This journal is
indexed in Scopus
Year 2018 Vol. 26 No 2
M.G. RYABKOV 2, E.B. KISELEVA 1, N.D. GLADKOVA 1, M.S. BALEEV 2, E.L. BEDERINA 2, E.E. LUKOYANYCHEV 2, A.A. MIRONOV 1, I.L. DEZORTSEV 2, V.V. BESCHASTNOV 2
THE ROLE OF INTRAMURAL BLOODSTREAM DYSFUNCTION IN THE DEVELOPMENT OF SMALL INTESTINE ISCHEMIC NECROSIS
Nizhny Novgorod State Medical Academy 1,
City Clinical Hospital ¹ 30, Nizhny Novgorod 2,
The Russian Federation
Objective. To study experimentally the mechanisms of intramural bloodstream dysfunction and small bowel necrosis development in case of the acute mesenteric ischemia.
Methods. Acute complete mesenteric ischemia was modelled in laboratory animals by ligating a. mesenterica cranialis. The OCT-based microangiography technique was used to monitor bowel microcirculation till the visual signs of its non-viability appeared. Then the bowel was resected, the degree of ischemic lesion was histologically evaluated.
Results. In occlusion of mesenteric arteries by the moment when macroscopic nonviability signs appear, the ischemic damage without necrosis spreads out to 22.2% of the bowel length and mucous tunic necrosis and transmural necrosis spread out to 38.1% and 39.7% of the bowel length correspondingly. While comparing the histological preparations and OCT images, the features of OCT-microangiograms were described in different degrees of ischemic lesion and bowel necrosis. According to OCT-microangiography, in 60.3% of the wall of the ischemic intestine the number of functioning vessels remained normal. The decrease in the length of functioning vessels (by 5.6%, p=0.029), the total area of the vascular bed (by 4.5%, p=0.032) and the average vascular density (by 5.1%, p=0.001) occurred only in the intestinal wall with transmural necrosis. The mechanism of the superficial bowel necrosis development was a decrease in the proportion of small diameter vessels (p=0.029) against the background of the preserved microcirculation.
Conclusions. The attempt to recommence hemocirculation in the bowel arteries which are traditionally considered empty is the basis of modern surgical treatment of the mesenteric ischemia. However, the authors came to the conclusion that for 38% of ischemic bowel the blood supply remains at a normal level till necrosis development. This fact seems important for improving results of surgical treatment of acute mesenteric ischemia because it gives the opportunity to save a part of the bowel without thrombectomy. In these cases the OCT-based microangiography method can be an effective noninvasive tool for functioning blood vessels visualization and control of treatment results.
- Garelik PV, Dubrovshchik OI, Marmysh GG, Dovnar IS, Polynskiy AA, Tsilindz IT, Mogilevets EV, Mileshko MI, Koleshko SV, Pakulnevich YuF, Deshuk AN. Diagnostic and medical problems of acute disorders of mesenteric circulation in emergency surgery. Zhurn GRGMU. 2011;(4):3-7. (in Russ.)
- Adaba F, Askari A, Dastur J, Patel A, Gabe SM, Vaizey CJ, Faiz O, Nightingale JM, Warusavitarne J. Mortality after acute primary mesenteric infarction: a systematic review and meta-analysis of observational studies. Colorectal Dis. 2015 Jul;17(7):566-77. doi: 10.1111/codi.12938.
- Prozorov SA, Grishin AV. Endovascular treatment for acute disorders of mesenteric circulation. Zhurn im NV Sklifosovskogo Neotlozh Med Pomoshch’. 2016;(2):37-42. (in Russ.)
- Timerbulatov VM, Urazbakhtin IM, Timerbulatov ShV, Sagitov RB, Smyr RA. Visualization and objectification of diagnosis in abdominal surgery. Med Vestn Bashkortostana. 2015;10(6):26-30. (in Russ.)
- Beaulieu RJ, Arnaoutakis KD, Abularrage CJ, Efron DT, Schneider E, Black JH 3rd. Comparison of open and endovascular treatment of acute mesenteric ischemia. J Vasc Surg. 2014 Jan;59(1):159-64. doi: 10.1016/j.jvs.2013.06.084.
- Gibbons ÑP, Roberts DE. Endovascular treatment of chronic arterial mesenteric ischemia: a changingperspective? Semin Vasc Surg. 2010 Mar;23(Is 1):47-53. doi: 10.1053/j.semvascsurg.2009.12.006.
- Plotnikov GP, Shukevich DL, Grigoryev EV. Abdominal complication in cardiac surgery with cardiopulmonary bypass. Kompleks Problemy Serdech-Sosud Zabolevanii. 2014;(1):75-86. (in Russ.)
- Basarab DA, Bagdasarov VV, Bagdasarova EA, Zelenskii AA, Ataian AA. Patofiziologicheskie aspekty problemy ostroi intestinal’noi ishemii. Infektsii v Khirurgii. 2012;10(2):6-13. (in Russ.)
- Gordeeva AE, Sharapov MG, Novoselov VI, Fesenko EE, Temnov AA, Khubutiya MSh. The effects of Peroxiredoxin VI on the preservation of the small intestine in rats after ischemia/reperfusion damage. Transplantologiia. 2014;(4):21-27. doi: 10.23873/2074-0506-2014-0-4-21-27. (in Russ.)
- Ermolov AS, Lebedev AG, Titova GP, Yartsev PA, Selina IE, Reznitsky PA, Alekseechkina OA, Kaloeva OKh, Shavrina NV, Evdokimova OL, Zhigalkin RG. The difficulties of diagnosis and treatment of non-occlusive mesenteric circulatory disorders. Khirurgiia Zhurn im NI Pirgova. 2015;(12):24-32. doi: 10.17116/hirurgia20151224-32. (in Russ.)
- Björck M, Wanhainen A. Nonocclusive mesenteric hypoperfusion syndromes: recognition and treatment. Semin Vasc Surg. 2010 Mar;23(1):54-64. doi: 10.1053/j.semvascsurg.2009.12.009.
- Acosta S. Epidemiology of mesenteric vascular disease: clinical implications. Semin Vasc Surg. 2010 Mar;23(1):4-8. doi: 10.1053/j.semvascsurg.2009.12.001.
- Sirotkina M, Matveev L, Shirmanova M, Zaytsev V, Buyanova N, Elagin V, Gelikonov GV, Kuznetsov SS, Kiseleva EB, Moiseev AA, Gamayunov SV, Zagaynova EV, Feldchtein FI, Vitkin A, Gladkova ND. Photodynamic therapy monitoring with optical coherence angiography. Sci Rep. 2017; Article number: 41506. doi: 10.1038/srep41506.
- Gelikonov VM, Gelikonov GV. New approach to cross-polarized optical coherence tomography based on orthogonal arbitrarily polarized modes. Laser Phys Lett. 2006 Sep;3(Is 9):445-51. doi: 10.1002/lapl.200610030.
- Matveev LA, Zaitsev VY, Gelikonov GV, Matveyev AL, Moiseev AA, Ksenofontov SY, Gelikonov VM, Sirotkina MA, Gladkova ND, Demidov V, Vitkin A. Hybrid M-mode-like OCT imaging of three-dimensional microvasculature in vivo using reference-free processing of complex valued B-scans. Opt Lett. 2015 Apr 1;40(7):1472-75. doi: 10.1364/OL.40.001472.
605157, The Russian Federation,
Nizhny Novgorod, Berezovskaya Str., 85À,
City Clinical Hospital ¹ 30
of Moscow District,
Surgical Unit ¹ 2,
Tel.: +7 905 012-21-50,
Ryabkov Maxim G.
Ryabkov Maxim G., MD, Associate Professor, Consultant of the Surgical Unit ¹ 2, City Clinical Hospital ¹ 30 of Moscow District, Nizhny Novgorod, Russian Federation.
Kiseleva Elena B., PhD, Researcher of the Laboratory of Studying the Optical Properties of Tissues of SRI of Biomedical Technologies, Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russian Federation.
Gladkova Natalia D., MD, Professor, Deputy Director of SRI of Biomedical Technologies, Nizhny Novgorod State Medical Academy, Russian Federation.
Baleev Mixail S., Surgeon, the Surgical Unit ¹ 2, City Clinical Hospital ¹ 30 of Moscow District, Nizhny Novgorod, Russian Federation.
Bedrina Evgenia L., Pathologist, City Clinical Hospital ¹ 30 of Moscow District, Nizhny Novgorod, the Chief Out-Of-Staff Specialist (Pathologist) of the Department of Health, Nizhny Novgorod, Russian Federation.
Lukoyanychev Egor E., PhD, Surgeon, City Clinical Hospital ¹ 30 of Moscow District, Nizhny Novgorod, Russian Federation.
Mironov Andrey A., PhD, Senior Researcher of the Central Research Laboratory, Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russian Federation.
Dezortsev Ilya L., Surgeon, City Clinical Hospital ¹ 30 of Moscow District, Nizhny Novgorod, Russian Federation.
Beschastnov Vladimir V., MD, Associate Professor, Surgical Unit N2, Consultant of the Surgical Unit ¹ 2, City Clinical Hospital ¹ 30 of Moscow District, Nizhny Novgorod, Russian Federation.
GENERAL & SPECIAL SURGERY
A. A. ZIANKOU 1, 2, K.S. VYKHRYSTSENKA 2, N.G. LOJKO1, W.A. CHUESHOW 1, YU.P. OSTROVSKY 3, 4
MIDTERM DISTANT RESULTS OF A PROSPECTIVE RANDOMIZED TRIAL MICSREVS
Vitebsk Regional Clinical Hospital 1,
Vitebsk State Medical University 2, Vitebsk,
Republic Scientific and Practical Center «Cardiology» 3,
Belarusian Medical Academy of Postgraduate Education 4, Minsk,
The Republic of Belarus
Objective. To evaluate midterm distant results of the prospective randomized controlled trial “Minimally Invasive Cardiac Surgery Revascularization Strategy”, aimed to compare the effectiveness of minimally invasive cardiac surgery coronary artery bypass grafting versus off-pump coronary artery bypass grafting and on-pump coronary artery bypass grafting.
Methods. The randomized controlled trial was started in January 2014 (http://www.clinicaltrials.gov/show/NCT02047266). In accordance with the trial plan, 150 patients were included, divided into 3 groups, 50 subjects in each. In the first (main) group, the minimally invasive bypass strategy was directed to perform multivessel full arterial revascularisation on the beating heart without manipulations on the ascending aorta through the left-sided minothoracotomy. Conventional myocardial revascularization was performed on the beating heart (2 group) or with cardio-pulmonary bypass (3 group) via the median sternotomy. Inclusion criteria were multivessel coronary artery disease; II-IV functional class of angina pectoris and terms longer than 1 month after acute myocardial infarction. Exclusion criteria were previous coronary artery bypass grafting, single-vessel disease and need for emergency revascularization. The main endpoints of the study were the main adverse cardiac and brain events, as well as death from the cardiovascular cause and from any cause.
Results. The follow-up period in the groups constituted 975.5 (691.8; 1151.0) days, 792.5 (638.3; 936.3) days and 691.0 (506.0; 803.0) days, respectively. Cumulative survival (taking into account all causes of deaths and cardiovascular death) and freedom from major adverse cardiac and cerebral-vascular events did not differ significantly within the specified terms between the treatment groups of patients (p>0.05).
Conclusions. Minimally invasive myocardial revascularization can be successfully applied potentially in every patient with coronary heart disease who needs the multivessel coronary artery bypass grafting in the scheduled manner, saving the coronary interventions effectiveness during the midterm distant follow-up.
- Head SJ, Davierwala PM, Serruys PW, Redwood SR, Colombo A, Mack MJ5, Morice MC, Holmes DR Jr, Feldman TE, Stahle E, Underwood P, Dawkins KD, Kappetein AP, Mohr FW. Coronary artery bypass grafting vs. percutaneous coronary intervention for patients with three-vessel disease: final five-year follow-up of the SYNTAX trial. Eur Heart J. 2014 Oct 21;35(40):2821-30. doi: 10.1093/eurheartj/ehu213.
- Lapierre H, Chan V, Sohmer B, Mesana TG, Ruel M. Minimally invasive coronary artery bypass grafting via a small thoracotomy versus off-pump: a case-matched study. Eur J Cardiothorac Surg. 2011 Oct;40(4):804-10. doi: 10.1016/j.ejcts.2011.01.066.
- Ruel M, Une D, Bonatti J, McGinn JT. Minimally invasive coronary artery bypass grafting: is it time for the robot? Curr Opin Cardiol. 2013 Nov;28(6):639-45. doi: 10.1097/HCO.0b013e3283653fd1.
- Poston RS, Tran R, Collins M, Reynolds M, Connerney I, Reicher B, Zimrin D, Griffith BP, Bartlett ST. Comparison of economic and patient outcomes with minimally invasive versus traditional off-pump coronary artery bypass grafting techniques. Ann Surg. 2008 Oct;248(4):638-46. doi: 10.1097/SLA.0b013e31818a15b5.
- Puskas JD, Williams WH, Mahoney EM, Huber PR, Block PC, Duke PG, Staples JR, Glas KE, Marshall JJ, Leimbach ME, McCall SA, Petersen RJ, Bailey DE, Weintraub WS, Guyton RA. Off-pump vs conventional coronary artery bypass grafting: early and 1-year graft patency, cost, and quality-of-life outcomes: a randomized trial. JAMA. 2004 Apr 21;291(15):1841-49. doi: 10.1001/jama.291.15.1841.
- Shennib H. Evolving strategies in minimally invasive coronary artery surgery. Int J Cardiol. 1997 Dec 1;62 Suppl 1:S81-88.
- Calafiore AM, Giammarco GD, Teodori G, Bosco G, D’Annunzio E, Barsotti A, Maddestra N, Paloscia L, Vitolla G, Sciarra A, Fino C, Contini M. Left anterior descending coronary artery grafting via left anterior small thoracotomy without cardiopulmonary bypass. Ann Thorac Surg. 1996 Jun;61(6):1658-63; discussion 1664-65. doi: 10.1016/0003-4975(96)00187-7.
- McGinn JT Jr, Usman S, Lapierre H, Pothula VR, Mesana TG, Ruel M. Minimally invasive coronary artery bypass grafting: dual-center experience in 450 consecutive patients. Circulation. 2009 Sep 15;120(11 Suppl):S78-84. doi: 10.1161/CIRCULATIONAHA.108.840041.
- Bonaros N, Schachner T, Lehr E, Kofler M, Wiedemann D, Hong P, Wehman B, Zimrin D, Vesely MK, Friedrich G, Bonatti J. Five hundred cases of robotic totally endoscopic coronary artery bypass grafting: predictors of success and safety. Ann Thorac Surg. 2013 Mar;95(3):803-12. doi: 10.1016/j.athoracsur.2012.09.071.
- Halkos ME, Walker PF, Vassiliades TA, Douglas JS, Devireddy C, Guyton RA, Finn AV, Rab ST, Puskas JD, Liberman HA. Clinical and angiographic results after hybrid coronary revascularization. Ann Thorac Surg. 2014 Feb;97(2):484-90. doi: 10.1016/j.athoracsur.2013.08.041.
- Ziankou AA, Laiko MG. Comparative Effectiveness of the Minimally Invasive Coronary Artery Bypass Grafting [Electronic resourse]. Clinicaltrials.gov. Available from: http://clinicaltrials.gov/show/NCT02047266
- Barsoum EA, Azab B, Shah N, Patel N, Shariff MA, Lafferty J, Nabagiez JP, McGinn JT Jr. Long-term mortality in minimally invasive compared with sternotomy coronary artery bypass surgery in the geriatric population (75 years and older patients). Eur J Cardiothorac Surg. 2015 May;47(5):862-67. doi: 10.1093/ejcts/ezu267.
- Ruel M, Shariff MA, Lapierre H, Goyal N, Dennie C, Sadel SM, Sohmer B, McGinn JT Jr. Results of the Minimally Invasive Coronary Artery Bypass Grafting Angiographic Patency Study. J Thorac Cardiovasc Surg. 2014 Jan;147(1):203-8. doi: 10.1016/j.jtcvs.2013.09.016.
- Shen L, Hu S, Wang H, Xiong H, Zheng Z, Li L, Xu B, Yan H, Gao R. One-stop hybrid coronary revascularization versus coronary artery bypass grafting and percutaneous coronary intervention for the treatment of multivessel coronary artery disease: 3-year follow-up results from a single institution. J Am Coll Cardiol. 2013 Jun 25;61(25):2525-33. doi: 10.1016/j.jacc.2013.04.007.
210037, The Republic of Belarus,
Vitebsk, W.-internationalists Str., 37,
Vitebsk Regional Clinical Hospital,
Cardiac Surgery Unit,
Tel. office: +375 212 61-63-15,
Ziankou Aliaksandr A.
Ziankou Aliaksandr A., PhD, Head of the Cardiac Surgery Unit, Vitebsk Regional Clinical Hospital, Associate Professor of the Surgery Department of the Faculty of Advanced Training and Retraining of Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Vykhrystsenka Kiryl S., PhD, Assistant of the Hospital Surgery Department, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Lojko Nikolaj G., Cardiac Surgeon of the Cardiac Surgery Unit, Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus.
Chueshow Wjacheslaw A., Angiosurgeon of the Cardiac Surgery Unit, Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus.
Ostrovsky Youry P., MD, Professor, Academician of NAS of Belarus, Head of the Heart Surgery Laboratory of the Republic Scientific and Practical Center «Cardiology», Head of the Department of Cardiac Surgery with the Course of Transplantology, Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus.
I.A. SANETS ¹, A.E. SILIN ¹, YU.I. YARETS ¹, V.V. ANICHKIN ²
GENETIC MARKERS OF VENOUS THROMBOEMBOLISM IN SURGICAL PATIENTS
The Republican Research Centre for Radiation Medicine and Human Ecology 1,
Gomel State Medical University2, Gomel
The Republic of Belarus
Objective. Òo study the occurrence of genetic markers of the venous thromboembolism (FV:G1691A, FII:G20210A, MTHFR:C677T and PAI-1:5G/4G) in patients who have previously had deep vein thrombosis and/or the pulmonary embolism as well as in surgical patients without phlebothrombosis episodes in the anamnesis.
Methods. The subjects of the study were patients (n=54) suffering from cholelithiasis. All individuals were divided into two groups: group 1 consisted of patients with deep vein thrombosis and/or pulmonary embolism in the past (n=29, 12 males and 17 females, the mean age of patients was 59.4±12.4 years). The second group was presented by patients without venous thromboembolism in the case history (n=25, 9 males and 16 females, the mean age – 54.7±8.4 years). The molecular genetic testing of four main factors associated with a predisposition to thrombotic complications (FV:G1691A, FII:G20210A, MTHFR:C677T and PAI-1:5G/4G) was performed in patients of both groups. The study was carried out using the PCR method with three different oligonucleotide primers to identify each genetic polymorphism (mutation).
Results. The incidence of Leiden mutation (FV:G1691A) in the surgical patients with the venous thromboembolism was significantly higher than in patients without phlebothrombosis episodes in the past (25% and 4%, respectively, ð=0.038).
There were no significant differences between the groups of patients with the venous thrombotic complications and in the control group patients in terms of others genetic polymorphism: FII: G20210A (ð=0.349), PAI-1: 5G/4G (ð=0.751) and MTHFR: C677T (ð=0.416).
Conclusions. The presence of the Leiden mutation of the V coagulation factor in surgical patients significantly increases the risk of thrombotic complications in the postoperative period. The presence of FII:G20210A, PAI-1:5G/4G, MTHFR:C677T genetic defects in surgical patients are not associated with the likelihood of the postoperative thrombosis development.
- Klinicheskii protokol lecheniia i profilaktiki venoznoi trombembolii: Prikaz M-va zdravookhraneniia Resp Belarus’ ¹ 150; 14.02.2011 [Elektronnyi resurs]. 2011 [Data dostupa: 12.12.2016]. Available from: http://minzdrav.gov.by/ru/static/spavochno-infirm/protololy_lechenia/protokoly_2011 (in Riss.)
- Beloenko ED, Volosheniuk AN, Boltrukevich SI, Prasmytskii OT, Bogomolov AN, Eismont OL, Il’iasevich IA, Mavrichev SA. Profilaktika i lechenie tromboembolicheskikh oslozhnenii v travmatologii i ortopedii: prakt posobie. Minsk, RB: V.I.Z.A. Grupp; 2006. 171 p. (in Russ.)
- Rosendaal FR. Risk factors for venous thrombosis: prevalence, risk, and interaction. Semin Hematol. 1997 Jul;34(3):171-87.
- Holst AG, Jensen G, Prescott E. Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study. Circulation. 2010 May 4;121(17):1896-903. doi: 10.1161/CIRCULATIONAHA.109.921460.
- Arnoud E, Reny JL, Emmerich J, Aiach M. Thrombose veineuse et anomalies génétiques de l’hémostase. Sang Thrombose Vaisseaux. 2000;12(7):426-32.
- Meltzer ME, Lisman T, de Groot PG, Meijers JC, le Cessie S, Doggen CJ, Rosendaal FR. Venous thrombosis risk associated with plasma hypofibrinolysis is explained by elevated plasma levels of TAFI and PAI-1. Blood. 2010 Jul 8;116(1):113-21. doi: 10.1182/blood-2010-02-267740.
- Jusić-Karić A, Terzić R, Jerkić Z, Avdić A, Podanin M. Frequency and association of 1691 (G>A) FVL, 20210 (G>A) PT and 677 (C>T) MTHFR with deep vein thrombosis in the population of Bosnia and Herzegovina. Balkan J Med Genet. 2016 Aug 2;19(1):43-50. eCollection 2016 Jul 1.
- Caprini JA, Glase CJ, Anderson CB, Hathaway K. Laboratory markers in the diagnosis of venous thromboembolism. Circulation. 2004 Mar 30;109(12 Suppl 1):14-18. doi: 10.1161/01.CIR.0000122869.59485.36.
- Hosseini S, Kalantar E, Hosseini MS, Tabibian S, Shamsizadeh M, Dorgalaleh A. Genetic risk factors in patients with deep venous thrombosis, a retrospective case control study on Iranian population. Thromb J. 2015 Nov 10;13:35. doi: 10.1186/s12959-015-0064-y. eCollection 2015.
- Miranda-Vilela AL. Role of polymorphisms in factor V (FV Leiden), prothrombin, plasminogen activator inhibitor type-1 (PAI-1), methylenetetrahydrofolate reductase (MTHFR) and cystathionineβ-synthase (CBS) genes as risk factors for thrombophilias. Mini Rev Med Chem. 2012 Sep 1;12(10):997-1006. doi: 10.2174/138955712802762338.
- Glueck CJ, Phillips H, Cameron D, Wang P, Fontaine RN, Moore SK, Sieve-Smith L, Tracy T. The 4G/4G polymorphism of the hypofibrinolytic plasminogen activator inhibitor type 1 gene: an independent risk factor for serious pregnancy complications. Metabolism. 2000 Jul;49(7):845-52. doi: 10.1053/meta.2000.6749.
- Gipergomotsisteinemiia kak etiologicheskii faktor reproduktivnoi nedostatochnosti pri trombofilii [Elektronnyi resurs]. 2017 [Data dostupa: 25.02.2017]. Available from: http://newlab-med.ru/vracham/poleznaya-informacziya/gipergomoczisteinemiya-kak-etiologicheskij-faktor-reproduktivnoj-nedostatochnosti-pri-trombofilii.html (in Russ.)
- Lee YH, Song GG. Plasminogen activator inhibitor-1 4G/5G and the MTHFR 677C/T polymorphisms and susceptibility to polycystic ovary syndrome: a meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2014 Apr;175:8-14. doi: 10.1016/j.ejogrb.2013.12.030.
- Strandberg K, Stenflo J, Nilsson C, Svensson PJ. APC-PCI complex concentration is higher in patients with previous venous thromboembolism with Factor V Leiden. J Thromb Haemost. 2005 Nov;3(11):2578-80. doi: 10.1111/j.1538-7836.2005.01617.x.
- Isordia-Salas I, Leaños-Miranda A, Sainz IM, Reyes-Maldonado E, Borrayo-Sánchez G. Association of the plasminogen activator inhibitor-1 gene 4G/5G polymorphism with ST elevation acute myocardial infarction in young patients. Rev Esp Cardiol. 2009 Apr;62(4):365-72. doi: 10.1016/S1885-5857(09)71663-9. [Article in English, Spanish]
246040, The Republic of Belarus,
Gomel, Ilyich Str., 290,
Republican Scientific Center
for Radiation Medicine and Human Ecology,
Surgical Unit of the Consultative Polyclinic,
Tel. office: +375-232-38 96 36,
Sanets Igor A.
Sanets Igor A., Surgeon, Surgical Unit of the Consultative Polyclinic, the Republican Scientific Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
Yarets Yuliya I., PhD, Associate Professor, Head of the Clinical and Diagnostic Laboratory, the Republican Scientific Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
Silin Arkadij E., PhD, Head of the Laboratory of Molecular Genetics, the Republican Scientific Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
Anichkin Vladimir V., MD, Professor, Professor of the Department of Surgical Diseases ¹3 with the Course of Urology, Gomel State Medical University, Gomel, Republic of Belarus.
V.M. CHUMAKOV, O.L. SYTNIK, V.I. BUGAIOV
POLYMORPHISM OF IL-8 CYTOKINE GENE IN PATIENTS WITH PANCREATOGENIC PERITONITIS
Sumy State University, Medical Institute,
Objective. This preliminary study was conducted to assess the possible association of IL-8 (-251À/Ò) polymorphism with clinical course and outcome of acute pancreatitis aggravated by pancreatogenic peritonitis.
Methods. Data for the study were DNA samples, received from the leucocytes of 143 humans: 83 patients with acute pancreatitis aggravated by pancreatogenic peritonitis, 60 healthy blood donors without acute pancreatitis in the anamnesis served as controls. IL-8 (-251À/Ò) polymorphism detection was made with polymerase chain reaction with further length analysis of the restriction fragments.
Results. The analysis of frequency of allelic variants of the cytokine gene IL-8 (-251À/Ò) revealed that genotype A/T was the dominant variant (45%) among healthy blood donors. Distribution of IL-8 (-251À/Ò) polymorphism among the patients with pancreatogenic peritonitis without and after surgical treatment is characterized by dominance of genotype T/T in group after surgical treatment (ð<0.05). This may indicate association of genotype T/T and unfavorable clinical course of pancreatogenic peritonitis (OR>1). Among patients after surgical treatment genotype A/T was less often met in comparison with the group without it (p<0.05). This may indicate the association of genotype A/T and favorable clinical course of pancreatogenic peritonitis (OR<1). Genotype A/A was rarely registered, which may be due to regional peculiarities of the patient’s genotype.
Conclusions. This preliminary study suggests that the identification of genetic polymorphism of IL-8 (-251A/T)
may be informative and serve as an additional criterion to predict both the clinical course and outcome of pancreatogenic peritonitis; it may also specify indications for surgical treatment. However, the possible role of IL-8 (-251A/T) cytokine polymorphism in the outcome of pancreatogenic peritonitis requires further carefully planned cohort investigations.
- Sah RP, Dawra RK, Saluja AK. New insights into the pathogenesis of pancreatitis. Curr Opin Gastroenterol. 2013 Sep;29(5):523-30. doi: 10.1097/MOG.0b013e328363e399.
- S tepanov IuM, Gravirovskaia NG, Skirda IIu, Petishko OP. Bolezni podzheludochnoi zhelezy kak odna iz vedushchikh problem gastroenterologii i abdominal’noi khirurgii (sovremennaia epidemiologiia). Gastroeterolog³ia. 2014;53(3):7-14. (in Russ.)
- Chernov VN, Belik BM, Alibekov AZ. Treatment of the infected forms of acute destructive pancreatitis using minimally invasive technologies. Novosti Khirurgii.2014;22(1):63-67. doi: 10.18484/2305-0047.2014.1.63. (in Russ.)
- van Brunschot S, Schut AJ, Bouwense SA, Besselink MG, Bakker OJ, van Goor H, Hofker S, Gooszen HG, Boermeester MA, van Santvoort HC. Abdominal compartment syndrome in acute pancreatitis: a systematic review. Pancreas. 2014 Jul;43(5):665-74. doi: 10.1097/MPA.0000000000000108.
- Khomiak IV, K³t OV. Intraabdominal pressure, compartment syndrome in surgical treatment of severe acute pancreatitis. Kl³n³chna Kh³rurg³ia. 2014;(4):56-59. Available from: http://nbuv.gov.ua/UJRN/KlKh_2014_4_19
- Zubritskiy V, Zemlyanoi A, Matveyev D, Ayrapetyan A, Golubev I, Rozberg Ye, Korenev D. Intra-abdominal hypertension and pancreatogenic peritonitis. Med Vestn MVD. 2015;76(4):27-31. (in Russ.)
- Kylänpää ML, Repo H, Puolakkainen PA. Inflammation and immunosuppression in severe acute pancreatitis. World J Gastroenterol. 2010 Jun 21;16(23):2867-72. doi: 10.3748/wjg.v16.i23.2867.
- Fisic E, Poropat G, Bilic-Zulle L, Licul V, Milic S, Stimac D. The role of IL-6, 8, and 10, sTNFr, CRP, and pancreatic elastase in the prediction of systemic complications in patients with acute pancreatitis. Gastroenterol Res Pract [Electronic resource]. 2013;2013:282645:[about 6 p.]. Available from: https://www.hindawi.com/journals/grp/2013/282645/abs.
- Firsova VG, Parshikov VV, Gradusov VP. Ostryi pankreatit: sovremennye aspekty patogeneza i klassifikatsii. Sovrem Tekhnologii v Meditsine. 2011;(2):127-34. (in Russ.)
- Ismailov EL, Eralina SN, Bekesbaev BB, Abdrasulov RB. Extracorporeal detoxification methods in the treatment of destructive pancreatitis. Obshch Reanimatologiia. 2015;11(3):65-74. doi: 10.15360/1813-9779-2015-3-65-74. (in Russ.)
- Cruz-Santamaría DM, Taxonera C, Giner M. Update on pathogenesis and clinical management of acute pancreatitis. World J Gastrointest Pathophysiol. 2012 Jun 15;3(3):60-70. doi: 10.4291/wjgp.v3.i3.60.
- Kylänpää L, Rakonczay ZJr, O’Reilly DA. The clinical course of acute pancreatitis and the inflammatory mediators that drive it. Int J Inflam. 2012; 2012:360685. doi: 10.1155/2012/360685.
- Yin YW, Sun QQ, Feng JQ, Hu AM, Liu HL, Wang Q. Influence of interleukin gene polymorphisms on development of acute pancreatitis: a systematic review and meta-analysis. Mol Biol Rep. 2013 Oct;40(10):5931-41. doi: 10.1007/s11033-013-2700-6.
- Li D, Li J, Wang L, Zhang Q. Association between IL-1β, IL-8, and IL-10 polymorphisms and risk of acute pancreatitis. Genet Mol Res. 2015 Jun 18;14(2):6635-41. doi: 10.4238/2015.June.18.6.
- Chen WC, Nie JS. Genetic polymorphism of MCP-1-2518, IL-8-251 and susceptibility to acute pancreatitis: a pilot study in population of Suzhou, China. World J Gastroenterol. 2008 Oct 7;14(37):5744-48. doi: 10.3748/wjg.14.5744.
Sumy, Rimsky-Korsakov Str., 2,
Sumy State University,
Department of Surgery and Oncology,
Tel. office: +380 542 64-03-18,
Chumakov Volodymyr M.
Chumakov Volodymyr N., Assistant of the Department of Surgery and Oncology, Sumy State University, Sumy, Ukraine.
Sytnik Oleksandr L., PhD, Associate Professor of the Department of Surgery and Oncology, Sumy State University, Sumy, Ukraine.
Bugaiov Volodymyr I., PhD, Associate Professor of the Department of Surgery and Oncology, Sumy State University, Sumy, Ukraine.
YU.V. AVDOSYEV 1, 2, I.V. BELOZEROV 2, O.N. KUDREVICH 2
ENDOVASCULAR METHODS OF DIAGNOSIS AND TREATMENT OF ACUTE HEMORRHAGES IN THE GASTROINTESTINAL TRACT LUMEN
Institute of General and Emergency Surgery named after V. T. Zaitsev of National Academy of Medical Sciences of Ukraine 1,
Kharkiv National University named after V.N. Karazin 2,
Objective. To assess the effectiveness of endovascular diagnosis and treatment methods of acute gastrointestinal hemorrhage.
Methods. The paper summarizes the experience of angiographic diagnosis and endovascular treatment of 342 patients who were admitted to the Institute of General and Emergency Surgery named after V. T. Zaitsev with a clinical picture of bleeding in the lumen of the gastrointestinal tract for the period from 1998 to 2016. There were 145 (42.4%) women and 197 (57.6%) men aged 16 to 77 years (mean age 59.3±11.1 years) among the patients.
Results. As the study has established the most informative method was superselective arteriography, which permitted to reveal both direct and indirect angiographic signs of gastrointestinal hemorrhage. Thus, in 63 (18.4%) patients the direct signs of continuing bleeding were diagnosed. In 272 (79.5%) examined patients, the indirect angiographic signs of stopped bleeding were revealed. A higher percentage of indirect signs of bleeding is associated with both the chronic course of the underlying disease and the characteristic angiographic pattern for a particular gastrointestinal disease complicated by bleeding and with stopping of active bleeding by the time of angiography.
Based on the clinical examination and angiographic data, a direct source of gastrointestinal hemorrhage was diagnosed in 215 (62.8%) patients.
Conclusions. The conducted study has confirmed that selective angiography of the branches of the abdominal aorta and iliac arteries is a highly informative diagnostic method and in 62.8% of observations it was possible to establish the source and localization of bleeding. In patients with ongoing gastrointestinal hemorrhage and questionably tolerance of surgical intervention, the endovascular hemostasis is often a choice of treatment of these patients. Differentiated using of both primary and repeated (in case of recurrent bleeding), the endovascular methods of hemostasis in patients with acute gastrointestinal hemorrhage allowed achieving final hemostasis in 90.4% of cases.
- Vertkin AL, Sveshnikov KA. Natsional’noe rukovodstvo po skoroi pomoshchi. Moscow, RF: EKSMO; 2012. 816 p. (in Russ.)
- Fallah MA, Prakash C, Edmundowicz S. Acute gastrointestinal bleeding. Med Clin North Am. 2000 Sep;84(5):1183-208.
- Pantsyrev IuM, Mikhlev AI, Fedorov ED, Kuzeev EA. Lechenie iazvennykh gastroduodenal’nykh krovotechenii. Khirurgiia Zhurn im NI Pirogova. 2000;(3):21-25. (in Russ.)
- Krylov NN. Krovotechenie iz verkhnikh otdelov pishchevaritel’nogo trakta: prichiny, faktory riska diagnostika, lechenie. Ros Zhurn Gastroenterologii Gepatologii i Koloproktologii. 2001;11(2):76-87. (in Russ.)
- Nikishin LF, Al’tman IV, Kondratiuk VA, Vereshchagin SV. Lechenie ostrykh zheludochno-kishechnykh krovotechenii metodami rentgenoendovaskuliarnoi khirurgii. Rentgenokh³rurg³ia nev³dkladnikh stan³v. Nove v ³ntervents³in³i rad³olog³¿: materialy dokl; 1997 Apr 24-26; Chernigov, Ukraina. p. 84-87. (in Russ.)
- Avdos’ev IuV, Boiko VV. Angiografiia i rentgenendovaskuliarnaia khirurgiia abdominal’nykh krovotechenii: monogr. Khar’kov, Ukraina: Izdatel’ Savchuk OO; 2011. 648 p. (in Russ.)
- Nanavati SM. What if endoscopic hemostasis fails? Alternative treatment strategies: interventional radiology. Gastroenterol Clin North Am. 2014 Dec;43(4):739-52. doi: 10.1016/j.gtc.2014.08.013.
- Dallal HJ, Palmer KR. ABC of the upper gastrointestinal tract: Upper gastrointestinal haemorrhage. BMJ. 2001 Nov 10;323(7321):1115-17.
- Annamalai G, Masson N, Robertson I. Acute gastrointestinal haemorrhage: investigation and treatment. Imaging. 2009;21(Is 2):142-51.
- Walker TG, Salazar GM, Waltman AC. Angiographic evaluation and management of acute gastrointestinal hemorrhage. World J Gastroenterol. 2012 Mar 21;18(11):1191-201. doi: 10.3748/wjg.v18.i11.1191.
- Teng HC, Liang HL, Lin YH, Huang JS, Chen CY, Lee SC, Pan HB. The Efficacy and long-term outcome of microcoil embolotherapy for acute lower gastrointestinal bleeding. Korean J Radiol. 2013 Mar-Apr; 14(2): 259-68. Published online 2013 Feb 22. doi: 10.3348/kjr.2013.14.2.259.
Kharkiv, Svoboda Square, 6,
Kharkiv National University
named after V.N. Karazin,
Department of Surgical Diseases,
Operative Surgery and Topographic Anatomy,
Tel. +380 50 902-72-72,
Kudrevich Olexandr N.
Avdosyev Yuriy V., MD, Head of the X-ray Surgery Unit, Institute of General and Emergency Surgery named after V. T. Zaitsev of National Academy of Medical Sciences of Ukraine, Professor of the Department of Surgical Diseases, Operative Surgery and Topographic Anatomy of the Medical Faculty, Kharkiv National University named after V.N. Karazin, Kharkiv, Ukraine.
Belozerov Igor V., MD, Dean of the Medical Faculty, Kharkiv National University named after V.N. Karazin, Kharkiv, Ukraine.
Kudrevich Olexandr N., PhD, Head of the Department of Surgical Diseases, Operative Surgery and Topographic Anatomy of the Medical Faculty, Kharkiv National University named after V.N. Karazin, Kharkiv, Ukraine.
A.YA. KOROVIN, M.B. ANDREEVA, D.V. TURKIN, N.A. TRIFANOV
COMPLEX TREATMENT OF PATIENTS WITH ACUTE MESENTERIC ISCHEMIA AND PERITONITIS
Kuban State Medical University,
The Russian Federation
Objective. To develop surgical tactics in acute mesenteric ischemia and purulent peritonitis and to find ways to improve the results of treatment of this complicated pathology.
Methods. 118 cases of acute mesenteric ischemia complicated by diffuse peritonitis were analyzed. For urgent diagnosis of the pathology, computed tomography was used. In the first group (n=72), one-step procedures were applied – the intestinal resection and embolthrombectomy with application of the primary anastomosis. Reoperations were performed «on demand». In the second group (n=46), operations were of a separate nature, along with thrombembolectomy and intestinal resection at the stages of the programmed relaparotomy, delayed interintestinal anastomoses were used. The maximum number of relaparotomies in both groups was 3. The gradual treatment outcomes were assessed during the first day hospital mortality and integrated rates of severity of the sepsis APACHE II and SOFA, the peritonitis index of Mannheim (IPM) and the abdominal cavity index (IAC) in the intervals between relaparotomies. At the final stage, hospital mortality was compared in the groups of patients.
Results. The mortality rate after the first operation in the groups was 43.6% and 41.3%, respectively. Reduction in the severity of abdominal sepsis was registered at the time of the third relaparotomy, in the second SOFA group <8, the IPM decreased by 16%, and the IAC by 27%. Significant differences in IPM and IAC indicators were registered only with the third relaparotomy, and the tendency of the positive dynamics of peritonitis course was traced in the second group of observations. Hospital lethality exceeded the staged predicted values and constituted 87.5% in the first, and 84.8% in the second group.
Conclusions. Surgical tactics, including the use of obstructive bowel resections with the delayed anastomosis after restoration of mesenteric hemocirculation and relief of the reperfusion syndrome at the stages of the programmed relaparotomy, contributes to improving the treatment results of acute mesenteric ischemia and diffuse peritonitis.
- Kosinets VA. Influence of new pathogenetic reasonable scheme of complex treatment of widespread purulent peritonitis on the course of inflammatory process. Khirurgiia Zhurn im NI Pirogova. 2012;(8):69-73. (in Russ.)
- Sazhin VP, Avdovenko AL, Iurishchev VA. Current trends in surgical treatment of peritonitis. Khirurgiia Zhurn im NI Pirogova. 2007;(11):36-39. (in Russ.)
- Shugaev AI, Vovk AV. Ostrye narusheniia arterial’nogo mezenterial’nogo krovoobrashcheniia. Vestn Khirurgii im II Grekova. 2005;164(4):112-15. (in Russ.)
- Düber C, Wüstner M, Diehl SJ, Post S. Emergency diagnostic imaging in mesenteric ischemia. Chirurg. 2003 May;74(5):399-406. [Article in German]
- Baeshko AA, Klimuk SA, Iushkevich VA. Prichina i osobennosti porazhenii kishechnika i ego sosudov pri ostrom narushenii bryzheechnogo krovoobrashcheniia. Khirurgiia Zhurn im NI Pirogova. 2005;(4):57-63. (in Russ.)
- Maskin SS, Golbraykh VA, Derbenzeva TV, Karsanov AM, Ermolaeva NK, Lopasteysky DS. Programmed and emergency relaparotomy in the treatment of diffuse peritonitis. Vestn VolgGMU. 2012;(4):105-107. (in Russ.)
- Gostishchev VK, Sazhin VP, Avdovenko AL. Peritonit. Moscow, RF: Geotar-med; 2002. 240 p. (in Russ.)
- Baeshko AA, Klimuk SA, Yushkevich VA. Acute disorders of mesenteric circulations: the etiology, risk factors and incidence of lesions. Angiologiia i Sosud Khirurgiia. 2004;10(4):99-13.
- Edwards MS, Cherr GS, Craven TE, Olsen AW, Plonk GW, Geary RL, Ligush JL, Hansen KJ. Acute occlusive mesenteric ischemia: surgical management and outcomes. Ann Vasc Surg. 2003 Jan;17(1):72-79.
- Park WM, Gloviczki P, Cherry KJ Jr, Hallett JW Jr, Bower TC, Panneton JM, Schleck C, Ilstrup D, Harmsen WS, Noel AA. Contemporary management of acute mesenteric ischemia: Factors associated with survival. J Vasc Surg. 2002 Mar;35(3):445-52.
- Klimovich IN, Maskin SS, Dubrovin IA, Karsanov AM, Derbentseva TV. Endovideokhirurgiia v diagnostike i lechenii posleoperatsionnogo peritonita. Vestn Khirurgii im II Grekova. 2015;174(4):113-16. (in Russ.)
- Alhan E, Usta A, çekiç A, Saglam K, Türky?lmaz S, Cinel A. A study on 107 patients with acute mesenteric ischemia over 30 years. Int J Surg. 2012;10(9):510-3. doi: 10.1016/j.ijsu.2012.07.011.
- Kirkpatrick ID, Kroeker MA, Greenberg HM. Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia: initial experience. Radiology. 2003 Oct;229(1):91-8. Epub 2003 Aug 27. doi: 10.1148/radiol.2291020991.
- Björck M, Acosta S, Lindberg F, Troeng T, Bergqvist D. Revascularization of the superior mesenteric artery after acute thromboembolic occlusion. Br J Surg. 2002 Jul;89(7):923-27.
- Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287.
350063, The Russian Federation,
Krasnodar, Sedin Str., 4,
Kuban State Medical University,
Department of the Faculty
Surgery with the Course of Anesthesiology
and Intensive Care,
Tel. mobile: + 7 988 244-69-44,
Korovin Alexander Ja.
Korovin Alexander Ja., MD, Professor, Head of the Department of the Faculty Surgery with the Course of Anesthesiology and Intensive Care, Kuban State Medical University, Krasnodar, Russian Federation.
Andreeva Marina B., PhD, Assistant of the Department of the Faculty Surgery with the Course of Anesthesiology and Intensive Care, Kuban State Medical University, Krasnodar, Russian Federation.
Turkin Denis V., PhD, Assistant of the Department of the Faculty Surgery with the Course of Anesthesiology and Intensive Care, Kuban State Medical University, Krasnodar, Russian Federation.
Trifanov Nikolay A., Post-Graduate Student of Department of the Faculty Surgery with the Course of Anesthesiology and Intensive Care, Kuban State Medical University, Krasnodar, Russian Federation.
V.A. LAZARENKO, E.A. BOBROVSKAYA
HYPERHOMOCYSTEINEMIA AND FUNCTIONAL STATE OF ENDOTHELIUM IN PATIENTS WITH PERIPHERAL ARTERY DISEASE WITH ARTERIAL RECONSTRUCTIONS
Kursk State Medical University, Kursk,
The Russian Federation
Objective. To study the relationship between homocysteine and markers of the functional state of the endothelium in patients with obliterating atherosclerosis in operations on the aorta and arteries of the lower limbs.
Methods. The study included 68 patients with peripheral artery disease, the average age was 57.8±7.3 years, with II B – III degree of chronic arterial insufficiency according to R. Fontaine-A.V. Pokrovsky, who were divided into three groups: I group underwent the femoro-popliteal bypass (n=32), II – the aorto-femoral bypass (n=20), III – x-ray endovascular angioplasty and stenting of the iliac arteries (n=16). A correlation analysis was made between the content of homocysteine and the markers of the endothelium functional state of: the oxidized low-density lipoproteins (oxidized LDL), a molecule of adhesion of the vascular endothelium type 1 (sVCAM-1), the tissue type 1 plasminogen activator inhibitor (PAI-1), the tissue plasminogen activator (t-PA), Annexin V in the systemic and local bloodstream prior to surgery and after the arterial reconstructions.
Results. Correlation relationships between homocysteine and oxidized LDL were established both in the systemic blood flow and the affected limb, this association persisted after the reconstructive intervention, the most significant in the local bloodstream after femoro-popliteal bypass surgery. Preoperative positive correlation of the systemic level of homocysteine and sVCAM-1 in group I was marked. The effect of homocysteine on the fibrinolytic function of the endothelium was shown, as indicated by the direct correlation between homocysteine and PAI-1 in the systemic blood flow and in the affected limb, which persist after open reconstructions. Significant links between homocysteine and the level of Annexin V were revealed in the group of patients with the lesion of the femoro-popliteal arterial segment.
Conclusions. Hyperhomocysteinemia contributes significantly to the disturbance of the endothelium functional state, affecting apoptosis, the activation of atherogenic LDL, and the procoagulant potential, which persist even after arterial reconstructions both in the systemic and local bloodstream.
- Petrishchev NN, Vasina LV, Vlasov TD, Gavrisheva NA, Menshutina MA. Tipovye formy disfunktsii endoteliia. Klin-Lab Konsilium. 2007;(18):31-35. (in Russ.)
2.Tsybikova NM, Tsybikov MN. Rol’ gipergomotsisteinemii v patologii cheloveka. Dal’nevostoch Med Zhurn. 2007;(4):110-112. (in Russ.)
- Chia S, Wilson R, Ludlam CA, Webb DJ, Flapan AD, Newby DE. Endothelial dysfunction in patients with recent myocardial infarction and hyperhomocysteinaemia: effects of vitamin supplementation. ClinSci (Lond). 2005 Jan;108(1):65-72. doi: 10.1042/CS20040150.
- Steed MM, Tyagi SC. Mechanisms of cardiovascular remodeling in hyperhomocysteinemia. Antioxid Redox Signal. 2011 Oct 1;15(7):1927-43. doi: 10.1089/ars.2010.3721.
- Loscalzo J. Homocysteine-mediated thrombosis and angiostasis in vascular pathobiology. J Clin Invest. 2009 Nov;119(11):3203-5. doi: 10.1172/JCI40924.
- Lazarenko VA, Bobrovskaya EA, Sorokin A.V. Hyperhomocysteinemia: peripheral atherosclerosis and
reconstructive surgery. Kursk Nauch-Prakt Vestn «Chelovek i Ego Zdorov’e». 2014;(4):63-66. (in Russ.)
- Zobova DA, Kozlov SA. Rol’ gomotsisteina v patogeneze nekotorykh zabolevanii. Izv Vysshikh Ucheb Zavedenii. Povolzh Region. Med Nauki. 2016;3(39):132-44. doi: 10.21685/2072-3032-2016-3-15. (in Russ.)
- Loscalzo J. The oxidant stress of hyperhomocyst(e)inemia. J Clin Invest. 1996 Jul 1;98(1):5-7. doi: 10.1172/JCI118776.
- Ingenbleek Y. The Oxidative stress of hyperhomocysteinemia results from reduced bioavailability of sulfur-containing reductants. Open Clin Chem J. 2011;4(1):34-44. doi: 10.2174/1874241601104010034.
- Karazhanova LK, Zhunuspekova AS. Hyperhomocysteinemia as a risk factor of cardiovascular diseases (literature review). Nauka i Zdravookhranenie. 2016;(4):129-44. orcid.org/0000-0003-1496-3281. (in Russ.)
- Leoncini G, Bruzzese D, Signorello MG. Activation of p38 MAPKinase/cPLA2 pathway in homocysteine-treated platelets. J Thromb Haemost. 2006;4(1):209-16. doi: 10.1111/j.1538-7836.2005.01708.x.
- Yeh JK, Chen CC, Hsieh MJ, Tsai ML, Yang CH, Chen DY, Chang SH, Wang CY, Lee CH, Hsieh IC. Impact of homocysteine level on long-term cardiovascular outcomes in patients after coronary artery stenting. J Atheroscler Thromb. 2017 Jul 1;24(7):696-705. doi: 10.5551/jat.36434.
- Tofler GH, Massaro J, O’Donnell CJ, Wilson PWF, Vasan RS, Sutherland PA, Meigs JB, Levy D, D’Agostino RB Sr. Plasminogen activator inhibitor and the risk of cardiovascular disease: The framingham heart study. Thromb Res. 2016 Apr;140:30-35. doi: 10.1016/j.thromres.2016.02.002.
- de Jong SC, Stehouwer CD, van-den Berg M, Vischer UM, Rauwerda JA, Emeis JJ. Endothelial marker proteins in hyperhomocysteinemia. ThrombHaemost. 1997 Nov;78(5):1332-37.
- Sipkens JA, Hahn N, van den Brand CS, Meischl C, Cillessen SA, Smith DE, Juffermans LJ, Musters RJ, Roos D, Jakobs C, Blom HJ, Smulders YM, Krijnen PA, Stehouwer CD, Rauwerda JA, van Hinsbergh VW, Niessen HW. Homocysteine-induced apoptosis in endothelial cells coincides with nuclear NOX2 and peri-nuclear NOX4 activity. Cell Biochem Biophys. 2013 Nov;67(2):341-52. doi: 10.1007/s12013-011-9297-y.
305041, The Russian Federation,
Kursk, K.Marx Str., 3,
Kursk State Medical University,
Department of Surgical Diseases
of the Faculty of Post-Graduate Training,
Tel.: +7 (4712) 58-81-32,
Lazarenko Viktor A.
Lazarenko Viktor A., MD, Professor, Rector, Head of the Department of Surgical Diseases of the Faculty of Post-Graduate Training, Kursk State Medical University, Kursk, Russian Federation.
Bobrovskaya Elena A., PhD, Associate Professor of the Department of Surgical Diseases of the Faculty of Post-Graduate Training, Kursk State Medical University, Kursk, Russian Federation.
TRAUMATOLOGY & ORTHOPEDICS
YE.N. TOKTAROV, M.A. ZHANASPAYEV, A.S. TLEMISSOV, D.T. BAKHTYBAEV, A.O. MYSSAYEV
INTERLOCKING NAILING OF TIBIA SHAFT FRACTURES BY EXPANDABLE NAIL: NON-RANDOMIZED CONTROLLED TRIAL
Semey State Medical University, Semey
The Republic of Kazakhstan
Objective. To improve the treatment results of the tibia diaphysis fracture by the designed device for intraosseous interlocking osteosynthesis.
Methods. It was a non-randomized controlled trial. There were two groups of patients (n=163): the main group (n=41) who underwent the fracture treatment by the designed device; the control group (n=122) who were treated with the ChM interlocking nail. The groups were comparable in age (p=0.066), sex (p=0.824), fracture level (p=0.659), type of injury (p=0.189) and fracture type (p=0.566). Preoperative and postoperative patients’ management was identical.
Results. The period of disability to work in the main group (M=62.8; Me=63.0; IQR=11 days) was shorter than in the control group (M=87.4; Me=82.0; IQR=28 days) (p<0.001). Also, higher weight bearing ability at the time of discharge (M=45.7 vs. M=33.0); and 1 month after the operation (M=90.9 vs. M=86.5) and earlier time for restoration of ability to walk without crutches (M=29.3 vs. 64.9 days) were registered in the main group vs. the control (p<0.001; p=0.018; p<0.001 respectively). At the same time, the number of inpatient days in the groups did not differ statistically (17.4 days in the control vs. 18.1 days in the main). There was not statistically significant difference in weight bearing ability at terms of 3 months after surgery (in both groups it reached 100%, p=0.059); number of complications (p=0.369); presence of shortening (p=0.149); treatment outcomes (p=0.849).
Conclusions. In this study, the designed expandable nail for interlocking osteosynthesis of the tibia shaft fracture enabled faster recovery of the patients’ ability to work. At the same time, for such parameters as inhospital stay, the presence of shortening and complications, the outcome of the treatment, the designed nail was not worse than the standard ChM nail.
- Madadi F, Eajazi A, Madadi F, Daftari Besheli L, Sadeghian R, Nasri Lari M. Adult tibial shaft fractures – different patterns, various treatments and complications. Med Sci Monit. 2011 Nov;17(11):CR640-645. doi: 10.12659/MSM.882049.
- Madadi F, Vahid Farahmandi M, Eajazi A, Daftari Besheli L, Madadi F, Nasri Lari M. Epidemiology of adult tibial shaft fractures: a 7-year study in a major referral orthopedic center in Iran. Med Sci Monit. 2010 May;16(5):CR217-21.
- Larsen P, Elsoe R, Hansen SH, Graven-Nielsen T, Laessoe U, Rasmussen S. Incidence and epidemiology of tibial shaft fractures. Injury. 2015 Apr;46(4):746-50. doi: 10.1016/j.injury.2014.12.027.
- Ediev MS, Morozov VP. Kombinirovannyi osteosintez diafizarnykh perelomov kostei goleni kak metod optimizatsii biomekhanicheskikh uslovii. Sarat Nauch-Med Zhurn. 2005;1(3):45-52. (in Russ.)
- Poletti FL, Macmull S, Mushtaq N, Mobasheri R Current concepts and principles in open tibial fractures – Part II Management and controversies. MOJ Orthop Rheumatol. 2017;8(2):00305. doi: 10.15406/mojor.2017.08.00305.
- Pisarev VV, Aleinikov AV, Vasin IV, Oshurkov YuA. Analysis of the results of different types of diaphyseal tibial fractures with intraosseous and of plate osteosynthesis. Travmatologiia i Ortopediia Rossii. 2013;(3):29-36. (in Russ.)
- Zelle BA, Boni G. Safe surgical technique: intramedullary nail fixation of tibial shaft fractures. Patient Saf Surg. 2015;9:40. Published online 2015 Dec 12. doi: 10.1186/s13037-015-0086-1.
- Hee HT, Wong HP, Low YP, Myers L. Predictors of outcome of floating knee injuries in adults: 89 patients followed for 2-12 years. Acta Orthop Scand. 2001 Aug;72(4):385-94. doi: 10.1080/000164701753542050.
- Kajzer A, Kajzer W, Marciniak J. Expandable intramedullary nail – experimental biomechanical evaluation. Int Sci J. 2010 Jan;41(Is I):45-52.
- Kutsenko SN, Mitiunin DA, Nikiforov RR. Rol’ vnutrikostnogo osteosinteza v sisteme khirurgicheskogo lecheniia perelomov kostei goleni i ikh posledstvii: mezhdunarodnyi opyt i sobstvennye rezul’taty. L³topis Travmatolog³³ ta Ortoped³³. 2013;(1/2):157-68. (in Russ.) http://nbuv.gov.ua/UJRN/Lto_2013_1-2_42.
- Sakhvadze Sh. Biological osteosynthesis as the treatment mode for multifragmental extra-articular fractures. Georgian Med News. 2009 Mar;(168):15-20.
071400, The Republic of Kazakhstan,
East Kazakhstan region,
Semey, Abaya Str., 103,
Semey State Medical University,
Department of Public Health,
Tel/fax: +7 (7222) 56 97 55,
Myssayev Ayan O.
Toktarov Yernar N., PhD Student of the Department of Traumatology and Orthopedics, Semey State Medical University, Semey, Republic of Kazakhstan.
Zhanaspayev Marat A., Doctor of medical Science, Head of the Department of Traumatology and Orthopedics, Semey State Medical University, Semey, Republic of Kazakhstan.
Tlemissov Aidos S., PhD, Assistant of the Department of Traumatology and Orthopedics, Semey State Medical University, Semey, Republic of Kazakhstan.
Bakhtybaev Daryn T., Assistant of the Department of Traumatology and Orthopedics, Semey State Medical University, Semey, Republic of Kazakhstan.
Myssayev Ayan O., PhD, Associate Professor, Head of the Department of Public Health, Semey State Medical University, Semey, Republic of Kazakhstan.
S.E. KATORKIN, A.V. ZHURAVLEV, A.A. CHERNOV, V.N. KRASNOVA
MODERN SPHINCTER SAVING METHODS OF TREATMENT OF TRANSPHINCTERIC AND EXTRASPHINCTERIC PERIANAL FISTULAS
Samara State Medical University, Samara,
The Russian Federation
The review presents the world experience, reflecting advances in the treatment of patients with extrasphincteric and high transphincteric perianal fistulas. There is no single approach in the treatment of patients with this form of chronic paraproctitis, there are no clear indications for the application of any method of surgical treatment. The priority tasks facing coloproctologists are to reduce the traumatic nature of the operation, to prevent complications, to preserve the anatomical integrity and functional capacity of the rectum apparatus. Currently, preference is given to low-traumatic methods of surgical treatment, denoted by the term «sphincter saving techniques» and aimed at secure closure of the internal fistula opening, excision of the peripheral part of the fistulous tract, detection and elimination of purulent leakages in the pararectal tissue. These include video-assisted anal fistula treatment (VAAFT), obstruction of the fistula by biological sealant tampons (AFP) and two-component fibrin glue (FGA), intersection of the fistula in submucosal (SLOFT) and intersphincter (LIFT) spaces. There are indications for each of the methods; each of them has both advantages and some disadvantages. At present, the most interesting is LIFT, the operation which attracts with its simplicity, high efficiency and safety of surgical techniques in relation to the rectum blockage apparatus. According to the literature, its effectiveness exceeds 75% with full preservation of the anal holding function. The performed analysis allows comparing different methods of treatment of pararectal fistulas and to determine the further direction of their improvement and scientific studies.
- Shelygin IuA, red. Klinicheskie rekomendatsii. Koloproktologiia. Moscow, RF: GEOTAR-Media; 2015. 528 p. (in Russ.)
- Ektov VN, Popov RV, Vollis EA. Fibrin glue as an option for improvement of surgical treatment of fistula-in-ano. Koloproktologiia. 2013;(2):44-49. http://www.gnck.ru/pdf/journal_2_44_2013.pdf. (in Russ.)
- Ektov VN, Popov RV, Vollis EA. Modern surgical approach for fistula-in-ano. Koloproktologiia. 2014;(3):62-69. http://www.gnck.ru/pdf/journal_3_49_2014.pdf. (in Russ.)
- Shalamov VI, Borota AV, Plakhotnikov IA, Sagalevich AI, Bulavitskii IuV. Opyt lecheniia ekstrasfinkternykh priamokishechnykh svishchei. Vestn Neotlozh i Vosstanovit Meditsiny. 2012;13(4):531-32. (in Russ.)
- Balogh G. Tube loop (seton) drainage treatment of recurrent extrasphincteric perianal fistulae. Am J Surg. 1999 Feb;177(2):147-49.
- Arroyo A, Pérez-Legaz J, Moya P, Armañanzas L, Lacueva J, Pérez-Vicente F, Candela F, Calpena R. Fistulotomy and sphincter reconstruction in the treatment of complex fistula-in-ano: long-term clinical and manometric results. Ann Surg. 2012 May;255(5):935-39. doi: 10.1097/SLA.0b013e31824e9112.
- Kostarev IV, Shelygin YA, Titov AY. Treatment of fistula in ano by advancement flap. Is it outdated or still modern approach? (systematic literature review) Koloproktologiia. 2016;(1):6-15. http://www.gnck.ru/pdf/journal_1_55_2016.pdf. (in Russ.)
- Kuz’minov AM, Borodkin AS, Volkov MV, Chubarov IuIu, Minbaev ShT. Rezul’taty khirurgicheskogo lecheniia ekstrasfinkternykh svishchei priamoi kishki putem nizvedeniia posloinogo segmenta stenki priamoi kishki v anal’nyi kanal. Koloproktologiia. 2004;(4):8-13. (in Russ.)
- Murav’ev AV, Maljugin VS, Zhuravel’ RV, Lysenko OV. A method of extrasphincteric fistula-in-ano repair. Koloproktologiia. 2012;(3):11-14. Ìóðàâüåâ ÀÌ, Ìàëþãèí ÂÑ, Æóðàâåëü ÐÂ, Ëûñåíêî ÎÂ. Ñïîñîá ïëàñòè÷åñêîé îïåðàöèè ïðè ýêñòðàñôèíêòåðíûõ ñâèùàõ ïðÿìîé êèøêè. Êîëîïðîêòîëîãèÿ. 2012;(3):11-14. http://www.gnck.ru/pdf/journal_3_41_2012.pdf. (in Russ.)
- Hjortrup A, Moesgaard F, Kjaergard J. Fibrin adhesive in the treatment of perineal fistulas. Dis Colon Rectum. 1991 Sep;34(9):752-54.
- Kosachenko AG, Gabibov SG, Gorin SG, Shodiev NA, Keropjan OK, Frolov NO, Rodnikov MV. The first experience of use of the video assisted treatment of fistula-in-ano. Koloproktologiia. 2012;(3):37-43. http://www.gnck.ru/pdf/journal_3_41_2012.pdf (in Russ.)
- Shanwani A, Nor AM, Amri N. Ligation of the intersphincteric fistula tract (LIFT): a sphincter-saving technique for fistula-in-ano. Dis Colon Rectum. 2010 Jan; 53(1):39-42. doi: 10.1007/DCR.0b013e3181c160c4.
- Ilkanich AJa, Darvin VV, Slepyh NV, Barbashinov NA, Abubakirov AS. Video assisted anal fistula treatment: feasibility and results. Koloproktologiia. 2014;(2):20-22. http://www.gnck.ru/pdf/journal_2_48_2014.pdf. (in Russ.)
- Titov AIu, Kostarev IV, Fomenko OIu, Mudrov AA. Opyt videoassistiruemykh operatsii s ushivaniem vnutrennego svishchevogo otverstiia pri khirurgicheskom lechenii ekstrasfinkternykh i vysokikh chressfinkternykh svishchei priamoi kishki. Koloproktologiia. 2015;(3):73-79.
- Meinero P, Mori L. Video-assistant anal fistula treatment (VAAFT): a novel sphincter-saving procedure for treating complex anal fistulas. Tech Coloproctol. 2011 Dec;15(4):417-22. doi: 10.1007/s10151-011-0769-2.
- Cirocchi R, Farinella E, La Mura F, Cattorini L, Rossetti B, Milani D, Ricci P, Covarelli P, Coccetta M, Noya G, Sciannameo F. Fibrin glue in the treatment of anal fistula: a systematic review. Ann Surg Innov Res. 2009 Nov 14;3:12. doi: 10.1186/1750-1164-3-12.
- Titov AYu, Kostarev IV, Anosov IS, Fomenko OYu. The experience of ligation of intersphinctericfistula tract in the treatment of patients with trans- and suprasphincteric anal fistulae. Koloproktologiia. 2016;(4):47-53. http://www.gnck.ru/pdf/journal_4_58_2016.pdf. (in Russ.)
- Chekanov MN, Chekanov AM, Verner IG. Ligirovanie svishchei priamoi kishki v mezhsfinkternom sloe: pervye rezul’taty. RZhGGK. 2012;22(4):81-83. (in Russ.)
- Chekanov MN, Chekanov AM. Otdalennye rezul’taty ligirovaniia svishchei priamoi kishki v mezhsfinkternom prostranstve. Meditsina i Obrazovanie v Sibiri. 2014;(5):19-20. (in Russ.)
- Rojanasakul A, Pattanaarun J, Sahakitrungruang C, Tantiphlachiva K. Total anal sphincter saving technique for fistula-in-ano; the ligation of intersphincteric fistula tract. J Med Assoc Thai. 2007 Mar;90(3):581-86.
- Rojanasakul A. LIFT procedure: a simplified technique for fistula-in-ano. Tech Coloproctol. 2009 Sep;13(3):237-40. doi: 10.1007/s10151-009-0522-2.
- Shakhrai SV, Gain YuM, Gain MYu. Experimental justification and first clinical experience of transplantation of culture of autological adipose tissue mesenchymal stem cells in complex surgical treatment of extra- and trans-sphincter rectum fistulas. Novosti Khirurgii. 2012;20(6):60-69. (in Russ.)
- Garcia-Olmo D, Herreros D, Pascual I, Pascual JA, Del-Valle E, Zorrilla J, De-La-Quintana P, Garcia-Arranz M, Pascual M. Expanded adipose-derived stem cells for the treatment of complex perianal fistula: a phase II clinical trial. Dis Colon Rectum. 2009 Jan;52(1):79-86. doi: 10.1007/DCR.0b013e3181973487.
- Wilhelm A. A new technique for sphincter-preserving anal fistula repair using a novel radial emitting laser probe. Tech Coloproctol. 2011 Dec;15(4):445-49. doi: 10.1007/s10151-011-0726-0.
- Il’in VA, Vorobei AV, Khulup GIa, Shved IA. Rezul’taty khirurgicheskogo lecheniia vysokikh svishchei priamoi kishki. Koloproktologiia. 2005;(2):8-15. http://www.gnck.ru/pdf/journal_2_12_2005.pdf. (in Russ.)
- Pomazkin VI. Application of anocutaneous flap in surgical treatment of complex fistulas-in-ano. Vestn Khirurgii im II Grekova. 2011;170(4):89-92. (in Russ.)
- Nelson RL, Cintron J, Abcarian H. Dermal island-flap anoplasty for transsphincteric fistula-in-ano: assessment of treatment failures. Dis Colon Rectum. 2000 May;43(5):681-84.
- Meinero P, Mori L, Gasloli G. Video-assisted anal fistula treatment: a new concept of treating anal fistulas. Dis Colon Rectum. 2014 Mar;57(3):354-59. doi: 10.1097/DCR.0000000000000082.
- Schwandner O. Video-assisted anal fistula treatment (VAAFT) combined with advancement flap repair in Crohn’s disease. Tech Coloproctol. 2013 Apr;17(2):221-25. doi: 10.1007/s10151-012-0921-7.
- Johnson EK, Gaw JU, Armstrong DN. Efficacy of anal fistula plug vs. fibrin glue in closure of anorectal fistulas. Dis Colon Rectum. 2006 Mar;49(3):371-76.
- Champagne BJ, O’Connor LM, Ferguson M, Orangio GR, Schertzer ME, Armstrong DN. Efficacy of anal fistula plug in closure of cryptoglandular fistulas: long-term follow-up. Dis Colon Rectum. 2006 Dec;49(12):1817-21.
- Ommer A, Herold A, Joos A, Schmidt C, Weyand G, Bussen D. Gore BioA Fistula Plug in the treatment of high anal fistulas-initial results from a German multicenter-study. Ger Med Sci. 2012;10:Doc13. doi: 10.3205/000164.
- Whiteford MH, Kilkenny J 3rd, Hyman N, Buie WD, Cohen J, Orsay C, Dunn G, Perry WB, Ellis CN, Rakinic J, Gregorcyk S, Shellito P, Nelson R, Tjandra JJ, Newstead G. Practice parameters for the treatment of perianal abscess and fistula-in-ano (revised). Dis Colon Rectum. 2005 Jul;48(7):1337-42. doi: 10.1007/s10350-005-0055-3.
- Chen H, Gu Y, Sun G, Zhou Z, Zhu P, Wu S, Yang B. Ligation of intersphincteric fistula tract in the treatment of complicated fistula-in-ano. Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Dec;17(12):1190-93. [Article in Chinese]
- Hall JF, Bordeianou L, Hyman N, Read T, Bartus C, Schoetz D, Marcello PW. Outcomes after operations for anal fistula: results of a prospective, multicenter, regional study. Dis Colon Rectum. 2014 Nov;57(11):1304-8. doi: 10.1097/DCR.0000000000000216.
- Madbouly KM, El Shazly W, Abbas KS, Hussein AM. Ligation of intersphincteric fistula tract versus mucosal advancement flap in patients with high transsphincteric fistula-in-ano: a prospective randomized trial. Dis Colon Rectum. 2014 Oct;57(10):1202-8. doi: 10.1097/DCR.0000000000000194.
- Tomiyoshi SD, Dos Santos CH. Effectiveness of the ligation of intersphincteric fistula tract (lift) in the treatment of anal fistula: initial results. Arq Bras Cir Dig. 2014 Apr-Jun; 27(2):101-103. doi: 10.1590/S0102-67202014000200004. [Article in English, Portuguese]
- Wu W, Yang G, Du Z, Zhang X, Song Y, Qiu J, Liao X, Shen Z. Modified ligation of the intersphincteric fistula tract in the treatment of simple transsphincteric perianal fistula. Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Dec;17(12):1194-97. [Article in Chinese]
- Zirak-Schmidt S, Perdawood SK. Management of anal fistula by ligation of the intersphincteric fistula tract – a systematic review. Dan Med J. 2014 Dec;61(12):A4977.
- Bastawrous A, Hawkins M, Kratz R, Menon R, Pollock D, Charbel J, Long K. Results from a novel modification to the ligation intersphincteric fistula tract. Am J Surg. 2015 May;209(5):793-8; discussion 798. doi: 10.1016/j.amjsurg.2015.01.002.
- Romaniszyn M, Walega PJ, Nowak W. Efficacy of lift (ligation of intersphincteric fistula tract) for complex and recurrent anal fistulas-a single-center experience and a review of the literature. Pol Przegl Chir. 2015 Feb 3;86(11):532-36. doi: 10.2478/pjs-2014-0094.
- Schulze B, Ho YH. Management of complex anorectal fistulas with seton drainage plus partial fistulotomy and subsequent ligation of intersphincteric fistula tract (LIFT). Tech Coloproctol. 2015 Feb;19(2):89-95. doi: 10.1007/s10151-014-1245-6.
- Ye F, Tang C, Wang D, Zheng S. Early experience with the modificated approach of ligation of the intersphincteric fistula tract for high transsphincteric fistula. World J Surg. 2015 Apr;39(4):1059-65. doi: 10.1007/s00268-014-2888-1.
- Zheng Y, Wang Z, Yang X, Cui J, Chen C, Zhang X, Wang X, Zhang X, Che X, Chen J, Cui F, Song W, Chen Y. A multicenter randomized controlled clinical trial of ligation of the intersphincteric fistula tract plus bioprosthetic anal fistula plug in the treatment of chronic anal fistula. Zhonghua Yi Xue Za Zhi. 2015 Nov 10;95(42):3454-57. [Article in Chinese]
- Khadia M, Muduli IC, Das SK, Mallick SN, Bag L, Pati MR. Management of fistula-in-ano with special reference to ligation of intersphincteric fistula tract. Niger J Surg. 2016 Jan-Jun;22(1):1-4. doi: 10.4103/1117-6806.169818.
- Parthasarathi R, Gomes RM, Rajapandian S, Sathiamurthy R, Praveenraj P, Senthilnathan P, Palanivelu C. Ligation of the intersphincteric fistula tract for the treatment of fistula-in-ano: experience of a tertiary care centre in South India. Colorectal Dis. 2016 May;18(5):496-502. doi: 10.1111/codi.13162.
- Vergana-Fernandez O, Espino-Urbina LA. Ligation of the intersphincteric fistula tract: What is the evidence in a review? World J Gastroenterol. 2013 Oct 28; 19(40):6805-13. doi: 10.3748/wjg.v19.i40.6805.
- Sirany AM, Nygaard RM, Morken JJ. The ligation of the intersphincteric fistula tract procedure for anal fistula: a mixed bag of results. Dis Colon Rectum. 2015 Jun;58(6):604-12. doi: 10.1097/DCR.0000000000000374.
- Bleier JI, Moloo H, Goldberg SM. Ligation of the intersphincteric fistula tract: an effective new technique for complex fistulas. Dis Colon Rectum. 2010 Jan;53(1):43-46. doi: 10.1007/DCR.0b013e3181bb869f.
- Tan KK, Tan IJ, Lim FS, Koh DC, Tsang CB. The anatomy of failures following the ligation of intersphincteric tract technique for anal fistula: a review of 93 patients over 4 years. Dis Colon Rectum. 2011 Nov;54(11):1368-72. doi: 10.1097/DCR.0b013e31822bb55e.
- Krasnova VN, Chernov AA, Katorkin SE, Zhuravlev AV. Comparative results of the experience in the ligation of intersphinteric fistula tract in the treatment of transsphincteric and extrasphincteric anal fistulas. Vrach-Aspirant. 2017;80(1.1):179-89. (in Russ.)
443079, The Russian Federation,
Samara, K. Marx Ave., 165B,
Clinic of Samara State Medical University,
Department and Clinic of Hospital Surgery,
Tel. office: 8 10 846 276 -77-89,
Katorkin Sergey E.
Katorkin Sergey E., PhD, Associate Professor, Head of the Department and Clinic of Hospital Surgery, Samara State Medical University, Samara, Russian Federation.
Zhuravlev Andrej V., PhD, Head of the Coloproctological Unit of the Hospital Surgery Clinic, Associate Professor of the Hospital Surgery Department, Samara State Medical University, Samara, Russian Federation.
Chernov Andrey A., PhD, Surgeon of the Coloproctological Unit of the Hospital Surgery Clinic, Assistant of the Hospital Surgery Department, Samara State Medical University, Samara, Russian Federation.
Krasnova Veronika N., Surgeon of the Coloproctological Unit of the Hospital Surgery Clinic, Samara State Medical University, Samara, Russian Federation.
PERFUSION CONDITIONING OF THE LIVER AND KIDNEY ALLOGRAFTS
The Republican Scientific and Practical Center for Organ and Tissue Transplantation,
9th Municipal Clinical Hospital of Minsk,
The Republic of Belarus
Transplantation is the only radical treatment method of terminal stage liver and kidney diseases. Therefore, there has been an increase in the number of transplantations of these organs all over the world and in our country in recent decades. Transplantation success is due to the quality of the donor organ, the clinical status of the recipient before the operation, the time of warm and cold ischemia, the transplantation operation to the recipient, and immunological aspects, but particular importance is attaching to ischemic-reperfusion injury. Static cold preservation determines the development of the ischemia-reperfusion injury of allografts and its severity determines the outcome of the postoperative period.
The review highlights the current state of various variants of machine perfusion of the liver and kidneys. Renewal of interest to perfusion technologies is related to their ability to prevent the ischemia-reperfusion damage, which can be especially important when using donor organs with extended inclusion criteria, the so-called marginal allografts. Hypothermic machine perfusion, subnormothermic machine perfusion, normothermic machine perfusion, controlled heating are used nowadays. The parameters of the perfusion flow of the liver and kidneys were studied. At present, the clinical and economic effectiveness of only hypothermic renal perfusion has been proven. At the same time, the standards of machine perfusion and the protocols of its application are not fully developed and further studies are required.
- Ildefonso JA, Arias-Díaz J. Pathophysiology of liver ischemia-reperfusion injury. Cir Esp. 2010 Apr;87(4):202-9. doi: 10.1016/j.ciresp.2009.11.009. [Article in Spanish]
- Durand F, Renz JF, Alkofer B, Burra P, Clavien PA, Porte RJ, Freeman RB, Belghiti J. Report of the Paris consensus meeting on expanded criteria donors in liver transplantation. Liver Transpl. 2008 Dec;14(12):1694-707. doi: 10.1002/lt.21668.
- Bussutil RW, Klintmalm GK, ed. Transplantation of the liver. 3nd ed. Philadelphia: Elsevier; 2014. 1520 p.
- Barshesa NR, Horwitz IB, Franzini L, Vierling JM, Goss JA. Waitlist mortality decreases with increased use of extended criteria donor liver grafts at adult liver transplant centers. Am J Transplant. 2007;7(5):1265-70. doi: 10.1111/j.1600-6143.2007.01758.x.
- Nemes B, Gelley F, Zádori G, Piros L, Perneczky J, Kóbori L, Fehérvári I, Görög D. Outcome of liver transplantation based on donor graft quality and recipient status. Transplant Proc. 2010 Jul-Aug;42(6):2327-30. doi: 10.1016/j.transproceed.2010.05.018.
- Moers C, Smits JM, Maathuis MH, Treckmann J, van Gelder F, Napieralski BP, van Kasterop-Kutz M, van der Heide JJ, Squifflet JP, van Heurn E, Kirste GR, Rahmel A, Leuvenink HG, Paul A, Pirenne J, Ploeg RJ. Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med. 2009 Jan 1;360(1):7-19. doi: 10.1056/NEJMoa0802289.
- Hoffman A, Burger C, Persky L. Extracorporeal renal storage. Invest Urol. 1965 May;2:567-73.
- Carrel A, Lindbergh CA. The culture of whole organs. Science. 1935 Jun 21;81(2112):621-23. doi: 10.1126/science.81.2112.621
- Belzer FO, Ashby BS, Gulyassy PF, Powell M. Successful seventeen-hour preservation and transplantation of human-cadaver kidney. N Engl J Med. 1968 Mar 14;278(11):608-10. doi: 10.1056/NEJM196803142781108.
- Belzer FO, Ashby BS, Dunphy JE. 24-hour and 72-hour preservation of canine kidneys. Lancet. 1967 Sep 9;2(7515):536-38.
- Opelz G, Terasaki PI. Advantage of cold storage over machine perfusion for preservation of cadaver kidneys. Transplantation. 1982 Jan;33(1):64-68.
- Collins GM, Bravo-Shugarman M, Terasaki PI. Kidney preservation for transportation. Initial perfusion and 30 hours’ ice storage. Lancet. 1969 Dec 6;2(7632):1219-22. doi: 10.1097/00007890-197009000-00011.
- Anaya-Prado R, Delgado-Vázquez JA. Scientific basis of organ preservation. Curr Opin Organ Transplant. 2008 Apr;13(2):129-34. doi: 10.1097/MOT.0b013e3282f6390a.
- Southard JH, Belzer FO. Organ preservation. Annu Rev Med. 1995;46:235-47.
- Bretschneider HJ. Myocardial protection. Thorac Cardiovasc Surg. 1980 Oct;28(5):295-302. doi: 10.1055/s-2007-1022099.
- Ayala-García MA, Pantoja Hernández M&AACUTE;, Ramírez-Barba éJ, Soel Encalada JM, González Yebra B. Ch 1: Preservation of renal allografts for transplantation. In: Long L, ed. Renal transplantation – Updates and Advances. 2012. p. 1-16. doi: 10.5772/27231.
- Jochmans I, Akhtar MZ, Nasralla D, Kocabayoglu P, Boffa C, Kaisar M, Brat A, O’Callaghan J, Pengel LH, Knight S, Ploeg RJ. Past, Present, and future of dynamic kidney and liver preservation and resuscitation. Am J Transplant. 2016 Sep;16(9):2545-55. doi: 10.1111/ajt.13778.
- Pabisiak K, Romanowski M, Myslak M, Szydłowski L, Sieńko J, Domański L, Wisniewska M, Janus T, Sulikowski T, Kempińska A, Kamiński M, Paczkowski M, Mizerski A, Ostrowski M, Ciechanowski K. Variations in temperature of the donor kidney during cold ischemia time and subsequent assessment of reperfusion using the application of thermovision camera. Transplant Proc. 2003 Sep;35(6):2157-59.
- Lakey JR, Rajotte RV, Warnock GL, Kneteman NM. Human pancreas reservation prior to islet isolation. Cold ischemic tolerance. Transplantation. 1995 Mar 15;59(5):689-94.
- Hoeger S, Lueg G, Tsagogiorgas C, Schneider M, Theisinger S, Theisinger B, Fontana J, Waldherr R, Krämer BK, Schnuelle P, Yard B. UW is superior compared with HTK after prolonged preservation of renal grafts. J Surg Res. 2011 Sep;170(1):e149-57. doi: 10.1016/j.jss.2011.05.020.
- Caldwell CC, Tschoep J, Lentsch AB. Lymphocyte function during hepatic ischemia/reperfusion injury. J Leukoc Biol. 2007 Sep;82(3):457-64. doi: 10.1189/jlb.0107062
- Hanschen M, Zahler S, Krombach F, Khandoga A. Reciprocal activation between CD4+ T cells and Kupfer cells during hepatic ischemia-reperfusion. Transplantation. 2008;86(5):710-18. doi: 10.1097/TP.0b013e3181821aa7.
- Schlegel A, Kron P, Dutkowski P. Hypothermic oxygenated liver perfusion: basic mechanisms and clinical application. Curr Transplant Rep. 2015; 2(1):52-62. doi: 10.1007/s40472-014-0046-1.
- Oniscu GC, Randle LV, Muiesan P, Butler AJ, Currie IS, Perera MT, Forsythe JL, Watson CJ. In situ normothermic regional perfusion for controlled donation after circulatory death–the United Kingdom experience. Am J Transplant. 2014 Dec;14(12):2846-54. doi: 10.1111/ajt.12927.
- D’Alessandro AM, Southard JH, Love RB, Belzer FO. Organ preservation. Surg Clin North Am. 1994 Oct;74(5):1083-95.
- Taylor MJ, Baicu S, Leman B, Greene E, Vazquez A, Brassil J. Twenty-four hour hypothermic machine perfusion preservation of porcine pancreas facilitates processing for islet isolation. Transplant Proc. 2008 Mar;40(2):480-82. doi: 10.1016/j.transproceed.2008.01.004.
- Moers C, Pirenne J, Paul A, Ploeg RJ. Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med. 2012 Feb 23;366(8):770-71. doi: 10.1056/NEJMc1111038.
- Groen H, Moers C, Smits JM, Treckmann J, Monbaliu D, Rahmel A, Paul A, Pirenne J, Ploeg RJ, Buskens E. Cost-effectiveness of hypothermic machine preservation versus static cold storage in renal transplantation. Am J Transplant. 2012 Jul;12(7):1824-30. doi: 10.1111/j.1600-6143.2012.04030.x.
- Monbaliu D, Brassil J. Machine perfusion of the liver: past, present and future. Curr Opin Organ Transplant. 2010 Apr;15(2):160-66. doi: 10.1097/MOT.0b013e328337342b.
- Butler AJ, Randle LV, Watson CJ. Normothermic regional perfusion for donation after circulatory death without prior heparinization. Transplantation. 2014 Jun 27;97(12):1272-78. doi: 10.1097/TP.0000000000000082.
- Selzner N, Boehnert M, Selzner M. Preconditioning, postconditioning, and remote conditioning in solid organ transplantation: basic mechanisms and translational applications. Transplant Rev (Orlando). 2012 Apr;26(2):115-24. doi: 10.1016/j.trre.2011.07.003.
- Ravikumar R, Jassem W, Mergental H, Heaton N, Mirza D, Perera MT, Quaglia A, Holroyd D, Vogel T, Coussios CC, Friend PJ. Liver transplantation after ex vivo normothermic machine preservation: a phase 1 (first-in-man) clinical nrial. Am J Transplant. 2016 Jun;16(6):1779-87. doi: 10.1111/ajt.13708.
- van Golen RF, van Gulik TM, Heger M. Mechanistic overview of reactive species-induced degradation of the endothelial glycocalyx during hepatic ischemia/reperfusion injury. Free Radic Biol Med. 2012 Apr 15;52(8):1382-402. doi: 10.1016/j.freeradbiomed.2012.01.013.
- op den Dries S, Karimian N, Sutton ME, Westerkamp AC, Nijsten MW, Gouw AS, Wiersema-Buist J, Lisman T, Leuvenink HG, Porte RJ. Ex vivo normothermic machine perfusion and viability testing of discarded human donor livers. Am J Transplant. 2013 May;13(5):1327-35. doi: 10.1111/ajt.12187.
- Weeder PD, van Rijn R, Porte RJ. Machine perfusion in liver transplantation as a tool to prevent non-anastomotic biliary strictures: Rationale, current evidence and future directions. J Hepatol. 2015 Jul;63(1):265-75. doi: 10.1016/j.jhep.2015.03.008.
- Schlegel A, Graf R, Clavien PA, Dutkowski P. Hypothermic oxygenated perfusion (HOPE) protects from biliary injury in a rodent model of DCD liver transplantation. J Hepatol. 2013 Nov;59(5):984-91. doi: 10.1016/j.jhep.2013.06.022.
- Bruinsma BG, Yeh H, Ozer S, Martins PN, Farmer A, Wu W, Saeidi N, Op den Dries S, Berendsen TA, Smith RN, Markmann JF, Porte RJ, Yarmush ML, Uygun K, Izamis ML. Subnormothermic machine perfusion for ex vivo preservation and recovery of the human liver for transplantation. Am J Transplant. 2014 Jun;14(6):1400-9. doi: 10.1111/ajt.12727.
- Gringeri E, Polacco M, D’Amico FE, Scopelliti M, Bassi D, Bonsignore P, Luisetto R, Lodo E, Carraro A, Zanus G, Cillo U. A new liver autotransplantation technique using subnormothermic machine perfusion for organ preservation in a porcine model. Transplant Proc. 2011 May;43(4):997-1000. doi: 10.1016/j.transproceed.2011.01.139.
- Liu Q, Nassar A, Farias K, Buccini L, Baldwin W, Mangino M, Mangino M, Bennett A, O’Rourke C, Okamoto T, Uso TD, Fung J, Abu-Elmagd K, Miller C, Quintini C. Sanguineous normothermic machine perfusion improves hemodynamics and biliary epithelial regeneration in donation after cardiac death porcine livers. Liver Transpl. 2014 Aug;20(8):987-99. doi: 10.1002/lt.23906.
- Minor T, Efferz P, Fox M, Wohlschlaeger J, Lüer B. Controlled oxygenated rewarming of cold stored liver grafts by thermally graduated machine perfusion prior to reperfusion. Am J Transplant. 2013 Jun;13(6):1450-60. doi: 10.1111/ajt.12235.
- Matsuno N, Obara H, Watanabe R, Iwata S, Kono S, Fujiyama M, Hirano T, Kanazawa H, Enosawa S. Rewarming preservation by organ perfusion system for donation after cardiac death liver grafts in pigs. Transplant Proc. 2014 May;46(4):1095-98. doi: 10.1016/j.transproceed.2013.12.035.
- Kozaki K, Sakurai E, Uchiyama M, Matsuno N, Kozaki M, Nagao T. Development of hypothermic continuous perfusion preservation machine equipped with nonpulsatile pump and its clinical application. Transplant Proc. 2000 Feb;32(1):5-9.
- Divonin AL, Mishchenko BP, Loginova LI, Mikhailova ML. Changes in the liver circulation and kidney function during pulsatile and non-pulsatile perfusion Anesteziol Reanimatol. 1991 May-Jun;(3):36-40. 44. Boon RA, Horrevoets AJ. Key transcriptional regulators of the vasoprotective effects of shear stress. Hamostaseologie. 2009 Jan;29(1):39-40, 41-3.
- Sebzda E, Zou Z, Lee JS, Wang T, Kahn ML. Transcription factor KLF2 regulates the migration of naive T cells by restricting chemokine receptor expression patterns. Nat Immunol. 2008 Mar;9(3):292-300. doi: 10.1038/ni1565.
- Tullius SG, García-Cardeña G. Organ procurement and perfusion before transplantation. N Engl J Med. 2009 Jan 1;360(1):78-80. doi: 10.1056/NEJMe0809215.
- Hart NA, van der Plaats A, Moers C, Leuvenink HG, Wiersema-Buist J, Verkerke GJ, Rakhorst G, Ploeg RJ. Development of the isolated dual perfused rat liver model as an improved reperfusion model for transplantation research. Int J Artif Organs. 2006 Feb;29(2):219-27.
220045, The Republic of Belarus,
Minsk, Semashko Str., 8,
Republican Scientific and Practical
Center for Organ and Tissue Transplantation,
9th Municipal Clinical Hospital, Department of Hepatology and Minimally Invasive Surgery,
Tel.:+375 29 675 12 57,
Fedaruk Aliaksei M.
Fedaruk Aliaksei M., MD, Associate Professor, Head of the Department of Hepatology and Minimally Invasive Surgery of Republican Scientific and Practical Center for Organ and Tissue Transplantation, 9th Municipal Clinical Hospital, Minsk, Republic of Belarus.
YU.P. ORLOV 1, V.V. AFANAS’EV 2
HYPOXIA AND HYPEROXIA IN ANESTHESIOLOGIST-REANIMATOLOGIST PRACTICE. THE ROLE OF SUCCINATES IN CRITICAL CONDITIONS
Omsk State Medical University1, Omsk,
North-Western State Medical University named after I.I. Mechnikov 2, St. Petersburg,
The Russian Federation
The aim of the review was to analyze the potentially negative effects of hyperoxia in different groups of critically ill patients, including those after the heart arrest, craniocerebral trauma, stroke, and in cases of sepsis. It was found out that in case of these pathological processes and nosological forms, there is evidence that hyperoxia can have a direct and indirect damaging effect. A severe consequence of hyperoxia is not only activation of free radical oxidation and excessive synthesis of active oxygen forms, but also direct toxic damage to the lungs, which is associated with the development of atelectasis, tracheobronchitis and interstitial fibrosis. Hyperoxia can cause damage to any tissues and organs through peripheral vasoconstriction, which is extremely unfavorable for patients after heart arrest, after a craniocerebral trauma and stroke, as well as in septic patients.
The survey data emphasize that, taking into account individual adaptation to hypoxia, oxygen must be used individually, in accordance with the assessment of the current need for it. When using hyperoxia in patients in critical condition, it is possible to reduce the toxic effect of oxygen with the help of succinates, which support the mechanism of adaptation to hypoxia, and which have an antioxidant and antihypoxic effects. When carrying out oxygen therapy, it is necessary to avoid high concentrations of oxygen as much as possible, and in cases requiring high concentrations, to reduce the toxic effects of oxygen with the help of succinates.
- Helmerhorst HJ, Schultz MJ, van der Voort PH, de Jonge E, van Westerloo DJ. Bench-to-bedside review: the effects of hyperoxia during critical illness. Crit Care. 2015 Aug 17;19:284. doi: 10.1186/s13054-015-0996-4.
- Savino PB, Sporer KA, Barger JA, Brown JF, Gilbert GH, Koenig KL, Rudnick EM, Salvucci AA. Chest pain of suspected cardiac origin: current evidence-based recommendations for prehospital care. West J Emerg Med. 2015 Dec;16(7):983-95. doi: 10.5811/westjem.2015.8.27971.
- Glober NK, Sporer KA, Guluma KZ, Serra JP, Barger JA, Brown JF, Gilbert G, Koenig K, Rudnick E, Salvucci A. Acute stroke: current evidence-based recommendations for prehospital care. West J Emerg Med. 2016 Mar;17(2):104-28. doi: 10.5811/westjem.2015.12.28995.
- Iscoe S, Beasley R, Fisher JA. Supplementary oxygen for nonhypoxemic patients: O2 much of a good thing? Crit Care. 2011;15(3):305. doi: 10.1186/cc10229.
- Smith JL. The pathological effects due to increase of oxygen tension in the air breathed. J Physiol. 1899 Mar 22;24(1):19-35.
- Parke RL, Eastwood GM, McGuinness SP. Oxygen therapy in non-intubated adult intensive care patients: a point prevalence study. Crit Care Resusc. 2013 Dec;15(4):287-93.
- de Jonge E, Peelen L, Keijzers PJ, Joore H, de Lange D, van der Voort PH, Bosman RJ, de Waal RA, Wesselink R, de Keizer NF. Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients. Crit Care. 2008;12(6):R156. Published online 2008 Dec 10. doi: 10.1186/cc7150.
- Brueckl C, Kaestle S, Kerem A, Habazettl H, Krombach F, Kuppe H, Kuebler WM. Hyperoxia-induced reactive oxygen species formation in pulmonary capillary endothelial cells in situ. Am J Respir Cell Mol Biol. 2006 Apr;34(4):453-63. doi: 10.1165/rcmb.2005-0223OC.
- Zaher TE, Miller EJ, Morrow DMP, Javdan M, Mantell LL. Hyperoxia-induced signal transduction pathways in pulmonary epithelial cells. Free Radic Biol Med. 2007 Apr 1; 42(7): 897-908. doi: 10.1016/j.freeradbiomed.2007.01.021
- Sjöberg F, Singer M. The medical use of oxygen: a time for critical reappraisal. J Intern Med. 2013 Dec;274(6):505-28. doi: 10.1111/joim.12139.
- Orbegozo CD, Puflea F, Donadello K, Taccone FS, Gottin L, Creteur J, Vincent JL, De Backer D. Normobaric hyperoxia alters the microcirculation in healthy volunteers. Microvasc Res. 2015 Mar;98:23-8. doi: 10.1016/j.mvr.2014.11.006.
- Dell’Anna AM, Lamanna I, Vincent JL, Taccone FS. How much oxygen in adult cardiac arrest? Crit Care. 2014 Oct 7;18(5):555. doi: 10.1186/s13054-014-0555-4.
- Kilgannon JH, Jones A.E, Shapiro NI, Angelos MG, Milcarek B, Hunter K, Parrillo JE, Trzeciak S. Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA. 2010;303(21):2165-2171. doi: 10.1001/jama.2010.707.
- Stub D, Smith K, Bernard S, Nehme Z, Stephenson M, Bray JE, Cameron P, Barger B, Ellims AH, Taylor AJ, Meredith IT, Kaye DM. Air versus oxygen in ST-segment-elevation myocardial infarction. Circulation. 2015 Jun 16;131(24):2143-50. doi: 10.1161/CIRCULATIONAHA.114.014494.
- Hofmann R, James SK, Svensson L, Witt N, Frick M, Lindahl B, östlund O, Ekelund U, Erlinge D, Herlitz J, Jernberg T. Determination of the role of Oxygen in suspected Acute Myocardial Infarction trial. Am Heart J. 2014 Mar;167(3):322-28. doi: 10.1016/j.ahj.2013.09.022.
- Elmer J, Scutella M, Pullalarevu R, Wang B, Vaghasia N, Trzeciak S, Rosario-Rivera BL, Guyette FX, Rittenberger JC, Dezfulian C.The association between hyperoxia and patient outcomes after cardiac arrest: analysis of a high-resolution database. Intensive Care Med. 2015 Jan;41(1):49-57. doi: 10.1007/s00134-014-3555-6.
- Davis DP, Meade W, Sise MJ, Kennedy F, Simon F, Tominaga G, Steele J, Coimbra R. Both hypoxemia and extreme hyperoxemia may be detrimental in patients with severe traumatic brain injury. J Neurotrauma. 2009 Dec;26(12):2217-23. doi: 10.1089/neu.2009.0940.
- Brenner M, Stein D, Hu P, Kufera J, Wooford M, Scalea T. Association between early hyperoxia and worse outcomes after traumatic brain injury. Arch Surg. 2012 Nov;147(11):1042-6. doi: 10.1001/archsurg.2012.1560.
- Singhal AB. Oxygen therapy in stroke: past, present, and future. Int J Stroke. 2006 Nov;1(4):191-200. doi: 10.1111/j.1747-4949.2006.00058.x.
- Taher A, Pilehvari Z, Poorolajal J, Aghajanloo M. Effects of normobaric hyperoxia in traumatic brain injury: a randomized controlled clinical trial. Trauma Mon. 2016 Feb;21(1):e26772. Published online 2016 Feb 6. doi: 10.5812/traumamon.26772.
- Asfar P, Calzia E, Huber-Lang M, Ignatius A, Radermacher P. Hyperoxia during septic shock–Dr. Jekyll or Mr. Hyde? Shock. 2012 Jan;37(1):122-3. doi: 10.1097/SHK.0b013e318238c991.
- Rodríguez-González R, Martín-Barrasa JL, Ramos-Nuez &AACUTE;, Cañas-Pedrosa AM, Martínez-Saavedra MT, García-Bello M&AACUTE;, López-Aguilar J, Baluja A, &AACUTE;lvarez J, Slutsky AS, Villar J. Multiple system organ response induced by hyperoxia in a clinically relevant animal model of sepsis. Shock. 2014 Aug;42(2):148-53. doi: 10.1097/SHK.0000000000000189.
- Stolmeijer R, ter Maaten JC, Zijlstra JG, Ligtenberg JJ. Oxygen therapy for sepsis patients in the emergency department: a little less? Eur J Emerg Med. 2014 Jun;21(3):233-5. doi: 10.1097/MEJ.0b013e328361c6c7.
- Girardis M, Busani S, Damiani E, Donati A, Rinaldi L, Marudi A, Morelli A, Antonelli M, Singer M. Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial. JAMA. 2016 Oct 18;316(15):1583-89. doi: 10.1001/jama.2016.11993.
- Manning HL, Schwartzstein RM. Pathophysiology of dyspnea. N Engl J Med. 1995 Dec 7;333(23):1547-53.
- Abernethy AP, McDonald CF, Frith PA, Clark K, Herndon JE, Marcello J, Young IH, Bull J, Wilcock A, Booth S, Wheeler JL, Tulsky JA, Crockett AJ, Currow DC. Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trial. Lancet. 2010 Sep 4;376(9743):784-93. doi: 10.1016/S0140-6736(10)61115-4.
- Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301-1308. doi: 10.1056/NEJM200005043421801.
- Manja V, Lakshminrusimha S, Cook DJ. Oxygen saturation target range for extremely preterm infants: a systematic review and meta-analysis. JAMA Pediatr. 2015 Apr;169(4):332-40. doi: 10.1001/jamapediatrics.2014.3307.
- Panwar R, Hardie M, Bellomo R, Barrot L, Eastwood GM, Young PJ, Capellier G, Harrigan PW, Bailey M. Conservative versus liberal oxygenation targets for mechanically ventilated patients. A pilot multicenter randomized controlled trial. Am J Respir Crit Care Med. 2016 Jan 1;193(1):43-51. doi: 10.1164/rccm.201505-1019OC.
- He H, Long Y, Liu D, Liu D, Wang X, Zhou X. Clinical classification of tissue perfusion based on the central venous oxygen saturation and the peripheral perfusion index. Crit Care. 2015;19(1):330. Published online 2015 Sep 14. doi: 10.1186/s13054-015-1057-8.
- Martin DS, Grocott MP. Oxygen therapy in critical illness: precise control of arterial oxygenation and permissive hypoxemia. Crit Care Med. 2013 Feb;41(2):423-32. doi: 10.1097/CCM.0b013e31826a44f6.
- Tannahill GM, Curtis AM, Adamik J, Palssonn-McDermott EM, McGettrick AF, Goel G, Frezza C, Bernard NJ, Kelly B, Foley NH, Zheng L, Gardet A, Tong Z, Jany SS, Corr SC, Haneklaus M, Caffrey BE, Pierce K, Walmsley S, Beasley FC, Cummins E, Nizet V, Whyte M, Taylor CT, Lin H, Masters SL, Gottlieb E, Kelly VP, Clish C, Auron PE, Xavier RJ, O’Neill LA. Succinate is an inflammatory signal that induces IL-1β through HIF-1α. Nature. 2013 11 Apr;496:238-42. doi: 10.1038/nature11986.
- Lukyanova L.D. Current issues of adaptation to hypoxia. Signal mechanisms and their role in system regulation. Patol Fiziologiia i Eksperim Terapiia. 2011;(1):3-19. (in Russ.)
- Krebs HA, Kornberg HL, Burnon K. A survey of the energy transformations in living matter. Ergeb Physiol. 1957;49:212-98.
- Singer M. The role of mitochondrial dysfunction in sepsis-induced multi-organ failure. Virulence. 2014 Jan 1;5(1):66-72. doi: 10.4161/viru.26907.
- Chouchani ET, Pell VR, Gaude E, Aksentijevic D, Sundier SY, Robb EL, Logan A, Nadtochiy SM, Ord ENJ, Smith AC, Eyassu F, Shirley R, Hu CH, Dare AJ, James AM, Rogatti S, Hartley RC, Eaton S, Costa ASH, Brookes PS, Davidson SM, Duchen MR, Saeb-Parsy K, Shattock MJ, Robinson AJ, Work LM, Frezza C, Krieg T, Murphy MP. Ischaemic accumulation of succinate controls reperfusion injury through mitochondrial ROS. Nature. 2014 Nov 20;515(7527):431-5. doi: 10.1038/nature13909.
- Krebs HA. Some aspects of the energy transformation in living matter. Br Med Bull. 1953;9(2): 97-104. 10.1093/oxfordjournals.bmb.a074347
- Sukach MS. Sravnitel’naia otsenka vliianiia geptrala i tsitoflavina na reologicheskie svoistva krovi pri eksperimental’nom pankreonekroze. Omsk Nauch Vestn. 2013;(1):89-91. (in Russ.)
- Shidlovskii AS, Saltanov AI. Varianty mekhanizmov izmeneniia aktivnosti transaminaz: klinicheskaia interpretatsiia. Vestn Intensiv Terapii. 2015(1):22-32. (in Russ.)
- Ehinger JK, Piel S, Ford F, Karlsson M, Sjövall F, Frostner EA, Morota S, Taylor RW, Turnbull DM, Cornell C, Moss SJ, Metzsch C, Hansson MJ, Fliri H, Elmér E. Cell-permeable succinate prodrugs bypass mitochondrial complex I deficiency. Nat Commun. 2016 Aug 9;7:12317. doi: 10.1038/ncomms12317.
- Jalloh I, Helmy A, Howe D, Shannon RJ, Grice P, Mason A, Gallagher CN, Stovell MG, van der Heide S, Murphy MP, Pickard JD, Menon DK, Carpenter TA, Hutchinson PJ, Carpenter KL. Focally perfused succinate potentiates brain metabolism in head injury patients. J Cereb Blood Flow Metab. 2017 Jul;37(7):2626-38. doi: 10.1177/0271678X16672665.
- Westerblad H, Allen DG. Emerging roles of ROS/RNS in muscle function and fatigue. Antioxid Redox Signal. 2011 Nov 1;15(9):2487-99. doi: 10.1089/ars.2011.3909.
- Orlov YP, Govorova NV, Glushchenko AV, Efremov EN, Vasilenko YuB. A critical incident during marathon competition as a result of metabolic decompensation. Klin Meditsina. 2017;95(1):85-89. (in Russ.)
- Hill GB. Hyperbaric oxygen exposures at 3 and 4 atmospheres absolute pressure for experimental gas gangrene: succinate protection against oxygen toxicity. Antimicrob Agents Chemother. 1972 Nov;2(5):384-89.
644119, The Russian Federation,
Omsk, Perelet Str., 9
City Clinical Emergency Hospital ¹ 1,
Department of Anesthesiology
Omsk State Medical University,
Orlov Yurij P.
Orlov Yurij P., MD, Professor of the Department of Anesthesiology and Reanimatology, Omsk State Medical University, Omsk, Russian Federation.
Afanas’ev Vasilij V., MD, Professor of the Department of Emergency Medicine, North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russian Federation.
S.V. IVANOV1, A.V. GOLIKOV1, O.S. GORBACHEVA2, I.S. IVANOV1
GIANT INGUINAL HERNIA IN A WOMAN
Kursk State Medical University1,
Kursk Regional Clinical Hospital2, Kursk
The Russian Federation
The article presents a clinical case of treatment of a 55-year-old patient with an incarcerated inguinal hernia of «giant» size. At hospitalization, the patient complained of having a bulging anterior abdominal wall in the inguinal area of «giant» sizes (25×30 cm), the pain with straining, self-service problems and cosmetic difficulties. The history of the disease is more than 40 years, when the first hernia protrusion in the right inguinal region appeared, freely inserted into the abdominal cavity. The patient has never turned for help to any medical establishment. Hernia protrusion gradually increased in size. Recently, the pain syndrome, which occurred with physical activity, coughing, sneezing and rapid growth of hernia size have joined to the symptoms mentioned above. However, the cause of the treatment in the clinic was not a cosmetic defect, but the fact of the hernia irreducibility. After a comprehensive examination, the patient underwent hernia repair, the plastic of the anterior abdominal wall with a polypropylene surgical mesh according to the «onlay» technique. The postoperative period occurred without any exudative complications and manifestations of the compartment syndrome. The given clinical case is interesting as a possible treatment option for a fairly rare, «giant» size inguinal hernia in women.
- Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009 Aug;13(4):343-403. doi: 10.1007/s10029-009-0529-7.
- Liem MS, van der Graaf Y, Zwart RC, Geurts I, van Vroonhoven TJ. Risk factors for inguinal hernia in women: a case-control study. Am J Epidemiol. 1997 Nov 1;146(9):721-26.
- Vinnik IuS, Petrushko SI, Nazar’iants IuA, Chaikin AA, Klimov NIu, Pakhomova RA. Anatomicheskaia i klinicheskaia kharakteristika u bol’nykh s pakhovymi gryzhami. Kuban Nauch Med Vestn. 2013;(3):33-36. (in Russ.)
- Rutenburg GM, Bezhenar’ VF, Strizheletskii VV, Zhemchuzhina TIu, Gordeeva TV. Simul’tannye laparoskopicheskie operatsii u zhenshchin s sochetannymi ginekologicheskimi zabolevaniiami i pakhovymi gryzhami. Zhurn Akusherstva i Zhen Boleznei. 2006;LV(1):63-69. (in Russ.)
- Musaev AI, Zhamankulova MK, Samarbekov NS. Sovremennye podkhody k lecheniiu pakhovykh gryzh. Vestn KGMA im IK Akhunbaeva. 2016;(4):63-65.
- Desai AY, Shirsat D, Pai VD. Giant inguinal hernia repair leading to the diagnosis of complete androgen insensitivity syndrome in an elderly lady. J Health Med Informat. 2015;6:211. doi: 10.4172/2157-7420.1000211.
- Vagholkar K, Iyengar M, Vagholkar S. Inguinal hernia in females: do we know enough? Int Surg J. 2016 Feb;3(1):354-56. doi: 10.18203/2349-2902.isj20160074.
305041, The Russian Federation,
Kursk, Karl Marx Str., 3,
Kursk State Medical University,
Department of Surgical Diseases ¹ 1.
Tel. office:+7 4712 35-36-90
Ivanov Il’ya S.
Ivanov Sergej V., MD, Professor, Head of the Department of Surgical Diseases ¹ 1, Kursk State Medical University, Kursk, Russian Federation.
Golikov Al’bert V., PhD, Associate Professor of the Department of Surgical Diseases ¹ 1, Kursk State Medical University, Kursk, Russian Federation.
Gorbacheva Ol’ga S., PhD, Head of the General Surgery Unit, Kursk Regional Clinical Hospital, Kursk, Russian Federation.
Ivanov Il’ya S., MD, Professor of the Department of Surgical Diseases ¹ 1, Kursk State Medical University, Kursk, Russian Federation.
A RARE CASE OF SURGICAL TREATMENT OF THE GIANT LIVER HEMANGIOMA
Grodno State Medical University, Grodno,
The Republic of Belarus
Hemangioma of the liver is its frequent benign tumor. However, giant hemangiomas of the liver are a rare pathology. The purpose of this message is to demonstrate the successful surgical treatment of the liver giant left lobe hemangioma. The patient for a long time has linked the abdomen gradual enlargement in volume with pregnancy. The main reason for her turn for help was the presence of signs of partial intestinal obstruction and anemia. Abdominal ultrasound demonstrated the presence of tumor masses originating from the left lobe of the liver. Red blood cell transfusion in the preoperative period to correct anemia was accompanied by a pronounced enlargement of the hemangioma in 4-6 hours after transfusion, with its subsequent reduction up to the initial state during the next 24-48 hours. During laparotomy it was found out that the left lobe of the liver presented by hemangioma occupying the entire abdominal cavity. Hemangioma was removed by the resection of the left lobe of the liver. The postoperative period was uneventful. During the next 12 months of observation, the patient felt satisfactory, without any complaints. According to the biochemical blood analysis the liver function was not impaired.
- Novozhilov AV, Chikoteev SP, Grigor’ev SE, Grigor’ev EG, Movsisjan MO, Klejmenova NS, Magolina OV. Giant hepatic hemangioma combined with generalized sarcoidosis. Annaly Khirurg Gepatologii. 2017;22(1):112-17. (in Russ.)
- Polysalov VN, Granov DA. Khirurgicheskoe lechenie gemangiom pecheni: zavisimost’ khirurgicheskoj taktiki ot formy zabolevanija. Vopr Onkologii. 2003;49(5):630-35. (in Russ.)
- Gupta Sh, Agarwal V, Acharya A. Spontaneous rupture of a giant hepatic hemangioma-report of a case. Indian J Surg. 2012 Oct;74(5): 434-36. doi: 10.1007/s12262-011-0309-3.
- Angelica MD. What is riskier for the patient with an asymptomatic large hepatic hemangioma: observation or the surgeon? World J Surg. 2013 Jun;37(6):1313-14.
- Chardarov NK, Ganiev FA, Bagmet NN, Skipenko OG. Liver hemangiomas: the surgical point of view. Annaly Khirurg Gepatologii. 2012;17(1):86-93. (in Russ.)
- Yedibela S, Alibek S, Müller V, Aydin U, Langheinrich M, Lohmüller C, Hohenberger W, Perrakis A. Management of hemangioma of the liver: surgical therapy or observation? World J Surg. 2013 Jun;37(6):1303-12. doi: 10.1007/s00268-013-1904-1.
- Zhang X, Yan L, Li B, Wen T, Wang W, Xu M, Wei Y, Yang J. Comparison of laparoscopic radiofrequency ablation versus open resection in the treatment of symptomatic-enlarging hepatic hemangiomas: a prospective study. Surg Endosc. 2016 Feb;30(2):756-63. doi: 10.1007/s00464-015-4274-y.
- Kim SH, Kim KH, Kirchner VA, Lee SK. Pure laparoscopic right hepatectomy for giant hemangioma using anterior approach. Surg Endosc. 2017 May;31(5):2338-2339. doi: 10.1007/s00464-016-5224-z.
- Strzelczyk J, Bialkowska J, Loba J, Jablkowski M. Rapid growth of liver hemangioma following interferon treatment for hepatitis C in a young woman. Hepatogastroenterology. 2004 Jul-Aug;51(58):1151-53.
- Aksenov IV, Fedorchenko AN. Hepatic hemangioma: the choice of treatment. Khirurgiia Zhurn im NI Pirogova. 2010;(6):40-42. (in Russ.)
- Herman P, Costa ML, Machado MA, Pugliese V, D’Albuquerque LA, Machado MC, Gama-Rodrigues JJ, Saad WA. Management of hepatic hemangiomas: a 14-year experience. J Gastrointest Surg. 2005 Jul-Aug;9(6):853-59.
- Noda T, Sasaki Y, Yamada T, Eguchi H, Takachi K, Noura S, Miyashiro I, Murata K, Doki Y, Ohigashi H, Ishikawa O, Imaoka S, Mitani H, Ishiguro S. Adult capillary hemangioma of the liver: report of a case. Surg Today. 2005;35(9):796-99.
210023, The Republic of Belarus,
Grodno, Sozialisticheskaya Str., 14, ap. 7,
Tel.:+375 298 227 188,
Iaskevich Nikolai N.
Iaskevich Nikolai N., MD, Professor of the 1st Department of Surgical Diseases, Grodno State Medical University, Grodno, Republic of Belarus
EXCHANGE OF EXPERIENCE
M.A. AKSELROV1,2, V.A. EMELYANOVA2, S.N. SUPRUNEC 1,2, T.V. SERGIENKO2, I.G. ANOXINA2, N.V. KISELEVA2
FIRST EXPERIENCE OF LAPAROSCOPIC DUODENO-DUODENAL ANASTOMOSIS IN NEONATES WITH HIGH INTESTINAL OBSTRUCTION CAUSED BY ANNULAR PANCREAS
Tyumen State Medical University1,
Regional Clinical Hospital ¹ 22, Tyumen,
The Russian Federation
In the Russian Federation, congenital malformations occupy the second place in the structure of infant mortality. Improving operational tactics, anesthesia and post-operative care is an important goal in reducing mortality from this group of diseases. Reduction of the traumatic nature of a surgical intervention directly correlates with the course of the postoperative period. The introduction of a minimally invasive, laparoscopic method of performing the operation must optimize the postoperative period. But volumetric laparoscopic interventions in newborns are difficult. Therefore, the description of laparoscopic treatment of the duodenal obstruction caused by the annular pancreas is sporadic. In the Children’s Surgery Clinic of Tyumen State Medical University, 5 newborns with the duodenal obstruction, caused by the annular pancreas, were operated with the use of laparoscopic technique. The course of the disease in all children was typical. The congenital malformation of development was corrected by the laparoscopic formation of duodeno-duodenal anastomosis. The postoperative period was more uneventful in these children compared with those operated openly. The operation technique and the postoperative course did not differ significantly. Enteral nutrition was started within a week after the operation in all children. After laparotomy, the passage through the gastrointestinal tract is restored not earlier than 10, often 14 days. It is associated with quicker stopping of the inflammation in the anastomosis zone. The article describes in details one clinical case. The technique of laparoscopic duodeno-duodenal anastomosis, when a surgeon has the experience of working with newborns, is a safe, effective technique and can be a choice of surgical treatment of congenital duodenal obstruction caused by the annular pancreas.
- Poroki razvitiia [Elektronnyi resurs]. Inform Biul. 2015 Apr;(370). Available from: http://www.who.int/mediacentre/factsheets/fs370/ru. (in Russ.)
- Goleva OP, Bogza OG. Sostoianie mladencheskoi smertnosti v sovremennoi Rossii. Zhurn Nauch Publikatsii Aspirantov i Doktorantov. 2013;(3):154-57. (in Russ.)
- Rossiiskii statisticheskii ezhegodnik 2016. Federal’naia sluzhba gosudarstvennoi statistiki [Elektronnyi resurs]. Available from: http://www.gks.ru/bgd/regl/b16_13/Main.htm. (in Russ.)
- Cochran WJ. Duodenal Obstruction. Available from: http://www.msdmanuals.com/professional/pediatrics/congenital-gastrointestinal-anomalies/duodenal-obstruction
- Ernst NP. A case of congenital atresia of the duodenum treated successfully by operation. Br Med J. 1916 May 6;1(2888):644-45. doi: 10.1136/bmj.1.2888.644
- Kimura K, Tsugawa C, Ogawa K, Matsumoto Y, Yamamoto T, Asada S. Diamond-shaped anastomosis for congenital duodenal obstruction. Arch Surg. 1977 Oct;112(10):1262-63. doi: 10.1001/archsurg.1977.01370100116026.
- Kozlov Y, Novogilov V, Yurkov P, Podkamenev A, Weber I, Sirkin N. Keyhole approach for repair of congenital duodenal obstruction. Eur. J. Pediatr. Surg. 2011; 21(2):124-127. doi: 10.1055/s-0030-1268455.
- Bax NM, Ure BM, van der Zee DC, van Tuijl I. Laparoscopic duodenoduodenostomy for duodenal atresia. Surg Endosc. 2001 Feb;15(2):217. doi: 10.1007/BF03036283.
- Chung PH, Wong CW, Ip DK, Tam PK, Wong KK. Is laparoscopic surgery better than open surgery for the repair of congenital duodenal obstruction? A review of the current evidences. J Pediatr Surg. 2017 Mar;52(3):498-503. doi: 10.1016/j.jpedsurg.2016.08.010.
- Li B, Chen WB, Wang SQ, Wang YB. Laparoscopic diagnosis and treatment of neonates with duodenal obstruction associated with an annular pancreas: report of 11 cases. Surg Today. 2015 Jan;45(1):17-21. doi: 10.1007/s00595-014-0850-3.
- Zelinskaya DI, Terletskaya RN. Regional peculiarities of infant mortality due to congenital defects in the Russian Federation. Det Bol’nitsa. 2013;(1):10-13. (in Russ.)
625023, The Russian Federation,
Tyumen, Odesskaya Str., 54,
Tyumen State Medical University,
Department of Pediatric Surgery,
Tel. office: 8 (3452) 28-71-66,
Emelyanova Viktoria A.
Akselrov Mikhail A., MD, Associate Professor, Head of the Department of Pediatric Surgery, Tyumen State Medical University, Head of the Pediatric Surgery Unit ¹ 1, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
Emelyanova Viktoria A, Anesthesiologist-Resuscitator of the Department of Anesthesiology, Resuscitation and Intensive Care for Newborns and Premature Babies, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
Suprunec Svetlana N., PhD, Associate Professor of the Children’s Diseases Department of the Department, Tyumen State Medical University, Head of the Department of Anesthesiology, Resuscitation and Intensive Care for Newborns and Premature Babies, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
Sergienko Tatyana V., Pediatric Surgeon of the Pediatric Surgery Unit ¹ 1, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
Anoxina Irina G., Anesthesiologist-Resuscitator of the Department of Anesthesiology, Resuscitation and Intensive Care for Newborns and Premature Babies, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
Kiseleva Natalya V., Anesthesiologist-Resuscitator of the Department of Anesthesiology, Resuscitation and Intensive Care for Newborns and Premature Babies, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.