Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion
Ýòîò ñàéò èñïîëüçóåò îñíîâíûå ôàéëû cookie äëÿ îáåñïå÷åíèÿ åãî íîðìàëüíîé ðàáîòû è ôàéëû cookie äëÿ îòñëåæèâàíèÿ, ÷òîáû ïîíÿòü, êàê âû ñ íèì âçàèìîäåéñòâóåòå. Ïîñëåäíèå áóäóò óñòàíîâëåíû òîëüêî ïîñëå îäîáðåíèÿ.
Ñîãëàñèòüñÿ

Year 2020 Vol. 28 No 3

SCIENTIFIC PUBLICATIONS
GENERAL & SPECIAL SURGE

K.S. KOBELEV 1, D.D. DOLOTOVA 2, O.V. MIDLENKO 1, N.I. BELONOGOV 1, V.I. MIDLENKO 1

INVESTIGATION OF RISK FACTORS OF THE DERMAL BURN WOUND CONVERSION

Ulyanovsk State University 1 , Ulyanovsk,
"Gammamed-Soft", Ltd 2, Moscow,
The Russian Federation

Objective. The present study is focused on risk factors of burn wound conversion in the local treatment with DDBM (dressing, dressing, Breitman-Menzul) dressing material in comparison with routine treatment based on gauze bandages with iodophors.
Methods. During the research work, we used retrospective data of 281 patients with second-degree burn injuries. The group was divided into two: those who were treated with DDBM dressing (n=130), and those who were treated with gauze bandages with iodophors (n=151). Patients were included in this study if: 1) their age was over 18; 2) they had II degree burns without scab; 3) admission was not later than 3 days after trauma; 4) predominance of II degree burns in case of its combination with full-thickness skin burns (III degree). A predictive model of burn wound conversion was designed with logistic regression.
Results. The analysis showed that usage of DDBM dressing led to wound epithelialization on 15th [13; 17] day and to the reduction of burn conversion frequency by 28% in comparison with the treatment with gauze bandages with iodophors. Body mass index was found to be a highly significant predictor: risk of wound conversion tended to increase strongly for patients with body mass index over 29.5 kg/m2. A set of such variables as the location of burns on the back of the body and buttocks, body mass index, and treatment method allowed development of a binary regression model with high sensitivity and specificity (97.2% and 99.5%, respectively).
Conclusions. The study identified the advantages of local treatment with DDBM in comparison with iodophors gauze bandages. The developed predictive model allowed calculating the probability of burn wound conversion with high accuracy.

Keywords: burn wound conversion, dermal burns, moist wound healing, film dressing, predictive model
p. 249-257 of the original issue
References
  1. Bogdanov SB, Afaunova ON, Babichev RG. Topical application of wound dressings in early surgical treatment of burns on border course children. Medical Herald of the South of Russia. 2016;(3):27-30. doi: 10.21886/2219-8075-2016-3-27-30 (In Russ.)
  2. Singh V, Devgan L, Bhat S, Milner SM. The pathogenesis of burn wound conversion. Ann Plast Surg. 2007 Jul;59(1):109-15. doi: 10.1097/01.sap.0000252065.90759.e6
  3. Glutkin AV, Koval’chuk VI Termicheskii ozhog kozhi u detei rannego vozrasta (opyt eksperimenta i kliniki): monografiia. Grodno, RB: GrGMU, 2016. 180 p. http://elib.grsmu.by/handle/files/861 (In Russ.)
  4. Lehnhardt M, Hartmann B, Reichert B, eds. Verbrennungschirurgie. Springer-Verlag Berlin Heidelberg; 2016. 501 ð. doi: 10.1007/978-3-642-54444-6
  5. Voinovskii EA, Menzul VA, Rudenko TG, Iusupov IE, Voinovskii AE, Shekhter AB, Kovalev AS, Guller AE. Sistema lecheniia ozhogovykh ran v sobstvennoi zhidkoi srede: monogr. Moscow, RF: Na boevom postu; 2015. 272 p. https://docplayer.ru/37857979-Sistema-lecheniya-ozhogovyh-ran-v-sobstvennoy-zhidkoy-srede-monografiya.html (In Russ.)
  6. Obshcherossiiskaia obshchestvennaia organizatsiia «Ob“edinenie kombustiologov «Mir bez ozhogov» Ozhogi termicheskie i khimicheskie. Ozhogi solnechnye. Ozhogi dykhatel‘nykh putei. Klinicheskie rekomendatsii [Elektronnyi resurs]. Moscow, RF; 2017 [data obrashcheniia: 2019 Mart 18]. 118 p. Available from: http://combustiolog.ru/wp-content/uploads/2013/07/Natsional-ny-e-klinicheskie-rekomendatsii-po-ozhogam-2017.pdf (In Russ.)
  7. Barret-Nerin J, Herndon DN. Principles and practice of burn surgery. N.Y.: Marcel Dekker; 2005. 412 p. https://pdfs.semanticscholar.org/0636/8b2aeedd6c2db6a5ffcfa12a55241d8a64d1.pdf
  8. Sokolov VA, Efimenko NA. Admakin AL, Petrachkov SA, Stepanchenko AA. Piecetime burns. Sources of danger. Klin. Med. 2015; 93 (6): 30-35. https://cyberleninka.ru/article/n/ozhogi-mirnogo-vremeni-istochniki-opasnosti (In Russ.)
  9. Aksoy N, Arli S, Yigit O. A retrospective analysis of the burn injury patients records in the emergency department, an epidemiologic study. Emerg (Tehran). 2014 Summer;2(3):115-20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614574/
  10. Zinoviev EV, Alov NV, Apchel AV, Vasilieva AG, Yakimov DK. Effectiveness of antiseptic solutions in treating dermal burns. Vestn Ros Voen-Med Akad. 2014;(4):173-81. https://www.vmeda.org/wp-content/uploads/2016/pdf/173-181.pdf (In Russ.)
  11. Ar’ev TIa. Termicheskie porazheniia. Leningrad: Meditsina; 1966. 702 p. (In Russ.)
  12. Singer AJ, Towery H, McClain SA. Effect of tadalafil on reduction of necrosis in the ischemic zone in a rat comb burn model. Burns. 2018 Sep;44(6):1427-32. doi: 10.1016/j.burns.2018.05.013
  13. Widgerow AD, King K, Tocco-Tussardi I, Banyard DA, Chiang R, Awad A, Afzel H, Bhatnager S, Melkumyan S, Wirth G, Evans GR. The burn wound exudate-an under-utilized resource. Burns. 2015 Feb;41(1):11-17. doi: 10.1016/j.burns.2014.06.002
  14. Bagnenko SF, Krylov KM. The real means of burn depth diagnostics. Skoraia Med Pomoshch’. 2000;1(4):28-33. https://www.elibrary.ru/item.asp?id=36151251 (In Russ.)
Address for correspondence:
432071, Russian Federation,
Ulyanovsk, Ryleev str., 30/30,
Ulyanovsk State University,
Institute of Medicine, Ecology and Physical Culture, the Department of Hospital Surgery,
Anesthesiology, Resuscitation, Urology,
Traumatology and Orthopedics,
tel. mobile: +79603686624,
e-mail: kskobelev78@mail.ru,
Kobelev Konstantin S.
Information about the authors:
Kobelev Konstantin S., Post-Graduate Student of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Traumatologist-Orthopedist of the Highest Category, Burn Department Employee, Central City Clinical Hospital, Ulyanovsk, Russian Federation.
http://orcid.org/0000-0002-0817-8175
Dolotova Daria D., PhD, Leading Researcher, «Gammamed-Soft», Ltd, Moscow, Russian Federation.
https://orcid.org/0000-0002-5538-1109
Midlenko Oleg V., MD, Professor of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russian Federation.
https://orcid.org/0000-0001-8076-7145
Belonogov Nikolaj I., MD, Professor of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute Of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russian Federation.
https://orcid.org/0000-0002-6064-9384
Midlenko Vladimir I., MD, Professor, Head of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russian Federation.
http://orcid.org/0000-0003-4358-8484

A.B. SANNIKOV 1, 2, E.V. SHAJDAKOV 3, V.M. EMELYNENKO 2, I.V. DROZDOVA 1, Y.A. DEMIDENKO 1

ON THE POSSIBILITY OF USING THE ADHESIVE COMPOSITION «SULFACRYLATE» FOR OBLITERATION OF VARICOSE VEINS OF THE LOWER EXTREMITIES

Medical Center «Palitra» 1, Vladimir,
N.I.Pirogov Russian National Research Medical University of the Ministry of Health 2, Moscow,
N.P. Bekhterev Institute of the Human Brain, RAS 3, St. Petersburg,
The Russian Federation

Objective. To conduct clinical experimental studies on the use of cyancrylate glue «Sulfacrylate» (produced in Russia) for obliteration the lower extremities varicose veins in humans.
Methods. Endovascular catheter obliteration of the tributaries and main trunks of the great saphenous vein on the tibia was performed in 15 patients with varicose disease (C2 to CEAR) in order to substantiate the possibility of using the adhesive compound «Sulfacrylate». Pain severity was clinically evaluated as well as presence or absence of phlebitis and thrombophlebitis, hyper pigmentation, neurological disorders, allergic reaction. Ultrasound control was carried out at various terms, starting from the 3rd day up to 6 months. Histological study of morphological changes was carried out selectively.
Results. All patients after the introduction of the glue «Sulfacrylate» had a clinic of moderate phlebitis, without the formation of blood clots in the lumen of the vein. No local or general allergic reaction was observed. Starting from the 7th day occluded venous segments were palpated in the form of moderate density bands without any infiltration of the surrounding tissues. In the absence of blood flow ultrasound examination showed gradual biodegradation of the adhesive strip inside the vein with the development of complete obliteration of the lumen starting from the 4th month. Starting from the 7th day aseptic inflammation in the wall of the vein was observed on histological examination which gradually stopped. Monocytic infiltration of the venous wall with the formation of multinucleated cells of foreign bodies was present until the complete biodegradation of the glue. The process of diffuse growth of connective tissue with the presence of fibroblasts from the subendothelium and in the middle shell was most actively observed in histological material from 90 to 120 days after occlusion. Within 180 days, the lumen of the veins occluded by "Sulfacrylate" was completely obliterated by mature connective tissue, in the absence of glue particles, which indicated its complete biodegradation.
Conclusions. The experimental studies conducted with the assessment of clinical symptoms, ultrasound examination and histological study of morphogenesis in the lumen of blood vessels in different periods up to 6 months allow us to conclude the potential use of the adhesive compound «Sulfacrylate» for endovasal obliteration of varicose veins in humans.

Keywords: cyanoacrylate embolization, non-thermal obliteration, non-tumescent obliteration, endovenous cyanoacrylate obliteration, varicose veins, cyanoacrylate medical glue "Sulfacrylate"
p. 258-267 of the original issue
References
  1. Morrison N, Gibson K, McEnroe S, Goldman M, King T, Weiss R. Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). J Vasc Surg. 2015 Apr;61(4):985-94. doi: 10.1016/j.jvs.2014.11.071
  2. Proebstle TM, Alm J, Dimitri S, Whiteley M, Lawson J, Cher D, Davies A. The European multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins. J Vasc Surg Venous Lymphat Disord. 2015 Jan;3(1):2-7. doi: 10.1016/j.jvsv.2014.09.001
  3. Bozkurt AK, Ylmaz MF. A prospective comparison of a new cyanoacrylate glue and laser ablation for the treatment of venous insufficiency. Phlebology. 2016 Mar;31(1 Suppl):106-13. doi: 10.1177/0268355516632652
  4. Yasim A, Eroglu E, Bozoglan O. A new non-tumescent endovenous ablation method for varicose vein treatment: Early results of N-butyl cyanoacrylate (VariClose®). Phlebology. 2017 Apr;32(3):194-99. doi: 10.1177/0268355516638577
  5. Srinath SR, Sharma G. Review of non-thermal non-tumescent endovenous ablation using cyanoacrylate. Surgery. 2018;14(2):10. doi: 10.7438/1584-9341-14-2-10
  6. Shaidakov EV, Mel’tsova AZh, Porembskaia OIa, Kudinova EA. Opyt primeneniia tsianokrilatnogo kleia pri endovaskuliarnom lechenii varikoznoi bolezni. Angiologiia i Sosud Khirurgiia. 2017;23(4):62-66. http://www.angiolsurgery.org/magazine/2017/4/9.htm (In Russ.)
  7. Marchenko VT, Prutovykh NN, Tolstikov GA, Tolstikov AG. Meditsinskii klei «Sul’fakrilat». Antibakterial’naia protivovospalitel’naia kleevaia kompozitsiia: ruk dlia primeneniia v khirurg otrasliakh [Elektronnyi resurs]. Novosibirsk, RF; 2013. 80 c. Rezhim dostupa: http://www.sulfakrilat.ru/upload/instruct_sulfakrilat.pdf (In Russ.)
  8. Marchenko VT, Shkurupii VA. Morfologicheskie osobennosti reparativnoi regeneratsii organov i tkanei pri ispol’zovanii «Sul’fakrilata» novogo pokoleniia. Biul Eksperim Biologii i Meditsiny. 2004;137(2):231-36. https://elibrary.ru/item.asp?id=21236209 (In Russ.)
  9. Almeida JI, Javier JJ, Mackay E, Bautista C, Proebstle TM. First human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. J Vasc Surg Venous Lymphat Disord. 2013 Apr;1(2):174-80. doi: 10.1016/j.jvsv.2012.09.010
  10. Min RJ, Almeida JI, McLean DJ, Madsen M, Raabe R. Novel vein closure procedure using a proprietary cyanoacrylate adhesive: 30-day swine model results. Phlebology. 2012 Dec;27(8):398-403. doi: 10.1258/phleb.2011.011084
  11. Almeida JI, Min RJ, Raabe R, McLean DJ, Madsen M. Cyanoacrylate adhesive for the closure of truncal veins: 60-day swine model results. Vasc Endovascular Surg. 2011 Oct;45(7):631-35. doi: 10.1177/1538574411413938
  12. Almeida JI, Javier JJ, Mackay EG, Bautista C, Cher DJ, Proebstle TM. Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. Phlebology. 2014 Jul;30(6):397-404. doi: 10.1177/0268355514532455
  13. Eroglu E, Yasim A, Ari M, Ekerbicer H, Kocarslan A, Kabalci M, Acpayam M. Mid-term results in the treatment of varicose veins with N-butyl cyanoacrylate. Phlebology. 2017 Dec;32(10):665-69. doi: 10.1177/0268355517718761
  14. Zielinski A, Sweircz P. Are non-thermal, non-tumescent techniques more recommended? Endovenous treatment of saphenous veins reflux – methods and results overview and discussion. Phlebological Review. 2018;26(1):4-9. doi: 10.5114/pr.2018.76383
Address for correspondence:
600031, Russian Federation.,
Vladimir, Dobroselskaya str., 36b,
Medical Center «Palitra»,
tel.: 8(999) 776-47-73,
å-mail: aliplast@mail.ru,
Sannikov Alexander B.
Information about the authors:
Sannikov Alexander B., PhD, Head of the Surgical Department of the Medical Center «Palitra», Vladimir, Associate Professor of the Department of Continuing Education of Health Professionals, N.I.Pirogov Russian National Research Medical University of the Ministry of Health, Moscow, Russian Federation.
https://orcid.org/0000-0003-1792-2434
Drozdova Irina V., Functional Diagnostics Physician of the Medical Center «Palitra», Vladimir, Russian Federation.
https://orcid.org/0000-0002-2430-053X
Demidenko Yaroslav A., PhD, Head Physician of the Medical Center «Palitra», Vladimir, Russian Federation.
https://orcid.îrg/0000-0002-7944-1516
Shajdakov Evgeny V., MD, Professor, N.P. Bekhterev Institute of the Human Brain, RAS, St. Petersburg, Russian Federation
https://orcid.org/0000-0002-7260-4968
Emelynenko Vladimir M., MD, Professor, Head of the Professor of the Department of Continuing Education of health Professionals, N.I. Pirogov Russian National Research Medical University of the Ministry of Health, Moscow, Russian Federation.
https://orcid.org/0000-0003-0909-1693

TRANSPLANTOLOGY

A.V. VATAZIN, A.B. ZULKARNAEV, V.A. STEPANOV

A PERSPECTIVE APPROACH TO THE TISSUE COMPATIBILITY ASSESSMENT OF A DONOR AND A RECIPIENT DURING CADAVERIC KIDNEY TRANSPLANTATION

Moscow Regional Research Clinical Institute named after M.F. Vladimirskiy, Moscow,
The Russian Federation

Objective. To perform a multiple factor analysis of the impact of the epitope mismatche number on the renal transplant survival.
Methods. An observational retrospective cohort study including 824 adult kidney graft recipients was performed.
Results. All recipient donor pairs had human leukocyte antigen mismatches. Significant risk factors for graft loss in the preassigned multivariate model were as follows: HLA MM (1 – HR 1; 2– HR 1.24 [95% confidence interval – 95% CI 0.7; 2.15], p=0.344; 3 – HR 1 , 48 [95% CI 0.86; 2.33], p=0.251; 4 – HR 1.88 [95% CI 1.32; 2.52], p<0.001; 5 – HR 2.41 [95 % CI 2; 2.93], p<0.001; 6 – HR 2.98 [95% CI 2.59; 3.46], p<0.001) p<0.001; duration of HR conservation 1.08 per hour [95% CI 1.02; 1.16], p=0.01; panel-reactive antibodies value (PRA) HR 1.24 per every 10% [95% CI 1.06; 1.58], p=0.01; but not the type of donor, age and gender of the recipient.
When including the epitope mismatches (EpMM) in the model, significant risk factors were: EpMM (<10– HR 1; 10-19– HR 1.71 [95% CI 1.09; 2.49], p=0.021; 20-29 – HR 2,11 [95% CI 1.59; 2.68], p<0.001; 30-39 – HR 2.4 [95% CI 1.96; 2.86], p<0.001; 40-49 – HR 2 , 59 [95% CI 2.17; 3.04], p<0.001; ≥50 – HR 2.71 [95% CI 2.31; 3.15], p<0.001) p<0.001; PRA HR 1.18 for every 10% [95% CI 1.09; 1.5], p=0.007; but not the duration of conservation, donor type, age and gender of the recipient. However, HLA MM was no longer a significant risk factor for HR graft loss 1.19 [95% CI 0.88; 1.55], p=0.451
Conclusions. The number of epitope mismatches between donor phenotype and recipient phenotype remains an important factor in long-term graft survival, even in despite of some corrections of the number of HLA mismatches, the donor type and the level of pre-sensitization of the recipient.

Keywords: kidney transplantation, HLA, epitope, eplet, tissue compatibility, recipient selection
p. 268-275 of the original issue
References
  1. Williams RC, Opelz G, Weil EJ, McGarvey CJ, Chakkera HA. The Risk of Transplant Failure With HLA Mismatch in First Adult Kidney Allografts 2: Living Donors, Summary, Guide. Transplantation Direct. 2017 May;3(5):e152. doi: 10.1097/TXD.0000000000000664
  2. Posmertnoe donorstvo organov. Natsional’nye klinicheskie rekomendatsii [Elektronnyi resurs]. Ros transplantol o-vo; 2016 [data dostupa 2019 Avg 20]. 59 p. Rezhim dostupa: http://transpl.ru/files/rto/possmertnoe_dnorstvo_organov.pdf (In Russ.)
  3. Abramowicz D, Cochat P, Claas FH, Heemann U, Pascual J, Dudley C, Harden P, Hourmant M, Maggiore U, Salvadori M, Spasovski G, Squifflet JP, Steiger J, Torres A, Viklicky O, Zeier M, Vanholder R, Van Biesen W, Nagler E. European Renal Best Practice Guideline on kidney donor and recipient evaluation and perioperative care. Nephrol Dial Transplant. 2015 Nov;30(11):1790-97. doi: 10.1093/ndt/gfu216
  4. Shi X, Lv J, Han W, Zhong X, Xie X, Su B, Ding J. What is the impact of human leukocyte antigen mismatching on graft survival and mortality in renal transplantation? A meta-analysis of 23 cohort studies involving 486,608 recipients. BMC Nephrol. 2018 May 18;19(1):116. doi: 10.1186/s12882-018-0908-3
  5. Massie AB, Leanza J, Fahmy LM, Chow EK, Desai NM, Luo X, King EA, Bowring MG, Segev DL. A risk index for living donor kidney transplantation. Am J Transplant. 2016 Jul;16(7):2077-84. doi: 10.1111/ajt.13709
  6. Campos A, Malheiro J, Tafulo S, Santos S, Dias L, Martins S, Almeida M, Pedroso S, Henriques AC, Cabrita A. Increase of allosensitization after a kidney graft failure: Predictors and effect on retransplantation outcomes. Nefrologia. 2017 Jul-Aug;37(4):397-405. doi: 10.1016/j.nefro.2016.11.020 [Article in English, Spanish]
  7. Lim WH, Chadban SJ, Clayton P, Budgeon CA, Murray K, Campbell SB, Cohney S, Russ GR, McDonald SP. Human leukocyte antigen mismatches associated with increased risk of rejection, graft failure, and death independent of initial immunosuppression in renal transplant recipients. Clin Transplant. 2012 Jul-Aug;26(4):E428-37. doi: 10.1111/j.1399-0012.2012.01654.x
  8. Süsal C, Opelz G. Current role of human leukocyte antigen matching in kidney transplantation. Curr Opin Organ Transplant. 2013 Aug;18(4):438-44. doi: 10.1097/MOT.0b013e3283636ddf
  9. Snell GD, Dausset J, Nathanson S. Histocompatibility. New York: Academic Press; 1976. 401 p.
  10. The National Marrow Donor Program Database [Internet] [cited 2018 May 12]. Available from: https://bioinformatics.bethematchclinical.org/
  11. The Allele Frequency Net Database [Internet] [cited 2018 May 12]. Available from: http://www.allelefrequencies.net
  12. HLA Epitope Registry Database [Internet] [cited 2018 May 12]. Available from: https://www.epregistry.com.br/
  13. Stolyarevich ES, Zhilinskaya TR, Artyukhina LYu, Kim IG, Zaydenov VA, Tomilina NA. Morphological structure of late renal graft dysfunction and its effect for long-term results. Russian Journal of Transplantology and Artificial Organs. 2018;20(1):45-54. doi: 10.15825/1995-1191-2018-1-45-54 (In Russ.)
  14. Campos A, Malheiro J, Tafulo S, Santos S, Dias L, Martins S, Almeida M, Pedroso S, Henriques AC, Cabrita A. Increase of allosensitization after a kidney graft failure: Predictors and effect on retransplantation outcomes. Nefrologia. 2017 Jul-Aug;37(4):397-405. doi: 10.1016/j.nefro.2016.11.020 [Article in English, Spanish]
  15. Jerne NK. Immunological speculations. Annu Rev Microbiol. 1960;14:341-58. doi: 10.1146/annurev.mi.14.100160.002013
  16. Lobashevsky AL, Senkbeil RW, Shoaf JL, Stephenson AK, Skelton SB, Burke RM, Deierhoi MH, Thomas JM. The number of amino acid residues mismatches correlates with flow cytometry crossmatching results in high PRA renal patients. Hum Immunol. 2002 May;63(5):364-74. doi: 10.1016/s0198-8859(02)00371-3
  17. Dankers MK, Witvliet MD, Roelen DL, de Lange P, Korfage N, Persijn GG, Duquesnoy R, Doxiadis II, Claas FH. The number of amino acid triplet differences between patient and donor is predictive for the antibody reactivity against mismatched human leukocyte antigens. Transplantation. 2004 Apr 27;77(8):1236-39. doi: 10.1097/01.tp.0000120385.03278.28
  18. Duquesnoy RJ, Takemoto S, de Lange P, Doxiadis II, Schreuder GM, Persijn GG, Claas FH. HLAmatchmaker: a molecularly based algorithm for histocompatibility determination. III. Effect of matching at the HLA-A,B amino acid triplet level on kidney transplant survival. Transplantation. 2003 Mar 27;75(6):884-89. doi: 10.1097/01.TP.0000055101.20821.AC
Address for correspondence:
129110, Russian Federation,
Moscow, Schepkin str., 61/2, 6,
Moscow Regional Research Clinical Institute
Named after M.F. Vladimirskiy,
the Surgical Department of Kidney Transplantation,
tel. mobile +7-916-705-98-99,
e-mail:7059899@gmail.com,
Zulkarnaev Alexey B.
Information about the authors:
Vatazin Andrey V., MD, Professor, Chief Researcher of the Surgical Department of Kidney Transplantation, Moscow Regional Research Clinical Institute Named after M.F. Vladimirskiy, Moscow, the Russian Federation.
http://orcid.org/0000-0001-8497-0693
Zulkarnaev Alexey B., MD, Associate Professor, Leading Researcher of the Surgical Department of Kidney Transplantation, Moscow Regional Research Clinical Institute Named after M.F. Vladimirskiy, Moscow, Russian Federation.
http://orcid.org/0000-0001-5405-7887
Stepanov Vadim A., PhD, Senior Researcher of the Surgical Department of Kidney Transplantation, Moscow Regional Research Clinical Institute Named after M.F. Vladimirskiy, Moscow, Russian Federation.
http://orcid.org/0000-0002-0881-0599

TRAUMATOLOGY

M.V. CHEPELEVA, N.M. KLIUSHIN, A.M. ERMAKOV, E.I. KUZNECOVA

LYMPHOCYTE POPULATIONS IN PATIENTS WITH PERIPROSTHETIC INFECTION OF THE HIP JOINT

National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of Russia, Kurgan,
The Russian Federation

Objective. To study the peculiarities of cell-mediated immunity in patients with periprosthetic hip joint infection depending on disease severity and according to the method of surgical intervention, subsequently used.
Methods. The values of cell-mediated immunity were studied at the preoperative stage in patients (n=66) with periprosthetic hip joint infection who were divided into three groups: group I (n=13) – debridement of the infected joint with the replacement of the implant modular components; group II (n=36) – articulating spacer installation; group III (n=17) – resection arthroplasty. Lymphocyte subpopulations were studied by laser flow cytofluorimetry method.
Results. In comparison of the cell immunity values in groups I, II, III with those of the control group there was observed the absence of subpopulation alterations in group I, as well as the elevation of relative content of ÑD3+ÑD8+ for normal content of ÑD3+ÑD4+ in group II; the elevation of both relative and absolute values of ÑD3+ÑD8+ while reduction of the values of ÑD3+ÑD4+ in group III. The content of activated T-lymphocytes was elevated in all three groups. A Kruskal-Wallis test to analyze 3 groups revealed significant difference between the groups (I, II, III) regarding the immunoregulatory index (CD4/CD3); (H-6,67; ð=0,035). There was statistically significant difference between groups I-III (p=0,012) and between groups II-III (p=0,011). Intergroup difference was also identified regarding ÑD3+ÑD4+ (%); (H-22,57; ð=0,0003). Statistically significant difference was determined between groups I-III (p=0,0002) and between groups II-III (p=0,0003).
Conclusions. The alterations in lymphocyte population composition can be considered as an informative marker of severe infection. The study of T-lymphocyte subpopulations Ò-helpers (ÑD3+ÑD4+) and cytotoxic T-lymphocytes (ÑD3+ÑD8+)) can be used to reveal immuno-compromised patients. These values can be regarded as additional diagnostic tests to select the optimal surgical treatment of periprosthetic infection.

Keywords: periprosthetic infection, hip joint, cell-mediated immunity, Ò-helpers (ÑD3+ÑD4+), cytotoxic T-lymphocytes (ÑD3+ÑD8+)
p. 276-283 of the original issue
References
  1. Kurtz SM, Lau EC, Son MS, Chang ET, Zimmerli W, Parvizi J. Are We winning or losing the battle with periprosthetic joint infection: trends in periprosthetic joint infection and mortality risk for the medicare population. J Arthroplasty. 2018 Oct;33(10):3238-45. doi: 10.1016/j.arth.2018.05.042
  2. Gomes LSM. Early Diagnosis of periprosthetic joint infection of the hip-current status, advances, and perspectives. Rev Bras Ortop (Sao Paulo). 2019 Jul;54(4):368-76. Published online 2019 Aug 20. doi: 10.1055/s-0039-1693138
  3. Izakovicova P, Borens O, Trampuz A. Periprosthetic joint infection: current concepts and outlook. EFORT Open Rev. 2019 Jul;4(7):482-94. Published online 2019 Jul 29. doi: 10.1302/2058-5241.4.180092
  4. Abblitt WP, Chan EW, Shinar AA. Risk of Periprosthetic joint infection in patients with multiple arthroplasties. J Arthroplasty. 2018 Mar;33(3):840-43. doi: 10.1016/j.arth.2017.10.024
  5. Winkler T, Trampuz A, Renz N, Perka C, Bozhkova SA. Classification and algorithm for diagnosis and treatment of hip prosthetic joint infection. Traumatology and Orthopedics of Russia. 2016;(1):33-45. doi: 10.21823/2311-2905-2016-0-1-33-45 (In Russ.)
  6. Saleh A, George J, Sultan AA, Samuel LT, Mont MA, Higuera-Rueda CA. The quality of diagnostic studies in periprosthetic joint infections: can we do better? J Arthroplasty. 2019 Nov;34(11):2737-43. doi: 10.1016/j.arth.2019.06.044
  7. Carli AV, Abdelbary H, Ahmadzai N, Cheng W, Shea B, Hutton B, Sniderman J, Philip Sanders BS, Esmaeilisaraji L, Skidmore B, Gauthier-Kwan OY, Bunting AC, Gauthier P, Crnic A, Logishetty K, Moher D, Fergusson D, Beaulé PE. Diagnostic accuracy of serum, synovial, and tissue testing for chronic periprosthetic joint infection after hip and knee replacements: a systematic review. J Bone Joint Surg Am. 2019 Apr 3;101(7):635-49. doi: 10.2106/JBJS.18.00632
  8. Saleh A, George J, Faour M, Klika AK, Higuera CA. Serum biomarkers in periprosthetic joint infections. Bone Joint Res. 2018 Jan;7(1):85-93. doi: 10.1302/2046-3758.71.BJR-2017-0323
  9. Gómez-García F, Espinoza-Mendoza RL. Whats new for the diagnosis of periprosthetic infections after the Philadelphia consensus? Acta Ortop Mex. 2019 Mar-Apr;33(2):127-35. [Article in Spanish; Abstract available in Spanish from the publisher]
  10. Chepeleva MV, Klyushin NM, Ermakov AM, Ababkov YuV. Interleukin-6 in predicting the course of postoperative period in patients with periprosthetic infection of the hip. Sib Nauch Med Zhurn. 2015;35(4):45-48. http://sibmed.net/article/360/8-4-2015.pdf (In Russ.)
  11. Heim CE, Vidlak D, Odvody J, Hartman CW, Garvin KL, Kielian T. Human prosthetic joint infections are associated with myeloid-derived suppressor cells (MDSCs): Implications for infection persistence. J Orthop Res. 2018 Jun;36(6):1605-13. doi: 10.1002/jor.23806
  12. Seebach E, Kubatzky KF. Chronic implant-related bone infections-can immune modulation be a therapeutic strategy? Front Immunol. 2019;10:1724. Published online 2019 Jul 23. doi: 10.3389/fimmu.2019.01724
  13. Preobrazhenskii PM, Kazemirskii AV, Goncharov MIu. Current views on diagnosing and treatment of patients with infection after the knee arthroplasty. Genii Ortopedii. 2016;(3):94-104. doi: 10.18019/1028-4427-2016-3-94-104 (In Russ)
  14. Lazarides AL, Vovos TJ, Reddy GB, Kildow BJ, Wellman SS, Jiranek WA, Seyler TM. Traditional laboratory markers hold low diagnostic utility for immunosuppressed patients with periprosthetic joint infections. J Arthroplasty. 2019 Jul;34(7):1441-45. doi: 10.1016/j.arth.2019.03.013
  15. Chuksina JuJu, Moscaletc OV, Jazdovskij VV, Eremin AV, Oshkukov SA. Clinical and immunological parallels in periprosthetic infection after total large joints arthroplasty. Kazan Med Zhurn. 2016;97(4):514-18. doi: 10.17750/KMJ2016-514 (In Russ.)
Address for correspondence:
640014, Russian Federation,
Kurgan, M. Ulyanova str., 6,
National Medical Research Center
of Traumatology and Orthopedics Named
after Academician G.A. Ilizarov of the Ministry
of Health of the Russian Federation,
tel. mobile: +7 912 838-42-49,
å-mail: citoz@mail.ru,
Kuznecova Elena I.
Information about the authors:
Chepeleva Marina V., PhD, Senior Researcher, Scientific Clinical Laboratory of Microbiology and Immunology, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of the Russian Federation, Kurgan, Russian Federation.
https://orcid.org/0000-0002-9731-115X
Kliushin Nicolay M., MD, professor, Head of the Clinic of “Purulent osteology”, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health the Russian Federation, Kurgan, Russian Federation.
https://orcid.org/0000-0002-1601- 9713
Ermakov Artem M., PhD, Traumatologist-Orthopedist, the Clinic of “Purulent osteology”, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of the Russian Federation, Kurgan, Russian Federation.
https://orcid.org/0000-0002-5420-4637
Kuznecova Elena I., Junior Researcher, Scientific Clinical Laboratory of Microbiology and Immunology, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of the Russian Federation, Kurgan, Russian Federation.
https://orcid.org/0000-0001-8022-5696

ONCOLOGY

S.A. LUKYANOV 1, S.V. SERGIYKO 1, S.E. TITOV 2, 3, YU.À. VERYASKINA 2

PROSPECTS OF MOLECULAR GENETIC PANELS USE IN THE PREOPERATIVE DIFFERENTIAL DIAGNOSIS OF NODULAR LESIONS OF THE THYROID GLAND

South Ural State Medical University 1, Chelyabinsk,
Institute of Molecular and Cellular Biology of Siberian Branch of RAS 2, Novosibirsk,
JSC ''Vector-Best'' 3, Novosibirsk,
The Russian Federation

Objective. To assess the possibility of a molecular genetic classifier in the preoperative thyroid cancer diagnosis using colored cytological preparations obtained during fine needle aspiration biopsy of thyroid nodes.
Methods. The results of cytological, histological and molecular genetic studies of patients (n=138) were compared. To conduct a molecular genetic study, colored glasses with cytological material from the thyroid nodes of patients were selected, the preoperative cytological conclusions corresponding to the classification of Bethesda (2017) group IV, V, and VI. All patients were operated on at the Regional Center of the Endocrine Surgery or the Regional Oncology and Nuclear Medicine Clinical Center in Chelyabinsk, where a final histological diagnosis was made. To determine agreement of preoperative cytological and postoperative histological conclusions the specimens were divided into 4 groups: a benign node; a follicular tumor without malignancy markers; papillary cancer; and a follicular tumor with malignancy markers.
Results. In thyroid cancer, the coincidence of the results of the preoperative molecular genetic and postoperative histological studies was found in 53 (94.6%) cases (a true positive result), and a discrepancy – in 10 (7.2%) (a false positive result). In 72 (52.2%) cases in benign tumors, no molecular genetic markers of malignancy were detected (a true negative result), in 3 (2.2%) cases the cancer was missed (a false negative result).
The prognostic value of a positive result of a molecular genetic study was 84.1%, and the prognostic value of a negative result – 96%.
Conclusions. Molecular genetic testing using commonly prepared colored smears can determine accurately the malignant and benign thyroid nodules, thereby it lets improving the quality of pre-operative differential diagnosis of the thyroid nodules and reduce the number of unreasonable operations.

Keywords: thyroid cancer, fine needle aspiration biopsy, molecular genetic study, micro-RNA, Bethesda classification
p. 284-289 of the original issue
References
  1. Beltsevich DG, Vanushko VE, Rumiantsev PO, Melnichenko GA, Kuznetsov NS, Abrosimov AYu, Polyakov VG, Mudunov AM, Podvyaznikov SO, Romanov IS, Polyakov AP, Sleptsov IV, Chernikov RA, Vorobyov SL. Fadeyev VV. 2017. Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment. Endokrin Khirurgiia. 2017;11(1):6-27. http://vidar.ru/Article.asp?fid=ESR_2017_1_6 (In Russ.)
  2. Ali S, Cibas E, eds. The Bethesda System for Reporting Thyroid Cytopathology: Definitions, Criteria, and Explanatory Notes. 2nd ed. New York: Springer; 2018.
  3. Yang J, Schnadig V, Logrono R, Wasserman PG. Fine-needle aspiration of thyroid nodules: a study of 4703 patients with histologic and clinical correlations. Cancer. 2007 Oct 25;111(5):306-15. doi: 10.1002/cncr.22955
  4. Wormald R, Sheahan P, Rowley S, Rizkalla H, Toner M, Timon C. Hemithyroidectomy for benign thyroid disease: who needs follow-up for hypothyroidism? Clin Otolaryngol. 2008 Dec;33(6):587-91. doi: 10.1111/j.1749-4486.2008.01794.x
  5. Stoll SJ, Pitt SC, Liu J, Schaefer S, Sippel RS, Chen H. Thyroid hormone replacement after thyroid lobectomy. Surgery. 2009 Oct;146(4):554-8; discussion 558-60. doi: 10.1016/j.surg.2009.06.026
  6. Vargas-Salas S, Martínez JR, Urra S, Domínguez JM, Mena N, Uslar T, Lagos M, Henríquez M, González HE. Genetic testing for indeterminate thyroid cytology: review and meta-analysis. Endocr Relat Cancer. 2018 Mar;25(3):R163-R77. doi: 10.1530/ERC-17-0405
  7. Duick DS, Klopper JP, Diggans JC, Friedman L, Kennedy GC, Lanman RB, McIver B. The impact of benign gene expression classifier test results on the endocrinologist-patient decision to operate on patients with thyroid nodules with indeterminate fine-needle aspiration cytopathology. Thyroid. 2012 Oct;22(10):996-1001. doi: 10.1089/thy.2012.0180
  8. Titov SE, Ivanov MK, Karpinskaya EV, Tsivlikova EV, Shevchenko SP, Veryaskina YA, Akhmerova LG, Poloz TL, Klimova OA, Gulyaeva LF, Zhimulev IF, Kolesnikov NN. miRNA profiling, detection of BRAF V600E mutation and RET-PTC1 translocation in patients from Novosibirsk oblast (Russia) with different types of thyroid tumors. BMC Cancer. 2016 Mar 9;16:201. doi: 10.1186/s12885-016-2240-2
  9. Titov S, Demenkov PS, Lukyanov SA, Sergiyko SV, Katanyan GA, Veryaskina YA, Ivanov MK. Preoperative detection of malignancy in fine-needle aspiration cytology (FNAC) smears with indeterminate cytology (Bethesda III, IV) by a combined molecular classifier.J Clin Pathol. 2020 Mar 25:jclinpath-2020-206445. doi: 10.1136/jclinpath-2020-206445
  10. Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2009 Nov;19(11):1159-65. doi: 10.1089/thy.2009.0274
Address for correspondence:
454092, Russian Federation,
Chelyabinsk, Vorovskii str., 64,
South Ural State Medical University,
the Department of General
and Pediatric Surgery,
tel. +7 950 744-45-95,
e-mail: 111lll@mail.ru,
Lukyanov Sergey A.
Information about the authors:
Lukyanov Sergey A., PhD, Assistant, the Department of General and Pediatric Surgery, South Ural State Medical University, Chelyabinsk, Russian Federation.
http://orcid.org/0000-0001-5559-9872
Sergiyko Sergey V., MD, Associate Professor, Head of the Department of General and Pediatric Surgery, South Ural State Medical University, Chelyabinsk, the Russian Federation.
http://orcid.org/0000-0001-6694-9030
Titov Sergei E., PhD, Senior Researcher of the Laboratory of the Molecular Genetics, Institute of Molecular and Cellular Biologyof Siberian Branch of RAS, JSC “Vector-Best”, Novosibirsk, Russian Federation.
http://orcid.org/0000-0001-9401-5737
Veryaskina Yuliya A., PhD, Researcher of the Laboratory of the Molecular Genetics, Institute of Molecular and Cellular Biology of Siberian Branch of RAS Novosibirsk, Russian Federation.
http://orcid.org/0000-0002-3799-9407

ANESTESIOLOGY-REANIMATOLOGY

D.P. MARKEVICH 1, A.V. MAROCHKOV 2

ANESTHESIA AND CORTISOL LEVEL IN PATIENTS WITH TRAUMATIC BRAIN INJURY DURING CRANIOTOMY

Mogilev City Emergency Hospital 1,
Mogilev Regional Hospital 2, Mogilev,
The Republic of Belarus

Objective. To analyze the serum cortisol level during the operation and in the early postoperative period in patients with traumatic brain injury to assess the effectiveness of anesthetic management methods for craniotomy.
Methods. The study included patients (n=111) with the traumatic brain injury. The patients of the 1st group (n=57) underwent to a combination of general anesthesia and cranial soft tissue nerve blockade with low-volumes of local anesthetics during craniotomy.
The patients of the 2nd group (n=58) underwent to general anesthesia. The serum cortisol was examined during the operation and within 10-12 hours after the intervention in 22 (38.6%) patients of the 1st group and 20 (37%) of patients in the 2nd group.
Results. During craniotomy in patients with cranial soft tissue nerve blockade the level of serum cortisol at the main stage of the operation and at the end of the intervention was lower than in patients of the 2nd group. In the 1st group cortisol level at the main stage of the operation was 136.4 (75; 325.4) ng/ml, and in the 2nd group – 258.8 (161.7; 543.5) ng/ml, p=0.024. At the initial stage of the operation in the 1st group cortisol level was 119.6 (47.6; 327.2) ng/ml, and in the 2nd group it was 323.1 (156.9; 673.1) ng/ml, p=0.027. Difference of cortisol levels in patients of both groups 10-12 hours postoperatively have not been detected.
Conclusions. The concentration of blood cortisol was lower in patients with traumatic brain injury who received a combination of general anesthesia and cranial soft tissue nerve blockades than in patients who underwent only general anesthesia. Cranial soft tissue nerve blockades with small volumes of local anesthetics in patients with traumatic brain injury during surgery demonstrated high pain relief.

Keywords: traumatic brain injury, craniotomy, cotrisol, general anesthesia, nerve blockades
p. 290-298 of the original issue
References
  1. Shanko YG, Sidarovich RR, Tanin AL, Naledzka AN, Zurauleu UA. Epidemiology of traumatic brain injury in the Republic of Belarus. Mezhdunar Nevrol Zhurn. 2017;5(91):33-37. http://dx.doi.org/10.22141/2224-0713.5.91.2017.110854 (in Russ.)
  2. Kusmenkov T, Braunstein M, Schneider HJ, Bidlingmaier M, Prall WC, Flatz W, Boecker W, Bogner V. Initial free cortisol dynamics following blunt multiple trauma and traumatic brain injury: a clinical study. J Int Med Res. 2019 Mar;47(3):1185-94. doi: 10.1177/0300060518819603
  3. Haldar R, Kaushal A, Gupta D, Srivastava S, Singh PK. Pain following craniotomy: reassessment of the available options. Biomed Res Int. 2015;2015:509164. doi: 10.1155/2015/509164
  4. Citerio G, Pesenti A, Latini R, Masson S, Barlera S, Gaspari F, Franzosi MG; NeuroMorfeo Study Group. A multicentre, randomised, open-label, controlled trial evaluating equivalence of inhalational and intravenous anaesthesia during elective craniotomy. Eur J Anaesthesiol. 2012 Aug;29(8):371-79. doi: 10.1097/EJA.0b013e32835422db
  5. Dzyadzko AM, Bolonkin LS, Minov AF, Piskun AB, Chugunova OA, Katin ML, Brukhatsky AA, Fedoruk AM, Shcherba AE. Evaluation of sympathetic blockade under thoracic epidural versus bilateral paravertebral anesthesias during high-traumaticity operations on the upper abdominal organs. Messenger of Anesthesiology and Resuscitation. 2015;12(1):34-40. doi: 10.21292/2078-5658-2015-12-1-34-40 (In Russ.)
  6. Papangelou A, Radzik BR, Smith T, Gottschalk A. A review of scalp blockade for cranial surgery. J Clin Anesth. 2013 Mar;25(2):150-59. doi: 10.1016/j.jclinane.2012.06.024
  7. Dimopoulou I, Tsagarakis S. Hypothalamic-pituitary dysfunction in critically ill patients with traumatic and nontraumatic brain injury. Intensive Care Med. 2005 Aug;31(8):1020-28. doi: 10.1007/s00134-005-2689-y
  8. Klose M, Feldt-Rasmussen U. Hypopituitarism in Traumatic Brain Injury-A Critical Note. J Clin Med. 2015 Jul 14;4(7):1480-97. doi: 10.3390/jcm4071480
  9. Mirzaie B, Mohajeri-Tehrani MR, Annabestani Z, Shahrzad MK, Mohseni S, Heshmat R, Afshani HR, Meybodi HR, Larijani B. Traumatic brain injury and adrenal insufficiency: morning cortisol and cosyntropin stimulation tests. Arch Med Sci. 2013 Feb 21;9(1):68-73. doi: 10.5114/aoms.2012.30833
  10. Llompart-Pou JA, Raurich JM, Pérez-Bárcena J, Barceló A, Ibáñez J, Ayestarán JI. Acute Hypothalamic-pituitary-adrenal response in traumatic brain injury with and without extracerebral trauma. Neurocrit Care. 2008;9(2):230-36. doi: 10.1007/s12028-008-9115-6
  11. Kuvshinov MV, Obryadina AP. The actual issues of comparing the results of quantative immune-enzyme tests. Klin Lab Diagnostika. 2012;(4):32-35. https://cyberleninka.ru/article/n/aktualnye-problemy-sravneniya-rezultatov-kolichestvennyh-immunofermentnyh-testov (In Russ.)
  12. Canakci E, Unal D, Yildirim T, Yilmaz A. Our scalp block results in craniotomy cases. J Anest & Inten Care Med. 2017;2(4):555592. doi: 10.19080/JAICM.2017.02.555592
  13. Can BO, Bilgin H. Effects of scalp block with bupivacaine versus levobupivacaine on haemodynamic response to head pinning and comparative efficacies in postoperative analgesia: A randomized controlled trial. J Int Med Res. 2017 Apr;45(2):439-50. doi: 10.1177/0300060516665752
  14. Ayoub C, Girard F, Boudreault D, Chouinard P, Ruel M, Moumdjian R. A comparison between scalp nerve block and morphine for transitional analgesia after remifentanil-based anesthesia in neurosurgery. Anesth Analg. 2006 Nov;103(5):1237-40. doi: 10.1213/01.ane.0000244319.51957.9f
  15. Geze S, Yilmaz AA, Tuzuner F. The effect of scalp block and local infiltration on the haemodynamic and stress response to skull-pin placement for craniotomy. Eur J Anaesthesiol. 2009 Apr;26(4):298-303. doi: 10.1097/EJA.0b013e32831aedb2
Address for correspondence:
212030, Republic of Belarus,
Mogilev, Botkin str., 2,
Mogilev City Emergency Hospital,
Anesthesiology and Intensive Care Unit,
tel./fax: +375(222) 22-16-26,
e-mail: snyter1977@gmail.com,
Markevich Denis P.
Information about the authors:
Markevich Denis P., Head of Anesthesiology and Intensive Care Unit, Mogilev Emergency City Hospital, Mogilev, Republic of Belarus.
http://orcid.org/0000-0002-1117-3877
Marochkov Alexey V., MD, Professor, Anesthesiologist-Resuscitator, Mogilev Regional Hospital, Mogilev, Republic of Belarus.
http://orcid.org/0000-0001-5092-8315

NEUROSURGERY

IA.V. TSYMBALIUK 1, V.I. TSYMBALIUK 1, 2, I.B. TRETYAK 1, V.V. MEDVEDIEV 2, V.G. GURIANOV 2, A.A. GATSKIY 1, T.I. PETRIV 1

COMPARATIVE ANALYSIS OF VARIOUS TYPES OF NEUROTIZATION AS A METHOD OF SURGICAL TREATMENT OF PERIPHERAL FACIAL PARESIS

Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine 1
National Medical University Named after A.A. Bogomolets 2, Êiev,
Ukraine

Objective. Determination of the optimal type of facial nerve neurotization in patients with the consequences of its traumatic injury.
Methods. The treatment results of patient (n=172) with the facial nerve injury who underwent neurotization using different donor nerves was analized.
Women (n=97) made up 56.4%, men (n=75) – 43.6%. The median age was 38 years; the interquartile range was 29 – 50 years. The most common cause of the facial nerve damage was the removal of posterior fossa tumor – 123 patients (71.5%). Various types of reconstructive interventions were performed: facial nerve neurotization by the branches of the accessory nerve to the sternocleidomastoid muscle – 87 patients, facial nerve neurotization by branch of the accessory nerve to the sternocleidomastoid muscle and the descending branch of the hypoglossal nerve – 62 patients, by the accessory nerve – 10 patients, by the descending branch of the hypoglossal nerve – 10 patients, anterior motor branches C2-C3 – 3 patients.
The immediate and long-term results of treatment were studied. Patients underwent a follow-up examination and an ENMG study no earlier than 4 months after the surgery. Long-term results were studied no earlier than 12 months and up to 24 months after the surgery by means of repeated neurological examinations and additional electrophysiological techniques.
Results. In all cases, a positive result has been achieved. In 147 (85.4%) out of 172 patients, the recovery of facial nerve function according to the House – Brackmann scale to II – III level was observed. The best results were achieved in the cases of neurotization by the branches of the accessory nerve and the simultaneous use of several donor nerves (p<0.001).
Conclusion. The use of the accessory nerve branches as donors ensures restoration of the facial nerve function to level II-III on the House – Brackmann scale in 89.7% of patients and in terms of effectiveness, it does not differ from the technically more complex and prognostically less favorable facial nerve neurotization by the descending branch of the hypoglossal nerve and the branch of accessory nerve.

Keywords: neurotization, facial nerve, donor nerve, electroneuromyography, surgical treatment
p. 299-308 of the original issue
References
  1. Spencer CR, Irving RM. Causes and management of facial nerve palsy. Br J Hosp Med (Lond). 2016 Dec 2;77(12):686-91. doi: 10.12968/hmed.2016.77.12.686
  2. Reich SG. Bell’s Palsy. Continuum (Minneap Minn). 2017 Apr;23(2, Selected Topics in Outpatient Neurology):447-66. doi: 10.1212/CON.0000000000000447
  3. Zhang W, Xu L, Luo T, Wu F, Zhao B, Li X. The etiology of Bell’s palsy: a review. J Neurol. 2019 Mar 28. doi: 10.1007/s00415-019-09282-4. Online ahead of print.
  4. Chang YS, Choi JE, Kim SW, Baek SY, Cho YS. Prevalence and associated factors of facial palsy and lifestyle characteristics: data from the Korean National Health and Nutrition Examination Survey 2010-2012. BMJ Open. 2016 Nov 9;6(11):e012628. doi: 10.1136/bmjopen-2016-012628
  5. Gordin E, Lee TS, Ducic Y, Arnaoutakis D. Facial nerve trauma: evaluation and considerations in management. Craniomaxillofac Trauma Reconstr. 2015 Mar;8(1):1-13. doi: 10.1055/s-0034-1372522
  6. Salles AG, da Costa EF, Ferreira MC, Remigio AF, Moraes LB, Gemperli R. Epidemiologic Overview of Synkinesis in 353 Patients with Longstanding Facial Paralysis under Treatment with Botulinum Toxin for 11 Years. Plast Reconstr Surg. 2015 Dec;136(6):1289-98. doi: 10.1097/PRS.0000000000001802
  7. Cooper L, Lui M, Nduka C. Botulinum toxin treatment for facial palsy: A systematic review. J Plast Reconstr Aesthet Surg. 2017 Jun;70(6):833-41. doi: 10.1016/j.bjps.2017.01.009
  8. Jowett N, Hadlock TA. A Contemporary Approach to Facial Reanimation. JAMA Facial Plast Surg. 2015 Jul-Aug;17(4):293-300. doi: 10.1001/jamafacial.2015.0399
  9. Robinson MW, Baiungo J. Facial Rehabilitation: Evaluation and Treatment Strategies for the Patient with Facial Palsy. Otolaryngol Clin North Am. 2018 Dec;51(6):1151-67. doi: 10.1016/j.otc.2018.07.011
  10. Socolovsky M, Páez MD, Masi GD, Molina G, Fernández E. Bell’s palsy and partial hypoglossal to facial nerve transfer: Case presentation and literature review. Surg Neurol Int. 2012;3:46. doi: 10.4103/2152-7806.95391
  11. Azizzadeh B, Irvine LE, Diels J, Slattery WH, Massry GG, Larian B, Riedler KL, Peng GL. Modified Selective Neurectomy for the Treatment of Post-Facial Paralysis Synkinesis. Plast Reconstr Surg. 2019 May;143(5):1483-96. doi: 10.1097/PRS.0000000000005590
  12. House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985 Apr;93(2):146-47. doi: 10.1177/019459988509300202
  13. Sforza C, Ulaj E, Gibelli DM, Allevi F, Pucciarelli V, Tarabbia F, Ciprandi D, Dell’Aversana Orabona G, Dolci C, Biglioli F. Three-dimensional superimposition for patients with facial palsy: an innovative method for assessing the success of facial reanimation procedures. Br J Oral Maxillofac Surg. 2018 Jan;56(1):3-7. doi: 10.1016/j.bjoms.2017.11.015
  14. Tret’iakova A². Kl³n³ko-elektroneirom³ograf³chna d³agnostika urazhen’ lits’ovogo nerva, kriter³¿ prognozuvannia efektivnost³ l³kuvannia. Ukr V³sn Psikhonevrolog³¿ii. 2002;10(2):79-81. (In Ukr.)
  15. Kimura M, Nakagawa I, Niinai H, Hamada H, Sakai A, Yasuuji M. Evaluation with blink reflex of bilateral facial palsy. Masui. 2000 Feb;49(2):159-62. [Article in Japanese]
  16. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013 Mar;48(3):452-58. doi: 10.1038/bmt.2012.244
  17. Nerobeev AI, Plotnikov NA. Vosstanovitel’naia khirurgiia miagkikh tkanei cheliustno-litsevoi oblasti: ruk dlia vrachei. Moskva, RF: Meditsina; 1997. 228 p. http://padabum.com/d.php?id=51328 (In Russ.)
Address for correspondence:
04050, Ukraine,
Êiev, Platon Mayboroda str., 32,
Institute of Neurosurgery Named
after A.P. Romodanov NAMS of Ukraine,
Department of Restorative Neurosurgery,
tel.: +38 (044) 483-12-53,
e-mail: yaroslav.neuro@gmail.com,
Tsymbaliuk Iaroslav V.
Information about the authors:
Tsymbaliuk Iaroslav V., Postgraduate Student of the Department of Neurosurgery, National Medical University Named after. A.A. Bogomolets, Neurosurgeon of the Restorative Neurosurgery Department, Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine, Êiev, Ukraine.
http://orcid.org/0000-0002-8746-0944
Tsymbaliuk Vitalii I., Academician of NAMS of Ukraine, Corresponding Member of NAS of Ukraine, MD, Professor, President of NAMS of Ukraine, Head of the Department of Neurosurgery, National Medical University Named after A.A. Bogomolets, Scientific Supervisor of Restorative Neurosurgery Department, Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine, Êiev, Ukraine.
http://orcid.org/0000-0003-3608-9679
Tretyak Igor B., MD, Head of Restorative Neurosurgery Department, Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine, Êiev, Ukraine.
http://orcid.org/0000-0003-0977-7062
Medvediev Vladimir V., MD, Associate Professor of the Department of Neurosurgery, National Medical University Named after. A.A. Bogomolets, Êiev, Ukraine.
http://orcid.org/0000-0001-7236-3191
Gurianov Vitaly G., PhD, Associate Professor of the Department of Public Health Service Management, National Medical University Named after A.A. Bogomolets, Êiev, Ukraine.
https://orcid.org/0000-0001-8509-6301
Gatskiy Alexander A., PhD, Neurosurgeon of the Restorative Neurosurgery Department, Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine, Êiev, Ukraine.
http://orcid.org/0000-0002-2212-2143
Petriv Taras I., PhD, Neurosurgeon of the Restorative Neurosurgery Department, Institute of Neurosurgery Named after A.P. Romodanov NAMS of Ukraine, Êiev, Ukraine.
http://orcid.org/0000-0001-9160-8908

REVIEWS

T.A. JARKENOV 1, O.G. SKIPENKO 2, M.N. ZHUMABAEV 1, S.T. ZAIROVA 3, N.A. AKATAEV 1, D.B. YESSENBAEV 1, M.M. MUKUSHEV 1, K.ZH. NURMANOV 1, M.E. BALSHAMBAEV 1

THE ASSOCIATION OF TUMOR NECROSIS FACTOR-α GENE POLYMORPHISM WITH THE SEVERITY OF ACUTE PANCREATITIS: A SYSTEMATIC REVIEW

West Kazakhstan Marat Ospanov State Medical University 1, Aktobe,
The Republic of Kazakhstan
Hepato-Pancreato-Biliary Association of Commonwealth of Independent States 2, Moscow,
The Russian Federation,
Military Institute of Air Defense Named after T.J. Begeldinov 3, Aktobe,
The Republic of Kazakhstan

Objective. The performance of a systematic review of the current literature and meta-analysis to provide the more precise estimations of the association between TNF-α gene polymorphism with the development and severity of acute pancreatitis (AP).
Methods. A systematic review, searching the Medline and Web of Science databases revealed the relevant researches. The analysis based on ten molecular genetic case-control studies of the TNF-α promoter in patients with acute pancreatitis (n=1660) and healthy volunteers (n=1618).
Results. A systematic review showed discrepant results. In three studies the association of functionally significant polymorphism -308G> A in the TNF gene promoter with a severe form of AP, development SIRS and MODS have been established. The association of -308 G / A polymorphism of the TNF gene with the risk of a developing of moderate form of acute non-biliary pancreatitis was identified in one study. In other studies the association of TNF gene polymorphism with the severity of AP was not confirmed.
Conclusions. The presented genetic studies of the TNF-α promoter at acute pancreatitis manifested the controversal results.

Keywords: acute pancreatitis, clinical course, molecular genetic studies, tumor necrosis factorα, genetic polymorphism
p. 309-317 of the original issue
References
  1. Shen HN, Lu CL, Li CY. Epidemiology of first-attack acute pancreatitis in Taiwan from 2000 through 2009: a nationwide population-based study. Pancreas. 2012 Jul;41(5):696-702. doi: 10.1097/MPA.0b013e31823db941
  2. Karakayali FY. Surgical and interventional management of complications caused by acute pancreatitis. World J Gastroenterol. 2014 Oct 7;20(37):13412-23. Published online 2014 Oct 7. doi: 10.3748/wjg.v20.i37.13412
  3. Makhija R, Kingsnorth AN. Cytokine storm in acute pancreatitis. J Hepatobiliary Pancreat Surg. 2002;9(4):401-10. doi: 10.1007/s005340200049
  4. Malleo G, Mazzon E, Siriwardena AK, Cuzzocrea S. Role of tumor necrosis factor-alpha in acute pancreatitis: from biological basis to clinical evidence. Shock. 2007 Aug;28(2):130-40. doi: 10.1097/shk.0b013e3180487ba1
  5. Zhang JM, An J. Cytokines, inflammation, and pain. Int Anesthesiol Clin. 2007 Spring;45(2):27-37. doi: 10.1097/AIA.0b013e318034194e
  6. Chen Y, Xie CL, Hu R, Shen CY, Zeng M, Wu CQ, Chen TW, Chen C, Tang MY., Xue HD, Jin ZY, Zhang XM. Genetic Polymorphisms: A Novel Perspective on Acute Pancreatitis. Gastroenterol Res Pract. 2017;2017:5135172. doi: 10.1155/2017/5135172
  7. Whitcomb DC. Value of genetic testing in the management of pancreatitis. Gut. 2004 Nov;53(11):1710-7. doi: 10.1136/gut.2003.015511
  8. Falagas ME, Pitsouni EI, Malietzis GA, Pappas G. Comparison of PubMed, Scopus, Web of Science, and Google Scholar: strengths and weaknesses. FASEB J. 2008 Feb;22(2):338-42. doi: 10.1096/fj.07-9492LSF
  9. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009 Jul 21;339:b2535. doi: 10.1136/bmj.b2535
  10. Balog A, Gyulai Z, Boros LG, Farkas G, Takács T, Lonovics J, Mándi Y. Polymorphism of the TNF-alpha, HSP70-2, and CD14 genes increases susceptibility to severe acute pancreatitis. Pancreas. 2005 Mar;30(2):e46-50. doi: 10.1097/01.mpa.0000153329.92686.ac
  11. Bishehsari F, Sharma A, Stello K, Toth C, O’Connell MR, Evans AC, LaRusch J, Muddana V, Papachristou GI, Whitcomb DC. TNF-alpha gene (TNFA) variants increase risk for multi-organ dysfunction syndrome (MODS) in acute pancreatitis. Pancreatology. 2012 Mar-Apr;12(2):113-18. doi: 10.1016/j.pan.2012.02.014
  12. Liu Y, Dan G, Wu L, Chen G, Wu A, Zeng P, Xu W. Functional effect of polymorphisms in the promoter of TNFAIP3 (A20) in acute pancreatitis in the Han Chinese population. PLoS One. 2014 Jul 22;9(7):e103104. doi: 10.1371/journal.pone.0103104. eCollection 2014.
  13. Samgina TA, Bushueva OYu, Ivanov VP, Solodilova MA, Nazarenko PM, Polonikov AV. The association study of the promoter polymorphism -308g>a of tumor necrosis factor gene with the development and severity of acute pancreatitis in Russian population of Kursk region. Eksperimental’naia i Klinicheskaia Gastroenterologiia. 2014;109 (9):17-20. https://elibrary.ru/item.asp?id=22677286 (In Russ.)
  14. Sargen K, Demaine AG, Kingsnorth AN. Cytokine gene polymorphisms in acute pancreatitis. JOP. 2000 Jul;1(2):24-35. doi: 10.6092/1590-8577/423
  15. Powell JJ, Fearon KC, Siriwardena AK, Ross JA. Evidence against a role for polymorphisms at tumor necrosis factor, interleukin-1 and interleukin-1 receptor antagonist gene loci in the regulation of disease severity in acute pancreatitis. Surgery. 2001 May;129(5):633-40. doi: 10.1067/msy.2001.113375
  16. Zhang DL, Li JS, Jiang ZW, Yu BJ, Tang XM, Zheng HM. Association of two polymorphisms of tumor necrosis factor gene with acute biliary pancreatitis. World J Gastroenterol. 2003 Apr;9(4):824-28. doi: 10.3748/wjg.v9.i4.824
  17. Tukiainen E, Kylänpää ML, Puolakkainen P, Kemppainen E, Halonen K, Orpana A, Methuen T, Salaspuro M, Haapiainen R, Repo H. Polymorphisms of the TNF, CD14, and HSPA1B genes in patients with acute alcohol-induced pancreatitis. Pancreas. 2008 Jul;37(1):56-61. doi: 10.1097/MPA.0b013e31815d9bad
  18. Özhan G, Yanar HT, Ertekin C, Alpertunga B. Polymorphisms in tumour necrosis factor alpha (TNFalpha) gene in patients with acute pancreatitis. Mediators Inflamm. 2010;2010:482950. doi: 10.1155/2010/482950
  19. Park JW, Choi JS, Han KJ, Lee SH, Kim EJ, Cho JH. Association of a genetic polymorphism of IL1RN with risk of acute pancreatitis in a Korean ethnic group. Korean J Intern Med. 2018 Nov;33(6):1103-10. doi: 10.3904/kjim.2017.133
  20. de Beaux AC, Goldie AS, Ross JA, Carter DC, Fearon KC. Serum concentrations of inflammatory mediators related to organ failure in patients with acute pancreatitis. Br J Surg. 1996 Mar;83(3):349-53. doi: 10.1002/bjs.1800830317
  21. Chen CC, Wang SS, Lee FY, Chang FY, Lee SD. Proinflammatory cytokines in early assessment of the prognosis of acute pancreatitis. Am J Gastroenterol. 1999 Jan;94(1):213-18. doi: 10.1111/j.1572-0241.1999.00709.x
  22. Sun Y, Qi H. Relationship between the 308GA polymorphism of the tumor necrosis factor alpha gene and acute or chronic pancreatitis: a meta-analysis. Asian Biomed. 2012 Feb;6(1):1-7. doi: 10.5372/1905-7415.0601.120
  23. Yin YW, Hu AM, Sun QQ, Liu HG, Wang Q, Zeng YH, Xu RJ, Hou ZZ, Zhang SJ. Association between tumor necrosis factor-alpha gene -308A/G polymorphism and the risk of acute pancreatitis: a meta-analysis. J Surg Res. 2012 Nov;178(1):409-14. doi: 10.1016/j.jss.2012.02.001
  24. Yang Z, Qi X, Wu Q, Li A, Xu P, Fan D. Lack of association between TNF-α gene promoter polymorphisms and pancreatitis: a meta-analysis. Gene. 2012 Jul 25;503(2):229-34. doi: 10.1016/j.gene.2012.04.057
  25. Farkas G Jr, Hofner P, Balog A, Takács T, Szabolcs A, Farkas G, Mándi Y. Relevance of transforming growth factor-beta1, interleukin-8, and tumor necrosis factor-alpha polymorphisms in patients with chronic pancreatitis. Eur Cytokine Netw. 2007 Mar;18(1):31-37. doi: 10.1684/ecn.2007.0084
  26. Malleo G, Mazzon E, Siriwardena AK, Cuzzocrea S. Role of tumor necrosis factor-alpha in acute pancreatitis: from biological basis to clinical evidence. Shock. 2007 Aug;28(2):130-40. doi: 10.1097/shk.0b013e3180487ba1
Address for correspondence:
030019, Republic of Kazakhstan,
Aktobe, Maresyev str., 68,
West Kazakhstan Marat Ospanov Medical University, Surgical Diseases In the absenc No 1,
tel. +7 7132 544297,
e-mail: timurjarkenov@gmail.com,
Timur A. Jarkenov
Information about the authors:
Jarkenov Timur A.,MD, Professor of the Surgical Diseases Department No 1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
https://orcid.org/0000-0003-4579-6412
Skipenko Oleg G., MD, Professor, Member of Board of Hepato-Pancreato-Biliary Association of Commonwealth of Independent States, Moscow, Russian Federation.
https://orcid.org/0000-0002-4192-9620
Zhumabaev Marat N., PhD, Associate Professor, Head of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
https://orcid.org/0000-0002-5092-6034
Zairova SauleT., PhD, Military Institute of Air Defense Named after T.J. Begeldinov, Aktobe, Republic of Kazakhstan.
https://orcid.org/0000-0003-3734-6884
Akataev Nagashybai A., PhD, Professor of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
https://orcid.org/0000-0001-8964-5152
Yessenbaev Daulet B., Assistant of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
https://orcid.org/0000-0001-9777-0594
Mukushev Manas M., PhD, Associate Professor of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan
https://orcid.org/0000-0003-1811-3276
Nurmanov Kairat Zh., Assistant of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University), Aktobe, Republic of Kazakhstan.
https://orcid.org/0000-0003-1422-7524
Balshambayev Madi E., Assistant of the Surgical Diseases Department No1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Republic of Kazakhstan.
https://orcid.org/0000-0002-0206-1769

YU.V. BELOV 1, I.A. GUBAREV 1, 2, A.Z. SALEKH 2, K.B. FROLOV 2, K.N. RYBAKOV 2

MINI-ACCESS IN THE ABDOMINAL AORTA SURGERY

Russian Research Surgery Center named after Academician B.V.Petrovsky 1,
N.I. Pirogov Municipal Clinical Hospital ¹1 2, Moscow
The Russian Federation

Minimally invasive surgery is an area of general surgery that allows surgical interventions to be performed with less damage to normal tissues and organs. Recently, a growth of operations on the aorto-iliac segment with the use of mini-laparotomy incisions is increasingly observed. Minimally invasive technologies are implemented through classical techniques of the reconstructive surgery of the abdominal aorta. According to most authors, the technique of mini-laparotomy access to the aorta has already been sufficiently studied and introduced into the standard clinical practice of many hospitals in our country. However, up to the present, many issues relating to abdominal aorta surgery from mini-access remain not covered: postoperative complications, features of surgical technique, causes of failures and conversion to laparotomy to complete the procedure, are not sufficiently described. Most surgeons don’t have yet clear information about the spatial structure for the reproduction of manual techniques in the delimited wound volume. In addition, at present, despite a large number of scientific information in the native and foreign literature, there are no reliable data on modeling access to the «working» section of the abdominal aorta during operations for Leriche syndrome and abdominal aortic aneurysms by applying mini-laparatomic access.

Keywords: Leriche syndrome, abdominal aortic aneurysm, mini-access, mini-laparotomy, aorta surgery
p. 318-328 of the original issue
References
  1. Wooten C, Hayat M, du Plessis M, Cesmebasi A, Koesterer M, Daly KP, Matusz P, Tubbs RS, Loukas M. Anatomical significance in aortoiliac occlusive disease. Clin Anat. 2014 Nov;27(8):1264-74. doi: 10.1002/ca.22444
  2. Diehm C, Schuster A, Allenberg JR, Darius H, Haberl R, Lange S, Pittrow D, von Stritzky B, Tepohl G, Trampisch HJ. High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: cross-sectional study. Atherosclerosis. 2004 Jan;172(1):95-105. doi: 10.1016/s0021-9150(03)00204-1
  3. Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH, Aboyans V, Aksoy M, Alexandrescu VA, Armstrong D, Azuma N, Belch J, Bergoeing M, Bjorck M, Chakfé N, Cheng S, Dawson J, Debus ES, Dueck A, Duval S, Eckstein HH, Ferraresi R, Gambhir R, Gargiulo M, Geraghty P, Goode S, Gray B, Guo W, Gupta PC, Hinchliffe R, Jetty P, Komori K, Lavery L, Liang W, Lookstein R, Menard M, Misra S, Miyata T, Moneta G, Prado JAM, Munoz A, Paolini JE, Patel M, Pomposelli F, Powell R, Robless P, Rogers L, Schanzer A, Schneider P, Taylor S, Vega De Ceniga M, Veller M, Vermassen F, Wang J, Wang S. Global vascular guidelines on the management of chronic limb-threatening ischemia. Eur J Vasc Endovasc Surg. 2019 Jul;58(1 Suppl):S1-S109.e33. doi: 10.1016/j.ejvs.2019.05.006
  4. Khamitov FF, Belov IuV, Vertkina NV, Kuzubova EA. Miniinvazivnaia khirurgiia pri sindrome Lerisha. Moscow, RF: Nauka; 2005. 103 p. (In Russ.)
  5. Pokrovskii AV (red), Zotikova AE. Klinicheskaia angiologiia: ruk dlia vrachei: v 2 t. Moscow, RF: Meditsina; 2004. 1700 p. https://www.booksmed.com/hirurgiya/733-klinicheskaya-angiologiya-pokrovskij.html (In Russ.)
  6. Ashton HA, Buxton MJ, Day NE, Kim LG, Marteau TM, Scott RA, Thompson SG. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial. Lancet. 2002 Nov 16;360(9345):1531-39. doi: 10.1016/s0140-6736(02)11522-4
  7. Schmidt T, Mühlberger N, Chemelli-Steingruber IE, Strasak A, Kofler B, Chemelli A, Siebert U. Benefit, risks and cost-effectiveness of screening for abdominal aortic aneurysm. Rofo. 2010 Jul;182(7):573-80. doi: 10.1055/s-0029-1245140
  8. Pokrovskii AV, Gontarenko VN. Sostoianie sosudistoi khirurgii v Rossii v 2013 godu [Elektronnyi resurs] [csylka aktivna na 2019 Sent 10]. Rezhim dostupa: http://www.angiolsurgery.org/society/report/2013/ (In Russ.)
  9. Joint Committee for Vascular Cenres of International Union of Angiology (IUA)1; Section and Board of Vascular Surgery of Union Européenne des Médecins Spécialistes (SBVS-UEMS), Benedetti-Valentini F, Diamantopoulos E, Antignani PL, Bastounis E, Carpentier P, Fernandes e Fernandes J, Nicolaides A, Bergqvist D, Cairols M, Liapis CD, Nevelsteen A, Van Bockel JH. Guidelines for the organisation of vascular centres in Europe. Part I. Int Angiol. 2009 Oct;28(5):347-52. https://search.proquest.com/openview/cb50181749288f55d8bae957e50b2652
  10. Pokrovskii AV, Ivandaev AS. Sostoianie sosudistoi khirurgii v Rossii v 2017 godu [Elektronnyi resurs]. Angiologiia i Sosud Khirurgiia. 2018;24(3 Pril). 60 p. http://www.angiolsurgery.org/society/situation/2017.pdf/ (In Russ.)
  11. Bokeriia LA, Pokrovskii AV, Akchurin RS, Alekian BG, Apkhanova TV, Arakelian VS, Akhmedzhanov NM, Burleva EP, Vachev AN, Gavrilenko AV, Galstian GR, Gamzatov TKh, Eroshenko AV, Eroshkin IA, Kalashnikov VIu, Zatevakhin II, Kalinin RE, Karpenko AA, Katel’nitskii II, Kokhan EP, Kuznetsov MR, Kul’chitskaia DB, Matiushkin AV, Mukhamadeev IS, Ostroumova OD, Sapelkin SV, Svetlikov AV, Sitkin II, Sokurenko GIu, Soroka VV, Suchkov IA, Terekhin SA, Fokin AA, Kharazov AF, Khorev NG, Cherniavskii M.A, Chupin A.V. Natsional’nye rekomendatsii po diagnostike i lecheniiu zabolevanii arterii nizhnikh konechnostei [Elektronnyi resurs] [csylka aktivna na 2019 Ianv 01]. Rezhim dostupa: http://www.angiolsurgery.org/library/recom-mendations/2019/recommendations_LLA_2019.pdf (In Russ.)
  12. Belov IuV. Rukovodstvo po sosudistoi khirurgii s atlasom operativnoi tekhniki. Moscow, RF: MIA; 2011. 464 p. https://www.mmbook.ru/catalog/hirurgija/sosudistaja-xirurgija/105170-detail (In Russ.)
  13. Raffetto JD, Cheung Y, Fisher JB, Cantelmo NL, Watkins MT, Lamorte WW, Menzoian JO. Incision and abdominal wall hernias in patients with aneurysm or occlusive aortic disease. J Vasc Surg. 2003 Jun;37(6):1150-54. doi: 10.1016/s0741-5214(03)00147-2
  14. Augestad KM, Wilsgaard T, Solberg S. Incisional hernia after surgery for abdominal aortic aneurysm. Tidsskr Nor Laegeforen. 2002 Jan 10;122(1):22-24. https://tidsskriftet.no/2002/01/klinikk-og-forskning/arrbrokk-etter-operasjon-abdominalt-aortaaneurisme [Article in Norwegian]
  15. Liapis CD, Dimitroulis DA, Kakisis JD, Nikolaou AN, Skandalakis P, Daskalopoulos M, Kostakis AG. Incidence of incisional hernias in patients operated on for aneurysm or occlusive disease. Am Surg. 2004 Jun;70(6):550-52.
  16. Schlosser V, Blümel J, Spillner G. Transverse laparotomy as an approach pathway in reconstructive vascular surgery. Chirurg. 1972 Oct;43(10):482-83. [Article in German]
  17. Savel’ev VS, Kirienko AI, red. Sosudistaia khirurgiia: nats ruk. Moscow, RF: GEOTAR-Media, 2014. 464 p. (In Russ.)
  18. Rob C. Extraperitoneal approach to the abdominal aorta. Surgery. 1963 Jan;53:87-89.
  19. Hioki M, Iedokoro Y, Kawamura J, Yamashita Y, Yoshino N, Orii K, Masuda S, Yamashita K, Tanaka S. Left retroperitoneal approach using a retractor to repair abdominal aortic aneurysms: a comparison with the transperitoneal approach. Surg Today. 2002;32(7):577-80. doi: 10.1007/s005950200104
  20. Wirth G, Moccia R, Clement Darling R, Roddy SP, Mehta M, Kramer BC, Chang BB, Kreienberg PB, Paty PS, Ozsvath KJ, Shah DM. Aortoiliac reconstruction: the retroperitoneal approach and splenic injury. Ann Vasc Surg. 2003 Nov;17(6):604-7. doi: 10.1007/s10016-003-0079-x
  21. Yamada M, Maruta K, Shiojiri Y, Takeuchi S, Matsuo Y, Takaba T. Atrophy of the abdominal wall muscles after extraperitoneal approach to the aorta. J Vasc Surg. 2003 Aug;38(2):346-53. doi: 10.1016/s0741-5214(03)00119-8
  22. Shumacker HB Jr. Extraperitoneal Approach for Vascular Operations: Retrospective Review. South Med J. 1982 Dec;75(12):1499-507, 1516. doi: 10.1097/00007611-198212000-00013
  23. Nakajima T, Kawazoe K, Komoda K, Sasaki T, Ohsawa S, Kamada T. Midline retroperitoneal versus midline transperitoneal approach for abdominal aortic aneurysm repair. J Vasc Surg. 2000 Aug;32(2):219-23. doi: 10.1067/mva.2000.106946
  24. Khamitov FF, Belov IuV, Bazylev VV, Kubuzova EA, Guleshov VA. Miniinvazivnaia khirurgiia sindroma Lerisha. Khirurgiia Zhurn im NI Pirogova. 2004;(2):14-17. (In Russ.)
  25. Khamitov FF, Dibirov MD, Vertkina NV, Lisitskii DA. Miniinvazivnaia khirurgiia anevrizm briushnogo otdela aorty. Moscow, RF: Nauka; 2007. 115 p. (In Russ.)
  26. Fedorov IV, Sigal EI, Odintsov VV. Endoskopicheskaia khirurgiia. Moscow, RF: Goetar-MTs; 2001. 413 p. (In Russ.)
  27. Danielsson G, Albrechtsson U, Norgren L, Danielsson P, Ribbe E, Thörne J, Zdanowski Z. Percutaneous transluminal angioplasty of crural arteries: diabetes and other factors influencing outcome. Eur J Vasc Endovasc Surg. 2001 May;21(5):432-36. doi: 10.1053/ejvs.2001.1351
  28. Maloney JD, Hoch JR, Carr SC, Acher CW, Turnipseed WD. Preliminary experience with minilaparotomy aortic surgery. Ann Vasc Surg. 2000 Jan;14(1):6-12. doi: 10.1007/s100169910002
  29. Goode SD, Keltie K, Burn J, Patrick H, Cleveland TJ, Campbell B, Gaines P, Sims AJ. Effect of procedure volume on outcomes after iliac artery angioplasty and stenting. Br J Surg. 2013 Aug;100(9):1189-96. doi: 10.1002/bjs.9199
  30. Vorwerk D, Günther RW, Schürmann K, Wendt G. Aortic and iliac stenoses: follow-up results of stent placement after insufficient balloon angioplasty in 118 cases. Radiology. 1996 Jan;198(1):45-48. doi: 10.1148/radiology.198.1.8539403
  31. Martin EC, Katzen BT, Benenati JF, Diethrich EB, Dorros G, Graor RA, Horton KM, Iannone LA, Isner JM, Ramee SR, Schwarten DE, Tegtmeyer CJ, Walker CM, Wholey MH. Multicenter trial of the wallstent in the iliac and femoral arteries. J Vasc Interv Radiol. 1995 Nov-Dec;6(6):843-49. doi: 10.1016/s1051-0443(95)71198-8
  32. Murphy TP, Webb MS, Lambiase RE, Haas RA, Dorfman GS, Carney WI Jr, Morin CJ. Percutaneous revascularization of complex iliac artery stenoses and occlusions with use of Wallstents: three-year experience. J Vasc Interv Radiol. 1996 Jan-Feb;7(1):21-27. doi: 10.1016/s1051-0443(96)70727-3
  33. Barbera L, Kemen M, Mammi A. Piatiletnii opyt khirurgii okkliuzii aortopodvzdoshnogo segmenta s ispol’zovaniem tol’ko laparoskopicheskoi tekhniki. Angiologiia i Sosud Khirurgiia. 2002;8(1):57-66. http://www.angiolsurgery.org/magazine/2002/1/9.htm (In Russ.)
  34. Fearn SJ, Thaveau F, Kolvenbach R, Dion YM. Minilaparotomy for aortoiliac aneurysmal disease: experience and review of the literature. Surg Laparosc Endosc Percutan Tech. 2005 Aug;15(4):220-25. doi: 10.1097/01.sle.0000174570.66301.c4
  35. Matsumoto M, Hata T, Tsushima Y, Hamanaka S, Yoshitaka H, Shinoura S, Sakakibara N. Minimally invasive vascular surgery for repair of infrarenal abdominal aortic aneurysm with iliac involvement. J Vasc Surg. 2002 Apr;35(4):654-60. doi: 10.1067/mva.2002.121745
  36. Turnipseed WD. A less-invasive minilaparotomy technique for repair of aortic aneurysm and occlusive disease. J Vasc Surg. 2001 Feb;33(2):431-34. doi: 10.1067/mva.2001.104588
  37. Weber G, Strauss AL, Jako G. Video controlled, minimally invasive exposure of the abdominal aorta by retroperitoneal approach for aorto-iliac reconstructions. Chirurg. 1995 Feb;66(2):146-50. https://www.researchgate.net/publication/15486044_Video_controlled_minimally_invasive_exposure_of_the_abdominal_aorta_by_retroperitoneal_approach_for_aorto-iliac_reconstructions [Article in German]
  38. Cerveira JJ, Halpern VJ, Faust G, Cohen JR. Minimal incision abdominal aortic aneurysm repair. J Vasc Surg. 1999 Dec;30(6):977-84. doi: 10.1016/s0741-5214(99)70035-2
  39. Prudkov MI. Osnovy minimal’no invazivnoi khirurgii, Ekaterinburg, RF; 2007. 64 p. (In Russ.)
  40. Fadin BV, Prudkov MI, Kuznetsov AA. Pervyi opyt aorto-bedrennogo shuntirovaniia s primeneniem minilaparotomnogo dostupa pri kriticheskoi ishemii nizhnikh konechnostei u bol’nykh mul’tifokal’nym aterosklerozom. Endoskop Khirurgiia. 2002;(5):4-7. (In Russ.)
  41. De Donato G, Veber G, De Donato Dzh. Aortobifemoral’noe shuntirovanie po metodike MIDAS. Angiologiia i Sosud Khirurgiia. 2002;8(1):48-56. http://www.angiolsurgery.org/magazine/2002/1/8.htm (In Russ.)
  42. Maksimov AB, Plotnikov MV, Feiskhanov AK, Nuretdinov RM, Galiullin OF. Opyt 500 rekonstruktsii aortobedrennogo segmenta s ispol’zovaniem minidostupa. Khirurgiia Zhurn im NI Pirogova. 2012;(5):48-51. https://www.mediasphera.ru/issues/khirurgiya-zhurnal-im-n-i-pirogova/2012/5/030023-1207201258phera.ru/issues/khirurgiya-zhurnal-im-n-i-pirogova/2012/5/030023-1207201258 (In Russ.)
  43. Khamitov FF, Lisitskii DA, Matochkin EA, Gadzhimuradov RU, Khalidov OKh. 15-letnii opyt khirurgicheskogo lecheniia bol‘nykh s mul‘tifokal‘nym porazheniem arterial‘nogo rusla. Moscow Meditsina. 2016;(S1):202. http://mosmed.niioz.ru/jour/article/view/10873 (In Russ.)
  44. Turnipseed WD, Carr SC, Tefera G, Acher CW, Hoch JR. Minimal incision aortic surgery. J Vasc Surg. 2001;34(1):47-53. doi: 10.1067/mva.2001.115809
  45. Fadin BV. Surgical procedures on aorto-iliac segment from mini-approach at chronic lower limb ischemia. Khirurgiia Zhurn im NI Pirogova. 2007;(2):14-19. (In Russ.)
  46. Maksimov AV, Mamaev VE, Khalilov IG, Mardeeva GR. Rekonstruktsiia aortobedrennogo segmenta iz minilaparotomnogo dostupa. Opyt 100 operatsii. Angiologiia i Sosud Khirurgiia. 2006;12(2):106-14. http://www.angiolsurgery.org/magazine/2006/2/15.htm (In Russ.)
  47. Putintev AM, Sultanov RV. Lutscnko VA. Moshneguts SV. Decrease of frequency of conversions of short-scar incision to the aorta using pre-operative 3d-modeling on the basis of the changes in aorta and patient’s individuality. Biul VSNTs SO RAMN. 2015;(1):48-54. https://cyberleninka.ru/article/n/snizhenie-chastoty-konversiy-mini-dostupa-k-aorte-putyom-ispolzovaniya-predoperatsionnogo-3d-proektirovaniya-ishodya-iz-izmeneniy-v/viewer (In Russ.)
  48. Maksimov AV, Mayanskaya SD, Plotnikov MV, Gaysina EA. Mathematical modeling of an optimal mini-access for reconstruction of arteries of the aortofemoral segment. Kazan Med Zhurn. 2012;93(4):611-16. doi: 10.17816/KMJ1554 (In Russ.)
  49. Kawaharada N, Morishita K, Fukada J, Yamada A, Muraki S, Hachiro Y, Fujisawa Y, Saito T, Kurimoto Y, Abe T. Minilaparotomy abdominal aortic aneurysm repair versus the retroperitoneal approach and standard open surgery. Surg Today. 2004;34(10):837-41. doi: 10.1007/s00595-004-2841-2
Address for correspondence:
119049, Russian Federation,
Moscow, Leninsky pr., 8,
N.I. Pirogov Municipal Clinical Hospital No1,
Center for Vascular, X-ray Endovascular
Surgery and Minimally Invasive Phlebology,
tel. mobile:+7 985 353 51 90,
e-mail: angiodoc@mail.ru,
Gubarev Igor’ A.
Information about the authors:
Belov Yurii V., MD, Professor, Academician of RAS, Head of the Cardio-Aortic Surgery, Russian Research Surgery Center Named after Academician B.V.Petrovsky, Moscow, Russian Federation.
http://orcid.org/0000-0002-9280-8845
Gubarev Igor’ A., Aspirant, Russian Research Surgery Center Named after Academician B.V.Petrovsky, Cardiovascular Surgeon, No1. Pirogov Municipal Clinical Hospital No1, Moscow, Russian Federation.
http://orcid.org/0000-0003-3961-5670
Salekh Amro Z., Cardiovascular Surgeon, N.I. Pirogov Municipal Clinical Hospital No1, Moscow, Russian Federation.
http://orcid.org/0000-0001-6479-1743
Frolov Konstantin B., PhD, Head of the Center of Vascular, Endovascular Surgery and Minimally Invasive Phlebology of N.I. Pirogov Municipal Clinical Hospital No1, Moscow, the Russian Federation.
https://orcid.org/0000-0001-6310-3590
Rybakov Kirill N., Cardiovascular Surgeon, N.I. Pirogov Municipal Clinical Hospital No1, Moscow, Russian Federation.
https://orcid.org/0000-0002-6530-3382

V.YA. KHRYSHCHANOVICH

MANAGEMENT PRINCIPLES OF PATIENTS WITH VENOUS THROMBOEMBOLISM DURING THE COVID-19 PANDEMIC

Belarusian State Medical University, Minsk,
The Republic of Belarus

The spread of the new SARS-CoV-2 infection, now classified as COVID-19, has become global. The physician who treats patients with COVID-19 face daily new serious problems. One of them is a high prevalence of venous thromboembolic complications, especially in the group of patients with a severe course of the infectious process. Current recommendations allow an empirical approach to prescribing anticoagulation in the case of a reasonable suspicion on the pulmonary embolism/deep vein thrombosis, if the assumed waiting period for visualization is >4/24 hours, respectively. The use of prophylactic doses of low-molecular-weight or unfractionated heparin or fondaparinux is mandatory for all COVID-19-positive inpatients throughout the entire period of hospitalization. If there are the absolute contraindications to anticoagulation, it is recommended to use compression therapy or to perform vena cava filter implantation . Most patients with the confirmed COVID-19-associated venous thromboembolism (VTE) or those with its reasonable suspicion should be prescribed a full treatment dose of anticoagulant. In ambulatory conditions for secondary long-term thromboprophylaxis the preference should be given to direct oral anticoagulants. Patients who had a ≥3-fold elevation of D-dimer level upon admission should continue the therapeutic anticoagulation after discharge. This literature review summarizes the latest recommendations on prevention, diagnosis, and treatment of COVID-19-associated VTE. Further research should focus on developing optimal management strategies for both inpatients and outpatients with COVID-19-associated venous thromboembolism (VTE ).

Keywords: venous thromboembolism, COVID-19, thromboprophylaxis, diagnosis, treatment
p. 329-338 of the original issue
References
  1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72,314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020 Feb 24. doi: 10.1001/jama.2020.2648. Online ahead of print.
  2. Zhang T, Sun LX, Feng RE. Comparison of clinical and pathological features between severe acute respiratory syndrome and coronavirus disease 2019. Zhonghua Jie He He Hu Xi Za Zhi. 2020 Apr 3;43(0):E040. doi: 10.3760/cma.j.cn112147-20200311-00312. Online ahead of print.
  3. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, Huang H, Zhang L, Zhou X, Du C, Zhang Y, Song J, Wang S, Chao Y, Yang Z, Xu J, Zhou X, Chen D, Xiong W, Xu L, Zhou F, Jiang J, Bai C, Zheng J, Song Y. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020 Mar 13:e200994. doi: 10.1001/jamainternmed.2020.0994 [Epub ahead of print]
  4. Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, Huisman M, King CS, Morris TA, Sood N, Stevens SM, Vintch JRE, Wells P, Woller SC, Moores L. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016 Feb;149(2):315-52. doi: 10.1016/j.chest.2015.11.026
  5. Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers D, Kant KM, Kaptein FHJ, van Paassen J, Stals MAM, Huisman MV, Endeman H. Confirmation of the high cumulative incidence of thrombotic complications in critically III ICU patients with COVID-19: An updated analysis. Thromb Res. 2020 Jul; 191:148-50. doi: 10.1016/j.thromres.2020.04.041
  6. Wichmann D, Sperhake JP, Lütgehetmann M, Steurer S, Edler C, Heinemann A, Heinrich F, Mushumba H, Kniep I, Schröder AS, Burdelski C, de Heer G, Nierhaus A, Frings D, Pfefferle S, Becker H, Bredereke-Wiedling H, Andreas de Weerth, MD, Hans-Richard Paschen, MD, Sara Sheikhzadeh-Eggers, MD, Axel Stang, MD, Stefan Schmiedel, Bokemeyer C, Addo MM, Aepfelbacher M, Püschel K, Kluge S. Autopsy findings and venous thromboembolism in patients with COVID-19: A prospective cohort study. Ann Intern Med. 2020 May 6:M20-2003. Published online 2020 May 6. doi: 10.7326/M20-2003
  7. Tal S, Spectre G, Kornowski R, Perl L. Venous Thromboembolism Complicated with COVID-19: What Do We Know So Far? Acta Haematol. 2020 May 12:1-8. doi: 10.1159/000508233. Online ahead of print.
  8. Obi AT, Barnes GD, Wakefield TW, Brown S, Eliason JL, Arndt E, Henke PK. Practical diagnosis and treatment of suspected venous thromboembolism during COVID-19 pandemic. J Vasc Surg Venous Lymphat Disord. 2020 Apr 17:S2213-333X(20)30221-3. doi: 10.1016/j.jvsv.2020.04.009. Online ahead of print.
  9. Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, Clark C, Iba T. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020 May;18(5):1023-26. doi: 10.1111/jth.14810
  10. Casini A, Alberio L, Angelillo-Scherrer A, Fontana P, Gerber B, Graf L, Hegemann I, Korte W, Hovinga JK, Lecompte T, Martinez M, Nagler M, Studt JD, Tsakiris D, Walter W, Asmis L. Thromboprophylaxis and Laboratory Monitoring for In-Hospital Patients With COVID-19 – A Swiss Consensus Statement by the Working Party Hemostasis. Swiss Med Wkly. 2020 Apr 11;150: w20247. doi: 10.4414/smw.2020.20247. eCollection 2020 Apr 6.
  11. Marietta M, Ageno W, Artoni A, De Candia E, Gresele P, Marchetti M, Marcucci R, Tripodi A. COVID-19 and haemostasis: a position paper from Italian Society on Thrombosis and Haemostasis (SISET). Blood Transfus. 2020 May;18(3):167-69. doi: 10.2450/2020.0083-20
  12. Considerations in prophylaxis and treatment of VTE in COVID-19 Patients [Internet]. The COVID-19 Sub-Committee of the American Venous Forum. 2020 Apr 17. Available from: https://www.veinforum.org/wp-content/uploads/2020/04/COVID-19-White-Paper-04-17-2020-FINAL-1.pdf
  13. BTS Guidance on Venous Thromboembolic Disease in patients with COVID-19 [Internet]. British Thoracic Sosiety. 2020 May 4. Available from: https://www.brit-thoracic.org.uk/about-us/covid-19-information-for-the-respiratory-community/
  14. Pannucci CJ, Swistun L, MacDonald JK, Henke PK and Brooke BS. Individualized Venous Thromboembolism Risk Stratification Using the 2005 Caprini Score to Identify the Benefits and Harms of Chemoprophylaxis in Surgical Patients: A Meta-analysis. Ann Surg. 2017 Jun; 265(6):1094-103. doi: 10.1097/SLA.0000000000002126
  15. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020 May;18(5):1094-9. doi: 10.1111/jth.14817
  16. Thachil J. The Versatile Heparin in COVID-19. J Thromb Haemost. 2020 May;18(5):1020-22. doi: 10.1111/jth.14821
  17. Li XY, Du B, Wang YS, Kang HYJ, Wang F, Sun B, Qiu HB, Tong ZH. The keypoints in treatment of the critical coronavirus disease 2019 patient. Zhonghua Jie He He Hu Xi Za Zhi. 2020 Apr 12;43(4):277-81. doi: 10.3760/cma.j.cn112147-20200224-00159
  18. Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Bondi-Zoccai G, Brown TS, Nigoghossian C, Zidar DA, Haythe J, Brodie D, Beckman JA, Kirtane AJ, Stone GW, Krumholz HM, Parikh SA. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the Coronavirus Disease 2019 (COVID-19) Pandemic. J Am Coll Cardiol. 2020 May 12;75(18):2352-71. doi: 10.1016/j.jacc.2020.03.031
  19. Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute Pulmonary Embolism Associated With COVID-19 Pneumonia Detected by Pulmonary CT Angiography. Radiology. 2020 Apr 23;201544. doi: 10.1148/radiol.2020201544. Online ahead of print.
  20. Ishiguro T, Matsuo K, Fujii S, Takayanagi N. Acute thrombotic vascular events complicating influenza-associated pneumonia. Respir Med Case Rep. 2019 Jun 14;28:100884. doi: 10.1016/j.rmcr.2019.100884. eCollection 2019.
  21. Vitali C, Minniti A, Del Papa N. Occurrence of pulmonary embolism in a patient with mild clinical expression of COVID-19 infection. Thromb Res. 2020 May 5. doi: 10.1016/j.thromres.2020.05.002 [Epub ahead of print]
  22. Zhai Z, Li C, Chen Y, Gerotziafas G, Zhang Z, Wan J, Liu P, Elalamy I, Wang C Prevention and Treatment of Venous Thromboembolism Associated with Coronavirus Disease 2019 Infection: A Consensus Statement before Guidelines. Thromb Haemost. 2020 Jun;120(6):937-48. doi: 10.1055/s-0040-1710019
  23. Wang T, Chen R, Liu C, Liang W, Guan W, Tang R, Tang C, Zhang N, Zhong N, Li S. Attention should be paid to venous thromboembolism prophylaxis in the management of COVID-19. Lancet Haematol. 2020 May;7(5):e362-e363. doi: 10.1016/S2352-3026(20)30109-5
  24. Testa S, Prandoni P, Paoletti O, Morandini R, Tala M, Dellanoce C, Giorgi-Pierfranceschi M, Betti M, Battista Danzi G, Pan A, Palareti G. Direct oral anticoagulant plasma levels’ striking increase in severe COVID-19 respiratory syndrome patients treated with antiviral agents: The Cremona experience. J Thromb Haemost. 2020 Apr 23. doi: 10.1111/jth.14871. Online ahead of print.
  25. Poyiadji N, Cormier P, Patel PY, Hadied MO, Bhargava P, Khanna K, Nadig J, Keimig T, Spizarny D, Reeser N, Klochko C, Peterson EL, Song T. Acute Pulmonary Embolism and COVID-19. Radiology. 2020 May 14;201955. doi: 10.1148/radiol.2020201955. Online ahead of print.
  26. Bahia A, Albert RK. The modified Wells score accurately excludes pulmonary embolus in hospitalized patients receiving heparin prophylaxis. J Hosp Med. 2011 Apr;6(4):190-94. doi: 10.1002/jhm.827
  27. Killewich LA, Nunnelee JD, Auer AI. Value of lower extremity venous duplex examination in the diagnosis of pulmonary embolism. J Vasc Surg. 1993 May;17(5):934-38; discussion 938-9. doi: 10.1016/0741-5214(93)90043-l
  28. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-62. doi: 10.1016/S0140-6736(20)30566-3
  29. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical Features of Patients Infected With 2019 Novel Coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5
  30. Klok FA, Barco S, Turpie AGG, Haas S, Kreutz R, Mantovani LG, Gebel M, Herpers M, Bugge J-P, Kostantinides SV, Ageno W. Predictive Value of Venous Thromboembolism (VTE)-BLEED to Predict Major Bleeding and Other Adverse Events in a Practice-Based Cohort of Patients With VTE: Results of the XALIA Study. Br J Haematol. 2018 Nov;183(3):457-65. doi: 10.1111/bjh.15533
  31. Wells PS, Anderson DR, Bormanis J, Guy F, Mitchell M, Gray L, Clement C, Robinson KS, Lewandowski B. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet. 1997 Dec 20-27;350(9094):1795-98. doi: 10.1016/S0140-6736(97)08140-3
  32. Silveira PC, Ip IK, Goldhaber SZ, Piazza G, Benson CB, Khorasani R. Performance of Wells Score for Deep Vein Thrombosis in the Inpatient Setting. JAMA Intern Med. 2015 Jul;175(7):1112-17. doi: 10.1001/jamainternmed.2015.1687
  33. Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, D.A.M.P.J. Gommers DAMPJ, Kant KM, Kaptein FHJ, van Paassen J, Stals MAM, Huisman MV, Endemane H. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020 Jul 01; 191:145-47. doi: 10.1016/j.thromres.2020.04.013
  34. Danzi GB, Loffi M, Galeazzi G, Gherbesi E. Acute pulmonary embolism and COVID-19 pneumonia: a random association? Eur Heart J. 2020 May 14;41(19):1858. doi: 10.1093/eurheartj/ehaa254
  35. Underhill J, Sherman MA, Howard R, Hage A, Obi A, Napolitano L, Coleman DM. The natural history and outcomes of line-associated upper extremity deep venous thromboses in critically ill patients. J Vasc Surg Venous Lymphat Disord. 2017 Sep;5(5):630-37. doi: 10.1016/j.jvsv.2017.03.018
  36. Poterucha TJ, Libby P, Goldhaber SZ. More than an anticoagulant: do heparins have direct anti-inflammatory effects? Thromb Haemost. 2017 Feb 28;117(3):437-44. doi: 10.1160/TH16-08-0620
  37. Weitz JI, Chan NC. Long-term management of venous thromboembolism: lessons from EINSTEIN CHOICE and other extension trials. Thromb Haemost. 2019 May;119(5):689-94. doi: 10.1055/s-0039-1679906
  38. Wells PS, Prins MH, Levitan B, Beyer-Westendorf J, Brighton TA, Bounameaux H, Cohen AT, Davidson BL, Prandoni P, Raskob GE, Yuan Z, Katz EG, Gebel M, Lensing AWA. Long-term Anticoagulation With Rivaroxaban for Preventing Recurrent VTE: A Benefit-Risk Analysis of EINSTEIN-Extension. Chest. 2016 Nov;150(5):1059-68. doi: 10.1016/j.chest.2016.05.023
Address for correspondence:
220116, Republic of Belarus,
Minsk, pr. Dzerzhinskii, 83,
Belarusian State Medical University,
tel. +375 17277-11-55,
e-mail: scienceprorektor@bsmu.by,
Khryshchanovich Vladimir Ya.
Information about the authors:
Khryshchanovich Vladimir Ya., MD, Professor, Vice-Rector for Scientific Work, Professor of the 2nd Department of Surgical Diseases, Belarusian State Medical University, Minsk, Republic of Belarus.
http://orcid.org/0000-0001-5353-205X

CASE REPORTS

S.A. MARKOSYAN

TESTICULAR DERMOID CYST IN A 14-YEAR-OLD CHILD

National Research Ogarev Mordovia State University, Institute of Medicine, Saransk,
The Russian Federation

The paper presents a clinical case of a 14-year-old child with a dermoid cyst of the right testicle. The formation was first detected during a routine check-up in the polyclinic. Then the external genitalia ultrasound examination was repeatedly performed to the patient, which revealed an inhomogeneous echostructure with dimensions of 14 mm, 13.7 mm and 12 mm with a clear, even contour in the upper pole of the right testicle.
The enzyme-linked immunosorbent assay (ELISA) did not show an increase in the main tumour markers. The biochemical blood test revealed an insignificant rise in conjugated bilirubin and serum iron.
To clarify the diagnosis, magnetic resonance tomography of the pelvic organs with intravenous contrast was recommended. After examination, the cystic lesion of the right testicle was diagnosed.
After carrying out the necessary additional diagnostic measures (ultrasound examination of the peripheral lymphatic nodes, the abdominal cavity exploration with intravenous contrast enhancement), the child underwent an operation consisting in revising the right half of the scrotum and removing the formation of the right testicle. Intraoperatively, according to the express biopsy test, the dermoid cyst of the right testicle was diagnosed, which was confirmed by the subsequent histological examination. The postoperative period was uneventful. The patient was discharged in satisfactory state.
Thus, the presented clinical observation emphasizes the need to optimize the preventive work of primary care medical personnel for timely diagnosis of tumor processes in the external genital organs, especially in children of puberty.

Keywords: dermoid cyst, testicle, ultrasound, magnetic resonance tomography, child
p. 339-343 of the original issue
References
  1. Davidov MI, Malkov AD. Dermoid cyst of the testis. Urologiia. 2003;(2):52-55. (In Russ.)
  2. Nemtsova MV, Andreeva YuYu. Testicular germ cell tumors: Molecular genetic and clinicomorphological aspects Onkourologiia. 2015;11(1):12-19. doi: 10.17650/1726-9776-2015-1-12-19 (In Russ.)
  3. Singh AP, Tanger R, Mishra D, Ansari M, Gupta AK, Shukla AK. Testicular mixed germ cell tumor in a newborn child: a rare case. J Indian Assoc Pediatr Surg. 2019 Apr-Jun;24(2):144-46. doi: 10.4103/jiaps.JIAPS_87_18
  4. Vasiliyeva IG, Strelnikov AI, Bogdanov GP, Alekseyev PV, Semenova EV. Testicle dermoid cyst in a child with indifferntiated connective tissue dysplasia. Vest IvGMA. 2011;16(1):71-72. https://cyberleninka.ru/article/n/sluchay-dermoidnoy-kisty-yaichka-u-rebenka-s-sindromom-nedifferentsirovannoy-soedinitelnotkannoy-displazii (In Russ.)
  5. Nosov AK, Mamizhev EM, Reva SA, Novikov RV, Vorobyev AV, Gafton GI, Petrov SB. Impact of delayed prehospital diagnosis on the results of treatment in patients with germinogenic testicular tumors in Saint-Petersburg. Onkourologiia. 2013;9(2):63-68. doi: 10.17650/1726-9776-2013-9-2-63-68 (In Russ.)
  6. Shen J, Bi Y, Wang X, Lu L, Tang L, Liu Y, Chen H, Zhang B. Epidemiologic study of 230 cases of testicular/paratesticular tumors or masses: 15-year experience of a single center. J Pediatr Surg. 2017 Dec;52(12):2056-60. doi: 10.1016/j.jpedsurg.2017.08.027
  7. Akiyama S, Ito K, Kim WJ, Tanaka Y, Yamazaki Y. Prepubertal testicular tumors: a single-center experience of 44 years. J Pediatr Surg. 2016 Aug;51(8):1351-54. doi: 10.1016/j.jpedsurg.2016.02.042
  8. Kuleva SA, Faseeva ND, Ivanova SV, Nomogram for the determination of primary-resistant forms of germ cell tumors in children. Russian Journal of Pediatric Hematology and Oncology. 2019;6(3):26-30. doi: 10.21682/2311-1267-2019-6-3-26-30 (In Russ.)
  9. Gilbert D, Rapley E, Shipley J. Testicular germ cell tumours: predisposition genes and the male germ cell niche. Nat Rev Cancer. 2011 Apr;11(4):278-88. doi: 10.1038/nrc3021
  10. Burova EA, Bulanov AA, Tryakin AA, Fedyan-in MYu, Matveev VB, Tulandin SA. Treatment for stage I nonseminomatous testicular germ cell tumors. Onkourologiia. 2011;(1):10-15. https://cyberleninka.ru/article/n/lechenie-neseminomnyh-germinogennyh-opuholey-yaichka-i-stadii (In Russ.)
  11. Maizlin II, Dellinger M, Gow KW, Goldin AB, Goldfarb M, Nuchtern JG, Langer M, Vasudevan SA, Doski JJ, Raval MV, Beierle EA. Testicular tumors in prepubescent patients. J Pediatr Surg. 2018 Sep;53(9):1748-52. doi: 10.1016/j.jpedsurg.2017.09.020
  12. Chung JM, Lee SD. Overview of pediatric testicular tumors in Korea. Korean J Urol. 2014 Dec;55(12):789-96. doi: 10.4111/kju.2014.55.12.789
Address for correspondence:
430032, Russian Federation,
Saransk, Ulyanov str., 26 a,
National Research Ogarev
Mordovia State University,
Institute of Medicine,
the Department of the Faculty Surgery
with Courses of Topographic Anatomy
and Operative Surgery, Urology
and Pediatric Surgery,
tel.mobile: +7 917 699 06 04,
e-mail: markosyansa@mail.ru,
Markosyan Sergey A.
Information about the authors:
Markosyan Sergey A., MD, Associate Professor, Professor, the Department of the Faculty Surgery with Courses of Topographic Anatomy and Operative Surgery, Urology and Pediatric Surgery, National Research Ogarev Mordovia State University, Institute of Medicine, Saransk, Russian Federation.
http://orcid.org/0000-0002-9876-4433

V.A. BELOBORODOV, A.P. FROLOV

EMPHYSEMATOUS OSTEOMYELITIS COMPLICATED BY NECROTISING FASCIITIS AND MYOSITIS

Irkutsk State Medical University, Irkutsk,
The Russian Federation

Emphysematous osteomyelitis is an extremely rare, potentially fatal bacterial disease characterized by the presence of gas within bone and adjacent soft tissues.
The disease is often complicated by anaerobic necrotizing fasciitis. The article presents a clinical observation of successfully treated emphysematous osteomyelitis of the right femur complicated by necrotizing fasciitis and myositis in the 55-year-old man. The disease manifested 20 years later after a closed fracture of the right femur and osteosynthesis. Emphysematous osteomyelitis was characterized by severe pain in the right thigh, serious intoxication syndrome and the presence of gas bubbles in the medullary cavity of the right femur which was observed in the computed tomography scans.
The feature of emphysematous osteomyelitis management was a three-step approach. The first step was the opening of the purulent-necrotic focus with a wide longitudinal incision of the skin and fascia, excision of necrotic soft tissues. The second step was guillotine amputation of the right lower limb on the level of the upper third of the thigh. The third step was the formation of the thigh stump in the early stages with flow-washing drainage of a wound. This tactic helped to reduce the risk of primary amputation, saved more soft tissue to form the thigh stump more suitable for prosthetics and to shorten the treatment terms.

Keywords: emphysematous osteomyelitis, intraosseous gas, necrotizing fasciitis, necrotizing myositis
p. 344-349 of the original issue
References
  1. Abdelbaki A, Bhatt N, Gupta N, Li S, Abdelbaki S, Kumar Y. Emphysematous osteomyelitis of the forefoot. Proc (Bayl Univ Med Cent). 2018 Jan;31(1):100-101. doi: 10.1080/08998280.2017.1390338
  2. Lee J, Jeong CH, Lee MH, Jeong EG, Kim YJ, Kim SI, Kim YR. Emphysematous Osteomyelitis due to Escherichia coli. Infect Chemother. 2017 Jun;49(2):151-54. doi: 10.3947/ic.2017.49.2.151
  3. Luey C, Tooley D, Briggs S. Emphysematous osteomyelitis: a case report and review of the literature. Int J Infect Dis. 2012 Mar;16(3):e216-e20. doi: 10.1016/j.ijid.2011.11.007
  4. Sun X, Xie T. Management of Necrotizing Fasciitis and Its Surgical Aspects. Int J Low Extrem Wounds. 2015 Dec;14(4):328-34. doi: 10.1177/1534734615606522
  5. Trent JT, Kirsner RS. Necrotizing Fasciitis. Wounds. 2002;14(8):284-92. doi: 10.1097/00129334-200205000-00010
  6. Goh T, Goh LG, Ang CH, Wong CH. Early diagnosis of necrotizing fasciitis. Br J Surg. 2014;101:119-25. doi: 10.1002/bjs.9371
  7. Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current concepts in the management of necrotizing fasciitis. Front Surg. 2014 Sep 29;1:36. doi: 10.3389/fsurg.2014.00036
  8. Elliott DC, Kufera JA, Myers RA. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management Ann Surg. 1996 Nov;224(5):672-83. doi: 10.1097/00000658-199611000-00011
  9. Kumar J, Bandhu S, Kumar A. Intraosseous and intraarticular pneumatosis in anaerobic osteomyelitis. Pediatr Radiol. 2006 Nov;36(11):1220. doi: 10.1007/s00247-006-0279-y
  10. Ram PC, Martinez S, Korobkin M, Breiman RS, Gallis HR, Harrelson JM. CT detection of intraosseous gas: a new sign of osteomyelitis. AJR Am J Roentgenol. 1981 Oct;137(4):721-23. doi: 10.2214/ajr.137.4.721
  11. Patton HM, Conlan JK, Long RF, Waller JT. Unusual presentation of anaerobic osteomyelitis. Am J Med. 1983 Oct;75(4):724-26. doi: 10.1016/0002-9343(83)90465-5
  12. Aiyappan SK, Ranga U, Veeraiyan S. Spontaneous emphysematous osteomyelitis of spine detected by computed tomography: Report of two cases. J Craniovertebr Junction Spine. 2014 Apr;5(2):90-92. doi: 10.4103/0974-8237.139207
  13. Khanduri S, Singh M, Goyal A, Singh S. Emphysematous osteomyelitis: Report of two cases and review of literature. Indian J Radiol Imaging. 2018 Jan-Mar;28(1):78-80. doi: 10.4103/ijri.IJRI_28_17
  14. Potocki J, Kaushik S, Mira JL. Anaerobic osteomyelitis of femoral head with intraosseous, intra-articular, bursal and muscle pneumatosis. Skeletal Radiol. 2003 Jan;32(1):46-48. doi: 10.1007/s00256-002-0567-z
Address for correspondence:
664003, Russian Federation
Irkutsk, Krasnoe Vosstaniye str., 1,
Irkutsk State Medical University,
the Department of General Surgery
and Anesthesiology,
tel. mobile: +7 914 884-50-96,
e-mail: frolovphd@mail.ru,
Frolov Aleksandr P.
Information about the authors:
Beloborodov Vladimir A., MD, Professor, Head of the Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russian Federation.
https://orcid.org/0000-0002-3299-1924
Frolov Aleksandr P., PhD, Associate Professor of the Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russian Federation.
https://orcid.org/0000-0002-3453-548X
Contacts | ©Vitebsk State Medical University, 2007-2023