Klinicheskaia khirurgiia最新文献

{"title":"Reconstruction of post–burn facial deformities, using stretched flaps","authors":"O. Zhernov, G. P. Kozynets","doi":"10.26779/2522-1396.2021.9-10.52","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.9-10.52","url":null,"abstract":"Objective. Improvement of the surgical treatment results in patients with post-burn deformities of the face, using maximal restoration of cutaneous coverings of principal parts with optimal application of stretched tissues in adjacent places. \u0000Materials and methods. Into the investigation were included 37 patients, who were treated in 2009 - 2019 yrs,23 men and 14 women, ageing 10 - 62 yrs old (median age have constituted 25.7 yrs old). For facial defects plasty were applied the stretched frontal flap (5), lateral and lower facial flaps (4), submandibular and submandibularly-cervical (8), cervical (7) and cervical and cervico-brachial flaps (16). In 2 patients with bilateral affection the cervical and cervico-brachial flaps were applied on both sides. \u0000Results. All the flaps applied took the root primarily. During first postoperative 24 h in 4 patients venous congestion in cervical and cervical-brachial flaps was noted, which have disappeared after application of the antiaggregate preparations. Main criteria of estimation of the treatment far remote results were: the completeness of the cicatrices excision, the secondary deformity occurrence and restoration of the face main contours. Far emote results were studied in 17 patients and were estimated as good. In other patients the result is unknown. \u0000Conclusion. Depending on the cicatricial defect localization and presence of unaffected tissues in various anatomical zones of the face and neck, application of the stretched flaps is possible, what permits to obtain a sufficient quantity of viable plastic material with textural properties, which are close to defect. Using stretched flapsin various anatomical zones of face and neck good result was obtained in immediate and far remote periods of observation.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90249836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction of the valves insufficiency after performance of orthotopic transplantation of the heart","authors":"B. Todurov, G. Kovtun, O. Loskutov, D. O. Loskutov","doi":"10.26779/2522-1396.2021.7-8.90","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.7-8.90","url":null,"abstract":"Correction of the valves insufficiency after performance of orthotopic transplantation of the heart","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78382914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The improved principle of hernioabdominoplasty in treatment of the patients, suffering parahernial surplus of tissues","authors":"A. Kot","doi":"10.26779/2522-1396.2021.9-10.27","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.9-10.27","url":null,"abstract":"Objective. Estimation of clinical efficacy of combined dermo- and fibrolipectomies with hernioabdominoplasty in treatment of patients, suffering external hernias. \u0000Materials and methods.The work was conducted on the base of own results of examinations and operating of 56 patients. \u0000Results.Rational principle of surgical interventions in abdominal obesity and other parahernial surplus of abdominal wall was substantiated.There was established, that this surplus have predominantly supraaponeurotic localization and pathometric characteristics in accordance to the hernia dimensions, and the parts of lipid-containing and fibrous-cicatricial tissues in their content. \u0000Conclusion.Application of tactics of the preoperatively weighted simultaneous interventions reduces the local complications of hernioplasty and improves the quality of life and health in various cohorts of herniological patients.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74797242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of the gastric shunting operation","authors":"O. Tyvonchuk, R. Vynogradov, V. V. Moskalenko, S. V. Іvchenko","doi":"10.26779/2522-1396.2021.7-8.60","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.7-8.60","url":null,"abstract":"Evolution of the gastric shunting operation","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88593981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The left atrium plasty in surgical correction of combined mitral-aortal failure, complicated by the left-sided atriomegaly","authors":"V. Popov, A. A. Bolshak, Yu. V. Bakhovskya, N. V. Povoroznyk, V. Lazoryshynets","doi":"10.26779/2522-1396.2021.7-8.26","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.7-8.26","url":null,"abstract":"Objective. Studying of possibilities of the left atrium triangular plasty procedure in correction of combined mitral-aortal failure, complicated by the left-sided atriomegaly. \u0000Materials and methods. Into the analysis the results of surgical treatment in 360 patients, suffering combined mitral-aortal failure, combined with left-sided atriomegaly, who were operated in Amosov National Institute of Cardiovascular Surgery through period from 01.01.2006 to 01.01.2021 yr, were included. In the main group, consisting of 73 patients, original procedure of the left atrium triangular plasty was performed while correcting a combined mitral-aortal failure. In the control group, consisting of 287 patients, correction of combined mitral-aortal failure in presence of concomitant left-sided atriomegaly was performed only. \u0000Results. Of 73 operated patients of the main group 3 died (lethality have constituted 4.1%). Dynamics of echocardiographic indices in the main group of patients in accordance to stagesof treatment was following: definitely-systolic index of the left ventricle – (69.1 ± 12.1) ml/m2 preoperatively, (59.3 ± 8.5) ml/m2 postoperatively, (48.4 ± 9.5) ml/m2 in late period; the ejection fraction of the left ventricle – 0.51 ± 0.05 preoperatively, 0.54 ± 0.05 postoperatively, 0.56 ± 0.04 in late period. Diameter of the left atrium – (65.8 ± 4.1) mm preoperatively, (52.3 ± 2.1) mm postoperatively, (53.5 ± 2.2) mm in late period. Of 287 operated patients of control group 9 died (lethality have constituted 3.1%). Dynamics of echocardiographic indices in the main group patients on the treatment stages was following: definitely-systolic index of the left ventricle – (68.3 ± 11.3) ml/m2 preoperatively, (60.4 ± 9.3) ml/m2 postoperatively, (52.7 ± 7.2) ml/m2 in late period; the ejection fraction of the left ventricle – 0.52 ± 0.05 preoperatively, 0.53 ± 0.05 postoperatively, 0.5 ± 0.04 in late period. Diameter of the left atrium – (66.5 ± 3.7) mm preoperatively, (64.5 ±3.3) mm postoperatively, (73.5 ± 2.8) in late follow-up period. \u0000Conclusion. While performing operation for the left-sided atriomegaly the correction of triangular plasty of the left atrium constitutes a mini-invasive and effective procedure, leading to significant improvement in the left atrium morphometry and accompanied by low risk of lethality as well as thromboembolic complications.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87324432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic pattern of sentinel lymphatic nodes: modern paradigm of nuclear medicine in surgical practice","authors":"P. Korol, О. Y. Usenko, M. Kostylev, O. Shcherbina","doi":"10.26779/2522-1396.2021.9-10.86","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.9-10.86","url":null,"abstract":"Diagnostic pattern of sentinel lymphatic nodes: modern paradigm of nuclear medicine in surgical practice","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77879505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of impact of various application methods for the blood plasm, enriched by the thrombocytes, on healing of the burn and scalped wounds in experiment","authors":"G. V. Terehov, O. A. Hyndych, І. M. Savytska, M. Kostylev, E. V. Symulyk, M. V. Chukhraiev","doi":"10.26779/2522-1396.2021.9-10.67","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.9-10.67","url":null,"abstract":"Objective. Comparison, in conditions of experiment between impact of the blood plasm, enriched by thrombocytes, on the terms of the burn and scalped wounds healing and morphological characteristics of the cicatrices formatted in its injectional or noninjectional introduction, using the method of electrophoresis. \u0000Materials and methods. The investigations were conducted on 30 white rats, which were divided into three groups with 10 animals in every group, median body mass of the animals have constituted (275.5 ± 15.1) gr. After achievement of medicinal sleep (intraperitoneal introduction of 1.0 ml of 0.5% solution of sodium thiopental in combination with 0.2 ml of propofol 1% solution the scalped skin incisions with the 1.5 × 0.5 cm dimensions were performed to the animals. Besides that, one of the incisions was processed with diathermy up to the scab crust formation. Both wounds were left open, without sutures. To the control group animals after the wounding conduction no procedures were performed, the wounds have been healed in primary pattern. To the Group I animals during two consequent weeks the blood plasm, enriched by thrombocytes, was introduced, using intracutaneous injections twice a week in quantity of 10 ml, puncturing the injured zone around. To the investigation Group II animals the electrophoresis in accordance to own procedure through napkin, soaked in the blood plasm, enriched by thrombocytes, was performed with the same rate. The blood plasm, enriched by thrombocytes, was prepared from the whole venous blood of human Group A(0), using centrifugation for achievement of targeted quantity of thrombocytes 850 000 in 1 ml. Morphological features of cicatrices formatted and their width were studied, using the methods of light microscopy and morphometry on the 21th day of experiment. \u0000Results. Application of the blood plasm, enriched by thrombocytes, was accompanied by statistically significant reduction of the cicatrices width, which were formatted on the 21-th day in locations of the scalped wounds simulation (p < 0.05 and p < 0.01 accordingly, for injectional and electrophoretic methods of application in comparison with the control group) and the burn (p < 0.01 and p < 0.005, accordingly, for the injectional and electrophoretic methods of application in comparison to the control group) wound. At the same time the cicatrices width in electrophoretic application of the blood plasm, enriched by thrombocytes, was statistically significantly lesser (p < 0.05), than in its injectional introduction, not depending on the wound type. Besides that, the cicatrices connective tissue while application of the blood plasm, enriched by thrombocytes, in a moment of the animals evacuation from the experiment have looked like more mature and differed by enhanced organization of the collagen fascicles localization. \u0000Conclusion. The method of noninjectional introduction of the blood plasm, enriched by thrombocytes, which was proposed, owes certain advant","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77168238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic cholecystectomy in patients with COVID–19 and in a postcovid period","authors":"V. V. Mіshchenko, P. I. Pustovoit, R. Y. Vododiuk, V. Velichko","doi":"10.26779/2522-1396.2021.9-10.62","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.9-10.62","url":null,"abstract":"Objective. Determination of the role and place for laparoscopic cholecystectomy on background of COVID-19 and in postcovid period. \u0000Materials and methods. Laparoscopic cholecystectomy was performed in 54 patients, suffering cholelithiasis, complicated by an acute calculous cholecystitis, who suffered or have had COVID-19 previously. \u0000Results. Duration of the disease befor hospitalization into the stationary more than 24 h was noted in 45(83,3%) patients. Destructive form of the gallbladder inflammation have appeared a typical one. Antibodies IgM and IgG for SARS-Cov-2 (COVID-19) and positive PCR-test, diagnostic for the viral RNA residuals was noted in 100% of the patients. \u0000Conclusion. The cholelithiasis and an acute clculous cholecystitis course in the patients, suffering COVID-19 or those who have had this disease, is accompanied by certain clinical peculiarities. Diagnosis of cholelithiasis and an acute calculous cholecystitis in the patients having COVID-19 or in a postcovid period must be rapid and precise. Laparoscopic cholecystectomy must be considered a «gold standard» as the operation for cholelithiasis and an acute calculous cholecystitis in the patients, suffering COVID-19 or in a postcovid period.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79948354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary synovial mediastinal sarcomas","authors":"V. Zakharychev, P. Gordiichuk, M. Gordiichuk","doi":"10.26779/2522-1396.2021.9-10.95","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.9-10.95","url":null,"abstract":"Primary synovial mediastinal sarcomas","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78820009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morpho–functional monitoring of the esophagus status as the base for the dispenser observation in the patients with achalasia of cardia after surgical esophagocardiomyotomy","authors":"S. Myasoyedov, S. A. Andreieshchev","doi":"10.26779/2522-1396.2021.9-10.16","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.9-10.16","url":null,"abstract":"Objective. To improve the early diagnosis of complications, occurring after esophagocardiomyotomy in the patients, suffering achalasia of cardia, and their correction, using the early dispenser examination, which have included endoscopic and timed roentgenographic esophageal investigations. \u0000Materials and methods. From 1972 to 2008 yr in the Institute of Surgery and Transplantology named after O. O. Shalimov NAMS of Ukraine of 568 patients with achalasia of cardia of all four degrees, except the cases of advanced dolihomegaesophagus, 389 (68.5%) the dispenser observation with the monitoring endoscopy and timed roentgenography of the esophagus were conducted. The patients were distributed into two Groups: Group I - 188 (48.3%) patients, to whom during the first seven postoperative years the yearly recommended elective examination was conducted, and Group II – 201 (51.7%) patients, to whom during the same period of time the recommended examination was performed 2 or 3 times only. \u0000Results. In total, in only 16 (8.5%) patients of the Group I it was necessary to conduct the conservative correcting treatment course, which have consisted of pneumocardiodilatation, while in the Group II such a treatment became necessary in 25 (12.4%) patients, and in particular, 16 – twice and 9 – three times, so in Group II 59 (29.4%) such courses were performed. Thus, in Group II the need for conduction of the correcting treatment courses was more, than in the Group I, what was confirmed by the patients' quantity, who needed such a treatment (the tendency was established only), and by the quantity of the courses completed (with statistically significant difference). The benefit from application of the proposed program for dispenser observation was in constant multi-year prolongation of the operation treatment potential and in correcting organ-preserving procedures as well. \u0000Conclusion. The proposed procedure of morpho-functional esophagological monitoring in the program of early dispenser examination in the patients with achalasia of cardia after esophagocardiomyotomy performance is based on data of chromoendoscopy with biopsy and timed esophagography about obstructive, reflux and preneoplastic esophageal changes, and guarantees a timely diagnosis of operative complications and the disease recurrence.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73135687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}