Novosti
Khirurgii
This journal is
indexed in Scopus









Year 2021 Vol. 29 No 3

SCIENTIFIC PUBLICATIONS
EXPERIMENTAL SURGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.275   |  

I.V. MAIBORODIN 1, 2, S.V. MARCHUKOV 2, V.I. MAIBORODINA 1

SOME FEATURES OF THE KIDNEY SCAR FORMATION AFTER SURGERY IN THE EXPERIMENT

Federal Research Center of Fundamental and Translational Medicine of the Ministry of Science and Higher Education of Russia, Institute of Molecular Pathology and Pathomorphology 1
Institute of Chemical Biology and Fundamental Medicine of the Russian Academy of Sciences, Siberian Branch2;
Novosibirsk,
The Russian Federation

Objective. To study the features of scar formation and structural changes in the remaining renal parenchyma in rats after the kidney resection in various terms.
Methods. A layered closure of midline laparotomy and the caudal part of the left kidney removal was performed in rats under general inhalation ether anesthesia in a clean operating room. The morphology of the remaining kidney part after resection was studied using light microscope in different terms.
Results. A thrombus from blood leaking out of the cut vessels is formed on the damaged surface of the kidney immediately after the resection. This clot with the parenchyma is gradually replaced by the connective tissue along the edge of the defect with the subsequently formation of a thin connective or fibrous tissue scar. However, in many cases, the number of which in rats can reach 40%, the processes of kidney damage continue for a long time after surgery, and leading to total or subtotal nephrosclerosis. The detected cystic change in tubular structures, apparently, occurred firstly due to their intersection during the resection, clamping by a blood clot and / or compression by edema distal to the observation site. Then, the forming extensive scar again clamped the adjacent tubular structures with subsequent cystic degeneration and sclerosis. In this case, detritus formed from non-viable renal tissues is eliminated by macrophages, which can form multinucleated cells with fused cytoplasm.
Conclusion. Structural changes in the nephrosclerosis progression after kidney resection consist in the gradual replacement of the all renal cortical and medullar parenchyma by the connective tissue. This is not associated with the autoimmune process, but is more likely due to both impaired urine outflow after intercut of the tubular structures at resection and/or compression by edema, inflammatory infiltrate, forming or organizing scar, and vascular disorders associated with these causes. The inflammation accompanying necrosis and sclerosis of the renal structures can become granulomatous.

Keywords: kidney, kidney resection, cystic change of the kidney tubules, renal scar, nephrosclerosis, granulomatous inflammation
p. 275-284 of the original issue
References
  1. Vogel H, Tödt HC. Scar tissue, organ atrophy and hypertrophy in the computed tomogram after abdominal surgery. Digitale Bilddiagn. 1985 Sep;5(3):138-41. https://www.ncbi.nlm.nih.gov/pubmed/4053498 [Article in German]
  2. Gebauer A, Antes G, Pfeifer KJ, Staehler G, Pielsticker K. Angiographic and isotopic studies following pole resection of kidneys in dogs and hemostasis performed by infrared-contact-coagulation. Röfo. 1981;134(6):649-52. doi: 10.1055/s-2008-1056433 [Article in German]
  3. Vtorenko VI, Trushkin RN, Lubennikov AE, Kolesnikov NO. Laparaskopicheskaia rezektsiia transplantirovannoi pochki po povodu pochechno-kletochnogo raka T1aN0M0. Urologiia. 2017;(1):71-75. doi: 10.18565/urol.2017.1.71-75 (In Russ.)
  4. Cadeddu JA, Corwin TS, Traxer O, Collick C, Saboorian HH, Pearle MS. Hemostatic laparoscopic partial nephrectomy: cable-tie compression. Urology. 2001 Mar;57(3):562-66. doi: 10.1016/s0090-4295(00)01009-8
  5. Popov SV, Novikov AI, Zaitsev EV, Guseinov RG, Topuzov TM. Opyt vypolneniia monoportovykh laparoskopicheskikh operatsii v lechenii zabolevanii pochek. Urologiia. 2013;(1):74-81. https://urologyjournal.ru/ru/archive/article/11601 (In Russ.)
  6. Nozaki T, Watanabe A, Fuse H. Laparoendoscopic single-site surgery for partial nephrectomy without ischemia using a microwave tissue coagulator. Surg Innov. 2013 Oct;20(5):439-43. doi: 10.1177/1553350612459682
  7. Kawai N, Yasui T, Umemoto Y, Kubota Y, Mizuno K, Okada A, Ando R, Tozawa K, Hayashi Y, Kohri K. Laparoendoscopic single-site partial nephrectomy without hilar clamping using a microwave tissue coagulator. J Endourol. 2014 Feb;28(2):184-90. doi: 10.1089/end.2013.0135
  8. Harty NJ, Laskey DH, Moinzadeh A, Flacke S, Benn JA, Villani R, Kalra A, Libertino JA, Madras PN. Temporary targeted renal blood flow interruption using a reverse thermosensitive polymer to facilitate bloodless partial nephrectomy: a swine survival study. BJU Int. 2012 Sep;110(6 Pt B):E274-80. doi: 10.1111/j.1464-410X.2012.10967.x
  9. Zana J, Nagy G, Fodor M, Pödör P. Bilateral renal tumours with reference to the reoperation of a solitary kidney resected for tumour. Acta Chir Hung. 1988;29(2):187-95. https://www.ncbi.nlm.nih.gov/pubmed/3176790
  10. Satirapoj B, Bruhn KW, Nast CC, Wang Y, Dai T, Lapage J, Wu X, Natarajan R, Adler SG. Oxidized low-density lipoprotein antigen transport induces autoimmunity in the renal tubulointerstitium. Am J Nephrol. 2012;35(6):520-30. doi: 10.1159/000338484
  11. Raskova J, Czerwinski DK, Shea SM, Raska K Jr. Cellular immunity and lymphocyte populations in developing uremia in the rat. J Exp Pathol. 1986 Summer;2(4):229-45. https://www.ncbi.nlm.nih.gov/pubmed/2946817
  12. Maiborodin IV, Minikeyev IM, Kim SA, Ragimova TM. Changes in the mucous membranes of the oral cavity in chronic renal failure (experimental study) Morfologiia. 2015;147(1):36-41. https://elibrary.ru/item.asp?id=22956798 (In Russ.)
Address for correspondence:
630090, Russian Federation,
Novosibirsk, Akad. Lavrentyev Aven., 8,
Institute of Chemical Biology and Fundamental Medicine of the Russian Academy of Sciences, Center of New Medical Technologies,
tel. mob. +7-913-753-0767
e-mail: imai@mail.ru
Maiborodin Igor V.
Information about the authors:
Maiborodin Igor V., MD, Professor, Chief Researcher of the Laboratory of Health Management Technologies, the Center of New Medical Technologies, Institute of Chemical Biology and Fundamental Medicine, the Russian Academy of Sciences, Novosibirsk, Russian Federation.
http://orcid.org/0000-0002-8182-5084
Marchukov Sergey V., Ph.D, Doctoral Student of the Laboratory of Health Management Technologies, the Center of New Medical Technologies, Institute of Chemical Biology and Fundamental Medicine, the Russian Academy of Sciences, Novosibirsk, Russian Federation.
https://orcid.org/0000-0002-7381-5820
Maiborodina Vitalina I., MD, Leading Researcher of the Laboratory of Ultrastructural Bases of Pathology, Institute of Molecular Pathology and Pathomorphology, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russian Federation
http://orcid.org/0000-0002-5169-6373

GENERAL & SPECIAL SURGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.285   |  

A.V. KOROTKIKH 1, 2, A.M. BABUNASHVILI 3, A.L. KALEDIN 4, R.V. AKHRAMOVICH 5, V.V. DERKACH 6, R.M. PORTNOV 6, A.V. SOZYKIN7

ANALYSIS OF INTERMEDIATE RESULTS OF A COMPARATIVE MULTICENTER RANDOMIZED TENDERA STUDY INVESTIGATING THE DISTAL RADIATION ACCESS

Regional Clinical Hospital No1 1, Tyumen,
Amur State Medical Academy 2, Blagoveshchensk,
Center for Endosurgery and Lithotripsy 3, Moscow,
I.I. Mechnikov North-West State Medical University4, St. Petersburg,
Mytishchi City Clinical Hospital 5, Mytishchi,
Clinic of Innovative Surgery 6, Klin
Central Clinical Hospital of the Russian Academy of Sciences 7, Moscow,
The Russian Federation

Objective. To prove the safety and efficacy of distal radial artery (DRA) puncture for endovascular interventions versus the traditional forearm radial artery (RA) puncture site by comparing immediate and long-term results.
Methods. In 2017, a multicenter, open, randomized (1:1) study TENDERA (Comparison between Traditional Entry Point and Distal Puncture of Radial Artery) was started. During 2 years, 520 patients were included, mean age 63.410.0 years. The observation group (DRA puncture) included 271 patients, the comparison group (RA puncture) 249 patients. The study included both stable patients and those with NSTEMI: the observation group 39 (14.4%), the comparison group 34 (13.7%), p=0.809. The primary endpoint is immediate (hospital) or late radial thrombosis. Secondary endpoints are: 1 composite point, complications from the access artery; 2 puncture parameters.
Results. The average difference in the diameters of the RA and DRA was 0.3 mm and 0.4 mm, in some patients the DRA diameter corresponded to the RA or even exceeded it. The diameter of RA and DRA in men and women significantly differs, 2.650.44 mm and 2.360.36 mm (p=0.001), 2.310.39 mm and 2.130.38 mm (p=0.001). Technical success of DRA access requre the number of attempts. 94.1% the percentage of successful cardiac catheterization performed through the distal radial artery approach, which is significantly less than via RA 100% (p<0.001). In the observation group, significantly fewer rebleedings and rehemostasis were occured. In the long-term period, there were registered outstandingly more hematomas in the observation group at the time of discharge and after 1 week.
Conclusion. Intermediate analysis of the results of the TENDERA study shows that there is no significant difference in the primary endpoint, but the number of complications in the observation group associated with the puncture markedly hematoma more than 5 cm to the day of discharge and after 7 days.

Keywords: radial access, distal radial access, research, percutaneous coronary intervention, acute coronary syndrome, coronary heart disease, radial artery
p. 285-295 of the original issue
References
  1. Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferović PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. 2018 ESC/EACTS Guidelines on myocardial revascularization. Euro Intervention. 2019 Feb 20;14(14):1435-34. doi: 10.4244/EIJY19M01_01
  2. Valgimigli M, Gagnor A, Calabró P, Frigoli E, Leonardi S, Zaro T, Rubartelli P, Briguori C, Andò G, Repetto A, Limbruno U, Cortese B, Sganzerla P, Lupi A, Galli M, Colangelo S, Ierna S, Ausiello A, Presbitero P, Sardella G, Varbella F, Esposito G, Santarelli A, Tresoldi S, Nazzaro M, Zingarelli A, de Cesare N, Rigattieri S, Tosi P, Palmieri C, Brugaletta S, Rao SV, Heg D, Rothenbühler M, Vranckx P, Jüni P; MATRIX Investigators. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. Lancet. 2015 Jun 20;385(9986):2465-76. doi: 10.1016/S0140-6736(15)60292-6
  3. Hamon M, Pristipino C, Di Mario C, Nolan J, Ludwig J, Tubaro M, Sabate M, Mauri-Ferré J, Huber K, Niemelä K, Haude M, Wijns W, Dudek D, Fajadet J, Kiemeneij F; European Association of Percutaneous Cardiovascular Interventions; Working Group on Acute Cardiac Care of the European Society of Cardiology; Working Group on Thrombosis on the European Society of Cardiology. Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology. Euro Intervention. 2013 Mar;8(11):1242-51. doi: 10.4244/EIJV8I11A192
  4. Korotkikh AV, Bondar VYu. Using a deep palmar branch of radial artery in the ragion of anatomical snuffbox during angiography. Dalnevostoch Med Zhurn. 2016;(1):24-27. http://www.fesmu.ru/dmj/20161/2016105.aspx (In Russ.)
  5. Petroglou D, Didagelos M, Chalikias G, Tziakas D, Tsigkas G, Hahalis G, Koutouzis M, Ntatsios A, Tsiafoutis I, Hamilos M, Kouparanis A, Konstantinidis N, Sofidis G, Pancholy SB, Karvounis H, Bertrand OF, Ziakas A. Manual versus mechanical compression of the radial artery after transradial coronary angiography: the memory multicenter randomized trial. JACC Cardiovasc Interv. 2018 Jun 11;11(11):1050-58. doi: 10.1016/j.jcin.2018.03.042
  6. Amato JJ, Solod E, Cleveland RJ. A second radial artery for monitoring the perioperative pediatric cardiac patient. J Pediatr Surg. 1977 Oct;12(5):715-17. doi: 10.1016/0022-3468(77)90399-2
  7. Kaledin AL, Kochanov IN, Seletskii SS, Arkharov IV, Burak TIa, Kozlov KL Peculiarities of arterial access in endovascular surgery in elderly patients. Uspekhi Gerontologii. 2014;27(1):115-19. https://pubmed.ncbi.nlm.nih.gov/25051767/?from (In Russ.)
  8. Oliveira MDP, Navarro EC, Kiemeneij F. Distal transradial access as default approach for coronary angiography and interventions. Cardiovasc Diagn Ther. 2019 Oct;9(5):513-19. doi: 10.21037/cdt.2019.09.06
  9. Frolov AA, Sorokin IN, Sharabrin EG, Bekhterev AV, Frolov IA, Savenkov AG. Comparison of traditional and distal radial approach in percutaneous coronary interventions. Kardiologiia i Serdechno-Sosudistaia Khirurgiia. 2019;12(5):410-17. doi: 10.17116/kardio201912051410 (In Russ.)
  10. Kim Y, Lee JW, Lee SY, Bae JW, Lee SJ, Jeong MH, Lee SH, Ahn Y. Feasibility of primary percutaneous coronary intervention via the distal radial approach in patients with ST-elevation myocardial infarction. Korean J Intern Med. 2021 Mar;36(Suppl 1):S53-S61. doi: 10.3904/kjim.2019.420
  11. Hadjivassiliou A, Cardarelli-Leite L, Jalal S, Chung J, Liu D, Ho S, Klass D. Left distal Transradial Access (ldTRA): a comparative assessment of conventional and distal radial artery size. Cardiovasc Intervent Radiol. 2020 Jun;43(6):850-57. doi: 10.1007/s00270-020-02485-7
  12. Rajah GB, Lieber B, Kappel AD, Luqman AW. Distal transradial access in the anatomical snuffbox for balloon guide-assisted stentriever mechanical thrombectomy: technical note and case report. Brain Circ. 2020 Feb 18;6(1):60-64. doi: 10.4103/bc.bc_22_19. eCollection 2020 Jan-Mar.
  13. Kühn AL, Rodrigues KM, Singh J, Massari F, Puri AS. Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study. J Neurointerv Surg. 2020 Aug;12(8):798-801. doi: 10.1136/neurintsurg-2019-015604
  14. Sgueglia GA, Di Giorgio A, Gaspardone A, Babunashvili A. Anatomic Basis and Physiological Rationale of Distal Radial Artery Access for Percutaneous Coronary and Endovascular Procedures. JACC Cardiovasc Interv. 2018 Oct 22;11(20):2113-19. doi: 10.1016/j.jcin.2018.04.045
  15. Coomes EA, Haghbayan H, Cheema AN. Distal transradial access for cardiac catheterization: A systematic scoping review. Catheter Cardiovasc Interv. 2020 Dec;96(7):1381-89. doi: 10.1002/ccd.28623
  16. Boumezrag M, Ummat B, Reiner J, Venbrux A, Sarin S. Pseudoaneurysm: a rare complication of distal transradial access in the anatomical snuffbox. CVIR Endovasc. 2019 Jun 29;2(1):21. doi: 10.1186/s42155-019-0064-2
  17. Nairoukh Z, Jahangir S, Adjepong D, Malik BH. Distal Radial Artery Access: The Future of Cardiovascular Intervention. Cureus. 2020 Mar 7;12(3):e7201. doi: 10.7759/cureus.7201
  18. Hadjivassiliou A, Kiemeneij F, Nathan S, Klass D. Ultrasound-guided access to the distal radial artery at the anatomical snuffbox for catheter-based vascular interventions: a technical guide. Euro Intervention. 2021 Mar 19;16(16):1342-48. doi: 10.4244/EIJ-D-19-00555
Address for correspondence:
675001, Russian Federation,
Blagoveshchensk, Gorkii Str., 97,
Amur State Medical Academy
of the Ministry of Health of Russia,
Cardiac Surgery Clinic,
tel. +7 922 079 06 22,
e-mail: ssemioo@rambler.ru,
Korotkikh Alexandr V.
Information about the authors:
Korotkikh Aleksandr V., Head Physician, Cardiovascular Surgeon, Specialist in X-ray Endovascular Diagnosis and Treatment, Cardiac Surgery Clinic, Amur State Medical Academy, Blagoveshchensk, Russian Federation.
https://orcid.org/0000-0002-9709-1097
Babunashvili Avtandil M., MD, Professor, Head of the Vascular Center, Center for Endosurgery and Lithotripsy, Moscow, Russian Federation.
https://orcid.org/0000-0003-2269-7059
Kaledin Alexandr L., PhD, Surgeon of the unit of X-ray endovascular methods of diagnosis and treatment, I.I. Mechnikov North-West State Medical University4, St. Petersburg, Russian Federation.
https://orcid.org/0000-0003-0581-6132
Akhramovich Ruslan V., Physician of X-ray Endovascular Diagnosis and Treatment Mytishchi City Clinical Hospital, Mytishchi, Russian Federation.
https://orcid.org/0000-0002-0026-6998
Derkach Vladislav V., Head of the Endovascular Surgery unit, Clinic of Innovative Surgery, Klin, Russian Federation.
https://orcid.org/0000-0002-0367-3628
Portnov Roman M., Physician of X-ray Endovascular Diagnosis and Treatment, Clinic of Innovative Surgery, Klin, Russian Federation.
https://orcid.org/0000-0001-5360-3815
Sozykin Alexey V., MD, Professor of the Cardiology Department, N.I. Pirogov Russian National Research Medical University, Head of the Unit of X-ray Endovascular Methods of Siagnosis and Treatment, Central Clinical Hospital of the Russian Academy of Sciences, Moscow, Russian Federation
https://orcid.org/0000-0002-2570-5758
DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.296   |  

V.F. RYBALCHENKO 1, A.A. PEREYASLOV 2, I.G. RYBALCHENKO 3, O.M. NYKYFORUK 2

STRATEGY AND EXPERIENCE OF INFANTILE HEMANGIOMA TREATMENT

P.L.Shupyk National Academy of Postgraduate Education, Kiev, Ukraine,
Danylo Halytsky Lviv National Medical University, Lviv, Ukraine,
National Children Specialized Hospital OXMATDYT, Kiev, Ukraine

Objective. To analyze the treatment results of patients with infantile hemangiomas using various methods.
Methods. The study is grounded on the treatment results of children (n=189) with infantile hemangiomas during the period of 2000-2018 years. All patients were divided into the groups: 1) dynamic observation 23 (12.2%) children; 2) local destruction 78 (41.3%); 3) surgical treatment 22 (11.6%); 4) drug therapy 66 (34.9%) patients. The interstitial coagulation (n=28) and electrocoagulation of hemangioma (n=50) were applied for the local destruction. 18 patients underwent the complete removal of hemangioma and 4 - segmental resection of tumor with the subsequent propranolol treatment. Propranolol was used for the drug treatment and it was combined with the topical application of timolol (n=13).
Results. Hemangioma regression was registered in 18 (78.3%) patients of the first group. Among the patients of the second group, involution of hemangioma was observed in 26 (92.6%) patients when the interstitial coagulation was applied and 2 (7.4%) children had hemangioma recurrence.
A strong positive effect can be reached by electrocoagulation of superficial hemangiomas (all patients). With primary radical intervention, complete cure was noted in all children, and with segmental resection only one (4.5%) child had a relapse. Keloid scars were formed in 3 (13.6%) children after surgery. Propranolol seemed to be effective in treating hemangiomas in children of all ages, and in 41 (62.1%) patients hemangiomas completely disappeared.
Conclusion. Before initiating therapy, the children need to be assessed for the contraindications and the treatment strategy. In case of infantile hemangioma should be individual based on the results of clinical investigation. Systemic propranolol treatment has gained rapid popularity as the treatment of choice for infantile hemangiomas and may be applied not only as the basic treatment, but also in combination with other methods. Surgical removal of hemangioma remains one of the common treatments components for children with infantile hemangiomas.

Keywords: children, infantile hemangioma, treatment, propranolol, surgery
p. 296-301 of the original issue
References
  1. Ding Y, Zhang JZ, Yu SR, Xiang F, Kang XJ. Risk factors for infantile hemangioma: a meta-analysis. World J Pediatr. 2019 Dec 18. doi: 10.1007/s12519-019-00327-2. Online ahead of print.
  2. Harter N, Mancini AJ. Diagnosis and Management of Infantile Hemangiomas in the Neonate. Pediatr Clin North Am. 2019 Apr;66(2):437-59. doi: 10.1016/j.pcl.2018.12.011
  3. Cazeau C, Blei F, Gonzáles Hermosa MDRF, Cavalli R, Boccara O, Fölster-Holst R, Berdeaux G, Delarue A, Voisard JJ. Burden of infantile hemangioma on family: an international observational cross-sectional study. Pediatr Dermatol. 2017 May;34(3):295-302. doi: 10.1111/pde.13133
  4. Vacirca SR, Nardi P, Ferlosio A, Orlandi A, Ruvolo G. Multifocal cardiac hemangioma. J Card Surg. 2018 Jun;33(6):310-12. doi: 10.1111/jocs.13719
  5. Léauté-Labrèze C, Baselga Torres E, Weibel L, Boon LM, El Hachem M, van der Vleuten C, Roessler J, Troilius Rubin A. The infantile hemangioma referral score: a validated tool for physicians. Pediatrics. 2020 Apr;145(4):e20191628. doi: 10.1542/peds.2019-1628
  6. Léauté-Labrèze C, Harper JI, Hoeger PH. Infantile haemangioma. Lancet. 2017 Jul 1;390(10089):85-94. doi: 10.1016/S0140-6736(16)00645-0
  7. Léaute-Labrèze C, Boccara O, Degrugillier-Chopinet C, Mazereeuw-Hautier J, Prey S, Lebbé G, Gautier S, Ortis V, Lafon M, Montagne A, Delarue A, Voisard JJ. Safety of oral propranolol for the treatment of infantile hemangioma: a systematic review. Pediatrics. 2016 Oct;138(4):e20160353. doi: 10.1542/peds.2016-0353
  8. Tangtatco JA, Freedman C, Phillips J, Pope E. Surgical treatment outcomes of infantile hemangioma in children: Does prior medical treatment matter. Pediatr Dermatol. 2018 Nov;35(6):e418-e419. doi: 10.1111/pde.13658
  9. Chinnadurai S, Sathe NA, Surawicz T. Laser treatment of infantile hemangioma: A systematic review. Lasers Surg Med. 2016 Mar;48(3):221-33. doi: 10.1002/lsm.22455
  10. DeHart A, Richter G. Hemangioma: recent advances. F1000Res. F1000Res. 2019 Nov 18;8:F1000 Faculty Rev-1926. doi: 10.12688/f1000research.20152.1. eCollection 2019.
  11. Hoeger PH, Harper JI, Baselga E, Bonnet D, Boon LM, Ciofi Degli Atti M, El Hachem M, Oranje AP, Rubin AT, Weibel L, Léauté-Labrèze C. Treatment of infantile haemangiomas: recommendations of a European expert group. Eur J Pediatr. 2015 Jul;174(7):855-65. doi: 10.1007/s00431-015-2570-0
  12. Broeks IJ, Hermans DJ, Dassel AC, van der Vleuten CJ, van Beynum IM. Propranolol treatment in life-threatening airway hemangiomas: a case series and review of literature. Int J Pediatr Otorhinolaryngol. 2013 Nov;77(11):1791-800. doi: 10.1016/j.ijporl.2013.08.011
  13. Darrow DH, Greene AK, Mancini AJ, Nopper AJ. Diagnosis and management of infantile hemangioma. Pediatrics. 2015 Oct;136(4):e1060-e104. doi: 10.1542/peds.2015-2485
  14. Robert J, Tavernier E, Boccara O, Mashiah J, Mazereeuw-Hautier J, Maruani A. Modalities of use of oral propranolol in proliferative infantile haemangiomas: an international survey among practitioners. Br J Dermatol. 2020 Mar 27. doi: 10.1111/bjd.19047. Online ahead of print.
  15. Streicher JL, Riley EB, Castelo-Soccio LA. Reevaluating the need for electrocardiograms prior to initiation of treatment with propranolol for infantile hemangiomas. JAMA Pediatr. 2016 Sep 1;170(9):906-7. doi: 10.1001/jamapediatrics.2016.0824
  16. Lund EB, Chamlin SL, Mancini AJ. Utility of routine electrocardiographic screening before initiation of propranolol for infantile hemangiomas. Pediatr Dermatol. 2018 Jul;35(4):e233-e34. doi: 10.1111/pde.13508
  17. Chan H, McKay C, Adams S, Wargon O. RCT of timolol maleate gel for superficial infantile hemangiomas in 524-week-olds. Pediatrics. 2013 Jun;131(6):e1739-47. doi: 10.1542/peds.2012-3828
Address for correspondence:
04112, Ukraine, Kiev,
Dorogozhitskaya Str., 9,
P.L. Shupyk National Academy of Postgraduate Education of the MH of Ukraine,
the Pediatric Surgery Department,
e-mail:pedsurgery_ua@ukr.net,
tel. mobile +380 50 412-26-89,
Rybalchenko Vasyl F.
Information about the authors:
Rybalchenko Vasyl F., MD, Professor of the Pediatric Surgery Department, P.L.Shupyk National Academy of Postgraduate Education, Kiev, Ukraine.
https://orcid.org/0000-0002-1872-6948
Pereyaslov Andriy A., MD, Professor of the Pediatric Surgery Department,.Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
http://orcid.org/0000-0002-1225-0299
Rybalchenko Inna G., PhD, Pediatric Surgeon, Neonatal Surgery Department, National Children Specialized Hospital OXMATDYT, Kiev, Ukraine.
https://orcid.org/0000-0003-0634-2725
Nykyforuk Olesya M., PhD, Assistant of the Pediatric Surgery Department, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0003-2967-5653
DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.302   |  

I.M. IHNATOVICH 1, D.M. BONTSEVICH 2, B.A. MASLIANSKI 3, YU.S. NEBYLITSYN 4, N.M. NOVIKAVA 5, A.V. KOSINETS 6, A.V. MIKHNEVICH 4, A.G. PAVLOV 4

THE APPLICATION OF COMPRESSION THERAPY IN PATIENTS WITH VARICOSE VEINS OF THE LOWER EXTREMITIES

Belarusian State Medical University 1, Minsk,
Medical Center ELMED2, Gomel,
Gomel Regional Clinical Hospital 3, Gomel,
Vitebsk State Medical University 4, Vitebsk
Minsk 5th City Clinical Hospital 5, Minsk
Vitebsk Regional Clinical Specialized Center 6, Vitebsk
The Republic of Belarus

Objective. To study the implementation of medical recommendations regarding the use of compression therapy in patients with varicose veins of the lower extremities.
Methods. A prospective comparative study, Patients Commitment to Compression Therapy (POMP), was conducted with the participation of phlebologist-surgeons who treat patients with chronic venous diseases in Minsk, Vitebsk, and Gomel. During 5 weeks each of the phlebologists included in the study patients with varicose veins who sought advice and needed compression therapy. 30-35 days after the consultation of the surgeon-phlebologist, an outsourcing call center conducted a telephone survey of patients in order to obtain information about the specifics of fulfilling medical recommendations.
Results. The registration data base of the study contained individual data on 394 patients with varicose veins (C1-C6) who received recommendations to use compression therapy. After 30-35 days, 302 patients (aged 43, 18-84 (Me, IQR)) were available for telephone survey. There were 58 men (19.2%), 244 women (80.8%). Among them, class C1 was registered in 39 (12.9%), C2 in 113 (37.4%), C3 in 122 (40.4%), C4 in 25 (8.3%), C5 in 1 (0.3%), C6 in 2 (0.7%) patients.
It was found that 245 (81.5%) of the respondents either already had compression hosiery at the time of the consultation, or purchased it within 30 days. 228 (75.2%) respondents reported compliance with the recommendations. Patients who had already experience with compression therapy and patients with the history of venous thromboembolism showed higher commitment to compression therapy (p<0.001). There were no significant differences in the compliance of patients with different levels of education and professional characteristics.
Conclusion. A high commitment of patients to compression therapy was established 1 month after receiving recommendations. To obtain more information about patient compliance, it is necessary to enlarge the follow-up period.

Keywords: varicose veins, compression therapy, compliance, implementation of recommendations, comparison of results
p. 302-310 of the original issue
References
  1. Lee BB, Nicolaides AN, Myers K, Meissner M, Kalodiki E, Allegra C, Antignani PL, Bækgaard N, Beach K, Belcaro G, Black S, Blomgren L, Bouskela E, Cappelli M, Caprini J, Carpentier P, Cavezzi A, Chastanet S, Christenson JT, Christopoulos D, Clarke H, Davies A, Demaeseneer M, Eklöf B, Ermini S, Fernández F, Franceschi C, Gasparis A, Geroulakos G, Gianesini S, Giannoukas A, Gloviczki P, Huang Y, Ibegbuna V, Kakkos SK, Kistner R, Kölbel T, Kurstjens RL, Labropoulos N, Laredo J, Lattimer CR, Lugli M, Lurie F, Maleti O, Markovic J, Mendoza E, Monedero JL, Moneta G, Moore H, Morrison N, Mosti G, Nelzén O, Obermayer A, Ogawa T, Parsi K, Partsch H, Passariello F, Perrin ML, Pittaluga P, Raju S, Ricci S, Rosales A, Scuderi A, Slagsvold CE, Thurin A, Urbanek T, van Rij A, Vasquez M, Wittens CH, Zamboni P, Zimmet S, Ezpeleta SZ. Venous hemodynamic changes in lower limb venous disease: the UIP consensus according to scientific evidence. Int Angiol. 2016 Jun;35(3):236-52. https://www.minervamedica.it/en/journals/international-angiology/article.php?cod=R34Y2016N03A0236
  2. Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG., Gillespie DL, Gloviczki ML, Lohr JM, McLafferty RB, Meissner MH, Murad MH, Padberg FT, Pappas PJ, Passman MA, Raffetto JD, Vasquez MA, Wakefield TW. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011 May;53(5 Suppl):2S-48S. doi: 10.1016/j.jvs.2011.01.079
  3. Nicolaides A, Kakkos S, Baekgaard N, Comerota A, de Maeseneer M, Eklof B, Giannoukas AD, Lugli M, Maleti O, Myers K, Nelzén O, Partsch H, Perrin M. Management of chronic venous disorders of the lower limbs. Guidelines According to Scientific Evidence. Part I. Int Angiol. 2018 Jun;37(3):181-54. Int Angiol. 2018 Jun;37(3):181-54. doi: 10.23736/S0392-9590.18.03999-8
  4. Wittens C, Davies AH, Bækgaard N, Broholm R, Cavezzi A, Chastanet S, de Wolf M, Eggen C, Giannoukas A, Gohel M, Kakkos S , Lawson J, Noppeney T, Onida S, Pittaluga P, Thomis S, Toonder I, Vuylsteke M. Management of chronic venous disease: clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2015;49:678-37. doi: 10.1016/j.ejvs.2015.02.007
  5. Kakkos SK, Timpilis M, Patrinos P, Nikolakopoulos KM, Papageorgopoulou CP, Kouri AK, Ntouvas I, Papadoulas SI, Lampropoulos GC, Tsolakis IA. Acute effects of craduated elastic compression stockings in patients with symptomatic varicose veins: a randomised double blind placebo controlled trial. Eur J Vasc Endovasc Surg. 2018 Jan;55(1):118-25. doi: 10.1016/j.ejvs.2017.10.004
  6. Huang TW, Chen SL, Bai CH, Wu CH, Tam KW. The optimal duration of compression therapy following varicose vein surgery: a meta-analysis of randomized controlled trials. Eur J Vasc Endovasc Surg. 2013 Apr;45(4):397-402. doi: 10.1016/j.ejvs.2013.01.030
  7. Kirienko AI., Stoyko YUM, Zolotukhin IA. Patients Compliance to compression treatment of chronic venous disease. Flebologija. 2018;12(4):244-51. DOI: 10.17116/flebo201812041244 (In Russ.)
  8. World Health Statistics 2019. Geneva: World Health Organization; 2019. [Internet]. Available from: https://apps.who.int/iris/bitstream/handle/10665/311696/WHO-DAD-2019.1-eng.pdf
  9. Socialnoe polozhenie i uroven zhizni naselenija Respubliki Belarus, 2019: statist sb [Jelektronnyj resurs]. Nac statist komitet Resp Belarus (Belstat). Rezhim dostupa: https://www.belstat.gov.by/ofitsialnaya-statistika/makroekonomika-i-okruzhayushchaya-sreda/uroven-zhizni-naseleniya/statisticheskie-izdaniya/index_14044 (In Russ.)
  10. Cataldo J L, Pereira de Godoy J M, de Barros N. The use of compression stockings for venous disorders in Brazil. Phlebology. 2012 Feb;27(1):33-37. doi: 10.1258/phleb.2011.010088
  11. Kankam HKN, Lim ChS, Fiorentino F, Davies AH, Gohel MS. A summation analysis of compliance and complications of compression hosiery for patients with chronic venous disease or post-thrombotic syndrome. Eur J Vasc Endovasc Surg. 2018 Mar;55(3):406-16. doi: 10.1016/j.ejvs.2017.11.025
  12. Uhl JF, Benigni JP, Chahim M, Fréderic D. Prospective randomized controlled study of patient compliance in using a compression stocking: Importance of recommendations of the practitioner as a factor for better compliance. Phlebology. 2018 Feb;33(1):36-43. doi: 10.1177/0268355516682886
Address for correspondence:
220083, Republic of Belarus, Minsk,
Dzerzhinskii Avenue, 83,
Belarusian State Medical University,
the 1st Department of Surgical Diseases,
tel.mobile+375 173400254,
e-mail: ini67@inbox.ru,
Ihnatovich Igor N.
Information about the authors:
Ihnatovich Igor N., MD, professor of the 1st Department of Surgical Diseases, Belarusian State Medical University, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-3185-8048
Bontsevich Dmitry N., PhD, Associate Professor, Angiosurgeon, Medical Center ELMED, Gomel, Republic of Belarus.
https://orcid.org/0000-0002-1894-1111
Maslianski Boris A., Surgeon, the 2nd Surgical Department, Gomel Regional Clinical Hospital, Gomel, Republic of Belarus.
https://orcid.org/0000-0002-6996-8461
Nebylitsyn Yury S., PhD, Associate Professor, Head of the Plastic Surgery and Cosmetology Department of the Clinic of VSMU, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-4022-0599
Novikova Natalya M., Ph, Surgeon, Minsk 5th City Clinical Hospital , Minsk, Republic of Belarus.
https://orcid.org/0000-0003-0164-5276
Kosinets Alexandr V., Surgeon of the Surgery Unit, Vitebsk Regional Clinical Specialized Center, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-0575-5299
Mikhnevich Alexey V., Senior Lecturer of the Hospital Surgery Department with the Course of Urology and Pediatric Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-8112-6822
Pavlov Alexandr G., PhD, Associate Professor of the Hospital Surgery Department with the Course of Urology and Pediatric Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-7280-4364

TRAUMATOLOGY AND ORTHOPEDICS

DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.311   |  

S.V. ZYBLEVA, S.L. ZYBLEV

IMMUNOLOGICAL PREDICTORS OF RENAL GRAFT REJECTION IN THE EARLY POSTOPERATIVE PERIOD

Republican Research Center for Radiation Medicine and Human Ecology, Gomel,
The Republic of Belarus

Objective. To determine the immunological predictors of renal graft rejection in the early postoperative period.
Methods. Three groups were formed out of the 197 renal graft recipients. The group PGF (n=101) was made up of patients with satisfactory primary graft function. The group PGD (n = 82) included patients with primary graft dysfunction without episodes of rejection. The group RGR (n=14) consisted of patients with primary dysfunction and renal graft rejection. On the 7th day after transplantation the early kidney graft function was assessed on the basis of serum creatinine levels. When the serum creatinine value was lower than 300 μmol/L the function was considered to be primary, at a creatinine concentration was equal to or higher than 300 μmol/L, as well as in the case of need for maintenance dialysis on the first week after transplantation, the state was classified as the renal graft dysfunction. In the early postoperative period, the number of LIN-HLA-DR+ dendritic cells with the LIN- HLA-DR+CD11c+CD123- and LIN-HLA-DR+CD11c-CD123+ phenotypes in the fluid from the drainage installed to the kidney graft during surgery was determined. Predictive characteristics of the mDC and pDC levels in the drainage fluid were determined to predict renal graft rejection, and diagnostic capability of this indicator were identified.
Results. It has been revealed that renal graft rejection is characterized by a significant growth of the total number of dendritic cells in the drainage fluid, mainly due to myeloid ones. Predictive characteristics were determined by the level of myeloid and plasmacytoid dendritic cells in the drainage fluid. The cut-off point of the level of myeloid dendritic cells was determined at the level of 60.32%, and for plasmacytoid dendritic cells it corresponded to 39.68%.
Conclusion. With the level of myeloid dendritic cells in the drainage fluid greater or equal 60.32%, and plasmacytoid cells lower or equal 39.68%, renal graft rejection is predicted with a sensitivity of 99% and 93%, respectively, and a specificity of 89% and 91%, respectively.

Keywords: dendritic cell, LIN-HLA-DR+CD11c+CD123-, LIN-HLA-DR+CD11c-CD123+, renal graft dysfunction, renal graft rejection, renal transplantation
p. 311-317 of the original issue
References
  1. Zhuang Q, Lakkis FG. Dendritic cells and innate immunity in kidney transplantation. Kidney Int. 2015 Apr;87(4):712-18. doi: 10.1038/ki.2014.430
  2. Morelli AE. Dendritic cells of myeloid lineage: the masterminds behind acute allograft rejection. Curr Opin Organ Transplant. 2014 Feb;19(1):20-27. doi: 10.1097/MOT.0000000000000039
  3. Ezzelarab M, Thomson AW. Tolerogenic dendritic cells and their role in transplantation. Semin Immunol. 2011 Aug;23(4):252-63. doi: 10.1016/j.smim.2011.06.007
  4. Belz GT, Nutt SL. Transcriptional programming of the dendritic cell network. Nat Rev Immunol. 2012 Jan 25;12(2):101-13. doi: 10.1038/nri3149
  5. Morelli AE, Thomson AW. Tolerogenic dendritic cells and the quest for transplant tolerance. Nat Rev Immunol. 2007 Aug;7(8):610-21. doi: 10.1038/nri2132
  6. Solari MG, Thomson AW. Human dendritic cells and transplant outcome. Transplantation. 2008 Jun 15;85(11):1513-22. doi: 10.1097/TP.0b013e318173a768
  7. Matta BM, Castellaneta A, Thomson AW. Tolerogenic plasmacytoid DC. Eur J Immunol. 2010 Oct;40(10):2667-76. doi: 10.1002/eji.201040839
  8. Maldonado RA, von Andrian UH. How tolerogenic dendritic cells induce regulatory T cells. Adv Immunol. 2010;108:111-65. doi: 10.1016/B978-0-12-380995-7.00004-5
  9. Pulendran B, Tang H, Manicassamy S. Programming dendritic cells to induce T(H)2 and tolerogenic responses. Nat Immunol. 2010 Aug;11(8):647-55. doi: 10.1038/ni.1894
  10. Cantaluppi V, Dellepiane S, Tamagnone M, Medica D, Figliolini F, Messina M, Manzione AM, Gai M, Tognarelli G, Ranghino A, Dolla C, Ferrario S, Tetta C, Segoloni GP, Camussi G, Biancone L. Neutrophil gelatinase associated lipocalin is an early and accurate biomarker of graft function and tissue regeneration in kidney transplantation from extended criteria donors. PLoS One. 2015 Jun 30;10(6):e0129279. doi: 10.1371/journal.pone.0129279. eCollection 2015.
  11. Zhou H, Wu L. The development and function of dendritic cell populations and their regulation by miRNAs. Protein Cell. 2017 Jul;8(7):501-513. doi: 10.1007/s13238-017-039
  12. Nosik AV, Korotkov SV, Smolnikova VV, Hrynevich VYU, Dmitrieva MV, Dolgolikova AA, Pikirenia II, Krivenko SI, Kalachik OV, Shcherba AE, Rummo OO. The value of assessment of lymphocytes subpopulations numbers in peripheral blood for diagnosis of cellular rejection after kidney transplantion. Novosti Khirurgii. 2019;27(4):409-20. doi: 10.18484/2305-0047.2019.4.409 (In Russ.)
  13. Colonna M, Trinchieri G, Liu YJ. Plasmacytoid dendritic cells in immunity. Nat Immunol. 2004 Dec;5(12):1219-26. doi: 10.1038/ni1141
  14. Zuidwijk K, de Fijter JW, Mallat MJ, Eikmans M, van Groningen MC, Goemaere NN, Bajema IM, van Kooten C. Increased influx of myeloid dendritic cells during acute rejection is associated with interstitial fibrosis and tubular atrophy and predicts poor outcome. Kidney Int. 2012 Jan;81(1):64-75. doi: 10.1038/ki.2011.289
Address for correspondence:
246000, Republic of Belarus,
Gomel, Ilyich Str., 290,
Republican Research Center
for Radiation Medicine and Human Ecology
tel. mobile: +375 44 547-69-85,
e-mail: zyb-svetlana@yandex.by,
Zybleva Svetlana V.
Information about the authors:
Zybleva Svetlana V., PhD, Immunologist, Scientific Secretary, Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
https://orcid.org/0000-0003-3061-5324
Zyblev Sergey L., PhD, Associate Professor, Surgeon of the Surgery Unit (Transplantation, Reconstructive and Endocrine Surgery), Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
https://orcid.org/0000-0002-0968-6630

UROLOGY

DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.318   |  

S.I. PANIN, A.V. BYKOV, A.B. DORONIN, A.A. KUZNETSOV, S.V. SHCHELKOV, A.A. PANINA, E.A. MOROZOV, S.N. KARPENKO

EVALUATION OF TREATMENT RESULTS OF UROLITHIASIS COMPLICATIONS AMONG COVID-19 PATIENTS

Volgograd State Medical University, Volgograd,
The Russian Federation

Objective. To study the peculiarities of diagnostics and treatment of urolithiasis complications among patients with new coronavirus infection COVID-19.
Methods. The prospective cohort study evaluated the treatment outcomes of patients (n=146). The first group (n=30) included patients treated in infectious diseases hospital with a complicated urinary calculi disease and a new coronavirus infection COVID-19, the second group (n=116) included patients treated in the urological department of multidisciplinary non-infectious hospital due to complicated urinary tract stone disease who were not infected by new coronavirus infection COVID-19. As for COVID 19 diagnostics, patients of the first group were done PCR tests that were positive in 19 (63,3%) cases, and thoracic cavity computer tomography scanning (upon admission the percentage of pulmonary tissue involvement varied since 5% up to 90%).
Results. Among the patients of the first group, elderly people prevailed (61+15 years) and there were more women among them (66%). The characteristic features of complicated urinary calculi disease in patients with COVID-19 are the prevalence of infectious and inflammatory complications (50%) and a combination of several complications of urolithiasis (40%). Among peculiarities of treatment, patients of the first group in 6.6% of cases underwent the lumbotomy with open nephrostomy, due to the spread of secondary suppurative process over the retroperitoneal space. According to the Clavien-Dindo scale, in the first group of patients the incidence of complications after surgery was 40%, in the second - 13.8%. Mortality rate in the first group reached 30%, in the second 0.9%. The duration of hospital treatment among patients of the first group reached 21 (5-39) days, among patients of the second group 8 (1-56) days.
Conclusion. The specificity of the course associated with significant morbidity and mortality require further optimization therapeutic approaches to achieve success in patients with complications of urolithiasis during COVID-19 outbreak.

Keywords: complications of urolithiasis, lumbotomy, urinary tract drainage, mortality rate, COVID-19
p. 318-326 of the original issue
References
  1. Timerbulatov MV, Timerbulatov SHV, Sibaev VM, Gainullina EN. Laparoscopic surgery in pandemic Covid-19. Endoskop Khirurgiia. 2020;26(3):59-64. doi: 10.17116/endoskop20202603159 (In Russ.)
  2. Pushkar DYu, Kasyan GR, Malkhasyan VA, Sazonova NA, Shaderkin IA, Shaderkina VA.. COVID-19: impact on the urological service of the Russian Federation. Eksperim i Klin Urologiia. 2020;(2):13-17. doi: 10.29188/2222-8543-2020-12-2-13-. (In Russ.)
  3. Naspro R, Da Pozzo LF. Urology in the time of corona. Nat Rev Urol. 2020 May;17(5):251-53. doi: 10.1038/s41585-020-0312-1
  4. McDermott A, OKelly J, Quinlan MJ, Little DM, Davis NF. A prospective study on the incidence of postponed time-sensitive urological procedures during the SARS-CoV-2 pandemic due to patient preference. Ir J Med Sci. 2020 Nov 17:1-5. doi: 10.1007/s11845-020-02438-6. Online ahead of print.
  5. Prikaz Ministerstva zdravookhraneniia RF ot 28 fevralia 2019 g. N 103n Ob utverzhdenii poriadka i srokov razrabotki klinicheskikh rekomendatsii, ikh peresmotra, tipovoi formy klinicheskikh rekomendatsii i trebovanii k ikh strukture, sostavu i nauchnoi obosnovannosti, vkliuchaemoi v klinicheskie rekomendatsii informatsii [Elektronnyi resurs] [data obrashcheniia: 2020 Dek 16]. Available from: http://base.garant.ru/72240714/. (In Russ.)
  6. Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19), versiia 9 (26.10.2020). Vremennye metodicheskie rekomendatsii Minzdrava Rossii [Elektronnyi resurs] [data obrashcheniia: 2020 Dek 16]. Moskva, RF: Minzdrav RF; 2020. 236 s. Available from: https://medvestnik.ru/content/documents/9-ot-26-10-2020.html. (In Russ.)
  7. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae
  8. COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020 Jul 4;396(10243):27-38. doi: 10.1016/S0140-6736(20)31182-X
  9. Sánchez MD, Sánchez M, De La Morena JM, Ogaya-Pinies G, Mateo E, Moscatiello P, Sánchez S, Rubio V, Bueno C, Barba R, Carracedo D. Nosocomial SARS-CoV-2 infection in urology departments: Results of a prospective multicentric study. Int J Urol. 2020 Oct 13:10.1111/iju.14402. doi: 10.1111/iju.14402
Address for correspondence:
400131, Russian Federation,
Volgograd, Pavshie Bortsy Square, 1
Volgograd State Medical University,
the Department of the General Surgery
with the Course Of Urology,
tel. +7 903 375-57-95,
e-mail: kouznetsov23@gmail.com,
Kuznetsov Alexandr A.
Information about the authors:
Panin Stanislav I., MD, Associate Professor, Head of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0003-4086-2054
Bykov Alexandr V., MD, Professor of the Department of Surgical Diseases No 1 of Institute of Continuing Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0002-1505-6256
Doronin Andrey B., PhD, Associate Professor of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0003-2944-6762
Kuznetsov Alexandr A., PhD, Associate Professor of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0002-7026-1746
Shchelkov Sergey V., PhD, Associate Professor of the Department of Surgical Diseases No1 of Institute of Continuing Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0001-8582-3687
Panina Anna A., PhD, Associate Professor of the Department of Radiation, Functional and Laboratory Diagnostics of Institute of Continuing Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0003-2750-8579
Morozov Egor A., Assistant of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0001-9495-3424
Karpenko Svetlana N., PhD, Associate Professor of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0002-9965-392X

ONCOLOGY

DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.326   |  

S.V. VOLKOV, S.L. LOBANOV, B.S. ERDINEYEVA, A.A. DUTOVA

THE ROLE OF THE INTESTINAL MICROBIOTA IN THE COLON CANCER DIAGNOSTICS

Chita State Medical Academy, Chita,
The Russian Federation

Objective. To determine the composition of the the parietal microflora of the colon under the condition of a tumor process and to assess the possibility of using these data from this study in the diagnosis of the colon cancer.
Methods. The main group included patients (n=75) operated on in the Trans-Baikal Regional Oncology Center for the colon cancer. Among them are 38 men and 37 women aged 20 to 75 years. Control group consisted of 25 patients.
The material of the main group, biopsies of tumor tissue and visually unchanged colon mucosa was taken intraoperatively during tumor removal. In patients of the control group, the material was taken during the colonoscopy. process. The detection of Helicobacter pylori in the biopsy of the mucous membrane was carried out by determining the urease activity, as well as by the method of polymerase chain reaction. The composition of the intestinal microbiota was determined by the bacteriological method.
Results. As a result of comparison of the colon microbiota of the cancer patients and the control group, statistically significant differences in the quantitative composition of Lactobacillus spp., Bifidobacterium spp., Bacteroides spp., Clostridium spp., Enterococcus spp., E. coli (typical), E. coli (lactose-negative), Enterobacteriaceae, Staphylococcus spp. (CNS), Candida spp. were revealed. Moreover, a clear tendency of changes in the level of certain microorganisms (Bifidobacterium spp., E. coli (typical), Clostridium sp.) was detected when comparing the mucous membrane of a healthy person, unchanged mucous membrane of a patient with colorectal cancer, tumor tissue. A statistically significant dependence of the level of microorganisms on the sex of a patient, as well as the form of tumor growth, was revealed.
Conclusion. Thus, a reliable correlation between the clinical and morphological characterization of the colon malignant tumor and the composition of the intestinal microbiota has been revealed. The microbiological features established within in the course of the study, which arise precisely under the conditions of colon cancer, can be used as an additional diagnostic marker in the diagnosis of a malignant process.

Keywords: colon cancer, Helicobacter pylori, intestinal microbiota, colon biopsy, tumor tissue
p. 326-333 of the original issue
References
  1. Dai Z, Zhang J, Wu Q, Chen J, Liu J, Wang L, Chen C, Xu J, Zhang H, Shi C, Li Z, Fang H, Lin C, Tang D, Wang D. The role of microbiota in the development of colorectal cancer. Int J Cancer. 2019 Oct 15;145(8):2032-41. doi: 10.1002/ijc.32017
  2. Hernández-Luna MA, López-Briones S, Luria-Pérez R. The four horsemen in colon cancer. J Oncol. 2019 Sep 29;2019:5636272. doi: 10.1155/2019/5636272
  3. Bahmani S, Azarpira N, Moazamian E. Anti-colon cancer activity of Bifidobacterium metabolites on colon cancer cell line SW742. Turk J Gastroenterol. 2019 Sep;30(9):835-42. doi: 10.5152/tjg.2019.18451
  4. Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, Malfertheiner P, Graham DY, Wong VWS, Wu JCY, Chan FKL, Sung JJY, Kaplan GG, Ng SC. Global prevalence of helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017 Aug;153(2):420-29. doi: 10.1053/j.gastro.2017.04.022
  5. Butt J, Epplein M. Helicobacter pylori and colorectal cancer-A bacterium going abroad? PLoS Pathog. 2019 Aug 8;15(8):e1007861. doi: 10.1371/journal.ppat. 1007861
  6. Volkov SV, Lobanov SL. Criteria of clinical aggressiveness of colorectal cancer. Zabajkal Med Vestn. 2018;(2):69-76. http://zabmedvestnik.ru/arhiv-nomerov/nomer-2-za-2018-god/kriterii-klinicheskoj-agressivnosti-kolorektalnogo-raka (In Russ.)
  7. Kountouras J, Kapetanakis N, Polyzos SA, Katsinelos P, Gavalas E, Tzivras D, Zeglinas C, Kountouras C, Vardaka E, Stefanidis E, Kazakos E. Active Helicobacter pylori infection is a risk factor for colorectal mucosa: early and advanced colonic neoplasm sequence. Gut Liver. 2017 Sep 15;11(5):733-34. doi: 10.5009/gnl16389
  8. Sivan A, Corrales L, Hubert N, Williams JB, Aquino-Michaels K, Earley ZM, Benyamin FW, Lei YM, Jabri B, Alegre ML, Chang EB, Gajewski TF. Commensal Bifidobacterium promotes antitumor immunity and facilitates anti-PD-L1 efficacy. Science. 2015 Nov 27;350(6264):1084-89. doi: 10.1126/science.aac4255
  9. Wei Y, Li F, Li L, Huang L, Li Q. Genetic and biochemical characterization of an exopolysaccharide with in vitro antitumoral activity produced by Lactobacillus fermentum YL-11. Front Microbiol. 2019 Dec 17;10:2898. doi: 10.3389/fmicb. 2019.02898
  10. Dai Z, Zhang J, Wu Q, Chen J, Liu J, Wang L, Chen C, Xu J, Zhang H, Shi C, Li Z, Fang H, Lin C, Tang D, Wang D. The role of microbiota in the development of colorectal cancer. Int J Cancer. 2019 Oct 15;145(8):2032-41. doi: 10.1002/ijc. 32017
  11. Zamani S, Taslimi R, Sarabi A, Jasemi S, Sechi LA, Feizabadi MM. Enterotoxigenic Bacteroides fragilis: a possible etiological candidate for bacterially-induced colorectal precancerous and cancerous lesions. Front Cell Infect Microbiol. 2020 Jan 17;9:449. doi: 10.3389/fcimb.2019.00449
  12. Sheng QS, He KX, Li JJ, Zhong ZF, Wang FX, Pan LL, Lin JJ. Comparison of gut microbiome in human colorectal cancer in paired tumor and adjacent normal tissues. Onco Targets Ther. 2020 Jan 21;13:635-46. doi: 10.2147/OTT.S218004
  13. Zorron Cheng Tao Pu L, Yamamoto K, Honda T, Nakamura M, Yamamura T, Hattori S, Burt AD, Singh R, Hirooka Y, Fujishiro M. Microbiota profile is different for early and invasive colorectal cancer and is consistent throughout the colon. J Gastroenterol Hepatol. 2019 Oct 23;35(3):433-37. doi: 10.1111/jgh.14868
  14. Butt J, Varga MG, Blot WJ, Teras L, Visvanathan K, Le Marchand L, Haiman C, Chen Y, Bao Y, Sesso HD, Wassertheil-Smoller S, Ho GYF, Tinker LE, Peek RM, Potter JD, Cover TL, Hendrix LH, Huang LC, Hyslop T, Um C, Grodstein F, Song M, Zeleniuch-Jacquotte A, Berndt S, Hildesheim A, Waterboer T, Pawlita M, Epplein M. Serologic response to helicobacter pylori proteins associated with risk of colorectal cancer among diverse populations in the United States. Gastroenterology. 2019 Jan;156(1):175-86.e2. doi: 10.1053/j.gastro.2018.09.054
  15. Changxi C, Mao Y, Du J, Xu Y, Zhu Z, Cao H. Helicobacter pylori infection associated with an increased risk of colorectal adenomatous polyps in the Chinese population. BMC Gastroenterol. 2019 Jan 21;19(1):14. doi: 10.1186/s12876-018-0918-4
Address for correspondence:
672090, Russian Federation,
Chita, Gorkii Str., 39a,
Chita State Medical Academy
of the Ministry of Health of Russia,
Oncology Department
tel.: +7 924 370-99-65,
e-mail: vsv_19@mail.ru,
Volkov Stepan V.
Information about the authors:
Volkov Stepan V., Assistant, the Oncology Department, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
https://orcid.org/0000-0002-8696-9562
Lobanov Sergey L., MD, Professor, Head of the Department of Faculty Surgery with the Course of Urology, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
http://orcid.org/0000-0003-1665-3754
Dutova Anastasiya A., PhD, Senior Researcher, the Laboratory of Molecular Genetics, RI of the Molecular Medicine, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
http://orcid.org/0000-0001-8285-6061
Erdineyeva Beligma S., PhD, Assistant, the Department of Microbiology, Virology, Immunology, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
http://orcid.org/0000-0003-3035-7900

REVIEWS

DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.334   |  

A.V. KADOMTSEVA, P.A. ZARUBENKO, L.B. LOGINOVA

THE ROLE OF IMMOBILIZED METAL-ORGANIC COMPOUNDS IN THE COMPLEX TREATMENT OF PURULENT-INFLAMMATORY DISEASE OF SKIN AND SOFT TISSUES

Privolzhsky Research Medical University, Nizhny Novgorod,
Russian Federation

Objective. To study the current Russian and foreign literature dedicated to the problem of application of organometallic compounds immobilized on drug delivery in the treatment of purulent-inflammatory disease of the skin and soft tissues.
Methods. The modern Russian and foreign literature, available in the Pubmed, Medline, Springer, Scopus, e-LIBRARY databases were reviewed according to the problems of purulent-inflammatory diseases, skin and soft tissue infections, the integrated approach to the treatment of purulent-inflammatory diseases, synthesis, immobilized organometallic compounds.
Results. The observational study of the specific recent achievements in the modification of antimicrobial biomaterials is presented. Metal ions have a broad range of antimicrobial activity (especially on proliferation and remodeling), possess by bacteriostatic and bactericidal effect, demonstrate multiple inhibitory effects against bacterial strains and have been proven effective in improving wound healing in all its phases. Natural products and especially biologically active metals such as silver, copper, zinc and germanium, are believed to be an alternative for the development of perspective biomaterials with antimicrobial properties. In recent years, new approach for the production and application of therapeutic and diagnostic drugs based on the immobilization or grafting of drug substances on polymer carriers has been developed. At present, namely the immobilized compounds that have opened the way to the creation of prolonged-action drugs with low toxicity and allergenicity.
Conclusion. Template synthesis of new organometallic drug compounds is considered to be a promising direction in the wound infection treatment, which requires further experimental and clinical study.

Keywords: purulent-inflammatory processes, organometallic frameworks, nanoparticles, immobilized compounds, biometals, synthesis
p. 334-346 of the original issue
References
  1. Ostapiuk L. Analysis of the Risk Factors of the Development of Purulent-Inflammatory Diseases. Online Journal of Gynecology and Reproductive Medicine. 2020;1(1):1-3.
  2. Stevens DL, Bryant AE. Necrotizing Soft-Tissue Infections. N Engl J Med. 2017 Dec 7;377(23):2253-65. doi: 10.1056/NEJMra1600673
  3. Järbrink K, Ni G, Sönnergren H, Schmidtchen A, Pang C, Bajpai R, Car J. The humanistic and economic burden of chronic wounds: a protocol for a systematic review. Syst Rev. 2017;6:15. Published online 2017 Jan 24. doi: 10.1186/s13643-016-0400-8
  4. Tretyakov AA, Pelrov SV, Neverov AN, Shchetinin AF. Treatment of Purulent Wounds. Novosti Khirurgii. 2015 Nov-Dec; Vol 23 (6):680-87. (In Russ.)
  5. Hua C, Sbidian E, Hemery F, Decousser JW, Bosc R, Amathieu R, Rahmouni A, Wolkenstein P, Valeyrie-Allanore L, Brun-Buisson C, de Prost N, Chosidow O. Prognostic factors in necrotizing soft-tissue infections (NSTI): A cohort study. J Am Acad Dermatol. 2015 Dec;73(6):1006-12.e8. doi: 10.1016/j.jaad.2015.08.054
  6. Yamamoto L.G. Treatment of Skin and Soft Tissue Infections. Pediatr Emerg Care. 2017 Jan;33(1):49-55. doi: 10.1097/PEC.0000000000001001
  7. Kadomtsev AV, Zhdanovich IV, Piskunov MS, Lineva AN, Novikova AN, Loginov PA. Assessment of toxicity of germanium coordination compounds. Toxicological Review. 2019;(2):16-21. doi: 10.36946/0869-7922-2019-2-16-21 (In Russ.)
  8. Hadeed GJ, Smith J, OKeeffe T, Kulvatunyou N, Wynne JL, Joseph B, Friese RS, Wachtel TL, Rhee PM, El-Menyar A, Latifi R. Early surgical intervention and its impact on patients presenting with necrotizing soft tissue infections: A single academic center experience. J Emerg Trauma Shock. 2016 Jan-Mar;9(1):22-27. doi: 10.4103/0974-2700.173868
  9. Chhabra S, Chhabra N, Kaur A, Gupta N. Wound Healing Concepts in Clinical Practice of OMFS. J Maxillofac Oral Surg. 2017 Dec;16(4):403-423. doi: 10.1007/s12663-016-0880-z
  10. Shaprynskyi VO, Rymsha OV, Mitiuk BO, Vovk IM, Nazarchuk SA, Khodakivskyi MA, Ivanova MO. Investigation of the sensitivity of pathogens of purulent-inflammatory processes of the mediastinum to modern antiseptics. Vsnik Vnnitskogo Natsonalnogo Medichnogo Unversitetu. 2020;24(1):69-74. doi: 10.31393/reports-vnmedical-2020-24(1)-13 (In Russ.)
  11. Abd-El-Aziz AS, Agatemor C, Etkin N. Antimicrobial resistance challenged with metal-based antimicrobial macromolecules. Biomaterials. 2017 Feb;118:27-50. doi: 10.1016/j.biomaterials.2016.12.002
  12. Hassan D, Fasiku VO, Madu SJ, Muazu J. Chapter 6 - Biodegradable Antibiotics in Wound Healing. In: Kokkarachedu V, Kanikireddy V, Sadiku R, editors. Antibiotic Materials in Healthcare. 1st. Academic Press; 2020. . 93-110. doi: 10.1016/B978-0-12-820054-4.00006-9
  13. Kosmala K, Szymańska R. Nanoczastki tlenku tytanu (IV). Otrzymywanie, własciwosci i zastosowanie. Kosmos. 2016;65(2):235-45. http://kosmos.icm.edu.pl/PDF/2016/235.pdf
  14. Bari SS, Mishra S. Chapter 23 - Recent Advances in nanostructured polymer composites for biomedical applications. In: Swain SK, Jawaid M, editors. Nanostructured polymer composites for biomedical applications. 2019 Elsevier Inc; 2019. . 489-506. doi: 10.1016/B978-0-12-816771-7.00024-7
  15. Han J, Zhao D, Li D, Wang X, Jin Z, Zhao K. Polymer-based nanomaterials and applications for vaccines and drugs. Polymers (Basel). 2018 Jan;10(1):31. Published online 2018 Jan 2. doi: 10.3390/polym10010031
  16. Kim HS, Sun X, Lee JH, Kim HW, Fu X, Leong KW. Advanced drug delivery systems and artificial skin grafts for skin wound healing. Adv Drug Deliv Rev. 2019 Jun;146:209-39. doi: 10.1016/j.addr.2018.12.014
  17. Lin CY, Lin SJ, Yang YC, Wang DY, Cheng HF, Yeh MK. Biodegradable polymeric microsphere-based vaccines and their applications in infectious diseases. Hum Vaccin Immunother. 2015 Mar;11(3):650-56. doi: 10.1080/21645515.2015.1009345
  18. Fumakia M, Ho EA. Nanoparticles encapsulated with LL37 and serpin A1 promotes wound healing and synergistically enhances antibacterial activity. Mol Pharm. 2016 Jul 5;13(7):2318-31. doi: 10.1021/acs.molpharmaceut.6b00099
  19. Kalita S, Kandimalla R, Devi B, Kalita B, Kalita K, Deka M, Kataki AC, Sharmaf A, Kotoky J. Dual delivery of chloramphenicol and essential oil by poly-ε-caprolactonePluronic nanocapsules to treat MRSA-Candida co-infected chronic burn wounds. RSC Advances. 2017;7(3):1749-58. doi: 10.1039/c6ra26561h
  20. Pereira GG, Detoni CB, Balducci AG, Rondelli V, Colombo P, Guterres SS, Sonvico F. Hyaluronate nanoparticles included in polymer films for the prolonged release of vitamin E for the management of skin wounds. Eur J Pharm Sci. 2016 Feb 15;83:203-11. doi: 10.1016/j.ejps.2016.01.002
  21. Patrulea V, Laurent-Applegate LA, Ostafe V, Borchard G, Jordan O. Polyelectrolyte nanocomplexes based on chitosan derivatives for wound healing application. Eur J Pharm Biopharm. 2019 Jul;140:100-108. doi: 10.1016/j.ejpb.2019.05.009
  22. Oyarzun-Ampuero F, Vidal A, Concha M, Morales J, Orellana S, Moreno-Villoslada I. Nanoparticles for the treatment of wounds. Curr Pharm Des. 2015;21(29):4329-41. doi: 10.2174/1381612821666150901104601
  23. Yu Y, Chen G, Guo J, Liu Y, Ren J, Kong T, Zhao Y. Vitamin metalorganic framework-laden microfibers from microfluidics for wound healing. Materials Horizons. 2018;5(6):1137-42. doi: 10.1039/C8MH00647D
  24. Alavijeh RK, Beheshti S, Akhbari K, Morsali A. Investigation of reasons for metal-organic frameworks antibacterial activities. Polyhedron. 2018 Dec 1;156:257-78. doi: 10.1016/j.poly.2018.09.028
  25. Cai W, Wang J, Chu C, Chen W, Wu C, Liu G. Metal-organic framework-based stimuli-responsive systems for drug delivery. Adv Sci (Weinh). 2018 Nov 20;6(1):1801526. doi: 10.1002/advs.201801526. eCollection 2019 Jan 9.
  26. Dovnar RI, Smotrin SM, Vasilkov AIu, Zhmakin AI. Antibakterialnyi i protivomikrobnyi effekt pereviazachnogo materiala, soderzhashchego nanochastitsy serebra. Novosti Khirurgii. 2010;18(6):3-11. http://www.surgery.by/pdf/full_text/2010_6_1_ft.pdf (In Russ.)
  27. Ximing G, Bin G, Yuanlin W, Shuanghong G. Preparation of spherical metal-organic frameworks encapsulating ag nanoparticles and study on its antibacterial activity. Mater Sci Eng C Mater Biol Appl. 2017 Nov 1;80:698-707. doi: 10.1016/j.msec.2017.07.027
  28. Shakya S, He Y, Ren X, Guo T, Maharjan A, Luo T, Wang T, Dhakhwa R, Regmi B, Li H, Gref R, Zhang J. Ultrafine silver nanoparticles embedded in cyclodextrin metal-organic frameworks with GRGDS functionalization to promote antibacterial and wound healing application. Small. 2019;15(27):e1901065. doi: 10.1002/smll.201901065
  29. Medici S, Peana M, Crisponi G, Nurchi VM, Lachowicz JI, Remelli M, Zoroddu MA, Remelli M. Silver coordination compounds: A new horizon in medicine. Coord Chem Rev. 2016;327:349-59. https://www.academia.edu/30868765/Silver_coordination_ compounds_A_new_horizon_in_medicine
  30. Shi G, Chen W, Zhang Y, Dai X, Zhang X, Wu Z. An Antifouling hydrogel containing silver nanoparticles for modulating the therapeutic immune response in chronic wound healing. Langmuir. 2019 Feb 5;35(5):1837-45. doi: 10.1021/acs.langmuir.8b01834
  31. Mofidfar M, Kim ES, Larkin EL, Long L, Jennings WD, Ahadian S, Ghannoum MA, Wnek GE. Antimicrobial Activity of Silver Containing Crosslinked Poly (Acrylic Acid) Fibers. Micromachines (Basel). 2019 Nov 28;10(12):829. doi: 10.3390/mi10120829
  32. Sheta SM, El-Sheikh SM, Abd-Elzaher MM. Simple synthesis of novel copper metal-organic framework nanoparticles: biosensing and biological applications. Dalton Trans. 2018 Apr 3;47(14):4847-55. doi: 10.1039/c8dt00371h
  33. Jo JH, Kim HC, Huh S, Kim Y, Lee DN. Antibacterial activities of Cu-MOFs containing glutarates and bipyridyl ligands. Dalton Trans.2019;48(23):8084-93. doi: 10.1039/c9dt00791a
  34. Ren X, Yang C, Zhang L, Li S, Shi S, Wang R, Zhang X, Yue T, Sun J, Wang J. Copper metal-organic frameworks loaded on chitosan film for the efficient inhibition of bacteria and local infection therapy. Nanoscale. 2019;11(24):11830-838. doi: 10.1039/c9nr03612A
  35. Ashfaq M, Verma N, Khan S. Copper/zinc bimetal nanoparticles-dispersed carbon nanofibers: A novel potential antibiotic material. Mater Sci Eng C Mater Biol Appl. 2016 Feb;59:938-47. doi: 10.1016/j.msec.2015.10.079
  36. Tamames-Tabar C, Imbuluzqueta E, Guillou N, Serre C, Miller SR, Elkaïm E, Horcajada , Blanco-Prieto MJ. A Zn azelate MOF: combining antibacterial effect. Cryst Eng Comm. 2015;17:456-62. doi: 10.1039/C4CE00885E
  37. Gutha Y, Pathak JL, Zhang W, Zhang Y, Jiao X. Antibacterial and wound healing properties of chitosan/poly(vinyl alcohol)/zinc oxide beads (CS/PVA/ZnO). Int J Biol Macromol. 2017 Oct;103:234-41. doi: 10.1016/j.ijbiomac.2017.05.020
  38. Straccia MC, dAyala GG, Romano I, Laurienzo P. Novel zinc alginate hydrogels prepared by internal setting method with intrinsic antibacterial activity. Carbohydr Polym. 2015 Jul 10;125:103-12. doi: 10.1016/j.carbpol.2015.03.010
  39. Haugen HJ, Lyngstadaas SP. Antibacterial effects of titanium dioxide in wounds. In: Ågren MS, ed. Wound healing biomaterials Vol. 2. 1st ed. Woodhead Publishing; 2016. . 439-50. doi: 10.1016/B978-1-78242-456-7.00021-0
  40. Verma R, Chaudhary V, Nain L, Srivastava AK. Antibacterial characteristics of TiO2 nano-objects and their interaction with biofilm. Mater Technol. 2017;32(6):385-90. doi: 10.1080/10667857.2016.1236515
  41. Gerber GB, Léonard A. Mutagenicity, carcinogenicity and teratogenicity of germanium compounds. Mutat Res. 1997 Dec;387(3):141-46. doi: 10.1016/s1383-5742(97)00034-3
  42. Vereshchagina IaA, Alimova AZ, Chachkov DV, Ishmaeva EA , Kochina TA. Poliarnost i stroenie 1,1-digalogeno-2, 8-dioksa-5-azagermokanov. Zhurn Organ Khimii. 2015;51(5):765-66. http://www.chachkov.ru/mediawiki/images /c/c3/Russian_Journal_of_Organic_Chemistry-2015_N5_Vereshchagina_ru.pdf (In Russ.)
  43. Unakar NJ, Tsui J, Johnson M. Effect of pretreatment of germanium-132 on Na(+)-K(+)-ATPase and galactose cataracts. Curr Eye Res. 1997 Aug;16(8):832-37. doi: 10.1076/ceyr.16.8.832.8980
  44. Ogwapit S.M. Analysis of Ge-132 and development of a simple oral anticancer formulation. Biosci Horiz. 2011 Jun;4(2):128-39. doi: 10.1093/biohorizons/hzr015
  45. Nazarov EA, Kuzmanin SA. O nekotorykh bioaktivnykh pokrytiiakh implantatov. Ros Med-Biol Vestn im Akad IP Pavlova. 2016;24(1):149-54. doi: 10.17816/PAVLOVJ20161149-154 (In Russ.)
  46. Slawson RM, Van Dyke MI, Lee H, Trevors JT. Germanium and silver resistance, accumulation, and toxicity in microorganisms. Plasmid. 1992 Jan;27(1):72-79. doi: 10.1016/0147-619x(92)90008-x
  47. Ukolova NY, Surkichin SI, Matel SK, Isaev AD, Ambrosov IV, Dirsh AV. Organogermanic peels: application method and efficacy evaluation. Klin Dermatologiia i Venerologiia. 2017;16(1):49-56. doi: 10.17116/klinderma201716149-56 (In Russ.)
  48. Ukolova NY, Matel SK, Isaev AD, Ambrosov IV, Dirsh AV, Kostkina EA. Innovative intradermal implants other drugs containing the germanium-organic complex: methods of injection and effects on various skin layers. Klin Dermatologiia i Venerologiia. 2018;17(5):151-57. doi: 10.17116/klinderma201817051151 (In Russ.)
  49. Tymchyshin OL. Hepatoprotective activity of a new germanium-organic biologically active substance (medgerm) in experimental hepatitis. Kazan Med Zhurn. 2013;94(5):628-32. doi: 10.17816/KMJ1905 (In Russ.)
  50. Karal-ogly D.D, Agrba V Z, Lavrenteva IN, Ambrosov IV, Matelo S K, Chuguev YuP, Gvaramiya IA, Gvozdik TE, Mukhametzyanova E I. Physiological parameters of Macaca Fascicularis immunized with anti-rubella vaccine with germanium-based adjuvants. Vestn Eksperim Biologii i Meditsiny. 2014;157(1):81-84. doi: 10.1007/s10517-014-2497-x (In Russ.)
  51. Tomljenovic L, Shaw CA. Mechanisms of aluminum adjuvant toxicity and autoimmunity in pediatric populations. Lupus. 2012 Feb;21(2):223-30. doi: 10.1177/0961203311430221
  52. Wang QM, Huang RQ. Synthesis and biological activity of novel N-tert-butyl-N,N-substitutedbenzoylhydrazines containing 2-methyl-3-(triphenylgermanyl) propoxycarbony. Appl Organometal Chem. 2002;16(10):593-96. doi: 10.1002/aoc.351
  53. Swami M, Singh RV. Sulfur-Bonded Organogermanium (IV) Complexes of Biopotent Bases and Their Antiandrogen and Biocidal Properties. Phosphorus Sulfur Silicon Relat Elem. 2008;183(6):1350-64. doi: 10.1080/10426500701641452
  54. Feng C, Ouyang J, Tang Z, Kong N, Liu Y, Fu L, Ji X, Xie T, Farokhzad OC, Tao W. Germanene-based theranostic materials for surgical adjuvant treatment: inhibiting tumor recurrence and wound infection. Matter. 2020 Jul;3(1):127-44. doi: 10.1016/j.matt.2020.04.022
Address for correspondence:
603950, Russian Federation,
Nizhny Novgorod, Minin Square, 10/1,
Privolzhsky Research Medical University,
General Chemistry Department,
tel. +7(910)872-41-51,
e-mail: kadomtseva@pimunn.ru,
Kadomtseva Alena V.
Information about the authors:
Kadomtseva Alena V., PhD, Senior Lecturer of the General Chemistry Department, Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation.
http://orcid.org/0000-0002-6962-0625
Loginova Lyubov B., Head of the Laboratory of the General Chemistry Department, Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation.
https://orcid.org/0000-0002-4917-2802
Zarubenko Polina A., Assistant of the General, Operative Surgery and Topographic Anatomy Named after A.I.Kozhevnikov, Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation.
https://orcid.org/0000-0001-7288-8625
DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.347   |  

R.N. KOMAROV, A.M. ISMAILBAEV, P.P. FROLOV, B.M. TLISOV

AN AORTIC VALVE-SPARING OPERATION: INDICATIONS, TECHNICAL ASPECTS AND RESULTS

Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow,
The Russian Federation

Reconstructive valve-sparing procedures on the aortic valve are one of the most dynamically developing directions in the cardiac surgery. Today cardiac surgeons all over the world prefer the aortic valve sparing operation using autologous tissues instead biological and mechanical prosthetics. The Ross, Yakub, David, Ozaki procedures have proved their effectives, and their indicators of long-term freedom from reoperations are not inferior to classical prosthetics. In this review the authors describe the key points of the native aortic valve reconstruction. Especially, from the surgical point of view the issues of anatomy of the aortic root and the determination of the optimal patients for the valve-sparing procedure are discussed. The principles of reconstruction of various variants of valve development, such as uni-, bi-, three-, and quadricuspid valve anatomy, are presented in details. The approaches to aortic valve repair are described step by step, including a description of the aortic root exposure technique, options for correcting prolapse, eliminating fenestration, and annuloplasty. The evaluation of literature data showed that the overall risks of aortic valve repair in isolation or as a component of a combined intervention are nothigher than in patients with biological or mechanical prosthetics. The violation of the orientation of the commissures, the use of a pericardial catheter, long-term prolapse, as well as expansion of the annulus fibrous are considred as an independent risk factors of significant regurgitation and reoperations in the long term after reconstruction.

Keywords: reconstructive valve-sparing interventions, aortic valve, regurgitation, stenosis, autologous tissues, aortic root, prosthetics of the valves
p. 347-359 of the original issue
References
  1. Taylor W, Thrower W, Black H, Harken DE. The surgical correction of aortic insufficiency by circumclusion. J Thorac Surg. 1958 Feb;35(2):192-205 passim. doi: 10.1016/S0096-5588(20)30272-5
  2. Ross DN. Surgical reconstruction of the aortic valve. Lancet. 1963 Mar 16;1(7281):571-74. doi: 10.1016/s0140-6736(63)92687-4
  3. David TE, Feindel CM. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg. 1992 Apr;103(4):617-21; discussion 622. doi: 10.1016/S0022-5223(19)34942-6
  4. Yacoub MH, Gehle P, Chandrasekaran V, Birks EJ, Child A, Radley-Smith R. Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root. J Thorac Cardiovasc Surg. 1998 May;115(5):1080-90. doi: 10.1016/S0022-5223(98)70408-8
  5. El Khoury G, de Kerchove L. Principles of aortic valve repair. J Thorac Cardiovasc Surg. 2013 Mar;145(3 Suppl):S26-29. doi: 10.1016/j.jtcvs.2012.11.071
  6. Yousry M, Rickenlund A, Petrini J, Jenner J, Liska J, Eriksson P, Franco-Cereceda A, Eriksson MJ, Caidahl K. Aortic valve type and calcification as assessed by transthoracic and transoesophageal echocardiography. Clin Physiol Funct Imaging. 2015 Jul;35(4):306-13. doi: 10.1111/cpf.12166
  7. Regeer MV, Versteegh MI, Klautz RJ, Stijnen T, Schalij MJ, Bax JJ, Ajmone Marsan N, Delgado V. Aortic valve repair versus replacement for aortic regurgitation: effects on left ventricular remodeling. J Card Surg. 2015 Jan;30(1):13-19. doi: 10.1111/jocs.12457
  8. Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH. Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. J Am Coll Cardiol. 2000 Oct;36(4):1152-58. doi: 10.1016/s0735-1097(00)00834-2
  9. Frater RW. Aortic valve insufficiency due to aortic dilatation: correction by sinus rim adjustment. Circulation. 1986 Sep;74(3 Pt 2):I136-42.
  10. Durán CM, Alonso J, Gaite L, Alonso C, Cagigas JC, Marce L, Fleitas MG, Revuelta JM. Long-term results of conservative repair of rheumatic aortic valve insufficiency. Eur J Cardiothorac Surg. 1988;2(4):217-23. doi: 10.1016/1010-7940(88)90075-9
  11. Cosgrove DM, Rosenkranz ER, Hendren WG, Bartlett JC, Stewart WJ. Valvuloplasty for aortic insufficiency. J Thorac Cardiovasc Surg. 1991 Oct;102(4):571-76; discussion 576-7. https://www.jtcvs.org/article/S0022-5223(20)31429-X/pdf
  12. Boodhwani M, El Khoury G. Aortic Valve Repair. Op Tech Thorac Cardiovasc Surg. 2009 Dec 01;14(4):266-80. doi: 10.1053/j.optechstcvs.2009.11.002
  13. Boodhwani M, El Khoury G, de Kerchove L. Graft sizing for aortic valve sparing surgery. Ann Cardiothorac Surg. 2013 Jan;2(1):140-43. doi: 10.3978/j.issn.2225-319X.2013.01.13
  14. de Kerchove L, Jashari R, Boodhwani M, Duy KT, Lengelé B, Gianello P, Mosala Nezhad Z, Astarci P, Noirhomme P, El Khoury G. Surgical anatomy of the aortic root: implication for valve-sparing reimplantation and aortic valve annuloplasty. J Thorac Cardiovasc Surg. 2015 Feb;149(2):425-33. doi: 10.1016/j.jtcvs.2014.09.042
  15. Kunzelman KS, Grande KJ, David TE, Cochran RP, Verrier ED. Aortic root and valve relationships. Impact on surgical repair. J Thorac Cardiovasc Surg. 1994 Jan;107(1):162-70.
  16. Schäfers HJ. Aortic annuloplasty: a new aspect of aortic valve repair. Eur J Cardiothorac Surg. 2012 May;41(5):1124-25. doi: 10.1093/ejcts/ezr284
  17. Mangini A, Contino M, Romagnoni C, Lemma M, Gelpi G, Vanelli P, Colombo S, Antona C. Aortic valve repair: a ten-year single-centre experience. Interact Cardiovasc Thorac Surg. 2014 Jul;19(1):28-35. doi: 10.1093/icvts/ivu058
  18. Evangelista A, Flachskampf FA, Erbel R, Sicari R, Nihoyannopoulos P, Zamorano J; European Association of Echocardiography; Document Reviewers: Pepi M, Breithardt OA, Plonska-Gosciniak E. Echocardiography in aortic diseases: EAE recommendations for clinical practice. Eur J Echocardiogr. 2010 Sep;11(8):645-58. doi: 10.1093/ejechocard/jeq056
  19. Loukas M, Bilinsky E, Bilinsky S, Blaak C, Tubbs RS, Anderson RH. The anatomy of the aortic root. Clin Anat. 2014 Jul;27(5):748-56. doi: 10.1002/ca.22295
  20. Schäfers HJ, Bierbach B, Aicher D. A new approach to the assessment of aortic cusp geometry. J Thorac Cardiovasc Surg. 2006 Aug;132(2):436-68. doi: 10.1016/j.jtcvs.2006.04.032
  21. Oka T, Okita Y, Matsumori M, Okada K, Minami H, Munakata H, Inoue T, Tanaka A, Sakamoto T, Omura A, Nomura T. Aortic regurgitation after valve-sparing aortic root replacement: modes of failure. Ann Thorac Surg. 2011 Nov;92(5):1639-44. doi: 10.1016/j.athoracsur.2011.06.080
  22. Lansac E, Di Centa I, Sleilaty G, Lejeune S, Khelil N, Berrebi A, Diakov C, Mankoubi L, Malergue MC, Noghin M, Zannis K, Salvi S, Dervanian P, Debauchez M. Long-term results of external aortic ring annuloplasty for aortic valve repair. Eur J Cardiothorac Surg. 2016 Aug;50(2):350-60. doi: 10.1093/ejcts/ezw070
  23. Bierbach BO, Aicher D, Issa OA, Bomberg H, Gräber S, Glombitza P, Schäfers HJ. Aortic root and cusp configuration determine aortic valve function. Eur J Cardiothorac Surg. 2010 Oct;38(4):400-6. doi: 10.1016/j.ejcts.2010.01.060
  24. Sharma V, Suri RM, Dearani JA, Burkhart HM, Park SJ, Joyce LD, Li Z, Schaff HV. Expanding relevance of aortic valve repair-is earlier operation indicated? J Thorac Cardiovasc Surg. 2014 Jan;147(1):100-7. doi: 10.1016/j.jtcvs.2013.08.015
  25. Boodhwani M, El Khoury G. Aortic valve repair: indications and outcomes. Curr Cardiol Rep. 2014;16(6):490. doi: 10.1007/s11886-014-0490-7
  26. dUdekem Y, Siddiqui J, Seaman CS, Konstantinov IE, Galati JC, Cheung MM, Brizard CP. Long-term results of a strategy of aortic valve repair in the pediatric population. J Thorac Cardiovasc Surg. 2013 Feb;145(2):461-67; discussion 467-9. doi: 10.1016/j.jtcvs.2012.11.033
  27. Schäfers HJ, Schmied W, Marom G, Aicher D. Cusp height in aortic valves. J Thorac Cardiovasc Surg. 2013 Aug;146(2):269-74. doi: 10.1016/j.jtcvs.2012.06.053
  28. Totaro P, Morganti S, Yon CL, Dore R, Conti M, Auricchio F, Vigano M. Computational finite element analyses to optimize graft sizing during aortic valve-sparing procedure. J Heart Valve Dis. 2012 Mar;21(2):141-47. https://pubmed.ncbi.nlm.nih.gov/22645846/
  29. Lansac E, de Kerchove L. Aortic valve repair techniques: state of the art. Eur J Cardiothorac Surg. 2018 Jun 1;53(6):1101-07. doi: 10.1093/ejcts/ezy176
  30. Arnaoutakis G, Sultan I, Siki M, Bavaria J. Bicuspid aortic valve repair: systematic review on long-term outcomes. Ann Cardiothorac Surg. 2019 May;8(3):302-12. doi: 10.21037/acs.2019.05.08
  31. Singh S, Ghayal P, Mathur A, Mysliwiec M, Lovoulos C, Solanki P, Klapholz M, Maher J. Unicuspid unicommissural aortic valve: an extremely rare congenital anomaly. Tex Heart Inst J. 2015 Jun 1;42(3):273-76. doi: 10.14503/THIJ-13-3634
  32. Yuan SM. Quadricuspid Aortic Valve: A Comprehensive Review. Braz J Cardiovasc Surg. 2016 Nov-Dec;31(6):454-60. doi: 10.5935/1678-9741.20160090
  33. Wong CHM, Chan JSK, Sanli D, Rahimli R, Harky A. Aortic valve repair or replacement in patients with aortic regurgitation: A systematic review and meta-analysis. J Card Surg. 2019 Jun;34(6):377-84. doi: 10.1111/jocs.14032
  34. Carpentier A. Cardiac valve surgery the French correction. J Thorac Cardiovasc Surg. 1983 Sep;86(3):323-37. 10.1016/S0022-5223 (19)39144-5
  35. Schäfers HJ. The 10 Commandments for Aortic Valve Repair. Innovations (Phila). 2019 Jun;14(3):188-98. doi: 10.1177/1556984519843909
  36. Cheruvu C, Mathur G, Akhunji Z, Grant P, Wolfenden H, Cranney G. Aortic Valve Fenestration An Under Reported Observation in Aortic Regurgitation. Heart Lung Circ. 2013;22(1):165. doi: 10.1016/j.hlc.2013.05.394
  37. David TE, Armstrong S. Aortic cusp repair with Gore-Tex sutures during aortic valve-sparing operations. J Thorac Cardiovasc Surg. 2010 May;139(5):1340-42. doi: 10.1016/j.jtcvs.2009.06.010
  38. de Kerchove L, Boodhwani M, Glineur D, Poncelet A, Rubay J, Watremez C, Vanoverschelde JL, Noirhomme P, El Khoury G. Cusp prolapse repair in trileaflet aortic valves: free margin plication and free margin resuspension techniques. Ann Thorac Surg. 2009 Aug;88(2):455-61; discussion 461. doi: 10.1016/j.athoracsur.2009.04.064
  39. Losenno K, Johnson M, Chu M. 688 Fenestrations of the Aortic Valve Cusps: Are They Related to Variations in Cusp Size? Can J Cardiol. 2012; 28(5 Suppl):361. doi: 10.1016/j.cjca.2012.07.622
  40. Schäfers HJ, Langer F, Glombitza P, Kunihara T, Fries R, Aicher D. Aortic valve reconstruction in myxomatous degeneration of aortic valves: are fenestrations a risk factor for repair failure? J Thorac Cardiovasc Surg. 2010 Mar;139(3):660-64. doi: 10.1016/j.jtcvs.2009.06.025
  41. Tekumit H, Cenal AR, Tataroglu C, Uzun K, Polat A, Akinci E. Cusp shaving for concomitant mild to moderate rheumatic aortic insufficiency. J Card Surg. 2010 Jan-Feb;25(1):16-22. doi: 10.1111/j.1540-8191.2009.00948.x
  42. Haydar HS, He GW, Hovaguimian H, McIrvin DM, King DH, Starr A. Valve repair for aortic insufficiency: surgical classification and techniques.Eur J Cardiothorac Surg. 1997 Feb;11(2):258-65. doi: 10.1016/s1010-7940(96)01014-7
  43. Pretre R, Kadner A, Dave H, Bettex D, Genoni M. Tricuspidisation of the aortic valve with creation of a crown-like annulus is able to restore a normal valve function in bicuspid aortic valves. Eur J Cardiothorac Surg. 2006 Jun;29(6):1001-6. doi: 10.1016/j.ejcts.2006.01.068
  44. Schäfers HJ, Aicher D, Riodionycheva S, Lindinger A, Rädle-Hurst T, Langer F, Abdul-Khaliq H. Bicuspidization of the unicuspid aortic valve: a new reconstructive approach. Ann Thorac Surg. 2008 Jun;85(6):2012-18. doi: 10.1016/j.athoracsur.2008.02.081
  45. Aicher D, Kunihara T, Abou Issa O, Brittner B, Gräber S, Schäfers HJ. Valve configuration determines long-term results after repair of the bicuspid aortic valve. Circulation. 2011 Jan 18;123(2):178-85. doi: 10.1161/CIRCULATIONAHA.109.934679
  46. Luciani GB, Morjan M, Faggian G, Mazzucco A. Repair of quadricuspid aortic valve by bicuspidization: a novel technique. Interact Cardiovasc Thorac Surg. 2010 Sep;11(3):348-50. doi: 10.1510/icvts.2010.237404
  47. Kunihara T, Aicher D, Rodionycheva S, Groesdonk HV, Langer F, Sata F, Schäfers HJ. Preoperative aortic root geometry and postoperative cusp configuration primarily determine long-term outcome after valve-preserving aortic root repair. J Thorac Cardiovasc Surg. 2012 Jun;143(6):1389-95. doi: 10.1016/j.jtcvs.2011.07.036
  48. Basmadjian L, Basmadjian AJ, Stevens LM, Mongeon FP, Cartier R, Poirier N, El Hamamsy I. Early results of extra-aortic annuloplasty ring implantation on aortic annular dimensions. J Thorac Cardiovasc Surg. 2016 May;151(5):1280-85.e1. doi: 10.1016/j.jtcvs.2015.12.014
  49. Aicher D, Fries R, Rodionycheva S, Schmidt K, Langer F, Schäfers HJ. Aortic valve repair leads to a low incidence of valve-related complications.Eur J Cardiothorac Surg. 2010 Jan;37(1):127-32. doi: 10.1016/j.ejcts.2009.06.021
  50. Jamieson WR, Burr LH, Miyagishima RT, Germann E, Macnab JS, Stanford E, Chan F, Janusz MT, Ling H. Carpentier-Edwards supra-annular aortic porcine bioprosthesis: clinical performance over 20 years. J Thorac Cardiovasc Surg. 2005 Oct;130(4):994-1000. doi: 10.1016/j.jtcvs.2005.03.040
  51. Tan Z, Valchanov K, Klein A. Complications in aortic surgery: are CSF drains to be blamed? Comment on Br J Anaesth 2018; 120: 904-913. Br J Anaesth. 2018 Oct;121(4):987. doi: 10.1016/j.bja.2018.07.018
  52. El Khoury G, Vanoverschelde JL, Glineur D, Pierard F, Verhelst RR, Rubay J, Funken JC, Watremez C, Astarci P, Lacroix V, Poncelet A, Noirhomme P. Repair of bicuspid aortic valves in patients with aortic regurgitation. Circulation. 2006 Jul 4;114(1 Suppl):I610-16. doi: 10.1161/CIRCULATIONAHA.105.001594
  53. Casselman FP, Gillinov AM, Akhrass R, Kasirajan V, Blackstone EH, Cosgrove DM. Intermediate-term durability of bicuspid aortic valve repair for prolapsing leaflet. Eur J Cardiothorac Surg. 1999 Mar;15(3):302-8. doi: 10.1016/s1010-7940(99)00003-2
  54. Beroukhim RS, Graham DA, Margossian R, Brown DW, Geva T, Colan SD. An echocardiographic model predicting severity of aortic regurgitation in congenital heart disease. Circ Cardiovasc Imaging. 2010 Sep;3(5):542-49. doi: 10.1161/CIRCIMAGING.110.957175
  55. Elkins RC, Knott-Craig CJ, McCue C, Lane MM. Congenital aortic valve disease. Improved survival and quality of life. Ann Surg. 1997 May;225(5):503-10; discussion 510-1. doi: 10.1097/00000658-199705000-00007
Address for correspondence:
119435, Russian Federation, Moscow,
Bolshaya Pirogovskaya Str., 6,1,
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University),
the Faculty Surgery Department
tel. +7 915 335-10-06,
e-mail: borya0994@inbox.ru,
Tlisov Boris M.
Information about the authors:
Komarov Roman N., MD, Head of the Faculty Surgery Department No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0002-3904-6415
Ismailbaev Alisher M., PhD, Assistant of the Faculty Surgery Department No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0001-8545-3276
Frolov Pavel P., Cardiovascular Surgeon of the Cardiac Surgery Unit of the University Clinical Hospital No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
http://orcid.org/0000-0003-1532-0173
Tlisov Boris M., Cardiovascular Surgeon of the Cardiac Surgery Unit of the University Clinical Hospital No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0003-4094-8771
DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.360   |  

A.S. TOLSTOKOROV, A.N. KULIKOVA, I.V.LARIN

CURRENT ASPECTS OF DIAGNOSIS AND TREATMENT OF ATHEROSCLEROSIS OF THE LOWER EXTREMITIES ARTERIES IN PATIENTS WITH DIABETIC FOOT SYNDROME

Saratov State Medical University named after V.I.Razumovsky, Saratov,
The Russian Federation

Atherosclerosis of lower-extremity arterial disease is a common pathology in diabetes mellitus, contributing to the development of ischemic and neuroischemic forms of diabetic foot syndrome. Early diagnosis of vascular lesions helps to reduce the number of cardiovascular complications, performed amputations and improves the quality of life in these patients.The review presents the current arsenal of modern comprehensive examinations of patients with diabetic foot syndrome, including clinical and functional screening, non-invasive and invasive methods of radiological diagnosis, as well as specific assessment scales and new classifications that allow detailing and systematizing trophic foot changes with the ability to predict the course of the pathological process occurring at sites. The using of open revascularization methods helps to achieve the healing of diabetic ulcers in a large percentage of cases, but the point is the problems associated with the localization of the lesion, the choice of conduit for bypass surgery and technical aspects significantly limit the possibilities of this treatment method. Recent technological advances in the development of endovascular surgery have expanded the indications for successful revascularization. The article highlights the results of shunting and endovascular methods in the treatment of atherosclerotic process in infrainguinal area in patients with diabetic foot syndrome.

Keywords: atherosclerosis, arteries of the lower limbs, diabetic foot syndrome, diabetes mellitus, revascularization
p. 360-369 of the original issue
References
  1. Hinchliffe RJ, Andros G, Apelqvist J, Bakker K, Friederichs S, Lammer J, Lepantalo M, Mills JL, Reekers J, Shearman CP, Valk G, Zierler RE, Schaper NC. A systematic review of the effectiveness of revascularization of the ulcerated foot in patients with diabetes and peripheral arterial disease. Diabetes Metab Res Rev. 2012 Feb;28(Suppl 1):179-17. doi: 10.1002/dmrr.2249
  2. Behroozian A, Beckman JA. Microvascular disease increases amputation in patients with peripheral artery disease. Arterioscler Thromb Vasc Biol. 2020 Mar;40(3):534-40. doi: 10.1161/ATVBAHA.119.312859
  3. Richter L, Freisinger E, Lüders F, Gebauer K, Meyborg M, Malyar NM. Impact of diabetes type on treatment and outcome of patients with peripheral artery disease. Diab Vasc Dis Res. 2018 Nov;15(6):504-10 doi: 10.1186/s12933-017-0524-8
  4. Aboyans V, Ricco JB, Bartelink MEL, Björck M, Brodmann M, Cohnert T, Collet JP, Czerny M, De Carlo M, Debus S, Espinola-Klein C, Kahan T, Kownator S, Mazzolai L, Naylor AR, Roffi M, Röther J, Sprynger M, Tendera M, Tepe G, Venermo M, Vlachopoulos C, Desormais I; ESC Scientific Document Group. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task force for the diagnosis and treatment of peripheral arterial diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018 Mar 1;39(9):763-16. doi: 10.1093/eurheartj/ehx095
  5. Ozdemir BA, Brownrigg JR, Jones KG, Thompson MM, Hinchliffe RJ. Systematic review of screening investigations for peripheral arterial disease in patients with diabetes mellitus. Surg Technol Int. 2013 Sep;23:51-58.
  6. Bunte MC, Jacob J, Nudelman B, Shishehbor MH. Validation of the relationship between ankle-brachial and toe-brachial indices and infragenicular arterial patency in critical limb ischemia. Vasc Med. 2015 Feb;20(1):23-29. doi: 10.1177/1358863X14565372
  7. Jeevanantham V, Chehab B, Austria E, Shrivastava R, Wiley M, Tadros P, Dawn B, Vacek JL, Gupta K. Comparison of accuracy of two different methods to determine ankle-brachial index to predict peripheral arterial disease severity confirmed by angiography. Am J Cardiol. 2014 Oct 1;114(7):1105-10. doi: 10.1016/j.amjcard.2014.07.023
  8. Hyun S, Forbang NI, Allison MA, Denenberg JO, Criqui MH, Ix JH. Ankle-brachial index, toe-brachial index, and cardiovascular mortality in persons with and without diabetes mellitus. J Vasc Surg. 2014 Aug;60(2):390-95. doi: 10.1016/j.jvs.2014.02.008
  9. Høyer C, Sandermann J, Petersen LJ. The toe-brachial index in the diagnosis of peripheral arterial disease. J Vasc Surg. 2013 Jul;58(1):231-38. doi: 10.1016/j.jvs.2013.03.044
  10. Vriens B, DAbate F, Ozdemir BA, Fenner C, Maynard W, Budge J, Carradice D, Hinchliffe RJ. Clinical examination and non-invasive screening tests in the diagnosis of peripheral artery disease in people with diabetes-related foot ulceration. Diabet Med. 2018 Jul;35(7):895-902 doi: 10.1111/dme.13634
  11. Hou XX, Chu GH, Yu Y. Prospects of contrast-enhanced ultrasonography for the diagnosis of peripheral arterial disease: a meta-analysis. J Ultrasound Med. 2018 May;37(5):1081-90. doi: 10.1002/jum.14451
  12. Durović Sarajlić V, Totić D, Bičo Osmanagić A, Gojak R, Lincender L. Is 64-row multi-detector computed tomography angiography equal to digital subtraction angiography in treatment planning in critical limb ischemia? Psychiatr Danub. 2019 Dec;31(Suppl 5):814-20. http://www.psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol31_noSuppl%205/dnb_vol31_noSuppl%205_814.pdf
  13. Palena LM, Diaz-Sandoval LJ, Candeo A, Brigato C, Sultato E, Manzi M. Automated carbon dioxide angiography for the evaluation and endovascular treatment of diabetic patients with critical limb ischemia. J Endovasc Ther. 2016 Feb;23(1):40-48. doi: 10.1177/1526602815616924
  14. Santema TB, Lenselink EA, Balm R, Ubbink DT. Comparing the Meggitt-Wagner and the University of Texas wound classification systems for diabetic foot ulcers: inter-observer analyses. Int Wound J. 2016 Dec;13(6):1137-41. doi: 10.1111/iwj.12429
  15. Cull DL, Manos G, Hartley MC, Taylor SM, Langan EM, Eidt JF, Johnson BL. An early validation of the Society for Vascular Surgery lower extremity threatened limb classification system. J Vasc Surg. 2014 Dec;60(6):1535-41. doi: 10.1016/j.jvs.2014.08.107
  16. Robinson WP, Loretz L, Hanesian C, Flahive J, Bostrom J, Lunig N, Schanzer A, Messina L. Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) score correlates with the intensity of multimodal limb treatment and patient-centered outcomes in patients with threatened limbs managed in a limb preservation center. J Vasc Surg. 2017 Aug;66(2):488-98 doi: 10.1016/j.jvs.2016.07.086
  17. Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg. 2019 Jun;69(6S):3S-125S.e40. doi: 10.1016/j.jvs.2019.02.016
  18. Almasri J, Adusumalli J, Asi N, Lakis S, Alsawas M, Prokop LJ, Bradbury A, Kolh P, Conte MS, Murad MH. A systematic review and meta-analysis of revascularization outcomes of infrainguinal chronic limb-threatening ischemia. Eur J Vasc Endovasc Surg. 2019 Jul;58(1S):S110-S119. doi: 10.1016/j.ejvs.2019.04.013
  19. Dorigo W, Pulli R, Castelli P, Dorrucci V, Ferilli F, De Blasis G, Monaca V, Vecchiati E, Pratesi C; Propaten Italian Registry Group. A multicenter comparison between autologous saphenous vein and heparin-bonded expanded polytetrafluoroethylene (ePTFE) graft in the treatment of critical limb ischemia in diabetics. J Vasc Surg. 2011 Nov;54(5):1332-38. doi: 10.1016/j.jvs.2011.05.046
  20. Ballotta E, Toniato A, Piatto G, Mazzalai F, Da Giau G. Lower extremity arterial reconstruction for critical limb ischemia in diabetes. J Vasc Surg. 2014 Mar;59(3):708-19. doi: 10.1016/j.jvs.2013.08.103
  21. Schanzer A, Hevelone N, Owens CD, Belkin M, Bandyk DF, Clowes AW, Moneta GL, Conte MS. Technical factors affecting autogenous vein graft failure: observations from a large multicenter trial. J Vasc Surg. 2007 Dec;46(6):1180-90; discussion 1190. doi: 10.1016/j.jvs.2007.08.033
  22. Brochado Neto F, Sandri GA, Kalaf MJ, Matielo MF, Casella IB, Godoy MR, Martins Cury MV, Sacilotto R. Arm vein as an alternative autogenous conduit for infragenicular bypass in the treatment of critical limb ischaemia: a 15 year experience. Eur J Vasc Endovasc Surg. 2014 Jun;47(6):609-14. doi: 10.1016/j.ejvs.2014.01.019
  23. Hinchliffe RJ, Forsythe RO, Apelqvist J, Boyko EJ, Fitridge R, Hong JP, Katsanos K, Mills JL, Nikol S, Reekers J, Venermo M, Zierler RE, Schaper NC; International Working Group on the Diabetic Foot (IWGDF). Guidelines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020 Mar;36(Suppl 1):e3276. doi: 10.1002/dmrr.3276
  24. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG; TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007 Jan;45(Suppl S):S5-67. doi: 10.1016/j.jvs.2006.12.037
  25. Hinchliffe RJ, Forsythe RO, Apelqvist J, Boyko EJ, Fitridge R, Hong JP, Katsanos K, Mills JL, Nikol S, Reekers J, Venermo M, Zierler RE, Schaper NC; International Working Group on the Diabetic Foot (IWGDF). Guidelines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020 Mar;36(Suppl 1):e3276. doi: 10.1002/dmrr.3276
  26. Kobayashi N, Hirano K, Yamawaki M, Araki M, Sakai T, Sakamoto Y, Mori S, Tsutsumi M, Honda Y, Tokuda T, Makino K, Shirai S, Ito Y. Characteristics and clinical outcomes of repeat endovascular therapy after infrapopliteal balloon angioplasty in patients with critical limb ischemia. Catheter Cardiovasc Interv. 2018 Feb 15;91(3):505-14. doi: 10.1002/ccd.27238
  27. Lo ZJ, Lin Z, Pua U, Quek LHH, Tan BP, Punamiya S, Tan GWL, Narayanan S, Chandrasekar S. Diabetic Foot limb salvage-a series of 809 attempts and predictors for endovascular limb salvage failure. Ann Vasc Surg. 2018 May;49:9-16. doi: 10.1016/j.avsg.2018.01.061
  28. Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg. 1987 Mar;40(2):113-41. doi: 10.1016/0007-1226(87)90185-8
  29. Biagioni RB, Biagioni LC, Nasser F, Burihan MC, Ingrund JC, Neser A, Miranda F Jr. Infrapopliteal angioplasty of one or more than one artery for critical limb ischaemia: a randomised clinical trial. Eur J Vasc Endovasc Surg. 2018 Apr;55(4):518-27. doi: 10.1016/j.ejvs.2017.12.022
  30. Cheun TJ, Jayakumar L, Sideman MJ, Pounds LC, Davies MG. Outcomes of isolated inframalleolar interventions for chronic limb-threatening ischemia in diabetic patients. J Vasc Surg. 2020 May;71(5):1644-652.e2. doi: 10.1016/j.jvs.2019.07.094
  31. Dormandy JA, Rutherford RB. Management of peripheral arterial disease (PAD): TASC Working Group: TransAtlantic Inter-Society Consensus (TASC). J Vasc Surg 2000;31(1 Pt 2):S1-S296. doi: 10.1016/S0741-5214(00)81002-2
  32. Laird JR, Katzen BT, Scheinert D, Lammer J, Carpenter J, Buchbinder M, Dave R, Ansel G, Lansky A, Cristea E, Collins TJ, Goldstein J, Jaff MR; RESILIENT Investigators. Nitinol stent implantation versus balloon angioplasty for lesions in the superficial femoral artery and proximal popliteal artery: twelve-month results from the RESILIENT randomized trial. Circ Cardiovasc Interv. 2010 Jun 1;3(3):267-76. doi: 10.1161/CIRCINTERVENTIONS.109.903468
  33. Schillinger M, Sabeti S, Dick P, Amighi J, Mlekusch W, Schlager O, Loewe C, Cejna M, Lammer J, Minar E. Sustained benefit at 2 years of primary femoropopliteal stenting compared with balloon angioplasty with optional stenting. Circulation. 2007 May 29;115(21):2745-49. doi: 10.1161/CIRCULATIONAHA.107.688341
  34. Chalmers N, Walker PT, Belli AM, Thorpe AP, Sidhu PS, Robinson G, van Ransbeeck M, Fearn SA. Randomized trial of the SMART stent versus balloon angioplasty in long superficial femoral artery lesions: the SUPER study. Cardiovasc Intervent Radiol. 2013 Apr;36(2):353-61. doi: 10.1007/s00270-012-0492-z
  35. Scheinert D, Scheinert S, Sax J, Piorkowski C, Bräunlich S, Ulrich M, Biamino G, Schmidt A. Prevalence and clinical impact of stent fractures after femoropopliteal stenting. J Am Coll Cardiol. 2005 Jan 18;45(2):312-15. doi: 10.1016/j.jacc.2004.11.026
  36. Davaine JM, Azéma L, Guyomarch B, Chaillou P, Costargent A, Patra P, Lambert G, Goueffic Y. One-year clinical outcome after primary stenting for Trans-Atlantic Inter-Society Consensus (TASC) C and D femoropopliteal lesions (the STELLA STEnting Long de LArtère fémorale uperficielle cohort). Eur J Vasc Endovasc Surg. 2012 Oct;44(4):432-41. doi: 10.1016/j.ejvs.2012.07.015
  37. Chan YC, Cheng SW, Ting AC, Cheung GC. Primary stenting of femoropopliteal atherosclerotic lesions using new helical interwoven nitinol stents. J Vasc Surg. 2014 Feb;59(2):384-91. doi: 10.1016/j.jvs.2013.08.037
  38. Schmidt A, Piorkowski M, Werner M, Ulrich M, Bausback Y, Bräunlich S, Ick H, Schuster J, Botsios S, Kruse HJ, Varcoe RL, Scheinert D. First experience with drug-eluting balloons in infrapopliteal arteries: restenosis rate and clinical outcome. J Am Coll Cardiol. 2011 Sep 6;58(11):1105-109. doi: 10.1016/j.jacc.2011.05.034
  39. Zeller T, Baumgartner I, Scheinert D, Brodmann M, Bosiers M, Micari A, Peeters P, Vermassen F, Landini M, Snead DB, Kent KC, Rocha-Singh KJ; IN.PACT DEEP Trial Investigators. Drug-eluting balloon versus standard balloon angioplasty for infrapopliteal arterial revascularization in critical limb ischemia: 12-month results from the IN.PACT DEEP randomized trial. J Am Coll Cardiol. 2014 Oct 14;64(15):1568-76. doi: 10.1016/j.jacc.2014.06.1198
  40. Schneider PA, Laird JR, Tepe G, Brodmann M, Zeller T, Scheinert D, Metzger C, Micari A, Sachar R, Jaff MR, Wang H, Hasenbank MS, Krishnan P; IN.PACT SFA Trial Investigators. Treatment effect of drug-coated balloons is durable to 3 years in the femoropopliteal arteries: long-term results of the IN.PACT SFA Randomized Trial. Circ Cardiovasc Interv. 2018 Jan;11(1):e005891. doi: 10.1161/CIRCINTERVENTIONS.117.005891
  41. Katsanos K, Spiliopoulos S, Kitrou P, Krokidis M, Karnabatidis D. Risk of death following application of paclitaxel-coated balloons and stents in the femoropopliteal artery of the leg: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc. 2018 Dec 18;7(24):e011245. doi: 10.1161/JAHA.118.011245
  42. Ouriel K, Adelman MA, Rosenfield K, Scheinert D, Brodmann M, Peña C, Geraghty P, Lee A, White R, Clair DG. Safety of Paclitaxel-Coated Balloon Angioplasty for Femoropopliteal Peripheral Artery Disease. JACC Cardiovasc Interv. 2019 Dec 23;12(24):2515-24. doi: 10.1016/j.jcin.2019.08.025
  43. Ipema J, Huizing E, Schreve MA, de Vries JPM, Ünlü Ç. Editors Choice Drug Coated Balloon Angioplasty vs. Standard percutaneous transluminal angioplasty in below the knee peripheral arterial disease: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2020 Feb;59(2):265-75. doi: 10.1016/j.ejvs.2019.10.002
  44. Rastan A, Tepe G, Krankenberg H, Zahorsky R, Beschorner U, Noory E, Sixt S, Schwarz T, Brechtel K, Böhme C, Neumann FJ, Zeller T. Sirolimus-eluting stents vs. bare-metal stents for treatment of focal lesions in infrapopliteal arteries: a double-blind, multi-centre, randomized clinical trial. Eur Heart J. 2011 Sep;32(18):2274-81. doi: 10.1093/eurheartj/ehr144
  45. Scheinert D, Katsanos K, Zeller T, Koppensteiner R, Commeau P, Bosiers M, Krankenberg H, Baumgartner I, Siablis D, Lammer J, Van Ransbeeck M, Qureshi AC, Stoll HP; ACHILLES Investigators. A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the sirolimus-eluting stent in patients with ischemic peripheral arterial disease: 1-year results from the ACHILLES trial. J Am Coll Cardiol. 2012 Dec 4;60(22):2290-95. doi: 10.1016/j.jacc.2012.08.989
  46. Bosiers M, Scheinert D, Peeters P, Torsello G, Zeller T, Deloose K, Schmidt A, Tessarek J, Vinck E, Schwartz LB. Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease. J Vasc Surg. 2012 Feb;55(2):390-98. doi: 10.1016/j.jvs.2011.07.099
  47. Bausback Y, Wittig T, Schmidt A, Zeller T, Bosiers M, Peeters P, Brucks S, Lottes AE, Scheinert D, Steiner S. Drug-eluting stent versus drug-coated balloon revascularization in patients with femoropopliteal arterial disease. J Am Coll Cardiol. 2019 Feb 19;73(6):667-79. doi: 10.1016/j.jacc.2018.11.039
  48. Adam DJ, Beard JD, Cleveland T, Bell J, Bradbury AW, Forbes JF, Fowkes FG, Gillepsie I, Ruckley CV, Raab G, Storkey H; BASIL trial participants. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet. 2005 Dec 3;366(9501):1925-34. doi: 10.1016/S0140-6736(05)67704-5
  49. Jones WS, Dolor RJ, Hasselblad V, Vemulapalli S, Subherwal S, Schmit K, Heidenfelder B, Patel MR. Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia: systematic review of revascularization in critical limb ischemia. Am Heart J. 2014 Apr;167(4):489-98.e7. doi: 10.1016/j.ahj.2013.12.012
Address for correspondence:
410012 Russian Federation,
Saratov, Bolshaya Kazachya Str., 112,
Saratov State Medical University
named after V.I. Razumovsky,
the Department of Surgery and Oncology,
tel. office: 898-73-07-84-31,
e-mail: i.larin.v@yandex.ru,
Larin Igor V.
Information about the authors:
Tolstokorov Aleksandr S., MD, Professor, Head of the Department of Surgery and Oncology, Saratov State Medical University Named after V.I.Razumovsky of the Ministry of Health of Russia, Saratov, Russian Federation.
https://orcid.org/0000-0002-8541-5330
Kulikova Alla N., MD, Professor of the Hospital Surgery Department of the Medical Faculty, Saratov State Medical University Named after V.I.Razumovsky of the Ministry of Health of Russia, Saratov, Russian Federation.
https://orcid.org/0000-0002-7116-4219
Larin Igor V., Post-Graduate Student of the Department of Surgery and Oncology, Saratov State Medical University Named after V.I.Razumovsky of the Ministry of Health of Russia, Saratov, Russian Federation.
https://orcid.org/0000-0001-7979-3071

CASE REPORTS

DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.370   |  

A.N. NECHIPORENKO 1, N.A. NECHIPORENKO 1, D.M. VASILEVICH 2, V.A. BASINSKY 1, A.S NECHIPORENKO 2, N.L. GAVINA 2

XANTHOGRANULOMATOUS PYELONEPHRITIS A RARE FORM OF CHRONIC CALCULOUS PYELONEPHRITIS

Grodno State Medical University 1,
Grodno University Hospital 2, Grodno,
The Republic of Belarus

The article represents the authors own observation of the patient with xanthogranulomatous pyelonephritis (XPN). Xanthogranulomatous pyelonephritis is a rare form of chronic bacterial calculous pyelonephritis. Factors predisposing to the development of xanthogranulomatous pyelonephritis include the following: the impairment of the urinary flow along the urinary tract, type II diabetes mellitus, and chronic inflammation of the kidney.
XPN is an uncommon cause of chronic pyelonephritis resulting in non-functioning kidneys and poses a preoperative diagnostic dilemma which may mimic other malignant diseases of a kidney (renal cell carcinoma, leiomyosarcoma) and acute pyelonephritis as a bacterial infection causing inflammation of the kidneys (a renal carbuncle). The patient was examined at the urology clinic of .Grodno State Medical University: general clinical blood and urine tests, ultrasound examination, X-ray computed tomography native and with contrast enhancement, magnetic resonance imaging were performed. The patient underwent nephrectomy due to the impossibility of organ-preserving surgery removal of a volumetric formation located at the hilum of the kidney and adjacent to the vessels. Histopathology of the specimen was concluded as xanthogranulomatous pyelonephritis. The patients underwent MR examinations, ultrasound examination and X-ray computed tomography with contrast enhancement, but a diagnosis of xanthogranulomatous pyelonephritis was not confirmed unequivocally. The final diagnosis is usually established only after histologic examination of biopsy specimens of removed kidney.

Keywords: xanthogranulomatous pyelonephritis, computed tomography, MR examination, nephrectomy, microscopic examination
p. 370-375 of the original issue
References
  1. Clapton WK, Boucaut HA, Dewan PA, Bourne AJ, Byard RW. Clinicopathological features of xanthogranulomatous pyelonephritis in infancy. Pathology. 1993 Apr;25(2):110-13. doi: 10.3109/00313029309084781
  2. Aljaev JuG, Grigorjan VA, Lokshin KL, Grigorev NA, Sultanova EA. Ostryj i ksantogranulematoznyj pielonefrit. Moscow, RF: GJeOTAR-Med; 2002. 24 p. (In Russ.)
  3. Alyaev Yu, Grigoryev N. Xanthogranulomatous pyelonephritis: the present view of the problem. Vrach. 2009;(4):8-12. https://elibrary.ru/item.asp?id=12415656 (In Russ.)
  4. Neimark AI, Pavlovskaya ZA., Yakovets YV, Kostyuk NA, Pavlovsky SV, Volkova GA, Bekuzarov SS, Kozhutyakin IG, Zahvaev AE. Our experience to diagnose and treatment of patients with xanthogranulomatous pyelonephritis. Kazan Med Zhurn. 2008;(4):472-75. https://cyberleninka.ru/article/n/nash-opyt-diagnostiki-i-lecheniya-bolnyh-ksantogranulematoznym-pielonefritom. (In Russ.)
  5. Onopko VR, Rojanskif RV. Deryaguitr RB, Krivtborskaycr EV, Mulin MYu, Otchirov GG. A case of diffuse xanthogranulomatous pyelonephritis. Sib Med Zhurn. 2014;(5): 117-19. https://cyberleninka.ru/article/n/klinicheskoe-nablyudenie-diffuznogo-ksantogranulyomatoznogo-pielonefrita/viewer (In Russ.)
  6. Abovich YuA, Afukova OA, Yudin AL. Coexistence xanthogranulomatous pyelonephritis with renal replacement lipomatosis. Computed tomography. linical case. Medical Visualization. 2018;(5):65-72. doi: 10.24835/1607-0763-2018-5-65-72 (In Russ.)
  7. Li L, Parwani AV. Xanthogranulomatous pyelonephritis. Arch Pathol Lab Med. 2011 May;135(5):671-74. doi: 10.1043/2009-0769-RSR.1
  8. Rajesh A, Jakanani G, Mayer N, Mulcahy K. Computed tomography findings in xanthogranulomatous pyelonephritis. J Clin Imaging Sci. 2011;1:45. doi: 10.4103/2156-7514.84323
Address for correspondence:
230009, Republic of Belarus,
Grodno, Gorkii Str., 80,
Grodno State Medical University,
the Department of Surgical Diseases No2,
tel. +375 29 651-35-69,
e-mail: nechiporenko_al@mail.ru
Nechiporenko Alexandr N.
Information about the authors:
Nechiporenko Alexandr N., MD, Professor of the Department of Surgical Diseases No2, Grodno State Medical University, Grodno, Republic of Belarus.
https://orcid.org/0000-0002-3304-6393
Nechiporenko Nikolay A., MD, Professor of the Department of Surgical Diseases No2, Grodno State Medical University, Grodno, Republic of Belarus.
https://orcid.org/0000-0002-1544-9287
Vasilevich Daniil M., Urologist of the Urological Department, Grodno University Hospital, Grodno, Republic of Belarus.
https://orcid.org/0000-0002-0052-5195
Basinsky Victor A., MD, Professor, Head of the Department, Grodno State Medical University, Grodno, Republic of Belarus.
https://orcid.org/0000-0001-9441-1342
Nechiporenko Anna S., Radiologist, CT Department, Grodno University Hospital, Grodno, Republic of Belarus.
https://orcid.org/0000-0002-4073-3132
Gavina Natalya L., Head of MRI Department, Grodno University Hospital, Grodno, Republic of Belarus.
https://orcid.org/0000-0003-3062-6592
DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.376   |  

R.V. UKRAINETS 1, 2, YU.S. KORNEVA 1, 2, A.V. SERGEEV 1, 3

PARTIAL DUPLICATION OF VERMIFORM APPENDIX AS A CAUSE OF THE APPENDICEAL INFILTRATE

Smolensk State Medical University 1,
Smolensk Regional Institute of Pathology 2,
Emergency Clinical Hospital 3, Smolensk,
The Russian Federation

The appendix anomalies are extremely rare malformations. Preoperative diagnosis of appendiceal duplication is often difficult and usually discovered incidentally during surgery for appendicitis. A clinical case of the development of chronic residual appendicitis in a 32-year-old woman with the abnormality of the vermiform appendix identified duplicity, type A according to the Cave-Wallbridge classification is described. During the first hospitalization, the patient was treated conservatively with a diagnosis of a dense appendiceal infiltrate; later, a planned appendectomy was performed. A duplication of the vermiform appendix type A was revealed during the examination of the removed appendix. Histopathological examination detected the underdevelopment of the wall of the accessory vermiform appendix - a complete absence of the outer longitudinal layer of the muscular membrane. The abnormally thin wall of the accessory appendix, as well as the related with it hypoperistalsis provoked the onset of chronic inflammation in the wall, which easily spread to the periappendiceal adipose tissue with the formation of a dense appendiceal infiltrate, which required surgical intervention. Thus, a rare clinical case of duplication of the vermiform appendix type A with forming of appendiceal infiltrate, associated with abnomality of muscular tissue, shown by the surgical findings and corroborated by pathology samples of intestinal tissue has been presented.

Keywords: congenital malformation, duplication of the vermiform appendix, appendiceal infiltrate, chronic appendicitis, intestinal visceral myopathy
p. 376-381 of the original issue
References
  1. Panda SK, Prasad C, Tirkey R, Rajesh V, Mishra J, Dora RK. Unusual association of Meckels diverticulum with double appendix A rare finding. Int J Surg Case Rep. 2014;5(11):879-81. doi: 10.1016/j.ijscr.2014.09.009
  2. Drino E, Radnić D, Kotjelnikov B, Aksamija G. Rare anomalies in the development of the appendix. Acta Chir Iugosl. 1991;38(1):103-11.
  3. Travis JR, Weppner JL, Paugh JC 2nd. Duplex vermiform appendix: case report of a ruptured second appendix. J Pediatr Surg. 2008 Sep;43(9):1726-28. doi: 10.1016/j.jpedsurg.2008.04.023
  4. Dubhashi SP, Dubhashi UP, Kumar H, Patil C. Double appendix. Indian J Surg. 2015 Dec;77(Suppl 3):1389-90. doi: 10.1007/s12262-013-1014-1
  5. Nazir S, Bulanov A, Ilyas MI, Jabbour II, Griffith L. Duplicate appendix with acute ruptured appendicitis: a case report. Int Surg. 2015 Apr;100(4):662-65. doi: 10.9738/INTSURG-D-14-00150.1
  6. Alves JR, Maranhão IG, de Oliveira PV. Appendicitis in double cecal appendix: Case report. World J Clin Cases. 2014 Aug 16;2(8):391-94. doi: 10.12998/wjcc.v2.i8.391
  7. Christodoulidis G, Symeonidis D, Spyridakis M, Koukoulis G, Manolakis A, Triantafylidis G, Tepetes K. Acute appendicitis in a duplicated appendix. Int J Surg Case Rep. 2012;3(11):559-62. Published online 2012 Aug 14. doi: 10.1016/j.ijscr.2012.08.004
  8. Tutcu Şahin S, Erhan Y, Aydede H. Double acute appendicitis in appendical duplication. Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):83-85. doi: 10.5505/tjtes.2013.80557
  9. Lombardi L, Bruder E, Pio L, Nozza P, Thai E, Lerone M, Del Rossi C, Mattioli G, Silini EM, Paraboschi I, Martucciello G. Diagnostic criteria of pediatric intestinal myopathies. J Pediatr Gastroenterol Nutr. 2018 Mar;66(3):383-86. doi: 10.1097/MPG.0000000000001727
  10. Stephens D, Arensman R, Pillai S, Alagiozian-Angelova V. Congenital absence of intestinal smooth muscle: a case report and review of the literature. J Pediatr Surg. 2009 Nov;44(11):2211-15. doi: 10.1016/j.jpedsurg.2009.08.008
  11. Panasyuk AI, Shurygina IA, Byrgazov RO, Grigoryev YG. Chronic appendicitis. definition, diagnosing and treatment. Russian Sklifosovsky Journal Emergency Medical Care. 2016;(3):74-78. https://www.jnmp.ru/jour/article/view/298/0 (In Russ.)
  12. Shurygina IA, Dremina NN, Panasjuk AI, Kanja OV, Shurygin MG. Chronic appendicitis morphological diagnosis. Sib Med Zhurn (Irkutsk). 2018;153(2):17-19. http://smj.ismu.baikal.ru/index.php/osn/article/view/289 (In Russ.)
  13. Kirillova IA, Kravcova GI, Kruchinskij GV. Teratologija cheloveka. Moscow, RF: Medicina; 1991. 480 p. (In Russ.)
Address for correspondence:
214019, Russian Federation,
Smolensk, Krupskaia Str., 28,
Emergency Clinical Hospital, Surgery Unit;
tel. +7(4812)242000, additional number 280,
e-mail: sergeev.alex@yahoo.com
tel. +375 29 651-35-69,
Sergeev Alexey V.
Information about the authors:
Ukrainets Roman V., Pathologist, the Department of Clinical Pathology No2, Smolensk Regional Institute of Pathology, Assistant of the Department of Pathological Anatomy, Smolensk State Medical University, Smolensk, Russian Federation.
https://orcid.org/0000-0002-0590-1399
Korneva Yulia S., PhD, Associate Professor of the Department of Pathological Anatomy, Smolensk State Medical University, Pathologist, the Department of Clinical Pathology No2, Smolensk Regional Institute of Pathology Smolensk, Russian Federation.
https://orcid.org/0000-0002-8080-904X
Sergeev Alexey V., PhD, Associate Professor of the Department of Hospital Surgery, Smolensk State Medical University, Head of the Surgical Unit of the Emergency Clinical Hospital, Smolensk, Russian Federation.
https://orcid.org/0000-0002-0437-9551

EXCHANGE OF EXPERIENCE

DOI: https://dx.doi.org/10.18484/2305-0047.2021.3.382   |  

S.E. GRYAZNOV 1, G.G. MELKONYAN 1, 3, A.M. SHULUTKO 2, V.I. SEMIKOV 2, E.G. OSMANOV 2, E.G. GANDYBINA 2

TRANSORAL THYROIDECTOMY AND PARATHYROIDECTOMY: SERIES OF CASES

City Clinical Hospital No4, Moscow Health Department 1,
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University) 2,
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation3, Moscow
The Russian Federation

Objective. To present the results of the authors own series of transoral operations in patients with pathology of the thyroid and parathyroid glands.
Methods. Transoral surgery was performed in women (n=20) and man (n=1). All patients were operated on for the primary disease and met the selection criteria based on ultrasound and cytological examinations, hormonal levels, and somatic status. Indications for surgery were: nodular goiter in 17 cases, diffuse toxic goiter in 2 cases, parathyroid adenoma in 2 cases. The surgical technique included a three-port approach in the lower fornix of the vestibule of the mouth and a gas technique for maintaining the working cavity. Standard laparoscopic instruments and an energy based ultrasonic device were used for the operation. In the postoperative period, patients underwent a test for subjective assessment of the aesthetic result of the operation using the survey of the dermatology life quality index.
Results. Thyroidectomy was performed in 4 patients, hemithyroidectomy in 15 patients and parathyroidectomy in 2 patients. In one patient, transoralparathyroidectomy was performed as a part of a simultaneous operation for multiple endocrine neoplasia type 1 syndrome. Papillary cancer T1N0M0 was verified in two patients after surgery. The mean operation time was 196.1 min (range 110 300 min). Average blood loss 39.5 ml (range 10 300 ml). The nineth operation required the conversion due to severe bleeding. In one case, the temporary recurrent laryngeal nerve (RLN) injury was reported, in one case hematoma. After surgery, the median and average values of the dermatology life quality index were 1 (IQR 0-4) and 2.05, respectively, which indicates an insignificant effect on the quality of life.
Conclusion. Transoral endoscopic surgery on the thyroid and parathyroid glands would be the promising optimal choice in patients to avoid scarring on the neck.

Keywords: transoral thyroidectomy, transoral parathyroidectomy, Dermatology Life Quality Index, endoscopic thyroidectomy, transoral neck surgery, natural orifice surgery
p. 382-392 of the original issue
References
  1. Miccoli P. Minimally invasive surgery for thyroid and parathyroid diseases. Surg Endosc. 2002;16:3-6. doi: 10.1007/s00464-001-8140-8
  2. Berber E, Bernet V, Fahey TJ 3rd, Kebebew E, Shaha A, Stack BC Jr, Stang M, 2. Steward DL, Terris DJ; American Thyroid Association Surgical Affairs Committee. American Thyroid Association Statement on Remote-Access Thyroid Surgery. Thyroid. 2016 Mar;26(3):331-37. doi: 10.1089/thy.2015.0407
  3. Witzel K, von Rahden BH, Kaminski C, Stein HJ. Transoral access for endoscopic thyroid resection. Surg Endosc. 2008 Aug;22(8):1871-75. doi: 10.1007/s00464-007-9734-6
  4. Wilhelm T, Metzig A. Endoscopic minimally invasive thyroidectomy (eMIT): a prospective proof-of-concept study in humans. World J Surg. 2011 Mar;35(3):543-51. doi: 10.1007/s00268-010-0846-0
  5. Karakas E, Steinfeldt T, Gockel A, Mangalo A, Sesterhenn A, Bartsch DK. Transoral parathyroid surgerya new alternative or nonsense? Langenbecks Arch Surg. 2014 Aug;399(6):741-45. doi: 10.1007/s00423-014-1187-5
  6. Wang C, Zhai H, Liu W, Li J, Yang J, Hu Y, Huang J, Yang W, Pan Y, Ding H. Thyroidectomy: a novel endoscopic oral vestibular approach. Surgery. 2014 Jan;155(1):33-38. doi: 10.1016/j.surg.2013.06.010
  7. Anuwong A. Transoral endoscopic thyroidectomy vestibular approach: a series of the first 60 human cases. World J Surg. 2016 Mar;40(3):491-97. doi: 10.1007/s00268-015-3320-1
  8. Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI) a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994 May;19(3):210-16. doi: 10.1111/j.1365-2230.1994.tb01167.x
  9. Benhidjeb T, Wilhelm T, Harlaar J, Kleinrensink GJ, Schneider TA, Stark M. Natural orifice surgery on thyroid gland: totally transoral video-assisted thyroidectomy (TOVAT): report of first experimental results of a new surgical method. Surg Endosc. 2009 May;23(5):1119-20. doi: 10.1007/s00464-009-0347-0
  10. Tartaglia F, Maturo A, Di Matteo FM, De Anna L, Karpathiotakis M, Pelle F, Tromba L, Carbotta S, Carbotta G, Biancucci A, Galiffa G, Livadoti G, Falbo F, Esposito A, Donello C, Ulisse S. Transoral video assisted thyroidectomy: a systematic review. G Chir. 2018 Sep-Oct;39(5):276-83.
  11. Nakajo A, Arima H, Hirata M, Mizoguchi T, Kijima Y, Mori S, Ishigami S, Ueno S, Yoshinaka H, Natsugoe S. Trans-Oral Video-Assisted Neck Surgery (TOVANS). A new transoral technique of endoscopic thyroidectomy with gasless premandible approach. Surg Endosc. 2013 Apr;27(4):1105-10. doi: 10.1007/s00464-012-2588-6
  12. Razavi CR, Russell JO. Indications and contraindications to transoral thyroidectomy. Ann Thyroid. 2017;2(5):12. doi: 10.21037/aot.2017.10.01
  13. Razavi CR, Tufano RP, Russell JO. Starting a Transoral thyroid and parathyroid surgery program. Curr Otorhinolaryngol Rep. 2019 Sep;7(3):204-208. doi: 10.1007/s40136-019-00246-w
  14. Celik S, Makay O, Yoruk MD, Bayzit Kocer I, Ozdemir M, Kilic KD, Tomruk C, Bilge O, Uyanikgil Y, Dionigi G. A surgical and anatomo-histological study on Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA). Surg Endosc. 2020 Mar;34(3):1088-102. doi: 10.1007/s00464-019-06856-1
  15. Grogan RH, Suh I, Chomsky-Higgins K, Alsafran S, Vasiliou E, Razavi CR, Chen LW, Tufano RP, MD, Duh QY, Angelos P, Russell JO. Patient eligibility for transoral endocrine surgery procedures in the United States. JAMA Netw Open. 2019 May;2(5):e194829. Published online 2019 May 31. doi: 10.1001/jamanetworkopen.2019.4829
  16. Shulutko AM, Semikov VI, Gryaznov SE, Gorbacheva AV , Patalova AR ,Mansurova GT, Boblak YuA. Transoral approach to thyroid gland in the experiment.. Khirurgiia Zhurn im NI Pirogova. 2017;(2):25-31. doi: 10.17116/hirurgia2017225-31. (In Russ.)
  17. Choi Y, Lee JH, Kim YH, Lee YS, Chang HS, Park CS, Roh MR. Impact of postthyroidectomy scar on the quality of life of thyroid cancer patients. Ann Dermatol. 2014 Dec;26(6):693-99. doi: 10.5021/ad.2014.26.6.693
  18. Russell JO, Clark J, Noureldine SI, Anuwong A, Al Khadem MG, Yub Kim H, Dhillon VK, Dionigi G, Tufano RP, Richmon JD. Transoral thyroidectomy and parathyroidectomy A North American series of robotic and endoscopic transoral approaches to the central neck. Oral Oncol. 2017 Aug;71:75-80. doi: 10.1016/j.oraloncology.2017.06.001
Address for correspondence:
115093, Russian Federation,
Moscow, Pavlovskaya Str., 25,
City Clinical Hospital No 4,
Moscow Health Department
tel.: +7 916 299-26-88,
e-mail: gryzli_37@mail.ru
Gryaznov Sergey E.
Information about the authors:
Gryaznov Sergey E., PhD, Surgeon, City Clinical Hospital No4, Moscow Health Department, Moscow, Russian Federation.
https://orcid.org/0000-0003-2074-4130
Melkonyan Georgiy G., MD, Professor of the Surgery Departmentr, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation , Head physician, City Clinical Hospital No4, Moscow Health Department, Moscow, Russian Federation.
https://orcid.org/0000-0001-7234-4185
Shulutko Alexandr M., MD, Professor of the Surgery Department No2, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0002-8001-1601
Semikov Vasily I., MD, Professor of the Surgery Department No2, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0002-3844-1632
Osmanov Elkhan G., MD, Professor of the Surgery Department No2, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0003-1451-1015
Gandybina Elena G., PhD, Associate Professor of the Surgery Department No245, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0002-6765-5154
Contacts | ©Vitebsk State Medical University, 2007