Pub Date : 2023-03-23DOI: 10.24884/0042-4625-2023-182-1-43-49
V. P. Molodcova, A. A. Ilin, I. V. Dvorakovskaya, A. L. Akopov
The article presents the latest trends of the diagnosis and treatment of tracheobronchial amyloidosis. Constriction of the bronchus due to amyloid deposits requires immunohistochemistry for protein typing. The only way of major airways recanalization is endoscopic surgical treatment. It is described the experience of treating four patients with tracheobronchial amyloidosis, in one of whom, a rare form of amyloidosis – lung amyloidoma developed.
{"title":"Tracheobronchial amyloidosis, isolated lung amyloidoma: invasive diagnostic and treatment","authors":"V. P. Molodcova, A. A. Ilin, I. V. Dvorakovskaya, A. L. Akopov","doi":"10.24884/0042-4625-2023-182-1-43-49","DOIUrl":"https://doi.org/10.24884/0042-4625-2023-182-1-43-49","url":null,"abstract":"The article presents the latest trends of the diagnosis and treatment of tracheobronchial amyloidosis. Constriction of the bronchus due to amyloid deposits requires immunohistochemistry for protein typing. The only way of major airways recanalization is endoscopic surgical treatment. It is described the experience of treating four patients with tracheobronchial amyloidosis, in one of whom, a rare form of amyloidosis – lung amyloidoma developed.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136174722","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 : 2023-03-13DOI: 10.24884/0042-4625-2023-182-1-11-19
G. G. Borshchev, R. V. Sidorov, D. S. Ulbashev
Introduction . In recent decades, the number of patients with coronary artery disease and diffuse coronary artery disease has significantly increased. Performing the full volume of myocardial revascularization in such patients is not always possible due to the nature of the lesion of the coronary bed, and the risk of shunt dysfunction in the early postoperative period remains high. Therefore, the use of ultrasound intraoperative flowmetry in coronary bypass surgery is especially necessary, but the issues of optimal indicators of graft patency remain unresolved. The Objective was to evaluate the possibilities of using intraoperative ultrasound flowmetry in patients with diffuse coronary bed lesion. Methods and Materials . The study included 188 patients with diffuse coronary bed lesion who underwent coronary bypass surgery at the St. George Thoracic and Cardiovascular Surgery Clinic, Pirogov National Medical and Surgical Center and the Center for Cardiology and Cardiovascular Surgery, Rostov-on-Don. Ultrasound Doppler flowmetry was performed in all patients, the following indicators were evaluated: the average volumetric blood flow rate (MGF – mean graft flow), the pulsation index (PI – pulsation index) and the percentage of diastolic volume filling (DF – diastolic filling). Coronaroshuntography was performed in 29 patients in the early postoperative period (within 2–6 hours after surgery). The comparison of angiographic data (slowing of blood flow through the shunt, stenosis, occlusion) with intraoperative parameters of ultrasound flowmetry was carried out. Results . 405 primary intraoperative flowmetry samples were analyzed in 188 patients with diffuse coronary lesion. It was found that 19.7 % of intraoperative flowmetry indicators were less than the recommended values: 9.3 % of autoarterial and 25 % of autovenous shunts to the anterior descending artery; 20.8 % of autovenous shunts to the diagonal artery; 33.3 % – to the envelope and 21.9 % – to the right coronary artery. In 21 % of the observations, technical problems were identified (defect of proximal or distal anastomoses; bend of the conduit; dissection of the autoarterial shunt), which were eliminated; in other cases, no technical problems were identified. When comparing the data of intraoperative ultrasound flowmetry and shuntography in the early postoperative period, statistical differences were revealed in patients with normal patency of venous shunts and their dysfunction: MGF 53±18 (46–59) vs. 38±15 (29–47), p=0.014; PI: 3±1 (2–3) vs. 7±1 (6–8), p≤0.001; DF: 79±15 (64–91) vs. 48±17 (41–60), p=0.005. There are differences in the flowmetry of autoarterial shunts depending on the risk of their dysfunction: MGF 32±11 (28–44) vs. 20±5 (13–24), p=0.005; PI: 2±1 (1–4) vs. 7±2 (5–9), p≤0.001; DF: 70±12 (61–85) vs. 50±15 (45–64), p=0.005. Conclusion . Intraoperative ultrasound flowmetry is a safe and effective tool for assessing blood flow through conduits during coronary bypass surgery in pa
{"title":"The use of flowmetry during coronary bypass surgery in patients with diffuse coronary bed lesion","authors":"G. G. Borshchev, R. V. Sidorov, D. S. Ulbashev","doi":"10.24884/0042-4625-2023-182-1-11-19","DOIUrl":"https://doi.org/10.24884/0042-4625-2023-182-1-11-19","url":null,"abstract":"Introduction . In recent decades, the number of patients with coronary artery disease and diffuse coronary artery disease has significantly increased. Performing the full volume of myocardial revascularization in such patients is not always possible due to the nature of the lesion of the coronary bed, and the risk of shunt dysfunction in the early postoperative period remains high. Therefore, the use of ultrasound intraoperative flowmetry in coronary bypass surgery is especially necessary, but the issues of optimal indicators of graft patency remain unresolved. The Objective was to evaluate the possibilities of using intraoperative ultrasound flowmetry in patients with diffuse coronary bed lesion. Methods and Materials . The study included 188 patients with diffuse coronary bed lesion who underwent coronary bypass surgery at the St. George Thoracic and Cardiovascular Surgery Clinic, Pirogov National Medical and Surgical Center and the Center for Cardiology and Cardiovascular Surgery, Rostov-on-Don. Ultrasound Doppler flowmetry was performed in all patients, the following indicators were evaluated: the average volumetric blood flow rate (MGF – mean graft flow), the pulsation index (PI – pulsation index) and the percentage of diastolic volume filling (DF – diastolic filling). Coronaroshuntography was performed in 29 patients in the early postoperative period (within 2–6 hours after surgery). The comparison of angiographic data (slowing of blood flow through the shunt, stenosis, occlusion) with intraoperative parameters of ultrasound flowmetry was carried out. Results . 405 primary intraoperative flowmetry samples were analyzed in 188 patients with diffuse coronary lesion. It was found that 19.7 % of intraoperative flowmetry indicators were less than the recommended values: 9.3 % of autoarterial and 25 % of autovenous shunts to the anterior descending artery; 20.8 % of autovenous shunts to the diagonal artery; 33.3 % – to the envelope and 21.9 % – to the right coronary artery. In 21 % of the observations, technical problems were identified (defect of proximal or distal anastomoses; bend of the conduit; dissection of the autoarterial shunt), which were eliminated; in other cases, no technical problems were identified. When comparing the data of intraoperative ultrasound flowmetry and shuntography in the early postoperative period, statistical differences were revealed in patients with normal patency of venous shunts and their dysfunction: MGF 53±18 (46–59) vs. 38±15 (29–47), p=0.014; PI: 3±1 (2–3) vs. 7±1 (6–8), p≤0.001; DF: 79±15 (64–91) vs. 48±17 (41–60), p=0.005. There are differences in the flowmetry of autoarterial shunts depending on the risk of their dysfunction: MGF 32±11 (28–44) vs. 20±5 (13–24), p=0.005; PI: 2±1 (1–4) vs. 7±2 (5–9), p≤0.001; DF: 70±12 (61–85) vs. 50±15 (45–64), p=0.005. Conclusion . Intraoperative ultrasound flowmetry is a safe and effective tool for assessing blood flow through conduits during coronary bypass surgery in pa","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136005970","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 : 2023-02-17DOI: 10.24884/0042-4625-2023-182-1-57-64
V. S. Litus, D. G. Gramatikov
Introduction . Coronary heart disease and aortic valve stenosis still occupy a leading position among cardiovascular diseases. Against the background of an increase in life expectancy, patients with a combined pathology of the heart are increasingly appearing. Without surgical treatment, such patients have an unfavorable prognosis of life with a high mortality rate. Simultaneous surgical correction of coronary heart disease and aortic valve stenosis is a treatment method that can improve the prognosis and prolong the life of a patient. At the same time, combined interventions remain higher-risk operations compared to isolated aortic valve replacement and isolated coronary artery bypass grafting. The Objective was to evaluate the effect of incomplete and complete myocardial revascularization on the immediate results of surgical correction of combined pathology of the aortic valve and coronary arteries. Methods and Materials . For the period from 2017 until June 2022, 62 aortic valve replacement operations in combination with coronary artery bypass grafting were performed in the cardiac surgery department of the Leningrad Regional Clinical Hospital. The operated patients were divided into two groups. The group 1 included (n=32) patients who underwent aortic valve replacement and complete myocardial revascularization. The group 2 included patients (n=30) who underwent aortic valve replacement and incomplete myocardial revascularization. Results . Postoperative periods in both groups, according to the structure of early postoperative complications, are generally similar. The mortality rate in both groups did not exceed the predicted mortality rate and corresponded to the data of various literary sources. Conclusion . Our observation data showed that the mortality rate in the early postoperative period, in combined operations, does not depend on the completeness of revascularization in combined operations of coronary artery bypass grafting and aortic valve replacement. It is necessary to perform as complete myocardial revascularization in combined operations as technically feasible and appropriate in a clinical situation.
{"title":"Immediate results of combined coronary bypass surgery and aortic valve replacement with incomplete and complete myocardial revascularization","authors":"V. S. Litus, D. G. Gramatikov","doi":"10.24884/0042-4625-2023-182-1-57-64","DOIUrl":"https://doi.org/10.24884/0042-4625-2023-182-1-57-64","url":null,"abstract":"Introduction . Coronary heart disease and aortic valve stenosis still occupy a leading position among cardiovascular diseases. Against the background of an increase in life expectancy, patients with a combined pathology of the heart are increasingly appearing. Without surgical treatment, such patients have an unfavorable prognosis of life with a high mortality rate. Simultaneous surgical correction of coronary heart disease and aortic valve stenosis is a treatment method that can improve the prognosis and prolong the life of a patient. At the same time, combined interventions remain higher-risk operations compared to isolated aortic valve replacement and isolated coronary artery bypass grafting. The Objective was to evaluate the effect of incomplete and complete myocardial revascularization on the immediate results of surgical correction of combined pathology of the aortic valve and coronary arteries. Methods and Materials . For the period from 2017 until June 2022, 62 aortic valve replacement operations in combination with coronary artery bypass grafting were performed in the cardiac surgery department of the Leningrad Regional Clinical Hospital. The operated patients were divided into two groups. The group 1 included (n=32) patients who underwent aortic valve replacement and complete myocardial revascularization. The group 2 included patients (n=30) who underwent aortic valve replacement and incomplete myocardial revascularization. Results . Postoperative periods in both groups, according to the structure of early postoperative complications, are generally similar. The mortality rate in both groups did not exceed the predicted mortality rate and corresponded to the data of various literary sources. Conclusion . Our observation data showed that the mortality rate in the early postoperative period, in combined operations, does not depend on the completeness of revascularization in combined operations of coronary artery bypass grafting and aortic valve replacement. It is necessary to perform as complete myocardial revascularization in combined operations as technically feasible and appropriate in a clinical situation.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135423460","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 : 2021-08-20DOI: 10.24884/0042-4625-2021-180-2-93-100
A. Akopov, S. Cherny, Ritu Mishra, M. Kovalev
The function of the respiratory parenchyma remaining after lung resection is one of the determining factors of the immediate result of the operation and the postoperative quality of life. A number of studies have been conducted to objectify the preoperative prognosis of the functional safety limit of thoracic interventions using a variety of methods and formulas. Unfortunately, until now, there is no convincing data on the correctness of at least one of the proposed methods for predicting respiratory function. The process of rehabilitation of postoperative ventilation function in the lungs is affected not only by the volume of parenchymal resection, but also by the area of resection, the method and trauma of access, the severity of emphysema, intraoperative trauma of mediastinal structures, postoperative progression of pulmonary fibrosis, etc., and video assisted surgery and segmental resections do not provide an obvious functional advantage in the long term after operations. During the first year after anatomical resection of the lung, functional indicators usually improve. Reasons (or reason) of such improvements are not always clear and may be associated with compensatory growth of the pulmonary parenchyma in a number of patients.
{"title":"Real and predicted lung function after anatomical lung resections (review of literature)","authors":"A. Akopov, S. Cherny, Ritu Mishra, M. Kovalev","doi":"10.24884/0042-4625-2021-180-2-93-100","DOIUrl":"https://doi.org/10.24884/0042-4625-2021-180-2-93-100","url":null,"abstract":"The function of the respiratory parenchyma remaining after lung resection is one of the determining factors of the immediate result of the operation and the postoperative quality of life. A number of studies have been conducted to objectify the preoperative prognosis of the functional safety limit of thoracic interventions using a variety of methods and formulas. Unfortunately, until now, there is no convincing data on the correctness of at least one of the proposed methods for predicting respiratory function. The process of rehabilitation of postoperative ventilation function in the lungs is affected not only by the volume of parenchymal resection, but also by the area of resection, the method and trauma of access, the severity of emphysema, intraoperative trauma of mediastinal structures, postoperative progression of pulmonary fibrosis, etc., and video assisted surgery and segmental resections do not provide an obvious functional advantage in the long term after operations. During the first year after anatomical resection of the lung, functional indicators usually improve. Reasons (or reason) of such improvements are not always clear and may be associated with compensatory growth of the pulmonary parenchyma in a number of patients.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69114570","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 : 2021-06-02DOI: 10.24884/0042-4625-2021-180-1-100-103
A. V. Borodulin, S. M. Lazarev, A. G. Kazarenko, L. V. Makar, A. Y. Kolesnichenko, E. Y. Lazareva, D. Chernishev
These two cases of successful treatment of a rare vascular disorder – cystic adventitial disease (CAD). Case 1: CAD of the popliteal artery with narrowing of the popliteal artery and intermittent claudication. Case 2: CAD of iliac vein with irreducible femoral hernia formation and iliac vein subocclusion. We described preoperative planning, surgical intervention and postoperative management in our cases. Surgery after careful preoperative planning is only one effective method of treatment of CAD and has good long-term results.
{"title":"Cystic adventitial disease of the popliteal artery and ILIAC vein","authors":"A. V. Borodulin, S. M. Lazarev, A. G. Kazarenko, L. V. Makar, A. Y. Kolesnichenko, E. Y. Lazareva, D. Chernishev","doi":"10.24884/0042-4625-2021-180-1-100-103","DOIUrl":"https://doi.org/10.24884/0042-4625-2021-180-1-100-103","url":null,"abstract":"These two cases of successful treatment of a rare vascular disorder – cystic adventitial disease (CAD). Case 1: CAD of the popliteal artery with narrowing of the popliteal artery and intermittent claudication. Case 2: CAD of iliac vein with irreducible femoral hernia formation and iliac vein subocclusion. We described preoperative planning, surgical intervention and postoperative management in our cases. Surgery after careful preoperative planning is only one effective method of treatment of CAD and has good long-term results.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"180 1","pages":"100-103"},"PeriodicalIF":0.0,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43720813","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 : 2021-06-02DOI: 10.24884/0042-4625-2021-180-1-31-39
O. Eshonkhodjaev, Shuhrat Khudaybergenov, R. Hayaliev
The objective was to improve the results of treatment of patients with persistent defects of the anterior tracheal wall and soft tissues of the neck.Methods and materials. 220 patients with tracheal cicatrical stenosis were treated, of which 120 patients had defects of the anterior tracheal wall of various sizes. In 70% of cases, PCT was postintubation/posttracheostomy. Men predominated – 89 (74.2 %), women – 31 (25.8 %). After a routine examination, including endoscopic examination, MSCT of the chest with the capture of the cervical region, and general clinical diagnostic methods, all patients underwent surgical treatment.Results. According to the nature of the elimination of the defect of the anterior tracheal wall, patients were divided into several groups. Both local plastic surgery and the elimination of the tracheal defect with the use of microsurgical techniques were used. Circular resection of the trachea with the elimination of the defect was performed in 5 cases. In 2 cases, in the presence of a large persistent defect of more than 6 cm in size, a composite pre-fabricated deltopectoral skin-fascial-cartilage flap was used.Conclusion. The choice of a method for eliminating a persistent open defect of the anterior tracheal wall is determined individually in each case, it depends on its size, the depth of the airway lumen, and the condition of the surrounding tissues. The use of displaced skin-fascial flaps on the vascular pedicle for closing the tracheal defect allows to restore the mucous membrane of the tracheal defect area without using the surrounding scar tissue and close the defect with a second flap without straining the edges of the wound.
{"title":"Multidisciplinary approach to surgical treatment and rehabilitation of patients with defects of the anterior tracheal wall","authors":"O. Eshonkhodjaev, Shuhrat Khudaybergenov, R. Hayaliev","doi":"10.24884/0042-4625-2021-180-1-31-39","DOIUrl":"https://doi.org/10.24884/0042-4625-2021-180-1-31-39","url":null,"abstract":"The objective was to improve the results of treatment of patients with persistent defects of the anterior tracheal wall and soft tissues of the neck.Methods and materials. 220 patients with tracheal cicatrical stenosis were treated, of which 120 patients had defects of the anterior tracheal wall of various sizes. In 70% of cases, PCT was postintubation/posttracheostomy. Men predominated – 89 (74.2 %), women – 31 (25.8 %). After a routine examination, including endoscopic examination, MSCT of the chest with the capture of the cervical region, and general clinical diagnostic methods, all patients underwent surgical treatment.Results. According to the nature of the elimination of the defect of the anterior tracheal wall, patients were divided into several groups. Both local plastic surgery and the elimination of the tracheal defect with the use of microsurgical techniques were used. Circular resection of the trachea with the elimination of the defect was performed in 5 cases. In 2 cases, in the presence of a large persistent defect of more than 6 cm in size, a composite pre-fabricated deltopectoral skin-fascial-cartilage flap was used.Conclusion. The choice of a method for eliminating a persistent open defect of the anterior tracheal wall is determined individually in each case, it depends on its size, the depth of the airway lumen, and the condition of the surrounding tissues. The use of displaced skin-fascial flaps on the vascular pedicle for closing the tracheal defect allows to restore the mucous membrane of the tracheal defect area without using the surrounding scar tissue and close the defect with a second flap without straining the edges of the wound.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"180 1","pages":"31-39"},"PeriodicalIF":0.0,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46595916","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 : 2021-06-02DOI: 10.24884/0042-4625-2021-180-1-104-106
A. N. Tulupov, M. I. Safoev, A. A. Esenokov, L. I. Karimova, M. Y. Boeva, M. Z. Yarmagomedov
Rectal wound occurs in 1 to 5 % of cases among wounds of the abdominal organs. In patient B., 32 years old, 3 days after a stab wound to the left gluteal region and after ligation of the internal iliac artery with an extraperitoneal approach to stop ongoing bleeding, rectoromanoscopy and chromovulneroscopy revealed damage to the rectal wall measuring 1.2×0.7 cm at a height of 15 cm from the anus. The defect in the rectal wall was closed using endoscopic clips (6 pcs.). The wound canal of the left gluteal region was overdrained. At the control examination of the rectum on the 20th day after suturing the defect with endoscopic clips, the intestinal wall was sealed. The wound in the gluteal region healed by secondary intention. The patient was discharged from the hospital after 3 weeks. This method of endoscopic clipping of a rectal wound with external drainage of the wound canal is a modern minimally invasive method of treatment and can be used as an alternative to sigmoidostomy. The obvious advantages of this method of treatment are: improving the patient’s quality of life, the absence of the need for additional surgical interventions in order to restore the continuity of the colon.
{"title":"Saint-Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine","authors":"A. N. Tulupov, M. I. Safoev, A. A. Esenokov, L. I. Karimova, M. Y. Boeva, M. Z. Yarmagomedov","doi":"10.24884/0042-4625-2021-180-1-104-106","DOIUrl":"https://doi.org/10.24884/0042-4625-2021-180-1-104-106","url":null,"abstract":"Rectal wound occurs in 1 to 5 % of cases among wounds of the abdominal organs. In patient B., 32 years old, 3 days after a stab wound to the left gluteal region and after ligation of the internal iliac artery with an extraperitoneal approach to stop ongoing bleeding, rectoromanoscopy and chromovulneroscopy revealed damage to the rectal wall measuring 1.2×0.7 cm at a height of 15 cm from the anus. The defect in the rectal wall was closed using endoscopic clips (6 pcs.). The wound canal of the left gluteal region was overdrained. At the control examination of the rectum on the 20th day after suturing the defect with endoscopic clips, the intestinal wall was sealed. The wound in the gluteal region healed by secondary intention. The patient was discharged from the hospital after 3 weeks. This method of endoscopic clipping of a rectal wound with external drainage of the wound canal is a modern minimally invasive method of treatment and can be used as an alternative to sigmoidostomy. The obvious advantages of this method of treatment are: improving the patient’s quality of life, the absence of the need for additional surgical interventions in order to restore the continuity of the colon.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69113911","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 : 2021-06-02DOI: 10.24884/0042-4625-2021-180-1-89-93
P. Yablonsky, A. Kuzmichev, E. Shepichev, A. L. Akinchev, Z. Matveeva
The publication presents the successful experience of using the DaVinci robotic system for the treatment of persistent hyperparathyroidism caused by mediastinal ectopic parathyroid adenoma in 62 years old female patient. The role of single photon emission computed tomography in diagnostics was demonstrated.
{"title":"Robotic thoracoscopic parathyroidectomy for ectopic mediastinal parathyroid adenoma","authors":"P. Yablonsky, A. Kuzmichev, E. Shepichev, A. L. Akinchev, Z. Matveeva","doi":"10.24884/0042-4625-2021-180-1-89-93","DOIUrl":"https://doi.org/10.24884/0042-4625-2021-180-1-89-93","url":null,"abstract":"The publication presents the successful experience of using the DaVinci robotic system for the treatment of persistent hyperparathyroidism caused by mediastinal ectopic parathyroid adenoma in 62 years old female patient. The role of single photon emission computed tomography in diagnostics was demonstrated.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69114566","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 : 2021-06-02DOI: 10.24884/0042-4625-2021-180-1-10-16
N. Puzakov, V. Cherebillo, I. Tregubenko
Introduction. Cysts of the chiasmo-sellar region include Rathke cleft cysts, colloid cysts, arachnoid cysts, dermoid cysts, and epidermoid cysts.The objective was to determine the specific features of surgical treatment for each type of cysts of the chiasmo-sellar region, allowing to achieve the best postoperative results.Methods and materials. During the period from 2009 to 2018, 57 patients with cysts of the chiasmo-sellar region were examined and treated. All patients underwent transsphenoidal endoscopic treatment of cysts of the chiasmo-sellar region.Results. Among 57 operated patients, follow-up observation revealed only 2 relapses.Conclusion. For each type of cysts of the chiasmal-sellar region, there are specific features of surgical treatment that allow to achieve the best postoperative results.
{"title":"Transsphenoidal endoscopic treatment of cysts of the chiasmo-sellar region","authors":"N. Puzakov, V. Cherebillo, I. Tregubenko","doi":"10.24884/0042-4625-2021-180-1-10-16","DOIUrl":"https://doi.org/10.24884/0042-4625-2021-180-1-10-16","url":null,"abstract":"Introduction. Cysts of the chiasmo-sellar region include Rathke cleft cysts, colloid cysts, arachnoid cysts, dermoid cysts, and epidermoid cysts.The objective was to determine the specific features of surgical treatment for each type of cysts of the chiasmo-sellar region, allowing to achieve the best postoperative results.Methods and materials. During the period from 2009 to 2018, 57 patients with cysts of the chiasmo-sellar region were examined and treated. All patients underwent transsphenoidal endoscopic treatment of cysts of the chiasmo-sellar region.Results. Among 57 operated patients, follow-up observation revealed only 2 relapses.Conclusion. For each type of cysts of the chiasmal-sellar region, there are specific features of surgical treatment that allow to achieve the best postoperative results.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"180 1","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42296742","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 : 2021-06-02DOI: 10.24884/0042-4625-2021-180-1-81-88
A. Khitaryan, D. Melnikov, A. Orekhov, A. Mezhunts, S. A. Adizov, А. A. Abovyan
The objective was to retrospectively analyze the dependence of long-term results of laparoscopic Roux-en-Y gastric bypass surgery according to the size of the formed gastric stumpMethods and materials. We retrospectively analyzed the long-term results of 207 morbidly obese patients who underwent laparoscopic Roux-en-Y gastric bypass surgery by two different techniques. The median follow-up was 36 months. Two groups of patients were identified according to the method of formation of the gastric stump: using 2 (1st group) or 3 (2nd group) stapler cassettes and performing of computed tomography volumetry to determine thevolume of the created gastric stump.Results. Statistically significant differences in the volume of the formed gastric stump, depending on the method of operation, were as follows: 23.8 ml (8.9–37.3 ml) in the 1st group and 47.7 ml (31.9–72.8 ml) in the 2nd group (p<0.0001). Significant differences were observed in the following indicators: relapse of weight gain or insufficient weight loss (loss of < 70 % overweight) at median follow-up of 36 months were observed in 2 (2.3 %) and 12 (9.9 %) cases in the 1st and 2nd groups, respectively (p<0.05).Conclusion. We revealed that the formation of the gastric stump of a very small volume by 2 stapler cassettes compared to using 3 stapler cassettes contributes to improving the results in the long-term postoperative period and minimizing the frequency of relapse of weight gain and insufficient weight loss. The restrictive component of the surgery with equal malabsorptive is fundamental for the clinical parameters of its effectiveness, that leads to increasing the frequency of relapses of weight gain and insufficient weight loss in the 2nd group in comparison with the 1st and group of patients (p<0.05). Based on computed tomography volumetry, the volume of a small-sized stomach stump can be reliably measured and, accordingly, weight loss is predicted in the long term after the surgery, as well as the absence of relapses of weight gain or insufficient weight loss.
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