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[Vascular reconstruction and transplantation technologies in liver surgery (part II)]. [肝脏手术中的血管重建和移植技术(第二部分)]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202402124
S E Voskanyan, A I Artemiev, E V Naidenov, I Yu Kolyshev, M V Shabalin, A N Bashkov, D V Chursin, H A Subkhonov, D S Raspopov

Objective: To systematize tactical and technical aspects of liver resections with reconstruction of afferent and efferent blood supply and/or inferior vena cava; to study postoperative outcomes in patients with focal liver lesions using transplantation technologies.

Material and methods: We enrolled 413 patients with parasitic lesions, primary and secondary liver tumors involving great vessels (portal vein, hepatic artery, hepatic veins, inferior vena cava, right atrium). All ones underwent liver resections with vascular resection and reconstruction, as well as liver autotransplantation in vivo, ante situ (ex situ in vivo), extracorporeal liver resections with autotransplantation (ex vivo).

Results: We obtained satisfactory immediate results after liver resections using transplantation technologies.

Conclusion: Transplantation technologies in liver surgery can significantly increase resectability of tumors and survival of patients. Transplantation technologies are an important new surgical strategy and necessary option in modern hepatic surgery.

目的:对重建传入和传出血液供应和/或下腔静脉的肝脏切除术的战术和技术方面进行系统化研究;利用移植技术研究病灶性肝脏病变患者的术后效果:我们共招募了413名患有寄生性病变、原发性和继发性肝脏肿瘤并累及大血管(门静脉、肝动脉、肝静脉、下腔静脉、右心房)的患者。所有患者都接受了肝脏切除、血管切除和重建术,以及肝脏在体内、原位(体外原位)、体外肝脏切除和自体移植术(体外移植):结果:使用移植技术进行肝脏切除术后,我们立即获得了令人满意的效果:结论:移植技术在肝脏手术中的应用可显著提高肿瘤的切除率和患者的存活率。移植技术是一种重要的外科新策略,也是现代肝脏手术的必要选择。
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引用次数: 0
[Functional assessment of internal carotid artery tortuosity in patients with multifocal atherosclerosis]. [多灶性动脉粥样硬化患者颈内动脉迂曲的功能评估]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024051146
O I Zagorulko, L A Medvedeva, O V Drakina, E F Dutikova, S P Baidin

The review is devoted to diagnosis and treatment of internal carotid artery tortuosity. The authors consider modern classification, epidemiology and diagnostic options using neuroimaging or ultrasound-assisted functional stress tests depending on medical history and complaints. In addition to standard Doppler ultrasound, rotational and orthostatic tests are advisable due to possible changes of local shape and hemodynamic parameters following body position changes, especially in patients with concomitant atherosclerotic stenosis. Thus, a personalized approach is especially important for treatment and diagnostics of internal carotid artery tortuosity.

这篇综述专门讨论颈内动脉迂曲的诊断和治疗。作者根据病史和主诉,考虑了现代的分类、流行病学以及神经影像学或超声辅助功能压力测试的诊断方案。除了标准的多普勒超声检查外,由于体位变化可能导致局部形状和血液动力学参数发生变化,因此建议进行旋转和正位测试,尤其是对合并动脉粥样硬化性狭窄的患者。因此,个性化方法对于颈内动脉迂曲的治疗和诊断尤为重要。
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引用次数: 0
[Intraductal radiofrequency ablation for neoplasms of the major duodenal papilla with intraductal spread]. [导管内射频消融术治疗十二指肠大乳头伴导管内扩散的肿瘤]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia20240615
Yu G Starkov, A I Vagapov, R D Zamolodchikov, S V Dzantukhanova

Objective: To analyze the efficacy of intraductal radiofrequency ablation (RFA) for neoplasms of the major duodenal papilla with intraductal spread.

Material and methods: Eleven patients with adenomas of the major duodenal papilla and intraductal spread underwent intraductal RFA between 2022 and 2023. Spread to the common bile duct ranged from 10 to 30 mm, to the main pancreatic duct - from 5 to 11 mm.

Results: Technical success was achieved in all cases. Complications after intraductal RFA occurred in 4 cases (post-manipulation pancreatitis - 2 cases, repeated intraductal RFA for residual adenomatous growths - 2 cases). Technical success of stenting of the main pancreatic and common bile ducts was achieved in all cases.

Conclusion: Intraductal radiofrequency ablation for neoplasms of the major duodenal papilla with intraductal spread ensured complete destruction of intraductal tumor with adequate clinical effect and no need for highly traumatic surgery.

摘要分析导管内射频消融术(RFA)对伴有导管内扩散的十二指肠大乳头肿瘤的疗效:11例十二指肠大乳头腺瘤伴导管内扩散的患者在2022年至2023年间接受了导管内射频消融术。向胆总管扩散的范围为10至30毫米,向主胰管扩散的范围为5至11毫米:结果:所有病例都取得了技术成功。4例患者在导管内射频消融术后出现并发症(2例为操作后胰腺炎,2例为残留腺瘤生长重复导管内射频消融术)。所有病例均成功完成了主胰管和胆总管支架技术:结论:导管内射频消融术治疗十二指肠大乳头伴导管内扩散的肿瘤,确保了导管内肿瘤的完全摧毁,具有充分的临床疗效,且无需进行高创伤性手术。
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引用次数: 0
[The results of clinical application of the mesh with anti-adhesive fluoropolymer coating in laparoscopic intraperitoneal repair of primary ventral hernia]. [在腹腔镜腹膜内原发性腹股沟疝修补术中应用带防粘氟聚合物涂层网片的临床效果]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202405186
A M Belousov, S L Nepomnyashchaya, V N Danilin, K O Timofeeva, V P Armashov, S A Makarov, N L Matveev

Objective: The purpose of the study was to evaluate the results of using fluoropolymer-coated mesh during intraperitoneal onlay mesh hernia repair in patients with primary ventral hernias.

Material and methods: The multicenter, non-randomized, controlled clinical study included 88 patients of both sexes who were operated on using a laparoscopic approach using the IPOM technique for a primary ventral hernia. The duration of observation ranged from 3 to 12 months. In the main group, 48 patients received fluoropolymer-coated meshes (Ftorex). A comparison was made with a retrospective group of 40 patients who were treated with anti-adhesive collagen-coated meshes (Parietene composite, Parietex Composite, Symbotex).

Results: The number of early and late postoperative complications in the groups did not have significant differences, at the same time, their number was lower in the group of patients in whom fluoropolymer-coated meshes were used. Most of the complications corresponded to Clavien-Dindo class I and II and did not pose a significant threat to health. There were no recurrences of hernias observed in patients included in the study. There were slightly more adhesions in the fluoropolymer-coated mesh group (35.4% vs. 25.0% in the collagen-coated mesh group). The quality of life of patients in the study groups did not differ.

Conclusion: In laparoscopic IPOM hernia repair fluoropolymer-coated meshes are not inferior in effectiveness and safety to traditionally used collagen-coated meshes and can be recommended for use in patients with primary ventral hernias.

研究目的该研究的目的是评估原发性腹股沟疝患者在腹腔内镶嵌网片疝修补术中使用含氟聚合物涂层网片的效果:这项多中心、非随机对照临床研究纳入了88名使用IPOM技术腹腔镜手术治疗原发性腹股沟疝的男女患者。观察时间从 3 个月到 12 个月不等。在主要组别中,48 名患者接受了氟聚合物涂层网片(Ftorex)。结果显示,术后早期和晚期疝气患者的数量均有所下降:结果:各组术后早期和晚期并发症的数量无明显差异,同时,使用含氟聚合物涂层网片的患者术后并发症的数量较少。大多数并发症属于克拉维恩-丁多(Clavien-Dindo)Ⅰ级和Ⅱ级,不会对健康造成重大威胁。研究中没有发现疝气复发的患者。氟聚合物涂层网片组的粘连率稍高(35.4% 对胶原涂层网片组的 25.0%)。研究组患者的生活质量没有差异:在腹腔镜 IPOM 疝修补术中,涂氟聚合物的网片在有效性和安全性方面并不逊色于传统使用的涂胶原蛋白的网片,可推荐用于原发性腹股沟疝患者。
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引用次数: 0
[Predictors of atrial fibrillation recurrence after biatrial cryo-maze procedure: a systematic review]. [双心房低温迷宫术后心房颤动复发的预测因素:系统综述]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024111100
R N Komarov, D A Matsuganov, M D Nuzhdin, D O Bystrov

Today, the issue of atrial fibrillation recurrence after ablation is increasingly discussed in the literature. Many authors analyze the factors predicting success or failure of cryo-maze procedure. This review is devoted to predictors of atrial fibrillation recurrence in long-term period after biatrial cryo-maze procedure. Primary screening identified 48 studies. There were 27 articles after removing duplicate articles, case reports and articles with unavailable full-text versions. Two independent researchers reviewed the full-text articles and enrolled 11 and 14 articles, respectively. After collegial discussion and involving the third researcher, we selected 13 articles for final analysis. It was established that atrial enlargement and duration of atrial fibrillation are the main independent predictors of recurrence in long-term period.

如今,有关消融术后心房颤动复发问题的文献讨论越来越多。许多学者分析了预测冷冻迷宫术成功或失败的因素。本综述主要探讨双心房低温迷宫术后长期心房颤动复发的预测因素。初筛确定了 48 项研究。去除重复文章、病例报告和无法获得全文版本的文章后,共有 27 篇文章。两位独立研究人员对全文进行了审阅,分别选取了 11 篇和 14 篇文章。经过共同讨论并邀请第三位研究人员参与后,我们选择了 13 篇文章进行最终分析。研究证实,心房扩大和心房颤动持续时间是长期复发的主要独立预测因素。
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引用次数: 0
[Cerebral protection in transcatheter aortic valve implantation]. [经导管主动脉瓣植入术中的脑保护]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024122150
Z A Kavteladze, P M Ermolaev, S Yu Danilenko, V M Nadaraya

The review is devoted to transcatheter aortic valve implantation (TAVI). Aortic stenosis (AS) is one of the most common valve diseases in the world and cause of premature death. TAVI is an important advance in the treatment of patients with severe aortic stenosis, particularly in those with moderate and high surgical risk. However, this method has some complications. Stroke prevention and development of strategies reducing the incidence of this event are not only important therapeutic goals for patients undergoing TAVI, but also have significant economic implications.

本文对经导管主动脉瓣植入术(TAVI)进行综述。主动脉瓣狭窄(Aortic stenosis, AS)是世界上最常见的瓣膜疾病之一,也是导致过早死亡的原因。TAVI是治疗严重主动脉瓣狭窄患者的重要进展,特别是对于那些有中高手术风险的患者。然而,这种方法有一些复杂性。卒中预防和降低卒中发生率的策略不仅是TAVI患者的重要治疗目标,而且具有重要的经济意义。
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引用次数: 0
[Clinical efficacy of carbohydrate preloading in reconstructive esophageal surgery]. [碳水化合物预负荷在食管重建手术中的临床疗效]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202412283
I A Tarasova, A T Tshkovrebov, T T Bitarov, I A Boeva, M Yu Ivanova, A L Shestakov

Objective: To evaluate clinical efficacy of preoperative carbohydrate loading as a component of ERAS in esophageal reconstructive surgery.

Material and methods: Post hoc analysis included 162 patients who underwent esophageal reconstructive interventions with ERAS principles between 2014 and 2024. The main group (n=61, CHO+) included patients who were metabolically loaded with carbohydrates in preoperative period with 12.5% maltodextrin solution 800 mL the day before and 400 mL 2 hours before surgery per os or enterally. The control group consisted of patients without carbohydrate load (n=101, CHO-). Primary endpoint was length of hospital-stay, secondary control points - postoperative glycemia and complication rate.

Results: Both groups were comparable in sex, age, character of the main and comorbid diseases, body mass index. Patients with CHO had significant lower incidence of respiratory complications (p=0.034). Both groups did not differ in the incidence of anastomosis failure, morbidity and mortality.

Conclusion: Preoperative carbohydrate loading in esophageal reconstructive surgery positively affects metabolic status and reduces the incidence of respiratory complications without effect on length of hospital-stay.

目的:评价食道重建手术中术前碳水化合物负荷作为ERAS组成部分的临床疗效。材料和方法:事后分析纳入了2014年至2024年间采用ERAS原则进行食管重建介入治疗的162例患者。主要组(n=61, CHO+)包括术前代谢负荷碳水化合物的患者,术前1天使用12.5%麦芽糊精溶液800 mL,术前2小时每日或肠内使用400 mL。对照组为无碳水化合物负荷患者(n=101, CHO-)。主要终点是住院时间,次要控制点是术后血糖和并发症发生率。结果:两组患者在性别、年龄、主要疾病及合并症特征、体重指数等方面具有可比性。CHO患者呼吸系统并发症发生率明显低于对照组(p=0.034)。两组吻合失败发生率、发病率和死亡率均无差异。结论:食道重建手术术前碳水化合物负荷对代谢状态有积极影响,可减少呼吸并发症的发生率,但不影响住院时间。
{"title":"[Clinical efficacy of carbohydrate preloading in reconstructive esophageal surgery].","authors":"I A Tarasova, A T Tshkovrebov, T T Bitarov, I A Boeva, M Yu Ivanova, A L Shestakov","doi":"10.17116/hirurgia202412283","DOIUrl":"https://doi.org/10.17116/hirurgia202412283","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate clinical efficacy of preoperative carbohydrate loading as a component of ERAS in esophageal reconstructive surgery.</p><p><strong>Material and methods: </strong>Post hoc analysis included 162 patients who underwent esophageal reconstructive interventions with ERAS principles between 2014 and 2024. The main group (<i>n</i>=61, CHO+) included patients who were metabolically loaded with carbohydrates in preoperative period with 12.5% maltodextrin solution 800 mL the day before and 400 mL 2 hours before surgery per os or enterally. The control group consisted of patients without carbohydrate load (<i>n</i>=101, CHO-). Primary endpoint was length of hospital-stay, secondary control points - postoperative glycemia and complication rate.</p><p><strong>Results: </strong>Both groups were comparable in sex, age, character of the main and comorbid diseases, body mass index. Patients with CHO had significant lower incidence of respiratory complications (<i>p</i>=0.034). Both groups did not differ in the incidence of anastomosis failure, morbidity and mortality.</p><p><strong>Conclusion: </strong>Preoperative carbohydrate loading in esophageal reconstructive surgery positively affects metabolic status and reduces the incidence of respiratory complications without effect on length of hospital-stay.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 12. Vyp. 2","pages":"83-90"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814365","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}
引用次数: 0
[Iron deficiency anemia in patients with hiatal hernias]. [食道裂孔疝缺铁性贫血]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202412277
A L Shestakov, T T Bitarov, I A Boeva, A T Tskchovrebov, I A Tarasova, D V Afanasyev, A A Moskvin

Hiatal hernia may be accompanied by chronic bleeding from erosions and subsequent iron deficiency anemia. This anemia is drug-resistant in 5-10% of patients with hiatal hernia. In this case, the only approach is antireflux surgery for hiatal hernia repair.

Material and methods: A prospective examination of 42 patients with hiatal hernia and concomitant iron deficiency anemia was conducted between 2023 and 2024. To identify latent iron deficiency anemia, patients underwent in-depth laboratory tests. All patients underwent original fundoplication. The results were assessed in 6 and 12 months after surgery.

Results: Favorable functional results with disappearance of reflux esophagitis symptoms were obtained in 39 patients (92.8%). The follow-up laboratory tests after 6 months revealed higher hemoglobin and normal serum iron in 35 (94.5%) out of 37 available patients. Patients did not take iron supplements during the second half of the year, but hemoglobin and serum iron were normal.

Conclusion: Original fundoplication demonstrates high efficiency in patients with hiatal hernia and concomitant chronic iron deficiency anemia.

裂孔疝可伴有糜烂引起的慢性出血和随后的缺铁性贫血。这种贫血在5-10%的裂孔疝患者中具有耐药性。在这种情况下,唯一的方法是抗反流手术治疗裂孔疝修补。材料与方法:对2023 - 2024年间42例裂孔疝合并缺铁性贫血患者进行前瞻性研究。为了识别潜在的缺铁性贫血,患者接受了深入的实验室检查。所有患者均行原发眼底复制。分别于术后6个月和12个月对结果进行评估。结果:39例(92.8%)患者功能恢复良好,反流性食管炎症状消失。6个月后的随访实验室检查显示,37例患者中有35例(94.5%)血红蛋白升高,血清铁正常。患者在下半年没有服用铁补充剂,但血红蛋白和血清铁正常。结论:原底吻合术治疗裂孔疝合并慢性缺铁性贫血疗效显著。
{"title":"[Iron deficiency anemia in patients with hiatal hernias].","authors":"A L Shestakov, T T Bitarov, I A Boeva, A T Tskchovrebov, I A Tarasova, D V Afanasyev, A A Moskvin","doi":"10.17116/hirurgia202412277","DOIUrl":"https://doi.org/10.17116/hirurgia202412277","url":null,"abstract":"<p><p>Hiatal hernia may be accompanied by chronic bleeding from erosions and subsequent iron deficiency anemia. This anemia is drug-resistant in 5-10% of patients with hiatal hernia. In this case, the only approach is antireflux surgery for hiatal hernia repair.</p><p><strong>Material and methods: </strong>A prospective examination of 42 patients with hiatal hernia and concomitant iron deficiency anemia was conducted between 2023 and 2024. To identify latent iron deficiency anemia, patients underwent in-depth laboratory tests. All patients underwent original fundoplication. The results were assessed in 6 and 12 months after surgery.</p><p><strong>Results: </strong>Favorable functional results with disappearance of reflux esophagitis symptoms were obtained in 39 patients (92.8%). The follow-up laboratory tests after 6 months revealed higher hemoglobin and normal serum iron in 35 (94.5%) out of 37 available patients. Patients did not take iron supplements during the second half of the year, but hemoglobin and serum iron were normal.</p><p><strong>Conclusion: </strong>Original fundoplication demonstrates high efficiency in patients with hiatal hernia and concomitant chronic iron deficiency anemia.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 12. Vyp. 2","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814402","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}
引用次数: 0
[History of anti-embolic protection in cardiac surgery]. 【心脏手术中抗栓塞保护的历史】。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024122139
Z A Kavteladze, P M Ermolaev, S Yu Danilenko, V M Nadaraya

The review is devoted to history of anti-embolic protection system, in particular protection against cerebral embolism, in cardiac surgery and endovascular surgery. Cerebral embolism is a common and dangerous complication in cardiovascular surgery, leading to disability of patients and significantly impairing treatment outcomes. Prevention of embolic complications is an urgent task in correction of heart valve disease in cardiac and endovascular surgery.

综述了心脏外科和血管内手术中抗栓塞保护系统的发展历史,特别是对脑栓塞的保护。脑栓塞是心血管手术中一种常见且危险的并发症,可导致患者残疾并显著影响治疗结果。预防栓塞并发症是心脏及血管内手术中心脏瓣膜疾病矫治的紧迫任务。
{"title":"[History of anti-embolic protection in cardiac surgery].","authors":"Z A Kavteladze, P M Ermolaev, S Yu Danilenko, V M Nadaraya","doi":"10.17116/hirurgia2024122139","DOIUrl":"https://doi.org/10.17116/hirurgia2024122139","url":null,"abstract":"<p><p>The review is devoted to history of anti-embolic protection system, in particular protection against cerebral embolism, in cardiac surgery and endovascular surgery. Cerebral embolism is a common and dangerous complication in cardiovascular surgery, leading to disability of patients and significantly impairing treatment outcomes. Prevention of embolic complications is an urgent task in correction of heart valve disease in cardiac and endovascular surgery.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 12. Vyp. 2","pages":"139-149"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814451","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}
引用次数: 0
[Modern aspects of photo and laser therapy for wound infection in surgical practice]. [外科手术中伤口感染的光和激光治疗的现代方面]。
Q4 Medicine Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024122134
I A Vinokurov, D G Tagabilev, N B Korchazhkina, A A Mikhailova, K V Kotenko, O V Bogolepova

The review is devoted to modern treatment technologies for wound infection. The majority of studies are devoted to pharmacological and surgical methods. A few reports describe non-drug methods including photo and laser therapy. We analyze the main types of phototherapy for complicated wound infection, mechanisms of action and therapeutic effects.

本文综述了伤口感染的现代治疗技术。大多数研究都致力于药理学和外科方法。一些报告描述了包括光和激光治疗在内的非药物方法。本文分析了光疗治疗复杂伤口感染的主要类型、作用机制及治疗效果。
{"title":"[Modern aspects of photo and laser therapy for wound infection in surgical practice].","authors":"I A Vinokurov, D G Tagabilev, N B Korchazhkina, A A Mikhailova, K V Kotenko, O V Bogolepova","doi":"10.17116/hirurgia2024122134","DOIUrl":"https://doi.org/10.17116/hirurgia2024122134","url":null,"abstract":"<p><p>The review is devoted to modern treatment technologies for wound infection. The majority of studies are devoted to pharmacological and surgical methods. A few reports describe non-drug methods including photo and laser therapy. We analyze the main types of phototherapy for complicated wound infection, mechanisms of action and therapeutic effects.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 12. Vyp. 2","pages":"134-138"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814406","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}
引用次数: 0
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Khirurgiya
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