Pub Date : 2021-06-02DOI: 10.24884/0042-4625-2021-180-1-111-117
Sergei S. Maskin, V. V. Aleksandrov, V. V. Matyukhin
Injuries of abdominal and retroperitoneal major blood vessels are the most severe injuries. Delayed diagnosis, irrational accesses and methods of temporary hemostasis aggravate the severity of the condition and lead to life-threatening complications. The objective was to summarize the data from Russian and foreign literature for improving the results of treatment of patients with injury of abdominal and retroperitoneal major vessels. The article discusses the etiology, clinic, diagnostic algorithm for abdominal vascular injury and treatment of patients with injury of abdominal arteries, describes the methods of temporary and final hemostasis. It is necessary for a general surgeon to know the therapeutic and diagnostic algorithm for vascular injury, rational accesses to them and methods of temporary and final hemostasis, as well as the principles of «damage control» tactics to save the life of the patient.
{"title":"Features of surgical tactics for injuries of abdominal and retroperitoneal major arteries (review of literature)","authors":"Sergei S. Maskin, V. V. Aleksandrov, V. V. Matyukhin","doi":"10.24884/0042-4625-2021-180-1-111-117","DOIUrl":"https://doi.org/10.24884/0042-4625-2021-180-1-111-117","url":null,"abstract":"Injuries of abdominal and retroperitoneal major blood vessels are the most severe injuries. Delayed diagnosis, irrational accesses and methods of temporary hemostasis aggravate the severity of the condition and lead to life-threatening complications. The objective was to summarize the data from Russian and foreign literature for improving the results of treatment of patients with injury of abdominal and retroperitoneal major vessels. The article discusses the etiology, clinic, diagnostic algorithm for abdominal vascular injury and treatment of patients with injury of abdominal arteries, describes the methods of temporary and final hemostasis. It is necessary for a general surgeon to know the therapeutic and diagnostic algorithm for vascular injury, rational accesses to them and methods of temporary and final hemostasis, as well as the principles of «damage control» tactics to save the life of the patient.","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":"69114097","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: 10.24884/0042-4625-2021-180-1-17-24
Н. Р. Абуталимова, Д.Г. Заварзина, K. Ismail-zade, V. Grebennik, I. Ivanov, N. Abutalimova, Daria G. Zavarzina, G. I. Ishmukhametov, M. Gordeev
The objective was to evaluate the immediate results of treatment of patients with symptomatic form of myocardial bridges of the coronary arteries.Methods and materials. In the course of a retrospective study, the results of treatment of 70 patients who had underwent drug treatment and 52 patients who had underwent surgical treatment were analyzed. All the subjects had high functional angina pectoris.Results. Pharmacological therapy showed significant positive dynamics in 18 (25.7 %) patients. Analysis of the intraoperative and early postoperative periods in patients who underwent supracoronary myotomy allows us to conclude that surgical treatment of patients with myocardial bridges of the coronary arteries shows satisfactory results.Conclusion. Drug therapy may be effective in some patients with myocardial bridges of the coronary arteries. In case of ineffectiveness of pharmacological treatment, the possibility of performing surgery in the amount of supracoronary myotomy should be considered.
{"title":"Immediate results of treatment of patients with myocardial bridges of the coronary arteries","authors":"Н. Р. Абуталимова, Д.Г. Заварзина, K. Ismail-zade, V. Grebennik, I. Ivanov, N. Abutalimova, Daria G. Zavarzina, G. I. Ishmukhametov, M. Gordeev","doi":"10.24884/0042-4625-2021-180-1-17-24","DOIUrl":"https://doi.org/10.24884/0042-4625-2021-180-1-17-24","url":null,"abstract":"The objective was to evaluate the immediate results of treatment of patients with symptomatic form of myocardial bridges of the coronary arteries.Methods and materials. In the course of a retrospective study, the results of treatment of 70 patients who had underwent drug treatment and 52 patients who had underwent surgical treatment were analyzed. All the subjects had high functional angina pectoris.Results. Pharmacological therapy showed significant positive dynamics in 18 (25.7 %) patients. Analysis of the intraoperative and early postoperative periods in patients who underwent supracoronary myotomy allows us to conclude that surgical treatment of patients with myocardial bridges of the coronary arteries shows satisfactory results.Conclusion. Drug therapy may be effective in some patients with myocardial bridges of the coronary arteries. In case of ineffectiveness of pharmacological treatment, the possibility of performing surgery in the amount of supracoronary myotomy should be considered.","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":"69114381","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: 10.24884/0042-4625-2021-180-1-25-30
D. Vasilevsky, Z. M. Khamid, A. Zakharenko, A. Korolkov, S. Balandov, S. Bagnenko
Introduction. Currently, traditional methods and minimally invasive surgical technologies are used in the treatment of celiac trunk compression syndrome. The choice of treatment method remains a subject of discussion. The drawback of the classical approach – laparotomy – is a significant trauma to the tissues of the abdominal wall, the risk of adhesions, wound infection and hernias. The disadvantage of videosurgical techniques is the risk of developing life-threatening bleeding requiring conversion of access. The main cause of this complication is damage to the wall of the aorta, celiac trunk and its branches during the intervention.Methods and materials. A set of tactical and technical principles was developed to reduce the risk of bleeding during laparoscopic decompression of the celiac trunk. The prerequisites were an assessment of the individual architectonics of the vessels according to 3D reconstruction data, the location of working instruments as parallel to the celiac trunk course, retrograde access to the compression zone, the use of an ultrasonic or bipolar dissector, contact with the vascular wall only with passive branches. With these principles surgical intervention was performed in 12 patients.Results. Complication (bleeding from the branch of the lower phrenic artery) – occurred in one (8.3 %) case – was eliminated laparoscopically. The average duration of the operation was 85 minutes, the average hospital day after the operation was 5 days. Treatment results within 3 to 12 months were evaluated in 8 out of 12 (66.7 %) patients. In 7 (87.5 % of patients with the studied results) cases, complete regression of symptoms and restoration of normal blood flow were noted. One (12.5 %) person had a slight abdominal pain syndrome against the background of normal hemodynamics in the celiac trunk.Conclusion. The presented data are comparable with the results of traditional surgical methods of treatment of celiac trunk compression syndrome and are the basis for further research.
{"title":"Laparoscopic decompression of the celiac trunk: tactical and technical aspects","authors":"D. Vasilevsky, Z. M. Khamid, A. Zakharenko, A. Korolkov, S. Balandov, S. Bagnenko","doi":"10.24884/0042-4625-2021-180-1-25-30","DOIUrl":"https://doi.org/10.24884/0042-4625-2021-180-1-25-30","url":null,"abstract":"Introduction. Currently, traditional methods and minimally invasive surgical technologies are used in the treatment of celiac trunk compression syndrome. The choice of treatment method remains a subject of discussion. The drawback of the classical approach – laparotomy – is a significant trauma to the tissues of the abdominal wall, the risk of adhesions, wound infection and hernias. The disadvantage of videosurgical techniques is the risk of developing life-threatening bleeding requiring conversion of access. The main cause of this complication is damage to the wall of the aorta, celiac trunk and its branches during the intervention.Methods and materials. A set of tactical and technical principles was developed to reduce the risk of bleeding during laparoscopic decompression of the celiac trunk. The prerequisites were an assessment of the individual architectonics of the vessels according to 3D reconstruction data, the location of working instruments as parallel to the celiac trunk course, retrograde access to the compression zone, the use of an ultrasonic or bipolar dissector, contact with the vascular wall only with passive branches. With these principles surgical intervention was performed in 12 patients.Results. Complication (bleeding from the branch of the lower phrenic artery) – occurred in one (8.3 %) case – was eliminated laparoscopically. The average duration of the operation was 85 minutes, the average hospital day after the operation was 5 days. Treatment results within 3 to 12 months were evaluated in 8 out of 12 (66.7 %) patients. In 7 (87.5 % of patients with the studied results) cases, complete regression of symptoms and restoration of normal blood flow were noted. One (12.5 %) person had a slight abdominal pain syndrome against the background of normal hemodynamics in the celiac trunk.Conclusion. The presented data are comparable with the results of traditional surgical methods of treatment of celiac trunk compression syndrome and are the basis for further research.","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":"69114452","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: 10.24884/0042-4625-2021-180-1-7-9
A. A. Kurygin, V. Semenov, I. S. Tarbaev
Professor Nikolai Nikodimovich Malinovsky was born on January 1, 1921 in the village of Zheltki, Vileisky district, Minsk region of Belarus, in a peasant family. In 1944, N. N. Malinovsky entered the Minsk Medical Institute and in 1948 graduated with honors. In 1954, he defended his thesis «Experimental observations during cardiac probing and angiocardiography». In 1957, he came to the Department of Hospital Surgery of the 1st MMI named after I. M. Sechenov at the invitation of B. V. Petrovsky, elected head of this Department. In 1964, N. N. Malinovsky defended his doctoral dissertation «Thrombosis of the left atrium and its ear in patients with mitral stenosis». In 1965, he was elected professor at the Department of Hospital Surgery of the 1st MMI, and in 1970, he became the head of the clinical department of the All-Union Research Institute of Clinical and Experimental Surgery of the Ministry of Health of the USSR (now FSBNU «Russian Scientific Center of Surgery named after acad. B. V. Petrovsky». N. N. Malinovsky’s scientific research was devoted to topical surgical problems, primarily cardiac surgery. One of the first in our country, he successfully performed embolectomy from the pulmonary artery. In addition, he was the author and co-author of more than 400 scientific papers, including 7 monographs, a practical guide to surgical diseases, one of the sections of the «Atlas of Thoracic Surgery», and a co-author of the monograph widely known among cardiovascular surgeons «Emergency Heart and Vascular Surgery» (edited by B. V. Petrovsky and M. E. DeBeiki). Academician N. N. Malinovsky – laureate of two State Prizes of the USSR (1985, 1987) and the Prize of the Russian Academy of Sciences named after A. N. Bakulev (2007), Honored Scientist of the Uzbek SSR (1979). For more than 25 years, Nikolai Nikodimovich worked as editor-in-chief of the journal «Surgery named after N. I. Pirogov», and also for many years was a member of the editorial board of the journal «Vestnik RAMS». Academician N.N. Malinovsky died on January 24, 2018 and was buried at the Troekurovsky cemetery in Moscow.
尼古拉·尼科迪莫维奇·马林诺夫斯基教授于1921年1月1日出生在白俄罗斯明斯克州维列斯基区热尔特基村的一个农民家庭。1944年，马林诺夫斯基进入明斯克医学院，并于1948年以优异成绩毕业。1954年，他为自己的论文《心脏探查和心血管造影的实验观察》进行了辩护。1957年，应B. V.彼得罗夫斯基的邀请，他来到以I. M.谢切诺夫命名的第一MMI医院外科，他当选为该部门的负责人。1964年，N. N. Malinovsky为他的博士论文《二尖瓣狭窄患者左心房及其耳部血栓形成》进行了辩护。1965年，他被选为第一MMI医院外科学系教授，1970年，他成为苏联卫生部全联盟临床和实验外科研究所(现为FSBNU“俄罗斯科学外科中心”，以彼得罗夫斯基院士命名”)临床部门的负责人。N. N.马林诺夫斯基的科学研究致力于局部外科问题，主要是心脏外科。他是我国最早成功实施肺动脉栓塞切除术的医生之一。此外，他还是400多篇科学论文的作者和合著者，其中包括7篇专著，一本外科疾病实用指南，《胸外科图集》的一个章节，以及在心血管外科医生中广为人知的专著《急诊心脏和血管外科》(由b.v. Petrovsky和m.e. DeBeiki编辑)的合著者。N. N.马林诺夫斯基院士——两次苏联国家奖(1985年、1987年)和以A. N.巴库列夫命名的俄罗斯科学院奖(2007年)获得者，乌兹别克斯坦苏维埃社会主义共和国荣誉科学家(1979年)。在超过25年的时间里，Nikolai Nikodimovich担任《以N. I. Pirogov命名的外科》杂志的主编，并且多年来一直是《Vestnik RAMS》杂志的编辑委员会成员。马林诺夫斯基院士于2018年1月24日去世，被安葬在莫斯科特罗埃库罗夫斯基公墓。
{"title":"Academician Nikolai Nikodimovich Malinovsky (1921–2018) (to the 100th anniversary of the birth)","authors":"A. A. Kurygin, V. Semenov, I. S. Tarbaev","doi":"10.24884/0042-4625-2021-180-1-7-9","DOIUrl":"https://doi.org/10.24884/0042-4625-2021-180-1-7-9","url":null,"abstract":"Professor Nikolai Nikodimovich Malinovsky was born on January 1, 1921 in the village of Zheltki, Vileisky district, Minsk region of Belarus, in a peasant family. In 1944, N. N. Malinovsky entered the Minsk Medical Institute and in 1948 graduated with honors. In 1954, he defended his thesis «Experimental observations during cardiac probing and angiocardiography». In 1957, he came to the Department of Hospital Surgery of the 1st MMI named after I. M. Sechenov at the invitation of B. V. Petrovsky, elected head of this Department. In 1964, N. N. Malinovsky defended his doctoral dissertation «Thrombosis of the left atrium and its ear in patients with mitral stenosis». In 1965, he was elected professor at the Department of Hospital Surgery of the 1st MMI, and in 1970, he became the head of the clinical department of the All-Union Research Institute of Clinical and Experimental Surgery of the Ministry of Health of the USSR (now FSBNU «Russian Scientific Center of Surgery named after acad. B. V. Petrovsky». N. N. Malinovsky’s scientific research was devoted to topical surgical problems, primarily cardiac surgery. One of the first in our country, he successfully performed embolectomy from the pulmonary artery. In addition, he was the author and co-author of more than 400 scientific papers, including 7 monographs, a practical guide to surgical diseases, one of the sections of the «Atlas of Thoracic Surgery», and a co-author of the monograph widely known among cardiovascular surgeons «Emergency Heart and Vascular Surgery» (edited by B. V. Petrovsky and M. E. DeBeiki). Academician N. N. Malinovsky – laureate of two State Prizes of the USSR (1985, 1987) and the Prize of the Russian Academy of Sciences named after A. N. Bakulev (2007), Honored Scientist of the Uzbek SSR (1979). For more than 25 years, Nikolai Nikodimovich worked as editor-in-chief of the journal «Surgery named after N. I. Pirogov», and also for many years was a member of the editorial board of the journal «Vestnik RAMS». Academician N.N. Malinovsky died on January 24, 2018 and was buried at the Troekurovsky cemetery in Moscow.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"180 1","pages":"7-9"},"PeriodicalIF":0.0,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45539629","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 : 2021-04-02DOI: 10.24884/0042-4625-2020-179-6-101-106
S. Aliev, E. S. Aliev
An analytical review of the literature on the pathogenesis of disorders of the motor-evacuation function of the intestine, which underlies the enteral insufficiency syndrome (EIS), which develops in various acute intra-abdominal surgical diseases, is presented. On the basis of a multivariate analysis of literature data, various pathogenetic mechanisms of enteric dysfunctions caused by morphological and structural changes in the wall of the small intestine, violations of its local defense mechanisms are described. The essence of the modern concept of the pathogenesis of enteral insufficiency – enteral distress syndrome (EDS) according to the literature is presented. According to new views, EDS is a combination of various pathogenetic mechanisms that are formed as a result of dysregulation and destabilization of biological membranes of tissue structures of the intestinal wall (especially its mucous membrane) and a violation of the functional and metabolic status of the intestine, developing in acute surgical diseases of the abdominal organs. Recognition of the validity of the concept will allow unifying the terminology and creating more evidence-based and generally accepted teaching about the nature of EIS.
{"title":"Enteral insufficiency syndrome: current provisions about the terminology, pathogenesis and treatment (review of literature)","authors":"S. Aliev, E. S. Aliev","doi":"10.24884/0042-4625-2020-179-6-101-106","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-6-101-106","url":null,"abstract":"An analytical review of the literature on the pathogenesis of disorders of the motor-evacuation function of the intestine, which underlies the enteral insufficiency syndrome (EIS), which develops in various acute intra-abdominal surgical diseases, is presented. On the basis of a multivariate analysis of literature data, various pathogenetic mechanisms of enteric dysfunctions caused by morphological and structural changes in the wall of the small intestine, violations of its local defense mechanisms are described. The essence of the modern concept of the pathogenesis of enteral insufficiency – enteral distress syndrome (EDS) according to the literature is presented. According to new views, EDS is a combination of various pathogenetic mechanisms that are formed as a result of dysregulation and destabilization of biological membranes of tissue structures of the intestinal wall (especially its mucous membrane) and a violation of the functional and metabolic status of the intestine, developing in acute surgical diseases of the abdominal organs. Recognition of the validity of the concept will allow unifying the terminology and creating more evidence-based and generally accepted teaching about the nature of EIS.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"179 1","pages":"101-106"},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69114353","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 : 2021-04-02DOI: 10.24884/0042-4625-2020-179-6-7-10
A. A. Kurygin, I. S. Tarbaev, V. Semenov
Professor Fedor Rodionovich Bogdanov was born on October 2 (15 in the Gregorian calendar), 1900. In 1919, Fedor successfully graduated from the classical men’s gymnasium and then entered the medical faculty of Rostov University. In 1930, F.R. Bogdanov and his wife moved to Sverdlovsk, where he became the head of the scientific and educational sector of the Institute and at the same time the head of the clinical department. There he actively studied the current and unresolved problem of treating intra-articular fractures at that time. In 1937, Fedor Rodionovich defended his doctoral thesis on the topic: «Reparative processes in intra-articular fractures and the principles of treatment of these fractures (experimental and clinical studies)». In 1958, F. R. Bogdanov moved to Kiev, where he was elected the head of the Department of Traumatology and Orthopedics of the Institute for Advanced Medical Studies and at the same time was appointed deputy director of the Kiev Research Institute of Traumatology and Orthopedics for scientific work. For all the time of his practical and scientific activity, F.R. Bogdanov was the academic advisor of 31 doctors and 86 candidates of medical sciences, the author and co-author of more than 200 scientific papers and 7 monographs. Professor Fedor Rodionovich Bogdanov died on March 27, 1973 and was buried at the Baikove Cemetery in Kiev.
{"title":"Professor Fedor Rodionovich Bogdanov (1900–1973) (on the 120th anniversary of the birthday)","authors":"A. A. Kurygin, I. S. Tarbaev, V. Semenov","doi":"10.24884/0042-4625-2020-179-6-7-10","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-6-7-10","url":null,"abstract":"Professor Fedor Rodionovich Bogdanov was born on October 2 (15 in the Gregorian calendar), 1900. In 1919, Fedor successfully graduated from the classical men’s gymnasium and then entered the medical faculty of Rostov University. In 1930, F.R. Bogdanov and his wife moved to Sverdlovsk, where he became the head of the scientific and educational sector of the Institute and at the same time the head of the clinical department. There he actively studied the current and unresolved problem of treating intra-articular fractures at that time. In 1937, Fedor Rodionovich defended his doctoral thesis on the topic: «Reparative processes in intra-articular fractures and the principles of treatment of these fractures (experimental and clinical studies)». In 1958, F. R. Bogdanov moved to Kiev, where he was elected the head of the Department of Traumatology and Orthopedics of the Institute for Advanced Medical Studies and at the same time was appointed deputy director of the Kiev Research Institute of Traumatology and Orthopedics for scientific work. For all the time of his practical and scientific activity, F.R. Bogdanov was the academic advisor of 31 doctors and 86 candidates of medical sciences, the author and co-author of more than 200 scientific papers and 7 monographs. Professor Fedor Rodionovich Bogdanov died on March 27, 1973 and was buried at the Baikove Cemetery in Kiev.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"179 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41903215","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 : 2021-04-02DOI: 10.24884/0042-4625-2020-179-6-44-49
S. Bogdanov, D. N. Marchenko, K. Pavlyk, O. V. Gospirovish, E. Artemova, M. L. Myhanov
The OBJECTIVE was to perform a comparative cytological analysis of the wound exudate in healing wounds during autodermoplasty on a granulating burn wound with and without vacuum therapy.METHODS AND MATERIALS. The article presents the results of the cytological study substantiated the use of vacuum therapy in combustiology. The comparative analysis was performed in 2 groups of patients. The first group consisted of patients with granulating burn wounds, who underwent surgical treatment with vacuum therapy. The second group consisted of patients who underwent surgical treatment without vacuum therapy. In both groups, the complex of surgical treatment included autodermoplasty on a granulating burn wound. All the patients were treated in the Burn Department of the «Scientific research institute – Ochapovsky regional clinic hospital № 1».RESULTS. The application of vacuum-associated dressings in the surgical treatment of patients in burn hospitals helps to reduce the time of graft retention in the plasty of granulating burn wound, decrease the number of dressings and the amount of dressing material, reduce the time of treatment of patients.CONCLUSION. The obtained cytological results allow us to justify the application of vacuum therapy in the surgical treatment of granulating burn wounds.
{"title":"Cytological substantiation of application of vacuum therapy in combustiology","authors":"S. Bogdanov, D. N. Marchenko, K. Pavlyk, O. V. Gospirovish, E. Artemova, M. L. Myhanov","doi":"10.24884/0042-4625-2020-179-6-44-49","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-6-44-49","url":null,"abstract":"The OBJECTIVE was to perform a comparative cytological analysis of the wound exudate in healing wounds during autodermoplasty on a granulating burn wound with and without vacuum therapy.METHODS AND MATERIALS. The article presents the results of the cytological study substantiated the use of vacuum therapy in combustiology. The comparative analysis was performed in 2 groups of patients. The first group consisted of patients with granulating burn wounds, who underwent surgical treatment with vacuum therapy. The second group consisted of patients who underwent surgical treatment without vacuum therapy. In both groups, the complex of surgical treatment included autodermoplasty on a granulating burn wound. All the patients were treated in the Burn Department of the «Scientific research institute – Ochapovsky regional clinic hospital № 1».RESULTS. The application of vacuum-associated dressings in the surgical treatment of patients in burn hospitals helps to reduce the time of graft retention in the plasty of granulating burn wound, decrease the number of dressings and the amount of dressing material, reduce the time of treatment of patients.CONCLUSION. The obtained cytological results allow us to justify the application of vacuum therapy in the surgical treatment of granulating burn wounds.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"179 1","pages":"44-49"},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46421381","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 : 2021-04-02DOI: 10.24884/0042-4625-2020-179-6-18-23
A. S. Polekhin, T. P. Gadelgaraevich, I. I. Tileubergenov, I. Rutkin, D. Granov
Transcatheter arterial chemoembolization of hepatocellular carcinoma on liver cirrhosis in patients awaiting liver transplantation OBJECTIVE. To evaluate the role of TACE as a method of neoadjuvant antitumor therapy of HCC before LT.METHODS AND MATERIALS. From January 1998 to April 2020, we performed 245 OLTs in 229 patients, among them in 25 (10.2 %) for HCC associated with LC. We analyzed treatment results of 16 patients who received 49 TACE sessions as neoadjuvant therapy. 10 (62.5 %) patients fell under Milan criteria, 6 (37.5 %) – beyond them. According to the Child – Pugh score of LC, two (12.5 %) patients matched A stage, 12 (75 %) – B stage, two (12.5 %) – C stage. According to the BCLC (Barcelona Clinic Liver Cancer) staging system, 10 patients matched A1–A4 stage and 6 – B stage. Totally, we performed 49 TACE sessions, both classical with lipiodol and hemostatic sponge, and with drug-eluting beads from 1 to 7 (on average 3) times. In all cases Doxorubicin was used.RESULTS. Technical success was 100 %. There were no complications. We performed RFA in three patients as an adjunct, in two patients – laparoscopic RFA-assisted atypical liver resection and in one patient – sequential resection and RFA. According to the m-Recist criteria, a complete response was observed in 6 (37.5 %), partial – in 7 (43.75 %), and stabilization – in 3 (18.75 %) patients. It was possible to achieve a tumor response to the treatment in 4 patients and return them to the Milan criteria. LT was performed in all 16 patients, among them – 14 (87.5 %) within the Milan criteria. The waiting periods for LT from the beginning of TACE were from 2 to 30 (on average 12.5) months. According to the histological studies, in 13 (81 %) patients, total and subtotal necrosis of HCC was revealed in excised organs.CONCLUSION. The results of the performed study indicate that neoadjuvant TACE delays the growth of HCC masses and prolongs (up to 30 months) a safe waiting period for the donor liver.
{"title":"Transcatheter arterial chemoembolization of hepatocellular carcinoma on liver cirrhosis in patients awaiting liver transplantation","authors":"A. S. Polekhin, T. P. Gadelgaraevich, I. I. Tileubergenov, I. Rutkin, D. Granov","doi":"10.24884/0042-4625-2020-179-6-18-23","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-6-18-23","url":null,"abstract":"Transcatheter arterial chemoembolization of hepatocellular carcinoma on liver cirrhosis in patients awaiting liver transplantation OBJECTIVE. To evaluate the role of TACE as a method of neoadjuvant antitumor therapy of HCC before LT.METHODS AND MATERIALS. From January 1998 to April 2020, we performed 245 OLTs in 229 patients, among them in 25 (10.2 %) for HCC associated with LC. We analyzed treatment results of 16 patients who received 49 TACE sessions as neoadjuvant therapy. 10 (62.5 %) patients fell under Milan criteria, 6 (37.5 %) – beyond them. According to the Child – Pugh score of LC, two (12.5 %) patients matched A stage, 12 (75 %) – B stage, two (12.5 %) – C stage. According to the BCLC (Barcelona Clinic Liver Cancer) staging system, 10 patients matched A1–A4 stage and 6 – B stage. Totally, we performed 49 TACE sessions, both classical with lipiodol and hemostatic sponge, and with drug-eluting beads from 1 to 7 (on average 3) times. In all cases Doxorubicin was used.RESULTS. Technical success was 100 %. There were no complications. We performed RFA in three patients as an adjunct, in two patients – laparoscopic RFA-assisted atypical liver resection and in one patient – sequential resection and RFA. According to the m-Recist criteria, a complete response was observed in 6 (37.5 %), partial – in 7 (43.75 %), and stabilization – in 3 (18.75 %) patients. It was possible to achieve a tumor response to the treatment in 4 patients and return them to the Milan criteria. LT was performed in all 16 patients, among them – 14 (87.5 %) within the Milan criteria. The waiting periods for LT from the beginning of TACE were from 2 to 30 (on average 12.5) months. According to the histological studies, in 13 (81 %) patients, total and subtotal necrosis of HCC was revealed in excised organs.CONCLUSION. The results of the performed study indicate that neoadjuvant TACE delays the growth of HCC masses and prolongs (up to 30 months) a safe waiting period for the donor liver.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"179 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42626160","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 : 2021-04-02DOI: 10.24884/0042-4625-2020-179-6-81-87
A. Akopov, D. Artioukh, T. Molnár
Modern surgery is difficult to imagine without mechanical stapling devices. The objective of the study was to trace the continuity of the development of mechanical stapling technology by European and American surgeons. The main step that led to this technological development was the idea of using a simple paper staple for suturing of human tissue. The first time the mechanical stapling device was used on a human was 9th May, 1908 in Budapest. Subsequently, surgeons and engineers of Europe, primarily Hungary (Austria-Hungary) (H. Hultl, V. Fischer, A. von Petz, etc), Germany (H. Friedrich, etc.) and the USSR (V. Gudov, V. Demikhov, P. Androsov, etc) refined the mechanical principles and practical implications of this new technology. By the mid-1950s, two types of devices were manufactured in the USSR for simple suturing tissues such as the pulmonary parenchyma or bronchus and for the construction of anastomosis. The disadvantages of these devices could be attributed the requirement of delicate manual loading of small metal staples into the cartridge and assembling of sterile parts immediately prior to application. A group of surgeons and engineers led by an American thoracic surgeon, Mark Ravitch, managed to overcome these disadvantages by making devices user-friendly, launched their production in the USA and even organized a training network for surgeons wishing to use the new instruments. The history of mechanical stapling devices illustrates the successful realization of novel ideas that were supported by technological advances and the professional ambitions of surgeons.
{"title":"History of mechanical staple surgical suture (review of literature)","authors":"A. Akopov, D. Artioukh, T. Molnár","doi":"10.24884/0042-4625-2020-179-6-81-87","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-6-81-87","url":null,"abstract":"Modern surgery is difficult to imagine without mechanical stapling devices. The objective of the study was to trace the continuity of the development of mechanical stapling technology by European and American surgeons. The main step that led to this technological development was the idea of using a simple paper staple for suturing of human tissue. The first time the mechanical stapling device was used on a human was 9th May, 1908 in Budapest. Subsequently, surgeons and engineers of Europe, primarily Hungary (Austria-Hungary) (H. Hultl, V. Fischer, A. von Petz, etc), Germany (H. Friedrich, etc.) and the USSR (V. Gudov, V. Demikhov, P. Androsov, etc) refined the mechanical principles and practical implications of this new technology. By the mid-1950s, two types of devices were manufactured in the USSR for simple suturing tissues such as the pulmonary parenchyma or bronchus and for the construction of anastomosis. The disadvantages of these devices could be attributed the requirement of delicate manual loading of small metal staples into the cartridge and assembling of sterile parts immediately prior to application. A group of surgeons and engineers led by an American thoracic surgeon, Mark Ravitch, managed to overcome these disadvantages by making devices user-friendly, launched their production in the USA and even organized a training network for surgeons wishing to use the new instruments. The history of mechanical stapling devices illustrates the successful realization of novel ideas that were supported by technological advances and the professional ambitions of surgeons.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"179 1","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49480423","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 : 2021-04-02DOI: 10.24884/0042-4625-2020-179-6-24-33
A. Skorokhod, A. Petrov, A. Kozak, M. Atyukov, A. Nefedov, P. Yаblonskiy
INTRODUCTION. A number of studies demonstrate the advantage of bilateral mediastinal lymphadenectomy in surgery of non-small cell lung cancer (nSCLC). For surgical approach to the opposite mediastinum for many years there were proposed sternotomy, video-thoracoscopy, and transcervical video-assisted interventions. In our practice, we use videoassisted mediastinal lymphadenectomy (VAMLA).The OBJECTIVE was to learn the efficiency and safety of VAMLA in surgery of NSCLC.METHODS AND MATERIALS. The study included the materials of examination and treatment of 102 patients with NSCLC. 102 patients were divided into 2 groups. In the 1st group (54 patients), VAMLA and lung resection were performed. In the 2nd group (48 patients): anatomical lung resection and systematic ipsilateral lymphadenectomy (SLD) were performed.RESULTS. The average number of remote lymph node stations in group 1 was (7.8±1.7); in group 2 – (4.5±1.2) (p<0.05). The average number of lymph nodes was 26±8.6 compared to (14.3±6) in both groups, respectively (p<0.05). «Occult» pN2-N3 metastasis was detected in 20 % (7/34) of patients of the group 1 and 6.5 % (2/31) of patients of the group 2 (p<0.05). The level of postoperative complications in both groups was 33.4 vs. 29.2 %, respectively (p>0.05). The duration of the postoperative day ((12.7±4.9) vs. (13.7±6.5)) and the duration of pleural drainage ((5.5±4.2) vs. (5.8±4.4)) did not differ in both groups (p>0.05).CONCLUSION. VAMLA is an effective and safe method for evaluating the pN stage of NSCLC. Performing VAMLA in left-sided NSCLC allows removing significantly more lymph nodes and stations in comparison with SLD available in VATS and thoracotomy, which increases the accuracy of postoperative N-staging. The use of the VAMLA in minimally invasive surgery of right-sided NSCLC may be promising in cases of high risk of «occult» pN3 lesion, but requires further study of the role of contralateral lymphatic dissection.
{"title":"Efficiency and safety of video-assisted mediastinal lymphadenectomy in the treatment of non-small cell lung cancer","authors":"A. Skorokhod, A. Petrov, A. Kozak, M. Atyukov, A. Nefedov, P. Yаblonskiy","doi":"10.24884/0042-4625-2020-179-6-24-33","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-6-24-33","url":null,"abstract":"INTRODUCTION. A number of studies demonstrate the advantage of bilateral mediastinal lymphadenectomy in surgery of non-small cell lung cancer (nSCLC). For surgical approach to the opposite mediastinum for many years there were proposed sternotomy, video-thoracoscopy, and transcervical video-assisted interventions. In our practice, we use videoassisted mediastinal lymphadenectomy (VAMLA).The OBJECTIVE was to learn the efficiency and safety of VAMLA in surgery of NSCLC.METHODS AND MATERIALS. The study included the materials of examination and treatment of 102 patients with NSCLC. 102 patients were divided into 2 groups. In the 1st group (54 patients), VAMLA and lung resection were performed. In the 2nd group (48 patients): anatomical lung resection and systematic ipsilateral lymphadenectomy (SLD) were performed.RESULTS. The average number of remote lymph node stations in group 1 was (7.8±1.7); in group 2 – (4.5±1.2) (p<0.05). The average number of lymph nodes was 26±8.6 compared to (14.3±6) in both groups, respectively (p<0.05). «Occult» pN2-N3 metastasis was detected in 20 % (7/34) of patients of the group 1 and 6.5 % (2/31) of patients of the group 2 (p<0.05). The level of postoperative complications in both groups was 33.4 vs. 29.2 %, respectively (p>0.05). The duration of the postoperative day ((12.7±4.9) vs. (13.7±6.5)) and the duration of pleural drainage ((5.5±4.2) vs. (5.8±4.4)) did not differ in both groups (p>0.05).CONCLUSION. VAMLA is an effective and safe method for evaluating the pN stage of NSCLC. Performing VAMLA in left-sided NSCLC allows removing significantly more lymph nodes and stations in comparison with SLD available in VATS and thoracotomy, which increases the accuracy of postoperative N-staging. The use of the VAMLA in minimally invasive surgery of right-sided NSCLC may be promising in cases of high risk of «occult» pN3 lesion, but requires further study of the role of contralateral lymphatic dissection.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"179 1","pages":"24-33"},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49034479","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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