This journal is
indexed in Scopus
Year 2019 Vol. 27 No 3
V.A. LIPATOV 1, S.V. LAZARENKO 1, A.N. BETZ 2, D.A. SEVERINOV 1
CHANGES OF PHYSICO-MECHANICAL PROPERTIES OF VASCULAR PATCHES IN CONDITIONS OF CHRONIC EXPERIMENT IN VIVO
Kursk State Medical University 1,
Kursk Regional Hospital 2, Kursk,
The Russian Federation
Objective. To study the changes of the physical and mechanical properties of the vascular patch canvas (breaking load and tensile elongation at uniaxial tension) in the conditions of a chronic experiment in vivo.
Methods. New samples of vascular patches based on polyethylene terephthalate (PETP) fibers were used for experimental studies. In the group 1 – warp-knitted canvas based on polyethylene terephthalate fibers was used; in the group 2 – woven canvas based on polyethylene terephthalate and fluoronone, additionally impregnated with gelatin; the group 3 – warp knitted canvas based on polyethylene terephthalate fibers, developed by the group of the authors. As a comparison group, the results of the study of the same samples of vascular patches, non-implanted into the tissue of laboratory animals were used.
As the object for implantation, 60 male rats of Wistar line were chosen. Rats were divided into 3 groups (20 in each) according to the number of types of experimental samples and within each group into subgroups (10 according to the time of elimination from the experiment: 15 and 30 days). The test samples were implanted in the paravertebral region to the laboratory animals. Testing of physical-mechanical characteristics was carried out according to standard methods for assessing the strength characteristics using a tensile testing machine REM-0.2-1. The elongation (%) of the implant canals after implantation at 8 N, 16 N was evaluated, the breaking load (N) was recorded.
Results. Samples of vascular patches of polyethylene terephthalate, which do not have additional treatment with gelatin in the production process (group 3), withstood the greatest breaking load - 147 N (on the 15th day of the experiment) and 151 N (30 day), respectively. The percentage of their elongation was from 6% to 49%. In the case of samples with gelatin treatment, it was 66, 5 N and 75 N.
Conclusions. The values of the indices of the studied parameters of the physical mechanical properties of polymeric vascular implants after implantation to laboratory animals are higher in the samples of the group 3 during all periods of the experiment (15 and 30 days).
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- Ivanov AV, Lipatov VA, Lazarenko SV, Zherdev NN, Severinov DA. The influence of mechanical characteristics of vascular patches on the formation of capsules. Klin i Eksperim Khirurgiia. Zhurn im Akad BV Petrovskogo. 2016;4(1):51-57. https://cyberleninka.ru/article/n/vliyanie-mehanicheskih-harakteristik-sosudistoy-zaplaty-na-formirovanie-periproteznoy-kapsuly (in Russ.)
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- Glushkova TV, Sevostyanova VV, Antonova LV, Klyshnikov KYu, Ovcharenko EA, Sergeeva EA, Vasyukov JYu, Seifalian AM, Barbarash LS. Biomechanical remodeling of biodegradable small-diameter vascular grafts in situ. Vestn Transplantologii i Iskusstv Organov. 2016;18(2):99-109. doi: 10.15825/1995-1191-2016-2-99-109 (in Russ.)
- Vinokur AA, Djakov VÅ, Alukhanjan ÎA. Comparative research of physicomechanical properties of new PTFE patches. Kuban Nauch Med Vestn. 2010;(8):40-46. https://cyberleninka.ru/article/n/sravnitelnoe-issledovanie-fiziko-mehanicheskih-svoystv-novyh-zaplat-iz-politetraftoretilena (in Russ.)
305041, The Russian Federation,
Kursk, Karl Marks Str., 3,
Kursk State Medical University,
Department of Operative Surgery
and Topographic Anatomy,
Tel: +7 920 262-15-55,
Dmitriy A. Severinov
Lipatov Viacheslav A., MD, Associate Professor, Professor of the Department of Operative Surgery and Topographic Anatomy, Kursk State Medical University, Kursk, Russian Federation.
Lazarenko Sergey V., PhD, Assistant of the Oncology Department, Kursk State Medical University, Kursk, Russian Federation.
Betz Alexander N., Cardiovascular Surgeon, Kursk Regional Hospital, Kursk, Russian Federation.
Severinov Dmitriy A., Assistant of the Department of Operative Surgery and Topographic Anatomy, Kursk State Medical University, Kursk, Russian Federation.
R.A. SADYKOV, B.A. ISMAILOV, O.V. KIM
NEW FILM COATING BASED ON CELLULOSE DERIVATIVES FOR LOCAL HEMOSTASIS
Republican Specialized Scientific and Practical Medical Center of Surgery named after academician V. Vakhidov, Tashkent,
Objective. To study hemostatic activity and biocompatibility of new film coating based on cellulose derivatives on the model of the liver injury in experiment.
Methods. The film coating based on cellulose derivatives was used for investigations. Tensile strength, implant structure evaluation, adhesion force were evaluated using “Zwick” apparatus (Germany), Agilent Technologies atomic force microscope (USA). Hemostatic activity was evaluated by the Lee-White method.
Experimental studies were performed on the model of the liver injury in 32 adult mongrel outbred white rats. Operations were performed under inhalation anesthesia. Animals were removed from the experiment after 1, 3, 12 hours and on the 1st, 3rd, 7th, 14th and 30th day after the operation according to the accepted ethical standards. Macroscopic and microscopic studies were conducted.
Results. The adhesion strength of the film coating was 7.3±0.2 kPa (M±m), the breaking strength – 390.4±4.8 kHz/ cm2 (M±m). The coagulation time was 2.4±0.6 minutes (M±m) in the presence of polymer.
The use of the film coating allowed stopping bleeding rather quickly in the parenchyma bleeding from the liver injury (5.3±3.1 seconds). Sequential observations of the animals showed that 1 hour after the operation the implant was kept on the liver surface as a white coating was not separated from the wound surface. No signs of bleeding were noted. Histological studies of the liver biopsy specimens revealed a mild inflammatory disease with complete degradation of the coating on the 14th day after the operation.
Conclusions. The designed new film coating based on cellulose derivatives causes effective hemostasis, has good adhesiveness to the injured liver tissue and sufficient tensile strength. Biodegradation of the implant occurs within 2 weeks after application to the liver wound without a severe inflammatory reaction.
- Ogushi Y, Sakai S, Kawakami K. Synthesis of enzymatically-gellable carboxymethylcellulose for biomedical applications. J Biosci Bioeng. 2007 Jul;104(1):30-33. doi: 10.1263/jbb.104.30
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- Lipatov VA, Ershov MP, Sotnikov KA, Ushanov AA, Novikova NV, Konstantinova YuE. The modern trends of using local applicational blood reestablishing instruments of surgery of abdominal organs (literature review). Nauch Elektron Zhurn «Innova». 2016;(2):64-67. http://innova-journal.ru/issues/2016-2-3/files/07.pdf (in Russ.)
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Tashkent, Kichik Khalqa Yoli, 10,
Republican Specialized Scientific and Practical
Medical Center of Surgery
Named after Academician V. Vakhidov,
Experimental Surgery Department.
Tel. +99 890 351-03-34,
Bakhodir A. Ismailov
Sadykov Rustam A., MD, Professor, Head of the Experimental Surgery Department, Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V. Vakhidov, Tashkent, Uzbekistan.
Ismailov Bakhodir A., Junior Researcher of the Experimental Surgery Department, Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V. Vakhidov, Tashkent, Uzbekistan.
Kim Olga V., Junior Researcher of the Experimental Surgery Department, Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V. Vakhidov, Tashkent, Uzbekistan.
GENERAL & SPECIAL SURGERY
S.A. BELOV 1, A.A. GRIGORYUK 2
INFLUENCE OF THORACOPLASTY ON THE EXTERNAL RESPIRATORY FUNCTION
Seaside Regional Antituberculous Dispensary 1,
Pacific State Medical University 2, Vladivostok,
The Russian Federation
Objective. To evaluate the function of external respiration after thoracoplasty using the polypropylene mesh.
Methods. 42 cases of collapse surgical treatment of fibrous-cavernous pulmonary tuberculosis were studied. Patients were divided into 2 groups. The 1st group (n=21) – patients who were performed the author’s method of extrapleural upper-posterior thoracoplasty using the mesh «Surgipro» implant; the 2nd group (n=21) – patients who underwent traditional extrapleural upper-posterior thoracoplasty. The function of external respiration, perfusion of the lungs, dead space ratio and efficiency of surgical method were compared.
Results. Pre-surgery spirographic study revealed the violation of the external respiration function in all patients. There was a change in the gas composition of the blood and ventilation-perfusion relations on the first day after the intervention in both groups. In the second group, there was a significant decrease in lung capacity, forced expiratory volume, the percentage of arterial blood oxygen saturation (p<0.05) and the development of respiratory and metabolic acidosis. In the first group, thoracoplasty using the mesh implant «Surgipro» revealed no violation of the ventilation-perfusion balance and a significant decrease in external respiration compared to the original figures (p>0.05). Clinical and x-ray examination of patients three weeks after the operation indicates that in the group with the use of polypropylene mesh, the occurrence of complications and the preservation of bacterial excretion is much lower. The developed method of extrapleural upper-posterior thoracoplasty using a mesh polypropylene implant can solve the problem of chest reconstruction, reduces the risk of paradoxical breathing and increases the degree of compression necessary to close the defects in the lungs.
Conclusions. Breach of the skeleton of the chest lowers the release of carbon dioxide from the body. The use of the mesh implant in the formation of a new pleural dome reduces the coefficient of dead space and prevents the development of the respiratory imbalance.
- Fu Y, Duanmu H, Fu Y. Surgery for Pulmonary Tuberculosis and Its Indications. In: Lu Y, Wang L, Duanmu H, Chanyasulkit C, Strong A, Zhang H. (eds). Handbook of Global Tuberculosis Control. Springer, Boston, MA; 2017. p 225-34 doi: 10.1007/978-1-4939-6667-7_14
- Ots ON, Chushkin MI, Struchkov PV. Post tuberculosis lung function impairment. Pul’monologiia. 2017;27(5):656-63. doi: 10.18093/0869-0189-2017-27-3-656-663 (in Russ.)
- Dewan RK, Moodley L. Resurgence of therapeutically destitute tuberculosis: amalgamation of old and newer techniques. J Thorac Dis. 2014 Mar;6(3):196-201. doi: 10.3978/j.issn.2072-1439.2013.12.19
- Kuhtin O, Veith M, Alghanem M, Martel I, Giller D, Haas V, Lampl L. Thoracoplasty-Current View on Indication and Technique. Thorac Cardiovasc Surg. 2018 May 17. doi: 10.1055/s-0038-1642633
- Hicks A, Muthukumarasamy S, Maxwell D, Howlett D. Chronic inactive pulmonary tuberculosis and treatment sequelae: chest radiographic features. Int J Tuberc Lung Dis. 2014 Feb;18(2):128-33. doi: 10.5588/ijtld.13.0360
- Korpusenko IV. Application of minimally invasive extapleural thoracoplasty in patients with bilateral tuberculosis of the lungs. Novosti Khirurgii. 2015;23(1):37-43. doi: 10.18484/2305-0047.2015.1.37 (in Russ.)
- Vishnevskii AA, Rudakov SS, Milanov NO. Khirurgiia grudnoi stenki: ruk. Moscow, RF: Vidar; 2005. 312 p. http://kingmed.info/knigi/Hiryrgia/Torakalnaya_hirurgiya/book_2032/Hirurgiya_grudnoy_stenki-Vishnevskiy_AA_Rudakov_SS_Milanov_NO-2005-pdf (in Russ.)
690041, The Russian Federation,
Vladivostok, Pyatnadtsataya Str., 2,
Seaside Regional Antituberculous Dispensary,
4th Pulmonary Surgical Department.
Tel. mobile: +7 914 734-35-74,
Sergei A. Belov
Belov Sergei A., PhD, Thoracic Surgeon, 4th Pulmonary Surgical Department, Seaside Regional Antituberculous Dispensary, Vladivostok, Russian Federation.
Grigoryuk Alexandr A., PhD, Associate Professor, Institute of Surgery, Pacific State Medical University, Vladivostok, Russian Federation.
S.N. ZAVGORODNIY, M.A. KUBRAK, M.B. DANYLIUK
SIMULTANEOUS OPERATIONAL INTERVENTIONS IN PATIENTS WITH THYROID PATHOLOGY
Zaporizhzhia State Medical University, Zaporizhzhia,
Objective. To improve the diagnostic of combined surgical diseases and evaluate the results of simultaneous surgical interventions performed in patients with thyroid pathology.
Methods. A retrospective analysis of case histories of 564 patients with the thyroid gland (TG) diseases was performed. The main group consisted of 247 (43.8%) hospitalized patients who were examined according to the developed diagnostic algorithm for combined surgical pathology. The comparison group included 317 (56.2%) patients examined according to the diagnostic and treatment protocols for patients with endocrine pathology approved in Ukraine. The levels of detection of combined surgical pathology, its structure, indicators of simultaneous operations, postoperative complications and mortality in both groups were evaluated using statistical methods of analysis.
Results. In the comparison group, 21 (6.6%) patients had a combined surgical pathology. In the main group – in 61 (24.7%) of the examined. 55 (90.2%) patients of the main group and 18 (85.7%) operated on in the comparison group underwent simultaneous surgical intervention. The level of simultaneous operations in the main group was 22.3%, in the comparison group – 5.7%. In 7 (12.7%) patients of the main group and in 2 (11.1%) of the comparison group, postoperative complications occurred. Lethal cases in both groups were not recorded.
Conclusions. The use of the developed algorithm for examining patients with thyroid pathology allowed an increase in the diagnostic of combined surgical diseases from 6.6% to 24.7%, χ2=9.342, p<0.01. This made it possible to increase the number of simultaneous operations performed from 5.7% to 22.3%, χ2=8.692, p<0.01. An increase in the percentage of simultaneous surgical procedures performed does not increase in mortality rates and postoperative complications.
- Kravchenko V², Postol SV. Dinam³ka zakhvoriuvanost³ na patolog³iu shchitopod³bno¿ zalozi v Ukra¿n³. Mezhdunar Endokrin Zhurn. 2011;(3):26-31. http://www.mif-ua.com/archive/article/17759 (in Russ.)
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- Zavgorodniy SM, Kubrak MA, Rylov AI, Danilyk MB. Diagnostic algorithm in combined surgical pathology in patients with diseases of endocrine system. Mezhdunar Endokrin Zhurn. 2017;13(8):591-95. doi: 10.22141/2224-07126.96.36.1997.119276 (in Russ.)
- Spanheimer PM, Weigel RJ. Management of patients with primary hyperparathyroidism and concurrent thyroid disease: an evolving field. Ann Surg Oncol. 2012 May;19(5):1428-29. doi: 10.1245/s10434-012-2286-6
- Emirikҫi S, Özҫ?nar B, Öner G, Omarov N, Ağcaoğlu O, Soytaş Y, Aksakal N, Yanar F, Barbaros U, Erbil Y. Thyroid cancer incidence in simultaneous thyroidectomy with parathyroid surgery. Ulus Cerrahi Derg. 2015 Aug 18;31(4):214-17. doi: 10.5152/UCD.2015.2666. eCollection 2015
- Simsek B, Guldogan CE, Ozden S, Saylam B, Karabeyoglu SM, Tez M. Concomitant thyroid cancer in patients with primary hyperparathyroidism in an endemic goitre region. Ann Ital Chir. 2017;88:15-19. https://www.annaliitalianidichirurgia.it/PDF/2017/03_2622+blocco.pdf
- Morris R, Yen TWF, Doffek K, Carr AA, Wilson SD, Evans DB, Wang TS. Concurrent endocrine and other surgical procedures: an institutional experience. J Surg Res. 2017 May 1;211:107-13. doi: 10.1016/j.jss.2016.12.013
Zaporizhzhia, Mayakovsky Ave., 26,
Zaporizhzhia State Medical University,
Department of Surgery and Anesthesiology
Of the Post-Graduate Training Faculty.
Tel. +38 095 700-78-93,
Mykhaylo A. Kubrak
Zavgorodniy Sergey N., MD, Professor, Head of the Department of Surgery and Anesthesiology of the Post-Graduate Training Faculty, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine.
Kubrak Mykhaylo A., Senior Laboratory Assistant of the Department of Surgery and Anesthesiology of the Post-Graduate Training Faculty, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine.
Danyliuk Mykhailo B., PhD, Assistant of the Department of Surgery and Anesthesiology of the Post-Graduate Training Faculty, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine.
V. SIHOTSKY 1, 2, I. KOPOLOVETS 1, 3, M. KUBIKOVA 1, 2, P. STEFANIC 1, 2, V. KATUCH 2
RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH AORTOILIAC ATHEROSCLEROSIS
Eastern Slovak Institute of Cardiovascular Diseases 1,
Pavol Jozef Safarik University 2, Kosice,
the Slovak Republic
Uzhhorod National University 3, Uzhhorod,
Objective. To investigate the results of surgical treatment of patients with aortoiliac pathology in the early postoperative period.
Methods. In the study 103 patients with aortoiliac pathology were included, who were referred to the Clinic of Vascular Surgery from 2015 to 2017 years. 53 patients were operated on because of aortoiliac atherosclerosis and 50 patients – because of abdominal aortic aneurysm. The indications for surgery were limiting claudication, critical limb ischemia or acute thrombosis of the aorta in patients with aortoiliac atherosclerosis. The indication for surgery in patients with abdominal aortic aneurysm was the aneurysm over 5.5 cm in the transverse diameter or the ruptured aneurysm. Early results of patients’ surgical treatment were assessed by the frequency of postoperative complications and deaths.
Results. 49 (92.5%) out of 53 patients with aortoiliac atherosclerosis were operated on as planned and 4 (7.5%) patients were operated on urgently. 52 (98.2%) aortobifemoral bypasses and one (1.8%) aortofemoral (unilateral) bypass were performed. Three complications (6.1%) occurred postoperatively in patients operated on according to plan and one complication (25%) – in patients operated urgently. The mortality rate was 25% in urgent patients and 2.0% in planned patients. 28 patients with asymptomatic abdominal aortic aneurysm and 22 with the ruptured abdominal aortic aneurysm were operated on. The mortality in the planned patients was 3.6%. 40.9% mortality rate was registered in the ruptured abdominal aortic aneurysm patients.
Conclusions. Early good and satisfactory results of the routine surgical treatment of symptomatic aortoiliac atherosclerosis in the early postoperative period accounted 98%, asymptomatic aortic aneurysm – 96.4%. Mortality after urgent surgery with aneurysm rupture made up 40.9%. Surgical treatment of aortic aneurysm is indicated in patients with low and moderate surgical risk.
- Menard MT. Aortoiliac Disease: Direct Aortoiliac Reconstruction. In: Cronenwett JL, Johnston ÊW. Rutherford's Vascular Surgery. 8th ed. Philadelphia: Elsevier Saunders; 2014. ð. 1701-21. https://www.uk.elsevierhealth.com/rutherfords-vascular-surgery-2-volume-set-9781455753048.html
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- Moll FL, Powell JT, Fraedrich G, Verzini F, Haulon S, Waltham M, van Herwaarden JA, Holt PJ, van Keulen JW, Rantner B, Schlösser FJ, Setacci F, Ricco JB. Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasc Endovasc Surg. 2011 Jan;41(Suppl 1):S1-S58. doi: 10.1016/j.ejvs.2010.09.011
- Patel R, Sweeting MJ, Powell JT, Greenhalgh RM. Endovascular versus open repair of abdominal aortic aneurysm in 15-years’follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial. Lancet. 2016 Nov 12;388(10058):2366-74. doi: 10.1016/S0140-6736(16)31135-7
- Wanhainen A, Verzini F, Van Herzeele I, Allaire E, Bown M, Cohnert T, Dick F, van Herwaarden J, Karkos C, Koelemay M, Kölbel T, Loftus I, Mani K, Melissano G, Powell J, Szeberin Z, Esvs Guidelines Committee, de Borst GJ, Chakfe N, Debus S, Hinchliffe R, Kakkos S, Koncar I, Kolh P, Lindholt JS, de Vega M, Vermassen F, Document Reviewers, Björck M, Cheng S, Dalman R, Davidovic L, Donas K, Earnshaw J, Eckstein HH, Golledge J, Haulon S, Mastracci T, Naylor R, Ricco JB, Verhagen H. Editor’s Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2019 Jan;57(1):8-93. doi: 10.1016/j.ejvs.2018.09.020
- Burke CR, Henke PK, Hernandez R, Rectenwald JE, Krishnamurthy V, Englesbe MJ, Kubus JJ, Escobar GA, Upchurch GR Jr, Eliason JL. A contemporary comparison of aortofemoral bypass and aortoiliac stenting in the treatment of aortoiliac occlusive disease. Ann Vasc Surg. 2010 Jan;24(1):4-13. doi: 10.1016/j.avsg.2009.09.005
- Creager MA, Kaufman JA, Conte MS. Clinical practice. Acute limb ischemia. N Engl J Med. 2012 Jun 7;366(23):2198-206. doi: 10.1056/NEJMcp1006054
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- Becquemin JP, Pillet JC, Lescalie F, Sapoval M, Goueffic Y, Lermusiaux P, Steinmetz E, Marzelle J. A randomized controlled trial of endovascular aneurysm repair versus open surgery for abdominal aortic aneurysms in low- to moderate-risk patients. J Vasc Surg. 2011 May;53(5):1167-73.e1. doi: 10.1016/j.jvs.2010.10.124
- Patel VI, Lancaster RT, Conrad MF, Lamuraglia GM, Kwolek CJ, Brewster DC, Cambria RP. Comparable mortality with open repair of complex and infrarenal aortic aneurysm. J Vasc Surg. 2011 Oct;54(4):952-59. doi: 10.1016/j.jvs.2011.03.231
- Williams CR, Brooke BS. Effectiveness of open versus endovascular abdominal aortic aneurysm repair in population settings: A systematic review of statewide databases. Surgery. 2017 Oct;162(4):707-20. doi: 10.1016/j.surg.2017.01.014
- Albuquerque FC Jr, Tonnessen BH, Noll RE Jr, Cires G, Kim JK, Sternbergh WC 3rd. Paradigm shifts in the treatment of abdominal aortic aneurysm: trends in 721 patients between 1996 and 2008. J Vasc Surg. 2010 Jun;51(6):1348-52; discussion 1352-53. doi: 10.1016/j.jvs.2010.01.078
- Patel R, Powell JT, Sweeting MJ, Epstein DM, Barrett JK, Greenhalgh RM. The UK EndoVascular Aneurysm Repair (EVAR) randomised controlled trials: long-term follow-up and cost-effectiveness analysis. Health Technol Assess. 2018 Jan;22(5):1-132. doi: 10.3310/hta22050
- Kapma MR, Dijksman LM, Reimerink JJ, de Groof AJ, Zeebregts CJ, Wisselink W, Balm R, Dijkgraaf MG, Vahl AC. Cost-effectiveness and cost-utility of endovascular versus open repair of ruptured abdominal aortic aneurysm in the Amsterdam Acute Aneurysm Trial. Br J Surg. 2014 Feb;101(3):208-15. doi: 10.1002/bjs.9356
Kosice, Ondavska Str., 8,
Eastern Slovak Institute
of Cardiovascular Diseases.
Tel. + 421 055 789-15-10,
e-mail: i.kopolovets@ gmail.com,
Sihotský Vladimir, PhD, Deputy Head of the Clinic of Vascular Surgery for Pedagogical Work, Vascular Surgeon, Eastern Slovak Institute of Cardiovascular Diseases, Pavol Jozef Safarik University, Medical Faculty, Kosice, Slovak Republic.
Kopolovets Ivan, PhD, Vascular Surgeon, Eastern Slovak Institute of Cardiovascular Diseases, Košice, Slovak Republic, Researcher of Uzhhorod National University, Uzhhorod, Ukraine.
Kubikový Maria, PhD, Vascular Surgeon, Eastern Slovak Institute of Cardiovascular Diseases, Pavol Jozef Safarik University, Medical Faculty, Kosice, Slovak Republic.
Stefanic Peter, PhD, Vascular Surgeon, Eastern Slovak Institute of Cardiovascular Diseases, Pavol Jozef Safarik University, Medical Faculty, Kosice, Slovak Republic.
Katuch Vladimir, PhD, Head of the Neurosurgery Clinic, Pavol Jozef Safarik University, Medical Faculty, Kosice, Slovak Republic.
VACUUM THERAPY IN COMPLEX TREATMENT OF PATIENTS WITH ODONTOGENIC INFLAMMATORY PROCESS OF THE MAXILLOFACIAL AREA AND NECK
Vitebsk State Medical University, Vitebsk,
The Republic of Belarus
Objective. To evaluate the effectiveness of the vacuum system in the complex treatment of patients with odontogenic inflammatory diseases of the maxillofacial area and neck.
Methods. The examination of 178 patients with acute odontogenic osteomyelitis of the jaw, complicated by phlegmon of the adjacent tissue spaces, was conducted. To manage the patients of the main group vacuum system was additionally used. Patients in the comparison group were treated using standard methods. The control group consisted of 50 healthy individuals. The erythrocyte deformability (ED) was evaluated by the time of their suspension passing of a standard distance through a porous filter. The adhesion of leukocyte-platelet suspension (LTS) was investigated by recording the changes in the light transmission of the leukocyte’s suspension before and after incubation with a fibrous substrate using the AR 2110 «SOLAR» aggregometer.
Results. When vacuum therapy was included in the medical complex, in shorter terms (5 (5-6) days) the pain during palpation of the inflammatory focus was stopped; the face configuration was restored on the 7 (5-8) day; the skin redness was stopped on the 5 (5-6) day; purulent exudation from the wound was stopped on the 6 (5-7) day; favorable conditions were created for the beginning of the formation of granulations on the 7 (6-8) day. A decrease in treatment terms (9 (8-10) days) of the main group of patients in relation to the duration of treatment in patients with standard complex treatment (10 (8-12) days) was revealed. Vacuum therapy at the end of treatment helps to reduce microcirculation indices elevated at the beginning of treatment to the level of healthy individuals.
Conclusions. The use of vacuum therapy in the treatment of patients with acute odontogenic osteomyelitis of the jaw, complicated by phlegmon of the adjacent tissue spaces, reduces the wound healing terms and reduces the duration of treatment from 10 (8; 12) days to 9 (8; 10) days. Normalization of the rate and degree of aggregation of LTS, DE in the blood plasma was revealed at the end of patients’ treatment using negative pressure.
- Pinelis IS, Turchina EV. Modern views on antibacterial therapy of póî-inflammatory diseases of maxillofacial area. Zabaikal Med Vestn. 2014;(3):182-88. http://zabmedvestnik.ru/journal/2014/3/28.pdf (in Russ.)
- Andrews BT, Smith RB, Goldstein DP, Funk GF. Management of complicated head and neck wounds with vacuum-assisted closure system. Head Neck. 2006 Nov;28(11):974-81. doi: 10.1002/hed.20496
- Schuster R, Moradzadeh A, Waxman K. The use of vacuum-assisted closure therapy for the treatment of a large infected facial wound. Am Surg. 2006 Feb;72(2):129-31. https://www.ingentaconnect.com/contentone/sesc/tas/2006/00000072/00000002/art00006
- Palm HG, Hauer T, Simon C, Willy C. Vacuum-assisted closure of head and neck wounds. HNO. 2011 Aug;59(8):819-30. doi: 10.1007/s00106-011-2364-2 [Article in German]
- Satteson ES, Crantford JC, Wood J, David LR. Outcomes of Vacuum-Assisted Therapy in the Treatment of Head and Neck Wounds. J Craniofac Surg. 2015 Oct;26(7):e599-602. doi: 10.1097/SCS.0000000000002047
- Qiu Y, Li Y, Gao B, Li J, Pan L, Ye Z, Lin Y, Lin L. Therapeutic efficacy of vacuum sealing drainage-assisted irrigation in patients with severe multiple-space infections in the oral, maxillofacial, and cervical regions. J Craniomaxillofac Surg. 2019 May;47(5):837-41. doi: 10.1016/j.jcms.2019.01.031
- Zemljanoj VP, Singaevikij AB, Kozhevnikov VP. Morphological and functional monitoring of the wound healing process in the evaluation of the vacuum therapy of wounos. Vestn Nats Med-Khirurg Tsentra im NI Pirogova. 2016;11(4):51-55. https://cyberleninka.ru/article/n/mor-fologicheskiy-i-funktsionalnyy-monitoring-ranevogo-protsessa-v-otsenke-effektivnosti-vakuum-terapii-ran (in Russ.)
- Javia P, Rana A, Shapiro N, Shah P. Machine learning algorithms for classification of microcirculation images from septic and non-septic patients. Proceedings of the 17th IEEE International Conference on Machine Learning and Applications (ICMLA-2018); 2018 Dec 17-20; Orlando, Florida, USA. ð. 165-72. doi: 10.1109/ICMLA.2018.00097
- Plotnikov PV. The miltimodal treatment of patients with pyogenic wounds depending on the ability of microbial agents to form biofilm. Novosti Khirurgii. 2014 Sep-Oct; Vol 22 (5): 575-581 doi: 10.18484/2305-0047.2014.5.575 (in Russ.)
- Kozlovsky VI, Dubas IO. Pathological orthostatic reactions in patients with arterial hypertension and community-acquired pneumonia. Vestn VGMU. 2011;10(10):54-61. http://vestnik.vsmu.by/downloads/2011/vestnikVGMU-10-3-2011.pdf (in Russ.)
- Razmakhnin EV, Konovalova OG, Lobanov SL, Shangin VA. Ispol’zovanie vakuum-terapii pri lechenii gnoinykh ran. Zabaikal Med Zhurn. 2015;(2):70-71. http://chitgma.ru/ric/zabajkalskij-meditsinskij-zhurnal/2015-god/3697-zabajkalskij-meditsinskij-zhurnal-2-2015 (in Russ.)
- Monakov VA, Savel‘ev AL, Selezneva IA. Tsitologicheskaia dinamika gnoinykh ran cheliustno-litsevoi oblasti pri vakuumno-promyvnom drenirovanii. Mezhdunar Zhurn Priklad i Fundam Issledovanii. 2015;11:41-46. https://www.applied-research.ru/ru/article/view?id=7669 (in Russ.)
- Baldwin C, Potter M, Clayton E, Irvine L, Dye J. Topical negative pressure stimulates endothelial migration and proliferation: a suggested mechanism for improved integration of Integra. Ann Plast Surg. 2009 Jan;62(1):92-6. doi: 10.1097/SAP.0b013e31817762fd
- Greene AK, Puder M, Roy R, Arsenault D, Kwei S, Moses MA, Orgill DP. Microdeformational wound therapy: effects on angiogenesis and matrix metalloproteinases in chronic wounds of 3 debilitated patients. Ann Plast Surg. 2006 Apr;56(4):418-22. doi: 10.1097/01.sap.0000202831.43294.02
- Terskov DV, Cherdantsev DV, Diatlov VIu, Kovalenko AA. Evoliutsiia primeneniia otritsatel’nogo davleniia dlia lecheniia ran. Sovrem Problemy Nauki i Obrazovaniia. 2016;(3). http://www.science-education.ru/ru/article/view?id=24723 (in Russ.)
210023, The Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Maxillofacial
Surgery and Surgical Dentistry
With a Course of Advanced
Training and Retraining of Medical Specialists.
Tel. +375 29 295-33-54,
Arina A. Kabanova
Kabanova Arina A., PhD, Associate Professor, Head of the Department of Maxillofacial Surgery and Surgical Dentistry with a Course of Advanced Training and Retraining of Medical Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
YU.V. SLABADZIN, E.A. ADUTCKEVICH, S.A. SIDOROV
LAPAROSCOPIC SURGERY OF COLORECTAL CANCER UNDER THE CONDITIONS OF ADHESIVE PROCESS OF THE ABDOMINAL CAVITY ORGANS
Republican Clinical Medical Center of the Presidential Administration of the Republic of Belarus, Minsk,
The Republic of Belarus
Objective. To assess safety and radicality of laparoscopic surgery of colorectal cancer in conditions of adhesive process of the abdominal organs.
Methods. 124 patients took part in the retrospective study, 41 of them were performed against the background of the existing adhesive process of the abdominal organs. Patients were divided into 2 groups: the main group (41 patients) – patients operated on for colorectal cancer on the background of the adhesive process of the abdominal cavity and control group (comparison group) – 83 patients operated on for colorectal cancer and not having any adhesive process in the abdominal cavity. In order to assess the severity of the adhesive process, as well as the places of fixing the intestinal loops to the anterior abdominal wall, to determine the point of possible installation of the first trocar, preoperative ultrasound examination was performed. Places through which it is possible to introduce trocars were marked. The severity of the adhesive process was assessed intraoperatively according to the scale of the peritoneal adhesion index.
Results. When installing the first 10 mm trocar or Veress needle, there was no damage to the internal organs in any case. The duration of surgical interventions was 40-50 minutes longer in the main group, this time was required for adhesiolysis. Mean hemorrhage in the first and the second group was minimal. Adhesive process of the abdominal cavity and laparoscopic method of surgical intervention did not violate the necessary lymph dissection. In the main and control groups in remote macroparts the proximal and distal margins of the resection were negative from the tumor process, which indicates the correct volume of resection and the possibility of performing laparoscopically in conditions of the adhesive process of the abdominal cavity.
Conclusions. Ultrasound examination of the abdominal cavity at the preoperative stage allows choosing the right points of the trocar entrance into the abdominal cavity. Execution of adhesions by laparoscopic method increases the visualization of the operation area and the quality of the conducted adhesiolysis, which increases the safety of the performed surgical intervention.
- Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, Brenner H, Dicker DJ, Chimed-Orchir O, Dandona R, Dandona L, Fleming T, Forouzanfar MH, Hancock J, Hay RJ, Hunter-Merrill R, Huynh C, Hosgood HD, Johnson CO, Jonas JB, Khubchandani J, Kumar GA, Kutz M, Lan Q, Larson HJ, Liang X, Lim SS, Lopez AD, MacIntyre MF, Marczak L, Marquez N, Mokdad AH, Pinho C, Pourmalek F, Salomon JA, Sanabria JR, Sandar L, Sartorius B, Schwartz SM, Shackelford KA, Shibuya K, Stanaway J, Steiner C, Sun J, Takahashi K, Vollset SE, Vos T, Wagner JA, Wang H, Westerman R, Zeeb H, Zoeckler L, Abd-Allah F, Ahmed MB, Alabed S, Alam NK, Aldhahri SF, Alem G, Alemayohu MA, Ali R, Al-Raddadi R, Amare A, Amoako Y, Artaman A, Asayesh H, Atnafu N, Awasthi A, Saleem HB, Barac A, Bedi N, Bensenor I, Berhane A, Bernabé E, Betsu B, Binagwaho A, Boneya D, Campos-Nonato I, Castañeda-Orjuela C, CatalÁ-López F, Chiang P, Chibueze C, Chitheer A, Choi JY, Cowie B, Damtew S, das Neves J, Dey S, Dharmaratne S, Dhillon P, Ding E, Driscoll T, Ekwueme D, Endries AY, Farvid M, Farzadfar F, Fernandes J, Fischer F, G/Hiwot TT, Gebru A, Gopalani S, Hailu A, Horino M, Horita N, Husseini A, Huybrechts I, Inoue M, Islami F, Jakovljevic M, James S, Javanbakht M, Jee SH, Kasaeian A, Kedir MS, Khader YS, Khang YH, Kim D, Leigh J, Linn S, Lunevicius R, El Razek HMA, Malekzadeh R, Malta DC, Marcenes W, Markos D, Melaku YA, Meles KG, Mendoza W, Mengiste DT, Meretoja TJ, Miller TR, Mohammad KA, Mohammadi A, Mohammed S, Moradi-Lakeh M, Nagel G, Nand D, Le Nguyen Q, Nolte S, Ogbo FA, Oladimeji KE, Oren E, Pa M, Park EK, Pereira DM, Plass D, Qorbani M, Radfar A, Rafay A, Rahman M, Rana SM, Søreide K, Satpathy M, Sawhney M, Sepanlou SG, Shaikh MA, She J, Shiue I, Shore HR, Shrime MG, So S, Soneji S, Stathopoulou V, Stroumpoulis K, Sufiyan MB, Sykes BL, Tabarés-Seisdedos R, Tadese F, Tedla BA, Tessema GA, Thakur JS, Tran BX, Ukwaja KN, Uzochukwu BSC, Vlassov VV, Weiderpass E, Wubshet Terefe M, Yebyo HG, Yimam HH, Yonemoto N, Younis MZ, Yu C, Zaidi Z, Zaki MES, Zenebe ZM, Murray CJL, Naghavi M. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017 Apr 1;3(4):524-48. doi: 10.1001/jamaoncol.2016.5688
- Jemal A, Ward EM, Johnson CJ, Cronin KA, Ma J, Ryerson B, Mariotto A, Lake AJ, Wilson R, Sherman RL, Anderson RN, Henley SJ, Kohler BA, Penberthy L, Feuer EJ, Weir HK. Annual Report to the Nation on the Status of Cancer, 1975-2014, Featuring Survival. J Natl Cancer Inst. 2017 Sep 1;109(9). doi: 10.1093/jnci/djx030
- Axel EM. Gastrointestinal cancer statistics. ÑSib Onkol Zhurn. 2017;16(3):5-11. doi: 10.21294/1814-4861-2017-3-5-11
- Okeanov AE, Moiseev PI, Levin LF, Sukonko OG (red). Statistika onkologicheskikh zabolevanii v Respublike Belarus’ (2005-2014). Minsk, RB; 2015. 204 p. (in Russ.)
- Roscio F, Boni L, Clerici F, Frattini P, Cassinotti E, Scandroglio I. Is laparoscopic surgery really effective for the treatment of colon and rectal cancer in very elderly over 80 years old? A prospective multicentric case-control assessment. Surg Endosc. 2016 Oct;30(10):4372-82. doi: 10.1007/s00464-016-4755-7
- Surgical Care and Outcomes Assessment Program (SCOAP) Collaborative, Kwon S, Billingham R, Farrokhi E, Florence M, Herzig D, Horvath K, Rogers T, Steele S, Symons R, Thirlby R, Whiteford M, Flum DR. Adoption of laparoscopy for elective colorectal resection: a report from the Surgical Care and Outcomes Assessment Program. J Am Coll Surg. 2012 Jun;214(6):909-18.e1. doi: 10.1016/j.jamcollsurg.2012.03.010
- Pascual M, Salvans S, Pera M. Laparoscopic colorectal surgery: Current status and implementation of the latest technological innovations. World J Gastroenterol. 2016 Jan 14;22(2):704-17. doi: 10.3748/wjg.v22.i2.704
- Zaevskaya EV. Prognosis of the complicacy of the laparoscopy in the patients with the adhesive disease of the abdominal cavity. Tavr Med-Biol Vestn. 2009;12(3):134-35. http://dspace.nbuv.gov.ua/bitstream/handle/123456789/25301/33-Zaevskaya.pdf?sequence=1 (in Russ.)
223028, The Republic of Belarus,
Minsk region, Zhdanovichi, 81/5,
Republican Clinical Medical Center
Of the Presidential Administration
of the Republic of Belarus,
Tel. mobile.: +375 29 230-66-84,
Sergey A. Sidorov
Slabadzin Yury V., PhD, Surgeon, Deputy Chief Physician for Surgery, Republican Clinical Medical Center of the Presidential Administration of the Republic of Belarus, Minsk, Republic of Belarus.
Àdutñkevich Ekaterina A., Oncologist, Republican Clinical Medical Center of the Presidential Administration of the Republic of Belarus, Minsk, Republic of Belarus.
Sidorov Sergey A., Surgeon, Republican Clinical Medical Center of the Presidential Administration of the Republic of Belarus, Minsk, Republic of Belarus.
EARLY RESPIRATORY SUPPORT IN PATIENTS WITH ACUTE NECROTIC PANCREATITIS
Vitebsk State Medical University, Vitebsk,
The Republic of Belarus
Objective. To analyze the results of carrying out the early respiratory support in patients with acute necrotic pancreatitis.
Methods. 53 patients with acute necrotic pancreatitis in the fermentative phase are surveyed. Patients have been divided into 2 groups: 1 group (n=29) – patients with standard intensive therapy; 2 group (n=24) – patients who were subject to the mechanical ventilation of the lungs from the first day. Patients of both groups had a severe course of the disease (Ranson >4 points and APACHE II >11 points). The research was conducted in 3 stages: the 1st stage – on admission to the intensive care unit; the 2nd stage – 1 day afterwards, 3 stage – after 4 days. The gases indicators of the arterial blood (pCO2, pO2, pO2/FiO2, lactate) were analyzed as well as the respiratory complains, intra-abdominal pressure, duration of respiratory therapy and mortality. The received results were compared in dynamics, between groups; their interrelation was analyzed.
Results. Carrying out of early respiratory support in patients with acute necrotic pancreatitis reduces the level of intra-abdominal pressure and normalizes the respiratory index, complains and the level of lactate. Indications for early respiratory support in patients with acute necrotic pancreatitis are the following: a severe course of the disease ≥4 points on scale Ranson and ≥11 points on APACHE II scale, intra-abdominal hypertension, low level of respiratory index <300 mm hg, high indicators of lactate >3.5 mmol/l.
Conclusions. Development of intra-abdominal hypertension in patients with acute necrotic pancreatitis aggravates the indicators of the respiratory status. Early mechanical ventilation of the lungs reduces the level of intra-abdominal pressure, normalizes the respiratory status indicators in the fermentative phase.
- Bechien UWu. Prognosis in acute pancreatitis. CMAJ. 2011 Apr 5; 183(6):673-77. doi: 10.1503/cmaj.101433
- Aggarwal A, Manrai M, Kochhar R. Fluid resuscitation in acute pancreatitis. World J Gastroenterol. 2014 Dec 28;20(48):18092-103. doi: 10.3748/wjg.v20.i48.18092
- Tezyaeva SA, Mlinnik RA, Borodkin AA. Destructive pancreatitis: our achievements or deadlock? MediAl’. 2017;(2):30-35. https://readera.ru/destruktivnyj-pankreatitnashi-dostizhenija-ili-tupik-14340165 (in Russ.)
- Skutova VA, Abrosimov SYu, Kasumian SA, Tchaikovskiy YuYa. Diagnosis, treatment strategy, and predictors of septic complications in necrotizing pancreatitis. Klin Mikrobiologiia i Antimikrob Khimioterapiia. 2012;14(4):351-357. http://www.antibiotic.ru/cmac/pdf/cmac.2012.t14.n4.p351.pdf (in Russ.)
- Beburishvili AG, Burchuladze NSh, Mazunov AS. Features of early systemic complications in patients with destructive pancreatitis. Vestn VolgGMU. 2017;(2):52-55. doi: 10.19163/1994-9480-2017-2(62)-52-55. (in Russ.)
- Anishchenko VV, Kim DA, Baram GI, Morozov VV, Kovgan YuM, Kan BV, Korotian AG. The substantiation of necessity the early surgical treatment of patients with heavy acute pancreatitis by the features complex. Sib Med Obozrenie. 2017;(3):43-49. doi: 10.20333/2500136-2017-3-43-49 (in Russ.)
- Kondratenko PG, Vasil’ev AA, Kon’kova MV. Ostryi pankreatit. Donetsk, Ukraina; 2008. 352 p. https://issuu.com/dednomto/docs/acute_pancreatitis(in Russ.).
- Rubenfeld GD, Herridge MS. Epidemiology and outcomes of acute lung injury. Chest. 2007 Feb;131(2):554-62. doi: 10.1378/chest.06-1976
- Sugrue M. Abdominal compartment syndrome. Curr Opin Crit Care. 2005 Aug;11(4):333-38. doi: 10.1097/01.ccx.0000170505.53657.48
- Turkevych ÎÌ, Pidgirnyy YaM, Zakotyanskyi ÎÐ. Features of respiratory therapy in intra-abdominal hypertension. Meditsina Neotlozh Sostoianii. 2017;(7):45-49. doi: 10.22141/2224-05188.8.131.527.116879 (in Ukr.)
- Gel’fand BR, Protsenko DN, Podachin PV, Chubchenko SV, Lapshina IIu. Sindrom abdominal’noi gipertenzii: sostoianie problemy. Meditsina Neotlozh Sostoianii. 2015;(7):41-50. http://www.mif-ua.com/archive/article/42334 (in Russ.)
- Maltseva LO, Mosentsev MF, Bazylenko DV, Bilan OM, Kunik LV. Respiratory Distress Syndrome: Current Issues of Definitions, Clinical Presentation, Diagnostic Algorithm. Emerg Med. 2016;4(75):108-110. doi: 10.22141/2224-05184.108.40.2066.75827
- Matiushko DN, Turgunov EM, Zlotnik A. Intraabdominal’naia gipertenziia i kompartment-sindrom: obzor literatury. Nauka i Zdravookhranenie. 2015;(1):22-32. https://elibrary.ru/download/elibrary_25052506_96179177.pdf (in Russ.)
- Romanov EI, Zubeev PS, Ryzhov MK. Bodrov AA. Risk factors of fatal outcome in pancreatonecrosis. Khirurgii im Grekova. 2014;173(4):39-42. doi: 10.24884/0042-4625-2014-173-4-39-42 (in Russ.)
- Litvin AA, Rebrova OYu. Decision support systems in the diagnosis and treatment of acute pancreatitis. Problemy Zdorov’ia i Ekologii. 2016;(2):10-17. https://cyberleninka.ru/article/n/sistemy-podderzhki-prinyatiya-resheniy-v-diagnostike-i-lechenii-ostrogo-pankreatita (in Russ.)
210023, The Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Anesthesiology and Resuscitation
With the Course of Advanced
Training and Retraining of Specialists.
Tel: +375 33 316-10-25,
Katsiaryna V. Nikitsina
Nikitsina Katsiaryna V, PhD, Associate Professor, Head of the Department of Anesthesiology and Resuscitation with the Course of Advanced Training and Retraining of Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
INFORMATION TECHNOLOGIES IN SURGERY
I.V. MAKAROV, V.V. ZHIROV, A.V. KOLSANOV, R.A. GALKIN, A.Y. SIDOROV, D.O. KHOKHLOVA
USING PREOPERATING 3D-MODELING IN DIAGNOSTICS AND SURGICAL TREATMENT OF TERTIARY HYPERPARATHYROIDISM
Samara State Medical University, Samara,
The Russian Federation
Objective. To design a patient-specific preoperational 3D model of the neck anatomical formations based on MRI study to facilitate the search and removal of parathyroid adenoma in patients with tertiary hyperparathyroidism (THPT).
Methods. Preoperative 3D modeling was done for 7 patients with tertiary hyperparathyroidism. All patients were on the program renal dialysis because of the terminal stage of chronic renal insufficiency. For obtaining the personified 3D model the results MRI and special software were used. Data in DICOM format were loaded in software; at the same time, individual series of MRI studies were recorded and brought to a single coordinate system, they were segmented – the selection on the images of borders of anatomical structures, and three-dimensional polygonal models of the anatomical structures of the anterior surface of the neck and pathological sites – adenomas of the parathyroid glands were designed.
Results. With the use of preoperation 3D modeling the obtained models of the anatomical formations of neck allowed revealing and removing parathyroid adenomas rapidly, with the smallest time interval. The operation time on the average comprised 60±15 the minutes (M±σ). The operation effectiveness was proved by the results of laboratory investigations and clinical picture on the whole. In the postoperative period, during the following day after operation the median of ionized calcium decreased to 0.88 mmol/L (decrease by 0.32 mmol/L or on 26.7%, with r=0.00001), the median of parathyroid hormone – to 98.2 pg/ml (decrease on 2048.8 pg/ml – 95.4% with r=0.00001); the median of phosphorus – to 1.28 mmol/L (it was lowered on 0.33 mmol/L – 20.5%). The pains in the bones and the joints were clinically stopped in patients.
Conclusions. The suggested method is a reliable technique of the preoperative topical diagnosis of the pathological changes of the parathyroid glands. Its use leads to the decrease of operation time and reduces the need for traumatic and time-consuming neck exploration, necessary to find 4 and more adenomas), thus reducing the risk of post-surgery complications. The given method can be used for objective visualization of parathyroid adenomas during the operation and serve as the effectiveness criterion of surgical treatment adequacy.
- Ermolenko VM, Volgina GV, Dobronravov VA, Rozhinskaia LIa, Smirnov AV, Tomilina NA, Shostka GD, Anashkin VA, Andrusev AM, Volkov MM, Gerasimchuk RP, Zemchenkov AIu, Diubanova GA, Strokov AG, Shilo VIu. Natsional’nye rekomendatsii po mineral’nym i kostnym narusheniiam pri khronicheskoi bolezni pochek. Nefrologiia i Dializ. 2011;13(1):33-51. http://journal.nephro.ru/index.php?r=journal/issueArchive (in Russ.)
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- Bilezikian JP, Brandi ML, Udelsman R, Marcocci C, Eastell R, Silverberg SJ, Potts JT Jr. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab. 2014 Oct:335-39. doi: 10.1210/jc.2008-1763
- Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C, Potts JT Jr. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab. 2014 Oct;99(10):3561-69. doi: 10.1210/jc.2014-1413
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443099, The Russian Federation,
Samara, Chapayevskaya Str., 89,
Samara State Medical University,
Department of Surgical Diseases ¹1.
Tel. +7 903 334-22-59,
Igor V. Makarov
Makarov Igor V., MD, Professor, Head of the Department of Surgical Diseases ¹1, Dean of the Pediatric Faculty, Samara State Medical University, Samara, Russian Federation.
Zhirov Vladimir V., PhD, Head of the Center for Educational Information Technologies, Programming Engineer of the Augmented Reality Technology Laboratory of the Virtual Technologies Department of the Center for Breakthrough Research “IT in Medicine”, Samara State Medical University, Samara, Russian Federation.
Kolsanov Alexander V., MD, Professor of RAMS, Head of the Department of Operative Surgery, Clinical Anatomy with the Course of Innovative Technologies, Samara State Medical University, Samara, Russian Federation.
Galkin Rudolf A., MD, Professor of the Department of Surgical Diseases ¹1, Samara State Medical University, Samara, Russian Federation.
Sidorov Aleksandr Yu., PhD, Associate Professor of the Department of Surgical Diseases ¹1, Samara State Medical University, Samara, Russian Federation.
Khokhlova Darya O., Clinical Intern of the Department of Surgical Diseases ¹1, Samara State Medical University, Samara, Russian Federation.
O.A. NAZARCHUK 1, M.O. FAUSTOVA 2, S.A. KOLODII 1
MICROBIOLOGICAL CHARACTERISTICS OF INFECTIOUS COMPLICATIONS, ACTUAL ASPECTS OF THEIR PREVENTION AND TREATMENT IN SURGICAL PATIENTS
National Pirogov Memorial Medical University 1, Vinnitsa,
Ukrainian Medical Stomatological Academy 2, Poltava,
According to the literature data, microbiota of complications in surgical hospitals consists mainly of representatives of Staphylococcus spp., Enterococcus spp., Escherichia spp., Enterobacter spp., Klebsiella spp., and Pseudomonas spp. However, the spectrum of microorganisms differs depending on the location of the lesions, therapy tactics and the type of unit, where a patient is treated. Nowadays the rapid acquisition of resistance to chemotherapeutic agents by pathogens is becoming the most ambitious problem of modern medicine. In hospitals and intensive care units, the situation is aggravated by the emergence of multi-resistant hospital strains of microorganisms. The mechanisms of bacterial resistance to antibiotics are diverse and can be carried out both at the genetic and at the biochemical level.
The incidence of infectious and inflammatory postoperative complications and increase of the problem of antibiotic resistance among microorganisms dictate the need for careful monitoring of the epidemic situation in hospitals and studying the changing tendencies in the spectrum of dominant pathogens. Moreover, developing and introducing into the clinic of new antibiotics and drugs with antimicrobial activity, revision of existing algorithms for the treatment and prevention of complications arising on the background of surgical interventions are necessary.
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Vinnitsa, Pirogov Str., 56,
National Pirogov Memorial Medical University,
Tel. +38 097 729-37-61,
Oleksandr A. Nazarchuk
Nazarchuk Oleksandr A., PhD, Associate Professor of the Microbiology Department, National Pirogov Memorial Medical University, Vinnitsa, Ukraine.
Faustova Mariia O., PhD, Lecturer of the Department of Microbiology, Virology and Immunology, Ukrainian Medical Stomatological Academy, Poltava, Ukraine.
Kolodii Svetlana A., PhD, Associate Professor of the Microbiology Department, National Pirogov Memorial Medical University, Vinnitsa, Ukraine.
V.S. MATSKEVICH 1, A.N. KIZIMENKO 2
FEATURES OF MICROELEMENTS EXCHANGE IN CRITICALLY ILL CHILDREN
Mogilev Regional Children's Hospital 1, Mogilev,
Vitebsk State Medical University 2, Vitebsk,
The Republic of Belarus
Objective. To study the publications, regarding effectiveness and safe usage of microelements during intensive care in children in critical state.
Methods. PubMed databases from January, 1998 to January, 2018 have been analyzed. The number of articles concerning this subject increased every 5 years in the mentioned period, which testifies to the interest to this problem in the scientific field.
Results. ESPEN and ASPEN recommendations as well as WHO regional recommendations for the European Union countries are given in the article regarding the usage of microelement dosage for children in the intensive care units. According to the study data, changes in the concentration of certain elements such as calcium, phosphorus, iron, zinc, selenium in the blood of children subjecting to intensive care therapy were registered. Also, the article presents the changes in the level of microelements in children with certain pathologies such as HIV, burn injury, chronic renal insufficiency, bronchial obstruction, multiple organ failure, septic shock.
Conclusions. The consumption of microelements and their dynamics during the course of illness has been almost unstudied. There are some incomplete works dedicated to the problem of microelement metabolism in healthy children and in pathology. There are no data about the deficiency of some microelements, which have a significant influence on the disease outcome; therefore, they require a constant control.
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- Negm FF, Soliman DR, Ahmed ES, Elmasry RA. Assessment of serum zinc, selenium, and prolactin concentrations in critically ill children. Pediatric Health Med Ther. 2016 Apr 4;7:17-23. doi: 10.2147/PHMT.S99191. eCollection 2016.
212025, The Republic of Belarus,
Mogilev, Byalynitsky-Birulya Str., 9,
Mogilev Regional Children’s Hospital,
Anesthesiology and Intensive Care Unit.
Tel. office: 8 0222 41-74-69,
Veranika S. Matskevich
Matskevich Veranika S., Physician of the Anesthesiology and Intensive Care Unit, Mogilev Regional Children’s Hospital, Mogilev, Republic of Belarus.
Kizimenko Andrei N., PhD, Associate Professor, Department of Anesthesiology and Resuscitation with the Course of Advanced Training and Retraining of Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
TREATMENT OF THE FRACTURES OF THE NECK OF THE TALUS
Republican Scientific and Practical Center of Traumatology and Orthopedics, Minsk,
The Republic of Belarus
Fractures of the talus are rare injuries (up to 2.5% from the foot fractures), but the consequences of incorrect treatment are catastrophic, leading to osteoarthritis and long-lasting function impairment. Fearing complication is avascular necrosis of the body of the talus with previously reported incidence up to 50-75%. The changes of surgical strategy during the last decades have led to significant improvement of results and decrease of complications. Urgent treatment is only indicated in open injuries, as well in cases of fracture-dislocations where the displaced bone fragment threatens with skin necrosis. If closed reduction is successful, internal fixation is better to perform in delayed manner after the resolution of soft-tissue swelling. According to the present-day literature data, such an approach does not lead to the increase of the rate of avascular necrosis, but reduces the rate of wound complications and improves long-term results by thorough pre-operative planning and execution of surgery. The use of double surgical approaches (antero-medial and antero-lateral) provides anatomic fracture reduction with maintenance of the tiny blood supply of talus bone.
- Rammelt S, Zwipp H. Talar neck and body fractures. Injury. 2009 Feb;40(2):120-35. doi: 10.1016/j.injury.2008.01.021
- Vallier HA. Fractures of the talus: state of the art. J Orthop Trauma. 2015 Sep;29(9):385-92. doi: 10.1097/BOT.0000000000000378
- Grear BJ. Review of talus fractures and surgical timing. Orthop Clin North Am. 2016 Jul;47(3):625-37. doi: 10.1016/j.ocl.2016.03.008
- Mulfinger GL, Trueta J. The blood supply of the talus. J Bone Joint Surg Br. 1970;52:160-67. https://online.boneandjoint.org.uk/doi/pdf/10.1302/0301-620x.52b1.160
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- Cronier P, Talha A, Massin P. Central talar fractures – therapeutic considerations. Injury. 2004 Sep;35 (Suppl 2):SB10-22. doi: 10.1016/j.injury.2004.07.009
- Peterson L, Goldie IF, Irstam L. Fracture of the neck of the talus. A clinical study. Acta Orthop Scand. 1977;48(6):696-706. doi: 10.3109/17453677708994820
- Fracture and Dislocation Classification Compendium – 2018. Foot. J Orthop Trauma. 2018 Jan;32(1 Suppl):S89-S100. doi: 10.1097/BOT.0000000000001060
- Hawkins LG. Fractures of the neck of the talus. J Bone Joint Surg Am. 1970 Jul;52(5):991-1002. https://journals.lww.com/jbjsjournal/Abstract/1970/52050/Fractures_of_the_Neck_of_the_Talus.13.aspx
- Ishikawa SN. Fractures and dislocations of the foot. In: Canale ST, Beaty JH, editors. Campbell’s operative orthopaedics. 12th ed. Philadelphia: Elsevier; 2013.
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- Whitaker C, Turvey B, Illical EM. Current Concepts in Talar Neck Fracture Management. Curr Rev Musculoskelet Med. 2018 Sep;11(3):456-74. doi: 10.1007/s12178-018-9509-9
- Buza JA 3rd, Leucht P. Fractures of the talus: Current concepts and new developments. Foot Ankle Surg. 2018 Aug;24(4):282-90. doi: 10.1016/j.fas.2017.04.008
- Fournier A, Barba N, Steiger V, Lourdais A, Frin JM, Williams T, Falaise V, Pineau V, Salle de Chou E, Noailles T, Carvalhana G, Ruhlmann F, Huten D. Total talar fracture – long-term results of internal fixation of talar fractures. A multicentric study of 114 cases. Orthop Traumatol Surg Res. 2012 Jun;98(4 Suppl):S48-55. doi: 10.1016/j.otsr.2012.04.012
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- Vallier HA, Reichard SG, Boyd AJ, Moore TA. A new look at the Hawkins classification for talar neck fractures: which features of injury and treatment are predictive of osteonecrosis? J Bone Joint Surg Am. 2014 Feb 5;96(3):192-97. doi: 10.2106/JBJS.L.01680
- Xue Y, Zhang H, Pei F, Tu C, Song Y, Fang Y, Liu L. Treatment of displaced talar neck fractures using delayed procedures of plate fixation through dual approaches. Int Orthop. 2014 Jan;38(1):149-54. Published online 2013 Dec 3. doi: 10.1007/s00264-013-2164-2
- Lindvall E, Haidukewych G, DiPasquale T, Herscovici D Jr, Sanders R. Open reduction and stable fixation of isolated, displaced talar neck and body fractures. J Bone Joint Surg Am. 2004 Oct;86(10):2229-34. doi: 10.2106/00004623-200410000-00014
- Babu N, Schuberth JM. Partial avascular necrosis after talar neck fracture. Foot Ankle Int. 2010 Sep;31(9):777-80. doi: 10.3113/FAI.2010.0777
- Gerken N, Yalamanchili R, Yalamanchili S, Penagaluru P, Md EM, Cox G. Talar revascularization after a complete talar extrusion. J Orthop Trauma. 2011 Nov;25(11):e107-10. doi: 10.1097/BOT.0b013e318210f236
- Sanders DW, Busam M, Hattwick E, Edwards JR, McAndrew MP, Johnson KD. Functional outcomes following displaced talar neck fractures. J Orthop Trauma. 2004 May-Jun;18(5):265-70. doi: 10.1097/00005131-200405000-00001
220024, The Republic of Belarus,
Minsk, Kizhevatov Str., 60-4,
Republican Scientific and Practical
Center of Traumatology and Orthopedics,
Laboratory of Adult Traumatology,
Tel. mobile: +375 29 354-00-84,
Alexandre A. Sitnik
Sitnik Alexandre A., PhD, Associate Professor, Head of the Laboratory of Adult Traumatology, Republican Scientific and Practical Center of Traumatology and Orthopedics, Minsk, Republic of Belarus.
T. VYKHTYUK, V. ZHYKOVSKIY
SURGICAL SITE INFECTION IN PATIENTS WITH THE DESTRUCTION OF THE VASCULAR IMPLANT
Danylo Halytsky Lviv National Medical University, Lviv,
Treatment of patients with occlusive-stenotic lesions of the lower limb arteries in the stage of critical limb ischemia and postoperative infectious complications is a pressing issue of modern vascular surgery. If a patient has a vascular prosthesis, the development of a surgical site infection can lead to arrosive bleeding with fatal outcome. The aim of this report is to demonstrate the case of successful surgical treatment of a patient with an infected synthetic vascular implant. The patient, born in 1962, addressed to a vascular surgeon 2 months after the surgical treatment of critical ischemia of the right lower limb with implantation of linear femoropopliteal prosthesis. The patient complained of the development of a wound with discharge and unpleasant odor. After inspection and examination of the patient, the infection of the vascular prosthesis with the formation of the fistula on the medial surface of the lower third of the right thigh was diagnosed. Surgical intervention was performed: removal of the infected femoropopliteal prosthesis with simultaneous autovenous femoropopliteal repeated bypass surgery by the great saphenous vein, performed subcutaneously, extra-anatomically within the healthy soft tissues, bypassing the infected area of the lower third of the thigh. Thus, one was able to save the limb of the patient, to prevent the development of arrosive bleeding and to improve the healing and recovery of the suppurative thigh lesion.
- Madden NJ, Calligaro KD, Dougherty MJ, Zheng H, Troutman DA. Lateral femoral bypass for prosthetic arterial graft infections in the groin. J Vasc Surg. 2019 Apr;69(4):1129-36. doi: 10.1016/j.jvs.2018.07.041
- Inui T, Bandyk DF. Vascular surgical site infection: risk factors and preventive measures. Semin Vasc Surg. 2015 Sep-Dec;28(3-4):201-7. doi: 10.1053/j.semvascsurg.2016.02.002
- Miyahara T, Hoshina K, Ozaki M, Ogiwara M. Efficacy of preoperative antibiotic therapy for the treatment of vascular graft infection. Ann Vasc Dis. 2018 Jun 25;11(2):191-95. doi: 10.3400/avd.oa.17-00128
- Miyake K, Sakagoshi N, Kitabayashi K. Results of graft removal and negative pressure wound therapy in management of graft infection. Int J Angiol. 2019 Mar;28(1):39-43. doi: 10.1055/s-0038-1676798
- Rancic Z, Ledergerber B, Veith FJ, Anagnostopoulos A, Lachat ML, Hasse B. Good early results of negative pressure wound nonexcisional treatment for prosthetic graft infection are durable. J Vasc Surg. 2018 Jun;67(Is 6):e62. doi: 10.1016/j.jvs.2018.03.039
- Legout L, Delia P, Sarraz-Bournet B, Rouyer C, Massongo M, Valette M, Leroy O, Haulon S, Senneville E. Factors predictive of treatment failure in staphylococcal prosthetic vascular graft infections: a prospective observational cohort study: impact of rifampin. BMC Infect Dis. 2014 Apr 28;14:228. doi: 10.1186/1471-2334-14-228
- Ketenciler S, Boyacioğlu K, Akdemir I, Kömürcü G, Polat A. Autologous saphenous vein panel graft for vascular reconstruction. Ann Vasc Surg. 2018 Nov;53:117-22. doi: 10.1016/j.avsg.2018.05.037
Lviv, Pekarskaya Str., 69,
Danylo Halytsky Lviv National
Surgery Department ¹2.
Tel. +38 032 275-76-32,
Taras I. Vykhtyuk
Vykhtyuk Taras I., Assistant of Surgery Department ¹2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
Zhykovskiy Volodymyr S., PhD, Assistant of the Department of Disaster Medicine and Military Medicine, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
A.G. MAKEEV 1, 2, S.A. KUSHTUMOV 1, 2, E.V. SHINKEVICH 2, P.I. MURAVIEV 2, M.P. GRUZIN 2, V.G. KUTORKIN 2
CHRONIC POSTTRAUMATIC THORACOABDOMINAL AORTIC ANEURYSM COMPLICATED BY RUPTURE
Irkutsk State Medical University 1,
Irkutsk State Regional Clinical Hospital 2, Irkutsk,
The Russian Federation
The article reports a rare clinical follow-up of the patient with chronic posttraumatic thoracoabdominal aortic aneurysm of IV type according to Crawford E.S., complicated with a rupture into the posterior mediastinum and retroperitoneal space. The occurrence of chronic posttraumatic thoracoabdominal aortic aneurysm is suspected to be associated with a blunt trauma of the lumbar region (a fall from own growth height) and with the aortic damage by metal structures implanted four years earlier for transpedicular fixation with intrabody vertebral fusion of the thoracic spine. Aneurysm rupture into the posterior mediastinum and retroperitoneal space, which occurred during the planned in-hospital examination of the patient, indicates the difficulties in predicting the moment of its onset. Timely diagnosis and emergency reconstructive surgery aimed at restoring the continuity of the damaged thoracoabdominal aorta, determined a good result of treatment. There is still no convincing information about the frequency of such complications as the formation of post-traumatic aneurysm after transpedicular fixation with interbody vertebral fusion of the spine; only the descriptions of single observations are presented. This fact stimulated us to describe a rather rare clinical follow-up.
- Zhang C, Liu Y. Combined pedicle screw fixation at the fracture vertebrae versus conventional method for thoracolumbar fractures: A meta-analysis. Int J Surg. 2018 May;53:38-47. doi: 10.1016/j.ijsu.2018.03.002
- Foxx KC, Kwak RC, Latzman JM, Samadani U. A retrospective analysis of pedicle screws in contact with the great vessels. J Neurosurg Spine. 2010 Sep;13(3):403-6. doi: 10.3171/2010.3.SPINE09657
- Mirza AK, Alvi MA, Naylor RM, Kerezoudis P, Krauss WE, Clarke MJ, Shepherd DL, Nassr A, DeMartino RR, Bydon M. Management of major vascular injury during pedicle screw instrumentation of thoracolumbar spine. Clin Neurol Neurosurg. 2017 Dec;163:53-59. doi: 10.1016/j.clineuro.2017.10.011
- Murase S, Oshima Y, Takeshita Y, Miyoshi K, Soma K, Kawamura N, Kunogi J, Yamazaki T, Ariyoshi D, Sano S, Inanami H, Takeshita K, Tanaka S. Anterior cage dislodgement in posterior lumbar interbody fusion: a review of 12 patients. J Neurosurg Spine. 2017 Jul;27(1):48-55. doi: 10.3171/2016.12.SPINE16429
- Rekomendatsii ESC po diagnostike i lecheniiu zabolevanii aorty 2014. Ros Kardiol Zhurn. 2015;(7):7-72. doi: 10.15829/1560-4071-2015-7-7-72 (in Russ.)
- Laine MT, Laukontaus SJ, Kantonen I, Venermo M. Population-based study of ruptured abdominal aortic aneurysm. Br J Surg. 2016 Nov;103(12):1634-39. doi: 10.1002/bjs.10200
664003, The Russian Federation,
Irkutsk, Krasnoye Vosstaniye Str., 1,
Irkutsk State Medical University,
Department of Human Anatomy,
Operative Surgery and Forensic Medicine.
Tel. +7 902 576-75-41,
Alexander G. Makeev
Makeev Alexander G., PhD, Associate Professor of the Department of Human Anatomy, Operative Surgery and Forensic Medicine, Irkutsk State Medical University, Cardiovascular Surgeon of the Vascular Surgery Unit, Irkutsk State Regional Clinical Hospital, Irkutsk, Russian Federation.
Kushtumov Sergei A., PhD, Assistant of the Department of Hospital Surgery, Irkutsk State Medical University, Head of the Vascular Surgery Unit, Irkutsk State Regional Clinical Hospital, Irkutsk, Russian Federation.
Shinkevich Eduard V., PhD, Cardiovascular Surgeon, Vascular Surgery Unit, Irkutsk State Regional Clinical Hospital, Irkutsk, Russian Federation.
Muraviev Pavel I., Cardiovascular Surgeon, Vascular Surgery Unit, Irkutsk State Regional Clinical Hospital, Irkutsk, Russian Federation.
Gruzin Maxim P., Cardiovascular Surgeon, Vascular Surgery Unit, Irkutsk State Regional Clinical Hospital, Irkutsk, Russian Federation.
Kutorkin Victor G., Cardiovascular Surgeon, Vascular Surgery Unit, Irkutsk State Regional Clinical Hospital, Irkutsk, Russian Federation.
V.V. BOYKO 1, R.M. SMACHYLO 1, M.S. CHERNYAYEV 2, I.I. YAKOVTSOVA 3, S.V. DANYLIUK 3, O.M. TYSHCHENKO 1, A.L. VESELYI 1
MULTIFOCAL ANGIOMYOLIPOMA OF THE LIVER AND LUNG
V.T. Zaytsev Institute of General and Urgent Surgery 1 of the National Academy of Medical Sciences of Ukraine,
Kharkiv National Medical University 2,
Kharkiv Medical Academy of Post-graduate Education 3, Kharkiv,
The article presents a clinical case of surgical treatment of a patient with a rare oncological disease – multifocal angiomyolipoma of the liver and lungs. The patient had been hospitalized to the clinic, examined using spiral computed tomography of the abdominal organs and the chest. The following was revealed – bilateral multiple lung neoplasms, liver neoplasms: in Sg2 and Sg4 – 3 tumors up to 2 cm in diameter, in Sg1 – a large similar tumor 10x8cm adjacent to the inferior vena cava. Differential diagnostics with hepatocellular carcinoma was performed by using the determination of the blood tumor markers and trepan biopsy of the tumor of the caudate hepatic lobe, followed by histological examination. After confirming of probable benign nature of the tumor, the patient was operated on. Intraoperative findings were the following: in Sg2 and Sg4 of the liver – neoplasms up to 2 cm in diameter; in Sg1 of the liver – a neoplasm 9×8×10 cm, closely adjacent to the inferior vena cava, easily vulnerable with bleeding after contact. Resection of Sg1 of the liver with a tumor was performed by the left-sided method using afferent vascular exclusion of the liver, clamp crush technique, and electrosurgical welding. The postoperative period was stable, without complications, the patient was discharged from hospital on the 12th postoperative day. The immunohistochemical study of the removed tumor confirmed the diagnosis of liver angiomyolipoma.
- Fukuda Y, Omiya H, Takami K, Mori K, Kodama Y, Mano M, Nomura Y, Akiba J, Yano H, Nakashima O, Ogawara M, Mita E, Nakamori S, Sekimoto M. Malignant hepatic epithelioid angiomyolipoma with recurrence in the lung 7 years after hepatectomy: a case report and literature review. Surg Case Rep. 2016 Dec;2:31. Published online 2016 Apr 2. doi: 10.1186/s40792-016-0158-1
- Deng YF, Lin Q, Zhang SH, Ling YM, He JK, Chen XF. Malignant angiomyolipoma in the liver: a case report with pathological and molecular analysis. Pathol Res Pract. 2008;204(12):911-18. doi: 10.1016/j.prp.2008.06.007
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Kharkiv, Balakirev Entry, 1,
V.T. Zaytsev Institute of General and Urgent Surgery
Of the National Academy of Medical
Sciences of Ukraine,
Surgery Department of the Liver and Bile Ducts.
Tel. mobile: +38 0506 15-45-55,
Mykyta S. Chernyayev
Boyko Valeriy V., MD, Professor, Corresponding Member of the National Academy of Medical Sciences of Ukraine, Director of V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine.
Smachylo Rostyslav M., MD, Professor, Head of the Surgery Department of the Liver and Bile Ducts, V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine.
Chernyayev Mykyta S, PhD, Assistant of the Surgery Department ¹1, Kharkiv National Medical University, Kharkiv, Ukraine.
Yakovtsova Iryna I., MD, Professor, Head of the Pathologic Anatomy Department, Kharkiv Medical Academy of Post-graduate Education, Kharkiv, Ukraine.
Danyliuk Svitlana V., PhD, Associate Professor of the Pathologic Anatomy Department, Kharkiv Medical Academy of Post-graduate Education, Kharkiv, Ukraine.
Tishchenko Olexander M., MD, Professor of the Surgery Department of the Liver and Bile Ducts, V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine.
Veselyi Andrii L., Radiologist of the Computed Tomography Cabinet, V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine.