Pub Date : 2020-08-03DOI: 10.24884/0042-4625-2020-179-3-25-32
D. Kuznetsov, A. Gevorgyan, V. V. Novokshenov, K. Mikhailov, A. V. Kryukov, S. Khokhlunov
The OBJECTIVE of the study was to compare the results of using the longitudinal – cross-linking method of sternum osteosynthesis with other methods (single wire stitches, 8-shaped wire stitches) for cardiosurgery patients.METHODS AND MATERIALS. The study included 3,150 patients, which were operated on in Samara cardiology dispensary named after V. P. Poliakov from 2012 to 2018. Patients were divided into 2 groups. Group 1 (1397 patients, operated on from 2012 to 2014) used single wire stitches or 8-shaped wire stitches for sternum osteosynthesis. Group 2 (1753 patients, operated from 2015 to 2018) used the longitudinal -cross-linking method of sternum osteosynthesis. The incidence of instability of the sternum without infection, superficial postoperative wound infection, deep sternal infection and hospital mortality were evaluated.RESULTS. Groups (1–68 % of men, average age (59.4±9,9) years; 2–68 % of men, average age 62.3±8.5) were significantly different in obesity patients (25.6 & 29.3 %, p=0.02), amount of smokers (50.5 & 64.2 %, p<0.001) and amount of urgent cases (3 & 10 %, p<0.001). The incidence of sternal instability without infection was less in group 2 (0.64 & 0.29 %; OR, 2.29; 95 % CI, 0.76 to 6.8; p=0.1). The amount of deep sternal infection was significant less in group 2 (1.6 & 0.6 %; OR, 2.53; 95 % CI, 1.2 to 5.2; p=0.009). The hospital mortality was 3.9 % in group 1 and 2.96 % in group 2 (OR, 1.34; 95 % CI, 0.9 to 1.9; p=0.1).CONCLUSION. The longitudinal-cross-linking method of sternum osteosynthesis is the available method that can significantly reduce the incidence of deep sternal infection in cardiosurgery.
{"title":"Longitudinal-cross-linking method of the sternum osteosynthesis – an additional way for the prophylaxis of deep sternal infection in cardiac surgery patients","authors":"D. Kuznetsov, A. Gevorgyan, V. V. Novokshenov, K. Mikhailov, A. V. Kryukov, S. Khokhlunov","doi":"10.24884/0042-4625-2020-179-3-25-32","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-3-25-32","url":null,"abstract":"The OBJECTIVE of the study was to compare the results of using the longitudinal – cross-linking method of sternum osteosynthesis with other methods (single wire stitches, 8-shaped wire stitches) for cardiosurgery patients.METHODS AND MATERIALS. The study included 3,150 patients, which were operated on in Samara cardiology dispensary named after V. P. Poliakov from 2012 to 2018. Patients were divided into 2 groups. Group 1 (1397 patients, operated on from 2012 to 2014) used single wire stitches or 8-shaped wire stitches for sternum osteosynthesis. Group 2 (1753 patients, operated from 2015 to 2018) used the longitudinal -cross-linking method of sternum osteosynthesis. The incidence of instability of the sternum without infection, superficial postoperative wound infection, deep sternal infection and hospital mortality were evaluated.RESULTS. Groups (1–68 % of men, average age (59.4±9,9) years; 2–68 % of men, average age 62.3±8.5) were significantly different in obesity patients (25.6 & 29.3 %, p=0.02), amount of smokers (50.5 & 64.2 %, p<0.001) and amount of urgent cases (3 & 10 %, p<0.001). The incidence of sternal instability without infection was less in group 2 (0.64 & 0.29 %; OR, 2.29; 95 % CI, 0.76 to 6.8; p=0.1). The amount of deep sternal infection was significant less in group 2 (1.6 & 0.6 %; OR, 2.53; 95 % CI, 1.2 to 5.2; p=0.009). The hospital mortality was 3.9 % in group 1 and 2.96 % in group 2 (OR, 1.34; 95 % CI, 0.9 to 1.9; p=0.1).CONCLUSION. The longitudinal-cross-linking method of sternum osteosynthesis is the available method that can significantly reduce the incidence of deep sternal infection in cardiosurgery.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69110443","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 : 2020-08-03DOI: 10.24884/0042-4625-2020-179-3-19-24
А. С. Толстокоров, С. Н. Котов, Г. А. Манахов, Российской Федерации, Yury V. Kovalenko, Aleksandr S. Tolstokorov, Sergey N. Kotov, German A. Manakhov, Elena N. Kurochkina
The OBJECTIVE was the reduction in the frequency of specific complications of surgical treatment of patients with pathology of the thyroid and parathyroid glands using the original method of monitoring the neuro-functional activity of the recurrent laryngeal nerve.METHODS AND MATERIALS. The research was conducted in two stages. At the first stage, the object of the topographic-anatomical study was 50 male and female corpses. The research, based on the fixed material, was focused upon the study of the anatomic special features of recurrent laryngeal nerves, their relations with neighboring structures, the study of peculiarities of recurrent laryngeal nerve syntopy and its neighboring structures to find the least traumatic way of incision during electroneurophysiological monitoring of activity. At the second stage, the object of the study was 60 patients with a benign pathology of the thyroid gland, who were operated on with the use of the original method of intra-operational visualization and control method over neuro-functional activity of recurrent laryngeal nerve.RESULTS. The frequency of the three different variants of topographic-anatomical position of recurrent laryngeal nerve depends on the side of the body. The safest, stable and the fastest one to be found is the left recurrent laryngeal nerve. Postoperative unilateral paresis of the larynx, diagnosed in 4 of 60 patients, is regarded as postischemic. Two-sided paresis of the larynx was diagnosed in 1 patient.CONCLUSION. This method allows to minimize the development of severe intraoperative complications, to reduce the frequency of postoperative paralysis and paresis of the larynx. Intra-operative visualization of recurrent laryngeal nerves is especially necessary during the repeated surgeries with postoperative scar transformations with wrong syntopy of neck organs and vascular-nerve structures, which makes it possible to minimize the number of postoperative paralyses and paresis of larynx and to get positive effect without carrying out the intubation of trachea among patients with postoperative paralysis of larynx or stenosis, and to avoid more serious damage of larynx or trachea in case of intubation.
{"title":"Application of the original method of intra-operative electrophysiological stimulation of recurrent laryngeal nerve with surgical interventions on the neck organs","authors":"А. С. Толстокоров, С. Н. Котов, Г. А. Манахов, Российской Федерации, Yury V. Kovalenko, Aleksandr S. Tolstokorov, Sergey N. Kotov, German A. Manakhov, Elena N. Kurochkina","doi":"10.24884/0042-4625-2020-179-3-19-24","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-3-19-24","url":null,"abstract":"The OBJECTIVE was the reduction in the frequency of specific complications of surgical treatment of patients with pathology of the thyroid and parathyroid glands using the original method of monitoring the neuro-functional activity of the recurrent laryngeal nerve.METHODS AND MATERIALS. The research was conducted in two stages. At the first stage, the object of the topographic-anatomical study was 50 male and female corpses. The research, based on the fixed material, was focused upon the study of the anatomic special features of recurrent laryngeal nerves, their relations with neighboring structures, the study of peculiarities of recurrent laryngeal nerve syntopy and its neighboring structures to find the least traumatic way of incision during electroneurophysiological monitoring of activity. At the second stage, the object of the study was 60 patients with a benign pathology of the thyroid gland, who were operated on with the use of the original method of intra-operational visualization and control method over neuro-functional activity of recurrent laryngeal nerve.RESULTS. The frequency of the three different variants of topographic-anatomical position of recurrent laryngeal nerve depends on the side of the body. The safest, stable and the fastest one to be found is the left recurrent laryngeal nerve. Postoperative unilateral paresis of the larynx, diagnosed in 4 of 60 patients, is regarded as postischemic. Two-sided paresis of the larynx was diagnosed in 1 patient.CONCLUSION. This method allows to minimize the development of severe intraoperative complications, to reduce the frequency of postoperative paralysis and paresis of the larynx. Intra-operative visualization of recurrent laryngeal nerves is especially necessary during the repeated surgeries with postoperative scar transformations with wrong syntopy of neck organs and vascular-nerve structures, which makes it possible to minimize the number of postoperative paralyses and paresis of larynx and to get positive effect without carrying out the intubation of trachea among patients with postoperative paralysis of larynx or stenosis, and to avoid more serious damage of larynx or trachea in case of intubation.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69110400","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 : 2020-08-03DOI: 10.24884/0042-4625-2020-179-3-69-74
P. Ionov, А. V. Elikin, I. Deinega, G. Yakovlev
The OBJECTIVE was to study the course and results of treatment of lung abscesses in HIV-infected patients.METHODS AND MATERIALS. We analyzed the case histories of 199 patients with lung abscesses who treated in the Department of thoracic surgery of St. Petersburg Pokrovskaya Municipal Hospital in the period from 2012 to 2018. The 1st group included 121 HIV-infected patients, and the 2nd group – 78 patients with HIV-negative status.RESULTS. Patients from the 1st group were younger than patients from the 2nd group (p <0.05). Lung abscesses without sequestration were detected in 105 (86.8 %) patients in the 1st I group and 65 (83.3 %) in the 2nd group. Lung abscesses with sequestration (gangrenous abscesses) was diagnosed in 16 (13.2 %) HIV-infected and 13 (16.7 %) uninfected patients. There were no differences between surgical methods of treatment and outcomes (p>0.05). The mortality rate in the 1st group was 9.1 %, and in the 2nd – 12.8 %.CONCLUSION. General surgical methods for treating lung abscess are equally effective in patients with HIV-negative status and HIV-positive status. Lung abscesses in HIV-positive and HIV-negative patients have a similar etiology, clinical symptomatology, courses and outcome.
{"title":"Clinic, diagnostics, treatment and results of acute lung accesses in HIV-infected patients","authors":"P. Ionov, А. V. Elikin, I. Deinega, G. Yakovlev","doi":"10.24884/0042-4625-2020-179-3-69-74","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-3-69-74","url":null,"abstract":"The OBJECTIVE was to study the course and results of treatment of lung abscesses in HIV-infected patients.METHODS AND MATERIALS. We analyzed the case histories of 199 patients with lung abscesses who treated in the Department of thoracic surgery of St. Petersburg Pokrovskaya Municipal Hospital in the period from 2012 to 2018. The 1st group included 121 HIV-infected patients, and the 2nd group – 78 patients with HIV-negative status.RESULTS. Patients from the 1st group were younger than patients from the 2nd group (p <0.05). Lung abscesses without sequestration were detected in 105 (86.8 %) patients in the 1st I group and 65 (83.3 %) in the 2nd group. Lung abscesses with sequestration (gangrenous abscesses) was diagnosed in 16 (13.2 %) HIV-infected and 13 (16.7 %) uninfected patients. There were no differences between surgical methods of treatment and outcomes (p>0.05). The mortality rate in the 1st group was 9.1 %, and in the 2nd – 12.8 %.CONCLUSION. General surgical methods for treating lung abscess are equally effective in patients with HIV-negative status and HIV-positive status. Lung abscesses in HIV-positive and HIV-negative patients have a similar etiology, clinical symptomatology, courses and outcome.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69111172","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 : 2020-08-03DOI: 10.24884/0042-4625-2020-179-3-100-106
Р. Бигашев, Н. Н. Шихвердиев, С. Пелешок, A. R. Bigashev, N. N. Shikhverdiev, A. Peleshok, V. Soroka
The objective of this article was to analyze current researches on the peculiarities of performing coronary artery bypass grafting in patients who primarily underwent intraluminal angioplasty and stenting due to acute coronary syndrome. Despite the priority of stenting in patients with acute coronary syndrome (ACS), there is still a significant number of unresolved issues in this category of patients, especially when these patients, previously stenting due to ACS, undergo coronary artery bypass grafting due to a repeated ACS case. The tactics of management and preparation of patients who were admitted for repeated CABG after preliminary stenting are still not clear, and therefore, a significant number of unresolved issues remains when performing CABG against the background of repeated ACS cases with a previously compromised vascular bed and the presence of chronic inflammation in the coronary arteries. Questions about the perioperative and postoperative complications in this category of patients remain open. We analyzed the latest works and researches about that problem using such systems as NLM, Google Scholar and Elibrary. Due to the current situation of mass use of stenting, a number of questions remain open (the time of cancellation of double disaggregation therapy, the need for shunting the previously stented vessel, the possibility of performing a combined method of treatment for ACS). There is a very little information on the need to bypass the previously stented coronary artery at an earlier date than indicated in the European recommendations.
{"title":"Problems of performing coronary artery bypass grafting after preliminary stenting of coronary arteries due to acute coronary syndrome (review of literature)","authors":"Р. Бигашев, Н. Н. Шихвердиев, С. Пелешок, A. R. Bigashev, N. N. Shikhverdiev, A. Peleshok, V. Soroka","doi":"10.24884/0042-4625-2020-179-3-100-106","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-3-100-106","url":null,"abstract":"The objective of this article was to analyze current researches on the peculiarities of performing coronary artery bypass grafting in patients who primarily underwent intraluminal angioplasty and stenting due to acute coronary syndrome. Despite the priority of stenting in patients with acute coronary syndrome (ACS), there is still a significant number of unresolved issues in this category of patients, especially when these patients, previously stenting due to ACS, undergo coronary artery bypass grafting due to a repeated ACS case. The tactics of management and preparation of patients who were admitted for repeated CABG after preliminary stenting are still not clear, and therefore, a significant number of unresolved issues remains when performing CABG against the background of repeated ACS cases with a previously compromised vascular bed and the presence of chronic inflammation in the coronary arteries. Questions about the perioperative and postoperative complications in this category of patients remain open. We analyzed the latest works and researches about that problem using such systems as NLM, Google Scholar and Elibrary. Due to the current situation of mass use of stenting, a number of questions remain open (the time of cancellation of double disaggregation therapy, the need for shunting the previously stented vessel, the possibility of performing a combined method of treatment for ACS). There is a very little information on the need to bypass the previously stented coronary artery at an earlier date than indicated in the European recommendations.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69108589","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 : 2020-08-03DOI: 10.24884/0042-4625-2020-179-3-107-112
M. E. Boriskova, U. Farafonova, P. A. Pankova, M. A. Bykov, E. A. Ramazanova, N. S. Feshenko, A. Zakharenko, N. A. Yaitsky
The definition of a sentinel lymph node is a technique that appeared at the middle of the 20th century. For a number of malignant neoplasms, the definition of a sentinel lymph node is standard procedure, but for highly differentiated thyroid cancer, the data is conflicting. The role of prophylactic central compartment lymph node dissection in the clinical N0 stage is not established. Sentinel lymph node detection seems to be the possible way to reduce the risk of persistence and recurrence of highly differentiated thyroid cancer.
{"title":"The role of defining the sentinel lymph node in the treatment of low-risk highly differentiated thyroid cancer (review of literature)","authors":"M. E. Boriskova, U. Farafonova, P. A. Pankova, M. A. Bykov, E. A. Ramazanova, N. S. Feshenko, A. Zakharenko, N. A. Yaitsky","doi":"10.24884/0042-4625-2020-179-3-107-112","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-3-107-112","url":null,"abstract":"The definition of a sentinel lymph node is a technique that appeared at the middle of the 20th century. For a number of malignant neoplasms, the definition of a sentinel lymph node is standard procedure, but for highly differentiated thyroid cancer, the data is conflicting. The role of prophylactic central compartment lymph node dissection in the clinical N0 stage is not established. Sentinel lymph node detection seems to be the possible way to reduce the risk of persistence and recurrence of highly differentiated thyroid cancer.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69109592","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 : 2020-08-03DOI: 10.24884/0042-4625-2020-179-3-48-57
Б. С. Харитонов, В. Масляков, Е. Логвина, Vladimir E. Fedorov, B. S. Haritonov, V. V. Masljakov, O. Logvina, M. A. Naryzhnaja
The OBJECTIVE was improving the results of diagnostics and assessment of the severity of patients with mechanical jaundice (MJ) at various stages of its development.METHODS AND MATERIALS. The basis of clinical and laboratory research was the data of 537 patients who were admitted during the period from 2010 to 2019. Principles of separation at the stage of the course of mechanical jaundice of non-tumor Genesis.RESULTS. Analysis of clinical and laboratory studies showed characteristic signs of various complications of cholelithiasis, accompanied by mechanical jaundice. Then, on this basis, specific symptoms characteristic of each stage of mechanical jaundice of non-tumor Genesis were determined.CONCLUSION. The course of mechanical jaundice, which develops with complications of cholelithiasis, has a phase-stage character, beginning with extrahepatic cholestasis, then-joining hepatocytolysis and ending with cholangitis. Initially, cholestasis and cytolysis are functional, which is confirmed by biochemical tests, so these processes are labile and reversible. This makes it possible to effectively use biliary decompression methods and infusion therapy with detoxification during treatment. Cholangitis is characterized by destructive morphological manifestations, so it is verified by specific clinical symptoms and laboratory tests characteristic of inflammatory-septic reactions and progresses to sepsis. Differentiation of stages of mechanical jaundice allows to personify surgical and conservative treatment of such patients.
{"title":"Features of mechanical jaundice course caused by complications of bile disease","authors":"Б. С. Харитонов, В. Масляков, Е. Логвина, Vladimir E. Fedorov, B. S. Haritonov, V. V. Masljakov, O. Logvina, M. A. Naryzhnaja","doi":"10.24884/0042-4625-2020-179-3-48-57","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-3-48-57","url":null,"abstract":"The OBJECTIVE was improving the results of diagnostics and assessment of the severity of patients with mechanical jaundice (MJ) at various stages of its development.METHODS AND MATERIALS. The basis of clinical and laboratory research was the data of 537 patients who were admitted during the period from 2010 to 2019. Principles of separation at the stage of the course of mechanical jaundice of non-tumor Genesis.RESULTS. Analysis of clinical and laboratory studies showed characteristic signs of various complications of cholelithiasis, accompanied by mechanical jaundice. Then, on this basis, specific symptoms characteristic of each stage of mechanical jaundice of non-tumor Genesis were determined.CONCLUSION. The course of mechanical jaundice, which develops with complications of cholelithiasis, has a phase-stage character, beginning with extrahepatic cholestasis, then-joining hepatocytolysis and ending with cholangitis. Initially, cholestasis and cytolysis are functional, which is confirmed by biochemical tests, so these processes are labile and reversible. This makes it possible to effectively use biliary decompression methods and infusion therapy with detoxification during treatment. Cholangitis is characterized by destructive morphological manifestations, so it is verified by specific clinical symptoms and laboratory tests characteristic of inflammatory-septic reactions and progresses to sepsis. Differentiation of stages of mechanical jaundice allows to personify surgical and conservative treatment of such patients.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69111323","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 : 2020-06-29DOI: 10.24884/0042-4625-2020-179-2-26-32
R. T. Mejidov, R. Sultanova
The OBJECTIVE was to make the comparative assessment of surgical methods for the treatment and prevention of the recurrence of echinococcal liver disease, as well as to study negative and positive aspects of closed echinococcectomy in relation to recurrent efficacy.METHODS AND MATERIAL. 1072 cases (1358 cysts) of echinococcal liver disease were subjected to a retrospective analysis. The clinic performed radical (closed) echinococcectomy using high-tech resection devices on 258 patients, including ultrasound dissectors and destructors-aspirators for 105 patients (main group), other resection devices (LigaSure, an argon plasma scalpel) for patients (control group).RESULTS. Inpatient treatment of patients in the main group amounted to (9.4±2.1) days, in the control group – (11.6±1.7). Postoperative complications in the main group were observed at 4.6 % of patients, in the control group – 11.0 %. Relapse of the liver echinococcosis in the control group occurred in 2.3 % of cases, there were no relapses in the main group. The quality of life of patients in the main group was (73.5±1.8) points, in the control group – (72, 8±1.7) points. There were no lethal outcomes in both groups of patients.CONCLUSION. The most effective in the treatment and prevention of recurrence of echinococcal liver disease are closed methods of echinococcectomy: a cyst pericystectomy, liver resection. When we use ultrasound resection techniques for closed (radical) surgical interventions, intra- and postoperative complications are reduced and the immediate and long-term results of patients with liver echinococcosis are improved.
{"title":"Treatment and prevention of the recurrence of liver echinococcosis","authors":"R. T. Mejidov, R. Sultanova","doi":"10.24884/0042-4625-2020-179-2-26-32","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-2-26-32","url":null,"abstract":"The OBJECTIVE was to make the comparative assessment of surgical methods for the treatment and prevention of the recurrence of echinococcal liver disease, as well as to study negative and positive aspects of closed echinococcectomy in relation to recurrent efficacy.METHODS AND MATERIAL. 1072 cases (1358 cysts) of echinococcal liver disease were subjected to a retrospective analysis. The clinic performed radical (closed) echinococcectomy using high-tech resection devices on 258 patients, including ultrasound dissectors and destructors-aspirators for 105 patients (main group), other resection devices (LigaSure, an argon plasma scalpel) for patients (control group).RESULTS. Inpatient treatment of patients in the main group amounted to (9.4±2.1) days, in the control group – (11.6±1.7). Postoperative complications in the main group were observed at 4.6 % of patients, in the control group – 11.0 %. Relapse of the liver echinococcosis in the control group occurred in 2.3 % of cases, there were no relapses in the main group. The quality of life of patients in the main group was (73.5±1.8) points, in the control group – (72, 8±1.7) points. There were no lethal outcomes in both groups of patients.CONCLUSION. The most effective in the treatment and prevention of recurrence of echinococcal liver disease are closed methods of echinococcectomy: a cyst pericystectomy, liver resection. When we use ultrasound resection techniques for closed (radical) surgical interventions, intra- and postoperative complications are reduced and the immediate and long-term results of patients with liver echinococcosis are improved.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69107340","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 : 2020-06-29DOI: 10.24884/0042-4625-2020-179-2-33-39
Ivan A. Stepanov, V. A. Beloborodov, Maria A. Shameeva
INTRODUCTION. Surgical site infections (SSIs) are one of the most serious adverse events that develop in patients after performing an operation of instrumental spinal fusion. A search of literary sources in various databases showed the presence of isolated studies devoted to studying the effectiveness of suprafascial local application of Vancomycin powder after performing an operation of posterior instrumental spinal fusion in preventing the development of SSIs. At the same time, the results of these studies are ambiguous and in many ways contradictory.The OBJECTIVE of this study was to study the effectiveness of the suprafascial local application of Vancomycin powder after performing the operation of the posterior instrumental spinal fusion in preventing the development of SSIs, and also to identify the main adverse drug reactions in the local use of this antibacterial drug.METHODS AND MATERIALS. The study included medical records of 219 patients who underwent surgery for posterior instrumental spinal fusion on the cervical, thoracic, and lumbosacral spine for various pathological conditions. Medical records of patients are divided into two groups: group I (comparison group) – 113 patients who used the standard protocol of prophylaxis of SSIs and group II (main group) – 106 patients who used the standard protocol of prophylaxis of SSIs in combination with suprafascial local use of Vancomycin powder. The analysis of the frequency of occurrence of SSIs after the operation of the posterior instrumental spinal fusion in the studied groups of respondents and the prevalence of undesirable medicinal phenomena in the case of local suprafascial application of Vancomycin powder was performed.RESULTS. The prevalence of SSI after posterior instrumental spinal fusion in the control group of patients was 4.2 %. At the same time, in the main group of patients, where the standard protocol was used in combination with suprafascial local use of Vancomycin powder for the purpose of prophylaxis of SSIs, there were no cases of SSIs development. We have not revealed any adverse drug reactions when using Vancomycin powder in patients of the main group.CONCLUSION. The local use of Vancomycin powder in patients after posterior instrumental spinal fusion is an effective and safe method of preventing the development of SSIs.
{"title":"Suprafascial application of Vancomycin powder in the operation of posterior instrumental fusion for the prevention of local infectious complications","authors":"Ivan A. Stepanov, V. A. Beloborodov, Maria A. Shameeva","doi":"10.24884/0042-4625-2020-179-2-33-39","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-2-33-39","url":null,"abstract":"INTRODUCTION. Surgical site infections (SSIs) are one of the most serious adverse events that develop in patients after performing an operation of instrumental spinal fusion. A search of literary sources in various databases showed the presence of isolated studies devoted to studying the effectiveness of suprafascial local application of Vancomycin powder after performing an operation of posterior instrumental spinal fusion in preventing the development of SSIs. At the same time, the results of these studies are ambiguous and in many ways contradictory.The OBJECTIVE of this study was to study the effectiveness of the suprafascial local application of Vancomycin powder after performing the operation of the posterior instrumental spinal fusion in preventing the development of SSIs, and also to identify the main adverse drug reactions in the local use of this antibacterial drug.METHODS AND MATERIALS. The study included medical records of 219 patients who underwent surgery for posterior instrumental spinal fusion on the cervical, thoracic, and lumbosacral spine for various pathological conditions. Medical records of patients are divided into two groups: group I (comparison group) – 113 patients who used the standard protocol of prophylaxis of SSIs and group II (main group) – 106 patients who used the standard protocol of prophylaxis of SSIs in combination with suprafascial local use of Vancomycin powder. The analysis of the frequency of occurrence of SSIs after the operation of the posterior instrumental spinal fusion in the studied groups of respondents and the prevalence of undesirable medicinal phenomena in the case of local suprafascial application of Vancomycin powder was performed.RESULTS. The prevalence of SSI after posterior instrumental spinal fusion in the control group of patients was 4.2 %. At the same time, in the main group of patients, where the standard protocol was used in combination with suprafascial local use of Vancomycin powder for the purpose of prophylaxis of SSIs, there were no cases of SSIs development. We have not revealed any adverse drug reactions when using Vancomycin powder in patients of the main group.CONCLUSION. The local use of Vancomycin powder in patients after posterior instrumental spinal fusion is an effective and safe method of preventing the development of SSIs.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69106960","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 : 2020-06-29DOI: 10.24884/0042-4625-2020-179-2-59-62
I. Khatkov, V. Tsvirkun, Yu. N. Ponоmareva, E. A. Loginova
Uterine myoma is the most common benign disease in the women of the reproductive period. According to different authors, the rate of uterine myoma in pregnancy is estimated from 0.1 to 12.5 %. We present the case of successful laparotomy myomectomy at 14–15 weeks of gestational age.
{"title":"Organ-preserving surgical treatment of giant uterine myoma in a pregnant woman","authors":"I. Khatkov, V. Tsvirkun, Yu. N. Ponоmareva, E. A. Loginova","doi":"10.24884/0042-4625-2020-179-2-59-62","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-2-59-62","url":null,"abstract":"Uterine myoma is the most common benign disease in the women of the reproductive period. According to different authors, the rate of uterine myoma in pregnancy is estimated from 0.1 to 12.5 %. We present the case of successful laparotomy myomectomy at 14–15 weeks of gestational age.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69107557","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 : 2020-06-29DOI: 10.24884/0042-4625-2020-179-2-68-72
Г. А. Носков, Д. В. Фокин, А. Казадаева, D. V. Cherdantsev, O. V. Pervova, I. Noskov, Dmitry V. Fokin, A. A. Kazadaeva, I. A. Kazadaeva
The problem of diagnosing postnecrotic cysts of the pancreas is considered in this article. The characteristics of laboratory (determination of the level of amylase, cytological research of punctate, determination of tumor markers) and radiation (ultrasound, endosonography, RCP, MSCT, etc.) methods of research of this pathology are presented, their specificity in the differential diagnosis of cystic formations, depressurization of the main pancreatic duct and formation of the cyst wall is considered. We concluded that the use of radiation methods of research significantly improves the diagnosis of pseudocyst of the pancreas and allows to choose a rational treatment tactics and an adequate surgical intervention.
{"title":"Diagnostics of postnecrotic pancreatic cysts (review of literature)","authors":"Г. А. Носков, Д. В. Фокин, А. Казадаева, D. V. Cherdantsev, O. V. Pervova, I. Noskov, Dmitry V. Fokin, A. A. Kazadaeva, I. A. Kazadaeva","doi":"10.24884/0042-4625-2020-179-2-68-72","DOIUrl":"https://doi.org/10.24884/0042-4625-2020-179-2-68-72","url":null,"abstract":"The problem of diagnosing postnecrotic cysts of the pancreas is considered in this article. The characteristics of laboratory (determination of the level of amylase, cytological research of punctate, determination of tumor markers) and radiation (ultrasound, endosonography, RCP, MSCT, etc.) methods of research of this pathology are presented, their specificity in the differential diagnosis of cystic formations, depressurization of the main pancreatic duct and formation of the cyst wall is considered. We concluded that the use of radiation methods of research significantly improves the diagnosis of pseudocyst of the pancreas and allows to choose a rational treatment tactics and an adequate surgical intervention.","PeriodicalId":23485,"journal":{"name":"Vestnik khirurgii imeni I. I. Grekova","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69107620","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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