Year 2020 Vol. 28 No 1

SCIENTIFIC PUBLICATIONS
GENERAL & SPECIAL SURGE

U.I. PETUKHOV, S.N. ERMASHKEVICH, M.G. SACHEK, M.V. KUNCEVICZ

INFLUENCE OF TESTOSTERONE DRUGS USE ON SURGICAL TREATMENT OF ACUTE INFECTIOUS PULMONARY DESTRUCTIONS

Vitebsk State Medical University, Vitebsk,
The Republic of Belarus

Objective. To evaluate the clinical effectiveness of testosterone drugs administration in the surgical treatment of male patients with acute infectious pulmonary destruction (AIPD).
Methods. The results of examination and treatment of 74 male patients with AIPD were studied. Using simple randomization 2 groups including 37 people were formed, which did not differ statistically significantly by age, duration of the disease, forms and complications of acute infectious pulmonary destructions, the level of initial total serum testosterone and the frequency of its deficiency. In each group, 35 patients were operated on. According to the frequency of simultaneous and staged operations, patients in the groups did not statistically significantly differ. In patients of group 1, the complex of therapeutic remedies in the postoperative period was supplemented by the introduction of testosterone preparations.
Results. The administration of testosterone preparations was accompanied by a decrease in the frequency of postoperative complications from 83% to 49% (p=0.025), and the total number of postoperative complications from 92 to 43 (p=0.011). Patients of group 1 were 21% less likely to develop pulmonary pleural fistula (p=0.055), pneumonia developed 2 times (p=0.1) less often, the frequency of purulent-resorptive wasting and cachexia decreased by 13% (p=0.11). The number of interventions for postoperative complications in group 1 were 7 in 35 (20%) cases, in group 2 12 in 35 (34%) (p=0.18). The overall mortality rate in group 1 was 11% (4 out of 37 patients died), in group 2 23% (9 out of 37 patients died), (p=0.22). Postoperative mortality was 11% (4 of 35) and 26% (9 of 35) in groups 1 and 2, respectively (with p=0.22).
Conclusions. The inclusion of testosterone drugs in the complex of the treatment program in patients operated on for acute infectious pulmonary destructions helps to reduce the number of cases of the complicated postoperative period from 83% to 49% (p=0.025) and the frequency of development of the postoperative complications by 2 times (p=0.011).

Keywords: acute infectious pulmonary destruction, lung abscess, lung gangrene, surgical treatment, postoperative complications, testosterone
p. 5-15 of the original issue
References
  1. Laptev AN. Etiologiia ostrykh gnoino-nekroticheskikh destruktsii legkikh i ostrykh empiem plevry. Med Panorama. 2009;(12):37-41 (In Russ.)
  2. Pande A, Nasir S, Rueda AM, Matejowsky R, Ramos J, Doshi S, Kulkarni P, Musher DM. The incidence of necrotizing changes in adults with pneumococcal pneumonia. Clin Infect Dis. 2012 Jan 1;54(1):10-16. doi: 10.1093/cid/cir749
  3. Iablonskii PK, Sokolovich EG, Galkin VB Torakalnaia khirurgiia 2018. Analiticheskii obzor. S-Peterburg, RF: SPb NIIF; 2019. 88 p. .(In Russ.)
  4. Bisenkov LN, Popov VI, Shalaev SA. Khirurgiia ostrykh infektsionnykh destruktsii legkikh. S-Peterburg, RF: DEAN; 2003. 400 p. (in Russ.)
  5. Shchegolev AV. Posleoperatsionnaia intensivnaia terapiia. V kn: Kotiv BN, Bisenkov LN, red. Khirurgicheskie infektsii grudi i zhivota. S-Peterburg, RF: SpetsLit; 2016. p. 136-49. (in Russ.)
  6. Luft VM, Shestopalov AE, Leiderman IN, Sviridov SV, Popova TS, Saltanov AI, Zviagin AA. Nutritivno-metabolicheskaia terapiia sepsisa. Osnovnye printsipy i tekhnologii. V kn: Gelfand BR (red), Savelev VS. Sepsis: klassifikatsiia, kliniko-diagnosticheskaia kontseptsiia i lechenie. Moscow, RF: OOO MIA; 2017. p. 170-96. (in Russ.)
  7. Shoykhet JN, Roshchev IP, Syzdykbaev MK, Zaremba SV, Ustinov VG. Treatment of a sharp abscess of a lung with sequestration. Grudnaia i Serdech-Sosud Khirurgiia. 2012;54(1):37-41. https://tcs-journal.com/catalog/detail.php?SECTION_ID=819&ID=17723 (In Russ.)
  8. Li H, Guo Y, Yang Z, Roy M, Guo Q. The efficacy and safety of oxandrolone treatment for patients with severe burns: A systematic review and meta-analysis. Burns. 2016 Jun;42(4):717-27. doi: 10.1016/j.burns.2015.08.023
  9. Meyer EJ, Wittert G. Endogenous testosterone and mortality risk. Asian J Androl. 2018 Mar-Apr;20(2):115-19. doi: 10.4103/aja.aja_70_17
  10. Murashko NV. Sovremennye podkhody k diagnostike i lecheniiu sindroma defitsita testosterona u muzhchin: ucheb-metod. posobie. Minsk, RB: BelMAPO; 2016. 20 p. (In Russ.)
  11. Kareva EN. Biokhimicheskaia farmakologiia preparatov steroidnykh gormonov. V kn: Sergeev PV, Shimanovskii NL, red. Biokhimicheskaia farmakologiia. Moscow, RF: MIA; 2010. p. 467-527
  12. Gonçalves RV, Novaes RD, Sarandy MM, Damasceno EM, da Matta SL, de Gouveia NM, Freitas MB, Espindola FS. 5α-Dihydrotestosterone enhances wound healing in diabetic rats. Life Sci. 2016 May 1;152:67-75. doi: 10.1016/j.lfs.2016.03.019
  13. Danilov AB, Iliasov RR. Polovye gormony v lechenii boli. Terapiia. 2017;(7):61-66. https://therapy-journal.ru/ru/archive/article/35696 (In Russ.)
  14. Kosyreva AM, Makarova OV. The influence of surgical castration on the systemic inflammatory response induced by the administration of lipopolysaccharide to adult wistar rats. Molekuliar Meditsina. 2018;16(5):22-29. doi: 10.29296/24999490-2018-05-04 (In Russ.)
  15. Vertkin AL, Shakhmunaev AA. Optimization of the treatment of chronic obstructive pulmonory disease in men the androgen deficiency. Effekt Farmakoterapiia. 2014;(32):16-21. https://cyberleninka.ru/article/n/optmizatsiya-lecheniya-hronicheskoy-obstruktivnoy-bolezni-legkih-u-muzhchin-s-androgennym-defitsitom (In Russ.)
  16. Giltay EJ, Tishova YA, Mskhalaya GJ, Gooren LJ, Saad F, Kalinchenko SY. Effects of testosterone supplementation on depressive symptoms and sexual dysfunction in hypogonadal men with the metabolic syndrome. J Sex Med. 2010 Jul;7(7):2572-82. doi: 10.1111/j.1743-6109.2010.01859.x
  17. Iyer A, Yadav S. Postoperative care and complications after thoracic surgery. in: firstenberg ms. principles and practice of cardiothoracic surgery. InTech; 2013. p. 57-84.
Address for correspondence:
210009, Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Hospital Surgery with Courses in Urology and Pediatric Surgery.
Tel. mob. +375 29 7191491,
e-mail: kuncevicz@mail.ru,
Maksim U. Kuncevicz
Information about the authors:
Petukhov Uladzimir I., MD, Associate Professor, Head of the Surgery Department of the Faculty of the Advanced Training and Retraining of Specialists, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-4042-3978
Ermashkevich Sergey N., PhD, Associate Professor of the Department of Hospital Surgery with Courses in Urology and Pediatric Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-0866-9070
Sachek Mikhail G., MD, Professor, Head of the Department of Hospital Surgery with Courses in Urology and Pediatric Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-9233-7249
Kuncevicz Maksim U., Post-Graduate Student of the Department of Hospital Surgery with Courses in Urology and Pediatric Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-8122-6655
Contacts | ©Vitebsk State Medical University, 2007-2023