invasive Aortic Valve Replacement (MAVR), which has been shown to be beneficial in improving patient satisfaction by minimizing pain and earlier recovery. Sutureless valves are preferred over traditional aortic valve replacement (AVR) due to the reduced operation time and the need for blood transfusion. The Perceval valve (Sorin, Sallugia, Italy) is a self-expanding bovine pericardial prosthesis placed in a nitinol stent designed to facilitate aortic valve implantation. A systematic review and meta-analysis demonstrated that the early clinical and hemodynamic characteristics of the Perceval valve are satisfactory and comparable to those of conventional AVRs. This literature review was carried out in accordance with the PRISM statement. The databases searched in this review included Pubmed, Web of Science, Scopus and Cochrane databases for systematic reviews","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121118656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of the study is to evaluate and analyze the results of surgical treatment of patients with ischemic mitral insufficiency. Material and methods. The results of the examination and surgical treatment of 35 patients with ischemic mitral insufficiency are analyzed. In the operative period, in order to identify the degree of mitral insufficiency and the valvular apparatus, an echocardiography was performed, where the diameter of the fibrous ring, the interpapillary distance, the annulopapillary distance, the area of the cusp tension, and the depth of the coaptation of the valves were determined. Results. A preoperative examination proved the presence of mitral valve insufficiency with regurgitation of varying degrees. 15 patients underwent myocardial revascularization, 20 patients underwent myocardial revascularization + various options for correction of ischemic mitral insufficiency. After the operation, a significant improvement in the spatial-geometric correlation of the LV and mitral valve by reducing the tension forces acting on the valves and in the group of patients undergoing myocardial revascularization + various options for the correction of ischemic mitral insufficiency as the elimination of regurgitation. Conclusion. In patients with ischemic heart disease after echocardiographic studies, having determined the degree of mitral insufficiency with its moderate and severe degree, it is necessary to have a surgical correction of the mitral valve in its apparatus; the use of myocardial revascularization + various options for the correction of ischemic mitral insufficiency gives more tantalizing results than isolated myocardial revascularization.
{"title":"MODERN PRINCIPLES OF DIAGNOSIS AND SURGICAL TREATMENT OF ISCHEMIC MITRAL INSUFFICIENCY","authors":"R. Mahmudov","doi":"10.35805/bsk2021iv011","DOIUrl":"https://doi.org/10.35805/bsk2021iv011","url":null,"abstract":"The purpose of the study is to evaluate and analyze the results of surgical treatment of patients with ischemic mitral insufficiency. Material and methods. The results of the examination and surgical treatment of 35 patients with ischemic mitral insufficiency are analyzed. In the operative period, in order to identify the degree of mitral insufficiency and the valvular apparatus, an echocardiography was performed, where the diameter of the fibrous ring, the interpapillary distance, the annulopapillary distance, the area of the cusp tension, and the depth of the coaptation of the valves were determined. Results. A preoperative examination proved the presence of mitral valve insufficiency with regurgitation of varying degrees. 15 patients underwent myocardial revascularization, 20 patients underwent myocardial revascularization + various options for correction of ischemic mitral insufficiency. After the operation, a significant improvement in the spatial-geometric correlation of the LV and mitral valve by reducing the tension forces acting on the valves and in the group of patients undergoing myocardial revascularization + various options for the correction of ischemic mitral insufficiency as the elimination of regurgitation. Conclusion. In patients with ischemic heart disease after echocardiographic studies, having determined the degree of mitral insufficiency with its moderate and severe degree, it is necessary to have a surgical correction of the mitral valve in its apparatus; the use of myocardial revascularization + various options for the correction of ischemic mitral insufficiency gives more tantalizing results than isolated myocardial revascularization.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"174 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133565809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Tazhimuradov, Maria Saranova, Rustam Madalihodjayev
Objective. Numerous studies regarding gastric hormones and their regulation have been performed until now. However, the effect of the hormones on the formation and malignisation of gastric polyps still remains not clear. Our aim was to identify the relation between the level of gastrin in the blood, gastric mucosa, polyp tissue, gastric juice and pathogenesis of gastric polyposis. Materials and methods. A thorough investigation of gastrointestinal hormones in serum and gastric juice, in polyp’s tissue and mucosa, gastrin-secreting cells and proteolytic activity of gastric juice was carried out in 40 patients with gastric polyps. These patients were divided into groups, depending on the location, number, and malignancy of the polyps. As a control group, 10 healthy individuals were used to determine the normal values of the studied indicators. Results: A significant increase (more than two times) in the gastrinemia level before the surgery was noted in patients with polyp recurrence, and gastrin level increased to more significant digits of 227.0+37.4 pg/ml (p<0.05) in one year after polypectomy. Conclusion. Gastrin is apparently involved in the process of polyp formation since polyp’s growth is accompanied by elevation of serum gastrin. This is confirmed by a response of gastrin in the blood to a test meal in individuals with different duration of the disease: a marked increase in gastrinemia appears in patients suffering from gastric polyposis for more than three years. Therefore, evaluation of gastrin level in the patients’ blood can be used to predict a recurrence potential of polyps. This is evidenced by more pronounced hypergastrinemia before polypectomy in patients who had a further recurrence of the disease within one year after the surgery
{"title":"GASTRIN IN SERUM AND MORPHOLOGICAL STATE OF GASTRIN-SECRETING CELLS IN PATIENTS WITH GASTRIC POLYPOSIS","authors":"R. Tazhimuradov, Maria Saranova, Rustam Madalihodjayev","doi":"10.35805/bsk2021iv038","DOIUrl":"https://doi.org/10.35805/bsk2021iv038","url":null,"abstract":"Objective. Numerous studies regarding gastric hormones and their regulation have been performed until now. However, the effect of the hormones on the formation and malignisation of gastric polyps still remains not clear. Our aim was to identify the relation between the level of gastrin in the blood, gastric mucosa, polyp tissue, gastric juice and pathogenesis of gastric polyposis. Materials and methods. A thorough investigation of gastrointestinal hormones in serum and gastric juice, in polyp’s tissue and mucosa, gastrin-secreting cells and proteolytic activity of gastric juice was carried out in 40 patients with gastric polyps. These patients were divided into groups, depending on the location, number, and malignancy of the polyps. As a control group, 10 healthy individuals were used to determine the normal values of the studied indicators. Results: A significant increase (more than two times) in the gastrinemia level before the surgery was noted in patients with polyp recurrence, and gastrin level increased to more significant digits of 227.0+37.4 pg/ml (p<0.05) in one year after polypectomy. Conclusion. Gastrin is apparently involved in the process of polyp formation since polyp’s growth is accompanied by elevation of serum gastrin. This is confirmed by a response of gastrin in the blood to a test meal in individuals with different duration of the disease: a marked increase in gastrinemia appears in patients suffering from gastric polyposis for more than three years. Therefore, evaluation of gastrin level in the patients’ blood can be used to predict a recurrence potential of polyps. This is evidenced by more pronounced hypergastrinemia before polypectomy in patients who had a further recurrence of the disease within one year after the surgery","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116471280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
De novo autoimmune hepatitis (AIH) is a clinical disease similar to AIH that develops in liver transplant recipients with diseases other than AIH. Timely recognition of this disease makes it possible to avoid graft rejection and liver re-transplantation (LT), liver fibrosis, and can ensure a long life expectancy, given the effectiveness of more active immunosuppression with the use of corticosteroids and azathioprine, as in the treatment of idiopathic AIH. The de novo prefix was added to distinguish this condition from primary autoimmune hepatitis prior to transplant, but the diagnostic algorithm adopted generally accepted diagnostic criteria for autoimmune hepatitis. In fact, de novo autoimmune hepatitis is characterized by typical necroinflammation of the liver, rich in plasma cells, increased serum gammaglobulin levels, and the appearance of inorganic specific autoantibodies. However, the general signs of autoimmune hepatitis de novo, apparently, cannot be associated with an unambiguous pathophysiological pathway, since they can develop in patients undergoing liver transplantation due to different etiologies. The literature review presents such aspects as the prevalence of this case, the influence of the HLA phenotype on the manifestation and outcome of the disease, diagnosis and treatment. Objective. To conduct a literary meta-analysis of scientific publications on the development of De novo Autoimmune hepatitis after liver transplantation in children. Materials and methods. The authors selected scientific bases for the search such as: Web of science, Cyberleninka, UpToDate, Pubmed and Cochrane, Google Scholar. Results. A meta-analysis of scientific articles in English and Russian was carried out for the selected keywords. The causes of development were not infectious or surgical complications. Liver biopsy revealed histological changes typical of acute or chronic ovulation. High levels of transaminases, hypergammaglobulinemia, positivity to autoantibodies – ANA, AMA, SMA, anti-LKM-1. De novo AIH patients did not respond to conventional anti-rejection therapy, but responded only to classical AIH therapy.
新生自身免疫性肝炎(De novo autoimmune hepatitis, AIH)是一种与AIH相似的临床疾病，发生在肝移植受者身上，并伴有AIH以外的疾病。及时发现这种疾病可以避免移植物排斥反应和肝再移植(LT)、肝纤维化，并且可以确保较长的预期寿命，因为在治疗特发性AIH时，使用皮质类固醇和硫唑嘌呤进行更积极的免疫抑制是有效的。添加de novo前缀是为了将这种情况与移植前的原发性自身免疫性肝炎区分开来，但诊断算法采用了普遍接受的自身免疫性肝炎诊断标准。事实上，新生自身免疫性肝炎的特征是典型的肝脏坏死性炎症，富含浆细胞，血清γ球蛋白水平升高，出现无机特异性自身抗体。然而，自身免疫性新生肝炎的一般症状显然不能与明确的病理生理途径相关联，因为它们可以在肝移植患者中由于不同的病因而发展。文献综述从本病例的流行情况、HLA表型对疾病表现和转归的影响、诊断和治疗等方面进行综述。目标。对儿童肝移植后发生自身免疫性肝炎的科学出版物进行文献荟萃分析。材料和方法。作者为搜索选择了科学基础，如:Web of science, Cyberleninka, UpToDate, Pubmed and Cochrane, Google Scholar。结果。对选取的关键词进行了英文和俄文科学文章的荟萃分析。发展的原因不是感染或手术并发症。肝活检显示急性或慢性排卵的典型组织学改变。转氨酶水平高，高γ球蛋白血症，自身抗体(ANA, AMA, SMA，抗lkm -1)阳性。新发AIH患者对常规抗排斥治疗无反应，但仅对经典AIH治疗有反应。
{"title":"DE NOVO AUTOIMMUNE HEPATITIS AFTER LIVER TRANSPLANTATION IN CHILDREN. REVIEW","authors":"N. Yerimova, A. Akhbetova","doi":"10.35805/bsk2021iv052","DOIUrl":"https://doi.org/10.35805/bsk2021iv052","url":null,"abstract":"De novo autoimmune hepatitis (AIH) is a clinical disease similar to AIH that develops in liver transplant recipients with diseases other than AIH. Timely recognition of this disease makes it possible to avoid graft rejection and liver re-transplantation (LT), liver fibrosis, and can ensure a long life expectancy, given the effectiveness of more active immunosuppression with the use of corticosteroids and azathioprine, as in the treatment of idiopathic AIH. The de novo prefix was added to distinguish this condition from primary autoimmune hepatitis prior to transplant, but the diagnostic algorithm adopted generally accepted diagnostic criteria for autoimmune hepatitis. In fact, de novo autoimmune hepatitis is characterized by typical necroinflammation of the liver, rich in plasma cells, increased serum gammaglobulin levels, and the appearance of inorganic specific autoantibodies. However, the general signs of autoimmune hepatitis de novo, apparently, cannot be associated with an unambiguous pathophysiological pathway, since they can develop in patients undergoing liver transplantation due to different etiologies. The literature review presents such aspects as the prevalence of this case, the influence of the HLA phenotype on the manifestation and outcome of the disease, diagnosis and treatment. Objective. To conduct a literary meta-analysis of scientific publications on the development of De novo Autoimmune hepatitis after liver transplantation in children. Materials and methods. The authors selected scientific bases for the search such as: Web of science, Cyberleninka, UpToDate, Pubmed and Cochrane, Google Scholar. Results. A meta-analysis of scientific articles in English and Russian was carried out for the selected keywords. The causes of development were not infectious or surgical complications. Liver biopsy revealed histological changes typical of acute or chronic ovulation. High levels of transaminases, hypergammaglobulinemia, positivity to autoantibodies – ANA, AMA, SMA, anti-LKM-1. De novo AIH patients did not respond to conventional anti-rejection therapy, but responded only to classical AIH therapy.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"464 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114056798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article provides an analysis of the results of surgical treatment of patients with various forms of coronary artery disease, the study of the quality and reliability of myocardial revascularization, assessment of patency and functional viability of coronary grafts in the early postoperative period using echocardiography and myocardial perfusion scintigraphy. The retrospective material of our study is based on the results of surgical treatment of 130 patients with coronary artery disease who were operated on in the IHD department over the past year. All patients underwent examination according to a standard protocol: electrocardiography, 24-hour Holter monitoring, selective coronary ventriculography and shuntography, echocardiography, perfusion scintigraphy before and after surgery, drug stress test to assess myocardial perfusion and contractility and its differentiation (ischemia, scarring) with hypoperfusion.
{"title":"DIRECT RESULTS OF CORONARY BYPASS GRAFTING OF PATIENTS WITH THE REDUCED MYOCARDIAL CONTRACTILITY IN TERMS OF MYOCARDIAL PERFUSION SCINTIGRAPHY AND ECHOCARDIOGRAPHY","authors":"A. Mansurov","doi":"10.35805/bsk2021iii005","DOIUrl":"https://doi.org/10.35805/bsk2021iii005","url":null,"abstract":"This article provides an analysis of the results of surgical treatment of patients with various forms of coronary artery disease, the study of the quality and reliability of myocardial revascularization, assessment of patency and functional viability of coronary grafts in the early postoperative period using echocardiography and myocardial perfusion scintigraphy. The retrospective material of our study is based on the results of surgical treatment of 130 patients with coronary artery disease who were operated on in the IHD department over the past year. All patients underwent examination according to a standard protocol: electrocardiography, 24-hour Holter monitoring, selective coronary ventriculography and shuntography, echocardiography, perfusion scintigraphy before and after surgery, drug stress test to assess myocardial perfusion and contractility and its differentiation (ischemia, scarring) with hypoperfusion.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131179540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The article describes the types of correction of the supracardial form of abnormal drainage of the pulmonary veins. One of the methods of correcting this defect is the Warden operation, which includes: after sternotomy, connection of artificial circulation, cardioplegia, the superior vena cava is cut off, the proximal end is sutured. Next, a right atriotomy is performed, an anastomosis is formed using an autopericardial patch between the abnormal drainage and the left atrium through the ASD. Then an anastomosis is formed between the auricle of the right atrium and the distal end of the superior vena cava. As a result, blood from the abnormal pulmonary veins begins to drain into the left atrium through the ASD.
{"title":"TYPES OF CORRECTION OF THE SUPRACARDIAC FORM OF PARTIAL ABNORMAL DRAINAGE OF THE PULMONARY VEINS. WARDEN PROCEDURE","authors":"I. Sagatov, N. Dosmailov","doi":"10.35805/bsk2021iii028","DOIUrl":"https://doi.org/10.35805/bsk2021iii028","url":null,"abstract":"The article describes the types of correction of the supracardial form of abnormal drainage of the pulmonary veins. One of the methods of correcting this defect is the Warden operation, which includes: after sternotomy, connection of artificial circulation, cardioplegia, the superior vena cava is cut off, the proximal end is sutured. Next, a right atriotomy is performed, an anastomosis is formed using an autopericardial patch between the abnormal drainage and the left atrium through the ASD. Then an anastomosis is formed between the auricle of the right atrium and the distal end of the superior vena cava. As a result, blood from the abnormal pulmonary veins begins to drain into the left atrium through the ASD.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122638721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article provides a review of the literature on bile duct injuries after laparoscopic cholecystectomy. Laparascopy is considered the gold standard in the treatment of gallstone disease. This technique has a number of positive advantages: minimally invasiveness, quick rehabilitation, a shorter hospital stay, a good cosmetic effect, and a low lethal outcome. Along with these advantages, the number of complications also increased: damage to the bile ducts, hepatic vessels, bile leakage, formation of strictures, defects in drainage of the biliary tract and improper treatment of the cystic duct, insufficient drainage of the abdominal cavity. Today, many aspects of surgical treatment and prevention of bile duct injuries remain controversial and are still considered relevant. The main reasons for this complication are: lack of experience of the surgeon, inattention, ignorance of the main options and possible anomalies of important anatomical structures in the area of the hepatic hilum and hepato-duodenal ligament, technical errors.
{"title":"DAMAGE TO THE BILE DUCTS AFTER LAPAROSCOPIC CHOLECYSTECTOMY. REVIEW.","authors":"M. Doskhanov","doi":"10.35805/bsk2021iii017","DOIUrl":"https://doi.org/10.35805/bsk2021iii017","url":null,"abstract":"This article provides a review of the literature on bile duct injuries after laparoscopic cholecystectomy. Laparascopy is considered the gold standard in the treatment of gallstone disease. This technique has a number of positive advantages: minimally invasiveness, quick rehabilitation, a shorter hospital stay, a good cosmetic effect, and a low lethal outcome. Along with these advantages, the number of complications also increased: damage to the bile ducts, hepatic vessels, bile leakage, formation of strictures, defects in drainage of the biliary tract and improper treatment of the cystic duct, insufficient drainage of the abdominal cavity.\u0000Today, many aspects of surgical treatment and prevention of bile duct injuries remain controversial and are still considered relevant. The main reasons for this complication are: lack of experience of the surgeon, inattention, ignorance of the main options and possible anomalies of important anatomical structures in the area of the hepatic hilum and hepato-duodenal ligament, technical errors.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114389873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A case of non-penetrating neck injury with contusion and dissection of the common carotid artery with transition to the internal carotid artery is presented in a clinical observation. The clinical picture of the development of brain failure after thrombosis of the common and internal carotid arteries and regression of brain symptoms after reconstructive surgery is presented. A mathematical model of the lesion mechanism is analyzed separately. It is concluded that in case of a nonpenetrating wound of the neck with a traumatic weapon, the revision of the underlying tissues should be mandatory.
{"title":"GUNSHOT WOUND TO THE NECK WITH THROMBOSIS OF THE COMMON CAROTID ARTERY IN THE DELAYED PERIOD. (ANALYSIS OF CLINICAL OBSERVATION)","authors":"L. Kossovich, I. Kirillova","doi":"10.35805/bsk2021iii010","DOIUrl":"https://doi.org/10.35805/bsk2021iii010","url":null,"abstract":"A case of non-penetrating neck injury with contusion and dissection of the common carotid artery with transition to the internal carotid artery is presented in a clinical observation. The clinical picture of the development of brain failure after thrombosis of the common and internal carotid arteries and regression of brain symptoms after reconstructive surgery is presented. A mathematical model of the lesion mechanism is analyzed separately. It is concluded that in case of a nonpenetrating wound of the neck with a traumatic weapon, the revision of the underlying tissues should be mandatory.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116385235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Кhanchi, A. Matkerimov, A. Tergeussizov, T. Demeuov, A. Baubekov, M. Zhakubayev, T. Tajibayev, M. Khanchi, A. Shamshiev
Peripheral artery aneurysms are dangerous with possible complications such as ruptures, bleeding, thromboembolism in the distal bed with subsequent tissue ischemia, neurological disorders due to pressure of closely located nerve trunks. One of the most common causes of peripheral artery aneurysms is trauma. Special attention should be paid to a significant increase in the number of iatrogenic injuries. From 2000 to 2019, 46 patients were operated on the arteries of the lower extremities. Operations of various types of reconstructions were performed. The total age of the patients ranged from 30 to 76 years, the average age of the patients was 43.3± 6.5 years. A total of 6 (9.2%) patients were operated on with combined aneurysmal lesion of the femoral and popliteal arteries. In the postoperative period, 91.5% of patients with peripheral artery aneurysm had positive clinical results. 4 (8.5%) developed complications. Long-term results were tracked in the period from 3 months to 3 years. A clinical examination was performed, supplemented by ultrasound control. 2 cases of thrombosis in the distal anastomosis were identified, which were restored after reconstruction of the distal anastomosis.
{"title":"SURGICAL TREATMENT OF ARTERIAL ANEURYSMS OF THE LOWER LIMB.","authors":"M. Кhanchi, A. Matkerimov, A. Tergeussizov, T. Demeuov, A. Baubekov, M. Zhakubayev, T. Tajibayev, M. Khanchi, A. Shamshiev","doi":"10.35805/bsk2021iii032","DOIUrl":"https://doi.org/10.35805/bsk2021iii032","url":null,"abstract":"Peripheral artery aneurysms are dangerous with possible complications such as ruptures, bleeding, thromboembolism in the distal bed with subsequent tissue ischemia, neurological disorders due to pressure of closely located nerve trunks. \u0000One of the most common causes of peripheral artery aneurysms is trauma. Special attention should be paid to a significant increase in the number of iatrogenic injuries. From 2000 to 2019, 46 patients were operated on the arteries of the lower extremities. Operations of various types of reconstructions were performed. The total age of the patients ranged from 30 to 76 years, the average age of the patients was 43.3± 6.5 years. \u0000A total of 6 (9.2%) patients were operated on with combined aneurysmal lesion of the femoral and popliteal arteries. In the postoperative period, 91.5% of patients with peripheral artery aneurysm had positive clinical results. 4 (8.5%) developed complications. Long-term results were tracked in the period from 3 months to 3 years. A clinical examination was performed, supplemented by ultrasound control. 2 cases of thrombosis in the distal anastomosis were identified, which were restored after reconstruction of the distal anastomosis.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127617149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-31DOI: 10.35805/KAZSURGERY.BSK.2018.4.5-7
D. Baiguisova, G. Kausova
To conduct a retrospective analysis of patient referrals for computed tomography to identify the main problems, both in writing the direction itself and in its validity. Materials and methods: The patient referrals for computed tomography (CT) were analyzed at the Radiology Department of the National Scientific Center named after AN Syzganov - outpatients for 3 months. Results and discussions: it has been established that, in the main, clinicians, when issuing a referral for a study, ignore such item as a diagnosis, or replace it with the word — examination. There is also the groundlessness and incorrectness of the referrals for the studies, considering their variability and insufficient awareness of doctors both in the indications and the need for a particular study. Conclusion: Clinicians are not sufficiently aware of the correctness of referrals for computed tomography and, as a result, write out incorrect referrals.
{"title":"RETROSPECTIVE ANALYSIS OF PATIENT REFERRALS FOR COMPUTED TOMOGRAPHY","authors":"D. Baiguisova, G. Kausova","doi":"10.35805/KAZSURGERY.BSK.2018.4.5-7","DOIUrl":"https://doi.org/10.35805/KAZSURGERY.BSK.2018.4.5-7","url":null,"abstract":"To conduct a retrospective analysis of patient referrals for computed tomography to identify the main problems, both in writing the direction itself and in its validity. Materials and methods: The patient referrals for computed tomography (CT) were analyzed at the Radiology Department of the National Scientific Center named after AN Syzganov - outpatients for 3 months. Results and discussions: it has been established that, in the main, clinicians, when issuing a referral for a study, ignore such item as a diagnosis, or replace it with the word — examination. There is also the groundlessness and incorrectness of the referrals for the studies, considering their variability and insufficient awareness of doctors both in the indications and the need for a particular study. Conclusion: Clinicians are not sufficiently aware of the correctness of referrals for computed tomography and, as a result, write out incorrect referrals.","PeriodicalId":197118,"journal":{"name":"BULLETIN OF SURGERY IN KAZAKHSTAN","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115305925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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