Pub Date : 2022-10-25DOI: 10.24060/2076-3093-2022-12-3-217-223
D. Vasiliev, B. Rudenko, D. Feshchenko, F. B. Shukurov, A. Shanoyan
Introduction. Coronary hagiography revealed 70%-prevalence of multivessel coronary lesions. Chronic coronary occlusion (CCO) occurs in approximately 20 % of patients with coronary heart disease. Endovascular recanalization of CCO is associated with technical difficulties and the risk of complications. In this regard, patients with CCO rarely undergo revascularization, which leads to incomplete myocardial revascularization.Materials and methods. Patient M., male, 64, was hospitalized at the National Medical Research Center for Therapy and Preventive Medicine in February 2020 with a diagnosis of CHD. Stable angina, FC III, multivessel coronary lesions. The recanalization of chronic occlusion of the right coronary artery was performed at the first stage. During the next stage of revascularization of the left main coronary artery, an acute occlusion of the circumflex artery occurred. Despite the acute occlusion, no ischemic dynamics wasm reported on the electrocardiogram, there were no complaints, hemodynamics was stable. Ischemic events did not occur due to the formed network of collaterals out of the system of the right coronary artery. This allowed the complication to be corrected without consequences for the patient. Results and discussion. Thanks to the accumulated experience and advanced technologies, the success rate of recanalization has reached 90–95 %, and complications are not more common than in cases of stenting of non-occlusive lesions. The conducted studies have proved that successful recanalization of CCO improves the patient’s clinical and functional status, intracardiac hemodynamics and quality of life.Conclusion. The clinical case given above clearly demonstrates the need for endovascular revascularization of CCO. The formed collateral network ensured blood flow in the area of acute occlusion and prevented the development of ischemia and myocardial infarction.
{"title":"Endovascular Treatment of a Patient with Multivessel Deсease Combined with Chronic Occlusion of the Right Coronary Artery","authors":"D. Vasiliev, B. Rudenko, D. Feshchenko, F. B. Shukurov, A. Shanoyan","doi":"10.24060/2076-3093-2022-12-3-217-223","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-3-217-223","url":null,"abstract":"Introduction. Coronary hagiography revealed 70%-prevalence of multivessel coronary lesions. Chronic coronary occlusion (CCO) occurs in approximately 20 % of patients with coronary heart disease. Endovascular recanalization of CCO is associated with technical difficulties and the risk of complications. In this regard, patients with CCO rarely undergo revascularization, which leads to incomplete myocardial revascularization.Materials and methods. Patient M., male, 64, was hospitalized at the National Medical Research Center for Therapy and Preventive Medicine in February 2020 with a diagnosis of CHD. Stable angina, FC III, multivessel coronary lesions. The recanalization of chronic occlusion of the right coronary artery was performed at the first stage. During the next stage of revascularization of the left main coronary artery, an acute occlusion of the circumflex artery occurred. Despite the acute occlusion, no ischemic dynamics wasm reported on the electrocardiogram, there were no complaints, hemodynamics was stable. Ischemic events did not occur due to the formed network of collaterals out of the system of the right coronary artery. This allowed the complication to be corrected without consequences for the patient. Results and discussion. Thanks to the accumulated experience and advanced technologies, the success rate of recanalization has reached 90–95 %, and complications are not more common than in cases of stenting of non-occlusive lesions. The conducted studies have proved that successful recanalization of CCO improves the patient’s clinical and functional status, intracardiac hemodynamics and quality of life.Conclusion. The clinical case given above clearly demonstrates the need for endovascular revascularization of CCO. The formed collateral network ensured blood flow in the area of acute occlusion and prevented the development of ischemia and myocardial infarction.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44334220","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 : 2022-10-25DOI: 10.24060/2076-3093-2022-12-3-250-255
G. A. Baksiyan, N. G. Stepanyants, D. Astakhov, A. V. Aksenenko, A. Zavyalov
Introduction. Sarcomas refer to a group of heterogeneous non-epithelial malignant tumors originating from connective tissue. These tumors are characterized by extremely aggressive local growth, relatively low incidence of lymphogenic metastases, predominant and early hematogenic generalization. These tumors most oft en metastasize to the lungs.Materials and methods. The paper describes a case of successful surgical treatment for a giant retroperitoneal fibrosarcoma metastasis to the lung.Results. Successful treatment for sarcoma depends primarily on a global understanding by oncologists of the complex pathogenesis, histological forms and principles of comprehensive treatment for this complex, polymorphic group of malignant pathologies. The earlier the primary site is diagnosed, the sooner and more definitely the surgical treatment is performed, and the more correctly the drug therapy is carried out, the better the result of the complex treatment approach. Similarly, sarcoma secondary sites should be treated proactively – without waiting until their size and local spread contraindicate surgical treatment. Conclusion. Neglected sarcoma cases indicate the need for combined and extended surgical interventions, one successful example of which is described in this paper.
{"title":"Clinical Case of Successful Surgical Treatment for Giant Cell Metastatic Lung Sarcoma","authors":"G. A. Baksiyan, N. G. Stepanyants, D. Astakhov, A. V. Aksenenko, A. Zavyalov","doi":"10.24060/2076-3093-2022-12-3-250-255","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-3-250-255","url":null,"abstract":"Introduction. Sarcomas refer to a group of heterogeneous non-epithelial malignant tumors originating from connective tissue. These tumors are characterized by extremely aggressive local growth, relatively low incidence of lymphogenic metastases, predominant and early hematogenic generalization. These tumors most oft en metastasize to the lungs.Materials and methods. The paper describes a case of successful surgical treatment for a giant retroperitoneal fibrosarcoma metastasis to the lung.Results. Successful treatment for sarcoma depends primarily on a global understanding by oncologists of the complex pathogenesis, histological forms and principles of comprehensive treatment for this complex, polymorphic group of malignant pathologies. The earlier the primary site is diagnosed, the sooner and more definitely the surgical treatment is performed, and the more correctly the drug therapy is carried out, the better the result of the complex treatment approach. Similarly, sarcoma secondary sites should be treated proactively – without waiting until their size and local spread contraindicate surgical treatment. Conclusion. Neglected sarcoma cases indicate the need for combined and extended surgical interventions, one successful example of which is described in this paper.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47003541","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 : 2022-10-25DOI: 10.24060/2076-3093-2022-12-3-237-243
Ya. O. Nikulshina, A. N. Redkin, A. Kolpakov, M. A. Zakharov
Introduction. Glioblastoma is a neuroepithelial malignant brain tumour of predominantly astrocytic origin with an aggressive course and an extremely unfavorable prognosis. Since the median of overall survival with glioblastoma is 14.6 months after complex treatment that includes a combination of surgical treatment, radiation therapy and chemotherapy, the development a personalized approach in the diagnosis and treatment of glioblastomas is appeared to be urgent.Materials and methods. MRIs of a patient undergoing chemoradiotherapy for glioblastoma G4 were performed on the following MRI scanners: Philips Ingenia 1.5T and Philips Ingenia Ambient 1.5T. The analysis of MR-images was carried out using the Matlab 2021 apps.Results and discussion. MR-images were analyzed before and after surgery, and after a course of chemoradiotherapy. The statistical characteristics of the local brightness distribution of the lesion image, which are described by statistical texture parameters, were analyzed as informative features of the lesion area on the images. Initial confirmation of the ability to objectify diagnosis and treatment using the above statistical parameters of T2 MR images of lesion area has been obtained.Conclusion. The aim of further research in this area is to use radiomic study for planning and monitoring the treatment of high-grade gliomas, estimate disease outcomes, and analyze the response to complex treatments in a predictive way.
{"title":"Radiomic Study for Objectification of Diagnostics and Complex Treatment of Glioblastoma","authors":"Ya. O. Nikulshina, A. N. Redkin, A. Kolpakov, M. A. Zakharov","doi":"10.24060/2076-3093-2022-12-3-237-243","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-3-237-243","url":null,"abstract":"Introduction. Glioblastoma is a neuroepithelial malignant brain tumour of predominantly astrocytic origin with an aggressive course and an extremely unfavorable prognosis. Since the median of overall survival with glioblastoma is 14.6 months after complex treatment that includes a combination of surgical treatment, radiation therapy and chemotherapy, the development a personalized approach in the diagnosis and treatment of glioblastomas is appeared to be urgent.Materials and methods. MRIs of a patient undergoing chemoradiotherapy for glioblastoma G4 were performed on the following MRI scanners: Philips Ingenia 1.5T and Philips Ingenia Ambient 1.5T. The analysis of MR-images was carried out using the Matlab 2021 apps.Results and discussion. MR-images were analyzed before and after surgery, and after a course of chemoradiotherapy. The statistical characteristics of the local brightness distribution of the lesion image, which are described by statistical texture parameters, were analyzed as informative features of the lesion area on the images. Initial confirmation of the ability to objectify diagnosis and treatment using the above statistical parameters of T2 MR images of lesion area has been obtained.Conclusion. The aim of further research in this area is to use radiomic study for planning and monitoring the treatment of high-grade gliomas, estimate disease outcomes, and analyze the response to complex treatments in a predictive way.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44748067","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 : 2022-10-25DOI: 10.24060/2076-3093-2022-12-3-224-229
Arina A. Vashkevich, Yuliya V. Semiletova, Inna M. Korablina, Elizaveta S. Kalashnikova, Polina A. Reztsova, Liia G. Kvichidze, Rostislav V. Pavlov, Valeriy N. Danilin, Irina A. Pavlikova, Yuliya I. Nikitina
Introduction. Skin metastases are the result of skin infiltration caused by the proliferation of cells of remotely located malignant tumors occurring with a frequency of 0.6–10.4 % in various oncological processes. They may be a sign of progressive neoplasm or a manifestation of newly diagnosed cancer. Due to a high variability of clinical manifestations leading to misdiagnoses, a limited number of articles describe clinical and dermatoscopic signs of solid tumors metastatic nodes. Aim: to analyze the clinical and dermatoscopic features of skin metastases from breast cancer.Materials and methods. A female patient has complaints of slight pain and itching in the lesions area on the scalp. According to her medical history, a right mastectomy was performed for right breast cancer in 2012, followed by hormone therapy willfully discontinued by the patient. Given the uncommon localization limited with the scalp, the differential diagnosis was made with a spectrum between a cylindroma, multiple basal cell cancer and metastatic carcinoma. A biopsy was carried out to confirm the diagnosis. Results and examination. The pathological skin process revealed itself through multiple nodes up to 2 cm in diameter, pinkish in color, dense, painless on palpation, poorly demarcated. Dermatoscopically: polymorphic vessels on an erythematous background, chrysalis-like structures. Breast cancer metastases were verified by histological and immunohistochemical examination.Conclusion. Skin metastases may be the first sign of cancer recurrence. Dermatoscopy can facilitate differenting them from other skin diseases. Density and diameter of pathological vessels are prognostically significant. Ifdetected lesions do not fit the standard pattern of skin neoplasms, histological verification of the diagnosis is recommended to be carried out.
{"title":"Dermatoscopy in the Diagnosis of Skin Metastases from Breast Cancer","authors":"Arina A. Vashkevich, Yuliya V. Semiletova, Inna M. Korablina, Elizaveta S. Kalashnikova, Polina A. Reztsova, Liia G. Kvichidze, Rostislav V. Pavlov, Valeriy N. Danilin, Irina A. Pavlikova, Yuliya I. Nikitina","doi":"10.24060/2076-3093-2022-12-3-224-229","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-3-224-229","url":null,"abstract":"Introduction. Skin metastases are the result of skin infiltration caused by the proliferation of cells of remotely located malignant tumors occurring with a frequency of 0.6–10.4 % in various oncological processes. They may be a sign of progressive neoplasm or a manifestation of newly diagnosed cancer. Due to a high variability of clinical manifestations leading to misdiagnoses, a limited number of articles describe clinical and dermatoscopic signs of solid tumors metastatic nodes. Aim: to analyze the clinical and dermatoscopic features of skin metastases from breast cancer.Materials and methods. A female patient has complaints of slight pain and itching in the lesions area on the scalp. According to her medical history, a right mastectomy was performed for right breast cancer in 2012, followed by hormone therapy willfully discontinued by the patient. Given the uncommon localization limited with the scalp, the differential diagnosis was made with a spectrum between a cylindroma, multiple basal cell cancer and metastatic carcinoma. A biopsy was carried out to confirm the diagnosis. Results and examination. The pathological skin process revealed itself through multiple nodes up to 2 cm in diameter, pinkish in color, dense, painless on palpation, poorly demarcated. Dermatoscopically: polymorphic vessels on an erythematous background, chrysalis-like structures. Breast cancer metastases were verified by histological and immunohistochemical examination.Conclusion. Skin metastases may be the first sign of cancer recurrence. Dermatoscopy can facilitate differenting them from other skin diseases. Density and diameter of pathological vessels are prognostically significant. Ifdetected lesions do not fit the standard pattern of skin neoplasms, histological verification of the diagnosis is recommended to be carried out.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48623853","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 : 2022-10-25DOI: 10.24060/2076-3093-2022-12-3-244-249
O. Vorobeva
Introduction. Cholangiocellular cancer is a malignant tumor from the epithelium of the bile ducts. Intravital diagnosis is often difficult to make due to the absence of any definitive signs of cancer and problems with detecting the first signs. Following the relevance of the problem, a case of cholangiocellular liver cancer with generalized metastases is presented.Materials and methods. The analysis of the received supporting medical documentation and the description of macroand micropreparations using histological (hematoxylin and eosin staining) and immunohistochemical methods were carried out.Results and discussion. Patient L.M., 60 years old, died at home, was referred by a general practitioner to the pathology department for autopsy examination. During the forensic autopsy, the macroscopic examination revealed dense liver substance, a «tree-like» mass of gray-yellow-brown color on the sections around the portal vein and intrahepatic bile ducts, with involvement of the right and left liver lobes and multiple gray nodules located throughout the liver parenchyma. The intrahepatic bile ducts malfunction due to expanding tumor tissue. Histological examination revealed a moderately differentiated tumor growth of cholangiocellular carcinoma, consisting of polymorphic cells separated by layers of fibrous tissue with areas of necrosis, foci of cholestasis. Immunohistochemical analysis of the tumor tissue of the lungs, liver: cytokeratins CAM 5.2 (+). All groups of lymph nodes of hepatoduodenal ligament, along vesicular and common bile ducts, hepatic artery and portal vein, surrounding left gastric and common hepatic artery, as well as lymph nodes of posterior pancreaticoduodenal group and distant lymph nodes are celiac; upper mesenteric and paraaortic zones appear unremarkable. Cerebral edema, pulmonary edema and necronephrosis were reported.Conclusion. The presented case is of particular interest to practitioners owing to the absence of the characteristic lymph node metastases and presence of hematogenous metastases and development of multiple organ failure.
{"title":"A Rare Case of Cholangiocellular Liver Cancer with Hematogenous Metastases and Organ Changes in the Generalization of the Process","authors":"O. Vorobeva","doi":"10.24060/2076-3093-2022-12-3-244-249","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-3-244-249","url":null,"abstract":"Introduction. Cholangiocellular cancer is a malignant tumor from the epithelium of the bile ducts. Intravital diagnosis is often difficult to make due to the absence of any definitive signs of cancer and problems with detecting the first signs. Following the relevance of the problem, a case of cholangiocellular liver cancer with generalized metastases is presented.Materials and methods. The analysis of the received supporting medical documentation and the description of macroand micropreparations using histological (hematoxylin and eosin staining) and immunohistochemical methods were carried out.Results and discussion. Patient L.M., 60 years old, died at home, was referred by a general practitioner to the pathology department for autopsy examination. During the forensic autopsy, the macroscopic examination revealed dense liver substance, a «tree-like» mass of gray-yellow-brown color on the sections around the portal vein and intrahepatic bile ducts, with involvement of the right and left liver lobes and multiple gray nodules located throughout the liver parenchyma. The intrahepatic bile ducts malfunction due to expanding tumor tissue. Histological examination revealed a moderately differentiated tumor growth of cholangiocellular carcinoma, consisting of polymorphic cells separated by layers of fibrous tissue with areas of necrosis, foci of cholestasis. Immunohistochemical analysis of the tumor tissue of the lungs, liver: cytokeratins CAM 5.2 (+). All groups of lymph nodes of hepatoduodenal ligament, along vesicular and common bile ducts, hepatic artery and portal vein, surrounding left gastric and common hepatic artery, as well as lymph nodes of posterior pancreaticoduodenal group and distant lymph nodes are celiac; upper mesenteric and paraaortic zones appear unremarkable. Cerebral edema, pulmonary edema and necronephrosis were reported.Conclusion. The presented case is of particular interest to practitioners owing to the absence of the characteristic lymph node metastases and presence of hematogenous metastases and development of multiple organ failure.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44818318","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 : 2022-10-24DOI: 10.24060/2076-3093-2022-12-3-205-216
K. Menshikov, A. V. Sultanbaev, S. Musin, A. Izmailov, O. Lipatov, I. Menshikova, N. Sultanbaeva, E. Popova
Bladder cancer is globally considered as one of the most aggressive neoplasms. Traditionally, first-line therapy for metastatic urothelial carcinoma has remained unchanged over the past decades and has been based on combinations of cisplatin. Unfortunately, almost all patients eventually progress and die from bladder cancer, despite the initial response associated with cisplatin-based combinations. Immune checkpoint inhibitors are becoming an increasingly widely used therapeutic option in many solid tumors. In bladder cancer, a high level of programmed death-ligand is determined by rapidly progressive and aggressive tumors and unsatisfactory survival rates. Although checkpoint inhibitors are effective in metastatic urothelial bladder cancer, only a small proportion of treated patients receive a clear benefit, while a large number of patients experience significant side effects and toxicity without improving quality of life or surviving. None of the available biomarkers at this point was associated with response rates. There is evidence of an correlation between PD-L1 expression, the efficacy of immune checkpoint inhibitors, and treatment outcomes in patients with bladder cancer. A major paradigm shift in bladder cancer medicine has followed the FDA approval of avelumab, pembrolizumab, durvalumab, atezolizumab, and nivolumab for the treatment of patients with metastatic urothelial carcinoma previously treated with chemotherapy. Combining classical clinicopathological parameters with data obtained via information technology, together with genomic profiling, could be the future of personalized therapy for bladder cancer.
{"title":"Immune Checkpoint Inhibitors in Urothelial Carcinoma (Literature Review)","authors":"K. Menshikov, A. V. Sultanbaev, S. Musin, A. Izmailov, O. Lipatov, I. Menshikova, N. Sultanbaeva, E. Popova","doi":"10.24060/2076-3093-2022-12-3-205-216","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-3-205-216","url":null,"abstract":"Bladder cancer is globally considered as one of the most aggressive neoplasms. Traditionally, first-line therapy for metastatic urothelial carcinoma has remained unchanged over the past decades and has been based on combinations of cisplatin. Unfortunately, almost all patients eventually progress and die from bladder cancer, despite the initial response associated with cisplatin-based combinations. Immune checkpoint inhibitors are becoming an increasingly widely used therapeutic option in many solid tumors. In bladder cancer, a high level of programmed death-ligand is determined by rapidly progressive and aggressive tumors and unsatisfactory survival rates. Although checkpoint inhibitors are effective in metastatic urothelial bladder cancer, only a small proportion of treated patients receive a clear benefit, while a large number of patients experience significant side effects and toxicity without improving quality of life or surviving. None of the available biomarkers at this point was associated with response rates. There is evidence of an correlation between PD-L1 expression, the efficacy of immune checkpoint inhibitors, and treatment outcomes in patients with bladder cancer. A major paradigm shift in bladder cancer medicine has followed the FDA approval of avelumab, pembrolizumab, durvalumab, atezolizumab, and nivolumab for the treatment of patients with metastatic urothelial carcinoma previously treated with chemotherapy. Combining classical clinicopathological parameters with data obtained via information technology, together with genomic profiling, could be the future of personalized therapy for bladder cancer.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43533828","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 : 2022-10-24DOI: 10.24060/2076-3093-2022-12-3-181-186
V. Panteleev, M. Nartaylakov, I. Z. Salimgareev, A. Petrov
Introduction. There are several classifications of alveolar disease of the liver, but they do not provide complete information regarding all possible surgical interventions in terms of this pathology. Our study was aimed at identifying and structuring various approaches to staged surgical treatment of the disease, taking into account the current possibilities of minimally invasive surgery.Materials and methods. After carrying out a retrospective analysis of surgical treatment of 72 patients with alveolar disease of liver, we have developed a classification of the surgical interventions and 6 main staged approaches to surgical treatment for the disease. Results and discussion. The presented classification of surgical interventions for alveolar disease of the liver is entirely sufficient to divide all surgeries into the following groups: radical/ relatively-radical surgical interventions that make the patient free or nearly free of the disease, and palliative/diagnostic surgeries, that focus on alleviation of the patient’s condition. In addition, the volume and radicality of the liver resection as well as the drainage of the bile ducts and liver decay cavities can be clarified. Based on the developed classification of surgical interventions, we presented 6 main staged, case-centered approaches to the surgical treatment for liver alveolar disease and its complications.Conclusion. The presented classification of surgical interventions for alveolar disease of the liver is a way to explicitly divide the surgeries according to several criteria. Surgical treatment for alveolar disease of the liver includes various parts, which made it possible to develop 6 main options for a staged approach to surgical interventions, ensuring scientific and practical applications.
{"title":"Alveolar Disease of the Liver: Classification and Surgical Interventions","authors":"V. Panteleev, M. Nartaylakov, I. Z. Salimgareev, A. Petrov","doi":"10.24060/2076-3093-2022-12-3-181-186","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-3-181-186","url":null,"abstract":"Introduction. There are several classifications of alveolar disease of the liver, but they do not provide complete information regarding all possible surgical interventions in terms of this pathology. Our study was aimed at identifying and structuring various approaches to staged surgical treatment of the disease, taking into account the current possibilities of minimally invasive surgery.Materials and methods. After carrying out a retrospective analysis of surgical treatment of 72 patients with alveolar disease of liver, we have developed a classification of the surgical interventions and 6 main staged approaches to surgical treatment for the disease. Results and discussion. The presented classification of surgical interventions for alveolar disease of the liver is entirely sufficient to divide all surgeries into the following groups: radical/ relatively-radical surgical interventions that make the patient free or nearly free of the disease, and palliative/diagnostic surgeries, that focus on alleviation of the patient’s condition. In addition, the volume and radicality of the liver resection as well as the drainage of the bile ducts and liver decay cavities can be clarified. Based on the developed classification of surgical interventions, we presented 6 main staged, case-centered approaches to the surgical treatment for liver alveolar disease and its complications.Conclusion. The presented classification of surgical interventions for alveolar disease of the liver is a way to explicitly divide the surgeries according to several criteria. Surgical treatment for alveolar disease of the liver includes various parts, which made it possible to develop 6 main options for a staged approach to surgical interventions, ensuring scientific and practical applications.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46956922","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 : 2022-10-24DOI: 10.24060/2076-3093-2022-12-3-187-192
I. Burovik, G. Prokhorov, S. Bagnenko, A. Vasilev
Introduction. The method of mininvasive percutaneous cryoablation is applied in the tumor lesions of bones for the purpose of local control and pain syndrome relief. In the case of chest bone destruction, such procedures are accompanied by a risk of damage to the thoracic and abdominal organs, as well as large vessels. This article discusses the peculiarities of percutaneous puncture cryoablation in patients with rib metastatic lesions.Aim. To analyze the methodological aspects of percutaneous cryoablation in patients with rib metastatic lesions and to clarify puncture stereotactic accesses.Materials and methods. The procedure was performed in 11 patients with oligometastatic bone lesions. The size of rib lesions varied from 7 to 55 mm. Surgery was performed in a CT operating room under endotracheal anesthesia. A nitric cryosystem with reusable probes of a diameter varying from 1.5 to 3.0 mm was used. The cryoablation included two cycles of cooling down to the target temperature of –190 °C with 10- and 6-min exposure, respectively.Results and discussion. As a result, optimum puncture accesses for the installation of cryoprobes in tumoral rib destruction, including tangential and perpendicular ones, were proposed. At the tangential access, the cryoprobe can be placed both directly into the tumor lesion (intraosseous variant) and into soft tissues along the bone at the lesion level (paraosseous variant). The follow-up period after the procedure varied from 3 to 27 months (11.4 ± 5.6 months). In 3 cases, the formation of a pathological fracture at the level of the ablated lesion was recorded. The local control of the tumoral process was achieved in 10 patients, a relapse in the ablation zone was noted in one case 3 months after the procedure.Conclusion. Due to the use of the described accesses, as well as the implementation of measures aimed at preventing cold cutaneous lesions, the surgery goals were successfully achieved and complications were avoided in all cases.
{"title":"Percutaneous Puncture Cryoablation in Patients with Rib Metastatic Lesions","authors":"I. Burovik, G. Prokhorov, S. Bagnenko, A. Vasilev","doi":"10.24060/2076-3093-2022-12-3-187-192","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-3-187-192","url":null,"abstract":"Introduction. The method of mininvasive percutaneous cryoablation is applied in the tumor lesions of bones for the purpose of local control and pain syndrome relief. In the case of chest bone destruction, such procedures are accompanied by a risk of damage to the thoracic and abdominal organs, as well as large vessels. This article discusses the peculiarities of percutaneous puncture cryoablation in patients with rib metastatic lesions.Aim. To analyze the methodological aspects of percutaneous cryoablation in patients with rib metastatic lesions and to clarify puncture stereotactic accesses.Materials and methods. The procedure was performed in 11 patients with oligometastatic bone lesions. The size of rib lesions varied from 7 to 55 mm. Surgery was performed in a CT operating room under endotracheal anesthesia. A nitric cryosystem with reusable probes of a diameter varying from 1.5 to 3.0 mm was used. The cryoablation included two cycles of cooling down to the target temperature of –190 °C with 10- and 6-min exposure, respectively.Results and discussion. As a result, optimum puncture accesses for the installation of cryoprobes in tumoral rib destruction, including tangential and perpendicular ones, were proposed. At the tangential access, the cryoprobe can be placed both directly into the tumor lesion (intraosseous variant) and into soft tissues along the bone at the lesion level (paraosseous variant). The follow-up period after the procedure varied from 3 to 27 months (11.4 ± 5.6 months). In 3 cases, the formation of a pathological fracture at the level of the ablated lesion was recorded. The local control of the tumoral process was achieved in 10 patients, a relapse in the ablation zone was noted in one case 3 months after the procedure.Conclusion. Due to the use of the described accesses, as well as the implementation of measures aimed at preventing cold cutaneous lesions, the surgery goals were successfully achieved and complications were avoided in all cases.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42738030","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 : 2022-10-24DOI: 10.24060/2076-3093-2022-12-3-199-204
Vladimir V. Vorotnikov, Regina A. Pakhomova, Alexander V. Soinov, Alexandra S. Gunina, Igor V. Kopytich, Mikhail G. Tsoi, Sardor A. Abdugaff
Breast cancer is the most common malignant disease in the world. One of the methods of treating breast cancer is neoadjuvant chemotherapy. Neoadjuvant chemotherapy (NCT) is now the standard of care for locally advanced breast cancer. Patients with HER2-positive and triple-negative breast cancer subtypes benefi t the most from NCT, with a 50–60 % chance of achieving pCR, while patients with hormone-sensitive, HER2-negative breast cancer subtypes have an average chance of achieving pCR of 10–20 %. For patients with locally advanced, hormone-sensitive Her2neu-negative breast cancer, neoadjuvant hormone therapy contributes to a tumor downstaging and an increasing rate of organ-preserving surgery. However, neoadjuvant hormone therapy is still not used routinely. There are a limited number of clinical guidelines that describe the choice of the optimal drugs, the optimal duration of hormone therapy and the criteria for selecting patients for preoperative hormone therapy. This is the first literature review in Russia that includes a systematization of the evidence regarding the effectiveness of neoadjuvant hormone therapy, a comparison of hormone therapy with neoadjuvant chemotherapy, comparison of hormonal drug groups, optimal duration of hormone therapy, attempts to combine hormone therapy with drugs of the group of selective CDK4/6 cyclin-dependent kinase inhibitors and phosphatidylinositol 3-kinase inhibitors for women with locally advanced hormone-sensitive Her2neu-negative breast cancer. The possibilities of using modern commercial multigene panels to assess the feasibility of identifying the cohort of patients for whom neoadjuvant hormone therapy would be most effective are also considered.
{"title":"Preoperative Hormone Therapy in the Treatment of Breast Cancer: What Do We Know So Far?","authors":"Vladimir V. Vorotnikov, Regina A. Pakhomova, Alexander V. Soinov, Alexandra S. Gunina, Igor V. Kopytich, Mikhail G. Tsoi, Sardor A. Abdugaff","doi":"10.24060/2076-3093-2022-12-3-199-204","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-3-199-204","url":null,"abstract":"Breast cancer is the most common malignant disease in the world. One of the methods of treating breast cancer is neoadjuvant chemotherapy. Neoadjuvant chemotherapy (NCT) is now the standard of care for locally advanced breast cancer. Patients with HER2-positive and triple-negative breast cancer subtypes benefi t the most from NCT, with a 50–60 % chance of achieving pCR, while patients with hormone-sensitive, HER2-negative breast cancer subtypes have an average chance of achieving pCR of 10–20 %. For patients with locally advanced, hormone-sensitive Her2neu-negative breast cancer, neoadjuvant hormone therapy contributes to a tumor downstaging and an increasing rate of organ-preserving surgery. However, neoadjuvant hormone therapy is still not used routinely. There are a limited number of clinical guidelines that describe the choice of the optimal drugs, the optimal duration of hormone therapy and the criteria for selecting patients for preoperative hormone therapy. This is the first literature review in Russia that includes a systematization of the evidence regarding the effectiveness of neoadjuvant hormone therapy, a comparison of hormone therapy with neoadjuvant chemotherapy, comparison of hormonal drug groups, optimal duration of hormone therapy, attempts to combine hormone therapy with drugs of the group of selective CDK4/6 cyclin-dependent kinase inhibitors and phosphatidylinositol 3-kinase inhibitors for women with locally advanced hormone-sensitive Her2neu-negative breast cancer. The possibilities of using modern commercial multigene panels to assess the feasibility of identifying the cohort of patients for whom neoadjuvant hormone therapy would be most effective are also considered.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48570386","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 : 2022-10-24DOI: 10.24060/2076-3093-2022-12-3-193-198
M. V. Timerbulatov, R. Garaev, S. Timerbulatov, A. Bakirov, A. R. Gafarova
Since March 2020, when COVID-19 pandemic was declared by WHO, the new coronavirus infection has spread widely around the world, claiming many lives and destroying the economies, social structures, and various aspects of people’s lives. The pandemic has had a major impact on health facilities, including the surgical service. The healthcare system had to completely reorganize its methods of work. The need to deploy a significant number of infectious disease beds necessitated the convertion of many medical organizations into Covid hospitals, with a reduction in surgical units and beds. The scheduled surgical operations were therefore cancelled and postponed. Emergency surgical care was provided as needed, albeit in a reduced scope. The number of patients seeking emergency surgical care decreased mainly due to the fear of contracting COVID-19. The data show that there is a significant increase in the number of perioperative complications and mortality, especially in patients with acute surgical pathology and co-occurring COVID-19. The paper presents the data from professional literature on the peculiarities of surgical care in the context of the coronavirus pandemic, changes in a number of obligatory indicators of the quality of surgical care for patients.
{"title":"Surgical Care under COVID-19 Pandemic Conditions (Literature Review)","authors":"M. V. Timerbulatov, R. Garaev, S. Timerbulatov, A. Bakirov, A. R. Gafarova","doi":"10.24060/2076-3093-2022-12-3-193-198","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-3-193-198","url":null,"abstract":"Since March 2020, when COVID-19 pandemic was declared by WHO, the new coronavirus infection has spread widely around the world, claiming many lives and destroying the economies, social structures, and various aspects of people’s lives. The pandemic has had a major impact on health facilities, including the surgical service. The healthcare system had to completely reorganize its methods of work. The need to deploy a significant number of infectious disease beds necessitated the convertion of many medical organizations into Covid hospitals, with a reduction in surgical units and beds. The scheduled surgical operations were therefore cancelled and postponed. Emergency surgical care was provided as needed, albeit in a reduced scope. The number of patients seeking emergency surgical care decreased mainly due to the fear of contracting COVID-19. The data show that there is a significant increase in the number of perioperative complications and mortality, especially in patients with acute surgical pathology and co-occurring COVID-19. The paper presents the data from professional literature on the peculiarities of surgical care in the context of the coronavirus pandemic, changes in a number of obligatory indicators of the quality of surgical care for patients.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46942223","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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