Khirurgiya最新文献_第4页

[Direct transfistulous ultrasound in minimally invasive surgical treatment of infected pancreatic necrosis]. [感染性胰腺坏死微创手术治疗中的直接输血超声]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202404138

S I Remizov, A V Andreev, V M Durleshter, S A Gabriel, O V Zasyadko

{"title":"[Direct transfistulous ultrasound in minimally invasive surgical treatment of infected pancreatic necrosis].","authors":"S I Remizov, A V Andreev, V M Durleshter, S A Gabriel, O V Zasyadko","doi":"10.17116/hirurgia202404138","DOIUrl":"https://doi.org/10.17116/hirurgia202404138","url":null,"abstract":"Objective: To develop a method for direct transfistulous ultrasound in minimally invasive treatment of infected pancreatic necrosis.Material and methods: There were 148 patients with infected pancreatic necrosis between 2015 and 2019 at the Krasnodar City Clinical Hospital No. 2. Drainage with 28-32 Fr tubes was carried out at the first stage, endoscopic transfistulous sequestrectomy - at the second stage (19 (12.8%) patients). In 84 (56.8%) patients, we applied original diagnostic method (transfistulous ultrasonic assessment of inflammatory focus).Results: There were 3 accesses to omental bursa in 93 (62.8%) patients and 2 in 43 (29.1%) patients. We also performed 2 access to retroperitoneal space in 63 (42.6%) patients and 1 access in 38 (25.8%) cases. Transfistulous ultrasound was used once in 19 (22.6%) patients, twice in 28 (33.3%) and 3 times in 37 (44.1%) patients. Examination was not performed in 18 (12.2%) patients due to the following reasons: migration of drainage catheters - 5, non-rectilinear fistulous tract - 13. No complications were observed.Conclusion: Transfistulous ultrasound makes it possible to diagnose pathological changes in the pancreas and parapancreatic tissue at various stages of surgical treatment.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860806","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}

引用次数: 0

[Choledochal cysts: surgical treatment in newborns and infants]. [胆总管囊肿：新生儿和婴儿的手术治疗]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia20240315

A B Alkhasov, A S Gurskaya, R R Bayazitov, O N Nakovkin, M A Sulavko, I V Karnuta, E V Ekimovskaya, I A Kyarimov, D M Akhmedova, A A Klepikova, S A Ratnikov, A P Fisenko

{"title":"[Choledochal cysts: surgical treatment in newborns and infants].","authors":"A B Alkhasov, A S Gurskaya, R R Bayazitov, O N Nakovkin, M A Sulavko, I V Karnuta, E V Ekimovskaya, I A Kyarimov, D M Akhmedova, A A Klepikova, S A Ratnikov, A P Fisenko","doi":"10.17116/hirurgia20240315","DOIUrl":"10.17116/hirurgia20240315","url":null,"abstract":"Objective: To improve postoperative outcomes in newborns and infants with choledochal cysts and to determine the indications for surgery.Material and methods: There were 13 children aged 0-3 months with choledochal cyst who underwent reconstructive surgery between 2019 and 2023. In all children, choledochal cyst was associated with cholestasis. Acholic stool was observed in almost half of the group (n=7). All children underwent cyst resection and Roux-en-Y hepaticoenterostomy.Results: Symptoms of cholestasis regressed in all patients. Mean surgery time was 128±27 min. There were no complications. Enteral feeding was started after 1-2 postoperative days, abdominal drainage was removed after 6.2±1.6 days. Mean length of hospital-stay was 16±3.7 days. Adequate bile outflow is one of the main principles. For this purpose, anastomosis with intact tissues of hepatic duct should be as wide as possible. Roux-en-Y loop should be at least 40-60 cm to prevent postoperative cholangitis.Conclusion: Drug-resistant cholestasis syndrome and complicated choledochal cysts (cyst rupture, bile peritonitis) are indications for surgical treatment in newborns and infants. When forming Roux-en-Y hepaticoenterostomy, surgeon should totally excise abnormal tissues of the biliary tract to prevent delayed malignant transformation.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111736","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}

引用次数: 0

[Is there an alternative to Getz procedure for common bile duct disruption?] [是否有替代Getz手术治疗胆总管断裂的方法？]

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202406177

S V Dergal, V K Koryttsev, A V Mazokha, A Yu Shesterkin, O I Stakhanova

引用次数: 0

[Cavitary lung lesions in COVID-19 associated pneumonia: a single-center study of 40 cases]. [COVID-19 相关肺炎中的腔隙性肺部病变：对 40 例病例的单中心研究]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202406128

Z G Berikhanov, S N Avdeev, G V Neklyudova, Z M Merzhoeva, S A Ponomar, M S Goltseva

{"title":"[Cavitary lung lesions in COVID-19 associated pneumonia: a single-center study of 40 cases].","authors":"Z G Berikhanov, S N Avdeev, G V Neklyudova, Z M Merzhoeva, S A Ponomar, M S Goltseva","doi":"10.17116/hirurgia202406128","DOIUrl":"https://doi.org/10.17116/hirurgia202406128","url":null,"abstract":"Objective: To demonstrate clinical features and outcomes in patients with cavitary lung lesions and COVID-19 associated pneumonia.Material and methods: A retrospective analysis of electronic medical records of 8261 patients with COVID-19 was performed. We selected 40 patients meeting the inclusion criteria. Sex, age, hospital-stay, lung tissue lesion, comorbidities, treatment, methods of respiratory support, complications and outcomes were evaluated.Results: Cavitary lung lesions were more common in men (67.5%). Age of patients ranged from 28 to 88 (mean 64.9±13.7) years. Hospital-stay in patients with cavitary lung lesions was 9-58 (median 27.5) days. There were 18 complications in 14 (35%) patients. Pneumothorax, isolated pneumomediastinum, pleural empyema, hemoptysis and sigmoid colon perforation were considered as complications of cavitary lung lesions. Nine (22.5%) patients died (5 of them with complications). Three patients died after surgical treatment. Long-term results were analyzed in 8 (25.8%) patients. Patients were followed-up for 3 months after discharge. Shrinkage of lesions occurred after 7-60 (mean 23) days, and complete obliteration of cavities came after 32 (range 14-90) days.Conclusion: Cavitary lung lesions are a rare complication of COVID-19 pneumonia. There was no significant correlation of complications with age, sex, therapy, volume of lung lesions and non-invasive ventilation (NIV). Despite more common fatal outcomes in older patients undergoing NIV, the last one was prescribed exclusively due to disease progression and respiratory failure. Further research on this problem is necessary to identify possible risk factors of cavitary lung lesions.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421252","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}

引用次数: 0

[Efficacy of prevention of recurrent laryngeal nerve injury in thyroid surgery]. [甲状腺手术中预防喉返神经损伤的效果]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202407185

R M Zakhokhov, T G Tlupova, I B Zhurtova, A A Mukaev, Z N Bakov, D A Teuvazhukova

{"title":"[Efficacy of prevention of recurrent laryngeal nerve injury in thyroid surgery].","authors":"R M Zakhokhov, T G Tlupova, I B Zhurtova, A A Mukaev, Z N Bakov, D A Teuvazhukova","doi":"10.17116/hirurgia202407185","DOIUrl":"https://doi.org/10.17116/hirurgia202407185","url":null,"abstract":"Objective: To evaluate the effectiveness of prevention of recurrent laryngeal nerve injury depending on thyroid gland lesion and extent of surgery.Material and methods: There were 2412 thyroid surgeries between 2000 and 2020. Patients were divided into the main group (1689 patients) and the control group (729 patients). Patients with nodular thyroid gland lesions prevailed in both groups (987 (58.4%) and 415 (56.9%), respectively). All ones underwent atraumatic extrafascial desection and thyroid resection (ultrasonic scalpel).Results. t: He upper laryngeal nerve injury occurred in 35 cases (1.4%). The number of surgeries with thyroid remnant preservation was significantly lower in the main group. The number of procedures with subtotal thyroid resection and thyroidectomy increased by 2.4 times (from 414 to 1010 operations, p<0.05).Conclusion: Improvement of surgical treatment of thyroid gland lesions consisting in new operative technique of recurrent laryngeal nerve isolation using ultrasonic scalpel reduces the incidence of recurrent laryngeal nerve injury from 2.3% to 1%. At the same time, the number of extended procedures in the main group significantly exceeded that in the control group (by 2.5 times).","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621126","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}

引用次数: 0

[Postoperative sternomediastinitis: morphology of lesion, treatment strategy]. [术后胸锁乳突炎：病变形态、治疗策略]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202407178

I A Vinokurov, Yu V Belov, D G Tagabilev, S A Yusupov

{"title":"[Postoperative sternomediastinitis: morphology of lesion, treatment strategy].","authors":"I A Vinokurov, Yu V Belov, D G Tagabilev, S A Yusupov","doi":"10.17116/hirurgia202407178","DOIUrl":"https://doi.org/10.17116/hirurgia202407178","url":null,"abstract":"Objective: To analyze bone tissue damage at different stages of disease (El Oakley classification), treatment options for each clinical situation and results after each approach.Material and methods: There were 45 patients with wound complications after cardiac surgery between October 2022 and September 2023. Thirty-eight (84.4%) patients underwent CABG, 7 (15.6%) patients - heart valve or aortic surgery. Mean age of patients was 68.1±10.3 years. There were 35 men (77.8%) and 10 women (22.2%). The first type was found in 11 (24.5%) patients, type 2-3 - 19 (42.2%), type 4 - 4 (8.8%), type 5 - 11 (24.5%) patients.Results: Systemic inflammatory response syndrome was observed in 7 (36.8%) persons of the 1st group, 14 (73.7%) ones of the 2nd group, 4 (100%) patients of the 3rd group and 2 (18.2%) patients of the 4th group. C-reactive protein and procalcitonin increased in all patients with the highest values in groups 2 and 3. Redo soft tissue inflammation occurred in all groups after treatment. Mean incidence was 25%. Two (10.5%) patients died in the 2nd group and 1 (25%) patient in the 3rd group.Conclusion: The modern classification of sternomediastinitis does not fully characterize severity of disease in a particular patient. Simultaneous debridement with wound closure demonstrates acceptable mortality (within 10%). The highest mortality rate was observed in patients with diffuse lesions of the sternum. Less aggressive treatment approaches are possible for stable anterior chest wall.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621132","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}

引用次数: 0

[Influence of diagnostic period on the outcomes in patients with Crohn's disease]. [诊断期对克罗恩病患者预后的影响]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202407136

E E Grishina, L R Aitova, T S Samokhodova, B T Muhametyanov

引用次数: 0

[Intraductal radiofrequency ablation under endosonography and cholangioscopy for residual adenoma of the major duodenal papilla with intraductal component]. [在内窥镜和胆道镜下进行导管内射频消融术治疗十二指肠大乳头伴导管内残留腺瘤]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024051138

Yu G Starkov, A I Vagapov, R D Zamolodchikov, S V Dzhantukhanova, D D Avdeeva

{"title":"[Intraductal radiofrequency ablation under endosonography and cholangioscopy for residual adenoma of the major duodenal papilla with intraductal component].","authors":"Yu G Starkov, A I Vagapov, R D Zamolodchikov, S V Dzhantukhanova, D D Avdeeva","doi":"10.17116/hirurgia2024051138","DOIUrl":"10.17116/hirurgia2024051138","url":null,"abstract":"All adenomas of the major duodenal papilla (MDP) require resection regardless of morphological structure due to high risk of malignancy. Currently, intraluminal endoscopic interventions are preferable for these adenomas. MDP neoplasms with intraductal spread (type III and IV) are of particular difficulty for endoscopic techniques. Intraductal radiofrequency ablation provides new opportunities for minimally invasive treatment of patients with MDP adenomas and intraductal component. A 72-year-old patient after previous endoscopic papillectomy for MDP adenoma admitted to the Vishnevsky National Research Medical Center of Surgery due to residual adenomatous growths within the papillectomy zone extending to the common bile duct throughout 13 mm. The patient underwent intraductal RFA under endosonography and cholangioscopy. Despite difficult localization of residual growths extending to the common bile duct, endosonography-guided intraductal RFA provided total destruction of residual tumor that was confirmed by cholangioscopy. Length of treatment was 4 months, relapse-free period - 10 months. Minimally invasive endoscopic technology for residual MDP adenoma provided good clinical results.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089358","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}

引用次数: 0

[Implementation of fluorescent imaging technology in endovideosurgical treatment of colorectal endometriosis]. [荧光成像技术在大肠子宫内膜异位症腔内视频手术治疗中的应用]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024051129

A K Politova, M I Rokhlina, Yu E Puchkova, I V Vashkevich, K Yu Belichuk

引用次数: 0

[Clinical and economic justification of icg-cholangiography in «difficult» laparoscopic cholecystectomy]. [在 "困难 "腹腔镜胆囊切除术中使用冰胆管造影术的临床和经济理由]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024041105

P N Romashchenko, A K Aliev, A S Pryadko, Sh Yu Abasov, N A Maistrenko

{"title":"[Clinical and economic justification of icg-cholangiography in «difficult» laparoscopic cholecystectomy].","authors":"P N Romashchenko, A K Aliev, A S Pryadko, Sh Yu Abasov, N A Maistrenko","doi":"10.17116/hirurgia2024041105","DOIUrl":"https://doi.org/10.17116/hirurgia2024041105","url":null,"abstract":"Objective: To prove from a clinical and economic point of view the expediency of using ICG cholangiography in patients with «difficult» laparoscopic cholecystectomy for the prevention of damage to the bile ducts.Material and methods: The results of treatment of 173 patients with cholelithiasis at various levels of health care providing were analyzed with regard to assessment of indicators of surgery complexity, developed complications and economic costs.Results: The effectiveness of the original scale of «difficult» laparoscopic cholecystectomy has been proved. The financial and economic costs of treatment of patients with damage of biliary ducts and patients with cholelithiasis without development of complications have been analyzed and evaluated. A comparative description of financial costs for patients with «difficult» laparoscopic cholecystectomy with the use of ICG-cholangiography has been given. A program on care delivery for patients suffering from cholelithiasis in the conditions of region with regard to safety and economic effectiveness has been developed.Conclusion: The implementation of this program provides the minimization of postoperative complications and fatality at all levels of surgical care delivery. It has been established that a rational approach to reducing the number of biliary ducts damages is their prevention by prediction of «difficult» laparoscopic cholecystectomy and performance of such interventions in medical organizations of III level with the possibility of modern technologies use.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872451","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}

引用次数: 0