Pub Date : 2021-12-21DOI: 10.24060/2076-3093-2021-11-4-284-287
S. P. Muzhikov, M. Eremenko, A. Baryshev
Background. Laparoscopic adrenalectomy is the current surgery of choice in most adrenal tumours, with a nearly 11 % complication rate and below 1 % mortality. Laparoscopy combines the advantages of minimally invasive surgery with well-known long-term prognosis of a traditional open surgery, at the same time requiring the surgeon’s skill of knowing the technique and avoiding complication.Aim. Concept definition of safe laparoscopic adrenalectomy.Materials and methods. A total of 28 patients with adrenal neoplasms were rendered laparoscopic adrenalectomy by same surgical team under benchmark recommendations during 2016–2019.Results. All patients have been discharged in satisfactory condition, with no intra-, postoperative complications or lethal outcomes.Discussion. Th e evidence presented displays feasibility of using the benchmark principles in laparoscopic adrenalectomy surgery. Laparoscopic adrenalectomy is superior in reducing the recovery time, surgical trauma, complication incidence, length of hospital stay, treatment cost, the improvement of overall wellbeing post-surgery and patients’ quality of life. Th ese principles proved effective to avoid intra- and postoperative complications of laparoscopic adrenalectomy and facilitated revamping of the operation technique in left -sided adrenalectomy.Conclusion. Th e benchmark principles of laparoscopic adrenalectomy enable the procedure higher efficacy and safety and require further implementation and long-term assessment of the outcome.
{"title":"Laparoscopic Adrenalectomy: Preventive Principles in Intra- and Postoperative Complications","authors":"S. P. Muzhikov, M. Eremenko, A. Baryshev","doi":"10.24060/2076-3093-2021-11-4-284-287","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-284-287","url":null,"abstract":"Background. Laparoscopic adrenalectomy is the current surgery of choice in most adrenal tumours, with a nearly 11 % complication rate and below 1 % mortality. Laparoscopy combines the advantages of minimally invasive surgery with well-known long-term prognosis of a traditional open surgery, at the same time requiring the surgeon’s skill of knowing the technique and avoiding complication.Aim. Concept definition of safe laparoscopic adrenalectomy.Materials and methods. A total of 28 patients with adrenal neoplasms were rendered laparoscopic adrenalectomy by same surgical team under benchmark recommendations during 2016–2019.Results. All patients have been discharged in satisfactory condition, with no intra-, postoperative complications or lethal outcomes.Discussion. Th e evidence presented displays feasibility of using the benchmark principles in laparoscopic adrenalectomy surgery. Laparoscopic adrenalectomy is superior in reducing the recovery time, surgical trauma, complication incidence, length of hospital stay, treatment cost, the improvement of overall wellbeing post-surgery and patients’ quality of life. Th ese principles proved effective to avoid intra- and postoperative complications of laparoscopic adrenalectomy and facilitated revamping of the operation technique in left -sided adrenalectomy.Conclusion. Th e benchmark principles of laparoscopic adrenalectomy enable the procedure higher efficacy and safety and require further implementation and long-term assessment of the outcome.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48961574","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 : 2021-12-21DOI: 10.24060/2076-3093-2021-11-4-300-306
O. Galimov, V. O. Khanov, V. Ishmetov, T. R. Ibragimov, A. F. Biglova, R. S. Sufiyarov
Background. The study aimed to improve treatment outcomes in diabetic foot syndrome patients by use of invasive pressure monitoring during arterial radiological interventions.Materials and methods. A total of 36 patients with type 2 diabetes and purulent necrotic lesions of lower extremities have been treated at the surgery unit of Bashkir State Medical University Clinic during 2019—2020, with 12 persons forming the main cohort and receiving the measures complemented with the newly developed “X-ray endovascular intraoperative significance evaluation of lower limb arterial stenosis” technique (Patent RU 2737215 of 26.11.2020). The control cohort comprised 24 patients following pertinent standard treatment and recommendations in this pathology.Results and discussion. Immediate treatment outcomes were evaluated by person in the main and control cohorts. Longterm outcomes were observed at 6, 12 and 24 months since hospital discharge in 10 (83.3 %) patients of the main and 19 (79.2 %) — of the control cohort. In a 2-year run, the limb was kept in 8 (66.7 %) patients having the new revascularisation technique and in 10 (41.7 %) persons of the control cohort (p < 0.05).Conclusion. The use of endovascular radiology for limb revascularisation and intraoperative significance monitoring of lower limb arterial stenosis allow the volume determination of balloon angioplasty and statement of revascularisation completeness.
{"title":"Angiographic Therapies for Diabetic Foot Syndrome","authors":"O. Galimov, V. O. Khanov, V. Ishmetov, T. R. Ibragimov, A. F. Biglova, R. S. Sufiyarov","doi":"10.24060/2076-3093-2021-11-4-300-306","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-300-306","url":null,"abstract":"Background. The study aimed to improve treatment outcomes in diabetic foot syndrome patients by use of invasive pressure monitoring during arterial radiological interventions.Materials and methods. A total of 36 patients with type 2 diabetes and purulent necrotic lesions of lower extremities have been treated at the surgery unit of Bashkir State Medical University Clinic during 2019—2020, with 12 persons forming the main cohort and receiving the measures complemented with the newly developed “X-ray endovascular intraoperative significance evaluation of lower limb arterial stenosis” technique (Patent RU 2737215 of 26.11.2020). The control cohort comprised 24 patients following pertinent standard treatment and recommendations in this pathology.Results and discussion. Immediate treatment outcomes were evaluated by person in the main and control cohorts. Longterm outcomes were observed at 6, 12 and 24 months since hospital discharge in 10 (83.3 %) patients of the main and 19 (79.2 %) — of the control cohort. In a 2-year run, the limb was kept in 8 (66.7 %) patients having the new revascularisation technique and in 10 (41.7 %) persons of the control cohort (p < 0.05).Conclusion. The use of endovascular radiology for limb revascularisation and intraoperative significance monitoring of lower limb arterial stenosis allow the volume determination of balloon angioplasty and statement of revascularisation completeness.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43514323","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 : 2021-12-21DOI: 10.24060/2076-3093-2021-11-4-307-315
I. Lutfarakhmanov, Sergey T. Lazarev, N. A. Zdorik, A. Lifanova, A. Grazhdankin, Galeev, Ilnur I. Musin, Pyotr I. Mironov, Valentin N. Pavlov
Background. Robot-assisted pelvic surgery rapidly becomes a choice in surgeries for gynaecological oncology and urology. These interventions require special settings (pneumoperitonaeum and Trendelenburg position), which inevitably and systemically impact oxygen transport. Low oxygen delivery during surgery associates with manifold adverse outcomes. A single universal oxygen delivery threshold is impractical, as oxygen consumption must be taken into account. This study examines the effects of pneumoperitonaeum and Trendelenburg position on oxygen transport in patients of ASA functional class I–III (as per American Society of Anaesthesiologists).Materials and methods. Delivery, consumption, oxygen extraction, perioperative adverse events and type of general anaesthesia were prospectively studied in 126 adult patients.Results and discussion. Mean oxygen consumption was 242 mL/min/m2 , mean oxygen delivery — 612 mL/min/m2 . Oxygen delivery was below median 529 mL/min/m2 in 54 (43 %) patients. Perioperative adverse events developed in 36 (29 %) patients. A strong correlation (r > 0.500; p<0.001) between oxygen delivery and consumption was observed in 54 patients. Blood lactate level of 2.7 mmol/L at surgery end was indicative of inadequate oxygen delivery.Conclusion. No relationship was revealed between oxygen delivery and adverse perioperative events, and neither — between oxygen delivery and consumption relative to a particular anaesthetic.
{"title":"Anaesthesia-Specifi c Oxygen Transport Assessment in Robot-Assisted Pelvic Surgery: a Clinical Trial","authors":"I. Lutfarakhmanov, Sergey T. Lazarev, N. A. Zdorik, A. Lifanova, A. Grazhdankin, Galeev, Ilnur I. Musin, Pyotr I. Mironov, Valentin N. Pavlov","doi":"10.24060/2076-3093-2021-11-4-307-315","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-307-315","url":null,"abstract":"Background. Robot-assisted pelvic surgery rapidly becomes a choice in surgeries for gynaecological oncology and urology. These interventions require special settings (pneumoperitonaeum and Trendelenburg position), which inevitably and systemically impact oxygen transport. Low oxygen delivery during surgery associates with manifold adverse outcomes. A single universal oxygen delivery threshold is impractical, as oxygen consumption must be taken into account. This study examines the effects of pneumoperitonaeum and Trendelenburg position on oxygen transport in patients of ASA functional class I–III (as per American Society of Anaesthesiologists).Materials and methods. Delivery, consumption, oxygen extraction, perioperative adverse events and type of general anaesthesia were prospectively studied in 126 adult patients.Results and discussion. Mean oxygen consumption was 242 mL/min/m2 , mean oxygen delivery — 612 mL/min/m2 . Oxygen delivery was below median 529 mL/min/m2 in 54 (43 %) patients. Perioperative adverse events developed in 36 (29 %) patients. A strong correlation (r > 0.500; p<0.001) between oxygen delivery and consumption was observed in 54 patients. Blood lactate level of 2.7 mmol/L at surgery end was indicative of inadequate oxygen delivery.Conclusion. No relationship was revealed between oxygen delivery and adverse perioperative events, and neither — between oxygen delivery and consumption relative to a particular anaesthetic.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48241496","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 : 2021-12-21DOI: 10.24060/2076-3093-2021-11-4-288-292
V. A. Ananev, V. Pavlov, A. M. Pushkarev
Background. Modern minimally invasive surgical techniques reduce traumatism of operative interventions and aggressive anaesthesia, which accordingly shortens the patient’s hospital stay and rehabilitation period.Aim. An improvement of surgical outcomes in patients with purulent pyelonephritis via introduction of laparoscopic techniques.Materials and methods. Th e study included 80 purulent pyelonephritis patients operated at the Territorial Clinical Hospital during 2006—2018. Th e patients were divided between two cohorts. Cohort 1 included 40 (50 %) patients operated with standard techniques (ST), cohort 2 — 40 (50 %) patients having surgery by an original minimally invasive technique (OT). Kidney decapsulation was found to outcome in parenchymal decompression and blood circulation restore in cortical layer. Intraarterial infusion of alprostadil prevents further spread of purulent-destructive processes in kidney.Results and discussion. In patients with the minimally invasive technique, postoperative period proceeded at no complications. On day 1, the patients reported reduced pain syndrome in the surgical area. Contrasted renal MSCT before and aft er surgery showed the recovery of renal blood flow and significant diminishing of destruction foci in short term. Nephrectomy was not performed as no-indication.Conclusion. The treatment outcomes in 40 patients having the new surgical technique demonstrate its efficacy and applicability in clinical practice.
{"title":"Comparative Assessment of Original vs. Standard Surgery Techniques in Treatment for Purulent Pyelonephritis","authors":"V. A. Ananev, V. Pavlov, A. M. Pushkarev","doi":"10.24060/2076-3093-2021-11-4-288-292","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-288-292","url":null,"abstract":"Background. Modern minimally invasive surgical techniques reduce traumatism of operative interventions and aggressive anaesthesia, which accordingly shortens the patient’s hospital stay and rehabilitation period.Aim. An improvement of surgical outcomes in patients with purulent pyelonephritis via introduction of laparoscopic techniques.Materials and methods. Th e study included 80 purulent pyelonephritis patients operated at the Territorial Clinical Hospital during 2006—2018. Th e patients were divided between two cohorts. Cohort 1 included 40 (50 %) patients operated with standard techniques (ST), cohort 2 — 40 (50 %) patients having surgery by an original minimally invasive technique (OT). Kidney decapsulation was found to outcome in parenchymal decompression and blood circulation restore in cortical layer. Intraarterial infusion of alprostadil prevents further spread of purulent-destructive processes in kidney.Results and discussion. In patients with the minimally invasive technique, postoperative period proceeded at no complications. On day 1, the patients reported reduced pain syndrome in the surgical area. Contrasted renal MSCT before and aft er surgery showed the recovery of renal blood flow and significant diminishing of destruction foci in short term. Nephrectomy was not performed as no-indication.Conclusion. The treatment outcomes in 40 patients having the new surgical technique demonstrate its efficacy and applicability in clinical practice.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41456058","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 : 2021-12-21DOI: 10.24060/2076-3093-2021-11-4-328-336
D. Ryabchikov, S. Chulkova, Farkhad A. Shamilov, Naily V. Chanturiya, S. D. Zheltikov, N. Tupitsyn
Breast cancer (BC) is most prevalent female malignancy worldwide. Despite advances in BC diagnosis and progress in drug therapy, a series of challenges associated with emergent tumour resistance causing the disease escalation still remain. Immune evasion is among the driving forces of tumour resistance against modern treatments, which promotes world-active research into the mechanisms of tumour—immune interaction.Tumour microenvironment is known to contribute greatly to the nature of this interaction. Immune cells are constitutive of tumour microenvironment as tumour-associated macrophages, myeloid-derived suppressor cells and tumour-infi ltrating lymphocytes. Tumour-infi ltrating lymphocytes are represented by B-, T- and NK-cells, which localisation and subpopulation structure in tumour may possess a prognostic and clinical significance. Th e infi ltration density by certain effector cell types prior to chemotherapy is an important predictor of patient survival. Putting otherwise, the presence of effector lymphocyte subpopulations in tumour defi nes the strength of antitumour immunity and may establish the success of drug treatment.This study analysed the infiltration levels of CD3, CD4, CD20 and CD38 lymphocytes in several molecular BC subtypes. Tumour immunophenotyping was performed in cryosectioning and immunofl uorescence assays with a ZEISS AXIOSKOP microscope, Germany. We analysed 96 luminal BC (37 subtype A (38.5 %), 52 B-Her2-negative subtype (54.2 %), 7 B-Her2-positive subtype (7.3 %)) and non-luminal BC samples (3 HER2+ subtype (14.3 %), 18 triple-negative subtype (85.7 %)). The infiltration and antigen expression patterns have been assessed. Analyses of tumour-infi ltrating subpopulations revealed lower infiltration in luminal BC vs. other subtypes, albeit at no significance.
{"title":"Intratumoural Effector Cell Subpopulations in Breast Cancer: a Literature Review and Own Data Report","authors":"D. Ryabchikov, S. Chulkova, Farkhad A. Shamilov, Naily V. Chanturiya, S. D. Zheltikov, N. Tupitsyn","doi":"10.24060/2076-3093-2021-11-4-328-336","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-328-336","url":null,"abstract":"Breast cancer (BC) is most prevalent female malignancy worldwide. Despite advances in BC diagnosis and progress in drug therapy, a series of challenges associated with emergent tumour resistance causing the disease escalation still remain. Immune evasion is among the driving forces of tumour resistance against modern treatments, which promotes world-active research into the mechanisms of tumour—immune interaction.Tumour microenvironment is known to contribute greatly to the nature of this interaction. Immune cells are constitutive of tumour microenvironment as tumour-associated macrophages, myeloid-derived suppressor cells and tumour-infi ltrating lymphocytes. Tumour-infi ltrating lymphocytes are represented by B-, T- and NK-cells, which localisation and subpopulation structure in tumour may possess a prognostic and clinical significance. Th e infi ltration density by certain effector cell types prior to chemotherapy is an important predictor of patient survival. Putting otherwise, the presence of effector lymphocyte subpopulations in tumour defi nes the strength of antitumour immunity and may establish the success of drug treatment.This study analysed the infiltration levels of CD3, CD4, CD20 and CD38 lymphocytes in several molecular BC subtypes. Tumour immunophenotyping was performed in cryosectioning and immunofl uorescence assays with a ZEISS AXIOSKOP microscope, Germany. We analysed 96 luminal BC (37 subtype A (38.5 %), 52 B-Her2-negative subtype (54.2 %), 7 B-Her2-positive subtype (7.3 %)) and non-luminal BC samples (3 HER2+ subtype (14.3 %), 18 triple-negative subtype (85.7 %)). The infiltration and antigen expression patterns have been assessed. Analyses of tumour-infi ltrating subpopulations revealed lower infiltration in luminal BC vs. other subtypes, albeit at no significance.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41708291","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 : 2021-10-01DOI: 10.24060/2076-3093-2021-11-3-228-234
N. V. Kharitonov, V. V. Vitsukaev, N. A. Trofimov, P. D. Makalsky, V. N. Zavgorodny
Coronary heart disease remains a leading cause of death worldwide, and coronary bypass surgery -- the treatment standard in haemodynamically significant multivessel and/or trunk coronary stenosis. Intraoperative haemodynamics support during coronary artery bypass grafting (CABG) in patients with reduced ejection fraction currently remains controversial. Manifold evidence favours CABG with no extracorporeal circulation in higher risk patients to avoid the system’s frequent complications of blood transfusion, renal failure, bleeding, wound infection, cerebrovascular events and humoral disturbances. On the other hand, CABG with extracorporeal circulation and heart arrest allows a bloodless operating field and complete revascularisation in most, often very complex, cases. The complication rate and outcome in beating-heart surgery are reckoned to depend directly on the relevant surgeon’s and clinic experience, which makes many relinquish the technique due to a limited history of skill. This essay overviews the current state of the art, discussions of recent systematic studies on intraoperative haemodynamics support in patients with reduced left ventricular ejection fraction and touches upon the importance of surgeon’s experience for the operation outcome.
{"title":"Haemodynamics Support during Surgical Myocardial Revascularisation in Patients with Systolic Left Ventricular Dysfunction","authors":"N. V. Kharitonov, V. V. Vitsukaev, N. A. Trofimov, P. D. Makalsky, V. N. Zavgorodny","doi":"10.24060/2076-3093-2021-11-3-228-234","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-3-228-234","url":null,"abstract":"Coronary heart disease remains a leading cause of death worldwide, and coronary bypass surgery -- the treatment standard in haemodynamically significant multivessel and/or trunk coronary stenosis. Intraoperative haemodynamics support during coronary artery bypass grafting (CABG) in patients with reduced ejection fraction currently remains controversial. Manifold evidence favours CABG with no extracorporeal circulation in higher risk patients to avoid the system’s frequent complications of blood transfusion, renal failure, bleeding, wound infection, cerebrovascular events and humoral disturbances. On the other hand, CABG with extracorporeal circulation and heart arrest allows a bloodless operating field and complete revascularisation in most, often very complex, cases. The complication rate and outcome in beating-heart surgery are reckoned to depend directly on the relevant surgeon’s and clinic experience, which makes many relinquish the technique due to a limited history of skill. This essay overviews the current state of the art, discussions of recent systematic studies on intraoperative haemodynamics support in patients with reduced left ventricular ejection fraction and touches upon the importance of surgeon’s experience for the operation outcome.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48281421","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 : 2021-10-01DOI: 10.24060/2076-3093-2021-11-3-256-259
V. P. Bodduluri, K. Gurevich, A. Urakov
The treatment of long-term non-healing wounds in the conditions of purulent surgery departments, widely uses solutions of chemotherapeutic and antiseptic agents. The most common are the solutions of 3–6 % hydrogen peroxide and solutions of 2–10 % sodium chloride. As a rule, solutions of these drugs are used to treat non-healing, particularly, purulent wounds, bedsores and trophic ulcers. Therefore, solutions are injected into the wound area repeatedly in the form of course therapy. The findings show that the mechanism of action of these drugs and the effect of treating long-term non-healing wounds is largely determined by such physical and chemical factors of their local interaction as concentration of the main ingredients, osmotic, alkaline activity and local temperature. The findings point out the leading role of the local temperature and the dependence of the local effect on the concentration. They describe the essence of the innovative method of treatment.
{"title":"Physico-Chemical Properties of Antiseptics in Surgery: What is not Taken into Account in Treating Long-Term Non-Healing Wounds","authors":"V. P. Bodduluri, K. Gurevich, A. Urakov","doi":"10.24060/2076-3093-2021-11-3-256-259","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-3-256-259","url":null,"abstract":"The treatment of long-term non-healing wounds in the conditions of purulent surgery departments, widely uses solutions of chemotherapeutic and antiseptic agents. The most common are the solutions of 3–6 % hydrogen peroxide and solutions of 2–10 % sodium chloride. As a rule, solutions of these drugs are used to treat non-healing, particularly, purulent wounds, bedsores and trophic ulcers. Therefore, solutions are injected into the wound area repeatedly in the form of course therapy. The findings show that the mechanism of action of these drugs and the effect of treating long-term non-healing wounds is largely determined by such physical and chemical factors of their local interaction as concentration of the main ingredients, osmotic, alkaline activity and local temperature. The findings point out the leading role of the local temperature and the dependence of the local effect on the concentration. They describe the essence of the innovative method of treatment.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43206293","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 : 2021-10-01DOI: 10.24060/2076-3093-2021-11-3-244-250
I. N. Sorokin, S. Ayvazyan, K. Gorshenin, S. Buslaeva, M. I. Dvornikova, A. Seregin
Background. Cryoballoon ablation of pulmonary vein orifices is an effective measure in atrial fibrillation but associates with risks of interventional complications, including haemoptysis. The described clinical case series presents novel evidence to revisit the complication sources.Materials and methods. Four haemoptysis-complicated cryoballoon ablations of pulmonary vein orifice have been analysed retrospectively. Interventions completed in a common clinical protocol with no additional postoperative complications.Results. Fluoroscopy revealed a loop-formed balloon-supporting end of guidewire located in peripheral lower lobe of right lung. Postoperative chest computed tomography also depicted the main lung blood volume confined in right lower lobe, thus indicating pulmonary damage by the guidewire.Discussion. Pulmonary vein anatomy is diverse and can greatly sophisticate the cryoballoon ablation procedure with a peculiar balloon navigation in left atrium. An optimal pulmonary vein orifice occlusion can be attained with guidewire, albeit incurring complications in form of haemoptysis.Conclusions. The appliance advancement towards lung periphery associates with a higher risk of haemoptysis and bleeding. Perioperative haemoptysis and bleeding are most likely associated with mechanical injury to minor veins and require further investigation.
{"title":"Haemoptysis as Complication of Wire-Guided Pulmonary Vein Orifice Cryoballoon Ablation in Complex Anatomy: a Clinical Case Series","authors":"I. N. Sorokin, S. Ayvazyan, K. Gorshenin, S. Buslaeva, M. I. Dvornikova, A. Seregin","doi":"10.24060/2076-3093-2021-11-3-244-250","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-3-244-250","url":null,"abstract":"Background. Cryoballoon ablation of pulmonary vein orifices is an effective measure in atrial fibrillation but associates with risks of interventional complications, including haemoptysis. The described clinical case series presents novel evidence to revisit the complication sources.Materials and methods. Four haemoptysis-complicated cryoballoon ablations of pulmonary vein orifice have been analysed retrospectively. Interventions completed in a common clinical protocol with no additional postoperative complications.Results. Fluoroscopy revealed a loop-formed balloon-supporting end of guidewire located in peripheral lower lobe of right lung. Postoperative chest computed tomography also depicted the main lung blood volume confined in right lower lobe, thus indicating pulmonary damage by the guidewire.Discussion. Pulmonary vein anatomy is diverse and can greatly sophisticate the cryoballoon ablation procedure with a peculiar balloon navigation in left atrium. An optimal pulmonary vein orifice occlusion can be attained with guidewire, albeit incurring complications in form of haemoptysis.Conclusions. The appliance advancement towards lung periphery associates with a higher risk of haemoptysis and bleeding. Perioperative haemoptysis and bleeding are most likely associated with mechanical injury to minor veins and require further investigation.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47039412","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 : 2021-10-01DOI: 10.24060/2076-3093-2021-11-3-220-227
Elena P. Kashirina, Roman N. Komarov, Dmitriy V. Vychuzhanin
Breasts symbolise femininity, sexuality and motherhood. The breast size and shape affect the woman’s self-esteem and social activity. Surgical treatment of malignant breast diseases concerns the medical, psychological, social and sexual aspects of life. Surgery for breast cancer dawns back to 1,600 B.C., with a milestone operation of radical mastectomy proposed in 1891–1894 by W. Halsted and W. Meyer and modified by D. Patey and W. Dyson in 1948. Tissue preservation has shaped a trend towards improving the technique. Since the 1990s, the modified J. Madden’s operation has become the treatment standard in breast cancer, irregardless of stage. The improvement of mass first-visit check-up advanced early diagnosis of initial breast tumourisation, which also influenced the choice of surgical tactics. U. Veronesi proposed a variant of organ-preserving surgery in 1970–80s involving three-level axillary lymph node dissection quadrantectomy, followed by radiotherapy. This combination facilitated aesthetic results at no compromise of radicality of the treatment. The need to observe radicality and sustain aesthetics contributed to the integration of plastic surgery into oncological cure and emergence of reconstructive and plastic breast surgery. The field has entered new cycle. Oncoplastic surgery is recognised safe, improves aesthetics and gives a salutary impact on psychological and social adjustment. Manifold surgical options in breast cancer coexist and develop towards maximal tissue preservation.
{"title":"Breast Cancer Surgery, History and Current State: a Literature Review","authors":"Elena P. Kashirina, Roman N. Komarov, Dmitriy V. Vychuzhanin","doi":"10.24060/2076-3093-2021-11-3-220-227","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-3-220-227","url":null,"abstract":"Breasts symbolise femininity, sexuality and motherhood. The breast size and shape affect the woman’s self-esteem and social activity. Surgical treatment of malignant breast diseases concerns the medical, psychological, social and sexual aspects of life. Surgery for breast cancer dawns back to 1,600 B.C., with a milestone operation of radical mastectomy proposed in 1891–1894 by W. Halsted and W. Meyer and modified by D. Patey and W. Dyson in 1948. Tissue preservation has shaped a trend towards improving the technique. Since the 1990s, the modified J. Madden’s operation has become the treatment standard in breast cancer, irregardless of stage. The improvement of mass first-visit check-up advanced early diagnosis of initial breast tumourisation, which also influenced the choice of surgical tactics. U. Veronesi proposed a variant of organ-preserving surgery in 1970–80s involving three-level axillary lymph node dissection quadrantectomy, followed by radiotherapy. This combination facilitated aesthetic results at no compromise of radicality of the treatment. The need to observe radicality and sustain aesthetics contributed to the integration of plastic surgery into oncological cure and emergence of reconstructive and plastic breast surgery. The field has entered new cycle. Oncoplastic surgery is recognised safe, improves aesthetics and gives a salutary impact on psychological and social adjustment. Manifold surgical options in breast cancer coexist and develop towards maximal tissue preservation.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44760215","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 : 2021-05-22DOI: 10.24060/2076-3093-2021-11-2-183-187
M. V. Loginova, V. Pavlov, I. Gilyazova
Prostate malignancies aggressively grow worldwide frequently occurring inoperable at diagnosis. A proper choice of treatment strategy is currently a challenge. Metastatic castration-resistant prostate cancer remains fatal and poor-prognosis, albeit the list of chemotherapeutic agents and androgen receptor signalling inhibitors has recently been extending towards a certain therapeutic success. Numerous studies suggest a frequent association of the unfavourable prognosis with germline or somatic damage of DNA repair genes. Such are mutations in the BRCA1 and BRCA2 genes bearing important clinical implications for the patient outcome through an adverse clinical manifest of primary tumours and poor treatment in metastatic castration-resistant prostate cancer. This review attempts to describe the BRCA1/2 mutations in prostate cancer with a focus on their prognostic value.
{"title":"Prognostic Value of BRCA1 and BRCA2 Gene Mutations in Prostate Cancer: a Literature Review","authors":"M. V. Loginova, V. Pavlov, I. Gilyazova","doi":"10.24060/2076-3093-2021-11-2-183-187","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-2-183-187","url":null,"abstract":"Prostate malignancies aggressively grow worldwide frequently occurring inoperable at diagnosis. A proper choice of treatment strategy is currently a challenge. Metastatic castration-resistant prostate cancer remains fatal and poor-prognosis, albeit the list of chemotherapeutic agents and androgen receptor signalling inhibitors has recently been extending towards a certain therapeutic success. Numerous studies suggest a frequent association of the unfavourable prognosis with germline or somatic damage of DNA repair genes. Such are mutations in the BRCA1 and BRCA2 genes bearing important clinical implications for the patient outcome through an adverse clinical manifest of primary tumours and poor treatment in metastatic castration-resistant prostate cancer. This review attempts to describe the BRCA1/2 mutations in prostate cancer with a focus on their prognostic value.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68976314","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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