Khirurgiya最新文献

{"title":"[Mesh suture in the treatment of diaphragmatic hernias].","authors":"A V Abolmasov, B N Bashankaev, B T Yunusov, A V Sidorova","doi":"10.17116/hirurgia2025031107","DOIUrl":"10.17116/hirurgia2025031107","url":null,"abstract":"<p><p>The paper studies the results of surgical treatment of the first 25 patients with diaphragmatic hernias who underwent laparoscopic surgeries for hiatal hernias using polypropylene mesh sutures using the proprietary method.</p><p><strong>Material and methods: </strong>Polypropylene mesh strips were used instead of traditional sutures to seal the crura of the diaphragm in 25 patients. The intervention technique and treatment outcomes are described. The study included 25 patients, 5 males and 20 females, operated on between 2019 and 2024 with a diagnosis of hiatal hernia (HH), aged 38 to 79 years.</p><p><strong>Results: </strong>The mean surgery duration was 83.4 minutes (50 to 120 minutes), and intraoperative and postoperative complications were not observed. The mean hospital stay was 1.5 days (1 to 4 days). Four patients (16%) had a recurrence of hernia diagnosed using imaging studies, but there were no clinically significant recurrences in all 25 patients. Twenty (80%) patients permanently discontinued proton pump inhibitors (PPIs), and 2 (8%) significantly reduced their dose. Eighteen (72%) patients had complete resolution of their HH-related symptoms; in 4 (16%) patients, these symptoms significantly reduced. All patients were satisfied with the treatment outcomes.</p><p><strong>Conclusions: </strong>The use of mesh sutures to seal the crura of the diaphragm supports the concept of pressure distribution and muscle resistance to incision, which is often seen with traditional suture material. In addition, the mesh material stimulates scar tissue growth through the pores of the prosthesis, strengthening the suture line.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 3","pages":"107-111"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658836","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":"[Primary outcomes after major anatomical liver resections in infants at the National Children's Medical Center].","authors":"K O Semash, T A Dzhanbekov","doi":"10.17116/hirurgia202504186","DOIUrl":"https://doi.org/10.17116/hirurgia202504186","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the results of major right-sided hemihepatectomies in infants with various neoplasms.</p><p><strong>Material and methods: </strong>There were 3 right-sided major hemihepatectomies in pediatric patients aged 5-10 months for different neoplasms between December 2023 and May 2024. Perioperative data of patients, indications for liver resection, and postoperative outcomes were retrospectively analyzed.</p><p><strong>Results. m: </strong>Ean age of patients was 7.3 months. The indications for liver resection were hepatoblastoma in two cases and anastomosing hemangioma in one case. Two patients underwent anatomical resection of the right hepatic lobe, and one patient underwent extended right-sided hemihepatectomy. Mean surgery time was 230 min, blood loss - 133 ml. No surgical complications were observed. Mean hospital-stay after surgery was 7.3 days. Patients with hepatoblastoma received postoperative chemotherapy. No recurrence of neoplasms was detected throughout the follow-up period.</p><p><strong>Conclusion: </strong>Primary results of liver resections demonstrated feasibility and safety of radical major hemihepatectomies in pediatric patients with large liver neoplasms. These outcomes are comparable with world literature. Such interventions in infants necessitate substantial experience in hepatobiliary surgery. Patients with hepatoblastoma require post-hepatectomy chemotherapy. There is a need to develop primary outpatient services for liver tumor screening and timely diagnosis in pediatric patients.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 4","pages":"86-94"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046537","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":"[The CryoMaze procedure for non-paroxysmal atrial fibrillation in patients undergoing heart valve surgery].","authors":"A Yu Bagdasaryan, D V Bendov, T S Shcherbinin, M L Gordeev","doi":"10.17116/hirurgia202505165","DOIUrl":"https://doi.org/10.17116/hirurgia202505165","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the results of CryoMaze procedure for non-paroxysmal atrial fibrillation in patients undergoing heart valve surgery.</p><p><strong>Material and methods: </strong>Cryoablation was performed in 22 patients with paroxysmal AF undergoing heart valve surgery in 2022-2023. All patients underwent biatrial ablation procedure.</p><p><strong>Results: </strong>In-hospital postoperative period was characterized by frequent paroxysms AF and atrial flutter (50%), AF persistence in 8 patients (36%), stable sinus rhythm in 3 patients (14%) and temporary pacing in more than 50% of cases. Implantation of permanent pacemaker was necessary in two patients (9%). Mean follow-up period was 10.2±3.7 months. Considering additional therapy (drug therapy, electrical cardioversion, catheter ablation), we can emphasize high percentage of sinus rhythm recovery outside the «blind period» after biatrial CryoMaze procedure (16 (73%) patients). At the same time, catheter ablation can increase the effectiveness of CryoMaze procedure.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 5","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054272","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":"[Regenerative capabilities of platelet-rich plasma in different age groups].","authors":"T I Vlasova, E P Brodovskaya, A P Vlasov, K S Madonov, E N Kovalenko, S S Myakushin, A I Polozova","doi":"10.17116/hirurgia202505136","DOIUrl":"https://doi.org/10.17116/hirurgia202505136","url":null,"abstract":"<p><strong>Objective: </strong>To study the age-adjusted regenerative potential of platelet-rich plasma (PRP) in a culture of dermal fibroblast cells with analysis of proliferative, migratory and metabolic activity of cells after their stimulation with PRP from donors of different ages.</p><p><strong>Material and methods: </strong>To prepare PRP, we used one of the classic protocols for one-stage centrifugation of whole blood from healthy donors divided into age groups: the first group (<i>n</i>=10) - donors aged 30-40 years, the second group (<i>n</i>=10) - donors aged 60-70 years. We used hTERT-HDFa (d220) cell line and added donor PRP to the experimental wells at concentrations of 10%. Samples without PRP comprised group 0 (K). The same medium without PRP supplemented with 10% FBS was used as a positive control (group 0 (K 10% FBS)). We analyzed metabolic activity of cells (MTT test) and migration activity of fibroblasts in \"scratch assay\". We estimated intensity of reactive oxygen species (ROS) release, morphological characteristics of cells and mechanisms of cell death (fluorescence microscopy).</p><p><strong>Results: </strong>PRP from donors aged 60-70 years reduced metabolic activity of hTERT-HDFa culture on the first day of experiment by 85.5% (<i>p</i><0.001) compared to the first group. ROS release by fibroblasts after addition of plasma from donors aged 30-40 years was maximum in the first hours and decreased throughout the follow-up period. After addition of plasma from donors aged 60-70 years, ROS release did not show significant changes in the first hours, but significantly increased throughout the follow-up period. Microscopy revealed the highest percentage of viable cells in groups 0 (K 10% FBS) and 1 (donors aged 30-40 years). The highest percentage of necrosis and apoptosis was recorded in group 2 (donors 60-70 years).</p><p><strong>Conclusion: </strong>In the first 24 hours, we revealed pro-oxidant stimulating effect of PRP from young donors with increase in metabolic activity and no cell necrosis. Addition of PRP from elderly donors on the first day was accompanied by lower metabolic activity of culture and higher percentage of cell necrosis and apoptosis. There was no difference in migration activity of cells depending on donor age.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 5","pages":"36-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048309","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":"[Resection of false posttraumatic aneurysm of the axillary artery within a separate medical airmobile detachment in special military operation zone].","authors":"O Yu Kharchenko, A N Kazantsev, O V Alekseev, R M Makhmudov, V N Kholmatov, R R Tenishev","doi":"10.17116/hirurgia2025061122","DOIUrl":"https://doi.org/10.17116/hirurgia2025061122","url":null,"abstract":"<p><p>The authors describe surgical treatment of soldier with false posttraumatic aneurysm of the left axillary artery in special military operation zone. As a result of mine-explosive wound, the left axillary artery was injured by metal fragment. This led to aneurysm with neuropathy and venous insufficiency of the left upper limb. Axillary artery replacement with saphenous vein was performed, and foreign body was removed. Postoperative period was uneventful. In 15 days after surgery, swelling of the left upper limb regressed. Hand sensitivity and motions recovered.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 6","pages":"122-127"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200304","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":"[Total gastrectomy with preserving duodenal passage by double tract reconstruction in patients with gastric cancer].","authors":"I B Uvarov, A M Manuilov, S N Derbenev, O M Asipovich","doi":"10.17116/hirurgia202506135","DOIUrl":"https://doi.org/10.17116/hirurgia202506135","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the immediate and long-term functional results of total gastrectomy (TGE) with restoration of duodenal passage through double tract reconstruction (DTR) in comparison with Roux-en-Y reconstruction.</p><p><strong>Material and methods: </strong>The study included 55 patients with gastric cancer who underwent TGE. They were divided into 2 groups: I - TGE with DTR (<i>n</i>=29); II - TGE with Roux-en-Y reconstruction (<i>n</i>=26). Follow-up examination was performed in 3, 6 and 12 months after surgery. Short-term results, nutritional status, morbidity and severity of dumping syndrome, as well as GSRS scores of the quality of life were assessed.</p><p><strong>Results: </strong>TGE with DTR does not increase duration of surgery, blood loss and postoperative morbidity. Patients after TGE and DTR were characterized by faster and more complete recovery of body weight, BMI, serum transferrin and NRI within 6 and 12 months after surgery. No between-group differences in the incidence and severity of reflux esophagitis were found. Availability of duodenum for endoscopic examination was 93.1%. TGE with DTR was followed by significantly lower incidence and severity of dumping syndrome. Patients with DTR reconstruction were characterized by faster recovery of the quality of life.</p><p><strong>Conclusion: </strong>TGE with DTR in patients with gastric cancer is characterized by comparable short-term results, faster recovery of nutritional status and quality of life in long-term period after surgery, lower incidence and severity of dumping syndrome.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 6","pages":"35-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200311","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":"[CT imaging in the treatment of ventral hernias].","authors":"A N Petrovskiy, V V Polovinkin, A A Sukhinin","doi":"10.17116/hirurgia202505186","DOIUrl":"https://doi.org/10.17116/hirurgia202505186","url":null,"abstract":"<p><p>Ventral hernias are one of the most common problems in abdominal surgery. At the same time, clinical diagnosis of abdominal hernia is a straightforward issue amenable to surgical treatment in the absence of severe comorbidities. However, long-term follow-up revealed disappointing results regarding complication rates and incidence of postoperative recurrences. In this context, preoperative planning with control of comorbidities and complete visualization of hernia and its anatomical relationships with abdominal organs is important. Computed tomography (CT) offers the best opportunity to determine dimensions and location of hernial defect(s), diastasis recti and/or associated muscle atrophy, as well as loss of domain. This information is valuable to select the best surgical technique (open or minimally invasive), location and fixation of mesh, possible need for various separation techniques, botulinum toxin, preoperative pneumoperitoneum or reduction interventions on abdominal organs. Nevertheless, this issue remains peripheral to active surgical discussions focusing on intervention techniques, postoperative management, etc., since there is currently no clear communication between radiologists and surgeons in this area of surgery. This review is devoted to the role of CT in the treatment of ventral hernias.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 5","pages":"86-95"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048186","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":"[Factors of delayed gastric emptying after pancreaticoduodenectomy].","authors":"V A Suvorov, S I Panin, M P Postolov, S E Tolstopyatov, A V Panova, A V Puzikova, M A Lyubimov, A A Linchenko","doi":"10.17116/hirurgia202504123","DOIUrl":"https://doi.org/10.17116/hirurgia202504123","url":null,"abstract":"<p><strong>Objective: </strong>To study the factors of delayed gastric emptying after pancreaticoduodenectomy using artificial intelligence.</p><p><strong>Material and methods. the: </strong>Study included 142 patients after pancreaticoduodenectomy for malignant pancreaticoduodenal tumors. The probability of delayed gastric emptying was determined using neural network analysis (SPSS Statistics v.26). Quality of the model was assessed considering sensitivity, specificity, diagnostic efficacy and AUROC.</p><p><strong>Results: </strong>Delayed gastric emptying after pancreaticoduodenectomy occurred in 33 (23.2%) patients. In multivariate analysis, delayed gastric emptying was associated with BMI > 30 kg/m², tumor diameter ≤2 cm and postoperative pancreatitis. Model sensitivity was 93.9%, specificity 97.2%, diagnostic efficacy 96.5%, AUROC 0.924±0.011 (95% CI: 0.834-0.967).</p><p><strong>Conclusion. a: </strong>Rtificial intelligence makes it possible to determine the factors of delayed gastric emptying after pancreaticoduodenectomy.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 4","pages":"23-29"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989099","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":"[Academician Mikhail Israelievich Perelman (20.12.1924-29.03.2013). 100 years since his birth].","authors":"V D Parshin, V A Porkhanov","doi":"10.17116/hirurgia2025021128","DOIUrl":"10.17116/hirurgia2025021128","url":null,"abstract":"<p><p>Modern thoracic surgery is quite young. Only after the Great Patriotic War conditions for performing thoracic surgery in the sense in which we understand it today appeared. The advent of intubation anesthesia and the solution of the issue of pneumothorax made it possible to operate safely in diseases and trauma of the thoracic cavity and thoracic organs. Further progress is associated with many famous domestic and foreign surgeons. It is gratifying that among them there are many representatives of the Russian surgical school: Y.Y. Janelidze, A.A. Vishnevsky, P.A. Kupriyanov, M.S. Grigoriev, A.P. Kolesov, F.G. Uglov, B.E. Linberg, I.S. Kolesnikov, S.M. Sokolov, N.V. Antelava, N.M. Amosov, B.V. Petrovsky, L.K. Bogush, V.I. Struchkov and others. It is especially gratifying that M.I. Perelman has also appeared among them since 1974. Their achievements were highly appreciated, including the awarding of State and Lenin prizes for works in the field of thoracic surgery.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 2","pages":"128-129"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366025","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":"[Successful groin flap for dorsal hand defect in elderly patient with comorbidity].","authors":"A Hakami","doi":"10.17116/hirurgia202501186","DOIUrl":"10.17116/hirurgia202501186","url":null,"abstract":"<p><p>The pedicled groin flap is a valuable and versatile option for covering wounds on the hand and distal forearm, offering predictable results with a procedure that is less complex and time-consuming than free-tissue transfer. Contrary to the common belief that the groin flap should be avoided in elderly patients due to the risk of shoulder stiffness, we observed satisfactory outcomes in a 93-year-old woman with comorbidities of type 2 DM, Arterial hypertension and rheumatoid arthritis and status post Hip TEP on both sides in 2009 and 2007. Immediate shoulder mobilization and continued physical therapy during flap maturation and pedicle division were essential to achieve positive results.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 1","pages":"86-92"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123677","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}