Pub Date : 2021-04-02DOI: 10.24884/0042-4625-2020-179-6-50-54
M. Gavshchuk, A. V. Gostimskii, O. V. Lisovskii, A. Zavyalova, I. V. Karpatsky, I. Lisitsa, T. Nikolskaya
The OBJECTIVE was to create a simulator for practicing manual skills of performing percutaneous endoscopic gastrostomy (PEG).METHODS AND MATERIALS. A patient simulator has been developed. It has a mouth, oropharynx, removable esophagus, stomach, and anterior abdominal wall that allows performing all stages of the operation. To objectify tension force of the gastrostomy tube during fixation and transmitting the proper manual sensations, a measuring device – bezmen was used. Initially, we used a single-use gastrostomy kit Freka PEG, FR 20 for the simulation. It increased the cost of the simulation. Therefore, instead of disposable kits, the Pezzer catheter No. 24 with a developed metal coneshaped tip was used as a gastrostomy tube (patent RU 2669483, 11.10.2018). Simulation was performed with reusable surgical instruments. At the final stage, an additional external pressure plate and a connector with a cover were used.RESULTS. The developed method of simulation training for PEG imposition allows performing all stages of endoscopic gastrostomy imposition. The simplicity of manufacturing and the possibility of replacing worn elements allows multiple implementation of the method. Using reusable instruments and a Pezzer catheter with a designed reusable tip increases the cost-effectiveness of training. The use of a measuring device allows to convey the necessary sensations of tension of the gastrostomy tube during fixation with an external pressure plate, corresponding to the sensations in real clinical simulation.CONCLUSION. The developed method of training for PEG imposition with the simulator allows to effectively work out manual skills and reduce the risk of iatrogenic complications during surgery on the patient.
{"title":"Simulation training technique for performing percutaneous endoscopic gastrostomy","authors":"M. Gavshchuk, A. V. Gostimskii, O. V. Lisovskii, A. Zavyalova, I. V. Karpatsky, I. Lisitsa, T. Nikolskaya","doi":"10.24884/0042-4625-2020-179-6-50-54","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-6-50-54","url":null,"abstract":"The OBJECTIVE was to create a simulator for practicing manual skills of performing percutaneous endoscopic gastrostomy (PEG).METHODS AND MATERIALS. A patient simulator has been developed. It has a mouth, oropharynx, removable esophagus, stomach, and anterior abdominal wall that allows performing all stages of the operation. To objectify tension force of the gastrostomy tube during fixation and transmitting the proper manual sensations, a measuring device – bezmen was used. Initially, we used a single-use gastrostomy kit Freka PEG, FR 20 for the simulation. It increased the cost of the simulation. Therefore, instead of disposable kits, the Pezzer catheter No. 24 with a developed metal coneshaped tip was used as a gastrostomy tube (patent RU 2669483, 11.10.2018). Simulation was performed with reusable surgical instruments. At the final stage, an additional external pressure plate and a connector with a cover were used.RESULTS. The developed method of simulation training for PEG imposition allows performing all stages of endoscopic gastrostomy imposition. The simplicity of manufacturing and the possibility of replacing worn elements allows multiple implementation of the method. Using reusable instruments and a Pezzer catheter with a designed reusable tip increases the cost-effectiveness of training. The use of a measuring device allows to convey the necessary sensations of tension of the gastrostomy tube during fixation with an external pressure plate, corresponding to the sensations in real clinical simulation.CONCLUSION. The developed method of training for PEG imposition with the simulator allows to effectively work out manual skills and reduce the risk of iatrogenic complications during surgery on the patient.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"179 1","pages":"50-54"},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46948651","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 : 2021-01-03DOI: 10.24884/0042-4625-2020-179-5-47-56
V. E. Fedorov, B. S. Kharitonov, V. Maslyakov, A. Aslanov, O. Logvina, M. A. Narizhnaya
The Objective was to improve the results of diagnostics of the severity of patients with complications of cholelithiasis, occurring in the form of mechanical jaundice, against the background of comorbidity.Methods and Materials. 537 patients admitted in the clinic of hospital surgery of Kabardino-Balkar State University named after H. M. Berbekov in the period from 2010 to 2019 were examined. The terms of admission to the hospital were different. 25 (4.6 %) people were admitted in a short period of time up to 6 hours. A day after the onset of the disease – 82 (15.3 %) people. More than half – 277 (51.6 %) people were hospitalized a week after the onset of the disease. We analyzed the data of comorbidity scales of CIRS, Kaplan–Feinstein and Mary Charlson Index, as well as biochemical criteria reflecting the severity of calculous cholecystitis, jaundice and concomitant diseases.Results. As a result of their analysis and comparison, we found that comorbidity in patients of this kind is the main aggravating factor and worsens the пeneral condition as the stages of jaundice develop.Conclusion. We found out that a common biochemical tests as for characterizing changes of the hepatocyte in nontumor obstructive jaundice, and for evaluating the degree of impact of comorbidity are the content of blood alkaline phosphatase, creatine phosphokinase and transaminases. Intoxication syndrome in patients with cholangitis and comorbidity so negatively affect all organs and systems of the body that it can lead to inoperability.
{"title":"Features of the clinic in patients with non-tumor mechanical jaundice with concomitant pathology","authors":"V. E. Fedorov, B. S. Kharitonov, V. Maslyakov, A. Aslanov, O. Logvina, M. A. Narizhnaya","doi":"10.24884/0042-4625-2020-179-5-47-56","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-5-47-56","url":null,"abstract":"The Objective was to improve the results of diagnostics of the severity of patients with complications of cholelithiasis, occurring in the form of mechanical jaundice, against the background of comorbidity.Methods and Materials. 537 patients admitted in the clinic of hospital surgery of Kabardino-Balkar State University named after H. M. Berbekov in the period from 2010 to 2019 were examined. The terms of admission to the hospital were different. 25 (4.6 %) people were admitted in a short period of time up to 6 hours. A day after the onset of the disease – 82 (15.3 %) people. More than half – 277 (51.6 %) people were hospitalized a week after the onset of the disease. We analyzed the data of comorbidity scales of CIRS, Kaplan–Feinstein and Mary Charlson Index, as well as biochemical criteria reflecting the severity of calculous cholecystitis, jaundice and concomitant diseases.Results. As a result of their analysis and comparison, we found that comorbidity in patients of this kind is the main aggravating factor and worsens the пeneral condition as the stages of jaundice develop.Conclusion. We found out that a common biochemical tests as for characterizing changes of the hepatocyte in nontumor obstructive jaundice, and for evaluating the degree of impact of comorbidity are the content of blood alkaline phosphatase, creatine phosphokinase and transaminases. Intoxication syndrome in patients with cholangitis and comorbidity so negatively affect all organs and systems of the body that it can lead to inoperability. ","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69113668","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 : 2021-01-03DOI: 10.24884/0042-4625-2020-179-5-21-29
O. O. Zavorotniy, E. Zinoviev, D. V. Kostyakov
The objective was to develop a methodology for predicting death in patients with burn injury using regression analysis methods.Methods and Materials. The analysis of the results of treatment of 330 burned with a shock injury, hospitalized in the Department of Anesthesiology and Resuscitation of the Department of Thermal Lesions of Saint-Petersburg I. I. Dzhanelidze research institute of emergency medicine in the period 2013–2019.Results. In the course of the study, 52 indicators were identified that characterized the condition of the victim with burn injury in the dynamics of treatment measures. To build a predictive model, only statistically significant parameters (p<0.05) were used, which were used to build a model of logistic regression. The final algorithm included 18 predictors. The model allows predicting a positive outcome of treatment and the likelihood of a fatal outcome with an accuracy of 93 and 87 % respectively.Conclusion. The use of a multivariate mathematical model made it possible to develop a method for predicting a fatal outcome, taking into account the peculiarities of the pathogenesis of burn disease and the principles of therapeutic measures in the first three days after injury. The use of linear regression analysis using new indicators of thermal injury in a retrospective cohort of 330 patients allowed us to achieve a high predictive value.
目的是利用回归分析方法开发一种预测烧伤患者死亡的方法。方法与材料。2013 - 2019年圣彼得堡I. I. Dzhanelidze急救医学研究所热损科麻醉与复苏科住院烧伤合并休克损伤330例救治结果分析在研究过程中，确定了52个指标，这些指标表征了烧伤患者在治疗措施中的动态状况。为了建立预测模型，只使用具有统计学意义(p<0.05)的参数，并使用这些参数建立逻辑回归模型。最终的算法包括18个预测因子。该模型可以预测治疗的积极结果和致命结果的可能性，准确率分别为93%和87%。考虑到烧伤疾病发病机制的特殊性和受伤后头三天的治疗措施原则，多变量数学模型的使用使预测致命结果的方法成为可能。在330例患者的回顾性队列中，使用热损伤新指标的线性回归分析使我们获得了很高的预测价值。
{"title":"Predicting for mortality rate using regression analysis in patient with burn injury","authors":"O. O. Zavorotniy, E. Zinoviev, D. V. Kostyakov","doi":"10.24884/0042-4625-2020-179-5-21-29","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-5-21-29","url":null,"abstract":"The objective was to develop a methodology for predicting death in patients with burn injury using regression analysis methods.Methods and Materials. The analysis of the results of treatment of 330 burned with a shock injury, hospitalized in the Department of Anesthesiology and Resuscitation of the Department of Thermal Lesions of Saint-Petersburg I. I. Dzhanelidze research institute of emergency medicine in the period 2013–2019.Results. In the course of the study, 52 indicators were identified that characterized the condition of the victim with burn injury in the dynamics of treatment measures. To build a predictive model, only statistically significant parameters (p<0.05) were used, which were used to build a model of logistic regression. The final algorithm included 18 predictors. The model allows predicting a positive outcome of treatment and the likelihood of a fatal outcome with an accuracy of 93 and 87 % respectively.Conclusion. The use of a multivariate mathematical model made it possible to develop a method for predicting a fatal outcome, taking into account the peculiarities of the pathogenesis of burn disease and the principles of therapeutic measures in the first three days after injury. The use of linear regression analysis using new indicators of thermal injury in a retrospective cohort of 330 patients allowed us to achieve a high predictive value. ","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69113329","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 : 2021-01-03DOI: 10.24884/0042-4625-2020-179-5-16-20
A. P. Trukhan, I. Samokhvalov, T. Skakunova, A. A. Ryadnov
The objective of the study was to compare the order of admission and distribution in hospitals of the incoming flow of victims with explosive peacetime injuries (based on the analysis of terrorist acts in Minsk on April 11, 2011 and in St. Petersburg on April 3, 2017). Methods and Materials. We analyzed the organization of inpatient medical care for 2 groups of victims who applied for medical care to hospital health organizations on the day of the terrorist attack. The first group – 195 victims of the explosion in the subway of Minsk. The second group – 55 victims of the explosion in the subway of St. Petersburg. Results. The order of admission of victims to the healthcare organization in both groups was similar, as was the number of requests for medical care within 1.5 hours from the time of the first treatment (72.7 and 63.6 %, p>0.05). In both groups, there were identical indicators of the victims aimed at inpatient treatment (80.5 and 83.6 %, p>0.05), and cases when the profile of the hospitalization department was crucial for the nature of medical care (74.5 and 76.1 %, p>0.05). The victims of both groups hospitalized in hospital healthcare organizations had identical indicators of subsequent transfers to other medical institutions or to other departments. Conclusion. The first 1.5 hours after the first call to hospitals after explosions in the subway are the most stressful, which may require limiting medical care only to emergency operations. Up to 20 % of the victims had no serious injuries and were referred for outpatient treatment.
{"title":"Features of flow of victims after terrorist attacks in the subway","authors":"A. P. Trukhan, I. Samokhvalov, T. Skakunova, A. A. Ryadnov","doi":"10.24884/0042-4625-2020-179-5-16-20","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-5-16-20","url":null,"abstract":"The objective of the study was to compare the order of admission and distribution in hospitals of the incoming flow of victims with explosive peacetime injuries (based on the analysis of terrorist acts in Minsk on April 11, 2011 and in St. Petersburg on April 3, 2017). Methods and Materials. We analyzed the organization of inpatient medical care for 2 groups of victims who applied for medical care to hospital health organizations on the day of the terrorist attack. The first group – 195 victims of the explosion in the subway of Minsk. The second group – 55 victims of the explosion in the subway of St. Petersburg. Results. The order of admission of victims to the healthcare organization in both groups was similar, as was the number of requests for medical care within 1.5 hours from the time of the first treatment (72.7 and 63.6 %, p>0.05). In both groups, there were identical indicators of the victims aimed at inpatient treatment (80.5 and 83.6 %, p>0.05), and cases when the profile of the hospitalization department was crucial for the nature of medical care (74.5 and 76.1 %, p>0.05). The victims of both groups hospitalized in hospital healthcare organizations had identical indicators of subsequent transfers to other medical institutions or to other departments. Conclusion. The first 1.5 hours after the first call to hospitals after explosions in the subway are the most stressful, which may require limiting medical care only to emergency operations. Up to 20 % of the victims had no serious injuries and were referred for outpatient treatment.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"179 1","pages":"16-20"},"PeriodicalIF":0.0,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49097083","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 : 2021-01-03DOI: 10.24884/0042-4625-2020-179-5-57-62
E. K. Dzidzava, A. Vlasov, O. V. Markin, I. V. Fedoseykin, I. V. Gluchova, O. V. Revva, A. Shukshin
The Objective was to evaluate the effectiveness of original physiotherapeutic methods in the treatment of patients with acute spread purulent peritonitis.Methods and Materials. We done a treatment approach analysis of 72 patients with peritonitis after programmed sanitation of the abdominal cavity. The control group included 42 patients with standardized treatment regimen. The main group consisted of 35 patients. Their treatment included low-intensity laser radiation of the abdominal cavity, electrical stimulation of the duodenum according to the original methods. We evaluated dynamic changes of the blood parameters, endogenous intoxication markers, the functional status of the liver, kidneys, and intestines.Results. The use of original physiotherapeutic methods in the treatment of patients with acute peritonitis leads to a significant improvement in clinical and laboratory data. The functional status of the liver, kidneys and intestine restored rapidly. Mortality rate decreased from 28.7 to 17.1 % (χ2=1.392, p=0.238), hospital stay decreased by 5.7 hospital days (p<0.05).Conclusion. The treatment regimen for severe peritonitis leads to a relatively rapid relief of the inflammatory process in the abdominal cavity, as well as the restoration of the functional status of the liver, kidneys and intestine. It largely determines the correction of homeostatic indicators, including reducing the severity of endogenous intoxication.
{"title":"The acute peritonitis treatment optimizing in early postoperative period","authors":"E. K. Dzidzava, A. Vlasov, O. V. Markin, I. V. Fedoseykin, I. V. Gluchova, O. V. Revva, A. Shukshin","doi":"10.24884/0042-4625-2020-179-5-57-62","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-5-57-62","url":null,"abstract":"The Objective was to evaluate the effectiveness of original physiotherapeutic methods in the treatment of patients with acute spread purulent peritonitis.Methods and Materials. We done a treatment approach analysis of 72 patients with peritonitis after programmed sanitation of the abdominal cavity. The control group included 42 patients with standardized treatment regimen. The main group consisted of 35 patients. Their treatment included low-intensity laser radiation of the abdominal cavity, electrical stimulation of the duodenum according to the original methods. We evaluated dynamic changes of the blood parameters, endogenous intoxication markers, the functional status of the liver, kidneys, and intestines.Results. The use of original physiotherapeutic methods in the treatment of patients with acute peritonitis leads to a significant improvement in clinical and laboratory data. The functional status of the liver, kidneys and intestine restored rapidly. Mortality rate decreased from 28.7 to 17.1 % (χ2=1.392, p=0.238), hospital stay decreased by 5.7 hospital days (p<0.05).Conclusion. The treatment regimen for severe peritonitis leads to a relatively rapid relief of the inflammatory process in the abdominal cavity, as well as the restoration of the functional status of the liver, kidneys and intestine. It largely determines the correction of homeostatic indicators, including reducing the severity of endogenous intoxication. ","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69113688","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 : 2021-01-03DOI: 10.24884/0042-4625-2020-179-5-71-74
G. Khubulava
.
．
{"title":"Commentary to article Il’ya I. Dzidzava et al. «Treatment of massive pulmonary embolism with systemic thrombolysis in the nearest postoperative period»","authors":"G. Khubulava","doi":"10.24884/0042-4625-2020-179-5-71-74","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-5-71-74","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69114233","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 : 2021-01-03DOI: 10.24884/0042-4625-2020-179-5-36-40
С. А. Караваева, А. В. Подкаменев, А. А. Скопец
The Objective of the study was to identify the clinical features of newborns and infants with perforation of the stomach, and to justify the possibility of organ-preserving operations even with extensive gastric necrosis. Methods and Materials. The results of treatment of 32 newborns with stomach perforation was analyzed: not only the risk factors that cause this condition, but diagnostic methods and variants of surgical treatment. All patients with extensive necrosis of the stomach wall underwent an atypical resection within healthy tissues, a gastric «tube» was formed on the drainage probe with a significant decrease of organ volume. In cases of the local damage of the gastric wall, the perforated area was sutured after the excision of the edges of the defect. Results . Mortality rate was 36.5 % (n = 12). The cause of death in 5 children (15 %), in 3 to 8 days after surgery, was multiple organ failure syndrome. In 7 patients (22 %), a fatal outcome occurred due to the severe post-intensive care syndrome at the age of 3 to 12 months of life. Conclusion. The mechanism of perforations of the stomach in newborns and infants is multifactorial. All children with stomach perforation need preoperative preparation. The operation of choice for the stomach perforation is an organpreserving surgery. The function of the stomach is restored in all children after extensive resection of the stomach.
{"title":"Некроз и перфорации желудка у новорождённых и детей раннего возраста","authors":"С. А. Караваева, А. В. Подкаменев, А. А. Скопец","doi":"10.24884/0042-4625-2020-179-5-36-40","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-5-36-40","url":null,"abstract":"The Objective of the study was to identify the clinical features of newborns and infants with perforation of the stomach, and to justify the possibility of organ-preserving operations even with extensive gastric necrosis. Methods and Materials. The results of treatment of 32 newborns with stomach perforation was analyzed: not only the risk factors that cause this condition, but diagnostic methods and variants of surgical treatment. All patients with extensive necrosis of the stomach wall underwent an atypical resection within healthy tissues, a gastric «tube» was formed on the drainage probe with a significant decrease of organ volume. In cases of the local damage of the gastric wall, the perforated area was sutured after the excision of the edges of the defect. Results . Mortality rate was 36.5 % (n = 12). The cause of death in 5 children (15 %), in 3 to 8 days after surgery, was multiple organ failure syndrome. In 7 patients (22 %), a fatal outcome occurred due to the severe post-intensive care syndrome at the age of 3 to 12 months of life. Conclusion. The mechanism of perforations of the stomach in newborns and infants is multifactorial. All children with stomach perforation need preoperative preparation. The operation of choice for the stomach perforation is an organpreserving surgery. The function of the stomach is restored in all children after extensive resection of the stomach.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"179 1","pages":"36-40"},"PeriodicalIF":0.0,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69113571","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 : 2021-01-03DOI: 10.24884/0042-4625-2020-179-5-91-94
S. Afanasyev, A. Dobrodeev, D. Kostromitsky, Yu. V. Rudyk, M. Y. Grishchenko, E. S. Drozdov, E. N. Samtsov, U. Urmonov
Kartagener Syndrome (CS) is a rare autosomal recessive disease that is a part of primary ciliary dyskinesia (PCD), and is characterized by a triad of syndrome including bronchiectasis, polysinusitis and a complete mirror arrangement of the internal organs of the chest and abdominal cavities (situs inversus). In most patients, bronchiectasis in the lungs develops from the first years of life and progresses in time. The tardy diagnostic leads to a poor prognosis of the disease and adduce the development of persistent violations of the function of external respiration. Most often, patients with CS are observed by physicians and pulmonologists from early childhood, since respiratory infections often require annual hospitalization in specialized medical institutions due to abnormalities of the ciliary epithelium of the respiratory tract. However, to date, there are no generally accepted recommendations for the management and treatment of patients in this category. This article describes the case of a newly diagnosed CS in an older patient undergoing surgical treatment for gastric cancer. Despite the pronounced concomitant pathology on the part of the bronchopulmonary system, the perioperative period in the patient proceeded relatively satisfactorily and did not entail an increase in the length of hospitalization.
{"title":"A rare case of surgical treatment of a patient with gastric cancer with Cartagener syndrome","authors":"S. Afanasyev, A. Dobrodeev, D. Kostromitsky, Yu. V. Rudyk, M. Y. Grishchenko, E. S. Drozdov, E. N. Samtsov, U. Urmonov","doi":"10.24884/0042-4625-2020-179-5-91-94","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-5-91-94","url":null,"abstract":"Kartagener Syndrome (CS) is a rare autosomal recessive disease that is a part of primary ciliary dyskinesia (PCD), and is characterized by a triad of syndrome including bronchiectasis, polysinusitis and a complete mirror arrangement of the internal organs of the chest and abdominal cavities (situs inversus). In most patients, bronchiectasis in the lungs develops from the first years of life and progresses in time. The tardy diagnostic leads to a poor prognosis of the disease and adduce the development of persistent violations of the function of external respiration. Most often, patients with CS are observed by physicians and pulmonologists from early childhood, since respiratory infections often require annual hospitalization in specialized medical institutions due to abnormalities of the ciliary epithelium of the respiratory tract. However, to date, there are no generally accepted recommendations for the management and treatment of patients in this category. This article describes the case of a newly diagnosed CS in an older patient undergoing surgical treatment for gastric cancer. Despite the pronounced concomitant pathology on the part of the bronchopulmonary system, the perioperative period in the patient proceeded relatively satisfactorily and did not entail an increase in the length of hospitalization.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69114292","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 : 2021-01-03DOI: 10.24884/0042-4625-2020-179-5-110-112
A. Akopov, I. Deynega, A. Agishev
.
．
{"title":"Lung cancer patient with purulent complications – oncological or thoracic patient? (commentary to article Korymasov E.A. Et al. «Who, how and where should treat a patient with surgical complications of lung cancer (organizational, diagnostic, therapeutic, socio-ethical aspects)?»)","authors":"A. Akopov, I. Deynega, A. Agishev","doi":"10.24884/0042-4625-2020-179-5-110-112","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-5-110-112","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69113266","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 : 2021-01-03DOI: 10.24884/0042-4625-2020-179-5-11-15
A. Korolkov, V. M. Teplov, D. A. Zaitsev, E. A. Tcebrovskaya, T. O. Nikitina
Objective. In this paper, we show the work of the emergency surgical department on the example of a large repurposed multidisciplinary hospital, also its necessity even for infectious hospitals not accepting patients with acute surgical pathology.Methods and Materials. The work of surgical department of Pavlov First Saint Petersburg State Medical University repurposed for COVID-19 patients was analyzed. About 1500 COVID-19 patients were hospitalized during 4-month period.Results. All patients undergoing surgery were in severe condition (at intensive care unit). Most common surgery in abdomen was diagnostic laparoscopy. Spontaneous bleedings of different localization occurred in these patients, what required endovascular and endoscopic treatment. We observed only Clavien – Dindo 1-degree postoperative complications. Mortality rate was high and amounted to 75 %.Conclusion. The work of surgical department in an infectious hospital for the treatment of a new coronavirus infection is extremely difficult. An infectious hospital should have a 24-hour diagnostic service (US, CT, MRI). Patients severity and the working conditions necessitate the availability of the trained surgical personnel. Given the high risks of bleedings in patients with COVID-19, it is necessary to have a 24-hour endoscopy and endovascular surgery departments with the ability to perform diagnostic and therapeutic interventions.
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