Khirurgiya最新文献_第7页

[Fascial abdominal closure is a key factor of effective VAC-assisted laparostomy]. [腹筋膜闭合是vaca辅助剖腹造口术有效的关键因素]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202504161

A A Shchegolev, R S Tovmasyan, A E Markarov, A Yu Chevokin, M V Vasiliev, V V Plotnikov, T G Muradyan

{"title":"[Fascial abdominal closure is a key factor of effective VAC-assisted laparostomy].","authors":"A A Shchegolev, R S Tovmasyan, A E Markarov, A Yu Chevokin, M V Vasiliev, V V Plotnikov, T G Muradyan","doi":"10.17116/hirurgia202504161","DOIUrl":"https://doi.org/10.17116/hirurgia202504161","url":null,"abstract":"Objective: To evaluate the efficiency of various methods of primary fascial abdominal closure in VAC-laparostomy.Material and methods: The study included 94 patients with traumatic and non-traumatic abdominal disasters. Treatment strategy of «open abdomen» (OA) was used. The following methods of fascial closure (FC) were used: primary fascial suturing (PFS) and various options for vacuum-assisted closure (VAC) including options without alloplasty (VAC-suturing) and with abdominal wall alloplasty (VAC-alloplasty).Results: The overall mortality was 34% (32 patients). Of these, 26 ones died before FC (27.7% of total number of patients and 81.2% of total number of deaths), and 6 patients after FC onset (6.4% of total number of patients and 18.8% of total number of deaths). Attempts of FC were made in 68 patients. Successful FC was performed in 45 patients (66.2% of all attempts).Conclusion: The best results were achieved after VAC-alloplasty (IPOM in-lay). FC through VAC-alloplasty with OA strategy significantly improves the results of treatment.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 4","pages":"61-70"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013879","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

[Surgical treatment of pulmonary tuberculosis in children and adolescents]. [儿童青少年肺结核的外科治疗]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202503116

M A Bagirov, S S Sadovnikova, V K Aliev, A E Ergeshova, M V Chashchina, G A Asoyan

{"title":"[Surgical treatment of pulmonary tuberculosis in children and adolescents].","authors":"M A Bagirov, S S Sadovnikova, V K Aliev, A E Ergeshova, M V Chashchina, G A Asoyan","doi":"10.17116/hirurgia202503116","DOIUrl":"10.17116/hirurgia202503116","url":null,"abstract":"Objective: To analyze the operable forms of pulmonary tuberculosis, structure of surgical interventions, and effectiveness of surgical treatment in children and adolescents.Material and methods: We analyzed surgical treatment of pulmonary tuberculosis in 423 children and adolescents between 2012 and 2023. Low-traumatic invasive surgical methods were a part of comprehensive treatment including antituberculous therapy.Results: Segmental (including anatomical) lung resections were performed in 39.9% of cases, resection of intrathoracic lymph nodes - 21.3%, peripheral lymph node dissection - 2.6%, large-volume resections - 19.6% (including pneumonectomy - 1.7%, lobectomy - 8.5%, combined resections - 9.5%), pleurectomies - 13.9%. Stage-by-stage surgical treatment was performed in 5.5% of patients. Postoperative complications occurred after 1.9% of surgical procedures. All complications were successfully eliminated, there were no fatal outcomes, and effectiveness of comprehensive treatment was 100%.Conclusion: Timely surgical treatment combined with antituberculous chemotherapy can enhance the effectiveness of treatment for pulmonary tuberculosis in children and adolescents.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"16-23"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658951","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

[Early complications after surgical treatment of spontaneous pneumothorax: risk factors analysis]. [自发性气胸手术治疗后的早期并发症：风险因素分析]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202503124

G M Agafonov, A S Petrov, O V Novikova, M A Atyukov, P K Yablonsky

{"title":"[Early complications after surgical treatment of spontaneous pneumothorax: risk factors analysis].","authors":"G M Agafonov, A S Petrov, O V Novikova, M A Atyukov, P K Yablonsky","doi":"10.17116/hirurgia202503124","DOIUrl":"10.17116/hirurgia202503124","url":null,"abstract":"Objective: To study the risk factors of complications after wedge resection with subsequent pleurectomy.Material and methods: There were 454 patients diagnosed with spontaneous pneumothorax between 2018 and 2023. Surgical intervention was performed in 331 (72.9%) patients according to commonly accepted indications for prevention of recurrence. Risk factors were studied using regression analysis and directed acyclic graph (DAG) method to build predictive models.Results: The complication rate was 11.5% (n=38). The most common complications were intrapleural bleeding and prolonged air leak (3.9% and 3.6%, respectively). One-third of cases were classified as major complications according to the Clavien-Dindo classification in thoracic surgery and required pleural cavity drainage or debridement. Significant risk factors of postoperative complications were secondary pneumothorax (HR 4.009; 95% 1.147-14.013; p=0.030) and severe pleural adhesions (HR 4.258; 95% 1.134-15.991; p=0.032).Conclusion: Secondary pneumothorax and severe pleural adhesions are independent risk factors of postoperative complications.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"24-32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658921","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

[Vacuum-instillation laparostomy for gunshot peritonitis]. 真空灌胃术治疗枪炮性腹膜炎。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202505113

A A Sazonov, P N Romashchenko, I A Makarov, R K Aliev, A A Erokhina, N A Maistrenko

{"title":"[Vacuum-instillation laparostomy for gunshot peritonitis].","authors":"A A Sazonov, P N Romashchenko, I A Makarov, R K Aliev, A A Erokhina, N A Maistrenko","doi":"10.17116/hirurgia202505113","DOIUrl":"https://doi.org/10.17116/hirurgia202505113","url":null,"abstract":"Objective. t: O evaluate efficacy of vacuum instillation laparostomy in the treatment of victims with gunshot peritonitis.Material and methods: We analyzed treatment outcomes in 103 victims with gunshot abdominal wounds complicated by peritonitis. All patients underwent multi-stage surgical treatment with vacuum-instillation laparostomy (VIL) in the main group (n=37) and vacuum-assisted laparostomy (VAL) in the control group (n=66). Negative pressure was 90 mm Hg due to high risk of bleeding following traumatic disease. The interval between debridement did not exceed 48 hours. VIL was carried out in the following format: duration of vacuum phase 3 hours 30 minutes, volume of injected solution 300 ml, exposure time 30 minutes.Results: Complications occurred in 32.4% and 43.9% of patients, respectively (p>0.05). There was a tendency towards significant differences (p=0.07) in the incidence of complications Clavien-Dindo grade III-IV (13.5% and 30.3%). In-hospital mortality was 3% and 6%, respectively (p>0.05). Bacteriological analysis revealed faster achievement of target indicators of microflora elimination in VIL (the 7th day) compared to VAL (the 11th day). Adhesive process following VIL was significantly less severe. Indeed, there was Björck stage 1B and 2B of abdominal cavity by the 4th debridement in majority of patients in both groups, respectively. These changes correlated with histological findings. VIL was accompanied by faster regression of leukocyte infiltration and less severe fibrous changes.Conclusion: VIL provides more effective abdominal decontamination and less severe adhesive process compared to VAL. This reduces the number of debridement procedures and risk of complications.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 5","pages":"13-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052783","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

[Unplanned redo surgeries after appendectomy characterizing the quality of acute appendicitis management]. [阑尾切除术后意外重做手术对急性阑尾炎处理质量的影响]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202505129

I A Matveev, I B Popov, A A Baradulin, A V Dmitriev, S V Lipovoy, A I Matveev, A O Matreninskikh

{"title":"[Unplanned redo surgeries after appendectomy characterizing the quality of acute appendicitis management].","authors":"I A Matveev, I B Popov, A A Baradulin, A V Dmitriev, S V Lipovoy, A I Matveev, A O Matreninskikh","doi":"10.17116/hirurgia202505129","DOIUrl":"https://doi.org/10.17116/hirurgia202505129","url":null,"abstract":"Objective: To study the effect of appendectomy technique on the incidence, causes and features of redo surgeries after appendectomy.Material and methods: Appendectomies were performed in 1114 patients. Repeated interventions were necessary in 19 (1.4%) people (10 (2.0%) patients after laparoscopic appendectomy and 9 (1.5%) patients after open surgery). Structure, surgical features and results are estimated.Results: There were 505 (45.3%) laparoscopic and 609 (54.7%) open appendectomies. Repeated interventions were performed in 10 (0.9%) and 9 (1.5%) cases, respectively. The causes of repeated surgeries were abdominal infectious complications in 7 (0.6%) cases, intra-abdominal bleeding in 5 people (0.4%), abdominal wall infection in 3 (0.3%) cases, eventeration in 4 (0.35%) cases, undiagnosed intestinal obstruction during index surgery in 1 patient (0.1%) and severe abdominal pain in 1 patient (0.1%). There were complications Clavien-Dindo grade IIIA-IIIB. There were no fatal outcomes. In 2023-2024, 286 laparoscopic appendectomies were performed including 2 (0.69%) repeated interventions. The number of laparoscopic interventions throughout this period exceeded the number of open appendectomies by 2.4 times and amounted to 81.7% of all appendectomies. Repeated interventions after traditional appendectomy were performed in 2 patients (3.1%).Conclusion: Predominant laparoscopic appendectomies in recent years improved the quality of care for patients with acute appendicitis regarding redo surgeries. Acceptable incidence of repeated interventions indicates sufficient institutional experience in the treatment of acute appendicitis.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 5","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044153","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

[Prevention of recurrent laryngeal nerve injury in thyroid surgery: a systematic review and meta-analysis]. [甲状腺手术中喉返神经损伤的预防：系统回顾和荟萃分析]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia2025031140

A E Tseimakh, Ya N Shoikhet, A A Pantyushin, I Saxena

{"title":"[Prevention of recurrent laryngeal nerve injury in thyroid surgery: a systematic review and meta-analysis].","authors":"A E Tseimakh, Ya N Shoikhet, A A Pantyushin, I Saxena","doi":"10.17116/hirurgia2025031140","DOIUrl":"10.17116/hirurgia2025031140","url":null,"abstract":"Objective: To evaluate the effectiveness of modern methods for preventing damage to recurrent laryngeal nerve in thyroid surgery.Material and methods: Full-text prospective comparative studies were reviewed in the PubMed Central databases, bibliographic database of the Russian Science Citation Index and Cochrane library database. Heterogeneity was assessed using forest plots, tau2 and I2 statistics.Results: Meta-analysis of pooled risk of recurrent laryngeal nerve injuries revealed significantly lower pooled estimate of the incidence of recurrent laryngeal nerve injuries in groups of intraoperative neuromonitoring (z=-2.04, p=0.0409). Heterogeneity among studies was not significant (I2=28%, p=0.25). Meta-analysis of pooled risk of damage to recurrent laryngeal nerve in case of prevention by precise dissection using ultrasound and electric cauterization found no significant differences in both groups (z= -0.19, p=0.8806). Heterogeneity among studies was moderate (I2=60%, p=0.11). There were no significant publication biases.Conclusion: Intraoperative neuromonitoring and precise dissection of recurrent laryngeal nerve using ultrasound and electric cauterization reduce surgery time. Intraoperative neuromonitoring is advisable as an optional procedure for prevention of damage to recurrent laryngeal nerve.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"140-148"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658844","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

[Original pericostal suture sparing the neurovascular bundle for prevention of post-thoracotomy pain syndrome after video-assisted mini-thoracotomy]. [保留神经血管束的原始肋周缝合预防电视辅助小开胸术后疼痛综合征]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202505151

D N Pilkevich, M A Chekasina

{"title":"[Original pericostal suture sparing the neurovascular bundle for prevention of post-thoracotomy pain syndrome after video-assisted mini-thoracotomy].","authors":"D N Pilkevich, M A Chekasina","doi":"10.17116/hirurgia202505151","DOIUrl":"10.17116/hirurgia202505151","url":null,"abstract":"Objective: To prevent post-thoracotomy pain syndrome and its consequences after video-assisted mini-thoracotomy using original pericostal suture sparing the neurovascular bundle.Material and methods: Original pericostal suture sparing the neurovascular bundle was developed to prevent post-thoracotomy pain syndrome. A prospective cohort controlled randomized clinical trial with 2-month follow-up was conducted to estimate postoperative pain syndrome after various pericostal sutures. The study included 71 patients who underwent video-assisted atypical lung resections for various lung diseases (29 women and 42 men aged 41.2 ±5.1 years). All patients were divided into 2 groups: group I - standard pericostal suture; group II - original pericostal suture sparing the neurovascular bundle.Results: Intensity of pain after 1-2 postoperative days was higher by 43.2% in the 1st group, at discharge - by 85.8%. Mean area of paresthesia was less by 39.7% after 1 postoperative month and by 28.8% after 2 months in the 2nd group.Conclusion: Original pericostal suture with subperiosteal canal through detachment of neurovascular bundle from the underlying rib reduces the incidence of post-thoracotomy pain syndrome.","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 5","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":"144002087","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

[Surgical significance of quantitative assessment of carotid artery tortuosity]. [颈动脉扭曲定量评估的外科意义]。

Khirurgiya Pub Date : 2025-01-01 DOI: 10.17116/hirurgia202503163

A V Gavrilenko, A V Abramyan, G F Magomedova, Zh Li, Z A Eremeeva, D A Semchenkova, P D Burkhanova, D D Donskaya

引用次数: 0

[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