Khirurgiya最新文献

{"title":"[Temporary endoscopic occlusion of tracheoesophageal fistula prior to radical surgery].","authors":"V D Parshin, M S Simonova, A V Parshin, M A Ursov, V V Parshin, D D Serpukhin","doi":"10.17116/hirurgia202601198","DOIUrl":"10.17116/hirurgia202601198","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of <i>Amplatzer Septal Occluder</i> as a palliative approach for temporary TEF occlusion before radical surgery.</p><p><strong>Material and methods: </strong>The authors present a patient with multifocal post-tracheostomy TEF after mechanical ventilation for COVID-19. Two <i>Amplatzer Septal Occluders</i> were implanted under endoscopic guidance for temporary occlusion. Effectiveness, recurrence rate, and feasibility of radical surgery were evaluated.</p><p><strong>Results: </strong>TEF occlusion successfully eliminated aspiration and enabled radical repair after four months with minimal postoperative complications. However, device dislocation and fistula enlargement were identified as limitations.</p><p><strong>Conclusion: </strong>This method appears promising but requires further research to assess complication risks and optimize implantation techniques.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"98-104"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053750","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":"[Metabolic correction of systemic oxidative-toxic lesions in urgent abdominal surgery].","authors":"T A Muratova, A P Vlasov, O V Markin, A A Alagulov, N A Myshkina, K M Dukhovnova, O I Mesikov, I V Kamalikhin","doi":"10.17116/hirurgia202603163","DOIUrl":"https://doi.org/10.17116/hirurgia202603163","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effectiveness of domestic succinate-containing drugs in correction of homeostasis disorders and early postoperative period after open surgery for acute urgent abdominal diseases.</p><p><strong>Material and methods: </strong>We examined 162 patients: the first group - 43 (26.5%) patients with acute appendicitis, acute intestinal obstruction complicated by acute peritonitis who underwent laparoscopic procedures, the second group - 38 (23.5%) patients with similar diseases who underwent open surgery, the third group - 81 (59.0%) patients with similar diseases who underwent open surgical procedures followed by complex therapy in early postoperative period: Remaxol (46) or Reamberin (35) for the first two days (800.0 ml each) and 400.0 ml for three days intravenously.</p><p><strong>Results: </strong>Complex early postoperative therapy in patients with acute surgical abdominal diseases, including drugs with antioxidant, antihypoxant, phospholipase-inhibiting effects (Reambirin, Remaxol), significantly improved postoperative clinical and laboratory data (lower incidence of complications by 18.4-27.8%, <i>p</i><0.05; shorter hospital-stay by 2.34-3.17 days, <i>p</i><0.05). This therapy affects the main pathogenetic components of urgent abdominal pathologies, course of early postoperative period and complications. Thus, we observe significantly lower endogenous intoxication, intensity of lipid peroxidation and phospholipase activity, as well as structural restoration of the main membrane-forming lipids.</p><p><strong>Conclusion: </strong>Effectiveness of complex therapy, including Reambirin and Remaxol, is based on its ability to affect key pathogenetic oxidative-toxic components that directly affects early postoperative period and incidence of complications. Positive effects appear early after surgery. The undoubted result of studies in urgent abdominal pathology is establishment of possible approximating the results of open traumatic surgical interventions to laparoscopic ones.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"63-70"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515447","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":"[By the 150th anniversary of famous quote by Austrian surgeon G. Wegner about peritonitis: \"I and my generation were raised in fear of God and peritonitis\". Evolution of study and treatment of peritonitis].","authors":"A P Vlasov, E K Salakhov, K K Salakhov, T I Muratova","doi":"10.17116/hirurgia2026031136","DOIUrl":"https://doi.org/10.17116/hirurgia2026031136","url":null,"abstract":"<p><p>The authors analyzed evolution of therapeutic approaches for acute peritonitis with accent on abdominal drainage. A systematic review enrolled the PubMed, Scopus, Web of Science, eLibrary and Cochrane Library databases for the period 1980-2024. Methods of abdominal sanitation in acute peritonitis underwent through a long way of evolution from simple passive drainage to complex programmed interventions. Historically, various approaches have been used (from closed systems to open abdominal management with laparostomy). The middle of the 20^th century was marked by revolution of programmed relaparotomies, which made it possible to carry out scheduled revisions regardless of clinical status. Modern techniques include vacuum-assisted therapy, peritoneal lavage dialysis with antibacterial drugs, minimally invasive laparoscopic sanitation. Clinical studies demonstrate the advantages of a programmed approach over \"on-demand\" relaparotomies. Active drainage with cyclic washing provides not only mechanical cleansing, but also systemic detoxification. Choice of optimal tactics should be based on severity of peritonitis, clinical status of patients and capabilities of a particular hospital. Evolution of treatment for peritonitis is a bright example of triumph (victory) of scientific medicine over seemingly invincible disease. Words of G. Wegner are now perceived as evidence of the past era. Modern surgeons with appropriate knowledge, technologies and effective medicines successfully manage disease that inspired sacred fear a century and a half ago. However, peritonitis is still a serious challenge requiring high professionalism and multidisciplinary approach.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"136-143"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515458","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":"[Heart rate variability as a predictor of severity of acute appendicitis: a prospective analytical study].","authors":"F Diaz-Leon, J Caballero-Alvarado, C Zavaleta-Corvera, V Lau-Torres, K Lozano-Peralta","doi":"10.17116/hirurgia202603157","DOIUrl":"10.17116/hirurgia202603157","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether heart rate variability (HRV) is a predictive of severity of acute appendicitis.</p><p><strong>Material and methods: </strong>A cross-sectional and prospective study was conducted in 144 patients who underwent appendectomy. The sample included 111 patients with complicated appendicitis and 33 ones with uncomplicated appendicitis. Clinical data, HRV parameters and their predictive capacity for complicated appendicitis were evaluated. HRV was measured as the difference between minimum and maximum heart rate over three minutes before anesthetic induction. The student's <i>t</i>-test and the ROC curve were used for statistical analysis.</p><p><strong>Results: </strong>Patients with complicated appendicitis had longer duration of illness (2.05±0.71 vs. 1.15±0.36 days, <i>p</i>=0.001) and higher leukocyte count (15.696.63±4.530.74 vs. 13.465.52±3.375.71, <i>p</i>=0.010). HRV was significantly lower in complicated cases (10.24±4.72 vs. 14.58±4.78, <i>p</i>=0.001). The area under the ROC curve was 0.750 (95% CI: 0.665-0.834) that indicated moderate predictive capacity of HRV for complicated appendicitis.</p><p><strong>Conclusion: </strong>Heart rate variability was associated with severity of acute appendicitis, and HRV was lower in complicated cases. ROC curve suggests that HRV may be moderate predictor for identifying complicated appendicitis.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515411","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":"[Methods for colon perfusion assessment].","authors":"T S Lankov, A N Lavrenteva, A M Karachun, V A Kashchenko, M Ya Belikova","doi":"10.17116/hirurgia2026041102","DOIUrl":"https://doi.org/10.17116/hirurgia2026041102","url":null,"abstract":"<p><p>Colorectal cancer is a malignant tumor arising from mucosa of large intestine (colon, rectosigmoid part and rectum). Currently, surgery is the primary treatment for colorectal cancer regarding oncological perspective. However, it is associated with high risk of postoperative complications, and one of these is anastomotic leakage (AL). According to various data, the incidence of AL can reach 35%. One of the main factors for AL is impairment of perfusion in anastomotic area. We hypothesize that preserving the left colic artery in rectosigmoid and rectal surgeries, as well as the first sigmoid artery in rectal surgeries will reduce the incidence of AL. Modern technologies, including CT perfusion, indocyanine green dye, photoplethysmography, perfusion flowmetry, and MASP (marginal artery stump pressure) allow us to assess perfusion preoperatively and intraoperatively. This review analyzes the main causes of AL from physiological and metabolic-biochemical perspective. It presents statistical data reflecting the relevance of intestinal perfusion assessment and proposes hypotheses that could significantly reduce the incidence of anastomotic leakage. Study objective was to select the optimal method for assessing intestinal perfusion. We analyzed the articles published in PubMed and Sci-Hub databases.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 4","pages":"102-109"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783559","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":"[Experimental substantiation of new meniscus root suture].","authors":"G P Kotelnikov, K E Gaziev, Yu D Kim, K V Egorova","doi":"10.17116/hirurgia202604148","DOIUrl":"https://doi.org/10.17116/hirurgia202604148","url":null,"abstract":"<p><strong>Objective: </strong>To confirm the effectiveness of new meniscus root suture in experiment.</p><p><strong>Material and methods: </strong>Experimental work was carried out on 40 biological mannequins with damaged meniscus root in two stages. At the 1^st stage, we measured 20 menisci after previous classical suturing and analyze the force for their rupture. At the 2^nd stage, we measured 20 menisci after previous new suturing (RU Patent No. 2809799).</p><p><strong>Results: </strong>At the 1^st stage, mean force for meniscus root suture rupture was 14.6 kg, at the 2^nd stage was 21.33 kg.</p><p><strong>Conclusion: </strong>A new method of surgical treatment for meniscus root damage increases strength and consistency of suture by 146.6%.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 4","pages":"48-53"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783605","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":"[Impaired reparative regeneration in patients with acute appendicitis].","authors":"A P Vlasov, E P Brodovskaya, K S Madonov, A P Abelova, A P Bezborodova, S A Pleshkov, T I Vlasova","doi":"10.17116/hirurgia202602173","DOIUrl":"10.17116/hirurgia202602173","url":null,"abstract":"<p><strong>Objective: </strong>To study reparative potential (cellular effects and biological characteristics) of platelet-rich plasma (PRP) in patients with acute appendicitis (AA).</p><p><strong>Material and methods: </strong>PRP was obtained by two-stage centrifugation of blood from patients with AA and healthy donors divided into age groups: group 1 (<i>n</i>=10) - healthy donors aged 30-40 years, group 2 (<i>n</i>=10) - healthy donors aged 60-70 years, group 3 (<i>n</i>=10) - patients with AA aged 30-40 years, group 4 (<i>n</i>=10) - patients with AA aged 60-70 years. The study was performed using hTERT-HDFa (d220) cell line of human dermal fibroblasts (HDF). Activated 10% PRP from donors was added to experimental wells. Samples without PRP were negative control (0 (K)), PRP samples with addition of 10% FBS - positive control. Metabolic activity of cells, viability of samples, ability to generate reactive oxygen species (ROS), migration activity and intensity of cellular aging were assessed. Biological characteristics of PRP were defined by ELISA of IL6, IL10, TGFB1, PAI-1, PDGF, VEGF proteins.</p><p><strong>Results: </strong>PRP from elderly patients with AA was characterized by elevated IL6 and IL10 relative to young patients with this pathology and increased TGF<i>β</i> relative to healthy peers. On the first day after HDF stimulation with plasma, the lowest viability was found in samples stimulated with PRP from health elderly donors. There were no significant differences among patients with AA regardless of age. After 3 days, we observed high proliferative and metabolic activity of cells after stimulation with plasma from AA patients regardless of age. Antioxidant reserve of PRP in elderly patients with AA was significantly lower than in young patients with AA. Correlation analysis revealed significant relationships between biological profile of PRP, cellular responses and clinical data of patients with AA of different ages.</p><p><strong>Conclusion: </strong>When comparing cellular responses with clinical data of patients, we found that significant prognostic markers of PRP in AA were IL6, IL10 and TGF<i>β</i>. Their levels correlated with postoperative hospital-stay. Moreover, high IL6 and IL10 was associated with prolonged hospital-stay in elderly patients.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"73-84"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228902","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":"[Surgery for recurrent benign tracheoesophageal fistula].","authors":"V D Parshin, M A Rusakov, M A Gasanov, A V Parshin, M A Ursov, D D Serpukhin, V V Parshin","doi":"10.17116/hirurgia202602136","DOIUrl":"https://doi.org/10.17116/hirurgia202602136","url":null,"abstract":"<p><strong>Objective: </strong>To optimize diagnosis and treatment methods for recurrent TEF based on analysis of extensive clinical experience; to propose preventive strategies reducing postoperative complications.</p><p><strong>Material and methods: </strong>Treatment outcomes were analyzed in 115 patients with TEF between 2004 and 2023. Of these, 40 (34.8%) ones underwent redo surgeries after previous failed fistula closure. There were 69 surgical interventions including third-time surgeries in 7 patients with repeated recurrences. TEF associated with tracheal cicatricial stenosis (TCS) in 29 (48.3%) cases necessitated concomitant surgical approaches. Treatment method was determined by characteristics of previous interventions and clinical situation.</p><p><strong>Results: </strong>No mortality was recorded. The most common postoperative complications were purulent-inflammatory processes. Key risk factors for recurrence were TEF associated with TCS and persistent tracheostomy after tracheoplasty with T-tube. Redo surgical interventions, 3-fold attempts of fistula closure, led to complete recovery in some cases.</p><p><strong>Conclusion: </strong>The study confirms feasibility of radical treatment for recurrent TEF, even in case of significant anatomical and functional alterations. Original strategies for prevention of recurrence and refined surgical indications enhance treatment efficacy. These data can be used to improve clinical guidelines aimed at reducing recurrence rates and achieving better long-term outcomes.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"36-42"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228908","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":"[Endoscopic diagnostic and treatment methods for abdominal trauma].","authors":"A K Botirov, J A Botirov, A Z Otaquziev, U D Usmonov, S Sh Egamov, Sh A Ziyayev, S M Yahyoev, Z B Solijonov","doi":"10.17116/hirurgia202602151","DOIUrl":"https://doi.org/10.17116/hirurgia202602151","url":null,"abstract":"<p><strong>Objective: </strong>To improve surgical treatment of abdominal trauma using endoscopic surgical methods.</p><p><strong>Material and methods: </strong>The study enrolled 87 patients with abdominal organ injuries. All patients were divided into two groups depending on surgical approach: group 1 - traditional surgical treatment, group 2 - advanced strategy based on endoscopic surgical methods.</p><p><strong>Conclusion: </strong>Endoscopic technologies for abdominal trauma reduce the incidence of open diagnostic surgeries, postoperative morbidity and length of hospital-stay.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"51-54"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228748","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":"[Effectiveness of autologous cells of stromal-vascular fraction of adipose tissue depending on transplantation method for skin grafting in patients with extensive deep burns].","authors":"A A Alekseev, K A Filimonov, T A Astrelina, I V Kobzeva, A E Bobrovnikov, S S Khromina, I A Chekmareva, V S Demidova","doi":"10.17116/hirurgia202602163","DOIUrl":"https://doi.org/10.17116/hirurgia202602163","url":null,"abstract":"<p><strong>Objective: </strong>To analyze different methods for autologous transplantation of stromal-vascular fraction of adipose tissue combined with skin grafting with split-thickness skin graft 1:6 in patients with extensive deep burns.</p><p><strong>Material and methods: </strong>Open comparative controlled prospective study was devoted to results of autologous skin grafting with split-thickness skin graft 1:6 and autologous cells of stromal-vascular fraction of adipose tissue. Patients were divided into 4 groups depending on transplantation method: injection, aerosol, combined (aerosol+injection) and comparison group (standard skin grafting with split-thickness perforated transplants).</p><p><p>There were 43 cases. Inclusion criteria: age 18-65 years, total area of skin burn 10-60% of body surface area, deep burn 10-45% of body surface area. Autologous skin grafting was performed on 10-15% of body surface area. Clinical, laboratory, cytological and histological methods were used to evaluate postoperative outcomes.</p><p><strong>Results: </strong>Combined (injection+aerosol) transplantation method was followed by significantly earlier engraftment (by 5 days, 9.9 ±0.7 days in the main group and 14.5±0.88 days in the control group, Student's t test 3.518) and reduction of postoperative complications to 6% (in the control group 27%).</p><p><strong>Conclusion: </strong>Analysis of biotechnological methods for surgical treatment of patients with extensive deep burns showed the effectiveness of combined (aerosol+injection) transplantation and skin grafting with split-thickness skin graft. This approach reduced skin recovery time and incidence of postoperative complications.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"63-72"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228751","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}