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Year 2023 Vol. 31 No 3

SCIENTIFIC PUBLICATIONS

H.A. POPEL, I.A. MAISEYENKA, R.R. ZHMAILIK, YU.P. OSTROVSKY

COMPARATIVE ANALYSIS OF INFLAMMATORY RESPONSE IN ANIMAL ORGANISM AFTER ABDOMINAL AORTIC REPLACEMENT

Republican Scientific and Practical Center of Cardiology, Minsk,
Republic of Belarus

Objective. To study variations of inflammatory markers level after abdominal aortic replacement using biological (BG) and synthetic (SG) vascular gelatin-coated Dacron grafts in experimental animals.
Methods. The study was performed on female white pigs (n = 12). The animals were uniformly divided into two groups: group 1 – implanted synthetic vascular modified gelatin-Dacron graft (6 animals); group 2 - implanted biological vascular graft using bovine xenopericardium (6 animals). The blood samples were taken before surgery and then on the 1st, 7th, 14th and 21st day postoperatively. To assess the systemic inflammatory response, the total number of white blood ulls, the absolute and relative numbers of granular and non-granular white blood ulls, the erythrocyte sedimentation rate and the concentration of C-reactive protein were determined.
Results. The total number of white blood ulls at all study points was not statistically significantly different in both groups: in the group of animals with a synthetic graft (p = 0.810) and in the group with a biological vascular graft (p = 0.170). On the 7th day after surgery, statistically significantly difference was reported in the concentration of C-reactive protein (Ìå 1.78 (1.60-1.99) mg/l in the BP group and Ìå 1.24 (1.06-1.36) mg/l in the BG and SG group, p = 0.019) and the erythrocyte sedimentation rate (Ìå 32.50 (31.00-36.25) mm/h and Me 19.50 (18.25-24.50) mm/h in the group of biological and synthetic grafts, respectively, p = 0.020). On the 14th and 21st day after surgery, there was no statistically significant difference in the study parameters.
Conclusion. No clinically significant difference in the intensity of the inflammatory response of experimental animals after abdominal aortic replacement with synthetic and biological vascular grafts was identified in the corresponding study.

Keywords: biological vascular graft, synthetic vascular graft, aorta, pig, inflammatory responce, xenopericardium
p. 181-189 of the original issue
References
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  2. Xing Z, Wu S, Zhao C, Bai Y, Jin D, Yin M, Liu H, Fan Y. Vascular transplantation with dual-biofunctional ePTFE vascular grafts in a porcine model. J Mater Chem B. 2021(9):7409-7422. doi: 10.1039/d1tb01398j.
  3. Góes AMO, Chaves RHF, Furlaneto IP, Rodrigues EM, de Albuquerque FBA, Smit JHA, de Oliveira CP, Abib SCV. Comparative angiotomographic study of swine vascular anatomy: contributions to research and training models in vascular and endovascular surgery. J Vasc Bras. 2021(14):e20200086. doi: 10.1590/1677-5449.200086.
  4. Fadeeva IS, Sorkomov MN, Zvyagina AI, Britikov DV, Sachkov AS, Evstratova YV, Fadeev RS, Muratov RM, Akatov VS. Study of Biointegration and Elastic-Strength Properties of a New Xenopericardium-Based Biomaterial for Reconstructive Cardiovascular Surgery. Bull Exp Biol Med. 2019(167):496-99. doi: 10.1007/s10517-019-04558-1.
  5. Chiba Y, Muraoka R, Ihaya A, Kimura T, Morioka K, Uesaka T, Tsuda T. Postoperative inflammatory reactions of impregnated Dacron grafts. Surg Today. 1999;29(11):1225-28. doi: 10.1007/BF02482279
Address for correspondence:
220036, Republic of Belarus,
Minsk, R. Luxemburg Str. 110B,
Republican Scientific and Practical
Center «Cardiology»,
Vascular Surgery Research Laboratory,
tel.: +375 17 201-28-08,
e-mail: hpopel@mail.ru,
Popel Henadzi A.
Information about the authors:
Popel Henadzi A. PhD, Associate Professor, Head of Vascular Surgery Research Laboratory, Republican Scientific and Practical Center of Cardiology, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-1140-0806
Maiseyenka Ivan A. Intern at Cardiac Surgery Department No.1, Researcher at Vascular Surgery Research Laboratory, Republican Scientific and Practical Center of Cardiology, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-5403-7464
Zhmailik Ruslan R. Cardiac Surgeon at Cardiac Surgery Department No. 1, Researcher at Vascular Surgery Research Laboratory, Republican Scientific and Practical Center of Cardiology, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-6342-3527
Ostrovsky Yury P. MD, Professor, Academician of NAS of Belarus and RAS, Vice-Director for Innovative Development and High Technologies, Republican Scientific and Practical Center of Cardiology, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-6826-3200

V.V. BESCHASTNOV, V.V. ANTOSHINA, N.YU. ORLINSKAYA, A.A. TULUPOV, I.E. POGODIN, M.G. RYABKOV

SKIN MICROTRANSPLANTATION ACCELERATES WOUND HEALING DUE TO INCREASED PROCESSES OF PROLIFERATION AND VASCULARIZATION

Privolzhskiy Research Medical University, Nizhny Novgorod, Russian Federation

Objective. Comparison of regenerative processes in wound tissue in the cases when it is closed with a split-thickness skin graft and split-thickness skin micrograft by the proposed method.
Methods. The study was performed on 15 animals (rats). In the back area of each animal, two grade III burn wounds were simulated, one of which was covered with split-thickness skin micrograft (main group), and the other with a solid split-thickness skin graft (control group). On the 7th, 14th, and 21st days, planimetric studies were performed, then the wound tissues were excised, followed by histological and immunohistochemical (Ki-67, CD31) studies.
Results. Split-thickness skin grafts are versatile adjuncts to wound closure in burns . During split-thickness skin micrograft, the processes of angiogenesis and proliferation of newly formed epithelial tissue in the area of the wound defect are stimulated. The newly formed integumentary tissue during split-thickness skin micrograft is more similar in structure to intact skin compared to plastic closure with a solid split autodermotransplant.
Conclusion. The hydrogel coating ensures the preservation of their regenerative properties. Split-thickness skin grafts are versatile adjuncts to wound closure in burns, trauma, reconstruction, and other large wounds. Split-thickness skin micrograft is considered to be an effective technique for closing full-layer skin defects and may increase wound repair quality. The proposed method of grafting split-thickness skin to the recipient wound improves its survival. Skin transplantation using split thickness skin grafts (STSGs) is the treatment of choice in large wounds

Keywords: burn wounds, plastic closure, free skin graft, split-thickness skin graft, split-thickness skin micrograft, hydro-gel
p. 190-202 of the original issue
References
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  5. Markiewicz-Gospodarek A, Kozioł M, Tobiasz M, Baj J, Radzikowska-Büchner E, Przekora A. Burn Wound Healing: Clinical Complications, Medical Care, Treatment, and Dressing Types: The Current State of Knowledge for Clinical Practice. Int J Environ Res Public Health. 2022 Jan 25;19(3):1338. doi: 10.3390/ijerph19031338
  6. Braza ME, Fahrenkopf MP. Split-Thickness Skin Grafts. 2022 Jul 25. In:StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
  7. Van Wicklin SA. Split-Thickness and Full-Thickness Skin Grafts. Plast Aesthet Nurs (Phila). 2022 Jul-Sep 01;42(3):122-123. doi: 10.1097/PSN.0000000000000453
  8. Alekseev AA, Bobrovnikov AE, Krutikov MG, Lagvilava MG. Vybor taktiki lecheniia pri dlitel’no sushchestvuiushchikh ostatochnykh ozhogovykh ranakh. Neotlozhnaia meditsinskaia pomoshch’. Zhurn im. N.V. Sklifosovskogo. 2011;1:17-21. (In Russ.)
  9. Wang JH, Li ZQ, Chen J, Ren JL, Qiu XW. Sequential management of residual wounds in burn patients. Zhonghua Shao Shang Za Zhi. 2007 Feb;23(1):16-9.
  10. Pertusi,G, Tiberio R, Graziola F, Boggio P, Colombo E, Bozzo C. Selective release of cytokines, chemokines, and growth factors by minced skin in vitro supports the effectiveness of autologous minced micrografts technique for chronic ulcer repair. Wound Repair and Regeneration. 2012; 20(2), 178–184. doi: 10.1111/j.1524-475x.2011.00762.x
  11. Ottoman C, Buntrock G, Gatz K, Hartmann B, Aarabi G, Kaschwich M, Kleemann M, Bayer A. SkinDot: A modified full-skin transplantation technique. Ann Anat. 2020 May;229:151454. doi: 10.1016/j.aanat.2019.151454
  12. Wang ZJ, Li HH, Ben C, Lu H, Zhu SH. Research advances on application of miniature free skin grafting technique Zhonghua Shao Shang Za Zhi. 2021 Jan 20;37(1):93-96
  13. MEEK Micro-skin Transplantation Technology Collaboration Group, Chinese Burn Association, Burn Institute of PLA. Clinical operation procedure of grafting technique of MEEK micro-skin. Zhonghua Shao Shang Za Zhi. 2019 Aug 20;35(8):561-564. Chinese. doi: 10.3760/cma.j.issn.1009-2587.2019.08.001
  14. Quintero EC, Machado JFE, Robles RAD. Meek micrografting history, indications, technique, physiology and experience: a review article. J Wound Care. 2018 Feb;27(2):12-18. doi: 10.12968/jowc.2018.27.Sup2.S12.
  15. Rijpma D, Claes K, Hoeksema H, de Decker I, Verbelen J, Monstrey S, Pijpe A, van Zuijlen P, Meij-de Vries A. The Meek micrograft technique for burns; review on its outcomes: Searching for the superior skin grafting technique. Burns. 2022 Sep;48(6):1287-1300. doi: 10.1016/j.burns.2022.05.011
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  20. Griban’ PA, Martynenko EE, Lemeshko TN. Analiz morfologicheskikh izmenenii v autodermotransplantate posle kozhnoi plastiki. Fund Issledovaniia. 2010;11:37-41.( In Russ.)
  21. Pertusi G, Tiberio R, Graziola F, Boggio P, Colombo E, Bozzo C. Selective release of cytokines, chemokines, and growth factors by minced skin in vitro supports the effectiveness of autologous minced micrografts technique for chronic ulcer repair. Wound Repair Regen. 2012 Mar-Apr;20(2):178-84. doi: 10.1111/j.1524-475X.2011.00762.x
  22. Barrientos S, Stojadinovic O, Golinko MS, Brem H, Tomic-Canic M. Growth factors and cytokines in wound healing. Wound Repair Regen. 2008 Sep-Oct;16(5):585-601. doi: 10.1111/j.1524-475X.2008.00410.x
  23. Hackl F, Bergmann J, Granter SR, Koyama T, Kiwanuka E, Zuhaili B, Pomahac B, Caterson EJ, Junker JPE, Eriksson E. Epidermal regeneration by micrograft transplantation with immediate 100-fold expansion. Plast Reconstr Surg. 2012 Mar;129(3):443e-452e. doi: 10.1097/PRS.0b013e318241289c.
Address for correspondence:
603005, Russian Federation,
Nizhny Novgorod, sq. Minin &
Pozharsky, 10/1,
Volga Research Medical University,
tel.: +79200641557,
e-mail: tulupov.a.a@yandex.ru,
Tulupov Alexander A.
Information about the authors:
Beschastnov Vladimir V., MD, Professor, Leading Researcher at the University Clinic of the Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of Russia, Nizhny Novgorod, Russian Federation.
http://orcid.org/0000-0002-9332-3858
Antoshina Veronika V., PhD, Researcher of the Pathological Anatomy Group of the Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of Russia, Nizhny Novgorod, Russian Federation.
http://orcid.org/0000-0003-3545-0223
Orlinskaya Natal’ya Y., MD, Head of the Department of Pathological Anatomy of the Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of Russia, Nizhny Novgorod, Russian Federation.
http://orcid.org/0000-0003-2896-2968
Tulupov Aleksandr A., Junior Researcher, University Clinic of the Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of Russia, Nizhny Novgorod, Russian Federation.
ORCID: 0000-0001-6567-7803
Pogodin Igor E., Traumatologist-Orthopedist, Head of the Burn Department (adults) of the University Clinic, Leading Researcher at the University Clinic of the Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of Russia, Nizhny Novgorod, Russian Federation.
http://orcid.org/0000-0002-7008-4962
Ryabkov Maksim G., MD, Associate Professor, Leading Researcher, University Clinic of the Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of Russia, Nizhny Novgorod, Russian Federation.
http://orcid.org/0000-0002-9555-190X

R.V. TARASOV 1, 2, S.S. SADOVNIKOVA 1, 3, E.V. KRASNIKOVA 1, M.A. BAGIROV 1, 3

TRANSSTERNAL OCCLUSION OF THE MAIN BRONCHUS WITH SIMULTANEOUS PLASTY OF THE ANTERIOR MEDIASTINUM WITH A MESH IMPLANT IN PATIENTS WITH GENERALIZED COMPLICATED DESTRUCTIVE PULMONARY TUBERCULOSIS

Federal State Budgetary Scientific Institution “Central Tuberculosis Research Institute” 1,
Moscow Medical University "Reaviz" 2,
Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation 3, Moscow,
Russian Federation

Objective. To show the effectiveness of surgery for patients with generalized destructive pulmonary tuberculosis complicated by pleural empyema with bronchopleural fistula and mediastinal pulmonary hernia when transsternal occlusion of the main bronchus of the affected lung and simultaneous plasty of the anterior mediastinum with a polymer mesh implant are performed.
Methods. The study included 45 patients. The patients were divided into 2 groups: patients of group 1 (n=13) underwent transsternal occlusion of the main bronchus with anterior mediastinal plastic mesh implant; patients of group 2 (n=32) - transsternal occlusion of the main bronchus without plastic surgery. The indicators of the course of the postoperative period, the degree of dyspnea on the mMRC scale, the results of X-ray, spirometric and gas exchange studies were evaluated.
Results. The effectiveness of surgery for patients with generalized destructive tuberculosis with mediastinal pulmonary hernia according to the course of the postoperative period of group 1 was 61% and 25% when performing occlusion without plastic - group 2. The degree of significant dyspnea on the mMRC scale with occlusion with plastic surgery decreased by 47%, with occlusion without plastic surgery by 34%. Indicators of external respiration in the compared methods did not differ significantly. Anterior pulmonary hernia (Vsm3) after anterior mediastinal plastic mesh implant with transsternal occlusion of the main bronchus decreased in size in 100% of cases, while after occlusion without mediastinal plastic it increased in 53% or remained the same size in 47%. When assessing the X–ray picture after 1 year, tuberculosis progression was detected in 8% and 22% of cases after occlusion with and without plastic surgery, respectively.
Conclusion. Plastic surgery of the anterior mediastinum with a mesh implant during transsternal occlusion of the main bronchus is considered to be an effective method for treating mediastinal pulmonary hernia in patients with generalized destructive pulmonary tuberculosis complicated by pleural empyema and bronchial fistula.

Keywords: mediastinal hernia, a polymer mesh implant, tuberculosis of the lungs, morphology, generalized pulmonary tuberculosis, transsternal occlusion of the main bronchus.
p. 203-210 of the original issue
References
  1. Benian AS, Iudin AE, Airapetova MP. Rare observation of bilateral pneumothorax at patient with bullous emphysema of the contralateral lung and mediastinal hernia after pneumonectomy. Diagnostic radiology and radiotherapy. 2019;10(4):93–97. doi: 10.22328/2079-5343-2019-10-4-93-97. (In Russ)
  2. Tarasov RV, Nikitina NM, Asoyan GA, Sadovnikova SS., Bagirov MA. Successful treatment of advanced pulmonary tuberculosis with simultaneous correction of mediastinal pulmonary hernia. Bulletin of the NMHC named after N.I. Pirogov. 2021;16(3):106-109. doi: 10.25881/20728255_2021_16_3_106 (In Russ)
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  12. Giller DB, Giller GV, KV, Tokaev KV, Martel’ II, Glotov AA, Enilenis II, Shcherbakova GV, Imagozhev IaG, Kesaev OSh, Koroev VV, Murgustov IB, Kolmakov NM. Method of surgical treatment of post-pneumonectomy syndrome. Patent No. 2427327 of the Russian Federation, No. 2010112156/14; application. 30.03.2010; publ. 27.08.2011. (In Russ)
  13. Bagirov MA, Ibriev AS, Krasnikova EV, Sadovnikova SS, Tokaev KV, Tokaev TK, Ergeshov AE . Method of prevention of post-pneumonectomy syndrome. Patent No. 2614525 of the Russian Federation; No. 2015151084; application No. 30.11.2015; publ. 17.04.2017.(In Russ)
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Address for correspondence:
107564, Russian Federation, Moscow,
Yauzskaya alley, .2
Central Tuberculosis Research Institute
Tel.+79260443191
e-mail: etavnai@yandex.ru
Tarasov Ruslan Vyacheslavovich
Information about the authors:
Tarasov Ruslan V., Surgeon, Junior Researcher of the Department of Surgery, Central Research Institute of Tuberculosis; Assistant of the Department of Surgical Diseases, Moscow Medical University «Reaviz», Moscow, Russian Federation.
http://orcid.org/0000-0001-9498-1142
Sadovnikova Svetlana S., MD, Thoracic Surgeon, Head of the 1st Surgical Department, Central Research Institute of Tuberculosis; Associate Professor, Department of Thoracic Surgery, RMNAPO, Moscow, Russian Federation.
http://orcid.org/0000-0002-6589-2834
Krasnikova Elena V. MD, Thoracic Surgeon, Head of the 2nd Surgical Department, Central Tuberculosis Research Institute, Moscow, Russian Federation.
http://orcid.org/0000-0002-5879-7062
Bagirov Mammad A., MD, Chief Researcher of the Department of Surgery, Central Research Institute of Tuberculosis; Professor of the Department of Thoracic Surgery RMNAPO, Moscow, Russian Federation.
http://orcid.org/0000-0001-9788-1024

B.K. OSMONALIEV, B.A. AVASOV, U.S. MUSAEV, R.B. ASYLBASHEV, J.T. KONURBAEVA

ALGORITHM OF DIAGNOSIS AND TREATMENT OF GASTROESOPHAGEAL REFLUXDISEASE

The Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek ,
Republic of Kyrgyzstan

Objective. Improving the outcomes of operative treatment of patients with gastroesophageal reflux disease by perfectioning the anti-reflux operations stages.
Methods. The paper presents the results of diagnosis and treatment of 120 patients with gastroesophageal reflux disease/ After endoscopic and radiological examination, and the use of the international questionnaire Gerd-Q (GastroEsophageal Reflux Disease – GERD and Questionnaire), 42 patients received conservative management ambulatory with positive dynamics. 78 patients underwent the surgery (dorsal cruroraphy and Nissen fundoplication).
Results. Specific surgery complications are absent. Lethal cases are not observed. Patients were discharged after surgery with the improvement. The positive results from both clinical groups with the improvement of the life quality justify the chosen methods of early diagnosis and treatment. since Nissen fundoplication is considered to be a surgery to treat GERD . Long-term results were observed in 55 (70%) patients between 6 months and 5 years after surgery. The results have been regarded as satisfactory, all patients felt good at the time of examination.
Conclusion. The obtained good results in two clinical groups, improving GERD Health-Related Quality of Life of patients has justified the chosen diagnostic algorithm and the method for preventing complications.

Keywords: gastroesophageal reflux disease, diagnosis, GerdQ questionnaire, fundoplication
p. 211-219 of the original issue
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Address for correspondence:
720054, Kyrgyz Republic,
Bishkek c., Yu.Fucnic Str., 15,
City Clinical Hospital No1,
The Department of Emergency Surgery
Phone mob.:+996 553 39 91 22,
e-mail: avasov_bakyt@mail.ru,
Avasov Baktybek Artisbekovich
Information about the authors:
Osmonaliev Bakytbek K. PhD, Assistant of Department of Faculty Surgery, Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek city, Kyrgyz Republic.
http://orcid.org/0000-0003-3939-0504
Avasov Baktybek A. MD, Associate Professor of the Department of Faculty Surgery, Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek city, Kyrgyz Republic.
http://orcid.org/ 0000-0002-2780-2930
Musaev Ulan S. MD, Associate Professor of the Department of Faculty Surgery, Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek city, Kyrgyz Republic.
http://orcid.org/ 0009-0002-4007-5958
Asylbashev Ruslan B. PhD, Assistant of Department of Faculty surgery, Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek city, Kyrgyz Republic.
http://orcid.org/0000-0003-3472-3349
Konurbaeva Jyldyz T. PhD, Associate Professor of the Department of Faculty Surgery, Kyrgyz State Medical Academy named after I.K. Akhunbaev, Bishkek city, Kyrgyz Republic.
http://orcid.org/000-0001-8132-5226

Y.I. GALITSKAYA 1, S.L. ACHINOVICH 2, Z.A. DUNDAROV 3, D.A. EVSEENKO 3

CLINICAL AND MORPHOLOGIC CRITERIA OF SCARRING SKIN CHANGES

State Institution RSPC for Radiation Medicine and Human Ecology MH RB 1,
Gomel Regional Clinical Oncologic Dispensary MH RB 2,
Educational Institution Gomel State Medical Universities, MH RB 3, Gomel,
Republic of Belarus

Objective. The research has focused on objectively defining scar criteria and outcomes. It is to provide information about current clinical and morphologic criteria of skin scarring changes to determine promising techniques of treatment, rehabilitation of patients with pathologic scarring.
Methods. The developed system allows analyzing the number of the publications and the citations by years, by keywords, by authors, by scientific sections, etc. in electronic bibliographic databases PubMed, eLibrary, Web of science, Cyberleninca, Cochrane Library over the period 2013 – 2023 yrs.
Results. For a review of the scientific literature 260 sources have been studied and 42 publications have been included in it. Over the last decade the use of domestic and foreign core data for comparative research ensures the comprehensiveness of the study. It has shown that rehabilitation of patients with scar deformities is considered as an actual problem of reconstructive surgery and as a socially significant issue requiring the involvement of high-tech diagnostic methods with the subsequent combined pathogenetic treatment.
Conclusion. The most important aim for scar treatment is the improvement of functional and aesthetical deformities. Studies to determine some pathohistological parameters, including the assessment of epithelial-mesenchymal transformation of scar deformities and clinical manifestations, provides the basis for building a new effective techniques of treatment.

Keywords: skin scarring, morphology, epithelial-mesenchymal transition, combined treatment
p. 220-230 of the original issue
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Address for correspondence:
246040, Republic of Belarus,
Gomel c., Ilyich str., 290,
State Institution «RSPC for Radiation
Medicine and Human Ecology»,
Surgical Department,
tel.: 8 0232 389641,
e-mail: yuliyagalitskaya@mail.ru,
Galitskaya Yu. I.
Information about the authors:
Galitskaya Yulia I., Plastic Surgeon of the Surgical Department (Transplantation, Endocrine and Reconstructive Surgery), State Institution RSPC of Radiation Medicine and Human Ecology, Ministry of Health of the Republic of Belarus, Gomel, Republic of Belarus.
https://orcid.org/0009-0004-9883-5731
Achinovich Sergei L., PhD, Head of Pathologoanatomical Department, U Gomel Regional Clinical Oncologic Dispensary, Ministry of Health of the Republic of Belarus, Gomel, Republic of Belarus Ministry of Health of the Republic of Belarus, Gomel, Republic of Belarus.
https://orcid.org/0000-0002-0977-5481
Dundarov Zalimkhan A., MD, Professor, Head the Department of Surgical Diseases No2 Gomel State Medical University, Ministry of Health of the Republic of Belarus, Gomel, Republic of Belarus.
https://orcid.org/0000-0001-8561-691X
Evseenko Dmitry A., PhD, Associate Professor of the Department of Surgical Diseases No2 Gomel State Medical University, Ministry of Health of the Republic of Belarus, Gomel, Republic of Belarus.
https://orcid.org/0000-0002-6835-779X

M.D. ROMANOV 1, E.M. KIREEVA 1, 2

PECULIARITIES OF BEZOAR-INDUCED SMALL BOWEL OBSTRUCTION

National Research Mordovia State University 1,
Republican Clinical Hospital No 4 2, Saransk,
Russian Federation

The article presents a clinical observation of a rare pathology – acute intestinal obstruction caused by phytobezoar of the ileum, in the debut of which signs of acute pancreatitis prevailed. Four percent of small bowel obstructions are caused by bezoars, which can be formed due to large fiber intake, inadequate mastication, hasty swallowing, reduced gastric motility and pyloric dysfunction. The causes of bezoar retention in the ileum could be anatomical and functional differences of the small intestine (smaller lumen of the ileum, presence of ileocecal valve, which prevents premature progression of the contents into the colon, less mobility due to shorter mesentery, increased intensity of water absorption compared to the jejunum), as well as adhesions in the right iliac fossa. The unusual debut of small intestinal obstruction could be due to the slow progress of bezoar from the jejunum to the ileum due to a violation of the motor evacuation function of the digestive tract against the background of gastritis and exacerbation of chronic pancreatitis. The obstruction was treated by manual fragmentation of the bezoar and its relegation to the colon during laparotomy and subsequent conservative therapy.

Keywords: ileum bezoar, obturator small intestinal obstruction, clinical observation, diagnostic and therapeutic tactics
p. 231-239 of the original issue
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Address for correspondence:
430032, Russian Federation,
Saransk, Ulyanov st., 32,
Mordovian State University
named after. N.P. Ogarev,
Department of Hospital Surgery,
tel.: +79279710237,
e-mail: mdromanov@yandex.ru,
Romanov Mikhail Dmitrievich
Information about the authors:
Romanov Mikhail D., MD, Professor, Professor of the Department of Hospital Surgery of National Research Mordovian State University named after. N.P. Ogarev, Saransk, Russian Federation.
https://orcid.org/0000-0002-9646-4007
Kireeva Ekaterina M., PhD. Associate Professor, Associate Professor, Department of Hospital Surgery of National Research Mordovian State University named after. N.P. Ogarev; Surgeon, Republican Clinical Hospital No4, Saransk, Russian Federation.
https://orcid.org/0000-0003-1034-167X

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LAPAROSCOPIC OPERATIONS OF GENERALIZED SECONDARY PERITONITIS

Peoples’ Friendship University of Russia. Moscow, Russian Federation

Currently, mortality in generalized peritonitis remains high, reaching 20-30%, and with the development of septic shock it increases to 70-90%. Surgeons actively discuss the choice of approach for generalized peritonitis based on intraoperative findings and the severity of the patient’s condition. The paper presents the results of studies and opinions of domestic and foreign surgeons on the possibility of performance laparoscopic operations in patients with generalized peritonitis. Despite the fact that world surgery has accumulated extensive experience in performance laparoscopic operations in patients with generalized peritonitis, the inconsistency of literature data, and that is the most important, the lack of a generally accepted approach in determining the criteria for choosing surgical access and reasonable indications and contraindications for performing laparoscopic surgery let talking about the relevance of this problems. A possible solution of this problem can be the creation of a scale, the combined criteria of which (local and general) will allow, at leastapproximately, to select the surgical approach in patients with generalized peritonitis.

Keywords: widespread peritonitis, laparoscopic operations, indications, contraindications
p. 240-249 of the original issue
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Address for correspondence:
123060, Russian Federation,
Moscow, Marshal Biryuzov st., 22, (3), 84
Russian University of Friendship
Narodov, Department of Faculty Surgery,
Tel. 1359125, tel. 89175989015.
E-mail: nickl55@mail.ru.
Lebedev Nikolay V.
Information about the authors:
Lebedev Nikolay V., MD, Professor. Department of Faculty Surgery of the Peoples’ Friendship University of Russia. Moscow, Russian Federation.
https://orcid.org/0000-0002-7745-1390
Klimov Aleksey E., MD, Professor, Head of the Department of Faculty Surgery of the Peoples’ Friendship University of Russia. Moscow, Russian Federation.
https://orcid.org/0000-0002-0001-8003
Belyakov Aleksey P., Post-Graduate Student of the Department of Faculty Surgery of the Peoples’ Friendship University of Russia. Moscow, Russian Federation.
https://orcid.org/0000-0002-4368-8648
Shadrina Valentina S., Post-Graduate Student of the Department of Faculty Surgery of the Peoples’ Friendship University of Russia. Moscow, Russian Federation.
https://orcid.org/0000-0003-1992-939X

CASE REPORTS

I.B. GOGINAVA 1, S.A. GOLOBOROD’KO 2, 3

INTRATENDINOUS GANGLION OF THE FINGER EXTENSOR OF THE HAND: CASE REPORT

West Georgia Medical Center1, Kutaisi 1, Georgia.
Kharkov National Medical University 2,
KNP HOS “Regional Clinical Traumatological Hospital” 3, Kharkov,
Ukraine

We present a case of a patient with an intratendinous ganglion of the extensor pollicis brevis. This type of pathology is extremely rare and only 23 cases of intratendinous ganglion of the flexor and extensor tendons of the fingers were described in the scientific literature.. A 38-year-old male came to the clinic with complaints of a severe limitation of active extension of the proximal phalanx and radial abduction of the thumb, dysfunction of the right hand. The patient noted that a few months ago, for no reason, the proximal phalanx gradually began to lose the usual amplitude of active extension and radial abduction. On clinical examination, active extension of the proximal phalanx and radial abduction of the thumb were impaired. Somewhat distally to the styloid process of the radius, in the area of the projection of the tendon of the extensor pollicis brevis, a tight-elastic, o-shaped, painless tumor-like formation 3-4 mm in diameter was palpated. When trying to actively flex and extend the thumb, the formation did not move. After a clinical examination, the preliminary diagnosis was established: closed injury of the tendon of the extensor pollicis brevis of the right hand? Intraoperatively, the intratendinous ganglion of the extensor pollicis brevis was found. Ganglion was completely enucleated. The tendon of the extensor pollicis brevis was closed by a running suture with a polypropylene thread 5/0. Pathological examination confirmed the presence of a ganglion. 5 months after the operation, no recurrence was detected, the amplitude of all active movements in the joints of the thumb was completely restored. We operated on 3 patients with intratendinous ganlion of the extensor tendon of the fingers of the hand. In surgical treatment, the most preffered method is enucleation of the ganglion while maintaining the integrity of the tendon. Depending on the condition of the tendon, a twisting reinforcing suture is applied or not applied. With a significant lesion of the tendon or its severe thinning, a section of the tendon is resected along with the ganglion and either autoplasty, or transposition of the tendon is performed.

Keywords: intratendinous ganglion, finger extensor, hand.
p. 250-254 of the original issue
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Address for correspondence:
4600, Kutaisi, Javakhishvili str., 83a, , Georgia.
Western Georgia Medical Center1
Head of the Department of Pelvic Fracture Surgery
E-mail: igoginava@evex.ge
MTN: +995568082035
Goginava Irakli B.
Information about the authors:
Goginava Irakli B., Post-Graduate Student, West Georgia Medical Center, Head of the Department of Pelvic Fractures Surgery, Kutaisi, Georgia.
https://orcid.org/0000-0003-3159-852X
Goloborod’ko Sergey A., PhD, Associate Professor, Kharkov National Medical University, Department of Surgery No.6, Kharkîv, Ukraine;
https://orcid.org/0000-0002-0153-8158
Contacts | ©Vitebsk State Medical University, 2007-2023