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[Laparoscopic repair of hiatal hernia after minimally invasive esophagectomy]. [微创食管切除术后食管裂孔疝的腹腔镜修补术]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202409186
A B Ryabov, V M Khomyakov, N M Abdulkhakimov, A V Chaika

Postoperative hiatal hernia is a rare and specific complication after esophagectomy. This complication leads to emergency and affects mortality. Incidence of this complication has increased due to the great number of minimally invasive procedures over the past decades. In addition, chronic cough, preoperative hiatal hernia and transhiatal approach also increase the risk of recurrent hernias. Most post-esophagectomy hiatal hernias do not require emergency surgery. About 70% of patients have symptoms reducing the quality of life. About 25% of cases are asymptomatic and discovered incidentally during follow-up examinations. The role of surgery for asymptomatic post-esophagectomy hernias is a matter of debate because the risk of symptoms or complications is poorly predictable. Surgical treatment is the only radical method for symptomatic or complicated hernias. However, there is still no consensus regarding surgical approach and technique. Most surgeons prefer open surgery fearing severe adhesive process and other technical difficulties. Laparoscopic approach is widely accepted as the "gold standard" for primary hiatal hernia. However, minimally invasive access for post-esophagectomy hiatal hernias is not sufficiently studied and described in several case reports. Currently, it is very important to study the risk factors of hiatal hernias after esophagectomy. We present successful laparoscopic repair of hiatal hernia after hybrid McKeown esophagectomy.

术后食管裂孔疝是食管切除术后一种罕见的特殊并发症。这种并发症会导致急诊并影响死亡率。过去几十年来,由于微创手术的大量使用,这种并发症的发生率有所上升。此外,慢性咳嗽、术前食管裂孔疝和经食管途径也会增加食管裂孔疝复发的风险。大多数食管切除术后食管裂孔疝不需要紧急手术。约 70% 的患者会出现降低生活质量的症状。约 25% 的病例没有症状,是在随访检查中偶然发现的。对于无症状的食管切除术后疝,手术治疗的作用还存在争议,因为出现症状或并发症的风险很难预测。对于有症状或复杂的疝气,手术治疗是唯一的根治方法。然而,关于手术方法和技术仍未达成共识。大多数外科医生更倾向于开腹手术,因为他们担心会出现严重的粘连过程和其他技术难题。腹腔镜方法被广泛认为是治疗原发性食管裂孔疝的 "金标准"。然而,对于食管切除术后食管裂孔疝的微创入路还没有进行充分的研究,仅有几篇病例报告对其进行了描述。目前,研究食管切除术后食管裂孔疝的风险因素非常重要。我们介绍了杂交麦氏食管切除术后食管裂孔疝的成功腹腔镜修补术。
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引用次数: 0
[Treatment of rectal prolapse after proctoplasty in a child with rectal atresia]. [直肠闭锁儿童直肠成形术后直肠脱垂的治疗]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024091106
V G Svarich, V A Svarich

Rectal prolapse is a common disease in childhood and observed mainly at the age of 1-4 years old (95% of cases). If conservative treatment is ineffective, surgical correction of rectal prolapse in children without previous anorectal surgery is performed at the age of over a year. There is a single report on examination of patients aged 4-16 years after surgical correction of anorectal malformations with postoperative rectal prolapse. We present diagnosis and successful surgical treatment of rectal prolapse in an infant who underwent previous perineal proctoplasty for fistulous form of anorectal malformation.

直肠脱垂是儿童时期的常见病,主要发生在 1-4 岁的儿童身上(占 95%)。如果保守治疗无效,则会在一岁多时对未做过肛门直肠手术的儿童进行直肠脱垂手术矫正。目前仅有一份关于 4-16 岁肛门直肠畸形手术矫正术后直肠脱垂患者的检查报告。我们介绍了一名曾因肛门直肠畸形瘘管而接受会阴直肠成形术的婴儿直肠脱垂的诊断和成功手术治疗。
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引用次数: 0
[Surgery for complicated accessory lobe of the azygos vein]. [复杂颧静脉附属叶手术]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202406170
V D Parshin, M V Sinitsyn, E G Sokolovich, A V Mariyko, I S Trubitsin, A V Parshin

Congenital anomalies of respiratory system are quite diverse and not all of them are subject to surgical treatment. One example is accessory lobe of the azygos vein. This anomaly usually has no clinical manifestations and requires only follow-up, as well as attention in surgery on the right half of the chest for some other disease. This situation changes when complications occur, for example, purulent-inflammatory process. Therapy is not always effective, and lung tissue destruction requires surgical treatment. Progressive destruction complicates diagnosis and choosing surgical tactics. We present a rare case of severe purulent-inflammatory complication with abscess in accessory lobe of v. azygos. Anatomical abnormalities following this congenital pulmonary anomaly can cause difficulties in surgeries for other intra-thoracic diseases. The situation is especially relevant for thoracoscopic access. This report will be useful for radiologists, pulmonologists and thoracic surgeons.

先天性呼吸系统畸形种类繁多,并非所有畸形都可以通过手术治疗。其中一个例子是颧静脉附属叶。这种畸形通常没有临床表现,只需要随访,以及在右半边胸部因其他疾病进行手术时给予关注。如果出现并发症,例如化脓性炎症过程,情况就会发生变化。治疗并不总是有效的,肺组织的破坏需要手术治疗。进行性破坏使诊断和手术策略的选择变得复杂。我们介绍了一例罕见的严重化脓性炎症并发症,并伴有颧骨后叶脓肿。这种先天性肺部异常的解剖异常会给其他胸腔内疾病的手术带来困难。这种情况与胸腔镜入路尤其相关。本报告对放射科、肺病科和胸外科医生都有帮助。
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引用次数: 0
[Laparoscopic surgery for advanced peritonitis]. [腹腔镜手术治疗晚期腹膜炎]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202410121
N V Lebedev, A E Klimov, V S Popov, I O Abuladze, A A Barkhudarov

Objective: To determine the criteria for choosing surgical access in patients with advanced peritonitis considering its local and general manifestations.

Material and methods: We analyzed treatment outcomes in 588 patients with advanced peritonitis. The most common causes of peritonitis were destructive forms of acute appendicitis (273 cases), perforated gastroduodenal ulcers (165 cases), acute cholecystitis (59 cases). To determine the criteria for choosing surgical access in advanced peritonitis, we analyzed treatment outcomes considering MPI, SPP and WSES SSS score.

Results: The choice of surgical access in advanced peritonitis can only symbolically be standardized according to modern scoring systems (MPI, SPP, WSES SSS). Laparotomy is necessary for MPI score ≥30 and SPP score > 10 (WSES SSS score > 8). Regardless of MPI, SPP, WSES SSS scores, the absolute contraindications for laparoscopic surgery are dense non-removable fibrin deposits, interintestinal abscesses, purulent recesses, intra-abdominal pressure > 20 mm Hg or small intestine dilation> 3 cm, sepsis or septic shock (qSOFA score 2-3), previous open abdominal surgery, unstable hemodynamics, technical difficulties. Conversion should be used at any doubt.

Conclusion: Careful patient selection, surgical experience and training in laparoscopic technique are decisive factors for wider use of laparoscopic approach in patients undergoing emergency abdominal surgery.

目的考虑到晚期腹膜炎的局部和全身表现,确定晚期腹膜炎患者选择手术入路的标准:我们分析了 588 名晚期腹膜炎患者的治疗结果。最常见的腹膜炎病因是破坏性急性阑尾炎(273 例)、胃十二指肠溃疡穿孔(165 例)和急性胆囊炎(59 例)。为了确定晚期腹膜炎选择手术入路的标准,我们分析了MPI、SPP和WSES SSS评分的治疗结果:结果:根据现代评分系统(MPI、SPP、WSES SSS),晚期腹膜炎手术入路的选择只能象征性地标准化。如果 MPI 评分≥30 分,SPP 评分大于 10 分(WSES SSS 评分大于 8 分),则必须进行腹腔手术。无论 MPI、SPP、WSES SSS 评分如何,腹腔镜手术的绝对禁忌症是:致密的不可清除的纤维蛋白沉积、肠间脓肿、化脓性凹陷、腹内压> 20 mm Hg 或小肠扩张> 3 cm、败血症或脓毒性休克(qSOFA 评分 2-3)、既往开腹手术、血流动力学不稳定、技术困难。如有任何疑问,应立即转为腹腔镜手术:结论:谨慎选择患者、手术经验和腹腔镜技术培训是在急诊腹部手术患者中广泛使用腹腔镜方法的决定性因素。
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引用次数: 0
[Influence of Clinical, Laboratory and Intraoperative Parameters on Postoperative Complications in Geriatric Patients with Acute Appendicitis: A Cross-Sectional Analysis]. [临床、实验室和术中参数对老年急性阑尾炎患者术后并发症的影响:横断面分析]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024111106
A Franco-Alva, J Caballero-Alvarado, C Zavaleta-Corvera

Objective: To determine the impact of clinical, laboratory, and intraoperative variables on postoperative complications in patients over 50 years of age with acute appendicitis.

Material and methods: An observational, analytical, cross-sectional study included patients over 50 years old who underwent surgery for acute appendicitis. The sample included 206 patients, and clinical, laboratory, and surgical data were collected from medical records. The Clavien-Dindo classification was used to estimate postoperative complications. Data were analyzed using SPSS software v.28.

Results: Postoperative morbidity rate was 30.09%. Clinical variables such as age, male gender, duration of illness, presence of type 2 diabetes (DM2), and arterial hypertension (HTA), along with laboratory variables such as leukocyte count, Neutrophil-to-Lymphocyte Ratio (NLR), blood glucose, creatinine, and C-reactive protein (CRP), were significantly associated with postoperative complications (p<0.05). In addition, intraoperative variables such as surgery time, ASA III score, perforated appendicitis, peritonitis, laparoscopic appendectomy and hospital stay were significantly associated with postoperative complications (p<0.05).

Conclusion: This study highlights the importance of various clinical, laboratory, and intraoperative variables in predicting postoperative complications in patients over 50 years old with acute appendicitis. ASA III score, CRP, perforated appendicitis, and surgery time are associated with postoperative complications.

摘要确定临床、实验室和术中变量对 50 岁以上急性阑尾炎患者术后并发症的影响:这是一项观察性、分析性、横断面研究,研究对象包括因急性阑尾炎而接受手术的 50 岁以上患者。样本包括 206 名患者,并从病历中收集了临床、实验室和手术数据。采用克拉维恩-丁多分类法估算术后并发症。数据使用 SPSS 软件 v.28 进行分析:术后发病率为 30.09%。年龄、男性性别、病程、是否患有 2 型糖尿病(DM2)和动脉高血压(HTA)等临床变量以及白细胞计数、中性粒细胞与淋巴细胞比值(NLR)、血糖、肌酐和 C 反应蛋白(CRP)等实验室变量与术后并发症显著相关(ppConclusion:本研究强调了各种临床、实验室和术中变量在预测 50 岁以上急性阑尾炎患者术后并发症方面的重要性。ASA III评分、CRP、穿孔性阑尾炎和手术时间与术后并发症有关。
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引用次数: 0
[Magnetic foreign bodies of the gastrointestinal tract in pediatric practice]. [儿科胃肠道磁性异物]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202403129
V V Ignatiev, A V Muraviev, T A Garapov, M Yu Tishukov

Objective: To analyze the pediatric patients with multiple magnetic foreign bodies of the gastrointestinal tract undergoing surgical intervention; to present the treatment and diagnostic algorithm in pediatric practice; to compare surgical interventions for these lesions and determine the most optimal one.

Material and methods: A retrospective single-center study included 9 patients diagnosed with multiple magnetic foreign bodies of the gastrointestinal tract. Exclusion criteria: outpatient cases and endoscopic removal of magnetic foreign bodies. All patients underwent laparoscopy and/or laparotomy. We analyzed postoperative data and determined the preferable approach.

Results: All patients were discharged without complications. Length of hospital-stay was shorter after laparoscopy (7 vs. 12 days). Patients after laparoscopy didn't need for intensive care while laparotomy required ICU stay for 4.5±2.2 days. Enteral feeding started after 1 and 3 days, respectively.

Conclusion: Laparoscopy is preferable for multiple magnetic foreign bodies of the gastrointestinal tract due to shorter hospital-stay, no need for ICU-stay, lower surgical trauma and earlier enteral feeding.

目的分析接受手术治疗的胃肠道多发性磁性异物儿科患者;介绍儿科实践中的治疗和诊断算法;比较这些病变的手术治疗方法,并确定最理想的治疗方法:一项回顾性单中心研究纳入了9例被诊断为胃肠道多发性磁性异物的患者。排除标准:门诊病例和内镜下磁性异物取出。所有患者均接受了腹腔镜和/或开腹手术。我们对术后数据进行了分析,并确定了可取的方法:结果:所有患者均无并发症出院。腹腔镜手术后的住院时间较短(7天对12天)。腹腔镜手术后患者无需重症监护,而开腹手术则需要在重症监护室住院4.5±2.2天。肠内喂养分别在1天和3天后开始:结论:对于胃肠道多发性磁性异物,腹腔镜手术具有住院时间短、无需入住重症监护室、手术创伤小、肠道喂养时间早等优点。
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引用次数: 0
[Comparative analysis of in-hospital and long-term results of patients with acute dysfunction of coronary bypass grafts depending on treatment tactics]. [冠状动脉旁路移植术急性功能障碍患者住院和长期疗效比较分析(取决于治疗策略)]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202401150
A A Semagin, O P Lukin, A A Fokin

Objective: Comparative analysis of in-hospital and long-term mortality of patients in whom acute dysfunction of coronary bypass grafts was detected in the early postoperative period depending on conservative or surgical tactics.

Material and methods: The study is a retrospective analysis of data from 8801 patients who underwent elective coronary artery bypass grafting (CABG) between 2011 and 2022 at the Federal Center for Cardiovascular Surgery (Russia, Chelyabinsk). Among them, 196 patients underwent emergency coronary artery bypass grafting due to suspected perioperative myocardial infarction in the early postoperative period. In 119 patients, dysfunction of coronary bypass grafts was detected, in 77 patients no pathological changes were found. The criteria for inclusion in the study were patients with dysfunction of coronary bypass grafts (n=119). The 1st group included patients who underwent conservative therapy (n=33), the 2nd group (n=86) included those who underwent repeated myocardial revascularization. The primary endpoint was hospital mortality, secondary endpoints were long-term mortality and adverse cardiovascular events (myocardial infarction, stroke, repeat myocardial revascularization). Patients were surveyed via telephone.

Results: In-hospital mortality in the group of surgical reintervention was 8.1%, in the group of conservative treatment - 9.1% (p=0.867). According to the results of multivariate analysis, predictors of hospital mortality in patients of both groups were extracorporeal membrane oxygenation (p=0.014), time of artificial circulation (p=0.031), duration of artificial ventilation (p=0.001), number of days in intensive care (p<0.001). When analyzing long-term mortality using the Kaplan-Meier method in group 1 and group 2, no statistically significant differences were found; in the group of conservative therapy - 85±9.6 [66.2-103.7] months versus 108.2±4.8 [98.8-117.6] months in the surgery group (log-rank p=0.06). When analyzing long-term mortality from cardiovascular causes and the occurrence of adverse cardiovascular events, statistically significant differences were determined: in the group of conservative therapy - 92.5±9.3 [74.2-110.7] months versus 117.8±3.3 [111.2-124.3] months in the surgical treatment group (log-rank p=0.007) and 78.1±9.2 [60-96.3] months versus 98.9±3.9 [91.3-106.5] months (log-rank p=0.008), respectively.

Conclusion: In-hospital mortality was comparable between groups. Long-term mortality from cardiovascular causes and the number of adverse cardiovascular events were significantly higher in the conservative therapy group. With timely detection of acute dysfunction of coronary bypass grafts, an active surgical approach has an advantage over conservative tactics and can improve the long-term prognosis of patients.

目的:对术后早期发现冠状动脉旁路移植术急性功能障碍的患者的院内和长期死亡率进行比较分析:比较分析在术后早期发现冠状动脉旁路移植术急性功能障碍的患者的院内死亡率和长期死亡率,具体取决于保守治疗还是手术治疗:本研究对2011年至2022年间在联邦心血管外科中心(俄罗斯,车里雅宾斯克)接受择期冠状动脉旁路移植术(CABG)的8801名患者的数据进行了回顾性分析。其中,196 名患者在术后早期因怀疑围手术期心肌梗死而接受了紧急冠状动脉旁路移植术。119 名患者的冠状动脉旁路移植术出现功能障碍,77 名患者的冠状动脉旁路移植术未发现病理变化。纳入研究的标准是冠状动脉旁路移植功能障碍患者(119 人)。第一组包括接受保守治疗的患者(33 人),第二组(86 人)包括接受重复心肌血管重建术的患者。主要终点是住院死亡率,次要终点是长期死亡率和不良心血管事件(心肌梗死、中风、重复心肌血管重建)。通过电话对患者进行了调查:结果:手术再介入组的院内死亡率为8.1%,保守治疗组为9.1%(P=0.867)。多变量分析结果显示,预测两组患者住院死亡率的因素分别是体外膜氧合(p=0.014)、人工循环时间(p=0.031)、人工通气时间(p=0.001)、重症监护天数(pp=0.06)。在分析心血管原因导致的长期死亡率和不良心血管事件的发生率时,确定了统计学上的显著差异:保守治疗组 - 92.5±9.3[74.2-110.7]个月,而手术治疗组为117.8±3.3[111.2-124.3]个月(log-rank p=0.007);保守治疗组为78.1±9.2[60-96.3]个月,而手术治疗组为98.9±3.9[91.3-106.5]个月(log-rank p=0.008):结论:两组患者的院内死亡率相当。保守治疗组心血管疾病导致的长期死亡率和不良心血管事件的数量明显高于保守治疗组。如果能及时发现冠状动脉旁路移植术的急性功能障碍,积极的手术方法比保守疗法更有优势,并能改善患者的长期预后。
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引用次数: 0
Improvement of Russian clinical guidelines and reduction of mortality in perforated ulcers [提高死亡率 俄罗斯临床指南和减少穿孔溃疡]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia20240215
S I Panin, V P Sazhin

Objective: To analyze the results of laparoscopic surgery in patients with perforated ulcers using evidence-based medicine approaches.

Material and methods: We compared the efficacy and effectiveness of laparoscopic and open surgeries in patients with perforated ulcers. Meta-analysis of mortality after laparoscopic surgeries (randomized controlled trials) and trial sequential analysis were carried out.

Results: We clarified the differences between the efficacy and effectiveness of laparoscopic surgeries regarding postoperative mortality. In the Russian Federation, mortality after laparoscopic surgery is 9-11 times lower compared to open procedures. According to evidence-based researches (efficacy of laparoscopic interventions in 10 meta-analyses), these differences are less obvious (1.4-3.0 times) and not significant. The diversity-adjusted required information size to draw reasonable conclusions about differences in mortality in trial sequential analysis was 68 181 participants. Meta-analyses of RCTs also demonstrate lower incidence of wound complications (1.8-5.0% after laparoscopic surgery and 6.3-13.3% after laparotomy), shorter hospital-stay (mean difference from -0.13 to -2.84) and less severe pain syndrome (mean difference in VAS score from -2.08 to -2.45) after laparoscopic technologies.

Conclusion: The obvious advantage of laparoscopic surgery in patients with perforated ulcers is fast-truck recovery following shorter hospital-stay, mild pain and rarer wound complications. Comparison of postoperative mortality regarding efficacy and effectiveness is difficult due to insufficient introduction of laparoscopic technologies in clinical practice and diversity-adjusted required information size.

目的采用循证医学方法分析腹腔镜手术治疗溃疡穿孔患者的效果:我们比较了腹腔镜手术和开腹手术对溃疡穿孔患者的疗效。对腹腔镜手术(随机对照试验)后的死亡率进行了荟萃分析,并对试验进行了序列分析:结果:我们明确了腹腔镜手术在术后死亡率方面的疗效差异。在俄罗斯联邦,腹腔镜手术后的死亡率比开腹手术低9-11倍。根据循证研究(10 项荟萃分析中的腹腔镜干预疗效),这些差异并不明显(1.4-3.0 倍),也不显著。在试验序列分析中,为就死亡率差异得出合理结论而进行多样性调整后的所需信息量为 68 181 人。RCT的元分析还显示,腹腔镜技术的伤口并发症发生率较低(腹腔镜手术后为1.8-5.0%,开腹手术后为6.3-13.3%),住院时间较短(平均差异从-0.13到-2.84),疼痛综合征较轻(VAS评分的平均差异从-2.08到-2.45):结论:腹腔镜手术在溃疡穿孔患者中的明显优势是住院时间短、疼痛轻微、伤口并发症少、恢复快。由于腹腔镜技术在临床实践中的应用还不够广泛,且所需信息量也不尽相同,因此很难对术后死亡率进行疗效比较。
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引用次数: 0
[D2 and D3 lymph node dissection for colon cancer]. [结肠癌 D2 和 D3 淋巴结清扫术]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202407125
O I Kit, Yu A Gevorkyan, A M Karachun, N V Soldatkina, O K Bondarenko, V E Kolesnikov

Objective: To evaluate surgical and oncological results of standard and extended lymph node dissection (D2 and D3) in patients with colon cancer.

Material and methods: We analyzed treatment outcomes in 74 patients with colon cancer stage T1-4aN0-2M0 who underwent right- and left-sided hemicolectomy, resection of sigmoid colon with standard and extended lymph node dissection (D2 and D3).

Results: Surgical approach and level of D3 lymph node dissection did not increase intra- and postoperative morbidity. Laparoscopic interventions were followed by significantly lower intraoperative blood loss and earlier gas discharge. Metastatic lesion of apical lymph nodes was observed in 5 out of 36 patients who underwent D3 lymph node dissection (13.8%), and metastases in regional lymph nodes rN1-2 were found in all these patients. Overall 5-year survival was 86%. Disease-free and overall 5-year survival were similar after D2 and D3 lymph node dissection.

Conclusion: D3 lymph node dissection is safe for colon cancer. Metastatic lesions of apical lymph nodes during D3 lymph node dissection were detected only in patients with lesions of regional lymph nodes (rN1-2). Disease-free and overall 5-year survival were similar after D2 and D3 lymph node dissection.

摘要评估结肠癌患者接受标准和扩大淋巴结清扫术(D2和D3)的手术和肿瘤学效果:我们分析了74例T1-4aN0-2M0期结肠癌患者的治疗结果,这些患者接受了左右侧半结肠切除术、乙状结肠切除术以及标准和扩大淋巴结清扫术(D2和D3):结果:手术方式和 D3 淋巴结清扫水平不会增加术中和术后发病率。腹腔镜手术后,术中失血量明显减少,出院时间也更早。在接受D3淋巴结清扫术的36例患者中,有5例(13.8%)观察到顶端淋巴结转移病灶,所有这些患者均发现区域淋巴结rN1-2转移。5年总生存率为86%。D2和D3淋巴结清扫术后的无病生存率和5年总生存率相似:结论:D3淋巴结清扫术对结肠癌是安全的。结论:D3淋巴结清扫术对结肠癌是安全的,D3淋巴结清扫术仅在区域淋巴结(rN1-2)有病变的患者中发现根尖淋巴结转移病灶。D2和D3淋巴结清扫术后的无病生存率和5年总生存率相似。
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引用次数: 0
[Laparoscopic nephrectomies and kidney resections in children]. [腹腔镜儿童肾切除术]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202407161
N N Merkulov, D G Akhaladze, G S Rabaev, I V Tverdov, P M Pavlushin, M M Minnullin, D Yu Kachanov, N S Grachev

Objective: To present the experience of laparoscopic nephrectomies and kidney resections in children.

Material and methods: There were 28 minimally invasive surgeries for renal tumors between July 2015 and March 2023 (92 months). There were 16 (57%) boys and 12 (43%) girls who underwent 22 nephrectomies and 6 kidney resections. The median age of patients was 54 (38; 76.5) months.

Results: In the laparoscopic nephrectomy group, the median surgery time was 135 (108-188) min, blood loss - 10 (3.75-15) ml. Total resection was confirmed in all patients. In the group of minimally invasive kidney resections, these values were 182.5 (157.5; 265) min and 50 (42.5; 117.5) ml, respectively. Histological examination confirmed total resection in all patients. In both groups, none patient developed postoperative complications. Event-free survival was 86.72% with a median follow-up of 82 months, and local recurrence-free survival was 95.8% with a median follow-up of 89.8 months.

Conclusion: Minimally invasive nephrectomies and resections are safe in children in case of careful patient selection.

目的:介绍儿童腹腔镜肾切除术和肾脏切除术的经验:介绍儿童腹腔镜肾切除术和肾脏切除术的经验:2015年7月至2023年3月(92个月)期间,共有28例肾脏肿瘤微创手术。其中16名男孩(57%)和12名女孩(43%)接受了22例肾切除术和6例肾切除术。患者的中位年龄为54(38;76.5)个月:腹腔镜肾切除术组的中位手术时间为 135 (108-188) 分钟,失血量为 10 (3.75-15) 毫升。所有患者均确认全切除。在微创肾切除术组中,上述数值分别为 182.5 (157.5; 265) 分钟和 50 (42.5; 117.5) 毫升。组织学检查证实,所有患者都进行了全切除。两组患者均未出现术后并发症。无事件生存率为86.72%,中位随访时间为82个月;无局部复发生存率为95.8%,中位随访时间为89.8个月:结论:在谨慎选择患者的情况下,微创肾切除术对儿童是安全的。
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引用次数: 0
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