Khirurgiya最新文献_第5页

[Eversion endarterectomy from common femoral artery bifurcation]. [股总动脉分叉处内翻性内膜剥脱术]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024101135

I P Mikhailov, V A Arustamyan, I A Eroshkin, B V Kozlovsky, E V Kungurtsev

引用次数: 0

[Small pelvis lipoma spreading to the gluteal region]. [小骨盆脂肪瘤扩散至臀部区域]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202401197

V I Panteleev, A G Kriger, A O Gushcha, M M Dzhigkaeva

引用次数: 0

[Endovascular treatment of deep vein thrombosis of the upper extremities]. [上肢深静脉血栓的血管内治疗]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202402145

B S Sukovatykh, A V Sereditsky, V F Muradyan, M B Sukovatykh, N V Bolomatov, M Y Gordov

{"title":"[Endovascular treatment of deep vein thrombosis of the upper extremities].","authors":"B S Sukovatykh, A V Sereditsky, V F Muradyan, M B Sukovatykh, N V Bolomatov, M Y Gordov","doi":"10.17116/hirurgia202402145","DOIUrl":"10.17116/hirurgia202402145","url":null,"abstract":"Objective: To improve the results of treatment of deep vein thrombosis of the upper extremities sing endovascular technologies.Material and methods: We analyzed safety and effectiveness of treatment in 24 patients with deep vein thrombosis of the upper extremities. All ones were divided into 2 homogeneous groups by 12 people each. In the first group, conventional anticoagulation was performed. In the second group, we used additional regional catheter thrombolysis with alteplase and, if necessary, venous stenting or balloon angioplasty for residual stenosis. Patients received apixaban at baseline and throughout 6 postoperative months. After 12 months, we performed ultrasound and clinical examination to identify deep vein patency and venous outflow disorders. Vein recanalization was evaluated as follows: <50% - minimal, 50-99% - partial, 100% - complete. The quality of life of patients was studied using the SF-36 questionnaire.Results: In the first group, we observed complete vein recanalization in 25% of cases, partial - in 33%, minimal - in 41% of cases; in the second group - 83.3% and 16.7% of patients, respectively. In the first group, clinical manifestations of venous outflow disorders were absent in 25% of patients, mild disorders - 25%, moderate - 8.3%, severe - 41.7% of patients. In the second group, venous outflow was not impaired in 83.7% of patients, mild violations occurred in 16.7% of patients. In the first group, physical health was equal to 44.2±1.7 scores, psychological health - 49.3±2.3 scores; in the second group - 69.3±5.7 and 71.3±5.4 scores, respectively.Conclusion: Endovascular treatment improved postoperative outcomes.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"45-51"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724308","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

[Analysis of indocyanine green plasma disappearance rate in clinical practice]. [吲哚菁绿血浆消失率在临床实践中的分析]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia20240225

V V Osovskikh, L N Kiseleva, I N Kolokolnikov, M S Vasilieva, A E Bautin

{"title":"[Analysis of indocyanine green plasma disappearance rate in clinical practice].","authors":"V V Osovskikh, L N Kiseleva, I N Kolokolnikov, M S Vasilieva, A E Bautin","doi":"10.17116/hirurgia20240225","DOIUrl":"10.17116/hirurgia20240225","url":null,"abstract":"Objective: To justify the optimal method for determining indocyanine green plasma disappearance rate (PDRICG).Material and methods: We analyzed PDRICG in intensive care units. Indocyanine green was administered intravenously at a dose of 0.25 mg/kg. PDRICG was analyzed simultaneously by using of three methods: 1) PDD (PiCCO2 LiMON device), 2) SBS with analysis of plasma samples on precise spectrophotometer, 3) SBS with analysis of plasma samples on simple experimental photometer.Results: PDD method was used for 346 PDRICG tests in 256 patients. Of these, 14.3% of measurements were erroneous. Paired tests using PDD and SBS methods were performed in 299 cases. SBS method resulted erroneous data in 0.6% of cases. Certain correlation (r=0.79, p<0.001) was found between the reference method (SBS with spectrophotometry) and the PDD method. Bland-Altman plot for these two methods showed that proportional bias of mean difference was caused by extremely high PDRICG of the PDD method (for example, more than 30%/min). Comparison of two SBS variants (spectrophotometer and experimental photometer) revealed good correlation (r=0.91, p<0.001).Conclusion: SBS method for measuring PDRICG ensures accurate results under mechanical interferences in patients with impaired capillary blood flow. This eliminates the need for redo measurement. Duplication of the PDD and SBS methods is recommended when repeating the test is not possible (organ donors).","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2. Vyp. 2","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913595","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

[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":" 4","pages":"38-43"},"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":" 3","pages":"5-13"},"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":" 6","pages":"28-35"},"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":" 7","pages":"85-91"},"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":" 7","pages":"78-84"},"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