Year 2016 Vol. 24 No 4




ME "Mogilev Regional Hospital"
The Republic of Belarus

The implantable cardioverter defibrillators (ICDs) currently play, along with drug therapy, one of the leading roles in the prevention of sudden cardiac death. Efficacy and safety of ICD in different groups of patients have been proven in a number of large randomized trials. Taking into account the high proportion of sudden cardiac death in the structure of total mortality, ICDs allow saving thousands of lives annually. Rapid scientific and technical progress, currently observed in all spheres of human activity, allows assuming with high probability a significant increase of reliability and therapeutic opportunities of ICDs in the nearest future. Due to the ever growing number of ICD implantations across the world, we consider important objective to increase interest in implantable antiarrhythmic devices among physicians of different specialties.
This paper briefly describes the history of the ICD from the formation of the concept in the late 60-ies of XX century, to current multifunctional implantable antiarrhythmic devices. The ICD example shows the impact of the development of microelectronics and computer technology at the end of XX - the beginning of XI century on the current medicine.

Keywords: sudden death, antiarrhythmic devices, implantable defibrillator, history of medicine, Mirowski, resynchronization therapy, microelectronics and computer technology
p. 317-327 of the original issue
  1. Deo R, Albert CM. Epidemiology and genetics of sudden cardiac death. Circulation. 2012 Jan 31;125(4):620-37. doi: 10.1161/CIRCULATIONAHA.111.023838.
  2. Gorbachev VV, Mrochek A.G. Profilaktika prezhdevremennoi i vnezapnoi smerti [Preventing premature and sudden death: a guide]: sprav posobie. Minsk, RB: Vysheishaia shk; 2000. 463 p.
  3. Myerburg RJ, Interian A, Simmons J, Castellanos A. Sudden cardiac death. In: Zipes DP, ed. Cardiac electrophysiology: from cell to bedside. 4th ed. Philadelphia: WB Saunders; 2004. p. 720-31.
  4. Sovari AA, Rottman JN, chief editor, Kocheril AG, Baas AS. Sudden cardiac death. Medscape [Electronic resource]. 2014. Available from:
  5. Go AS, Mozaffarian DM, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart Disease and Stroke Statistics2014 Update: a report from the American Heart Association. Circulation. 2014; 129(3): e28-e292. 10.1161/01.cir.0000441139.02102.80.
  6. Straus SM, Bleumink GS, Dieleman JP, van der Lei J, Stricker BH, Sturkenboom MC. The incidence of sudden cardiac death in the general population. J Clin Epidemiol. 2004 Jan;57(1):98-102.
  7. Mrochek AG, Gorbachev VV. Ekstremal'naia kardiologiia: profilaktika vnezapnoi smerti: ruk dlia vrachei [Emergency cardiology: prevention of sudden death: a quide for physicians]. Moscow, RF: Medkniga; 2010. 432 p.
  8. Perkins GD, Handley AJ, Koster RW, Castrén M, Michael AS, Olasveengen T, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81-99. doi: 10.1016/j.resuscitation.2015.07.015.
  9. Ladzeyeu AI, Marochkov AV, Dzmitryieva VN, Shumskaia OV. Istoriia elektricheskoi defibrilliatsii s drevneishikh vremen i do nashikh dnei [History of electrical defibrillation from the ancient times to the present day]. Novosti Khirurgii. 2014;22(5):513-25. doi: 10.18484/2305-0047.2014.5.513.
  10. MacWilliam J. Cardiac failure and sudden death. Br Med J. 1889;1:6-8.
  11. Arkhiv istorii defibrilliatsii v SSSR, Rossii i Ukraine [Archive a history of defibrillation in the Soviet Union, Russia and Ukraine]. Gurvich Naum Lazarevich [Elektronnyi resurs]. 2016 [data dostupa 2016 Apr 28]. Rezhim dostupa:
  12. Gurvich NL, Iun'ev GS. O vosstanovlenii normal'noi deiatel'nosti fibrilliruiushchego serdtsa teplokrovnykh posredstvom kondensatornogo razriada [On the recovery of the normal activity of the fibrillated heart of the warm-blooded by the condenser discharge]. Biul Eksperim Biologii i Meditsiny. 1939;8(1):55-59.
  13. Lown B, Amarasingham R, Neuman J. New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge. JAMA. 1962 Nov 3;182:548-55.
  14. Jude JR, Kouwenhoven WB, Knickerbocker GG. An experimental and clinical study of a portable external cardiac defibrillator. Surg Forum. 1962;13:185.
  15. Venin IV, Vostrikov VA, Gorbunov BB, Selishchev SV. Istoriia defibrilliatsii v USSR, Rossii i Ukraine: tekhnika na sluzhbe meditsiny [History of defibrillation in the USSR, Russia and Ukraine: technique in the service of medicine]. Arkhiv istorii defibrilliatsii v USSR, Rossii i Ukraine. 2014. 70 p.
  16. Schneider T, Martens PR, Paschen H, Kuisma M, Wolcke B, Gliner BE, et al. Multicenter, randomized, controlled trial of 150-J biphasic shocks compared with 200- to 360-J monophasic shocks in the resuscitation of out-of-hospital cardiac arrest victims. Optimized Response to Cardiac Arrest (ORCA) Investigators. Circulation. 2000 Oct 10;102(15):1780-87.
  17. Baum Robert S, Alvarez H III, Cobb LA. Survival after resuscitation from out-of-hospital ventricular fibrillation. Circulation. 1974;50:1231-35. doi: 10.1161/01.CIR.50.6.1231.
  18. Kastor JA. Michel Mirowski and the automatic implantable defibrillator. Am J Cardiol. 1989 Apr 15;63(13):977-82 contd.
  19. Elmkvist Rune [Elektronnyi resurs]. 2015 [data dostupa 2015 Dek 29]. Rezhim dostupa:,_Rune.
  20. Hill WE, Murray A, Bourke JP, Howell L, Gold RG. Minimum energy for cardiac pacing. Clin Phys Physiol Meas. 1988 Feb;9(1):41-6.
  21. Kirk J. Preventing sudden cardiac death: the implantable de?brillator. In: Machines in our hearts. The cardiac pacemaker, the implantable defibrillator, and American health care. JHU Press; 2001. . 235-63.
  22. Cakulev I, Efimov IR, Waldo AL. Cardioversion: past, present, and future. Circulation. 2009;120(16):1623-32. doi: 10.1161/CIRCULATIONAHA.109.865535.
  23. Mirowski M, Mower MM, Staewen WS, Tabatznik B, Mendeloff AI. Standby automatic defibrillator. An approach to prevention of sudden coronary death. Arch Intern Med. 1970 Jul;126(1):158-61.
  24. Mirowski M, Mower MM. Transvenous automatic defibrillator as an approach to prevention of sudden death from ventricular fibrillation. Heart Lung. 1973Nov;2(6):867-69.
  25. Lown B, Axelrod P. Implanted standby defibrillators. Circulation. 1972 Oct;46(4):637-39.
  26. Mirowski M, Mower MM, Langer A, Heilman MS, Schreibman J. A chronically implanted system for automatic defibrillation in active conscious dogs. Experimental model for treatment of sudden death from ventricular fibrillation. Circulation. 1978 Jul;58(1):90-4. 08/1978; 58(1):90-4. doi: 10.1161/01.CIR.58.1.90.
  27. Kenny T, ed. Chapter 2. The History of ICDs. In: The nuts and bolts of ICD therapy. St Jude Medical; 2006. . 12-15. Published Online: 30 Nov. doi: 10.1002/9780470750834.ch2.
  28. Winkle RA, Thomas A. The Automatic implantable cardioverter de?brillator: The U.S. experience. In: P. Brugada, H.J. Wellens, eds. Cardiac arrhythmias: where to go from here? Futura Publishing Company, Inc., Mount Kisco, New York; 1987. p. 663-80.
  29. Mirowski M, Mower MM, Gott VL, Brawley RK. Feasibility and effectiveness of low-energy catheter defibrillation in man. Circulation. 1973 Jan;47(1):79-85.
  30. Troup P. Early development of defibrillation devices. IEEE Eng Med Biol Mag. 1990;9(2):19-24.
  31. Bokeriia LA, Revishvili ASh, Neminushchii NM. Implantiruemye antiaritmicheskie ustroistva dlia profilaktiki vnezapnoi serdechnoi smerti i lecheniia serdechnoi nedostatochnosti [Antiarrhythmic implantable device for the prevention of sudden cardiac death and cardiac insufficiency]. V: Chazov EI, Golitsyn SP, red. Rukovodstvo po narusheniiam ritma serdtsa. Moscow, RF: GEOTAR-Media; 2010. p. 309-15.
  32. Kenny T. Chapter 8. Arrhythmia therapy. In: The nuts and bolts of ICD therapy. St Jude Medical; 2006. p. 50-61.
  33. Moser S, Troup P, Saksena S, Parsonnet V, Furman S, Fisher J, et al. Non-thoracotomy implanted defibrillator system. PACE. 1988;11:887.
  34. Damiano RJ Jr. Implantable cardioverter defibrillators: current status and future directions. J Card Surg. 1992 Mar;7(1):36-57.
  35. Sweeney MO. Antitachycardia pacing for ventricular tachycardia using implantable cardioverter defibrillators: Substrates, methods, and clinical experience. Pacing Clin Electrophysiol. 2004 Sep;27(9):1292-305. doi: 10.1111/j.1540-8159.2004.00622.x.
  36. Winkle RA, Mead RH, Ruder MA, Gaudiani V, Buch WS, Pless B, et al. Improved low energy defibrillation efficacy in man with the use of a biphasic truncated exponential waveform. Am Heart J. 1989 Jan;117(1):122-27.
  37. Troup P. Early development of defibrillation devices. IEEE Eng Med Biol Mag. 1990;9(2):19-24.
  38. Fain ES, Winkle RA. Implantable cardioverter defibrillator: Ventritex Cadence. J Cardiovasc Electrophysiol. 1993 Apr;4(2):211-23.
  39. Golino A, Pappone C, Panza A, Santomauro M, Iorio D, De Amicis V, et al. Clinical experience with the transvenous Medtronic Pacer Cardioverter Defibrillator (PCD) System. Tex Heart Inst J. 1993;20(4):264-70.
  40. Steawen WS, Mower MM. History of the ICD. In: Kroll MW, Lehmann MH, eds. Implantable cardioverter defibrillator therapy: The engineering-clinical interface. Springer Science & Business Media; 2012. p. 17-30.
  41. Bardy GH, Johnson G, Poole JE, Dolack GL, Kudenchuk PJ, Kelso D, et al. A simplified, single-lead unipolar transvenous cardioversion-defibrillation system. Circulation. 1993 Aug;88(2):543-7.
  42. Marcus G. Implantable cardioverter defibrillator chest X-ray [Electronic resource]. 2016 [cited 2016 28]. Available from:
  43. Lavergne T, Daubert JC, Chauvin M, Dolla E, Kacet S, Leenhardt A, et al. Preliminary clinical experience with the first dual chamber pacemaker defibrillator. Pacing Clin Electrophysiol. 1997 Jan;20(1 Pt 2):182-88.
  44. Antiarrhythmics Versus Implantable Defibrillators (AVID) Investigators. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med. 1997; 337:1576-83.
  45. Gregoratos G, Cheitlin MD, Conill A, Epstein AE, Fellows C, Ferguson TB Jr, et al. ACC/AHA guidelines for implantation of cardiac pacemakers and antiarrhythmic devices: a report of the ACC/AHA Task Force on practice guidelines. Circulation. 1998;97:1325-35. doi: 10.1161/01.CIR.97.13.1325.
  46. Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H, et al. For the multicenter automatic defibrillator implantation trial investigators. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med. 1996 Dec26;335:1933-40. doi: 10.1056/NEJM199612263352601.
  47. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002 Mar 21;346:877-83. doi: 10.1056/NEJMoa013474.
  48. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005 Jan 20;352(3):225-37.
  49. Moss AJ. Narrow QRS is not the right substrate for cardiac resynchronization therapy. Circulation. 2013;127:1093-1094. doi: 10.1161/CIRCULATIONAHA.113.001363.
  50. Thompson M. Combined CRT/ICD Therapy for Heart Failure Patients: Is the Evidence In? Medscape Cardiology [Electronic resource]. 2002 [cited 2015 Dec 27]. Avialable from:
  51. Abraham WT, Fisher WG, Smith AL, Delurgio DB, Leon AR, Loh E, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. 2002 Jun 13;346(24):1845-53.
  52. Tang AS, Wells GA, Talajic M, Arnold MO, Sheldon R, Connolly S, et al. Resynchronization-defibrillation for ambulatory heart failure trial investigators. Cardiac-resynchronization therapy for mild-to-moderate heart failure. N Engl J Med. 2010 Dec 16;363:2385-951. doi: 10.1056/NEJMoa1009540.
  53. Klein HU, Inama G. Implantable defibrillators: 30 years of history. G Ital Cardiol. 2010;11(10 Suppl 1):485-25.
  54. Raatikainen MJ, Arnar DO, Zeppenfeld K, Merino JL, Levya F, Hindriks G, et al. Statistics on the use of cardiac electronic devices and electrophysiological procedures in the European Society of Cardiology countries: 2014 report from the European Heart Rhythm Association. Europace. 2015 Jan;17 Suppl 1:i1-75. doi: 10.1093/europace/euu300.
  55. Kuck KH, Hindricks G, Padeletti L, Raatikainen P, Arnar DO. The EHRA White Book 2015. The current status of cardiac electrophysiology in ESC member countries. EHRA; 2015. p. 69-78.
Address for correspondence:
212026, Republic of Belarus, Mogilev, B. Biruli str., 12,
ME "Mogilev Regional Hospital" department of anesthesiology and intensive care. Tel: +375 222 27-87-39
Ladzeyeu Andrey Yurevich
Information about the authors:
Ladzeyeu A.Y. Anesthesiologist, ME "Mogilev Regional Hospital", department of anesthesiology and reanimation.
Marochkov A.V. MD, professor, Head, ME "Mogilev Regional Hospital", department of anesthesiology and reanimation.
Dzmitryieva V.N. Anesthesiologist, ME "Mogilev Regional Hospital", department of anesthesiology and reanimation.




EE "Grodno State Medical University"1,
Grodno Regional Council of Deputies2,
ME "City Clinical Emergency Hospital"3
The Republic of Belarus

Objectives. To carry out a comparative evaluation of the liver tissue reaction at the ultrastructural level to closure of its wound surface by the omentum and fluoroplastic.
Methods. In the experiment on white rats the marginal resection of the left liver lobe was performed. In the 1st group the wound was peritonized by the strand on the vascular pedicle of omentum fixed to the capsule with koralen 7/0 single interrupted sutures. In the 2nd group the wound defect was closed by a fibrous-porous fluoroplastic flap (2 mm thickness). On the 21st day 5 animals from each group were withdrawn from the experiment. At a distance of 5 mm in depth from the wound surface the samples of material were taken to produce the electron-microscopic preparations. The complex of digital camera Olympus Mega View III and the program for image processing iTEM were used. The morphometric evaluation of quantitative and qualitative parameters of hepatocyte mitochondria with further statistical analysis of the obtained material was performed.
Results. It has been found out that in closure of the liver wound by the omentum and fluoroplastic the similar reversible changes including activation of reparative processes in response to injury after surgery are developed at the ultrastructural level. However, the use of polymer fluoroplastic for plastic closure also causes increased secretory processes with moderate cellular response of the mononuclear phagocyte system. In addition, in the second group the number of lipid inclusions in hepatocytes being an additional source of energy production is increased. At the same time, the signs of active collagen production and therefore fibrosis at the subcellular level are not determined.
Conclusion. The use of the fluoroplastic for the plastic closure of the liver wounds in the experiment is justified due to evoking the same ultrastructural changes in the liver tissue so as using the greater omentum for this purpose.

Keywords: liver wound, resection, omentum, fluoroplastic, peritonization, lipid inclusions in hepatocytes, sealing
p. 328-335 of the original issue
  1. Vishnevskii VA, Kubyshkin VA, Chzhao AV, Ikramov RZ. Operatsii na pecheni [Operations on the liver: A guide for Surgery ]: ruk dlia khirurgov. Moscow, RF: Miklosh; 2003. 158 p.
  2. Lau WY, Lai EC. Classification of iatrogenic bile duct injury. Hepatobiliary Pancreat Dis Int. 2007 Oct;6(5):459-63.
  3. Antonenkova NN, Averkin IuI, Belotserkovskii IV, Zalutskii IV, red. Onkologiia [Oncology]: ucheb posobie. Minsk, RB: Vysh shk; 2007. 703 p.
  4. Kroez M, Lang W, Dickneite G. Wound healing and degradation of the fibrin sealant Beriplast P following partial liver resection in rabbits. Wound Repair Regen. 2005 May-Jun;13(3):318-23.
  5. Koshelev VN, Chalyk IuV, Koshelev VN. Prichiny letal'nosti pri povrezhdeniiakh pecheni i selezenki [Causes of mortality in liver and spleen damage]. Vest Khirurgii im II Grekova. 1996;(2):51-53.
  6. Bondarevskii IIa, Bychkovskikh VA. Rezektsiia pecheni i pochki: tekhnicheskoe obespechenie operatsii i plasticheskie materialy [Resection of the liver and kidneys: logistics operations and plastic materials]. Vestn IuUrGU. 2011;(26):67-70.
  7. Gal'perin EI, Dederer IuM. Nestandartnye situatsii pri operatsiiakh na pecheni i zhelchnykh putiakh [Non-standard situations during operations on the liver and biliary tract]. Moscow, RF: Meditsina; 1987. 336 p.
  8. Kovanov VV, Shekhter AB, red. Kollagenoplastika v meditsine [Collagen plastic medicine]. Moscow, RF: Meditsina; 1978. 256 p.
  9. Grakovich PN, Ivanov LF, Kalinin LA, Riabchenko IL, Tolstopiatov EM, Krasovskii AM. Lazernaia abliatsiia politetraftoretilena [Laser ablation polytetrafluoroethylene]. Ros Khim Zhurn. 2008;LII(3):97-105.
  10. Tsydik IS, Zhuk IG, Morozov VL. Eksperimental'noe obosnovanie primeneniia otechestvennogo voloknisto-poristogo ftoroplasta-4 (PTFE) dlia plastiki defektov miagkikh tkanei [Experimental substantiation of application of native fiber-porous PTFE-4 (PTFE) plastic for soft tissue defects]. Zhurn GrGMU. 2005;(2):83-85.
  11. Sudakov NP, Nikiforov SB, Konstantinov IuM, Lepekhova SA. Rol' mitokhondrii v realizatsii mekhanizmov programmirovannoi gibeli kletki [Role of mitochondria in the realization of programmed cell death mechanisms]. Biul VSNTs SO RAMN. 2007;53(1):103-107.
  12. Gazizov IM, Kaligin MS, Andreeva DI, Iylmaz TS, Gumerova AA, Kiiasov AP. Izmeneniia mikrostruktury pecheni posle chastichnoi gepatektomii u krys [Changes microstructure liver after partial hepatectomy in rats]. Geny i Kletki. 2013;(3):101-105.
    , , , , , . . . 2013;(3):101-105.
  13. Lyzikov AN, Skuratov AG, Osipov BB. Mekhanizmy regeneratsii pecheni v norme i pri patologii [Mechanisms liver regeneration in norm and at pathology]. Problemy Zdorov'ia i Ekologii. 2015;(1):4-9.
  14. Roberts RA, Ganey PE, Ju C, Kamendulis LM, Rusyn I, Klaunig JE. Role of the Kupffer cell in mediating hepatic toxicity and carcinogenesis. Toxicol Sci. 2007 Mar;96(1):2-15.
  15. Sidorova VF, Riabinina ZA, Leikina ZM. Regeneratsiia pecheni u mlekopitaiushchikh [Liver regeneration in mammals]. Leningrad, USSR: Meditsina; 1966. 237 p.
Address for correspondence:
230025, Republic of Belarus, Grodno, Sverdlov st, 3,
EE "Grodno State Medical University", chair of operative surgery and topographic anatomy.
Tel: + 375 152 72-11-72 E-mail:
Kudla Viktor Valentinovich
Information about the authors:
Kudla V.V. Senior lecturer, EE "Grodno State Medical University", chair of operative surgery and topographic anatomy.
Zhuk I.G. MD, Professor, Chairman, Grodno Regional Council of Deputies.
Kravchuk R.I. PhD (B), Senior researcher, "Grodno State Medical University", research department.
Kurbat M.A. PhD, Ass. Professor, Head, EE "Grodno State Medical University", research department.
Zhmailik R.R. Surgeon-intern, ME "Grodno Clinical Emergency Hospital".



Semey State Medical University1, Semey
JSC "Scientific Research Institute of Eye Diseases of the Badge of Honor Order"2 of Kazakhstan, Almaty
The Republic of Kazakhstan

Objectives. To study the anti-proliferative effect of chitosan film (ChF) in surgical treatment of experimental proliferative vitreoretinopathy (PVR) by the ultrasound method (US).
Methods. This study has been conducted on 10 adult rabbits (20 eyes) of chinchilla breed weighing 2,5 4,0 kg. To develop an experimental PVR the autohemotherapy (0,4 ml) is used. The eyes of animals were divided into 4 groups: the 1st and 2nd the main groups 10 right eyes (5 eyes the implantation of ChF saturated with 5-fluorouracil (5-FU) and 5 eyes ChF without 5-FU), the 1st and 2nd control groups 10 left eyes (without implanting the film). On the 10th and 31st days after operation the anti-proliferative effect has been compared.
Results. On the 10th day the partial hemophthalmos in 4 eyes of the 1st and 2nd main groups and in all eyes of control groups has been noted. There was a vitreoretinal cord in the posterior part in 4 eyes of the 1st and 2nd control groups. On the 31st day in 2 eyes of the 1st main group turbidity of a vitreous body was observed. In 1 eye of the Ist main group and 3 eyes of the 2nd main group the partial hemophthalmos was noted. A vitreoretinal cord was visualized in 3 eyes of the 2nd main group. In all eyes of the control groups a hemophthalmos in the forming stage was observed, and the posterior covers were thickened. There was a vitreoretinal cord in 4 eyes of the 1st control and in 5 eyes of the 2nd control groups, the whole vitreous body was filled with accurate contours shadows; the exudate in the posterior part.
Conclusion. Using the chitosan film with 5-fluorouracil enhances the anti-proliferative effect to a great extent. The chitosan film without 5-fluorouracil also blocks the proliferation process, but to a lesser extent. After the morphological studies the given implant can be clinically applied during vitreous surgery to prevent recurrence in the incisional period.

Keywords: vitreous body, proliferative vitreoretinopathy, chitosan, 5-fluorouracil, morphological studies, vitreous surgery, incisional period
p. 336-341 of the original issue
  1. Sosnovskii SV, Boiko EV, Kharitonova NN. Obosnovanie i razrabotka sistemy kolichestvennoi otsenki tiazhesti proliferativnoi vitreoretinopatii [Justification and development of a quantitative estimation of severity of proliferative vitreoretinopathy]. Oftal'mokhirurgiia. 2009;(4):25-30.
  2. Kochmala OB, Zapuskalov IV, Krivosheina OI, Dashko IA. Khirurgiia otsloiki setchatki: sovremennoe sostoianie problemy [Retinal detachment surgery: state of the problem]. Vestn Oftal'mologii. 2010;(6):46-49.
  3. Goezinne F, La Heij EC, Berendschot TT, Kessels AG, Liem AT, Diederen RM, et al. Incidence of redetachment 6 months after scleral buckling surgery. Acta Ophthalmol. 2010 Mar;88(2):199-206. doi: 10.1111/j.1755-3768.2008.01425.x.
  4. Heimann H, Zou X, Jandeck C, Kellner U, Bechrakis NE, Kreusel KM, et al. Primary vitrectomy for rhegmatogenous retinal detachment: an analysis of 512 cases. Graefes Arch Clin Exp Ophthalmol. 2006 Jan;244(1):69-78.
  5. Salicone A, Smiddy WE, Venkatraman A, Feuer W. Management of retinal detachment when no break is found. Ophthalmology. 2006 Mar;113(3):398-403.
  6. Foster RE, Meyers SM. Recurrent retinal detachment more than 1 year after reattachment. Ophthalmology. 2002 Oct;109(10):1821-27.
  7. Miki D, Hida T, Hotta K, Shinoda K, Hirakata A. Comparison of scleral buckling and vitrectomy for retinal detachment resulting from flap tears in superior quadrants. Jpn J Ophthalmol. 2001 Mar-Apr;45(2):187-91.
  8. Sharma YR, Karunanithi S, Azad RV, Vohra R, Pal N, Singh DV, et al. Functional and anatomic outcome of scleral buckling versus primary vitrectomy in pseudophakic retinal detachment. Acta Ophthalmol Scand. 2005 Jun;83(3):293-97.
  9. Zakharov VD, Sharipova DN, Shatskikh AV, Novikov SV, Leont'eva GD. Sposob kombinirovannogo lecheniia eksperimental'noi PVR s primeneniem 5-ftoruratsila na gidrogelevom nositele [The method of combined treatment of experimental proliferative vitreoretinopathy with 5-fluorouracil on the hydrogel carrier]. Oftal'mokhirurgiia. 2006;(3):25-29.
  10. Lazarenko VI, Bol'shakov IN, Il'enkov SS, Shatilova RI, Kuzovnikov VV, Chanchikov DG, dr. Opyt primeneniia izdelii meditsinskogo naznacheniia Bol-khit i Kollakhit-bol v oftal'mologii [Experience of the application of medical devices "Balll-chit" and "Kollachit-ball" in ophthalmology]. Ros Oftal'mol Zhurn. 2009;2(4):21-24.
  11. Yang H, Wang R, Gu Q, Zhang X. Feasibility study of chitosan asintravitreous tamponade material. Graefes Arch Clin Exp Ophthalmol. 2008; 246(8):1095-97. doi: 10.1007/s00417-008-0813-8.
  12. Botabekova TK, Baiyrkhanova AO, Enin EA, Semenova IuM, Kampik A. Izuchenie sostoianiia vnutriglaznykh struktur posle intravitreal'nogo vvedeniia khitozanovoi plenki, nasyshchennoi 5-ftoruratsilom v eksperimente [The experimental study of the intraocular structures after intravitreal injection of chitosan film saturated with 5-fluorouracil]. Nauka i Zdravookhranenie. 2015;(6):133-46.
  13. Baiyrkhanova A, Ismailova A, Botabekova T, Enin E, Semenova Y. Crosslinked Chitosan/PVA film, suturated with 5- Fluorouracil for the prevention of proliferative vitreoretinopathy. Int J Drug Deliv Tech. 2016 Apr-Jun;6(2):47-51.
  14. Nassar K, Lüke J, Lüke M, Kamal M, Soliman MM, Grisanti S, et al. Effect of different fixative solutions on eyes with experimental proliferative vitreoretinopathy. Int J Exp Pathol. 2015 Apr;96(2):103-10. doi: 10.1111/iep.12119.
  15. Berger AS, Cheng CK, Pearson PA, Ashton P, Crooks PA, Cynkowski T, et al. Intravitreal sustained release corticosteroid-5-fluoruracil conjugate in the treatment of experimental proliferative vitreoretinopathy. Invest Ophthalmol Vis Sci. 1996 Oct;37(11):2318-25.
  16. Hou H, Nieto A, Ma F, Freeman WR, Sailor MJ, Cheng L. Tunable sustained intravitreal drug delivery system for daunorubicin using oxidized porous silicon. J Control Release. 2014 Mar 28;178:46-54. doi: 10.1016/j.jconrel.2014.01.003.
Address for correspondence:
071400, Republic of Kazakhstan, Semey, Abay str.,103, office 141,
State Medical University.
Tel: 8701720 30 42
Information about the authors:
Baiyrkhanova A.O. Applicant for Doctors degree, Semey State Medical University.
Botabekova T.K. Corresponding member, NAS of the Republic of Kazakhstan, MD, Professor, JSC "Scientific Research Institute of Eye Diseases of the Badge of Honor Order"2 of Kazakhstan, Chairman of the Board, Almaty.
Semenova Y.M. PhD, Head teacher, chair of ophthalmology, Ass. Professor, chair of general surgery, Semey State Medical University.




ME "Gomel Regional Clinical Cardiologic Center",
The Republic of Belarus

Objectives. To study the effects of protamine overdose on hemostatic parameters in vitro and to work out the criteria of protamine overdose using thromboelastometer ROTEM.
Methods. Three groups of patients were formed randomly. The 10 l of protamine solution (8,5 U) were added to the blood samples of the first group of patients. The concentration of protamine in the blood of the test sample was 1,57 U/ml. 10l of sodium chloride solution were administrated to the blood samples of the second group. The third group (the control one) no any additional drugs were introduced into the blood samples.
Results. In the first group of patients by Extem test the increase of the CT (104,5 s) was observed, which was higher by 37% (65,5 s) in the second group of patients and by 26% (77,0 s) in the third group. In the first group of patients by Intem test the increase of the CT values and CFT and also α angle change was determined compared with the second and third groups. The values of CT, CFT in the first group were higher than in the second group by 42% (210,0 s) and by 41% (71,5 s); the α angle in the first group (67,0º) was lower by 12% compared to the second group (75,5º). The values of CT, CFT in the first group were higher than in the third group by 50% (182,5 s) and by 23% (94,0 s); the α angle in the first group was lower by 7% compared to the third group (72,0º).
Conclusion. Protamine at a concentration of 1.57 U/ml has a strong hypocoagulation effect in vitro, which is manifested by specific changes in thromboelastometry ROTEM

Keywords: blood, anticoagulants, heparin, protamine, measurement techniques, thromboelastometr, Rotem
p. 342-347 of the original issue
  1. Ostrovskii IuP, Valentiukevich AV, Zhigalkovich AS. Kardiokhirurgiia [Cardiosurgery]: sprav. Moscow, RF: Med lit; 2014. 512 p.
  2. Khensli FA, Martin DE, Grevli GP. Prakticheskaia kardioanesteziologiia [Practical cardioanesthesiology]: per s angl. 3-e izd. Moscow, RF: Med inform agentstvo; 2008. 1104 p.
  3. Miller R. Lebedinskii KM, red. Anesteziia Ronal'da Millera [Anesthesia Ronald Miller]: ruk v 4 t. Saint-Petersburg, RF: Edinitsa; 2015. 3328 p.
  4. Yamamoto T, Wolf HG, Sinzobahamvya N, Asfour B, Hraska V, Schindler E. Prolonged activated clotting time after protamine administration does not indicate residual heparinization after cardiopulmonary bypass in pediatric open heart surgery. Thorac Cardiovasc Surg. 2015 Aug;63(5):397-403. doi: 10.1055/s-0035-1554998.
  5. Mochizuki T, Olson PJ, Szlam F, Ramsay JG, Levy JH. Protamine reversal of heparin affects platelet aggregation and activated clotting time after cardiopulmonary bypass. Anesth Analg. 1998 Oct;87(4):781-85.
  6. Cammerer U, Dietrich W, Rampf T, Braun SL, Richter JA. The predictive value of modified computerized thromboelastography and platelet function analysis for postoperative blood loss in routine cardiac surgery. Anesth Analg. 2003 Jan;96(1):51-7, table of contents.
  7. Lang T, Bauters A, Braun SL, Pötzsch B, von Pape KW, Kolde HJ, et al. Multi-centre investigation on reference ranges for ROTEM thromboelastometry. Blood Coagul Fibrinolysis. 2005 Jun;16(4):301-10.
  8. Mittermayr M, Velik-Salchner C, Stalzer B, Margreiter J, Klingler A, Streif W, et al. Detection of protamine and heparin after termination of cardiopulmonary bypass by thrombelastometry (ROTEM): results of a pilot study. Anesth Analg. 2009 Mar;108(3):743-50. doi: 10.1213/ane.0b013e31818657a3.
  9. Gertler R, Wiesner G, Tassani-Prell P, Braun SL, Martin K. Are the point-of-care diagnostics MULTIPLATE and ROTEM valid in the setting of high concentrations of heparin and its reversal with protamine? J Cardiothorac Vasc Anesth. 2011 Dec;25(6):981-6. doi: 10.1053/j.jvca.2010.11.020.
  10. Mittermayr M, Margreiter J, Velik-Salchner C, Klingler A, Streif W, Fries D, et al. Effects of protamine and heparin can be detected and easily differentiated by modified thrombelastography (Rotem): an in vitro study. Br J Anaesth. 2005 Sep;95(3):310-16.
  11. Ammar T, Fisher CF. The effects of heparinase 1 and protamine on platelet reactivity. Anesthesiology. 1997 Jun;86(6):1382-86.
  12. Nielsen VG1. Protamine enhances fibrinolysis by decreasing clot strength: role of tissue factor-initiated thrombin generation. Ann Thorac Surg. 2006 May;81(5):1720-27.
Address for correspondence:
246046, Republic of Belarus, Gomel, Medical st., 4, ME "Gomel Regional Clinical Cardiology Center", department of anesthesiology and intensive care. Tel / fax: (0232) 43-48-01
Osipenko Dmitriy Vasilevich
Information about the authors:
Osipenko D.V. PhD, anesthesiologist, ME "Gomel Regional Clinical Cardiologic Center", department of anesthesiology and reanimation with intensive care.
Khristin A.G. Anesthesiologist, ME "Gomel Regional Clinical Cardiologic Center", department of anesthesiology and reanimation with intensive care.



SBEE HPE "Ryazan State Medical University named after Academician I.P. Pavlov"
The Russian Federation

Objectives. Optimization of the surgical treatment of chronic pancreatitis with the regard to variants of the blood supply of the pancreatic head.
Methods. The study was conducted in two stages. At the 1st stages extraorgan arteries of the pancreas and duodenum were studied by the preparation method of 42 organ complex of the upper level of the abdominal cavity. At the 2nd, clinical stage, the patients were divided into 2 subgroups depending on the operative intervention. In the patients of A group (32 cases) the resection of the pancreatic head with the longitudinal pancreatojejunoanastomosis was performed by modified technique (2003) over standard Frey procedures taking into consideration the changes according to the obtained anatomical findings. The patients of B group (44 cases) were operated on by the Frey classical method (modification of 2003). The comparative retrospective and prospective assessment of treatment outcomes among the patients has been conducted.
Results. The anterior pancreatoduodenal arc has been found out to have several variants of localization in relation to the pancreatoduodenal complex. However, the sources of the arteries, forming the arc, and the sites of their offshoot are characterized by relatively constancy permiting ligation the elements of the anterior arc beyond the pancreatic altered tissues up to the stage of the parenchyma resection. Intraoperative blood loss was less than 400 ml (<0,01) in 24 patients in the group A and in 22 patients in the group B (<0,01). The early postoperative complications were observed in 18,75% patients in the group A and in 22,7% patients in the group B. In the late postoperative period (6 months after the surgery) the abdominal pain syndrome according to Visual Analogue Scale in 29 patients of the group A was assessed on the level 1-2 (<0,01), and in 31 patienrs of the group B the same parameters were registered (<0,01).
Conclusion. Combination of the preliminary ligation of the elements of the anterior pancreatoduodenal arterial arc with more radical excision of the scar-altered pancreatic parenchyma allows optimizing the surgical treatment of chronic pancreatitis.

Keywords: chronic pancreatitis, complications, pancreatic arteries, the Frey surgery, abdominal pain syndrome, Visual Analogue Scale, life quality
p. 348-354 of the original issue
  1. Egorov VI, Vishnevskij VA, Shastnyj AT, Shevchenko TV, Zhavoronkova OI, Petrov RV, i dr. Rezekcija golovki podzheludochnoj zhelezy pri hronicheskom pankreatite [Resection of the head of the pancreas in chronic pancreatitis]. Khirurgija Zhurn im NI Pirogova. 2009;(8):57-66.
  2. Tarasenko SV, Karjuhin IV, Rahmaev TS, Lun'kov IA, Nikitin DA, Donjukova SP, i dr. Opyt primenenija punkcionno-drenirujushhih vmeshatel'stv s ul'trazvukovoj navigaciej v lechenie pacientov s kistami podzheludochnoj zhelezy pri hronicheskom pankreatite [Experience of puncture-draining interventions with ultrasound navigation in the treatment of patients with pancreatic cysts in chronic pancreatitis]. Ros Med-Biol Vestn im akad IP Pavlova. 2013;(3):124-29.
  3. Kochatkov AV, Kriger AG, Berelavichus SV, Korolev SV, Svitina KA, Kosova IA. Rezekcija golovki podzheludochnoj zhelezy s prodol'nym pankreatikoejunoanastomozom (operacija Freja) [Resection of the pancreatic head with a longitudinal anastomosis pancreatin (Frey's operation)]. Khirurgija Zhurn im NI Pirogova. 2012;(2):31-36.
  4. Lazutkin MV, Ivanusa SJa, Tihomirova OE. Vnutriarterial'nyj regionarnyj infuzionnyj trakt v diagnostike i lechenii ostrogo pankreatita [Intra-regional infusion path in the diagnosis and treatment of acute pancreatitis]. Ros Med-Biol Vestn im akad IP Pavlova. 2014;(3):120-25.
  5. Pronin NA, Pavlov AV. Znachenie variantov krovosnabzhenija pankreatoduodenal'noj oblasti pri operativnom lechenii hronicheskogo pankreatita [The value of blood supply options of pancreatoduodenal area during surgical treatment of chronic pancreatitis]. Ros Med-Biol Vestn im akad IP Pavlova. 2015;(3):27-31.
  6. Kolotushkin IA, Balnykov S, Trohanov MJu. Ocenka vlijanija oktreotida na dinamiku letal'nosti u bol'nyh pankreonekrozom [Assessment of octreotide impact on the dynamics of mortality in patients with pancreatic necrosis]. Nauka molodyh Eruditio Juvenium. 2014;(4):88-94.
  7. Di Sebastiano P, di Mola FF, Bockman DE, Friess H, Büchler MW. Chronic pancreatitis: the perspective of pain generation by neuroimmune interaction. Gut. 2003 Jun;52(6):907-11.
  8. Emmrich J, Weber I, Nausch M, Sparmann G, Koch K, Seyfarth M, et al. Immunohistochemical characterization of the pancreatic cellular infiltrate in normal pancreas, chronic pancreatitis and pancreatic carcinoma. Digestion. 1998;59(3):192-98.
  9. Bockman DE, Buchler M, Malfertheiner P, Beger HG. Analysis of nerves in chronic pancreatitis. Gastroenterology. 1988 Jun;94(6):1459-69.
  10. Kopchak VM, Usenko AJu, Kopchak KV, Zelinskij AI. Hirurgicheskaja anatomija podzheludochnoj zhelezy [Surgical anatomy of the pancreas]. Kiev, Ukraina: Askanija; 2011. 141 s.
  11. Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas. 1987;2(6):701-7.
  12. Frey CF, Mayer KL. Comparison of local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy (Frey procedure) and duodenum-preserving resection of the pancreatic head (Beger procedure). World J Surg. 2003 Nov;27(11):1217-30.
  13. Kolesnikov LL, red. Mezhdunarodnaja anatomicheskaja terminologija (s oficial'nym spiskom russkih jekvivalentov) [International anatomical terminology (on an official list of russian equivalents)]. Moscow. RF; 2003.424 p.
  14. Timerbulatov ShV, Fajazov RR, Smyr RR, Gataullina JeZ, Shakirov RF, Idrisov TS, i dr. Metod opredelenija ob#ema i stepeni krovopoteri [The method of determining of the volume and extent of blood loss]. Klin i Jeksperim Khirurgija. 2012;(5):49-54.
  15. Johson C. Measuring pain. Visual analog scale versus numeric pain scale: what is the difference? J Chiropr Med. 2005 Winter;4(1):43-44. doi: 10/1016/S0899-3467(07)60112-8.
Address for correspondence:
390026, Russian Federation,
Ryazan, Vyisokovoltnaya str. 9,
Medical University RyazGMU Russian Ministry of Health,
chair of cardiovascular, endovascular, operative surgery and topographic anatomy. Tel: 8 9056 91-34-56
Pronin Nikolay Alekseevich
Information about the authors:
Pronin N.A. Assistant, SBEE HPE Ryazan State Medical University named after Academician I.P.Pavlov, chair of anatomy.
Tarasenko S.V. MD, Professor, Head, SBEE HPE "Ryazan State Medical University named after Academician I.P.Pavlov", chair of hospital surgery, chief physician, SBE RR "City Clinical Emergency Hospital", Ryazan, Director, Center "Surgery of the liver, biliary tracts and pancreas".
Pavlov A.V. MD, Ass. Professor, SBEE HPE "Ryazan State Medical University named after Academician I.P.Pavlov", chair of cardiovascular, endovascular, operative surgery and topographic anatomy.
Suchkov I.A. MD, Ass. Professor, Professor, SBEE HPE "Ryazan State Medical University named after Academician I.P.Pavlov", chair of cardiovascular, endovascular, operative surgery and topographic anatomy.



SHEE "Uzhgorod National University",

Objectives. To investigate the dynamics of α1-antitrypsin (α1-AT) indices in the blood and feces of patients with complicated forms of chronic pancreatitis (CP).
Methods. The patients (n=158) with the pseudocystic forms chronic pancreatitis (PCP) were examined. They were distributed into 2 groups: group I (n=76) the patients with pancreatic pseudocysts without CP complications; group II (n=82) patients with CP, in whom was complicated with the pre-liver portal hypertension (PH), infectioning of the PCP, hemorrhage from the upper parts of the digestive tract, duodenal obstruction and obstructive jaundice. The levels of α1-AT (Immundiagnostic AG, Germany) were determined in the blood serum and feces of patients and its clearance were calculated. The study was conducted before treatment and on the 5th day after the surgery.
Results. In patients of group I the indices of α1-AT in the blood plasma were slightly higher than the indices of the control group, but the level in the feces and its clearance did not differ from those in healthy people. In patients of group II the overall level of α1-AT in the blood plasma was 6,6 fold higher than the indices of the control group. High concentration of α1-AT in the blood in the given patients before treatment was accompanied by its increased level in feces as well as its fecal clearance.
Conclusion. In patients with complicated forms of PCP pancreatitis an increase of α1-AT level in the blood plasma and feces is observed as well as its fecal clearance. The highest indices of α1-AT in the blood plasma and feces are determined in infecting of PCP, pre-liver PH and duodenal obstruction in patients with CP. Surgical interventions on the pancreas lead to reduction of α1-AT level in the blood plasma and feces as well as its fecal clearance.

Keywords: chronic pancreatitis, pancreas, α1-antitrypsin, blood plasma, duodenal obstruction, surgical intervention, fecal clearance
p. 355-360 of the original issue
  1. Gubergrits NB. Osnovnye napravleniia v reabilitatsii bol'nykh khronicheskim pankreatitom [The main directions in rehabilitation of patients with chronic pancreatitis]. Zdorov'ia Ukrani. 2008;19(1):60-61.
  2. Dorofeev AE, Khorunzhaia VS. Rol' narusheniia ravnovesiia "proteazy-antiproteazy" v patogeneze khronicheskogo pankreatita [The role of disequilibrium "antiprotease-protease" in the pathogenesis of chronic pancreatitis]. Gastroenterologia. 2012.;(46):107-13.
  3. Dorofeev AE, Khorunzhaia VS, Khorostovska I, Struniavski R, Parkhomenko TA. Uroven' antiproteoliticheskoi zashchity u patsientov s sochetannoi patologiei organov dykhaniia i podzheludochnoi zhelezy [The level of anti-proteolytic protection in patients with combined pathology of the respiratory system and pancreas]. Pitannia Eksperimental'no ta Klnchno Meditsini. 2012;2(16):31-36.
  4. Stepanov IuM, Zachenko NG. Khronchnii pankreatit: blarnii mekhanzm, chinniki ta perebg [Chronic pancreatitis: biliary mechanism causes and course]. Zaporozh Med Zhurn. 2012;(1):46-50.
  5. Khristich TN, Kendezerskaia TB, Pishak VP, Gubergrits NB. Pankreaticheskii omnibus (nasledstvennyi pankreatit) ["Pancreatic horsebus" (nasledstvenny pancreatitis)]. Vestn Kluba Pankreatologov. 2009;(5):40-47.
  6. Shevchenko BF, Babii AM, Makarchuk VA, Oshmianskaia NIu, Petishko OP. Morfofunktsional'noe sostoianie podzheludochnoi zhelezy na etapakh ee fibroznoi transformatsii pri khronicheskom pankreatite [Morphofunctional state of the pancreas at stages of its fibrous transformation in chronic pancreatitis]. Vestn Problem Biologii i Meditsiny. 2014;1(4):305-13.
  7. Jupp J, Fine D, Johnson PD. The epidemiology and socioeconomic impact of chronic pancreatitis. Best Pract Res Clin Gastroenterol. 2010 Jun;24(3):219-31. doi: 10.1016/j.bpg.2010.03.005.
  8. Kavutharapu S, Nagalla B, Abbagani V, Porika SK, Akka J, Nallari P, et al. Role of proteases and antiprotease in the etiology of chronic pancreatitis. Saudi J Gastroenterol. 2012 Nov-Dec;18(6):364-8. doi: 10.4103/1319-3767.103427.
  9. Stoller JK, Aboussouan LS. A review of α1-antitrypsin deficiency. Am J Respir Crit Care Med. 2012 Feb 1;185(3):246-59. doi: 10.1164/rccm.201108-1428CI.
  10. Wang Q, Du J, Yu P, Bai B, Zhao Z, Wang S, et al. Hepatic steatosis depresses alpha-1-antitrypsin levels in human and rat acute pancreatitis. Sci Rep. 2015 Dec 4;5:17833. doi: 10.1038/srep17833.
Address for correspondence:
88000, Ukraine, Transcarpathian region, Uzhgorod, People sq., 1, SHEE "Uzhhorod National University", faculty of medicine, chair of propedeutics of internal deseases. Tel: + 38050-976-17-94
Sirchak Elizaveta Stepanovna
Information about the authors:
Rusin V.I. MD, Professor, SHEE "Uzhgorod National University", chair of surgical diseases, medical faculty.
Sirchak E.S. MD, Professor, SHEE "Uzhgorod National University", chair of propaedeutics of internal diseases, medical faculty.
Filip S.S. MD, Professor, SHEE "Uzhgorod National University", chair of general surgery, medical faculty.
Servetnik P.F. Post-graduate student, SHEE "Uzhgorod National University", chair of general surgery , medical faculty.



EE "Belarusian State Medical University"1,
UE "Lotios"2,
ME "Minsk 10th City Clinical Hospital"3
Minsk The Republic of Belarus

Objectives. To study an application opportunity of a new local haemostatic agent Gamastat in the combination with a selective electrocoagulation of particular bleeding vessels of the gall bladder bed during cholecystectomy.
Methods. The comparative study of treatment results of patients (n=77), divided into two groups has been conducted. In the main group (n=45) of patients to stop bleeding from the gallbladder bed a haemostatic agent Gamastat and a selective coagulation only of particular bleeding vessels have been applied during surgery versus a standard technique of a continuous electrocoagulation of the gall bladder bed in cholecystectomy, used in the control group (n=32). A bleeding arrest after treating of the liver wound surface with local haemostatic agents or electrocoagulation was registered; dynamics of changes of the blood cytological and biochemical indicators and plasma haemostasis parameters were studied preoperatively and on the 3rd postoperative day.
Results. The complete haemostasis at Gamastat application and a selective coagulation of particular bleeding vessels have been achieved in a greater number of cases (88,9%), than at the application of a continuous electrocoagulation of the gall bladder bed (75% of cases).
If haemostasis by the abovementioned methods was not achieved, gall bladder bed bleeding was stopped by the use of more extensive electrocoagulation of the gall bladder bed and the plate Tachoomb. The combination of Gamastat application and a selective electrocoagulation of bleeding vessels in the area of the gall bladder bed provides less hepatic parenchyma coagulation injury as evidenced by a reduced manifestation of hepatocyte cytolysis versus a continuous electrocoagulation.
Conclusion. In the main group the expressed local haemostatic activity of Gamastat has been established as well as reliably insignificant manifestation of electrocoagulative injury of the liver accompanied by less marked growth of indicators of cytolisis AlAt and AsAt in comparison with those in patients of the control group. Negative effects of Gamastat application were not observed.

Keywords: local haemostatic agent, Gamastat, selective electrocoagulation, bleeding arrest, hepatic bleeding, cholecystectomy, haemostasis
p. 361-367 of the original issue
  1. Bunatian AG, Zavenian ZS, Bagmet NN, Shatverian GA, Skipenko OG. Problemy gemostaza i germetizma pri rezektsiiakh pecheni s ispol'zovaniem fibrin-kollagenovoi substantsii [Problems of hemostasis and hermetism in liver resections with application of fibrin-collagen substance]. Khirurgiia Zhurn im NI Pirogova. 2003;(9):18-23.
  2. Ong AM, Bhayani SB, Hsu TH, Pinto PA, Rha KH, Thomas M, et al. Bipolar needle electrocautery for laparoscopic partial nephrectomy without renal vascular occlusion in a porcine model. Urology. 2003 Dec;62(6):1144-48.
  3. Sedov VM, Iurlov VV, Petrishin VL, Boikova NV, Semenov GM, Korablin NM. Nekotorye zakonomernosti morfologicheskikh izmenenii tkani pecheni pri elektrovozdeistvii [Some regularities of morphological changes of the liver tissue under electric influence]. Vestn Khirurgii im II Grekova. 2001;160(4):27-31.
  4. Cherkova NV. Sravnitel'naia Otsenka regeneratsii pecheni pri vozdeistvii elektrokoaguliatsii i ul'trazvukovogo skal'pelia [Evaluation of liver regeneration in electric coagulation and ultrasonic scalpel]. Vestn KhNU im VN Karazina. Ser Meditsina. 2004;(7):9-13.
  5. Boiko VV, Remneva NA, Cherniaev NS, Britskaia NN. Patomorfologicheskie osobennosti rezektsionnogo kraia pecheni neposredstvenno posle ispol'zovaniia apparata vysokochastotnoi elektrokhirurgicheskoi svarki i monopoliarnogo elektrokoaguliatora [Pathomorphological features of resection edge of the liver immediately after application of high frequency electrosurgical welding device and electrocoagulator and welding]. Novosti Khirurgii. 2015;23(3):256-61.
  6. Dambaev GTs, Baikov AN, Semichev EV, Shpisman MN, Aleinik A N, Deneko OI, i dr. Intraoperatsionnye sposoby gemostaza pri operatsiiakh na pecheni [Intraoperative methods for hemostasis during operations on the liver]. Biul Sib Meditsiny. 2011;10(4):89-92.
  7. Tarkova AR, Cherniavskii AM, Morozov SV, Grigor'ev IA, Tkacheva NI, Rodionov VI. Gemostaticheskii material mestnogo deistviia na osnove okislennoi tselliulozy [Hemostatic material of local effects based on oxidized cellulose]. Sib Nauch Med Zhurn. 2015;35(2):11-15.
  8. Gain IuM, Aleksandrova OS, Gapanovich VN. Sovremennye metody mestnogo gemostaza pri povrezhdeniiakh parenkhimatoznykh organov zhivota [Modern techniques of local hemostasis in abdominal parenchymal organs injuries]. Novosti Khirurgii. 2009;17(4):160-71.
  9. Nouri S, Sharif MR, Afzali H, Sharif A, Satkin M. The Advantages and disadvantages of methods used to control liver bleeding: a review. Trauma Mon. 2015 Nov;20(4):e28088. doi: 10.5812/traumamon.28088.
  10. Mel'nova NI, Zhavoronok IS, Zhuk IN, Berdina EL, Ermaliuk NM, Kutsuk OK, i dr. Primenenie novogo gemostaticheskogo sredstva "Gamastat" pri parenkhimatoznom krovotechenii v eksperimente [Application of the new haemostatic agent "Gamastat" in parenchymal bleeding in the experiment]. Voen Meditsina. 2013;(2):62-66.
Address for correspondence:
220116, Republic of Belarus, Minsk, Dzerzhinskiyi pr., d. 83, Belarusian State Medical University, chair of surgical diseases N1. Tel: + 375 29 624-98-37
Zhavoronok Irina Sergeevna
Information about the authors:
Zhavoronok I.S. Post-graduate student, EE "Belarusian State Medical University", chair of surgical diseases N1.
Kondratenko G.G. MD, Professor, Head, EE "Belarusian State Medical University", chair of surgical diseases N1.
Gapanovich V.N. MD, Director, UE "Lotios".
Esepkin A.V. Head, ME "Minsk 10th city clinical hospital", surgical department N1.
Karman A.D. PhD, Ass. Professor, EE "Belarusian State Medical University", chair of surgical diseases N1.



SBEE HPE "Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky",
The Russian Federation

Objectives. To estimate life quality of patients with obliterating atherosclerosis of the vessels in the lower extremities against the background of a combined application of lyophilisate alprostadil and a systemic ozone therapy.
Methods. The patients were distributed among four groups depending on the conducted therapy. The standard treatment regimen was applied in the control group. The lyophilisate alprostadil was included in the complex therapy for patients of the first group. The systemic ozone therapy together with a basic therapy was applied in the second group. The lyophilisate alprostadil and ozone therapy were included in the complex treatment regimen for patients of the third group. To study the life quality of patients the questionnaire SF-36 was used before and after a therapy (6 months afterwards).
Results. Low rates of physical functioning and role-physical functioning as well as pain intensiveness were found out to be present in patients with atherosclerosis on admission. Low rates in all groups testified the pain considerably limits the activity of the studied patients. General health, vitality level, social and role-physical functioning were evaluated as average ones. Thus, the indices in all groups had no significant differences and were comparable. Six months afterwards, the indices of "physical functioning" for patients treated with lyophilisate alprostadil and ozone therapy together with the complex treatment regimen were higher than in the control, first and second groups. In 6 months the reduction of "a health psychological component" caused by progression of the main disease was noted in the control group.
Conclusion. The conducted study has verified that a combined application of lyophilisate alprostadil and a systemic ozone therapy reliably reduces pain during walking, thus improving physical and emotional health of patients.

Keywords: obliterating atherosclerosis of lower limbs vessels, physical functioning, role-physical functioning, complex therapy, life quality, lyophilisate alprostadil, ozone therapy
p. 368-372 of the original issue
  1. Nazarova ES, Marchenko AV. Otdalennye rezul'taty konservativnogo lecheniia bol'nykh s obliteriruiushchim aterosklerozom sosudov nizhnikh konechnostei [Long-term results of conservative treatment of patients with atherosclerosis obliterans of the lower limbs]. Vestn Khirurgii im II Grekova. 2006;165(4):74-76.
  2. Fattakhov VV. Obliteriruiushchii ateroskleroz nizhnikh konechnostei v praktike poliklinicheskogo khirurga [Atherosclerosis of the lower extremities in outpatient practice surgeon]. Prakt Meditsina. 2010; (2):126-30.
  3. Lambert MA, Belch JJ. Medical management of critical limb ischaemia: where do we stand today? J Intern Med. 2013 Oct;274(4):295-307. doi: 10.1111/joim.12102.
  4. Sukovatykh BS, Kniazev VV. Vliianie razlichnykh sposobov nepriamoi revaskuliarizatsii na kachestvo zhizni bol'nykh s kriticheskoi ishemiei nizhnikh konechnostei [Effect of different methods of indirect revascularization of the quality of life of patients with critical limb ischemia]. Vestn Khirurgii im II Grekova. 2008;(2):44-47.
  5. Lagutchev VV, Shchupakova AN. Osobennosti kholesterinovogo profilia syvorotki krovi u patsientov s obliteriruiushchim aterosklerozom arterii nizhnikh konechnostei v sochetanii s klinicheskoi manifestatsiei ateroskleroza mozgovykh, koronarnykh i mezenterial'nykh arterii [Features of cholesterol profile of blood serum in patients with obliterating atherosclerosis of the arteries of the lower extremities in conjunction with the clinical manifestation of cerebral atherosclerosis, coronary and mesenteric arteries]. Vestn VGMU. 2010;9(3):35-43.
  6. Gul'man MI, Vinnik IuS, Iakimov SV, Anishina OV, Karapetian GE, Dunaevskaia SS. Primenenie ozona v khirurgicheskoi praktike [The use of ozone in surgical practice]. Sib Med Obozrenie. 2003;29(4):84-86.
  7. Ware J E. Measuring patients' views: the optimum outcome measure. BMJ. 1993 May 29; 306(6890): 1429-30.
  8. Novik AA, Ionova TI, Kaind P. Kontseptsiia issledovaniia kachestva zhizni v meditsine [Concept of quality of life research in medicine]. Saint-Petersburg, RF: Elbi; 1999. 140 p.
  9. Koshkin VM, Sergeeva NA, Kuznetsov MR, Nastavsheva OD. Konservativnaia terapiia u bol'nykh khronicheskimi obliteriruiushchimi zabolevaniiami arterii nizhnikh konechnostei [Conservative therapy in patients with chronic obliterating diseases of lower limb arteries. Current ideas]. Sovremennye predstavleniia. Med Sovet. 2015;(8):6-9.
  10. Okrut IE, Kontorshchikova KN, Shakerova DA. Ozonoterapiia i produktsiia endotelial'nykh markerov NO i VEGF pri ateroskleroze [Ozone products and markers of endothelial NO and VEGF in atherosclerosis]. Med Al'm. 2013;(3):136-37.
Address for correspondence:
660077, Russian Federation, Krasnoyarsk, Partizan Zheleznyak, 1, Medical University "Krasnoyarsk State Medical University named by Professor VF Voyno-Yasenetsky ", chair of general surgery named by Professor MI Gulman.
Tel: 963-191-29-70
Information about the authors:
Vinnik Y.S. MD, Professor, Head, SBEE HPE "Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky", chair of general surgery named after Professor M.I. Gulman.
Dunaevskaya S.S. MD, Ass. Professor, SBEE HPE "Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky", Professor, chair of general surgery named after Professor M.I. Gulman.
Antufrieva D.A. Post-graduate student, SBEE HPE "Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky", chair of general surgery named after Professor M.I. Gulman.




FSBE " Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics", of the RF Ministry of Health,
The Russian Federation

Objectives. To study the features of the functional rehabilitation of children with congenital and acquired shortenings of the lower limbs after surgical lengthening using different regimes of distraction osteosynthesis.
Methods. Treatment results of children (n=95) with congenital and acquired lower limb shortening by the Ilizarov method for distraction osteosynthesis been analyzed. The distraction regime: group 1 (n=27, mean age 9,94,1 yrs) 1mm a day (n=4); group 2 (n=30, mean age 10,11,9 yrs) 1mm a day (n=60) in the automated regime; group 3 (n=38, mean age 11,52,3 yrs) a distraction regime 1 mm a day (n=60) in an automated regime combined with intramedullary reinforcement by elastic wires with hydroxyapatite coating. After removing the Ilizarov device the restoration of normal knee and ankle joint function, the dynamics of the antagonist muscles forces and onset time walking without additional support have been assessed.
Results. It was shown that at femoral lengthening by using a robotic high-division distractor with using intramedullary reinforcement with bioactive coating, the earlier restoration of active and passive amplitude of motions in the adjacent joints, segment muscle force and complete limb axial load had occured. Such effects could be associated with both the favorable conditions for regeneration of bone and muscle tissues at high-division rate as well as with the possibility of the earlier full functional load after the removal of the Ilizarov apparatus and leaving intramedullary implants in site.
Conclusion. Thus, the combination of robotic high-division distraction (24 h) and intramedullary bioactive reinforcement creates favorable conditions for a rehabilitation process and a faster functional recovery.

Keywords: robotic automated distractor, limb lengthening, bioactive implants, intramedullary implants, regeneration, muscular system, functional rehabilitation
p. 373-378 of the original issue
  1. Sokolovskii OA, Serdiuchenko SN, Brodko GA, Ur'ev GA. Uravnivanie dliny nizhnikh konechnostei istoricheskie rakursy i sovremennye tendentsii [Equalization of the length of the lower extremities - historical perspectives and current trends]. Med Novosti. 2011;(7):11-19.
  2. Sabharwal S, Green S, McCarthy J, Hamdy RC. What's New in Limb Lengthening and Deformity Correction. J Bone Joint Surg Am. 2011;93:213-221. doi: 10.2106/JBJS.J.01420.
  3. Dinah AF. Predicting duration of Ilizarov frame treatment for tibial lengthening. Bone. 2004 May;34(5):845-48.
  4. Matsubara H, Tsuchiya H, Sakurakichi K, Watanabe K, Tomita K. Deformity correction and lengthening of lower legs with an external fixator. Int Orthop. 2006 Dec; 30(6): 550-54. doi: 10.1007/s00264-006-0133-8.
  5. Sun XT, Easwar TR, Manesh S, Ryu JH, Song SH, Kim SJ, et al. Complications and outcome of tibial lengthening using the Ilizarov method with or without a supplementary intramedullary nail: a case-matched comparative study. J Bone Joint Surg Br. 2011 Jun;93(6):782-87. doi: 10.1302/0301-620X.93B6.25521.
  6. Kim SJ, Balce GC, Agashe MV, Song SH, Song HR. Is bilateral lower limb lengthening appropriate for achondroplasia? Midterm analysis of the complications and quality of life. Clin Orthop Relat Res. 2012 Feb;470(2):616-21. doi: 10.1007/s11999-011-1983-y.
  7. Ur'ev GA, Il'iasevich IA, Zarovskaia AV, Sokolovskii OA, Iuzefovich AI. Izmenenie funktsional'nogo sostoianiia nervno-myshechnoi i sosudistoi sistem ukorochennykh konechnostei v usloviiakh distraktsionnogo osteosinteza [Changing of the functional state of neuromuscular and cardiovascular systems of shortened limbs in conditions of distraction osteosynthesis]. Med Zhurn. 2008;(2):97-100.
  8. Alzahrani MM, Anam EA, Makhdom AM, Villemure I, Hamdy RC. The effect of altering the mechanical loading environment on the expression of bone regenerating molecules in cases of distraction osteogenesis. Front Endocrinol (Lausanne). 2014 Dec 10;5:214. doi: 10.3389/fendo.2014.00214.
  9. Shchurov VA, Dolganova TI, Dolganov DV. Ustanovka dlia izmereniia sily myshts bedra [A device for measuring of the thigh muscles strength]. Med Tekhnika. 2014;(1):27-30.
  10. Bhave A, Shabtai L, Ong PH, Standard SC, Paley D, Herzenberg JE. Custom knee device for knee contractures after internal femoral lengthening. Orthopedics. 2015 Jul 1;38(7):e567-72. doi: 10.3928/01477447-20150701-53.
  11. Burghardt RD, Manzotti A, Bhave A, Paley D, Herzenberg JE. Tibial lengthening over intramedullary nails: A matched case comparison with Ilizarov tibial lengthening. Bone Joint Res. 2016 Jan;5(1):1-10. doi: 10.1302/2046-3758.51.2000577.
  12. Prince DE, Herzenberg JE, Standard SC, Paley D. Lengthening with external fixation is effective in congenital femoral deficiency. Clin Orthop Relat Res. 2015 Oct;473(10):3261-71. doi: 10.1007/s11999-015-4461-0.
  13. Radler C, Antonietti G, Ganger R, Grill F. Recurrence of axial malalignment after surgical correction in congenital femoral deficiency and fibular hemimelia. Int Orthop. 2011 Nov;35(11):1683-8. doi: 10.1007/s00264-011-1266-y.
  14. Dal Monte A, Donzelli O. Tibial lengthening according to Ilizarov in congenital hypoplasia of the leg. J Pediatr Orthop. 1987 Mar-Apr;7(2):135-38.
  15. Popkov AV, Popkov DA. Osobennosti funktsional'nogo vosstanovleniia posle operativnogo lecheniia detei s vrozhdennym ukorocheniem nizhnikh konechnostei [Features of functional recovery after surgical treatment of children with congenital shortening of the lower limb]. Genii Ortopedii. 2008;(1):19-26.
Address for correspondence:
640014, Russian Federation, Kurgan, M. Ulyanova st., 6,
FGBI "Russian Scientific Center" Restorative Traumatology and Orthopaedics" named by Academician GA Ilizarov", laboratory of limb lengthening and correction of deformity in the lower limbs.
Tel: 7 (3522) 41-52-27
Kononovich Natalya Andreevna
Information about the authors:
Popkov D.A. MD, Head, FSBE "Russian Ilizarov Center for Restorative Traumatology and Orthopedics", laboratory of limb lengthening and correction of deformity in the lower limbs.
Popkov A.V. MD, Professor, Chief researcher,
FSBE "Russian Ilizarov Center for Restorative Traumatology and Orthopedics", laboratory of limb lengthening and correction of deformity in the lower limbs.
Shchurov V.A. MD, Professor, Chief researcher,
FSBE "Russian Ilizarov Center for Restorative Traumatology and Orthopedics", laboratory of limb lengthening and correction of deformity in the lower limbs.
Kononovich N.A. PhD, Leading researcher,
FSBE "Russian Ilizarov Center for Restorative Traumatology and Orthopedics",laboratory of limb lengthening and correction of deformity in the lower limbs.




The branch of PIEE HE "Medical University "Reaviz",
The Russian Federation

Objectives. To analyze the treatment results of the chest gunshot wounds among the civilian trauma patients under the local military conflict.
Methods. The results of medical aid rendering to 106 patients were analyzed. The victims were divided into two groups: group A 62 (58,5%) of wounded patients evacuated to hospitals within 1 hour after the chest injured, group B 44 (41.5%) admitted within more than 1 hour after chest injury.
Results. Penetrating wounds in the group A were diagnosed in 38 (61,3%) patients; non-penetrating in 24 (38,7%). Visceral injuries were revealed in 39 (62,9%) cases. Penetrating wounds in the group B occured in 21 patients (44,7%), non-penetrating in 23 (52,3%) cases. Injuries of the internal organs were detected in 21 (44,7%) cases.
The patients (group A) were subjected to the following operative interventions: the primary surgical procedure (PSP) of wound of the chest in 50 (80,6%) victims, the emergency thoracotomy was carried out at once in 12 (19,4%) cases. Non-penetrating chest wound was diagnosed during PSP in 24 (38,7%) cases The rest 26 (41,9%) patients were performed thoracotomy after PST. The patients (group B) underwent the following interventions: PSP of the wound was performed in 39 (88,6%) cases; the emergency thoracotomy was carried out at once in 5 (11,4%) victims. The wound was found out to be non-penetrating during PSP in 23 (52,3%). Thoracotomy was carried out after PSP in the rest 16 (36,4%) patients.
In the immediate postoperative period, 30 complications were registered in the group A, 21 complications - in group B. Total mortality in the group A was 12 (19,4%), in the group B 20 (45,5%).
Conclusion. The breast gunshot wounds of patients among the civilian population, resulting in a local military conflicts, characterized by high morbidity and mortality, the number of which depends on the time of delivery of the injured patients.

Keywords: chest gunshot wounds, victims, emergency thoracotomy, immediate postoperative period, civilian population, complications, lethal outcomes
p. 379-384 of the original issue
  1. Bedin VV, Radionov IA. Sovremennye podkhody k khirurgicheskomu lecheniiu travmaticheskikh povrezhdenii pecheni [Current approaches to surgical treatment of traumatic lesions of the liver]. Annaly Khirurg Gepatologii. 2007;12(3):248-49.
  2. Gaidarov GM, Alekseeva NIu, Kuz'mina VV. Kontseptual'nye podkhody k organizatsii deiatel'nosti otdeleniia intensivnoi terapii, anesteziologii i reanimatsii v sovremennykh usloviiakh [Conceptual approaches to the organization of intensive care, anesthesiology and intensive care in modern conditions]. Zam Gl Vracha. 2008;(3):22-30.
  3. Kerimov AZ, Gromov MS. Khirurgicheskaia taktika pri ognestrel'nykh raneniiakh zhivota v usloviiakh regional'nogo konflikta [Surgical Management of gunshot wounds abdomen in a regional conflict]. Sarat Nauch-Med Zhurn. 2010;6(2):460-62.
  4. Borisov AE, Kuiuachev KE, Muskudinov ND, Turdyev MS. Diagnostika i khirurgicheskaia taktika pri izolirovannoi i sochetannoi travme pecheni [Diagnosis and surgical tactics in isolated and combined liver injury]. Annaly Khirurg Gepatologii. 2007;12(3):250.
  5. Briusov PG, Urazovskii NIu. Novye tekhnologii pri khirurgicheskom lechenii ognestrel'nykh pronikaiushchikh ranenii grudi [New technologies in the surgical treatment of gunshot wounds penetrating the chest]. Khirurgiia Zhurn im NI Pirogova. 2001;(3):46-51.
  6. Gumanenko EK, Samokhvalov IM, Trusov AA, Badalov VI. Organizatsiia i soderzhanie spetsializirovannoi khirurgicheskoi pomoshchi v mnogoprofil'nykh voennykh gospitaliakh 1-go eshelona vo vremia kontrterroristicheskikh operatsii na Severnom Kavkaze [Organization and maintenance of specialized surgical care in a multidisciplinary military hospitals of the 1st tier during counter-terrorist operations in the North Caucasus] (Soobshch 5). Voen- Med Zhurn. 2006;327(3):7-18.
  7. Masliakov VV, Voinovskii AE, Lysov NA, Gromov MS, Dadaev AIa, Kerimov A3, i dr. Rezul'taty lecheniia ranenii grudi sredi grazhdanskogo naseleniia v lokal'nom voennom konflikte [Results of treatment of chest injuries among the civilian population on a local military conflict]. Med Nauka i Obrazovanie Urala. 2014;(2):96-100.
Address for correspondence:
410012, Russian Federation, Saratov, Upper market, 10. Branch of PEE HE "Medical University" Reaviz "Saratov, chair of surgical diseases.

Tel: 8 (8452) 74-27-21
Maslyakov Vladimir Vladimirovich
Information about the authors:
Maslyakov V.V. MD, professor, Vice Rector (science work and public relations), PEE HE "Saratov Medical University "Reaviz".
Barsukov V.G. PhD, Associate professor, PEE HE "Saratov Medical University "Reaviz", chair of surgical diseases.
Kurkin K.G. Post-graduate student, PEE HE "Saratov Medical University "Reaviz", chair of surgical diseases.




SE "Republican Scientific-Practical Center of Oncology and Medical Radiology named after N.N. Alexandrov"1,
ME "The 9th City Clinical Hospital"2,
The Republic of Belarus

Objectives. To evaluate the immediate and long-term results of surgical treatment of patients with locally advanced non-small cell lung cancer (NSCLC stage IIIA-IIIB) accompanied by mediastinal invasion of the tumor.
Methods. 180 surgeries had been performed (1996-2012 yrs) to the patients with locally advanced pT4 NSCLC. The age varied from 21 up to 81, the median age 58. The right-sided tumor was registered in 103 cases and left-sided in 77. The pT4 descriptor was determined on the basis of the lung cancer invasion of different structures or mediastinal organs. Affection of two or more structures occurred in 77 cases. The disease was staged as pT4N0M0 in 23 cases, pT4N1M0 in 54, pT4N2M0 in 103. Surgical interventions such as combined lobectomy or bilobectomy were performed only in 5 patients, and combined pneumonectomy in 175, including 34 cases the carinal wedge resection of tracheal bifurcation and 42 sleeve resection. Resection of the vena cava superior was performed in 36 patients. The aorta was resected in 27 cases, the left atrium in 70, the esophagus in 31, the vertebrae in 8 patients; ribs were resected in 18 cases.
Results. The postoperative morbidity was 33,9%, mortality 17,8%. Overall five-year survival rate of patients with stages IIIA-IIIB (pT4N0-2M0) was 19,8%, median survival 14,9 months. In the group of IIIA (pT4N0-1M0) stage 26,0%, 22,7 months, respectively. In the group of patients with metastatic mediastinal lymph nodes (pT4N2M0) 14,7%, 13,6 months, respectively (p=0,038).
Conclusion. Combined surgery allows achieving satisfactory immediate and long-term results of treatment at the admissible indices of postoperative mortality. The best results can be obtained for patients with stage IIIA (pT4N0-1M0) NSCLC.

Keywords: non-small cell lung cancer, locally advanced lung cancer, combined surgeries, overall survival, morbidity, mortality, postoperative period
p. 385-393 of the original issue
  1. Okeanov AE, Moiseev PI, Levin LF. Statistika onkologicheskikh zabolevanii v Respublike Belarus' [Statistics of oncologic diseases in Belarus]. Minsk, RB; 2014. 382 p.
  2. McPhail S, Johnson S, Greenberg D, Peake M, Rous B. Stage at diagnosis and early mortality from cancer in England. Br J Cancer. 2015 Mar 31;112(Is s1):S108-S115. doi:10.1038/bjc.2015.49.
  3. Kolbanov KI, Trakhtenberg AKh, Pikin OV, Riabov AB, Glushko VA. Khirurgicheskoe lechenie bol'nykh rezektabel'nym nemelkokletochnym rakom legkogo [Surgical treatment of patients with respectable NSCLC]. Issledovaniia i Praktika v Meditsine. 2014;1(1):16-23. doi: 10.17709/2409-2231-2014-1-1-16-23.
  4. Schuurman MS, Groen HJM, Pruim J, Janssen-Heijnen MLG, Pukkala E, Siesling S. Temporal trends and spatial variation in stage distribution of non-small cell lung cancer in the Netherlands. OA Epidemiology. 2014 Jul 18;2(1):10.
  5. Gonzalo Varela1 and Pascal Alexandre Thomas2 Surgical management of advanced non-small cell lung cancer. J Thorac Dis. 2014 May;6(Suppl 2):S217-S223. doi: 10.3978/j.issn.2072-1439.2014.04.34.
  6. Dartevelle PG. Herbert Sloan Lecture. Extended operations for the treatment of lung cancer. Ann Thorac Surg. 1997 Jan;63(1):12-9.
  7. Osaki T, Sugio K, Hanagiri T, Takenoyama M, Yamashita T, Sugaya M, et al. Survival and prognostic factors of surgically resected T4 non-small cell lung cancer. Ann Thorac Surg. 2003 Jun;75(6):1745-51; discussion 1751.
  8. Yildizeli B, Dartevelle PG, Fadel E, Mussot S, Chapelier A. Results of primary surgery with T4 non-small cell lung cancer during a 25-year period in a single center: the benefit is worth the risk. Ann Thorac Surg. 2008 Oct;86(4):1065-75; discussion 1074-5. doi: 10.1016/j.athoracsur.2008.07.004.
  9. Izbicki JR, Passlick B, Pantel K, Pichlmeier U, Hosch SB, Karg O, et al. Effectiveness of radical systematic mediastinal lymphadenectomy in patients with resectable non-small cell lung cancer: results of a prospective randomized trial. Ann Surg. 1998 Jan;227(1):138-44.
  10. Mountain CF, Dresler CM. Regional lymph node classification for lung cancer staging. Chest. 1997 Jun;111(6):1718-23.
  11. Spaggiari L, D' Aiuto M, Veronesi G, Pelosi G, de Pas T, Catalano G, et al. Extended pneumonectomy with partial resection of the left atrium, without cardiopulmonary bypass, for lung cancer. Ann Thorac Surg. 2005 Jan;79(1):234-40.
  12. Es'kov S, Zharkov V. Khirurgicheskaia tekhnika rezektsii levogo predserdiia pri rake legkogo [Surgical technique of resection of the left atrium in lung cancer]. Onkol Zhurn. 2012;6(2):35-41.
  13. Mountain CF. Revisions in the international system for staging lung cancer. Chest. 1997 Jun;111(6):1710-17.
  14. Pitz CC, Brutel de la Rivière A, van Swieten HA, Westermann CJ, Lammers JW, van den Bosch JM. Results of surgical treatment of T4 non-small cell lung cancer. Eur J Cardiothorac Surg. 2003 Dec;24(6):1013-18.
  15. Gielda BT, Marsh JC, Zusag TW, Faber LP, Liptay M, Basu S, et al. Split-course chemoradiotherapy for locally advanced non-small cell lung cancer: a single-institution experience of 144 patients. J Thorac Oncol. 2011 Jun;6(6):1079-86. doi: 10.1097/JTO.0b013e3182199a7c.
  16. Mansour Z, Kochetkova EA, Santelmo N, Meyer P, Wihlm JM, Quoix E, et al. Risk factors for early mortality and morbidity after pneumonectomy: a reappraisal. Ann Thorac Surg. 2009 Dec;88(6):1737-43. doi: 10.1016/j.athoracsur.2009.07.016.
  17. Farjah F, Wood DE, Varghese TK Jr, Symons RG, Flum DR. Trends in the operative management and outcomes of T4 lung cancer. Ann Thorac Surg. 2008 Aug;86(2):368-74. doi: 10.1016/j.athoracsur.2008.04.090.
Address for correspondence:
220116, Republic of Belarus, Minsk, Semashko st., 8, ME "9th
City Clinical Hospital", thoracic department.
Tel: 375 29 115-77-36
Yeskov Sergey Aleksandrovich
Information about the authors:
Zharkov V.V. MD, Professor, Head "Republican scientific-practical center of oncology and medical radiology named after N.N. Alexandrov", surgical department.
Yeskov S.A. Head, ME "The 9th city clinical hospital", thoracic department.
Erokhov V.V. Surgeon, ME "The 9th city clinical hospital", thoracic department.




SBEE HPE "Volgograd State Medical University",
The Russian Federation

An obstructed defecation is a widespread problem encountered by coloproctology and gastroenterology in the practice. These disorders socially and psychologically distress patients and greatly diminished quality of life at the other. Despite the terminological distinction in naming etiopathogenic causes of obstructive defecation syndrome (ODS), they all can be reduced to two principal points: functional - (dysfunction and dyssynergia of the pelvic fundus muscles) and mechanical - (rectocele, rectal intussusception) and their combinations. Problems of treatment of ODS are in the correct choice of conservative and operative treatment, and combinations thereof. The management of obstructed defecation syndrome (ODS) is mainly conservative and consists of diet, laxatives, hydrocolontherapy, biofeedback, transanal electrostimulation and psychotherapy. The goal of surgical treatment is to restore various pelvic organs to their appropriate anatomic positions. However, there is a poor correlation between anatomic and functional results. Until today there is not a surgical gold standard. Functional outcomes of stapled transanal rectal resection for obstructed defecation are still controversial.

Keywords: constipation, obstructed defecation, pelvic dyssynergy, rectocele, rectal prolapse, hydrocolontherapy, psychotherapy
p. 394-400 of the original issue
  1. Andromanakos N, Skandalakis P, Troupis T, Filippou D. Constipation of anorectal outlet obstruction: pathophysiology, evaluation and management. J Gastroenterol Hepatol. 2006 Apr;21(4):638-46.
  2. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006 Apr;130(5):1480-91.
  3. Bharucha AE, Wald A, Enck P, Rao S. Functional anorectal disorders. Gastroenterol. 2006 Apr;130(5):1508-8.
  4. Zbar AP, Wexner SD. Coloproctology. Springer-Verlag Specialist Surgery Series. London, UK: Springer-Verlag London Limited; 2010. 221 p.
  5. Wald A, Bharucha AE, Cosman BC, Whitehead WE. ACG clinical guideline: management of benign anorectal disorders. Am J Gastroenterol. 2014 Aug;109(8):1141-57; (Quiz) 1058. doi: 10.1038/ajg.2014.190.
  6. Steele SR, Mellgren A. Constipation and Obstructed Defecation. Clin Colon Rectal Surg. 2007 May; 20(2): 110-17. doi: 10.1055/s-2007-977489.
  7. Bartolo D, Roe A. Obstructed defaecation. Br J Hosp Med. 1986 Apr;35(4):228-36.
  8. D'Hoore A1, Penninckx F. Obstructed defecation. Colorectal Dis. 2003 Jul;5(4):280-7.
  9. Ambe P, Weber SA, Esfahani BJ, Köhler L. Surgical options in the treatment of the obstructed defaecation syndrome. Dtsch Med Wochenschr. 2011 Mar;136(12):586-90. doi: 10.1055/s-0031-1274543. [Article in German]
  10. Remes-Troche JM, Carmona-Sánchez R, González-Gutiérrez M, Martínez-Salgado JC, Gómez-Escudero O, Ramírez A, et al. What people mean by constipation? A general population based-study. Rev Gastroenterol Mex. 2009 Oct-Dec;74(4):321-8. [Article in Spanish]
  11. Travaglio E, Lemma M, Cuccia F, Tondo M, Giannini I, Di Lena M, et al. Prevalence of constipation in a tertiary referral Italian Colorectal Unit. Ann Ital Chir. 2014 May-Jun;85(3):287-91.
  12. Davila GW, Ghoniem GM, Wexner SD. Pelvic floor dysfunction. Springer-Verlag London Limited; 2006. 365 p.
  13. Kaizer AM. Kolorektal'naia khirurgiia [Colorectal surgery]: per s angl. Moscow, RF: Binom, 2011. 751 p.
  14. Podzemny V, Pescatori LC, Pescatori M. Management of obstructed defecation. World J Gastroenterol. 2015;21(4):1053-60. doi: 10.3748/wjg.v21.i4.1053PMCID: PMC4306148.
  15. Fillips R, Robin KS, red. Kolorektal'naia khirurgiia [Colorectal surgery]: ruk. Moscow, RF: Geotar-Media; 2009. 352 p.
  16. Petros P. Zhenskoe tazovoe dno. Funktsii, disfunktsii i ikh lechenie v sootvetstvii s integral'noi teoriei [Zhenskoe tazovoe dno. Funktsii, disfunktsii i ikh lechenie v sootvetstvii s integral'noi teoriei]. Moscow, RF: MEDpress-inform; 2016. 396 p.
  17. Vorob'ev GI, Achkasov S, Tikhonov AA, Aleshin DV, Fomenko OIu. Rol' dissinergii myshts tazovogo dna v patogeneze khronicheskikh zaporov [The role of the pelvic floor muscles dyssynergia in the pathogenesis of chronic constipation]. RZhGGK. 2007;17(3):59-64.
  18. Pescatori M, Spyrou M, Pulvirenti d'Urso A. A prospective evaluation of occult disorders in obstructed defecation using the 'iceberg diagram'. Colorectal Dis. 2007 Jun;9(5):452-56.
  19. Madbouly KM, Abbas KS, Hussein AM. Disappointing long-term outcomes after stapled transanal rectal resection for obstructed defecation. World J Surg. 2010 Sep;34(9):2191-6. doi: 10.1007/s00268-010-0638-6.
  20. Shafik A, Shafik AA, Ahmed I. Role of positive anorectal feedback in rectal evacuation: the concept of a second defecation reflex: the anorectal reflex. J Spinal Cord Med. 2003 Winter;26(4):380-83.
  21. Ellis CN, Essani R. Treatment of Obstructed Defecation. Clin Colon Rectal Surg. 2012;25(1):24-33. doi: 10.1055/s-0032-1301756.
  22. Khaikin M, Wexner SD. Treatment strategies in obstructed defecation and fecal incontinence. World J Gastroenterol. 2006 May 28;12(20):3168-73. doi: 10.3748/wjg.v12.i20.3168.
  23. Mongardini M, Cola A, Iachetta RP, Gioffrè M, Karpathiotakis M, Maturo A, et al. Treatment of obstructive defecation syndrome related to hedrocele. Our experience. Giorn Chir. 2010;31(11-12):502-6.
  24. Shelygin IuA, Biriukov OM, Vasil'ev SV, Grigor'ev EG, Zarodniuk IV, Isaev VR, i dr. Klinicheskie rekomendatsii po diagnostike i lecheniiu vzorslykh patsientov s vypadeniem priamoi kishki, vnutrennei rektal'noi invaginatsiei i solitarnoi iazvoi priamoi kishki [Clinical guidelines for the diagnosis and treatment of adult patients with prolapse of the rectum, internal rectal intussusception, and solitary rectal ulcer] [Elektronnyi resurs]. Moscow, RF; 2013. 16 p. [data dostupa 2016 Mart 23]. Rezhim dostupa:
  25. Bove A, Pucciani F, Bellini M, Battaglia E, Bocchini R, Altomare DF, Dodi G, Sciaudone G, Falletto E, Piloni V, Gambaccini D, Bove V. Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). World J Gastroenterol. 2012 Apr 14;18(14):1555-64. doi: 10.3748/wjg.v18.i14.1555.
  26. Senagore AJ1. Management of rectal prolapse: the role of laparoscopic approaches. Semin Laparosc Surg. 2003 Dec;10(4):197-202.
  27. Kulikovskii VF, Oleinik NV. Tazovyi prolaps u zhenshchin [Pelvic prolapse in women]. Moscow, RF: GEOTAR-Media; 2008. 255 p.
  28. D'Hoore A, Vanbeckevoort D, Penninckx F. Clinical, physiological and radiological assessment of rectovaginal septum reinforcement with mesh for complex rectocele. Br J Surg. 2008 Oct;95(10):1264-72. doi: 10.1002/bjs.6322.
  29. Varma MG, Wang JY, Berian JR, Patterson TR, McCrea GL, Hart SL. The constipation severity instrument: a validated measure. Dis Colon Rectum. 2008 Feb;51(2):162-72. doi: 10.1007/s10350-007-9140-0.
  30. Ratuapli S, Bharucha AE, Harvey D, Zinsmeister AR. Comparison of rectal balloon expulsion test in seated and left lateral positions. Neurogastroenterol Motil. 2013 Dec;25(12):e813-20. doi: 10.1111/nmo.12208.
  31. Bharucha AE, Rao SS. An update on anorectal disorders for gastroenterologists. Gastroenterology. 2014 Jan;146(1):37-45.e2. doi: 10.1053/j.gastro.2013.10.062.
  32. Vorob'ev GI. Osnovy koloproktologii [Basics of Coloproctology]. 2-e izd. Moscow, RF: MIA; 2006. 432 p.
  33. Hicks CW, Weinstein M, Wakamatsu M, Savitt L, Pulliam S, Bordeianou L. In patients with rectoceles and obstructed defecation syndrome, surgery should be the option of last resort. Surgery. 2014 Apr;155(4):659-67. doi: 10.1016/j.surg.2013.11.013.
  34. Maria G, Cadeddu F, Brandara F, Marniga G, Brisinda G. Experience with type A botulinum toxin for treatment of outlet-type constipation. Am J Gastroenterol. 2006 Nov;101(11):2570-75.
  35. Bove A, Pucciani F, Bellini M, Battaglia E, Bocchini R, Altomare DF, et al. Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). World J Gastroenterol. 2012 Apr 14;18(14):1555-64. doi: 10.3748/wjg.v18.i14.1555.
  36. Pescatori M, Boffi F, Russo A, Zbar AP. Complications and recurrence after excision of rectal internal mucosal prolapse for obstructed defaecation. Int J Colorectal Dis. 2006 Mar;21(2):160-65.
  37. Madbouly KM, Abbas KS, Hussein AM. Disappointing long-term outcomes after stapled transanal rectal resection for obstructed defecation. World J Surg. 2010 Sep;34(9):2191-96. doi: 10.1007/s00268-010-0638-6.
  38. Pucciani F, Raggioli M, Ringressi MN. Usefulness of psyllium in rehabilitation of obstructed defecation. Tech Coloproctol. 2011 Dec;15(4):377-83. doi: 10.1007/s10151-011-0722-4.
  39. Ivashkin VT, Abdulkhakov SR, Baranskaia EK, Lapina TL, Maev IV, Osipenko MF, i dr. Klinicheskie rekomendatsii gastroenterologicheskoi assotsiatsii po diagnostike i lecheniiu vzroslykh patsientov s khronicheskim zaporom [Clinical Gastroenterological Association recommendations for diagnosis and treatment of adult patients with chronic constipation]. RZhGGK. 2014;24(5):69-76.
  40. Pizzetti D, Annibali R, Bufo A, Pescatori M. Colonic hydrotherapy for obstructed defecation. Colorectal Dis. 2005 Jan;7(1):107-8.
  41. Taffinder NJ, Tan E, Webb IG, McDonald PJ. Retrograde commercial colonic hydrotherapy. Colorectal Dis. 2004 Jul;6(4):258-60.
  42. Tsiaoussis J, Chrysos E, Glynos M, Vassilakis JS, Xynos E. Pathophysiology and treatment of anterior rectal mucosal prolapse syndrome. Br J Surg. 1998 Dec;85(12):1699-702.
  43. Maher C. ICI 2012: pelvic organ prolapse surgery. Int Urogynecol J. 2013 Nov;24(11):1781. doi: 10.1007/s00192-013-2168-x.
  44. Boenicke L, Jayne DG, Kim M, Reibeianz J, Bolic R, Kenn W, et al. What happens in stapled transanal rectum resection? Dis Colon Rectum. 2011;54:593-600.
  45. Bocassanta P, Venturi M, Roviaro G. What is the benefit of a new stapler device in the surgical treatment of obstructed defecation? Three-year outcomes from a randomized controlled trial. Dis Colon Rectum. 2011;54:77-84.
  46. Isbert C, Germer CT. Transanal procedure for functional bowel diseases.
    Chirurg. 2013 Jan;84(1):30-4, 36-8. doi: 10.1007/s00104-012-2350-6. [Article in German]
  47. Ribaric G, D'Hoore A, Schiffhorst G, Hempel E. STARR with CONTOUR TRANSTAR device for obstructed defecation syndrome: one-year real-world outcomes of the European TRANSTAR registry. Int J Colorectal Dis. 2014 May;29(5):611-22. doi: 10.1007/s00384-014-1836-8.
  48. Harris MA, Ferrara A, Gallagher J, DeJesus S, Williamson P, Larach S. Stapled transanal rectal resection vs. transvaginal rectocele repair for treatment of obstructive defecation syndrome. Dis Colon Rectum. 2009 Apr;52(4):592-7. doi: 10.1007/DCR.0b013e31819edbb1.
  49. Tschuor C, Limani P, Nocito A, Dindo D, Clavien PA, Hahnloser D. Perineal stapled prolapse resection for external rectal prolapse: is it worthwhile in the long-term? Tech Coloproctol. 2013 Oct;17(5):537-40. doi: 10.1007/s10151-013-1009-8.
  50. Vermeulen J, Lange JF, Sikkenk AC, van der Harst E. Anterolateral rectopexy for correction of rectoceles leads to good anatomical but poor functional results. Tech Coloproctol. 2005 Apr;9(1):35-41; discussion 41.
Address for correspondence:
400131, Russian Federation, Volgograd, Fallen Fighters Sq., 1, Volgograd State Medical University, chair of surgical diseases and neurosurgery of advanced medical faculty. Tel: +7 (8442) 54-60-16
Perov Yuriy Vadimovich
Information about the authors:
Perov Y.V. PhD, Coloproctologist, SME "Emergency City Clinical Hospital 25", laboratory assistant, SBEE HPE "Volgograd State Medical University", chair of surgical diseases and neurosurgery.
Popova I.S. MD, Professor, SBEE HPE "Volgograd State Medical University", chair of surgical diseases and neurosurgery.
Mihailov I.A. Post-graduate student, SBEE HPE "Volgograd State Medical University", chair of surgical diseases and neurosurgery.




SPEE HPE "I.M. Sechenov First Moscow Sate Medical University",
The Russian Federation

Objectives. To investigate various forms of late purulent complications of injection contour mammoplasty from the point of view of therapeutic and diagnostic tactics elaboration in regard of this patient category.
Methods. Regarding to therapy results of patients (n=8) who had previously undergone breast augmentation by polyacrylamide hydrogel injections complicated by the infection of implants, the causes, clinical presentation, optimal diagnostic and therapeutic measures referring to different forms of late postoperative purulent complications had been studied.
Results. The risk of post-implantation infection remains for many years after the augmentation mammoplasty. The features of surgical treatment of these complications include the necessity of radical removal of all tissues infiltrated by hydrogel that leads to a severe cosmetic defect. With a view to eliminate the cosmetic defect, the endoprosthetics of mammary glands using silicone breast implants could be performed (6 - 12 months after the inflammatory process). In this case another aesthetic surgery would be accompanied by an increased risk of postoperative purulent complications.
Conclusion. Augmentation mammoplasty by polyacrylamide hydrogel injections appears to be inaccurate and dangerous technique of breast augmentation and should be officially prohibited. Surgical treatment of late purulent complications of augmentation mammoplasty by polyacrylamide hydrogel injections has a range of significant characteristics. To improve the long-term results the principal diagnostic and therapeutic conception of treatment the postoperative purulent complications after augmentation mammoplasty has been formulated in this study.

Keywords: augmentation mammoplasty, cosmetic defect, silicone breast implants, polyacrylamide hydrogel, purulent complications, post-implantation polyacrylamide mammary syndrome, long-term results
p. 401-406 of the original issue
  1. Adamian AA, Svetukhin AM, Skuba ND. Poliakrilamidnyi mammarnyi sindrom: klinika, diagnostika i lechenie [Polyacrylamide mammary syndrome: clinical features, diagnosis and treatment]. Annaly Plast Rekonstrukt i Estet Khirurgii. 2001;(4):20-32.
  2. Adamian AA, i dr. Plastika molochnoi zhelezy i defektov prilezhashchikh tkanei gidrogelevymi endoprotezami [Plastic breast cancer and adjacent tissue defects by hydrogel endoprostheses]. V: Aktual'nye voprosy plasticheskoi khirurgii molochnoi zhelezy. Moscow, USSR; 1990. p. 24-25.
  3. Lopatin V.V. Poliakrilamidnye materialy dlia endoprotezirovaniia i ikh mesto v riadu polimernykh materialov meditsinskogo naznacheniia [Polyacrylamide materials for joint replacement and their place in a number of polymer materials for medical purposes]. Annaly Plast Rekonstrukt i Estet Khirurgii. 2000;(3):57-60.
    1. Patlazhan G, Unukovych D, Pshenisnov K. Breast reconstruction and treatment algorithm for patients with complications after polyacrylamide gel injections: a 10-year experience. Aesthetic Plast Surg. 2013 Apr;37(2):312-20. doi: 10.1007/s00266-012-0045-5.
  4. Lukomskii GI, Mironova OIu, Men'shikova GK, Smagin EN. Plastika molochnykh zhelez silikonovymi endoprotezami [Breast reconstruction with silicone prosthesis]. Vestn Khirurgii im II Grekova. 1988;(1):121-22.
  5. Gasperoni C, Salgarello M, Gargani G. Polyurethane-covered mammary implants: a 12-year experience. Ann Plast Surg. 1992 Oct;29(4):303-8.
  6. Ostretsova NI, Adamian AA, Kopyl'tsova AA, Nikolaeva-Fedorova AV. Poliakrilamidnye geli, ikh bezopasnost' i effektivnost' [Polyacrylamide gels, their safety and efficacy]. Annaly Plast Rekonstrukt i Estet Khirurgii. 2003;(3):72-87.
  7. Nerobeev AI, Lopatin VV. In"ektsionnye implantaty dlia uvelicheniia ob"ema miagkikh tkanei real'nost' i perspektivy [Injectable implants for soft tissue augmentation - reality and perspectives]. Annaly Plast Rekonstrukt i Estet Khirurgii. 2003;(1):41-46.
  8. Dobriakova OB, Dobriakov BS, Gulev VS, Nosov AP. Istoriia konturnoi plastiki [History contour plasty]. Vopr Rekonstrukt i Plast Khirurgii. 2013;16(4):65-74.
  9. Kazinnikova OG. Reaktsiia organizma na vvedenie poliakrilamidnykh gelei s tsel'iu uvelicheniia ob"ema molochnykh zhelez [Reaction to administration of the polyacrylamide gels to increase the volume of the mammary glands]. Annaly Plast Rekonstrukt i Estet Khirurgii. 2000;(3):71-73.
  10. Christensen LH, Breiting VB, Aasted A, Jørgensen A, Kebuladze I. Long-term effects of polyacrylamide hydrogel on human breast tissue. Plast Reconstr Surg. 2003 May;111(6):1883-90.
  11. Shekhter AB, Matiashvili GG, Lopatin VV, Chochia SL. In"ektsionnyi poliakrilamidnyi gidrogel' Formakril i tkanevaia reaktsiia na ego implantatsiiu [Injection polyacrylamide hydrogel Formacryl and tissue response to its implantation]. Annaly Plast Rekonstrukt i Estet Khirurgii. 1997;(2):11-21.
  12. Kebuladze IM. Konturnaia plastika miagkikh tkanei s pomoshch'iu gidrofil'nogo poliamidnogo gelia PAAG INTERFAL [Contour plasty of soft tissue with a hydrophobic polymeric gel PAGE "INTERFAL"]. Razrabotka i vnedrenie novykh polimernykh implantatov dlia plasticheskoi khirurgii: Materialy 1 mezhdunar konf; Kiev, Ukraina; 1995. p. 25.
  13. Milanov NO, Startseva OI, Kelekhsaeva MV. Lechenie negativnykh posledstvii uvelichivaiushchei mammoplastiki molochnykh zhelez poliakrilamidnym gelem [Treatment of adverse effects of augmentation mammoplasty breast by polyacrylamide gel]. Annaly Khirurgii. 2008;(4):25-30.
  14. Ghasemia HM, Damsgaarda TE, Stolle LB, Bekka OC. Complications 15 years after breast augmentation with polyacrylamide. JPRAS Open. 2015 Jun;4:3034. doi:10.1016/j.jpra.2015.04.002.
  15. Cheng NX, Wang YL, Wang JH, Zhang XM, Zhong H. Complications of breast augmentation with injected hydrophilic polyacrylamide gel. Aesthetic Plast Surg. 2002 Sep-Oct;26(5):375-82.
Address for correspondence:
119991, Russian Federation, Moskow,
ul. Bolshaya Pirogovskaya, d. 2, str. 4,
"Pervyiy Moskovskiy meditsinskiy
universitet im. I.M. Sechenova",
kafedra obschey khirurgii,
tel. mob. 89166358988,
Lipatov Konstantin Vladimirovich
Information about the authors:
Lipatov K.V. MD, professor of the general surgery chair of SBEE HPE "I.M.Sechenov First Moscow State Medical University".
Struchkov Y.V. MD, professor of the general surgery chair of SBEE HPE "I.M.Sechenov First Moscow State Medical University".
Komarova E.A. PhD, an assistant of the general surgery chair of SBEE HPE "I.M.Sechenov First Moscow State Medical University".
Nasibov B.Sh., applicant of the general surgery chair of SBEE HPE "I.M.Sechenov First Moscow State Medical University".




SBE "Belarusian Medical Academy of Post-Graduate Education"1,
ME "Minsk Regional Clinical Hospital"2,
The Republic of Belarus

Objectives. To develop a differentiated algorithm of application of the most informative diagnostic methods for improving the treatment outcomes of patients with congenital vascular malformations (CVMs) of the external localization.
Methods. The study included 202 patients with VM aged 1-78 years for the period 1990-2015. Depending on the blood flow velocity, all CVMs were divided into two types: low-velocity and high-velocity. The arteriovenous malformations (AVMs) were corresponded to high-velocity blood flow CVM; venous (VM), capillary (CM) and lymphatic malformations (LM) were corresponded to low-velocity blood flow. For the evaluation of patients with CVM the diagnostic algorithm was proposed. In addition to general clinical examination of patients the following diagnostic methods were used: a comprehensive ultrasound of the vessels, plain radiography of soft tissues and bones, tomographic methods of investigation, including computed tomography with dynamic contrast-enhanced image (CTI) and magnetic resonance angiography (MRA) as well as arteriography and phlebography.
Results. Analysis of demographic studies has shown that the detection of congenital vascular development occurs in the majority of cases in females at a young age (11-20 years), and indirectly indicates the clinical manifestation of the disease during the hormonal changes. Comprehensive ultrasound is leading in the evaluation of patients with CVM. Computed tomography (T) and magnetic resonance imaging (MRI) are the most informative methods for accurate topical diagnosis of congenital vascular malformations, for estimation of the extension of the pathological process, for visualization of blood vessels. To reveal an intense blood flow at CVM the selective angiography should be prefered, as in some cases it can be a medical procedure to perform embolization of the arteriovenous reset.
Conclusion. The current examination of patients with CVM of the external localization should be based on a multidisciplinary approach, including ultrasound diagnostic methods, tomographic methods of investigation, as well as angiography.

Keywords: vascular malformations, arteriovenous malformation, venous malformation, ultrasound, computed tomography, magnetic resonance imaging, angiography
p. 407-416 of the original issue
  1. Tasnadi G. Epidemiology and Etiology of Congenital Vascular Malformations Seminars. Seminars in Vascular Surgery. 1994 Jan;6(4):200-3.
  2. Mattassi R, Belov S, Loose DA, Vaghi M. Hemangiomas and vascular malformations, tlas of diagnosis and treatment. Foreword by Villavicencio JL. Springer-Verlag, Italia; 2009. 331 .
  3. Mahady K, Thust S, Berkeley R, Stuart S, Barnacle A, Robertson F, et al. Vascular anomalies of the head and neck in children. Quant Imaging Med Surg. 2015 Dec;5(6):886-97. doi: 10.3978/j.issn.2223-4292.2015.04.06.
  4. Lee BB, Laredo J, Lee TS, Huh S, Neville R. Terminology and classification of congenital vascular malformations. Phlebology. 2007;22(6):249-52.
  5. Nosher JL, Murillo PG, Liszewski M, Gendel V, Gribbin CE. Vascular anomalies: A pictorial review of nomenclature, diagnosis and treatment. World J Radiol. 2014 Sep 28;6(9):677-92. doi: 10.4329/wjr.v6.i9.677.
  6. Dan VN, Sapelkin CB. Angiodisplazii (vrozhdennye poroki razvitiia sosudov) [Angiodysplasia (congenital vascular malformations)]. Moscow, RF: Verdana; 2008. 200 p.
  7. Mabeta P, Pepper MS. Hemangiomas-cur-rent therapeutic strategies. Int J Dev Biol. 2011;55:431-37.
  8. Hyodoh H, Hori M, Akiba H, Tamakawa M, Hyodoh K, Hareyama M. Peripheral vascular malformations: imaging, treatment approaches, and therapeutic issues. Radiographics. 2005 Oct;25(Suppl 1):S159-71.
  9. Leliuk VG, Leliuk SE. Ul'trazvukovaia angiologiia [Ultrasonic angiology]. 2-e izd. Moscow, RF; 2003. 336 p.
  10. Kollipara R, Dinneen L, Rentas KE, Saettele MR, Patel SA, Rivard DC, et al. Current classification and terminology of pediatricvascular anomalies. AJR. 2013 Nov:201:1124-35.
  11. Flors L, Leiva-Salinas C, Maged IM, Norton PT, Matsumoto AH, Angle JF, et al. MR imaging of soft-tissue vascular malformations: diagnosis, classification, and therapy follow-up. Radiographics. 2011 Sep-Oct;31(5):1321-40; discussion 1340-1. doi: 10.1148/rg.315105213.
  12. Rutherford RB, Anderson BO. Diagnosis of congenital vascular malformations of the extremities: new perspectives. Int Angiol. 1990 Jul-Sep;9(3):162-67.
Address for correspondence:
223041, Republic of Belarus, Minsk region and district, Lesnoy setl.,1, ME "Minsk Regional Clinical Hospital", chair of surgery.
Tel: 37517 2652263
Popel Gennadiy Adolfovich
Information about the authors:
Popel G.A. Assistant, SEE "Belarusian Medical Academy of Post-Graduate Education", chair of surgery .
Varabei A.V. Corresponding Member of NAS of Belarus, MD, Head, SEE "Belarusian Medical Academy of Post-Graduate Education", chair of surgery, Head, Republican Center of the Reconstructive Surgical Gastroenterology and Coloproctology.
Davidovski I.A. Ass. Professor, SEE "Belarusian Medical Academy of Post-Graduate Education", chair of surgery.
Voevoda M.T. Ass. professor SEE "Belarusian Medical Academy of Post-graduate Education", chair of surgery.
Rogaten A.I. Physician, ME "Minsk Regional Clinical Hospital", ultrasound diagnostics unit.
Derkacheva N.V. Head ME "Minsk Regional Clinical Hospital", MRI room.
Contacts | ©Vitebsk State Medical University, 2007-2023