Khirurgiya最新文献_第6页

[Causes of unsatisfactory postoperative outcomes in patients with hiatal hernia]. 【裂孔疝患者术后预后不理想的原因】。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202506198

Yu G Starkov, N I Khizrieva, R D Zamolodchikov

引用次数: 0

[Prognostic model and calculator for assessing the risk of prolonged pleural effusion after lobectomy]. [评估肺叶切除术后长期胸腔积液风险的预后模型和计算器]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202506126

R F Shagdaleev, E A Toneev, A A Martynov, M A Belova, A D Teryagova

{"title":"[Prognostic model and calculator for assessing the risk of prolonged pleural effusion after lobectomy].","authors":"R F Shagdaleev, E A Toneev, A A Martynov, M A Belova, A D Teryagova","doi":"10.17116/hirurgia202506126","DOIUrl":"https://doi.org/10.17116/hirurgia202506126","url":null,"abstract":"Objective: To develop a nomogram and risk assessment calculator for prolonged pleural effusion after lobectomy for lung cancer.Material and methods: The study was conducted at the Thoracic Oncology Surgery Department of the Ulyanovsk Regional Oncology Dispensary. Patients who underwent lobectomy between January 1, 2022 and January 1, 2024 were included (database registration state No. 2024622456). There were 78 patients including 48 ones without prolonged pleural effusion (PPE) and 30 ones with this complication. After statistical analysis, data bootstrapping and logistic regression calibration based on artificial intelligence machine learning were carried out.Results: The incidence of PPE was 30/78 (39%). Multivariate statistical analysis revealed the following significant factors: neutrophil-lymphocyte index after 4-5 days, leukocyte count in pleural fluid after 2 and 4-5 days, as well as drainage output after 4-5 days. Prognostic model showed high sensitivity (71%) and specificity (89.4%). A decision tree was obtained depending on surgical approach.Conclusion: The first prognostic model and interactive calculator for assessing the risk of PPE after lobectomy were developed.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 6","pages":"26-34"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200293","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

[Choosing the optimal surgical method for duodenal ulcer complicated by bleeding]. [十二指肠溃疡并发出血的最佳手术方法选择]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia2025021111

S R Genrikh, V M Durleshter, A G Kalachev, K M Bedanokov

引用次数: 0

[Blood transfusion at the stages of evacuation of the wounded in military conflicts of the XIX century]. [19世纪军事冲突中伤员撤离阶段的输血]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia2025021130

M S Sergeeva, N N Krylov

引用次数: 0

[Laparoscopic ALPPS procedure: a series of cases]. [腹腔镜ALPPS手术：一系列病例]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202502120

V K Lyadov, A N Moskalenko, M M Magomedov, V N Galkin

{"title":"[Laparoscopic ALPPS procedure: a series of cases].","authors":"V K Lyadov, A N Moskalenko, M M Magomedov, V N Galkin","doi":"10.17116/hirurgia202502120","DOIUrl":"10.17116/hirurgia202502120","url":null,"abstract":"The combination of liver resection and chemotherapy is the most effective way to treat primary and secondary malignant liver tumors. One of the methods for increasing resectability is the use of two-stage liver resection (associated liver partition and portal vein ligation for staged hepatectomy - ALPPS).Objective: To demonstrate the feasibility of laparoscopic ALPPS with good short-term and long-term results.Material and methods: From 2020 to 2021, in the oncology department No. 4 of the State Budgetary Healthcare Institution \"GKOB 1 DZM\" 6 laparoscopic ALPPS were performed for metastases of colorectal cancer in the liver in 4 patients and cholangiocellular cancer in two in the presence of an insufficient volume of remaining liver parenchyma (13-32.1%).Results: All patients underwent the first stage of ALPPS laparoscopically without conversions or intraoperative complications. The duration of the operation ranged from 300 to 470 minutes (average 347.5±74 minutes), blood loss - from 100 to 300 ml (average 175±88 ml). The duration of the second stage is from 165 to 470 minutes (average 281.5±132.9 minutes) with blood loss from 100 to 850 ml (average 484.5±392.3 ml). The increase in the volume of residual liver parenchyma was 36-68%. The period between the ALPPS stages ranged from 13 to 22 days. Final resection to the extent of R0 was performed in 4 of 6 patients. The second stage of ALPPS was complicated in two patients by the formation of an external biliary fistula and in another two by right-sided hydrothorax.The median follow-up was 25 months, during which time 3 patients died: two patients with incomplete second stage ALPPS due to cancer progression and one patient from coronavirus infection.Conclusion: ALPPS can be performed entirely laparoscopically with good short-term and long-term results, but should be performed in high-volume liver surgery centers by an experienced surgical team.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"20-26"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366131","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

[Repeated breast reconstruction after previous complications]. 【既往并发症后重复乳房重建】。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202506151

V N Sipki, M Yu Vlasova, E A Zanozina, M V Moshurova, A D Zikiryakhodzhaev

{"title":"[Repeated breast reconstruction after previous complications].","authors":"V N Sipki, M Yu Vlasova, E A Zanozina, M V Moshurova, A D Zikiryakhodzhaev","doi":"10.17116/hirurgia202506151","DOIUrl":"https://doi.org/10.17116/hirurgia202506151","url":null,"abstract":"Objective: To evaluate the effectiveness of repeated breast reconstruction in cancer patients depending on complications after primary reconstruction.Material and methods: There were 117 patients who underwent primary one-stage breast reconstruction with endoprosthesis, autograft and/or their combination.Results: A retrospective analysis included 117 patients who underwent complex treatment in 2017-2021. Surgical treatment (subcutaneous/skin-sparing mastectomy with one-stage reconstruction) was realized at the department of oncology and reconstructive surgery of the breast and skin. Analysis included patients after one-stage reconstruction with silicone endoprosthesis (n=96, 82%), different flaps (n=3, 2.5%), combination of auto- and allogenic materials (n=18, 15.3%). The most common complications were Backer grade III/IV capsular contracture, implant rupture, endoprosthesis protrusion and flap necrosis. The most preferable redo surgery was implant-to-implant replacement (n=58). Of these, there were 40 (68.9%) redo surgeries for Backer grade III/IV capsular contracture, implant protrusion (n=7, 12%) and rupture (n=5, 8.6%). Flap necrosis required flap replacement with implant, flap reduction and implant placement under the flap.Conclusion: Each technique has certain advantages and disadvantages, and the choice of method depends on individual characteristics of each patient.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 6","pages":"51-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200303","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

[Risk factors for bronchopleural complications after pneumonectomy]. [肺切除术后支气管胸膜并发症的危险因素]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia20250317

D B Giller, B M Giller, B D Giller, S V Smerdin, A E Ergeshov, S S Saenko, G V Shcherbakova, M A Kulaeva, I I Martel

{"title":"[Risk factors for bronchopleural complications after pneumonectomy].","authors":"D B Giller, B M Giller, B D Giller, S V Smerdin, A E Ergeshov, S S Saenko, G V Shcherbakova, M A Kulaeva, I I Martel","doi":"10.17116/hirurgia20250317","DOIUrl":"10.17116/hirurgia20250317","url":null,"abstract":"Objective: To assess various risk factors for bronchopleural complications, as well as effectiveness of some techniques for bronchial stump closure and covering.Material and methods: We studied the results of 2022 pneumonectomies between 1958 and 2023. Different techniques for bronchial stump closure and covering were used. We studied the influence of the following factors on the incidence of bronchial fistula: pulmonary disease; pulmonary lesion complicated by bleeding, empyema; acute progression of tuberculosis as caseous pneumonia; Mycobacterium tuberculosis with multiple and extensive drug resistance; tuberculosis of the main bronchus; preoperative destructive tuberculosis-related lesion of contralateral lung; pulmonary gangrene; partial resection of cancer; extended bilateral lymph node dissection, etc.Results: The incidence of bronchopleural complications and mortality significantly decreased over time. Nevertheless, these events remained the main cause of death after pneumonectomy until the last decade. Most often, death following bronchopleural complications was noted in patients with bronchial fistula within 21 days. Among 111 patients with this complication, 48 (43.24%) ones died.Conclusion: According to our data, bronchial suturing technique and side of surgery are the most significant factors regarding the incidence of bronchial fistula. The highest risk is associated with surgery for pulmonary gangrene, the lowest risk - with total resection of cancer. The incidence of delayed bronchial fistula in tuberculosis exceeds the incidence of early bronchial fistula.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"7-15"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658925","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

[The role of early predictors in diagnosis of stapler suture and anastomotic failure in bariatric patients]. [早期预测指标在肥胖患者吻合器缝合及吻合口衰竭诊断中的作用]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202503176

A G Khitaryan, A V Mezhunts, O V Voronova, M Yu Shtilman, A A Orekhov, D A Melnikov, O S Pen, D Yu Pukovsky

{"title":"[The role of early predictors in diagnosis of stapler suture and anastomotic failure in bariatric patients].","authors":"A G Khitaryan, A V Mezhunts, O V Voronova, M Yu Shtilman, A A Orekhov, D A Melnikov, O S Pen, D Yu Pukovsky","doi":"10.17116/hirurgia202503176","DOIUrl":"10.17116/hirurgia202503176","url":null,"abstract":"Objective: To study the role of early predictors in diagnosis of stapler suture and anastomotic failure in bariatric patients and to determine the indications for redo laparoscopy.Material and methods: A single-center retrospective study enrolled 2011 patients who underwent surgery. All patients were categorized into two groups: group 1 (1983 patients) - standard postoperative period; group 2 (28 patients) - major inflammatory complications with redo laparoscopy.Results: We found no significant differences in BMI, weight and age between patients with and without complications. Conversely, high serum glucose, duration of type 2 DM over 5 years, tachycardia > 100 bpm and high VAS score of abdominal pain significantly increased the risk of complications. Contrast-enhanced CT of the abdomen has the greatest informative value. To ascertain critical value of each factor for between-group differentiation, we performed ROC analysis and demonstrated specificity of these indicators.Conclusion: The challenge of early diagnosis of intra-abdominal inflammatory complications in bariatric patients is compounded by no typical symptoms and small informative value of laboratory and instrumental diagnostic methods. According to ROC analysis, combination of fever, hypotension, tachycardia and tachypnoea resulted AUC 0.80. Sensitivity 65% and specificity 82% indicated the need for immediate repeated surgery. However, availability of standardized surgical technique and clear algorithms for the entire team are essential for timely diagnosis and management of all potential complications in patients with serious postoperative bariatric complications.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"76-86"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658953","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

[Endovascular treatment and selection criteria for acute mesenteric ischemia]. 急性肠系膜缺血的血管内治疗及选择标准。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202502113

A B Mironkov, A D Pryamikov, S A Rautbart, A I Khripun

{"title":"[Endovascular treatment and selection criteria for acute mesenteric ischemia].","authors":"A B Mironkov, A D Pryamikov, S A Rautbart, A I Khripun","doi":"10.17116/hirurgia202502113","DOIUrl":"10.17116/hirurgia202502113","url":null,"abstract":"Objective: To demonstrate the results of endovascular intervention in patients with acute arterial mesenteric ischemia, while observing the indications developed in the clinic.Material and methods: In total, endovascular approach in the treatment of acute mesenteric ischemia were used in 49 patients in the clinic. In compliance with the developed indications and criteria, endovascular intestinal revascularization was performed in 27 patients. Various endovascular intervention techniques were used (aspiration, balloon dilation, artery stenting and their combinations). Extracorporeal filtration techniques were used as a treatment for reperfusion syndrome after intestinal revascularization in 10 patients.Results: Angiographic success in the form of complete restoration of the main blood flow in the basin of the superior mesenteric artery and its large branches was obtained in 85% of cases. Intestinal viability was preserved in 15 (56%) patients. After successful endovascular surgery, intestinal necrosis was diagnosed on laparoscopy in the remaining 12 (44%) patients, which required extensive (n=2) or non-extensive (n=10) resection. Postoperative mortality was 48% (13 patients).Conclusion: Endovascular surgery in acute mesenteric ischemia is an effective method of intestinal revascularization. To optimize the indications for these interventions, it is necessary to gain experience and conduct large-scale studies.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"13-19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366128","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

[Hemorrhage after pancreaticoduodenectomy]. 胰十二指肠切除术后出血。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202501114

V A Solodky, A G Kriger, D S Gorin, A A Goev, A B Varava, V I Panteleev

{"title":"[Hemorrhage after pancreaticoduodenectomy].","authors":"V A Solodky, A G Kriger, D S Gorin, A A Goev, A B Varava, V I Panteleev","doi":"10.17116/hirurgia202501114","DOIUrl":"10.17116/hirurgia202501114","url":null,"abstract":"Objective: To analyze the incidence, clinical manifestations and treatment of post-pancreaticoduodenectomy hemorrhage in patients with pancreaticoduodenal tumors.Material and methods: There were 362 pancreaticoduodeneectomies for ductal adenocarcinoma of the pancreatic head and pancreatoduodenal tumors in 2016-2023. Post-pancreatectomy hemorrhage (PPH) occurred in 52 (14.4%) patients. Delayed post-pancreatectomy hemorrhage followed postoperative pancreatitis, pancreatic fistula or non-drained fluid collections. Bleeding was diagnosed considering clinical manifestations with verification through contrast-enhanced CT.Results: Emergency re-laparotomy was required in 15 (28.8%) patients with unstable hemodynamics; 9 (60%) people died. Thirty-seven patients with stable hemodynamics underwent emergency contrast-enhanced CT and subsequent endovascular hemostasis. Bleeding was stopped in 31 patients (89.2%). Endovascular hemostasis was ineffective in 1 patient who underwent re-laparotomy. We found no the cause of bleeding in 3 patients, and there was no hemorrhage recurrence. Six (18.7%) people died. The overall mortality among patients with PPH was 28.8% (15 out of 52 postoperative patients).Conclusion: PPH follows postoperative pancreatitis, pancreatic fistula or non-drained fluid collection. In case of stable hemodynamics, endovascular hemostasis is preferable for this complication.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"14-21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123132","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