Pub Date : 2023-04-04DOI: 10.24060/2076-3093-2023-13-1-5-12
V. Pavlov, M. Urmantsev, M. R. Bakeev
Introduction. Bladder cancer dominates among global health problems. Radical cystectomy is the recognized standard of care for muscle-invasive bladder cancer with bilateral pelvic lymphadenectomy as a mandatory step in the surgical procedure. The concept of sentinel lymph nodes, acting as a barrier to the spread of malignant process, can be beneficial in terms of reducing the extent of pelvic lymphadenectomy. Intraoperative imaging using indocyanine green now appears to be a contemporary and relevant method for intraoperative imaging of sentinel lymph nodes. Materials and methods. A study involving 28 patients diagnosed with bladder cancer was carried out at the clinic of the Bashkir State Medical University. All patients underwent robot-assisted radical cystectomy with intracorporeal formation of a heterotopic neobladder using Bricker technique. At the stage of pelvic lymphadenectomy, the isolated lymph nodes were evaluated and intraoperative ICG-fluorescence was performed. All lymph nodes obtained were examined microscopically and the results were interpreted taking into account the intraoperative diagnosis. Results and discussion. Intraoperative ICG fluorescence identified sentinel lymph nodes in 7 of 9 patients (77.8%, p < 0.05), with sensitivity equal to 77.8%, p < 0.05 and specificity — 87.5%, p < 0.05. Conclusion. The results proved a high reliability of the method of intraoperative lymph nodes imaging with indocyanine green in patients with muscle-invasive bladder cancer. Fluorescence navigation in cancer surgery opens up new opportunities for improving perioperative outcomes and reducing complications.
{"title":"Intraoperative ICG-Fluorescence Imaging of Lymph Nodes in Robot-Assisted Radical Cystectomy in Patients with Bladder Cancer","authors":"V. Pavlov, M. Urmantsev, M. R. Bakeev","doi":"10.24060/2076-3093-2023-13-1-5-12","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-1-5-12","url":null,"abstract":"Introduction. Bladder cancer dominates among global health problems. Radical cystectomy is the recognized standard of care for muscle-invasive bladder cancer with bilateral pelvic lymphadenectomy as a mandatory step in the surgical procedure. The concept of sentinel lymph nodes, acting as a barrier to the spread of malignant process, can be beneficial in terms of reducing the extent of pelvic lymphadenectomy. Intraoperative imaging using indocyanine green now appears to be a contemporary and relevant method for intraoperative imaging of sentinel lymph nodes. Materials and methods. A study involving 28 patients diagnosed with bladder cancer was carried out at the clinic of the Bashkir State Medical University. All patients underwent robot-assisted radical cystectomy with intracorporeal formation of a heterotopic neobladder using Bricker technique. At the stage of pelvic lymphadenectomy, the isolated lymph nodes were evaluated and intraoperative ICG-fluorescence was performed. All lymph nodes obtained were examined microscopically and the results were interpreted taking into account the intraoperative diagnosis. Results and discussion. Intraoperative ICG fluorescence identified sentinel lymph nodes in 7 of 9 patients (77.8%, p < 0.05), with sensitivity equal to 77.8%, p < 0.05 and specificity — 87.5%, p < 0.05. Conclusion. The results proved a high reliability of the method of intraoperative lymph nodes imaging with indocyanine green in patients with muscle-invasive bladder cancer. Fluorescence navigation in cancer surgery opens up new opportunities for improving perioperative outcomes and reducing complications.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44018688","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 : 2023-04-04DOI: 10.24060/2076-3093-2023-13-1-45-50
D. V. Omelchenko, A. Vasin
{"title":"Patients with Primary Malignant Retroperitoneal Tumor: Surgical Treatment Outcomes","authors":"D. V. Omelchenko, A. Vasin","doi":"10.24060/2076-3093-2023-13-1-45-50","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-1-45-50","url":null,"abstract":"","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46453150","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 : 2023-04-04DOI: 10.24060/2076-3093-2023-13-1-39-44
M. V. Timerbulatov, A. S. Shornina, R. A. Lihter, A. É. Kaipov
{"title":"Comparative Analysis of Isolated Abdominoplasty and Concomitant Hernio-Abdominoplasty","authors":"M. V. Timerbulatov, A. S. Shornina, R. A. Lihter, A. É. Kaipov","doi":"10.24060/2076-3093-2023-13-1-39-44","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-1-39-44","url":null,"abstract":"","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43646338","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 : 2023-04-04DOI: 10.24060/2076-3093-2023-13-1-51-57
{"title":"Detecting Associations Between Body Mass Index and Bone Mineral Density in Patients with Fractures of Different Localizations","authors":"","doi":"10.24060/2076-3093-2023-13-1-51-57","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-1-51-57","url":null,"abstract":"","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46281789","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 : 2023-03-13DOI: 10.24060/2076-3093-2023-2
A. Nosov, M. Berkut, E. Mamizhev, T. Y. Galunova, D. Rumyantseva, D. P. Semeyko, S. Reva, S. Y. Konyashkina
Introduction. The key treatment for high-risk non-invasive bladder tumor or invasive urothelial cancer remains radical cystectomy (RCE), which provides the best survival rates. At the same time, the incidence of infectious complications in a number of studies reaches 33%, which in most cases causes repeated hospitalizations and disrupts the Enhanced Recovery After Surgery (ERAS) guidelines. Therefore, research into effective alternations of antibiotic prophylaxis remains relevant.Materials and methods. The MACS trial is a Russian Phase 3 study with a prospective randomized set of participants to assess the incidence of infectious complications after RCE in the context of the ERAS guidelines (intermediate data snapshot after including 39% of the data). Detailed inclusion and exclusion criteria are published on ClinicalTrials. gov, ID – NCT05392634. The study has been approved by the Local Ethics Committee, No. 1/129 of April 28, 2022. Statistical data processing was performed with StatPlus:Mac LE.Results and discussion. 36 patients were included in the study (39% of the expected sample). For the period from May 30, 2022 to February 01, 2023. A heterotopic Bricker reservoir was formed intracorporeally in 83.3% of cases (30/36), an orthotopic J-pouch reservoir was created in 13.8% of cases (5/36) and in 2.9% of cases (1/36) the urodereating stage was completed with ureteral clipping. No significant differences were revealed in urine bacterial contamination before surgery. However, in group A, the incidence of positive bacterial cultures, when the ureteric intubators were removed, was 2-fold higher than in the prolonged antibiotic therapy group: 7/14 cases (50.0%) and 3/12 cases (25.0%), respectively. In group B, the risk of complications in the prolonged antibiotic therapy group reduced by 47% within 30 days after RCE (HR 0.53 (95CI %: 0.21-1.32).Conclusion. An intermediate data snapshot in MACS study revealed that RCE was associated with a high risk of early postoperative infectious complications. The prognostic significance of systemic inflammation indices as predictors of infectious complications subject to further evaluation in the remaining 61% of cases.
{"title":"Russian Randomized Trial to Select Optimal Antibiotic Prophylaxis in Radical Cystectomy: Initial Results of MACS-TRIAL (NCT05392634)","authors":"A. Nosov, M. Berkut, E. Mamizhev, T. Y. Galunova, D. Rumyantseva, D. P. Semeyko, S. Reva, S. Y. Konyashkina","doi":"10.24060/2076-3093-2023-2","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-2","url":null,"abstract":"Introduction. The key treatment for high-risk non-invasive bladder tumor or invasive urothelial cancer remains radical cystectomy (RCE), which provides the best survival rates. At the same time, the incidence of infectious complications in a number of studies reaches 33%, which in most cases causes repeated hospitalizations and disrupts the Enhanced Recovery After Surgery (ERAS) guidelines. Therefore, research into effective alternations of antibiotic prophylaxis remains relevant.Materials and methods. The MACS trial is a Russian Phase 3 study with a prospective randomized set of participants to assess the incidence of infectious complications after RCE in the context of the ERAS guidelines (intermediate data snapshot after including 39% of the data). Detailed inclusion and exclusion criteria are published on ClinicalTrials. gov, ID – NCT05392634. The study has been approved by the Local Ethics Committee, No. 1/129 of April 28, 2022. Statistical data processing was performed with StatPlus:Mac LE.Results and discussion. 36 patients were included in the study (39% of the expected sample). For the period from May 30, 2022 to February 01, 2023. A heterotopic Bricker reservoir was formed intracorporeally in 83.3% of cases (30/36), an orthotopic J-pouch reservoir was created in 13.8% of cases (5/36) and in 2.9% of cases (1/36) the urodereating stage was completed with ureteral clipping. No significant differences were revealed in urine bacterial contamination before surgery. However, in group A, the incidence of positive bacterial cultures, when the ureteric intubators were removed, was 2-fold higher than in the prolonged antibiotic therapy group: 7/14 cases (50.0%) and 3/12 cases (25.0%), respectively. In group B, the risk of complications in the prolonged antibiotic therapy group reduced by 47% within 30 days after RCE (HR 0.53 (95CI %: 0.21-1.32).Conclusion. An intermediate data snapshot in MACS study revealed that RCE was associated with a high risk of early postoperative infectious complications. The prognostic significance of systemic inflammation indices as predictors of infectious complications subject to further evaluation in the remaining 61% of cases.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47777336","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 : 2023-03-13DOI: 10.24060/2076-3093-2023-3
M. S. Mosoyan, G. Shanava, R. E. Nikulin
Introduction. The incidence of postoperative ureteral strictures induced by iatrogenic injuries tends to increase. Reconstructive surgery involves open or laparoscopic intervention to repair strictures. However, both methods have their drawbacks. Surgical treating strictures of the lower third of the ureter can be effectively performed by means of robotic surgery.Aim. To determine outcomes of robot-assisted reconstructive surgery in treating postoperative strictures of the lower third of the ureter.Materials and methods. Five female patients with postoperative strictures of the lower third of the ureter underwent robot-assisted reconstructive surgery. Clinical and radiological outcomes in the long-term postoperative period were determined.Results and discussion. Two patients underwent simultaneous robot-assisted reconstructive surgery, namely, robot-assisted uretero-cysto-neoanastomosis on the right side and Boari operation on the left; robot-assisted Boari operation and isolation of post-traumatic uretero-vaginal fistula. In the remaining three cases, robot-assisted Boari operation and uretero-cysto-neoanastomosis with psoas-hitch were performed. No evidence of ureteral stricture in all cases was detected via multislice spiral CT (MSCT) urography in 3 months after surgery.Conclusion. At present, robot-assisted reconstructive surgery, being suitable for simultaneous surgery, is safe and effective whentreating postoperative strictures of the lower third of the ureter.
{"title":"Robot-Assisted Surgery in Treating Postoperative Strictures of Lower Third of Ureter","authors":"M. S. Mosoyan, G. Shanava, R. E. Nikulin","doi":"10.24060/2076-3093-2023-3","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-3","url":null,"abstract":"Introduction. The incidence of postoperative ureteral strictures induced by iatrogenic injuries tends to increase. Reconstructive surgery involves open or laparoscopic intervention to repair strictures. However, both methods have their drawbacks. Surgical treating strictures of the lower third of the ureter can be effectively performed by means of robotic surgery.Aim. To determine outcomes of robot-assisted reconstructive surgery in treating postoperative strictures of the lower third of the ureter.Materials and methods. Five female patients with postoperative strictures of the lower third of the ureter underwent robot-assisted reconstructive surgery. Clinical and radiological outcomes in the long-term postoperative period were determined.Results and discussion. Two patients underwent simultaneous robot-assisted reconstructive surgery, namely, robot-assisted uretero-cysto-neoanastomosis on the right side and Boari operation on the left; robot-assisted Boari operation and isolation of post-traumatic uretero-vaginal fistula. In the remaining three cases, robot-assisted Boari operation and uretero-cysto-neoanastomosis with psoas-hitch were performed. No evidence of ureteral stricture in all cases was detected via multislice spiral CT (MSCT) urography in 3 months after surgery.Conclusion. At present, robot-assisted reconstructive surgery, being suitable for simultaneous surgery, is safe and effective whentreating postoperative strictures of the lower third of the ureter.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47008112","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 : 2023-01-05DOI: 10.24060/2076-3093-2022-12-4-345-349
D. M. Sharafutdinov, R. R. Shavaleev, I. Kabirov, V. Pavlov
Introduction. Inguinal hernia repair is one of the most common elective surgeries today. In our clinic, the majority of inguinal hernia repairs are performed laparoscopically. The most frequent complication after transabdominal preperitoneal inguinal hernia repair is postoperative seroma.Materials and methods. A 35-year-old patient C. with a right-sided inguinal hernia sought medical care in our clinic. He underwent robot-assisted TAPP with fluorescence lymphography using indocyanine green (ICG).Results and discussion. The present paper describes the possible relationship between intraoperative damage of the lymphatic vessels within the spermatic cord induced by robot-assisted transabdominal preperitoneal inguinal hernia repair and postoperative development of inguinal seroma. 5 mg/ml of indocyanine green was injected into the testicle on the side with the hernial bulge to visualize the lymphatic vessels. In this case such procedure is safe and feasible. Due to the tight fusion of the hernia sac with two visualized lymphatic vessels, they were excised during surgery. In the early postoperative period, an ultrasound scan revealed a subclinical seroma in the inguinal region of approximately 10 ml.Conclusion. A case series of ICG fluorescence lymphography during robot-assisted TAPP should be performed further to elucidate the relationship between lymphatic vessel damage and hydrocele.
{"title":"Preventing postoperative complications after robot-assisted transabdominal preperetoneal repair: clinical case","authors":"D. M. Sharafutdinov, R. R. Shavaleev, I. Kabirov, V. Pavlov","doi":"10.24060/2076-3093-2022-12-4-345-349","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-4-345-349","url":null,"abstract":"Introduction. Inguinal hernia repair is one of the most common elective surgeries today. In our clinic, the majority of inguinal hernia repairs are performed laparoscopically. The most frequent complication after transabdominal preperitoneal inguinal hernia repair is postoperative seroma.Materials and methods. A 35-year-old patient C. with a right-sided inguinal hernia sought medical care in our clinic. He underwent robot-assisted TAPP with fluorescence lymphography using indocyanine green (ICG).Results and discussion. The present paper describes the possible relationship between intraoperative damage of the lymphatic vessels within the spermatic cord induced by robot-assisted transabdominal preperitoneal inguinal hernia repair and postoperative development of inguinal seroma. 5 mg/ml of indocyanine green was injected into the testicle on the side with the hernial bulge to visualize the lymphatic vessels. In this case such procedure is safe and feasible. Due to the tight fusion of the hernia sac with two visualized lymphatic vessels, they were excised during surgery. In the early postoperative period, an ultrasound scan revealed a subclinical seroma in the inguinal region of approximately 10 ml.Conclusion. A case series of ICG fluorescence lymphography during robot-assisted TAPP should be performed further to elucidate the relationship between lymphatic vessel damage and hydrocele.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44293290","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 : 2023-01-05DOI: 10.24060/2076-3093-2022-12-4-328-336
K. R. Ishmuratova, K. Gantsev
Peritoneal metastasis occurs in a number of heterogeneous tumors originating from the ovaries, stomach, intestines, pancreas, lungs, breast, and melanoma. Peritoneal carcinomatosis significantly reduces overall survival. While being almost unresponsive to treatment, dissemination of tumor cells along the peritoneum aggravates the course of the disease. Despite the use of locoregional treatment, peritoneal carcinomatosis is still considered to be an aggravating factor with a poor prognosis. Peritoneal carcinomatosis cannot be defined as a separate locoregional process with its own biology and oncogenesis due to the lack of clear understanding the molecular and biological features of peritoneal metastasis, as well as generally recognized standards for diagnosis and treatment of malignant neoplasms with various localizations. Addressing peritoneal carcinomatosis as a separate developing molecular event will enhance the understanding of its morpho- and oncogenesis and strengthen the search for therapeutic, diagnostic and preventive approaches to its management. Th e paper presents a bibliographic study of publications on exploring peritoneal metastases from various sites, including the abdominal and pelvic organs. Th e known mechanisms of tumors metastasis to the peritoneum are characterized in the paper. Diagnostic approaches to peritoneal carcinomatosis were assessed and compared. Th e collected data analysis revealed the main gaps in the understanding of peritoneal carcinomatosis oncogenesis.
{"title":"New views on pathogenesis and diagnosis of peritoneal carcinomatosis","authors":"K. R. Ishmuratova, K. Gantsev","doi":"10.24060/2076-3093-2022-12-4-328-336","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-4-328-336","url":null,"abstract":"Peritoneal metastasis occurs in a number of heterogeneous tumors originating from the ovaries, stomach, intestines, pancreas, lungs, breast, and melanoma. Peritoneal carcinomatosis significantly reduces overall survival. While being almost unresponsive to treatment, dissemination of tumor cells along the peritoneum aggravates the course of the disease. Despite the use of locoregional treatment, peritoneal carcinomatosis is still considered to be an aggravating factor with a poor prognosis. Peritoneal carcinomatosis cannot be defined as a separate locoregional process with its own biology and oncogenesis due to the lack of clear understanding the molecular and biological features of peritoneal metastasis, as well as generally recognized standards for diagnosis and treatment of malignant neoplasms with various localizations. Addressing peritoneal carcinomatosis as a separate developing molecular event will enhance the understanding of its morpho- and oncogenesis and strengthen the search for therapeutic, diagnostic and preventive approaches to its management. Th e paper presents a bibliographic study of publications on exploring peritoneal metastases from various sites, including the abdominal and pelvic organs. Th e known mechanisms of tumors metastasis to the peritoneum are characterized in the paper. Diagnostic approaches to peritoneal carcinomatosis were assessed and compared. Th e collected data analysis revealed the main gaps in the understanding of peritoneal carcinomatosis oncogenesis.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41522622","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 : 2023-01-05DOI: 10.24060/2076-3093-2022-12-4-337-344
U. Mukhametov, S. Lyulin, D. Borzunov
The expansion in the number of primary joint replacements worldwide is causing a rise in revision joint replacements due to bacterial infection. Revision surgery with cementless implants appears to be beneficial for long-term outcome, and using antibiotic-impregnated bone grafts can control infection and provide good implant support. Autologous bone graft s (autografts) areused in surgery to fill defects and impaction bone grafting in spinal reconstruction. Because of their superior osteoinductive ability, autograft sare considered the “gold standard” for these treatments. However, due to a better cost-benefit ratio, allografts are also often used. In case of limited donor availability for autologous or allogeneic bone graft s, bone grafting materials are a reasonable alternative or adjunct. Bone grafting materials combine or are based on different substances. Growth factors of the bone morphogenetic protein family are recombinant proteins that specifically induce bone and cartilage growth. One advantage of bone grafting materials is that they can be combined with several antibiotics. Th e choice of antibiotics should consider possible dose-dependent cellular and pharmacological side effects at the implantation site, as well as be based on antimicrobial efficacy. Thus, microbiologists, pharmacologists and surgeons must decide together which combination is more appropriate. Bone grafting materials with active ingredient supplements are considered to be combination drugs, characterised by a primary effect (bone replacement function) and a secondary effect (prevention of bacterial recolonization of the bone grafting materials). Both functions must be clinically validated during the registration process as a Class III medical device. Currently, only a few combination products are available on the market. In this review, we considered the existing hydroxyapatite-based bone grafting materials and the potential for their use in spine surgery.
{"title":"Potential for application of hydroxyapatite-based bone grafting materials in spine surgery","authors":"U. Mukhametov, S. Lyulin, D. Borzunov","doi":"10.24060/2076-3093-2022-12-4-337-344","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-4-337-344","url":null,"abstract":"The expansion in the number of primary joint replacements worldwide is causing a rise in revision joint replacements due to bacterial infection. Revision surgery with cementless implants appears to be beneficial for long-term outcome, and using antibiotic-impregnated bone grafts can control infection and provide good implant support. Autologous bone graft s (autografts) areused in surgery to fill defects and impaction bone grafting in spinal reconstruction. Because of their superior osteoinductive ability, autograft sare considered the “gold standard” for these treatments. However, due to a better cost-benefit ratio, allografts are also often used. In case of limited donor availability for autologous or allogeneic bone graft s, bone grafting materials are a reasonable alternative or adjunct. Bone grafting materials combine or are based on different substances. Growth factors of the bone morphogenetic protein family are recombinant proteins that specifically induce bone and cartilage growth. One advantage of bone grafting materials is that they can be combined with several antibiotics. Th e choice of antibiotics should consider possible dose-dependent cellular and pharmacological side effects at the implantation site, as well as be based on antimicrobial efficacy. Thus, microbiologists, pharmacologists and surgeons must decide together which combination is more appropriate. Bone grafting materials with active ingredient supplements are considered to be combination drugs, characterised by a primary effect (bone replacement function) and a secondary effect (prevention of bacterial recolonization of the bone grafting materials). Both functions must be clinically validated during the registration process as a Class III medical device. Currently, only a few combination products are available on the market. In this review, we considered the existing hydroxyapatite-based bone grafting materials and the potential for their use in spine surgery.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41833806","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 : 2023-01-05DOI: 10.24060/2076-3093-2022-12-4-350-355
O. V. Vorobеva
Aim. The study is aimed at describing pancreatic islets as one of the SARS-CoV-2 targets.Materials and methods. The object of the study was the pancreas. The study involved histological staining.Results and discussion. The autopsy study revealed the signs typical of bilateral viral interstitial pneumonia. Histological examination revealed alveoli with disatelectasis, intra-alveolar edema, hyaline membranes in a part of alveoli. The pancreas histological examination showed hemorrhages, necrotic areas of the islets and detected the following DIC signs: small hyaline thrombi in the heart cavities and large vessels, petechial hemorrhages in the internal organs and adrenal glands, foci of adrenal cortex necrosis with perifocal infiltration (Waterhouse—Friderichsen syndrome); as well as signs of necronephrosis with fibrinoid areas of necrosis in the glomerular capillary network and perivascular lymphoid infiltrates.Conclusion. SARS-CoV-2 was revealed to target human pancreatic islets, where areas of necrosis developed.
{"title":"Pancreatic islets as a SARS-CoV-2 target","authors":"O. V. Vorobеva","doi":"10.24060/2076-3093-2022-12-4-350-355","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-4-350-355","url":null,"abstract":"Aim. The study is aimed at describing pancreatic islets as one of the SARS-CoV-2 targets.Materials and methods. The object of the study was the pancreas. The study involved histological staining.Results and discussion. The autopsy study revealed the signs typical of bilateral viral interstitial pneumonia. Histological examination revealed alveoli with disatelectasis, intra-alveolar edema, hyaline membranes in a part of alveoli. The pancreas histological examination showed hemorrhages, necrotic areas of the islets and detected the following DIC signs: small hyaline thrombi in the heart cavities and large vessels, petechial hemorrhages in the internal organs and adrenal glands, foci of adrenal cortex necrosis with perifocal infiltration (Waterhouse—Friderichsen syndrome); as well as signs of necronephrosis with fibrinoid areas of necrosis in the glomerular capillary network and perivascular lymphoid infiltrates.Conclusion. SARS-CoV-2 was revealed to target human pancreatic islets, where areas of necrosis developed.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49005997","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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