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Year 2021 Vol. 29 No 3

SCIENTIFIC PUBLICATIONS
EXPERIMENTAL SURGERY

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

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

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

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

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

GENERAL & SPECIAL SURGERY

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

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

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

Objective. To prove the safety and efficacy of distal radial artery (DRA) puncture for endovascular interventions versus the traditional forearm radial artery (RA) puncture site by comparing immediate and long-term results.
Methods. In 2017, a multicenter, open, randomized (1:1) study TENDERA (Comparison between Traditional Entry Point and Distal Puncture of Radial Artery) was started. During 2 years, 520 patients were included, mean age 63.4±10.0 years. The observation group (DRA puncture) included 271 patients, the comparison group (RA puncture) – 249 patients. The study included both stable patients and those with NSTEMI: the observation group – 39 (14.4%), the comparison group – 34 (13.7%), p=0.809. The primary endpoint is immediate (hospital) or late radial thrombosis. Secondary endpoints are: 1 – composite point, complications from the access artery; 2 – puncture parameters.
Results. The average difference in the diameters of the RA and DRA was 0.3 mm and 0.4 mm, in some patients the DRA diameter corresponded to the RA or even exceeded it. The diameter of RA and DRA in men and women significantly differs, 2.65±0.44 mm and 2.36±0.36 mm (p=0.001), 2.31±0.39 mm and 2.13±0.38 mm (p=0.001). Technical success of DRA access requre the number of attempts. 94.1% – the percentage of successful cardiac catheterization performed through the distal radial artery approach, which is significantly less than via RA – 100% (p<0.001). In the observation group, significantly fewer rebleedings and rehemostasis were occured. In the long-term period, there were registered outstandingly more hematomas in the observation group at the time of discharge and after 1 week.
Conclusion. Intermediate analysis of the results of the TENDERA study shows that there is no significant difference in the primary endpoint, but the number of complications in the observation group associated with the puncture markedly – hematoma more than 5 cm to the day of discharge and after 7 days.

Keywords: radial access, distal radial access, research, percutaneous coronary intervention, acute coronary syndrome, coronary heart disease, radial artery
p. 285-295 of the original issue
References
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  2. Valgimigli M, Gagnor A, Calabró P, Frigoli E, Leonardi S, Zaro T, Rubartelli P, Briguori C, Andò G, Repetto A, Limbruno U, Cortese B, Sganzerla P, Lupi A, Galli M, Colangelo S, Ierna S, Ausiello A, Presbitero P, Sardella G, Varbella F, Esposito G, Santarelli A, Tresoldi S, Nazzaro M, Zingarelli A, de Cesare N, Rigattieri S, Tosi P, Palmieri C, Brugaletta S, Rao SV, Heg D, Rothenbühler M, Vranckx P, Jüni P; MATRIX Investigators. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. Lancet. 2015 Jun 20;385(9986):2465-76. doi: 10.1016/S0140-6736(15)60292-6
  3. Hamon M, Pristipino C, Di Mario C, Nolan J, Ludwig J, Tubaro M, Sabate M, Mauri-Ferré J, Huber K, Niemelä K, Haude M, Wijns W, Dudek D, Fajadet J, Kiemeneij F; European Association of Percutaneous Cardiovascular Interventions; Working Group on Acute Cardiac Care of the European Society of Cardiology; Working Group on Thrombosis on the European Society of Cardiology. Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology. Euro Intervention. 2013 Mar;8(11):1242-51. doi: 10.4244/EIJV8I11A192
  4. Korotkikh AV, Bondar VYu. Using a deep palmar branch of radial artery in the ragion of anatomical snuffbox during angiography. Dal’nevostoch Med Zhurn. 2016;(1):24-27. http://www.fesmu.ru/dmj/20161/2016105.aspx (In Russ.)
  5. Petroglou D, Didagelos M, Chalikias G, Tziakas D, Tsigkas G, Hahalis G, Koutouzis M, Ntatsios A, Tsiafoutis I, Hamilos M, Kouparanis A, Konstantinidis N, Sofidis G, Pancholy SB, Karvounis H, Bertrand OF, Ziakas A. Manual versus mechanical compression of the radial artery after transradial coronary angiography: the memory multicenter randomized trial. JACC Cardiovasc Interv. 2018 Jun 11;11(11):1050-58. doi: 10.1016/j.jcin.2018.03.042
  6. Amato JJ, Solod E, Cleveland RJ. A “second” radial artery for monitoring the perioperative pediatric cardiac patient. J Pediatr Surg. 1977 Oct;12(5):715-17. doi: 10.1016/0022-3468(77)90399-2
  7. Kaledin AL, Kochanov IN, Seletskii SS, Arkharov IV, Burak TIa, Kozlov KL Peculiarities of arterial access in endovascular surgery in elderly patients. Uspekhi Gerontologii. 2014;27(1):115-19. https://pubmed.ncbi.nlm.nih.gov/25051767/?from (In Russ.)
  8. Oliveira MDP, Navarro EC, Kiemeneij F. Distal transradial access as default approach for coronary angiography and interventions. Cardiovasc Diagn Ther. 2019 Oct;9(5):513-19. doi: 10.21037/cdt.2019.09.06
  9. Frolov AA, Sorokin IN, Sharabrin EG, Bekhterev AV, Frolov IA, Savenkov AG. Comparison of traditional and distal radial approach in percutaneous coronary interventions. Kardiologiia i Serdechno-Sosudistaia Khirurgiia. 2019;12(5):410-17. doi: 10.17116/kardio201912051410 (In Russ.)
  10. Kim Y, Lee JW, Lee SY, Bae JW, Lee SJ, Jeong MH, Lee SH, Ahn Y. Feasibility of primary percutaneous coronary intervention via the distal radial approach in patients with ST-elevation myocardial infarction. Korean J Intern Med. 2021 Mar;36(Suppl 1):S53-S61. doi: 10.3904/kjim.2019.420
  11. Hadjivassiliou A, Cardarelli-Leite L, Jalal S, Chung J, Liu D, Ho S, Klass D. Left distal Transradial Access (ldTRA): a comparative assessment of conventional and distal radial artery size. Cardiovasc Intervent Radiol. 2020 Jun;43(6):850-57. doi: 10.1007/s00270-020-02485-7
  12. Rajah GB, Lieber B, Kappel AD, Luqman AW. Distal transradial access in the anatomical snuffbox for balloon guide-assisted stentriever mechanical thrombectomy: technical note and case report. Brain Circ. 2020 Feb 18;6(1):60-64. doi: 10.4103/bc.bc_22_19. eCollection 2020 Jan-Mar.
  13. Kühn AL, Rodrigues KM, Singh J, Massari F, Puri AS. Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study. J Neurointerv Surg. 2020 Aug;12(8):798-801. doi: 10.1136/neurintsurg-2019-015604
  14. Sgueglia GA, Di Giorgio A, Gaspardone A, Babunashvili A. Anatomic Basis and Physiological Rationale of Distal Radial Artery Access for Percutaneous Coronary and Endovascular Procedures. JACC Cardiovasc Interv. 2018 Oct 22;11(20):2113-19. doi: 10.1016/j.jcin.2018.04.045
  15. Coomes EA, Haghbayan H, Cheema AN. Distal transradial access for cardiac catheterization: A systematic scoping review. Catheter Cardiovasc Interv. 2020 Dec;96(7):1381-89. doi: 10.1002/ccd.28623
  16. Boumezrag M, Ummat B, Reiner J, Venbrux A, Sarin S. Pseudoaneurysm: a rare complication of distal transradial access in the anatomical snuffbox. CVIR Endovasc. 2019 Jun 29;2(1):21. doi: 10.1186/s42155-019-0064-2
  17. Nairoukh Z, Jahangir S, Adjepong D, Malik BH. Distal Radial Artery Access: The Future of Cardiovascular Intervention. Cureus. 2020 Mar 7;12(3):e7201. doi: 10.7759/cureus.7201
  18. Hadjivassiliou A, Kiemeneij F, Nathan S, Klass D. Ultrasound-guided access to the distal radial artery at the anatomical snuffbox for catheter-based vascular interventions: a technical guide. Euro Intervention. 2021 Mar 19;16(16):1342-48. doi: 10.4244/EIJ-D-19-00555
Address for correspondence:
675001, Russian Federation,
Blagoveshchensk, Gor’kii Str., 97,
Amur State Medical Academy
of the Ministry of Health of Russia,
Cardiac Surgery Clinic,
tel. +7 922 079 06 22,
e-mail: ssemioo@rambler.ru,
Korotkikh Alexandr V.
Information about the authors:
Korotkikh Aleksandr V., Head Physician, Cardiovascular Surgeon, Specialist in X-ray Endovascular Diagnosis and Treatment, Cardiac Surgery Clinic, Amur State Medical Academy, Blagoveshchensk, Russian Federation.
https://orcid.org/0000-0002-9709-1097
Babunashvili Avtandil M., MD, Professor, Head of the Vascular Center, Center for Endosurgery and Lithotripsy, Moscow, Russian Federation.
https://orcid.org/0000-0003-2269-7059
Kaledin Alexandr L., PhD, Surgeon of the unit of X-ray endovascular methods of diagnosis and treatment, I.I. Mechnikov North-West State Medical University4, St. Petersburg, Russian Federation.
https://orcid.org/0000-0003-0581-6132
Akhramovich Ruslan V., Physician of X-ray Endovascular Diagnosis and Treatment Mytishchi City Clinical Hospital, Mytishchi, Russian Federation.
https://orcid.org/0000-0002-0026-6998
Derkach Vladislav V., Head of the Endovascular Surgery unit, Clinic of Innovative Surgery, Klin, Russian Federation.
https://orcid.org/0000-0002-0367-3628
Portnov Roman M., Physician of X-ray Endovascular Diagnosis and Treatment, Clinic of Innovative Surgery, Klin, Russian Federation.
https://orcid.org/0000-0001-5360-3815
Sozykin Alexey V., MD, Professor of the Cardiology Department, N.I. Pirogov Russian National Research Medical University, Head of the Unit of X-ray Endovascular Methods of Siagnosis and Treatment, Central Clinical Hospital of the Russian Academy of Sciences, Moscow, Russian Federation
https://orcid.org/0000-0002-2570-5758

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

STRATEGY AND EXPERIENCE OF INFANTILE HEMANGIOMA TREATMENT

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

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

Keywords: children, infantile hemangioma, treatment, propranolol, surgery
p. 296-301 of the original issue
References
  1. Ding Y, Zhang JZ, Yu SR, Xiang F, Kang XJ. Risk factors for infantile hemangioma: a meta-analysis. World J Pediatr. 2019 Dec 18. doi: 10.1007/s12519-019-00327-2. Online ahead of print.
  2. Harter N, Mancini AJ. Diagnosis and Management of Infantile Hemangiomas in the Neonate. Pediatr Clin North Am. 2019 Apr;66(2):437-59. doi: 10.1016/j.pcl.2018.12.011
  3. Cazeau C, Blei F, Gonzáles Hermosa MDRF, Cavalli R, Boccara O, Fölster-Holst R, Berdeaux G, Delarue A, Voisard JJ. Burden of infantile hemangioma on family: an international observational cross-sectional study. Pediatr Dermatol. 2017 May;34(3):295-302. doi: 10.1111/pde.13133
  4. Vacirca SR, Nardi P, Ferlosio A, Orlandi A, Ruvolo G. Multifocal cardiac hemangioma. J Card Surg. 2018 Jun;33(6):310-12. doi: 10.1111/jocs.13719
  5. Léauté-Labrèze C, Baselga Torres E, Weibel L, Boon LM, El Hachem M, van der Vleuten C, Roessler J, Troilius Rubin A. The infantile hemangioma referral score: a validated tool for physicians. Pediatrics. 2020 Apr;145(4):e20191628. doi: 10.1542/peds.2019-1628
  6. Léauté-Labrèze C, Harper JI, Hoeger PH. Infantile haemangioma. Lancet. 2017 Jul 1;390(10089):85-94. doi: 10.1016/S0140-6736(16)00645-0
  7. Léaute-Labrèze C, Boccara O, Degrugillier-Chopinet C, Mazereeuw-Hautier J, Prey S, Lebbé G, Gautier S, Ortis V, Lafon M, Montagne A, Delarue A, Voisard JJ. Safety of oral propranolol for the treatment of infantile hemangioma: a systematic review. Pediatrics. 2016 Oct;138(4):e20160353. doi: 10.1542/peds.2016-0353
  8. Tangtatco JA, Freedman C, Phillips J, Pope E. Surgical treatment outcomes of infantile hemangioma in children: Does prior medical treatment matter. Pediatr Dermatol. 2018 Nov;35(6):e418-e419. doi: 10.1111/pde.13658
  9. Chinnadurai S, Sathe NA, Surawicz T. Laser treatment of infantile hemangioma: A systematic review. Lasers Surg Med. 2016 Mar;48(3):221-33. doi: 10.1002/lsm.22455
  10. DeHart A, Richter G. Hemangioma: recent advances. F1000Res. F1000Res. 2019 Nov 18;8:F1000 Faculty Rev-1926. doi: 10.12688/f1000research.20152.1. eCollection 2019.
  11. Hoeger PH, Harper JI, Baselga E, Bonnet D, Boon LM, Ciofi Degli Atti M, El Hachem M, Oranje AP, Rubin AT, Weibel L, Léauté-Labrèze C. Treatment of infantile haemangiomas: recommendations of a European expert group. Eur J Pediatr. 2015 Jul;174(7):855-65. doi: 10.1007/s00431-015-2570-0
  12. Broeks IJ, Hermans DJ, Dassel AC, van der Vleuten CJ, van Beynum IM. Propranolol treatment in life-threatening airway hemangiomas: a case series and review of literature. Int J Pediatr Otorhinolaryngol. 2013 Nov;77(11):1791-800. doi: 10.1016/j.ijporl.2013.08.011
  13. Darrow DH, Greene AK, Mancini AJ, Nopper AJ. Diagnosis and management of infantile hemangioma. Pediatrics. 2015 Oct;136(4):e1060-e104. doi: 10.1542/peds.2015-2485
  14. Robert J, Tavernier E, Boccara O, Mashiah J, Mazereeuw-Hautier J, Maruani A. Modalities of use of oral propranolol in proliferative infantile haemangiomas: an international survey among practitioners. Br J Dermatol. 2020 Mar 27. doi: 10.1111/bjd.19047. Online ahead of print.
  15. Streicher JL, Riley EB, Castelo-Soccio LA. Reevaluating the need for electrocardiograms prior to initiation of treatment with propranolol for infantile hemangiomas. JAMA Pediatr. 2016 Sep 1;170(9):906-7. doi: 10.1001/jamapediatrics.2016.0824
  16. Lund EB, Chamlin SL, Mancini AJ. Utility of routine electrocardiographic screening before initiation of propranolol for infantile hemangiomas. Pediatr Dermatol. 2018 Jul;35(4):e233-e34. doi: 10.1111/pde.13508
  17. Chan H, McKay C, Adams S, Wargon O. RCT of timolol maleate gel for superficial infantile hemangiomas in 5–24-week-olds. Pediatrics. 2013 Jun;131(6):e1739-47. doi: 10.1542/peds.2012-3828
Address for correspondence:
04112, Ukraine, Kiev,
Dorogozhitskaya Str., 9,
P.L. Shupyk National Academy of Postgraduate Education of the MH of Ukraine,
the Pediatric Surgery Department,
e-mail:pedsurgery_ua@ukr.net,
tel. mobile +380 50 412-26-89,
Rybalchenko Vasyl F.
Information about the authors:
Rybalchenko Vasyl F., MD, Professor of the Pediatric Surgery Department, P.L.Shupyk National Academy of Postgraduate Education, Kiev, Ukraine.
https://orcid.org/0000-0002-1872-6948
Pereyaslov Andriy A., MD, Professor of the Pediatric Surgery Department,.Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
http://orcid.org/0000-0002-1225-0299
Rybalchenko Inna G., PhD, Pediatric Surgeon, Neonatal Surgery Department, National Children Specialized Hospital «OXMATDYT», Kiev, Ukraine.
https://orcid.org/0000-0003-0634-2725
Nykyforuk Olesya M., PhD, Assistant of the Pediatric Surgery Department, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0003-2967-5653

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

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

Belarusian State Medical University 1, Minsk,
Medical Center «ELMED»2, Gomel,
Gomel Regional Clinical Hospital 3, Gomel,
Vitebsk State Medical University 4, Vitebsk
Minsk 5th City Clinical Hospital 5, Minsk
Vitebsk Regional Clinical Specialized Center 6, Vitebsk
The Republic of Belarus

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

Keywords: varicose veins, compression therapy, compliance, implementation of recommendations, comparison of results
p. 302-310 of the original issue
References
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  3. Nicolaides A, Kakkos S, Baekgaard N, Comerota A, de Maeseneer M, Eklof B, Giannoukas AD, Lugli M, Maleti O, Myers K, Nelzén O, Partsch H, Perrin M. Management of chronic venous disorders of the lower limbs. Guidelines According to Scientific Evidence. Part I. Int Angiol. 2018 Jun;37(3):181-54. Int Angiol. 2018 Jun;37(3):181-54. doi: 10.23736/S0392-9590.18.03999-8
  4. Wittens C, Davies AH, Bækgaard N, Broholm R, Cavezzi A, Chastanet S, de Wolf M, Eggen C, Giannoukas A, Gohel M, Kakkos S , Lawson J, Noppeney T, Onida S, Pittaluga P, Thomis S, Toonder I, Vuylsteke M. Management of chronic venous disease: clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2015;49:678-37. doi: 10.1016/j.ejvs.2015.02.007
  5. Kakkos SK, Timpilis M, Patrinos P, Nikolakopoulos KM, Papageorgopoulou CP, Kouri AK, Ntouvas I, Papadoulas SI, Lampropoulos GC, Tsolakis IA. Acute effects of craduated elastic compression stockings in patients with symptomatic varicose veins: a randomised double blind placebo controlled trial. Eur J Vasc Endovasc Surg. 2018 Jan;55(1):118-25. doi: 10.1016/j.ejvs.2017.10.004
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  11. Kankam HKN, Lim ChS, Fiorentino F, Davies AH, Gohel MS. A summation analysis of compliance and complications of compression hosiery for patients with chronic venous disease or post-thrombotic syndrome. Eur J Vasc Endovasc Surg. 2018 Mar;55(3):406-16. doi: 10.1016/j.ejvs.2017.11.025
  12. Uhl JF, Benigni JP, Chahim M, Fréderic D. Prospective randomized controlled study of patient compliance in using a compression stocking: Importance of recommendations of the practitioner as a factor for better compliance. Phlebology. 2018 Feb;33(1):36-43. doi: 10.1177/0268355516682886
Address for correspondence:
220083, Republic of Belarus, Minsk,
Dzerzhinskii Avenue, 83,
Belarusian State Medical University,
the 1st Department of Surgical Diseases,
tel.mobile+375 173400254,
e-mail: ini67@inbox.ru,
Ihnatovich Igor N.
Information about the authors:
Ihnatovich Igor N., MD, professor of the 1st Department of Surgical Diseases, Belarusian State Medical University, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-3185-8048
Bontsevich Dmitry N., PhD, Associate Professor, Angiosurgeon, Medical Center «ELMED», Gomel, Republic of Belarus.
https://orcid.org/0000-0002-1894-1111
Maslianski Boris A., Surgeon, the 2nd Surgical Department, Gomel Regional Clinical Hospital, Gomel, Republic of Belarus.
https://orcid.org/0000-0002-6996-8461
Nebylitsyn Yury S., PhD, Associate Professor, Head of the Plastic Surgery and Cosmetology Department of the Clinic of VSMU, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-4022-0599
Novikova Natalya M., Ph, Surgeon, Minsk 5th City Clinical Hospital , Minsk, Republic of Belarus.
https://orcid.org/0000-0003-0164-5276
Kosinets Alexandr V., Surgeon of the Surgery Unit, Vitebsk Regional Clinical Specialized Center, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-0575-5299
Mikhnevich Alexey V., Senior Lecturer of the Hospital Surgery Department with the Course of Urology and Pediatric Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-8112-6822
Pavlov Alexandr G., PhD, Associate Professor of the Hospital Surgery Department with the Course of Urology and Pediatric Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-7280-4364

TRAUMATOLOGY AND ORTHOPEDICS

S.V. ZYBLEVA, S.L. ZYBLEV

IMMUNOLOGICAL PREDICTORS OF RENAL GRAFT REJECTION IN THE EARLY POSTOPERATIVE PERIOD

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

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

Keywords: dendritic cell, LIN-HLA-DR+CD11c+CD123-, LIN-HLA-DR+CD11c-CD123+, renal graft dysfunction, renal graft rejection, renal transplantation
p. 311-317 of the original issue
References
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Address for correspondence:
246000, Republic of Belarus,
Gomel, Ilyich Str., 290,
Republican Research Center
for Radiation Medicine and Human Ecology
tel. mobile: +375 44 547-69-85,
e-mail: zyb-svetlana@yandex.by,
Zybleva Svetlana V.
Information about the authors:
Zybleva Svetlana V., PhD, Immunologist, Scientific Secretary, Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
https://orcid.org/0000-0003-3061-5324
Zyblev Sergey L., PhD, Associate Professor, Surgeon of the Surgery Unit (Transplantation, Reconstructive and Endocrine Surgery), Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
https://orcid.org/0000-0002-0968-6630

UROLOGY

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

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

Volgograd State Medical University, Volgograd,
The Russian Federation

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

Keywords: complications of urolithiasis, lumbotomy, urinary tract drainage, mortality rate, COVID-19
p. 318-326 of the original issue
References
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Address for correspondence:
400131, Russian Federation,
Volgograd, Pavshie Bortsy Square, 1
Volgograd State Medical University,
the Department of the General Surgery
with the Course Of Urology,
tel. +7 903 375-57-95,
e-mail: kouznetsov23@gmail.com,
Kuznetsov Alexandr A.
Information about the authors:
Panin Stanislav I., MD, Associate Professor, Head of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0003-4086-2054
Bykov Alexandr V., MD, Professor of the Department of Surgical Diseases No 1 of Institute of Continuing Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0002-1505-6256
Doronin Andrey B., PhD, Associate Professor of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0003-2944-6762
Kuznetsov Alexandr A., PhD, Associate Professor of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0002-7026-1746
Shchelkov Sergey V., PhD, Associate Professor of the Department of Surgical Diseases No1 of Institute of Continuing Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0001-8582-3687
Panina Anna A., PhD, Associate Professor of the Department of Radiation, Functional and Laboratory Diagnostics of Institute of Continuing Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0003-2750-8579
Morozov Egor A., Assistant of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0001-9495-3424
Karpenko Svetlana N., PhD, Associate Professor of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0002-9965-392X

ONCOLOGY

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

THE ROLE OF THE INTESTINAL MICROBIOTA IN THE COLON CANCER DIAGNOSTICS

Chita State Medical Academy, Chita,
The Russian Federation

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

Keywords: colon cancer, Helicobacter pylori, intestinal microbiota, colon biopsy, tumor tissue
p. 326-333 of the original issue
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Address for correspondence:
672090, Russian Federation,
Chita, Gor’kii Str., 39a,
Chita State Medical Academy
of the Ministry of Health of Russia,
Oncology Department
tel.: +7 924 370-99-65,
e-mail: vsv_19@mail.ru,
Volkov Stepan V.
Information about the authors:
Volkov Stepan V., Assistant, the Oncology Department, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
https://orcid.org/0000-0002-8696-9562
Lobanov Sergey L., MD, Professor, Head of the Department of Faculty Surgery with the Course of Urology, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
http://orcid.org/0000-0003-1665-3754
Dutova Anastasiya A., PhD, Senior Researcher, the Laboratory of Molecular Genetics, RI of the Molecular Medicine, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
http://orcid.org/0000-0001-8285-6061
Erdineyeva Beligma S., PhD, Assistant, the Department of Microbiology, Virology, Immunology, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
http://orcid.org/0000-0003-3035-7900

REVIEWS

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

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

Privolzhsky Research Medical University, Nizhny Novgorod,
Russian Federation

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

Keywords: purulent-inflammatory processes, organometallic frameworks, nanoparticles, immobilized compounds, biometals, synthesis
p. 334-346 of the original issue
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Address for correspondence:
603950, Russian Federation,
Nizhny Novgorod, Minin Square, 10/1,
Privolzhsky Research Medical University,
General Chemistry Department,
tel. +7(910)872-41-51,
e-mail: kadomtseva@pimunn.ru,
Kadomtseva Alena V.
Information about the authors:
Kadomtseva Alena V., PhD, Senior Lecturer of the General Chemistry Department, Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation.
http://orcid.org/0000-0002-6962-0625
Loginova Lyubov B., Head of the Laboratory of the General Chemistry Department, Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation.
https://orcid.org/0000-0002-4917-2802
Zarubenko Polina A., Assistant of the General, Operative Surgery and Topographic Anatomy Named after A.I.Kozhevnikov, Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation.
https://orcid.org/0000-0001-7288-8625

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

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

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

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

Keywords: reconstructive valve-sparing interventions, aortic valve, regurgitation, stenosis, autologous tissues, aortic root, prosthetics of the valves
p. 347-359 of the original issue
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Address for correspondence:
119435, Russian Federation, Moscow,
Bolshaya Pirogovskaya Str., 6,1,
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University),
the Faculty Surgery Department
tel. +7 915 335-10-06,
e-mail: borya0994@inbox.ru,
Tlisov Boris M.
Information about the authors:
Komarov Roman N., MD, Head of the Faculty Surgery Department No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0002-3904-6415
Ismailbaev Alisher M., PhD, Assistant of the Faculty Surgery Department No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0001-8545-3276
Frolov Pavel P., Cardiovascular Surgeon of the Cardiac Surgery Unit of the University Clinical Hospital No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
http://orcid.org/0000-0003-1532-0173
Tlisov Boris M., Cardiovascular Surgeon of the Cardiac Surgery Unit of the University Clinical Hospital No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0003-4094-8771

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

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

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

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

Keywords: atherosclerosis, arteries of the lower limbs, diabetic foot syndrome, diabetes mellitus, revascularization
p. 360-369 of the original issue
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  42. Ouriel K, Adelman MA, Rosenfield K, Scheinert D, Brodmann M, Peña C, Geraghty P, Lee A, White R, Clair DG. Safety of Paclitaxel-Coated Balloon Angioplasty for Femoropopliteal Peripheral Artery Disease. JACC Cardiovasc Interv. 2019 Dec 23;12(24):2515-24. doi: 10.1016/j.jcin.2019.08.025
  43. Ipema J, Huizing E, Schreve MA, de Vries JPM, Ünlü Ç. Editor’s Choice – Drug Coated Balloon Angioplasty vs. Standard percutaneous transluminal angioplasty in below the knee peripheral arterial disease: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2020 Feb;59(2):265-75. doi: 10.1016/j.ejvs.2019.10.002
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Address for correspondence:
410012 Russian Federation,
Saratov, Bolshaya Kazachya Str., 112,
Saratov State Medical University
named after V.I. Razumovsky,
the Department of Surgery and Oncology,
tel. office: 898-73-07-84-31,
e-mail: i.larin.v@yandex.ru,
Larin Igor V.
Information about the authors:
Tolstokorov Aleksandr S., MD, Professor, Head of the Department of Surgery and Oncology, Saratov State Medical University Named after V.I.Razumovsky of the Ministry of Health of Russia, Saratov, Russian Federation.
https://orcid.org/0000-0002-8541-5330
Kulikova Alla N., MD, Professor of the Hospital Surgery Department of the Medical Faculty, Saratov State Medical University Named after V.I.Razumovsky of the Ministry of Health of Russia, Saratov, Russian Federation.
https://orcid.org/0000-0002-7116-4219
Larin Igor V., Post-Graduate Student of the Department of Surgery and Oncology, Saratov State Medical University Named after V.I.Razumovsky of the Ministry of Health of Russia, Saratov, Russian Federation.
https://orcid.org/0000-0001-7979-3071

CASE REPORTS

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

XANTHOGRANULOMATOUS PYELONEPHRITIS – A RARE FORM OF CHRONIC CALCULOUS PYELONEPHRITIS

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

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

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

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

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

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

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

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

EXCHANGE OF EXPERIENCE

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

TRANSORAL THYROIDECTOMY AND PARATHYROIDECTOMY: SERIES OF CASES

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

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

Keywords: transoral thyroidectomy, transoral parathyroidectomy, Dermatology Life Quality Index, endoscopic thyroidectomy, transoral neck surgery, natural orifice surgery
p. 382-392 of the original issue
References
  1. Miccoli P. Minimally invasive surgery for thyroid and parathyroid diseases. Surg Endosc. 2002;16:3-6. doi: 10.1007/s00464-001-8140-8
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  10. Tartaglia F, Maturo A, Di Matteo FM, De Anna L, Karpathiotakis M, Pelle F, Tromba L, Carbotta S, Carbotta G, Biancucci A, Galiffa G, Livadoti G, Falbo F, Esposito A, Donello C, Ulisse S. Transoral video assisted thyroidectomy: a systematic review. G Chir. 2018 Sep-Oct;39(5):276-83.
  11. Nakajo A, Arima H, Hirata M, Mizoguchi T, Kijima Y, Mori S, Ishigami S, Ueno S, Yoshinaka H, Natsugoe S. Trans-Oral Video-Assisted Neck Surgery (TOVANS). A new transoral technique of endoscopic thyroidectomy with gasless premandible approach. Surg Endosc. 2013 Apr;27(4):1105-10. doi: 10.1007/s00464-012-2588-6
  12. Razavi CR, Russell JO. Indications and contraindications to transoral thyroidectomy. Ann Thyroid. 2017;2(5):12. doi: 10.21037/aot.2017.10.01
  13. Razavi CR, Tufano RP, Russell JO. Starting a Transoral thyroid and parathyroid surgery program. Curr Otorhinolaryngol Rep. 2019 Sep;7(3):204-208. doi: 10.1007/s40136-019-00246-w
  14. Celik S, Makay O, Yoruk MD, Bayzit Kocer I, Ozdemir M, Kilic KD, Tomruk C, Bilge O, Uyanikgil Y, Dionigi G. A surgical and anatomo-histological study on Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA). Surg Endosc. 2020 Mar;34(3):1088-102. doi: 10.1007/s00464-019-06856-1
  15. Grogan RH, Suh I, Chomsky-Higgins K, Alsafran S, Vasiliou E, Razavi CR, Chen LW, Tufano RP, MD, Duh QY, Angelos P, Russell JO. Patient eligibility for transoral endocrine surgery procedures in the United States. JAMA Netw Open. 2019 May;2(5):e194829. Published online 2019 May 31. doi: 10.1001/jamanetworkopen.2019.4829
  16. Shulutko AM, Semikov VI, Gryaznov SE, Gorbacheva AV , Patalova AR ,Mansurova GT, Boblak YuA. Transoral approach to thyroid gland in the experiment.. Khirurgiia Zhurn im NI Pirogova. 2017;(2):25-31. doi: 10.17116/hirurgia2017225-31. (In Russ.)
  17. Choi Y, Lee JH, Kim YH, Lee YS, Chang HS, Park CS, Roh MR. Impact of postthyroidectomy scar on the quality of life of thyroid cancer patients. Ann Dermatol. 2014 Dec;26(6):693-99. doi: 10.5021/ad.2014.26.6.693
  18. Russell JO, Clark J, Noureldine SI, Anuwong A, Al Khadem MG, Yub Kim H, Dhillon VK, Dionigi G, Tufano RP, Richmon JD. Transoral thyroidectomy and parathyroidectomy – A North American series of robotic and endoscopic transoral approaches to the central neck. Oral Oncol. 2017 Aug;71:75-80. doi: 10.1016/j.oraloncology.2017.06.001
Address for correspondence:
115093, Russian Federation,
Moscow, Pavlovskaya Str., 25,
City Clinical Hospital No 4,
Moscow Health Department
tel.: +7 916 299-26-88,
e-mail: gryzli_37@mail.ru
Gryaznov Sergey E.
Information about the authors:
Gryaznov Sergey E., PhD, Surgeon, City Clinical Hospital No4, Moscow Health Department, Moscow, Russian Federation.
https://orcid.org/0000-0003-2074-4130
Melkonyan Georgiy G., MD, Professor of the Surgery Departmentr, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation , Head physician, City Clinical Hospital No4, Moscow Health Department, Moscow, Russian Federation.
https://orcid.org/0000-0001-7234-4185
Shulutko Alexandr M., MD, Professor of the Surgery Department No2, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0002-8001-1601
Semikov Vasily I., MD, Professor of the Surgery Department No2, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0002-3844-1632
Osmanov Elkhan G., MD, Professor of the Surgery Department No2, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0003-1451-1015
Gandybina Elena G., PhD, Associate Professor of the Surgery Department No245, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
https://orcid.org/0000-0002-6765-5154
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