KhirurgiyaPub Date : 2025-01-01DOI: 10.17116/hirurgia202501122
I V Vervekin, A A Trushin, R V Kursenko, L I Gainullina, A A Zakharenko
{"title":"[Immediate results of laparoscopic spleen-preserving distal pancreatectomy: Kimura vs Warshaw procedure].","authors":"I V Vervekin, A A Trushin, R V Kursenko, L I Gainullina, A A Zakharenko","doi":"10.17116/hirurgia202501122","DOIUrl":"https://doi.org/10.17116/hirurgia202501122","url":null,"abstract":"<p><strong>Objective: </strong>To study the immediate results of spleen-preserving distal pancreatectomy and to compare the outcomes after Kimura and Warshaw procedures.</p><p><strong>Material and methods: </strong>A retrospective non-randomized study included 27 patients with benign tumors of pancreatic tail and body who underwent spleen preserving distal pancreatectomy between 2020 and 2024. All patients were divided into 2 groups: 1 - Kimura procedure (<i>n</i>=16), 2 - Warshaw procedure (<i>n</i>=16). We excluded patients who underwent enucleations, central resections, and other interventions instead of distal pancreatectomy.</p><p><strong>Results: </strong>Mean surgery time was 269.06±70.95 (95% CI 227.74 - 319. 95) and 197.27±42.09 min (95% CI 184.36 - 240.64), respectively (<i>p</i>=0.006). Blood loss, length of hospital day, incidence of laparotomy, splenectomy, splenic infarction, and redo surgeries were similar. Clinically significant postoperative fistula B-C was more common in 1<sup>st</sup> group (10 (62.4%) vs. 5 (45.5%) cases, <i>p</i>=0.028). There were no significant between-group differences in the incidence of postoperative complications Clavien-Dindo grade >III and mortality.</p><p><strong>Conclusion: </strong>Laparoscopic spleen preserving distal pancreatectomy is the «gold» standard for benign tumors of pancreatic body and tail. The Warshaw and Kimura techniques are safe and effective surgical approaches with similar results. The Warshaw procedure may be more advantageous regarding less surgical resources without deterioration of immediate postoperative results.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"22-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123067","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}
KhirurgiyaPub Date : 2025-01-01DOI: 10.17116/hirurgia202501168
D A Kharagezov, E A Mirzoyan, O N Stateshny, A A Antonyan, I A Leyman, K D Iozefi
{"title":"[Resection of sternum body with anterior segments of ribs II-III and bone replacement with individual titanium implant].","authors":"D A Kharagezov, E A Mirzoyan, O N Stateshny, A A Antonyan, I A Leyman, K D Iozefi","doi":"10.17116/hirurgia202501168","DOIUrl":"https://doi.org/10.17116/hirurgia202501168","url":null,"abstract":"<p><p>Metastatic breast cancer is the most common malignancy and urgent problem due to high mortality. This fact emphasizes the need for development of innovative surgical approaches. Innovative approaches, including 3D modeling, provide unique opportunities for accurate reconstruction of the sternum. This method promises significant progress in individualized treatment with higher effectiveness and survival. We present resection of sternum body with anterior segments of ribs II-III and bone replacement with individual titanium implant in a patient with metastatic breast cancer.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"68-73"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123675","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}
KhirurgiyaPub Date : 2025-01-01DOI: 10.17116/hirurgia2025021119
S Yu Boldyrev, P K Tyutyunikov, S B Abidzakh, V A Sapunov, S A Raff, V Yu Ivashchuk, I V Tolstykh, K O Barbukhatti
{"title":"[Ascending aorta and aortic arch replacement without circulatory arrest].","authors":"S Yu Boldyrev, P K Tyutyunikov, S B Abidzakh, V A Sapunov, S A Raff, V Yu Ivashchuk, I V Tolstykh, K O Barbukhatti","doi":"10.17116/hirurgia2025021119","DOIUrl":"10.17116/hirurgia2025021119","url":null,"abstract":"<p><p>Circulatory arrest is the main method used in surgical interventions for prosthetics of the proximal aorta. However, recently, facts have been discovered that prove the benefits of avoiding circulatory arrest during planned and emergency surgical interventions. We present a clinical case of planned prosthetics of the ascending section and the aortic arch with a Intergard Woven 28 mm multibranch prosthesis without circulatory arrest in conditions of mild hypothermia. The patient was extubated 5 hours after the operation, and was discharged home in satisfactory condition on the 7th day. The rejection of circulatory arrest made it possible to reduce the duration of surgery, the duration of hospitalization and complications associated with hypoperfusion of organs and tissues that occur during cooling of patients.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366028","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}
KhirurgiyaPub Date : 2025-01-01DOI: 10.17116/hirurgia202502127
A N Polyakov, A V Korshak, A G Kotelnikov, I V Sagaidak, N E Kudashkin, M V Batalova, A Sh Umirzokov, D V Podluzhny
{"title":"[Preliminary results of fluorescent lymphography in patients with biliary cancer undergoing liver resection].","authors":"A N Polyakov, A V Korshak, A G Kotelnikov, I V Sagaidak, N E Kudashkin, M V Batalova, A Sh Umirzokov, D V Podluzhny","doi":"10.17116/hirurgia202502127","DOIUrl":"10.17116/hirurgia202502127","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic capability of intraoperative fluorescence lymphography (FLG) in detecting of sentinel lymph nodes (SLN) and lymph outflow pathways in patients with biliary cancer (BC).</p><p><strong>Material and methods: </strong>From April 2023 till March 2024, ten liver resections for BC were performed using FLG. We carried out the standard lymph node dissection with additional removal of lymph nodes (LN) that have accumulated indocyanine green (ICG). The lymphatic outflow pathways in all patients and frequency of SLN invasion were evaluated.</p><p><strong>Results: </strong>Ten patients were included: five patients had been diagnosed with intrahepatic cholangiocarcinoma (IHCC), two - with perichilar tumor (PT), the last three ones had gallbladder cancer (GBC). SLN No. 1 were detected in eight patients, the accumulation of ICG was detected in the following groups of LN: No. 8 (<i>n</i>=2), No. 13 (<i>n</i>=1), No. 12b (<i>n</i>=2), cystic lymph node (<i>n</i>=2), and No. 7 (<i>n</i>=1). SLN No. 2 was detected in seven patients. In three cases LN No. 13 were stained, in one - LN No. 12a, in another - LN No. 8. In two patients, staining of vesicular LN was noted. The combined morphological assessment of SLN No. 1 and SLN No. 2 made it possible to predict the presence of LN metastases in all patients (100%, <i>n</i>=3). Fluorescence of third-order LN was detected in four patients. In one case, the staining of LN No. 13 was noted. Another patient revealed accumulation of ICG in LN No. 3. In two cases, at the third stage, fluorescence of LN No. 7 was noted, while metastatic invasion of LN No. 7 was detected in one patient with IHCC.</p><p><strong>Conclusion: </strong>Using FLG, it was possible to determine an alternative lymph flow outpath to LN No. 7 in three patients. The method allowed to identify and remove metastatic LN No. 7 in one case. 100% sensitivity was shown in the determination of SLN in BC in a small group of patients. It is advisable to study the sensitivity of the method in large-scale studies.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"27-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366153","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}
KhirurgiyaPub Date : 2025-01-01DOI: 10.17116/hirurgia2025021123
A V Lysenko, G I Salagaev, Yu S Gilevskaya, A I Malmina, Yu V Belov
{"title":"[Redo surgical treatment of a patient with hypertrophic cardiomyopathy and recurrent left ventricular outflow tract obstruction].","authors":"A V Lysenko, G I Salagaev, Yu S Gilevskaya, A I Malmina, Yu V Belov","doi":"10.17116/hirurgia2025021123","DOIUrl":"10.17116/hirurgia2025021123","url":null,"abstract":"<p><p>Septal myectomy is the gold standard for patients with obstructive hypertrophic cardiomyopathy. Nevertheless, some patients develop postoperative recurrence of left ventricular outflow tract obstruction and clinical symptoms of heart failure. Such ones require redo surgery if optimal medical therapy is ineffective.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"123-127"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366157","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}
KhirurgiyaPub Date : 2025-01-01DOI: 10.17116/hirurgia202501129
Yu I Vedenin, M I Turovets, V V Mandrikov, G V Mikhailichenko
{"title":"[Personalized prediction of acute pancreatitis after endoscopic transpapillary interventions].","authors":"Yu I Vedenin, M I Turovets, V V Mandrikov, G V Mikhailichenko","doi":"10.17116/hirurgia202501129","DOIUrl":"https://doi.org/10.17116/hirurgia202501129","url":null,"abstract":"<p><strong>Objective: </strong>To develop the personalized model for predicting the risk of acute pancreatitis after endoscopic transpapillary interventions.</p><p><strong>Material and methods: </strong>A retrospective analysis of treatment outcomes included 366 patients with benign and malignant pancreaticobiliary diseases who underwent endoscopic transpapillary interventions. Risk factors associated with patients, underlying diseases and interventions were analyzed. Logistic regression analysis was used to present the personalized model for predicting the risk of acute pancreatitis.</p><p><strong>Results: </strong>Female gender (<i>p</i>=0.028), age <40 years (<i>p</i>=0.001-0.018), calculous cholecystitis (<i>p</i>=0.010) and stenosis of the major duodenal papilla (<i>p</i>=0.008) are patient-associated risk factors of acute postoperative pancreatitis. Stenting of the main pancreatic duct and thoracic epidural analgesia reduced this risk by 6.5 and 4.6 times, respectively. We developed significant (<i>p</i><0.001) regression model to determine the likelihood of acute post-manipulation pancreatitis.</p><p><strong>Conclusion: </strong>Original prediction model is valuable to determine the risk of acute pancreatitis after endoscopic transpapillary interventions. This model justifies various methods to prevent this complication.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"29-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123607","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}
KhirurgiyaPub Date : 2025-01-01DOI: 10.17116/hirurgia202501154
L P Kotelnikova, S A Plaksin
{"title":"[Surgical access for thoracic and intrathoracic goiter].","authors":"L P Kotelnikova, S A Plaksin","doi":"10.17116/hirurgia202501154","DOIUrl":"https://doi.org/10.17116/hirurgia202501154","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of surgical approach for resection of retrosternal and intrathoracic goiter.</p><p><strong>Material and methods: </strong>There were 33 patients who underwent surgery for retrosternal (31) and intrathoracic goiter (2) through various surgical approaches. For retrosternal goiter, a Farabeuf hook was used to remove a large retrosternal component of tumor.</p><p><strong>Results: </strong>In 28 cases (84.8%), substernal goiter was resected through cervical collar incision. In 4 cases, a Farabeuf hook was used to extract retrosternal part of the goiter to the neck and avoid sternotomy. In one case, a combined approach was used (thoracoscopy and cervical collar incision). Sternotomy was performed in only one patient for suspected thyroid malignancy. In two patients with tumors of posterior mediastinum, intrathoracic goiter was removed through thoracoscopic access.</p><p><strong>Conclusion: </strong>Cervical collar incision allows resection of retrosternal goiter in 84.4% of cases. Retrosternal part can be effectively displaced to the neck wound using a Farabeuf hook. Thoracoscopy is preferable for removal of intrathoracic goiter and can be used to mobilize a large node in mediastinum as an alternative to sternotomy.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"54-61"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123679","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}
KhirurgiyaPub Date : 2025-01-01DOI: 10.17116/hirurgia202502177
A P Vlasov, V A Trofimov, T I Vlasova, N A Myshkina, T A Muratova, N Y Leshchankina, K M Dukhovnova
{"title":"[Pulmonary distress syndrome in urgent surgery: A concept, pathogenesis, and fundamentals of treatment].","authors":"A P Vlasov, V A Trofimov, T I Vlasova, N A Myshkina, T A Muratova, N Y Leshchankina, K M Dukhovnova","doi":"10.17116/hirurgia202502177","DOIUrl":"10.17116/hirurgia202502177","url":null,"abstract":"<p><strong>Objective: </strong>To study several non-respiratory lung functions in conjunction with the respiratory component in acute abdominal diseases with different natures of the inflammatory process; to identify the key mechanisms of organ damage; and, based on the data, establish a new syndrome in urgent surgery-pulmonary distress syndrome-and evaluate the effectiveness of Remaxol in its treatment.</p><p><strong>Material and methods: </strong>Chronic experiments have been done on dogs. Under anesthesia, progressive acute peritonitis was simulated in the first group (24) (the first subgroup (12) received infusion therapy, the second subgroup (12) received Remaxol (20 mL/kg)), in the second group (8) acute destructive pancreatitis, in the third group (8) acute obstructive ileus. The treatment outcomes of 78 patients with acute surgical pathology of the abdomen were analyzed: 38 patients with acute peritonitis caused by destructive appendicitis, hollow viscus perforation (the first subgroup (16) received standard of care, in the second (22) Remaxol was added to the standard of care); 18 with acute severe pancreatitis complicated by enzymatic peritonitis, 22 with acute intestinal obstruction. Surgeries were performed on all the patients. The extension and type of the surgeries depended on the condition. In the early postoperative period (up to 5 days), several indicators of respiratory lung function were evaluated in the experiment and patients, and non-respiratory function was assessed using several indicators of arterial and venous blood. In the experiment, the state of lipid metabolism and the hemostasis system was assessed in lung tissues.</p><p><strong>Results: </strong>It was established that in acute abdominal diseases, lung damage occurs regardless of the nature of the inflammatory process. It manifested not only with changes in the homeostasis indicators due to modifications of the respiratory component but also non-respiratory functions of the organ. It was shown that the signs of the non-respiratory dysfunction of the lungs, as indicated by the parameters of blood inflowing to the lungs and outflowing from the lungs, included a deterioration in their detoxification and lipid-modifying ability and changes in the blood coagulation system. The key and unifying feature of respiratory and non-respiratory lung damage in various types of inflammatory processes are disorders of the lipid metabolism of lung cells. In the pathogenesis of membrane destabilization, the peroxidation of membrane lipids and the high activity of phospholipases play a decisive role. In the pathological process, a certain role is assigned to the tissue (pulmonary) coagulation-lytic system. The inclusion of Remaxol in the treatment of acute peritonitis increased lung tolerance to trigger pathogenetic agents, as indicated by improved laboratory and clinical parameters.</p><p><strong>Conclusion: </strong>Experimental and clinical evidence was obtained for establishing th","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"77-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366155","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}
KhirurgiyaPub Date : 2025-01-01DOI: 10.17116/hirurgia202502186
A M Zainutdinov, I S Malkov, A V Berdnikov
{"title":"[The use of low-frequency ultrasound in the treatment of patients with infected pancreatic necrosis].","authors":"A M Zainutdinov, I S Malkov, A V Berdnikov","doi":"10.17116/hirurgia202502186","DOIUrl":"10.17116/hirurgia202502186","url":null,"abstract":"<p><strong>Objective: </strong>To improve the treatment of patients with infected pancreatic necrosis by using non-contact ultrasound treatment of purulent-necrotic foci (NUST).</p><p><strong>Material and methods: </strong>We analyzed the results of treatment of 39 patients with infected pancreatic necrosis, admitted to the surgical department No. 2 of the City Clinical Hospital No. 7 in Kazan from 2017 to 2021. The central method of their surgical treatment was open draining operations combined with sequestrectomy. The study group consisted of 20 patients (4 women, 16 men) aged from 39 to 60 years (mean age - 49±9.5 years). In this group, the effectiveness of non-contact ultrasound treatment of purulent-necrotic foci using the SONOCA-185 apparatus was studied.</p><p><strong>Results: </strong>The application of ultrasound treatment of purulent foci of infected pancreatic necrosis in the study group allowed to increase their drainage effectiveness, which was reflected in the dynamics of reparative-proliferative process and relief of systemic inflammatory reaction. Wound healing occurred on the 7-9 day (on average, on the 7.6±2<sup>th</sup> day) without resuturing.</p><p><p>The pronounced bactericidal effect of low-frequency ultrasound and its phonophoretic effect are confirmed by the reduction of microbial content of wounds and cavities from 105 CFU and 104 CFU to 102 CFU after 3 sessions.</p><p><p>The sparing ultrasound sequestrectomy allows to remove only devitalized tissues, without causing destructions of the ductal system, vascular wall and hollow organs.</p><p><p>Ultrasound treatment of cavities in the study group resulted in a pronounced increase in transparency indicators and its approximation to reference solution, decreased peripheral blood leukocytosis, temperature reaction in patients on the 3<sup>rd</sup>, 7<sup>th</sup>, 12<sup>th</sup> days compared to the control group, where the temperature response is maintained at this time, and reduction in hospitalization duration on the 2.6±1 day in the study group of patients.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"86-93"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366163","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}
KhirurgiyaPub Date : 2025-01-01DOI: 10.17116/hirurgia202501162
Yu G Starkov, A I Vagapov, R D Zamolodchikov, S V Dzhantukhanova, P Sh Arabova
{"title":"[Laparoendoscopic hybrid treatment of a patient with choledocholithiasis, cholecystitis and large duodenal diverticula].","authors":"Yu G Starkov, A I Vagapov, R D Zamolodchikov, S V Dzhantukhanova, P Sh Arabova","doi":"10.17116/hirurgia202501162","DOIUrl":"https://doi.org/10.17116/hirurgia202501162","url":null,"abstract":"<p><p>We present laparoendoscopic hybrid treatment of a patient with choledocholithiasis, cholecystitis and large duodenal diverticula. A 69-year-old patient underwent one-stage hybrid laparoendoscopic intervention. Despite the difficult situation caused by large duodenal diverticula and calculus in terminal part of common bile duct, hybrid technique with rendez-vous procedure allowed successful lithoextraction and cholecystectomy. The follow-up examination found no residual biliary calculi. Hybrid laparoendoscopic intervention in the treatment of a patient with choledocholithiasis, cholecystitis and large duodenal diverticula provided optimal clinical effect, reduced the risk of postoperative complications and shortened in-hospital treatment.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"62-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123587","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}