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Possibilities and place of endoscopy in improving the results of treatment of gastroduodenal bleedings 内镜在改善胃十二指肠出血治疗效果中的可能性和地位
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.24884/0042-4625-2023-182-1-93-97
M. P. Korolev, R. G. Avanesyan, L. E. Fedotov, B. L. Fedotov, M. V. Antipova, L. Z. Khafizov
The results of treatment of gastroduodenal bleedings in the Russian Federation leave much to be desired. According to the chief surgeon and endoscopist of the Russian Federation, Academician A. Sh. Ramishvili [2], operative mortality in the treatment of gastroduodenal bleedings is 19 %, and only in 32 % of cases, bleeding was stopped endoscopically. The article analyzes the problems in the treatment of gastroduodenal bleedings. The main problem is organizational. Strict implementation of national clinical recommendations by surgeons and endoscopists is necessary for high-quality care for patients with gastroduodenal bleedings (1). Special conditions should be created in hospitals to help patients with gastroduodenal bleedings. These are the presence of a surgical team, intensive care unit, blood transfusion department or cabinet, 24-hour endoscopy (department or cabinet) equipped with modern digital endoscopes and all the tools to stop bleedings. It is necessary to treat not the bleeding but the patient with bleeding. For this purpose, it is necessary to use drug antisecretory therapy after endoscopic treatment. It is very important that surgeons and endoscopists equally understand the complexity of the problem – the treatment of gastroduodenal bleedings.
在俄罗斯联邦,胃十二指肠出血的治疗结果还有很多需要改进的地方。根据俄罗斯联邦首席外科医生和内窥镜医师A. Sh. Ramishvili院士[2]的研究,治疗胃十二指肠出血的手术死亡率为19%,只有32%的病例在内窥镜下止血。文章分析了胃十二指肠出血治疗中应注意的问题。主要的问题是组织上的。外科医生和内镜医师严格执行国家临床建议,对胃十二指肠出血患者进行高质量的护理是必要的(1)。医院应创造特殊条件,帮助胃十二指肠出血患者。这些条件包括外科团队、重症监护病房、输血科或输血柜、配备现代数字内窥镜的24小时内窥镜(科或柜)以及所有止血工具。有必要治疗的不是出血本身,而是出血的病人。为此,有必要在内镜治疗后使用药物抗分泌治疗。外科医生和内窥镜医生同样了解胃十二指肠出血治疗问题的复杂性是非常重要的。
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引用次数: 0
Academician Vladimir Mikhailovich Mysh (1873–1947) (on the 150th anniversary of his birth) 弗拉基米尔·米哈伊洛维奇·米什院士(1873-1947)(纪念他诞辰150周年)
Q4 Medicine Pub Date : 2023-10-25 DOI: 10.24884/0042-4625-2023-182-1-7-10
A. A. Kurygin, V. V. Semenov
An outstanding surgeon, scientist, teacher and organizer of healthcare, academician of the USSR Academy of Medical Sciences (1945), Honored Scientist of the RSFSR (1934), founder of the largest surgical school in Siberia, Professor Vladimir Mikhailovich Mysh was born on January 4 (16), 1873 in St. Petersburg in the family of a lawyer. He received his secondary education in a classical gymnasium and entered the Imperial Military Medical Academy, which he graduated in 1895 with honors and was left for three years to improve at the Department of Surgery under the guidance of Professor N. A. Velyaminov. In 1898, V. M. Mysh defended his doctoral dissertation on the topic: «Herniae vaginales ingvinales in childhood» and was assigned to Kaluga, where he worked as the head of the Surgical Department in a Military hospital. In 1901, he was elected by competition to the position of professor of the Department of General Surgery with Desmurgy and the study of dislocations and fractures at the Medical Faculty of Tomsk University. In 1909, V. M. Mysh became the head of the Department of Faculty Surgery of Tomsk University, which he headed until 1931, and in 1922, he concurrently headed the Department of Urology created by him. He was the first in Russia and the third in the world to perform radical surgery for alveolar echinococcosis of the liver. In 1931, Vladimir Mikhailovich together with the staff of Tomsk State Medical University moved to Novosibirsk, where he continued to head the Department of Surgery, and in 1935, took an active part in the opening of Novosibirsk Medical Institute and the creation of the Department of Faculty Surgery in it. V. M. Mysh initiated the introduction of specialized urological care in Siberia and made a very great contribution to the development of neurosurgery. Academician V. M. Mysh created the largest surgical school in Siberia, from which famous professors came out: V. S. Levit, G. M. Mukhadze, M. S. Rabinovich, S. L. Schneider, B. I. Fuchs, K. N. Cherepnin, A. G. Savinykh, V. M. Galkin. Vladimir Mikhailovich was the author and co-author of 136 scientific papers, including 11 monographs and manuals on abdominal and thoracic surgery, oncology, urology, neurosurgery, diseases of bones and joints, general and plastic surgery. He was awarded two Orders of Lenin, the Order of the Red Banner of Labor, medals «For Valiant Labor in the Great Patriotic War of 1941–1945», «For Labor Valor». Academician V. M. Mysh died on December 31, 1947 and was buried at the Zaeltsovsky Cemetery in Novosibirsk. The surgical clinic of the State Institute for Advanced Training of Doctors and the Department of Faculty Surgery of NSMU were named after V. M. Mysh. He was listed in the gallery of Honorary Professors of the Novosibirsk State Medical Academy.
弗拉基米尔·米哈伊洛维奇·米什教授是一位杰出的外科医生、科学家、教师和卫生保健的组织者,苏联医学科学院院士(1945年),俄罗斯联邦社会主义共和国荣誉科学家(1934年),西伯利亚最大的外科学校的创始人,他于1873年1月4日(16日)出生于圣彼得堡的一个律师家庭。他在一个古典体育馆接受了中等教育,然后进入了帝国军事医学院,1895年以优异的成绩毕业,然后在n.a. Velyaminov教授的指导下在外科部门学习了三年。1898年,v.m.迈什为他的博士论文辩护,题目是“儿童时期的阴道疝”,并被分配到卡卢加,在那里他担任一家军事医院外科主任。1901年,他在竞争中当选为托木斯克大学医学院普通外科和脱位与骨折研究系的教授。1909年,V. M. Mysh成为托木斯克大学外科学系主任,直到1931年,1922年,他兼任他创建的泌尿科主任。他是俄罗斯第一个,世界上第三个对肝脏肺泡包虫病进行根治性手术的人。1931年,弗拉基米尔·米哈伊洛维奇与托木斯克国立医科大学的工作人员一起搬到新西伯利亚,在那里他继续领导外科学系,并于1935年积极参与新西伯利亚医学研究所的开幕和其中的外科学系的创建。v.m. Mysh在西伯利亚开创了专门的泌尿外科护理,对神经外科的发展做出了巨大的贡献。V. M. Mysh院士创建了西伯利亚最大的外科学校,出了许多著名的教授:V. S. Levit、G. M. Mukhadze、M. S. Rabinovich、S. L. Schneider、B. I. Fuchs、K. N. Cherepnin、A. G. Savinykh、V. M. Galkin。Vladimir Mikhailovich是136篇科学论文的作者和合著者,其中包括11部专著和手册,内容涉及腹部和胸外科、肿瘤学、泌尿外科、神经外科、骨骼和关节疾病、普通外科和整形外科。他被授予两枚列宁勋章,劳动红旗勋章,“1941-1945年卫国战争中的英勇劳动”奖章,“劳动英勇”奖章。m.m ish院士于1947年12月31日去世,被安葬在新西伯利亚的Zaeltsovsky公墓。国家医生高级培训学院的外科诊所和NSMU的教员外科部门以v.m. Mysh命名。他被列入新西伯利亚国立医学院名誉教授名单。
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引用次数: 0
Primary esophageal melanoma with a family history of esophageal cancer 有食管癌家族史的原发性食管黑色素瘤
Q4 Medicine Pub Date : 2023-10-25 DOI: 10.24884/0042-4625-2023-182-1-76-80
B. V. Sigua, A. S. Kachiuri, D. V. Gurzhy, A. V. Belyaeva, S. Yu. Rakita, S. A. Vinnichuk, V. P. Zemlyanoy
A rare clinical observation of a 46-year-old patient with primary esophageal melanoma is presented. We demonstrate the difficulties of verifying the disease, taking into account the complex morphological picture of the tumor, anatomical features. The possibilities of modern combined treatment of this category of patients are also shown. For the first time, a case of primary esophageal melanoma with a family history of esophageal cancer is described.
本文报告一位46岁原发性食道黑色素瘤患者的罕见临床观察。我们证明了验证疾病的困难,考虑到复杂的形态图的肿瘤,解剖特征。这类患者的现代联合治疗的可能性也显示。第一次,一个病例原发性食管黑色素瘤与食管癌的家族史被描述。
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引用次数: 0
Contrast-induced nephropathy after recanalization chronic coronary occlusion in patients with renal artery stenosis and normal creatinine levels 肾动脉狭窄且肌酐水平正常的慢性冠状动脉闭塞患者再通后造影剂所致肾病
Q4 Medicine Pub Date : 2023-06-23 DOI: 10.24884/0042-4625-2023-182-1-65-70
N. A. Yaitskiy, O. G. Zverev, A. V. Voynov, S. M. Lazarev, A. I. Azeyan, A. F. Bokov
Introduction . Contrast-induced nephropathy (CIN) is a complication that occurs after contrast medium (CM) administration. The existing risk scales for possible CIN include chronic kidney disease and do not take into account stenotic changes in the renal artery with normal serum creatinine levels. The Objective was to study the frequency of CIN in patients with acute and chronic coronary occlusion (CCO) after endovascular recanalization in the presence of hemodynamically significant renal artery damage with initially normal creatinine levels. Methods and Materials . The study included 38 patients with acute coronary syndrome (control group) and 67 patients with CCO and hemodynamically significant renal artery stenosis (main group). Stenting of one of the renal arteries was performed in 25 patients out of 67 patients before planned coronary revascularization. Results . The incidences of CIN were significantly higher than the calculated one in patients with CCO and renal artery stenosis. In the group of patients with pre-stenting of the renal arteries, there was a decrease in cases of CIN. Conclusions . Renal artery stenosis with normal creatinine levels is an additional risk factor for CIN.
介绍。造影剂肾病(CIN)是造影剂(CM)使用后发生的并发症。现有可能发生CIN的风险量表包括慢性肾脏疾病,没有考虑血清肌酐水平正常的肾动脉狭窄改变。目的是研究急性和慢性冠状动脉闭塞(CCO)患者在血管内再通后存在血流动力学上显著的肾动脉损伤且初始肌酐水平正常的CIN频率。方法与材料。研究纳入38例急性冠状动脉综合征患者(对照组)和67例CCO合并血流动力学显著的肾动脉狭窄患者(主要组)。在计划冠状动脉重建术之前,67例患者中有25例患者接受了肾动脉支架术。结果。CCO合并肾动脉狭窄患者的CIN发生率明显高于计算值。在肾动脉支架置入术组中,CIN的发生率有所下降。结论。肾动脉狭窄而肌酐水平正常是CIN的另一个危险因素。
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引用次数: 0
Improvement of methods of diagnosis and treatment of patients with obstructive jaundice of tumor genesis 肿瘤源性梗阻性黄疸诊治方法的改进
Q4 Medicine Pub Date : 2023-04-27 DOI: 10.24884/0042-4625-2023-182-1-28-34
E. B. Revazov, T. S. Khutiev, M. R. Revazova, A. N. Chetiev, U. S. Beslekoev, T. B. Ardasenov
The Objective was to improve medical and diagnostic care for patients with obstructive jaundice of tumor genesis. Methods and Materials . Retrospective analysis of the treatment results of 309 patients with obstructive jaundice of tumor genesis. We studied the results of endoscopic transpapillary and/or percutaneous transhepatic antegrade endobilliary minimally invasive surgical interventions of 307 (99.3 %) patients. We carried out the analysis of complications, reasons and possible elimination path. A new, more effective method of trepan-biopsy of tumors of the pancreatic head and distal choledochus and devise for it implementation were developed (patent № 2722655, 2747591). Results . Minimally invasive decompression interventions at the first stage of treatment of patients with obstructive jaundice of tumor genesis reduced the percentage of fatal postoperative complications to 1.3 %. The first results of the application of the developed trepan-biopsy method showed their high efficiency, reliability and safety. Conclusion . The differentiated approach to the choice of the method of decompression of the biliary tract at the first stage is important for improving the results of treatment. The use of the method of simultaneous puncture transhepatic billioduadenal drainage with trepan-biopsy of tumors of the pancreatic head and distal choledochus is, as it seems to us, a new, promising adjustment in solving the problem of morphological verification of tumors of the hepatopancreatoduodenal zone and reducing the time of diagnosis and treatment of patients with obstructive jaundice of the tumor genesis.
目的是提高肿瘤源性梗阻性黄疸患者的医疗和诊断护理水平。方法与材料。回顾性分析309例肿瘤源性梗阻性黄疸的治疗结果。我们研究了307例(99.3%)患者经内镜经乳头和/或经皮经肝顺行胆道内微创手术治疗的结果。我们对并发症、原因及可能的消除途径进行了分析。开发了一种新的,更有效的胰腺头和远端胆总管肿瘤穿刺活检方法及其实施设计(专利号2722655,2747591)。结果。在肿瘤源性梗阻性黄疸患者治疗的第一阶段,微创减压干预将术后致命并发症的百分比降低到1.3%。初步应用结果表明,该方法高效、可靠、安全。结论。鉴别第一阶段胆道减压方法的选择对提高治疗效果具有重要意义。采用经肝十二指肠穿刺引流联合胰头及胆总管远端肿瘤穿刺活检的方法,在解决肝胰十二指肠区肿瘤的形态验证问题,减少肿瘤发生的梗阻性黄疸患者的诊断和治疗时间方面,是一种新的、有希望的调整。
{"title":"Improvement of methods of diagnosis and treatment of patients with obstructive jaundice of tumor genesis","authors":"E. B. Revazov, T. S. Khutiev, M. R. Revazova, A. N. Chetiev, U. S. Beslekoev, T. B. Ardasenov","doi":"10.24884/0042-4625-2023-182-1-28-34","DOIUrl":"https://doi.org/10.24884/0042-4625-2023-182-1-28-34","url":null,"abstract":"The Objective was to improve medical and diagnostic care for patients with obstructive jaundice of tumor genesis. Methods and Materials . Retrospective analysis of the treatment results of 309 patients with obstructive jaundice of tumor genesis. We studied the results of endoscopic transpapillary and/or percutaneous transhepatic antegrade endobilliary minimally invasive surgical interventions of 307 (99.3 %) patients. We carried out the analysis of complications, reasons and possible elimination path. A new, more effective method of trepan-biopsy of tumors of the pancreatic head and distal choledochus and devise for it implementation were developed (patent № 2722655, 2747591). Results . Minimally invasive decompression interventions at the first stage of treatment of patients with obstructive jaundice of tumor genesis reduced the percentage of fatal postoperative complications to 1.3 %. The first results of the application of the developed trepan-biopsy method showed their high efficiency, reliability and safety. Conclusion . The differentiated approach to the choice of the method of decompression of the biliary tract at the first stage is important for improving the results of treatment. The use of the method of simultaneous puncture transhepatic billioduadenal drainage with trepan-biopsy of tumors of the pancreatic head and distal choledochus is, as it seems to us, a new, promising adjustment in solving the problem of morphological verification of tumors of the hepatopancreatoduodenal zone and reducing the time of diagnosis and treatment of patients with obstructive jaundice of the tumor genesis.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"665 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136266943","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}
引用次数: 0
Professor Anatoly Alekseevich Kurygin (1932–2011) (to the 90th anniversary of the birth) 阿纳托利·阿列克谢耶维奇·库里金教授(1932-2011)(纪念诞辰90周年)
Q4 Medicine Pub Date : 2023-04-12 DOI: 10.24884/0042-4625-2022-181-4-7-12
N. N. Lebedev, A. E. Demko, Al. A. Kurygin, A. N. Shikhmetov, V. G. Verbitsky, S. I. Peregudov, V. V. Semenov
Anatoly Alekseevich Kurygin was born on September 10, 1932 in the village of Zaborye, Solotchinsky District (now Ryazansky District), Ryazan Region, into a peasant family. In 1950, Anatoly Kurygin graduated from the Solotchinsk complete secondary school with excellent and good marks and applied for admission to the Ryazan Medical Institute. A. Kurygin decided to become a surgeon already at the beginning of his studies at the Institute and persistently went to achieve this goal. After graduating from the 4th year, Anatoly Alekseevich, along with other most successful students, received an offer to continue the study at the Military Medical Faculty at the Kuibyshev Medical Institute named after D. I. Ulyanov, agreed and joined the ranks of the Soviet Army. In July 1956, having received a diploma with honors, lieutenant of the medical service A. A. Kurygin, together with his wife Lyudmila Nikiforovna, departed for the Belarusian Military District. In April 1961, having got the highest grades (five) in the entrance exams, Anatoly Alekseevich was enrolled in the postgraduate course at the Department of Faculty Surgery named after S. P. Fedorov. As a dissertation research, Anatoly Alekseevich was instructed to study the state of lavsan prostheses and a new vascular bed at different times after arterial alloplasty. Soon after defending his dissertation, V. M. Sitenko suggested Anatoly Alekseevich to take up the issue of chronic pancreatitis, which was little studied at that time. During the year, A. A. Kurygin studied the literature on this topic and came to the convincing conclusion that it was impossible as a doctoral dissertation. Anatoly Alekseevich reported his thoughts to the head of the department, substantiated the futility of this topic and expressed a desire to study the physiological and surgical aspects of vagotomy as a new and alternative method of gastric resection for the treatment of chronic duodenal ulcers and its complications. In June 1978, the deputy head of the department, associate professor A. A. Kurygin, successfully defended the first doctoral dissertation in the USSR on the treatment of duodenal ulcers by vagotomy in combination with pyloroplasty. Five years later, in November 1987, professors of the Military Medical Academy V. M. Sitenko, A. A. Kurygin and A. I. Nechay, as part of a group of surgeons from Moscow, Kyiv and Tallinn, were awarded the title of Laureate of the USSR State Prize «For the development and implementation of new methods of treatment of peptic ulcer». In 1985, Professor A. A. Kurygin was appointed head of the Department of Surgery № 2 (for advanced medical training) of the Military Medical Academy. Anatoly Alekseevich was the author and co-author of more than 300 scientific papers, including 39 monographs and manuals, more than 25 teaching aids, 14 inventions, as well as the editor of the Abdominal Surgery section of the Small Medical Encyclopedia. Also, A.A. Kurygin published three collections of poetry.
阿纳托利·阿列克谢耶维奇·库里金于1932年9月10日出生在梁赞州索洛钦斯基区(现梁赞斯基区)扎博尔耶村的一个农民家庭。1950年,阿纳托利·库里金以优异的成绩从索罗特钦斯克中学毕业,并申请进入梁赞医学院。a .库里金在学院学习之初就决定成为一名外科医生,并坚持不懈地实现这一目标。第四年毕业后,阿纳托利·阿列克谢耶维奇和其他最成功的学生一起,收到了在以乌里扬诺夫命名的古比雪夫医学研究所军事医学院继续学习的邀请,同意并加入了苏联军队的行列。1956年7月,获得荣誉证书的医务中尉a . a .库里金和他的妻子柳德米拉·尼基福罗夫娜前往白俄罗斯军区。1961年4月,阿纳托利·阿列克谢耶维奇在入学考试中取得了最高分(5分),进入了以费多罗夫命名的外科学院的研究生课程。作为一项论文研究,Anatoly Alekseevich被指示研究动脉异体成形术后不同时间lavsan假体和新血管床的状态。在完成论文答辩后不久,v·m·西滕科建议阿纳托利·阿列克谢耶维奇着手研究慢性胰腺炎的问题,当时这方面的研究很少。在这一年里,a . a .库里金研究了关于这个话题的文献,得出了一个令人信服的结论:作为一篇博士论文,这是不可能的。Anatoly Alekseevich向系主任报告了他的想法,证实了本课题的无效,并表示希望研究迷走神经切开术作为治疗慢性十二指肠溃疡及其并发症的一种新的替代胃切除方法的生理和外科方面。1978年6月,该系副主任、副教授A. A. Kurygin成功地为苏联第一篇关于迷走神经切开术联合幽门成形术治疗十二指肠溃疡的博士论文进行了辩护。五年后,1987年11月,军事医学院的教授V. M. Sitenko、a . a . Kurygin和a . I. Nechay,作为来自莫斯科、基辅和塔林的一组外科医生的一部分,被授予苏联国家奖“发展和实施治疗消化性溃疡的新方法”。1985年,A. A.库里金教授被任命为军事医学院外科第二部(高级医学培训)主任。阿纳托利·阿列克谢耶维奇是300多篇科学论文的作者和合著者,其中包括39本专著和手册,超过25本教学辅助工具,14项发明,以及《小型医学百科全书》腹部外科部分的编辑。此外,A.A.库里金出版了三本诗集。2011年11月12日,阿纳托利·阿列克谢耶维奇·库里金医生久病复发,离开了我们。15日,在圣彼得堡塞拉菲莫夫斯基公墓安葬了军医部少将a·a·库里金。
{"title":"Professor Anatoly Alekseevich Kurygin (1932–2011) (to the 90th anniversary of the birth)","authors":"N. N. Lebedev, A. E. Demko, Al. A. Kurygin, A. N. Shikhmetov, V. G. Verbitsky, S. I. Peregudov, V. V. Semenov","doi":"10.24884/0042-4625-2022-181-4-7-12","DOIUrl":"https://doi.org/10.24884/0042-4625-2022-181-4-7-12","url":null,"abstract":"Anatoly Alekseevich Kurygin was born on September 10, 1932 in the village of Zaborye, Solotchinsky District (now Ryazansky District), Ryazan Region, into a peasant family. In 1950, Anatoly Kurygin graduated from the Solotchinsk complete secondary school with excellent and good marks and applied for admission to the Ryazan Medical Institute. A. Kurygin decided to become a surgeon already at the beginning of his studies at the Institute and persistently went to achieve this goal. After graduating from the 4th year, Anatoly Alekseevich, along with other most successful students, received an offer to continue the study at the Military Medical Faculty at the Kuibyshev Medical Institute named after D. I. Ulyanov, agreed and joined the ranks of the Soviet Army. In July 1956, having received a diploma with honors, lieutenant of the medical service A. A. Kurygin, together with his wife Lyudmila Nikiforovna, departed for the Belarusian Military District. In April 1961, having got the highest grades (five) in the entrance exams, Anatoly Alekseevich was enrolled in the postgraduate course at the Department of Faculty Surgery named after S. P. Fedorov. As a dissertation research, Anatoly Alekseevich was instructed to study the state of lavsan prostheses and a new vascular bed at different times after arterial alloplasty. Soon after defending his dissertation, V. M. Sitenko suggested Anatoly Alekseevich to take up the issue of chronic pancreatitis, which was little studied at that time. During the year, A. A. Kurygin studied the literature on this topic and came to the convincing conclusion that it was impossible as a doctoral dissertation. Anatoly Alekseevich reported his thoughts to the head of the department, substantiated the futility of this topic and expressed a desire to study the physiological and surgical aspects of vagotomy as a new and alternative method of gastric resection for the treatment of chronic duodenal ulcers and its complications. In June 1978, the deputy head of the department, associate professor A. A. Kurygin, successfully defended the first doctoral dissertation in the USSR on the treatment of duodenal ulcers by vagotomy in combination with pyloroplasty. Five years later, in November 1987, professors of the Military Medical Academy V. M. Sitenko, A. A. Kurygin and A. I. Nechay, as part of a group of surgeons from Moscow, Kyiv and Tallinn, were awarded the title of Laureate of the USSR State Prize «For the development and implementation of new methods of treatment of peptic ulcer». In 1985, Professor A. A. Kurygin was appointed head of the Department of Surgery № 2 (for advanced medical training) of the Military Medical Academy. Anatoly Alekseevich was the author and co-author of more than 300 scientific papers, including 39 monographs and manuals, more than 25 teaching aids, 14 inventions, as well as the editor of the Abdominal Surgery section of the Small Medical Encyclopedia. Also, A.A. Kurygin published three collections of poetry.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134952247","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}
引用次数: 0
Laparoscopic cholecystectomy for double gallbladder 腹腔镜胆囊切除术治疗双胆囊
Q4 Medicine Pub Date : 2023-04-11 DOI: 10.24884/0042-4625-2023-182-1-81-87
P. V. Markov, O. R. Arutyunov, V. S. Pykhteev, L. A. Vlaskina
Gallbladder duplication is a rare abnormality of the biliary system. When a pathology develops in a doubled gallbladder, there can be difficulties in diagnosis and surgical treatment. Apart from the ultrasound investigation, other imaging methods are of great importance for more accurate diagnostics: computed tomography, magnetic resonance tomography, magnetic resonance cholangiopancreatography and endoscopic ultrasonography. The article presents a literature review and demonstrates our own clinical case of laparoscopic cholecystectomy in the patient with gallbladder duplication.
胆囊重复是一种罕见的胆道系统异常。当双胆囊病理发展时,诊断和手术治疗可能会有困难。除了超声检查外,其他成像方法对更准确的诊断也很重要:计算机断层扫描、磁共振断层扫描、磁共振胰胆管造影和超声内镜检查。本文回顾了文献资料,并介绍了我们自己的临床病例腹腔镜胆囊切除术患者胆囊重复。
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引用次数: 0
Minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertension 微创预防肝外门脉高压患儿食管静脉曲张出血
Q4 Medicine Pub Date : 2023-04-06 DOI: 10.24884/0042-4625-2023-182-1-35-42
R. Z. Yuldashev, M. M. Aliev, Sh. I. Shokhaidarov
The objective of the work was to study the efficacy of minimally invasive endoscopic treatment of esophageal varices (EV) in children with extrahepatic portal hypertension (EHPH). Methods and Materials . Eighty children aged 3 to 17 years of age with EHPH included in this study. The patients were divided into three analysis groups. The group I (n=14) included children with EHPH who had not previously undergone any surgical interventions and endoscopic ligation of EV was performed against the background of acute bleeding or after medical hemostatic treatment. The group II (n=37) included patients who had undergone the endoscopic treatment of EV after an unsatisfactory outcome of previously performed surgical interventions. The group III included 29 children who underwent only azygos-portal disconnection procedures. We performed the comparative analysis of the severity of EV before and after sessions of the endoscopic treatment of EV, as well as the analysis of the frequency of recurrent bleedings in comparison groups. Results . According to the research results, recurrent gastroesophageal hemorrhages were noted in 44.4 % of cases in the group I. In the group II, 37 patients underwent a total of 68 sessions of the stage endoscopic treatment of EV. According to the control endoscopic examinations, there was a significant reduction in the risk of bleeding from EV between ligation sessions (p=0.001) of the endoscopic treatment of EV. During the follow-up period, in the group II, recurrent bleedings from EV were noted in 6 (16.2 %) patients. Whereas in 10 (34.5 %) children of the group III, recurrent gastroesophageal hemorrhages were noted in the postoperative period. The analysis showed a significant correlation of the presence of «red flags» with recurrent episodes of bleedings in children of the group II after the endoscopic treatment of EV (r=0.32 p=0.05). Analysis of the causes of recurrent gastroesophageal bleedings in children of the group III did not reveal significant differences in such parameters as the degree of EV and «red flags». Conclusion . Thus, the endoscopic treatment of EV is a safe and effective method of secondary prevention of bleedings from EV. The question concerning the primary prevention of gastroesophageal hemorrhages require further study.
本研究旨在探讨内镜下微创治疗食管静脉曲张(EV)患儿肝外门脉高压(EHPH)的疗效。方法与材料。本研究纳入了80名3至17岁EHPH患儿。将患者分为三个分析组。第一组(n=14)包括以前未接受任何手术干预的EHPH患儿,在急性出血或药物止血治疗的背景下进行内窥镜结扎EV。II组(n=37)包括在先前手术干预结果不满意后接受内窥镜治疗的EV患者。第三组包括29名仅行奇静脉-门静脉断开术的儿童。我们比较分析了内镜治疗前和治疗后脑出血的严重程度,并分析了各组复发出血的频率。结果。研究结果显示,第1组胃食管出血复发率为44.4%。第2组共37例患者接受了68次内镜治疗。根据对照内窥镜检查,内窥镜治疗内窥镜结扎术之间的内窥镜出血风险显著降低(p=0.001)。在随访期间,II组有6例(16.2%)患者出现EV复发性出血。而在10例(34.5%)III组患儿中,术后复发胃食管出血。分析显示,II组儿童在内镜下治疗EV后出现“危险信号”与出血复发有显著相关性(r=0.32 p=0.05)。对III组儿童胃食管出血复发原因的分析没有显示出EV程度和“危险信号”等参数的显著差异。结论。因此,内窥镜治疗颅内出血是一种安全有效的二级预防颅内出血的方法。胃食管出血的一级预防问题有待进一步研究。
{"title":"Minimal invasive prophylaxis of bleeding from esophageal varices in children with extrahepatic portal hypertension","authors":"R. Z. Yuldashev, M. M. Aliev, Sh. I. Shokhaidarov","doi":"10.24884/0042-4625-2023-182-1-35-42","DOIUrl":"https://doi.org/10.24884/0042-4625-2023-182-1-35-42","url":null,"abstract":"The objective of the work was to study the efficacy of minimally invasive endoscopic treatment of esophageal varices (EV) in children with extrahepatic portal hypertension (EHPH). Methods and Materials . Eighty children aged 3 to 17 years of age with EHPH included in this study. The patients were divided into three analysis groups. The group I (n=14) included children with EHPH who had not previously undergone any surgical interventions and endoscopic ligation of EV was performed against the background of acute bleeding or after medical hemostatic treatment. The group II (n=37) included patients who had undergone the endoscopic treatment of EV after an unsatisfactory outcome of previously performed surgical interventions. The group III included 29 children who underwent only azygos-portal disconnection procedures. We performed the comparative analysis of the severity of EV before and after sessions of the endoscopic treatment of EV, as well as the analysis of the frequency of recurrent bleedings in comparison groups. Results . According to the research results, recurrent gastroesophageal hemorrhages were noted in 44.4 % of cases in the group I. In the group II, 37 patients underwent a total of 68 sessions of the stage endoscopic treatment of EV. According to the control endoscopic examinations, there was a significant reduction in the risk of bleeding from EV between ligation sessions (p=0.001) of the endoscopic treatment of EV. During the follow-up period, in the group II, recurrent bleedings from EV were noted in 6 (16.2 %) patients. Whereas in 10 (34.5 %) children of the group III, recurrent gastroesophageal hemorrhages were noted in the postoperative period. The analysis showed a significant correlation of the presence of «red flags» with recurrent episodes of bleedings in children of the group II after the endoscopic treatment of EV (r=0.32 p=0.05). Analysis of the causes of recurrent gastroesophageal bleedings in children of the group III did not reveal significant differences in such parameters as the degree of EV and «red flags». Conclusion . Thus, the endoscopic treatment of EV is a safe and effective method of secondary prevention of bleedings from EV. The question concerning the primary prevention of gastroesophageal hemorrhages require further study.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135905834","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}
引用次数: 0
Nonstandard approach to the ischemic stroke treatment 缺血性脑卒中的非标准治疗方法
Q4 Medicine Pub Date : 2023-04-05 DOI: 10.24884/0042-4625-2023-182-1-71-75
K. M. Vakhitov, P. A. Vladimirov, N. V. Zukovskaya, A. F. Kuvazhukova, E. G. Kmetik
Ischemic stroke is one of the most common causes of disability and mortality worldwide. Occlusive-stenotic lesion of the extra- and intracranial carotid arteries, which developed acutely and led to acute cerebrovascular accident, is a prognostically unfavorable factor. The appearance of endovascular technologies has revolutionized the salvation of this category of patients; however, they are sometimes powerless in the fight against nature. The article presents a case of tandem and bilateral lesions of the extra- and intracranial internal carotid artery, the successful result of treatment of which became possible only due to the development of spontaneous recanalization.
缺血性中风是全世界最常见的致残和死亡原因之一。颅内外颈动脉的闭塞性狭窄病变,其急性发展可导致急性脑血管意外,是预后不利的因素。血管内技术的出现彻底改变了这类患者的拯救;然而,他们有时在与自然的斗争中无能为力。本文报告一例颅内外颈内动脉的串联和双侧病变,由于自发再通的发展,治疗的成功结果成为可能。
{"title":"Nonstandard approach to the ischemic stroke treatment","authors":"K. M. Vakhitov, P. A. Vladimirov, N. V. Zukovskaya, A. F. Kuvazhukova, E. G. Kmetik","doi":"10.24884/0042-4625-2023-182-1-71-75","DOIUrl":"https://doi.org/10.24884/0042-4625-2023-182-1-71-75","url":null,"abstract":"Ischemic stroke is one of the most common causes of disability and mortality worldwide. Occlusive-stenotic lesion of the extra- and intracranial carotid arteries, which developed acutely and led to acute cerebrovascular accident, is a prognostically unfavorable factor. The appearance of endovascular technologies has revolutionized the salvation of this category of patients; however, they are sometimes powerless in the fight against nature. The article presents a case of tandem and bilateral lesions of the extra- and intracranial internal carotid artery, the successful result of treatment of which became possible only due to the development of spontaneous recanalization.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136048898","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}
引用次数: 0
Successful treatment of a patient with a severe course of a new coronavirus infection and purulent complications after left-sided hemicolectomy under the immunosuppressive therapy 免疫抑制疗法成功治疗1例左侧半结肠切除术后新型冠状病毒感染重症化脓性并发症
Q4 Medicine Pub Date : 2023-04-04 DOI: 10.24884/0042-4625-2023-182-1-88-92
G. G. Nakopiya, S. A. Danilov, Yu. V. Radionov, Yu. V. Grebtsov, E. V. Pykhtin, N. Yu. Kohanenko, Yu. N. Ulyanov, I. A. Nechay
On the seventh day after the operation, the patient was diagnosed with the new coronavirus infection. On the fifth day from the onset of the viral disease and on the 12th day after the operation, the signs of a “cytokine storm” were appeared, the volume of lung damage increased from 6 to 50 %, and the phenomena of respiratory failure increased. Immunosuppressive therapy (high doses of glucocorticoids, interleukin blockers) was prescribed. The condition was stabilized. On the 20th day after the operation and the 13th day from the start of the diagnosis of the new coronavirus infection, there were signs of peritonitis, which required laparoscopic sanitation and drainage of the abdominal cavity for widespread serous peritonitis without a primary focus. On the 26th day after hemicolectomy and the 19th day from the onset of coronavirus infection, the extraperitoneal opening of the retroperitoneal phlegmon on the left was performed. On the 61st day after hemicolectomy and the 68th day from the onset of coronavirus infection, the extraperitoneal opening of the phlegmon of the retroperitoneal space on the right was performed. On the 78th day, he was discharged from the hospital in a satisfactory condition.
术后第7天,患者被确诊为新型冠状病毒感染。从病毒性疾病发病的第5天和手术后的第12天,出现了“细胞因子风暴”的迹象,肺损伤的体积从6%增加到50%,呼吸衰竭的现象增加。给予免疫抑制治疗(高剂量糖皮质激素、白细胞介素阻滞剂)。病情稳定下来。术后第20天、诊断为新型冠状病毒感染后第13天出现腹膜炎征象,无原发灶的广泛性浆液性腹膜炎需行腹腔镜环卫及腹腔引流。在半结肠切除术后第26天,冠状病毒感染发生后第19天,对左侧腹膜后痰进行腹膜外切开。在半结肠切除术后第61天,冠状病毒感染后第68天,对右侧腹膜后间隙的痰行腹膜外切开。第78天,他出院了,情况令人满意。
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Vestnik khirurgii imeni I. I. Grekova
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