Vol 174, No 6 (2015)
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THE GALLERY OF NATIONAL SURGEONS
PROBLEMS OF GENERAL AND SPECIAL SURGERY
13-16 446
Abstract
The study generalized the 15-year experience of classical carotid endarterectomy performance with application of a temporary carotid shunt and an autovenous path in 325 patients. There were analyzed the more frequent complications in standard groups. Advantages of given method were determined and it was specified the ways, which facilitated to reduction of intraoperative risks and increase of technical quality realization of different stages of surgery.
17-21 461
Abstract
The authors measured the changes of hemodynamics in 72 patients. It was also estimated a blood oxygenation and volume of liquid sectors of the organism in different degree of obesity before and after liposuction of the large volume. It was shown, that this operation facilitated to an improvement of respiratory lung function due to changes of pulmonary circulation.
22-24 388
Abstract
It was shown by the authors that changes of the level of cytokines reflected the degree of invasiveness of operative intervention. The endovideosurgical approach was less traumatic and provided a rapid rehabilitation of the patients in postoperative period. It is possible to consider the high levels of IL-10 as a predictor of development of local inflammatory process and as an indicator of probable infectious complications in postoperative period.
25-28 432
Abstract
Given study was aimed to research a role of kinetic performance of PSA in selection of the patients for conduction ¹¹C-choline PET/CT in order to reveal local recurrences in patient with prostate cancer after radiation therapy (RT) and radical prostatectomy (RP). The study included 185 patients with histologically distinctive prostate cancer and biochemical signs of tumor recurrence after RP (61 patients) or RT (124 patients). All the patients were examined using ¹¹C-choline PET/ CT in order to detect local relapses. Calculation of growth rate of the PSA level and PSA doubling time were made. According to results of ¹¹C-choline PET/CT, recurrences of prostate cancer were detected in 124 out of 185 (65%). There were 22 patients out of 61 (36%) after RP and there were 102 patients out of 124 (82%) after RT. It was stated a correlation between PSA rates, growth rate of PSA level and presence or absence of relapse according to PET/CT results. PSA level and growth rate of PSA were indicated as the most significant predictive signs, which could influence on the selection of the patients for conduction of ¹¹C-choline PET/CT in relation to detection of local recurrence after RT and RP.
SURGERY OF INJURIES
29-34 625
Abstract
The data of examination and treatment of 356 victims with extremely severe combined injury and shock of III degree were analyzed. All the patients had a medical unfavorable life prognosis. On the basis of the research, it was proved, that the modern approach of treatment of such trauma should include an adequate anti-shock treatment in conditions of the first-level trauma center. The operative activity should be increased in cases of combined trauma of bones by their early external fixation. The authors re commend an application of up-to-date prevention sepsis treatment, late reconstructive - restorative operation performance after its full relief and nutritive metabolic therapy. This approach allowed reducing of the rate of life-threaten infectious complications on 32,4% and noninfectious - on 31,7%, the lethality - on 24%.
35-41 412
Abstract
The abnormalities of myoelectrical activity of gastrointestinal tract were detected in 80 victims with severe combined trauma. There were observed a decrease of total electrical activity and dyscoordination of electrical activity of sections of gastrointestinal tract. An application of substrate antihypoxants should normalize the indices of myoelectrical activity of gastrointestinal tract. This approach allowed elimination of imbalance of total power between superposed (the stomach, the duodenum) and other sections of gastrointestinal tract. This would remove dyscoordination contraction of the jejunum and the ileum.
42-45 471
Abstract
On the basis of treatment results of 28 patients, the authors suggested that the clinical method of diagnostics allowed performance of topical diagnostics of injury using bedside test. It would help to choose a therapeutic approach in each clinical case.
SURGERY IN CHILDREN
46-51 584
Abstract
The article presents an analysis of 10-year treatment results of 62 children with gastroschisis. Children were divided into two groups and it depended on the applied surgical treatment. An elimination of congenital eventration using Bianchi method was performed for children of the main group. The operative methods such as siloplasty, Gross operation, alloplasty and primary radical abdominoplasty were performed for children of comparison group. Comparative assessment of efficacy of the treatment methods of gastroschisis showed, that Bianchi method had a number of advantages: an early transition to independent breath and enteral feeding, shortening of hospital stay, decrease of the rate of lethality from 66,6% to 14,2%.
NEW AND RATIONAL SUGGESTIONS
52-55 485
Abstract
The authors suggested the advanced method of vessel separation and hemostasis, which was applied in 13 patients. This method was compared with the traditional method used for 8 patients. Proposed approach allowed separation of vascular fascicle twice faster than in usual way. There were noted a less decrease of hemoglobin level and shortening of hospital stay. The results of treatment were improved due to the application of the method of vessel mobilization and temporal hemostasis in surgery of stab-cut wound of the neck.
56-59 567
Abstract
The bleeding of intraoperative period is one of the actual problem in surgery. There aren’t any universal hemostatic means in spite of large variety of modern hemostatic methods. An experimental research studied the results of hemostatic activity of different forms of materials on the basis of oxidize cellulose (a gauze, a powder) as compared with their foreign analog (a hemostatic gauze «Surgicel»). Median of hemostasis time consisted of (120±59,9) and (73±46,8) s, in case of application of gauze and powder preparations, respectively. The rate of group using the hemostatic gauze «Surgicel» was (142±77,4) s. The authors made a conclusion on the basis of given research, that the hemostatic material based on oxidize cellulose (the powder form) showed a more expressed hemostatic activity and reliably twice reduced the time of hemostasis as compared with their analog forms of gauze (p<0,05).
60-62 514
Abstract
On the basis of great clinical experience, the authors developed the method of choice of optimal surgical aid and suggested an original surgical method of treatment of complicated hemorrhoid. The results obtained were analyzed. There was reliably noted, that the quantity of early postoperative complications decreased, an expression of pain syndrome was lower and there were no relapses during three-year of follow-up. Given technologies allowed an introduction of them as stationary substituting operations on the basis of private medical centers with one day of hospital stay.
EXPERIENCE OF WORK
63-67 444
Abstract
Preoperative planning on the basis of combined data of navigated transcranial magnetic stimulation and MR-tractography give an opportunity to choose an optimal treatment approach in each clinical case. There were performed the examinations in 52 patients with tumors situated in projection of central gyrus. The neurosurgical interference was admitted as inappropriate in 3 (5,8%) patients. The volume of planned operation was reduced in 14 (26,9%) cases. The examination of 15 (28,9%) patients allowed choice of the correct access trajectory. The navigated transcranial magnetic stimulation assisted in performance of more safe removal of neoplasms closed to the functionally meaningful zones of the brain in 20 (38,4%).
A. A. Krivopalov,
Yu. K. Yanov,
S. V. Astashchenko,
A. Yu. Shcherbuk,
S. A. Artyushkin,
S. G. Vakhrushev,
I. S. Piskunov,
V. S. Piskunov,
N. A. Tuzikov
68-79 580
Abstract
A retrospective analysis of treatment was made in 127 adult patients with acute and chronic otitis media complicated by suppurative-inflammatory pathology of the brain. Purulent meningitis was revealed in 52 (40,9%) of hospitalized patients. Meningoencephalitis was often diagnosed in the cases of acute otitis media (15,4%) and in cases of chronic otitis (22,7%). The otogenic brain abscess was detected in 13,5% of otitis media cases and it was noted to be twice frequent (33,3%) in cases of purulent otitis media. The patients 124 (97,6%) have been operated. An extended mastoidotomy and antromastoidotomy were performed in the acute purulent otitis media. An extended radical operation on the ear was applied in case of chronic otitis media. Performance of craniotomy and complete removal of the abscess using modern systems of neuronavigation showed a higher clinical efficacy as compared with transtemporal approach during sanitizing intervention on the ear including the opening and abscess drainage in surgery of otogenic abscesses of the brain.
D. V. Gladyshev,
S. A. Kovalenko,
M. E. Moiseev,
S. S. Gnedash,
A. M. Karachun,
B. N. Kotiv,
D. S. Shelegetov,
I. I. Dzidzava
80-84 413
Abstract
This article analyzed the immediate treatment results of 210 patients, underwent endovideosurgical operative treatment concerning colorectal cancer (106 laparoscopic and 104 robotic-assisted operations). According to the first results, there was no significant difference between two methods in such medical indices as the volume of intraoperative hemorrhage, terms of hospital stay and peristalsis recovery, the rate of conversion and complications in early postoperative period, quantity of removed lymph nodes, quality of TME. The application of robotics allowed performance of precision work in conditions of limited space of the small pelvis.
OBSERVATION FROM PRACTICE
А. Игнашов,
Л. Ковалева,
М. Антонов,
А. Гичкин,
С. Баландов,
Д. Качалов,
М. Мамченкова,
Ч. Ван,
А. Весельский
94-99 391
HISTORY OF SURGERY
REVIEWS
НЕКРОЛОГИ
УКАЗАТЕЛИ
ISSN 0042-4625 (Print)
ISSN 2686-7370 (Online)
ISSN 2686-7370 (Online)