Khirurgiya最新文献_第8页

[Surgery for mediastinal teratoma containing pancreatic tissue]. [含有胰腺组织的纵隔畸胎瘤手术]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202402175

V D Parshin, A V Parshin, M A Ursov, N B Paramonova, A S Tertychnyy, V O Dzhuganova

{"title":"[Surgery for mediastinal teratoma containing pancreatic tissue].","authors":"V D Parshin, A V Parshin, M A Ursov, N B Paramonova, A S Tertychnyy, V O Dzhuganova","doi":"10.17116/hirurgia202402175","DOIUrl":"10.17116/hirurgia202402175","url":null,"abstract":"Surgery for mediastinal tumors is still one of the most difficult in modern medicine. This is due to vital organs and various nature of tumors in this area. Teratomas are relatively rare among mediastinal tumors. However, they have certain features that is important for treatment strategy and management of possible complications. This can complicate diagnostic algorithm, exclude transthoracic biopsy and contribute to active surgical approach even for benign process. Oncogenesis of teratoma has its own characteristics. Tissues of different organs are always present in this tumor. Among these, pancreatic tissue inclusions are rare. A few data in the world literature on the treatment of such patients do not allow to develop a universally accepted algorithm of diagnosis and treatment. The authors present two patients with mediastinal teratoma. The second patient had teratoma with pancreatic tissue. The authors discuss the diagnostic algorithm for similar cases. A special attention is paid to description of possible complications throughout long-term follow-up period. Surgical aspects including the choice of access and local spread of process (adhesions in the area of surgical interest) are considered. The report on the treatment of two patients with rare mediastinal tumors containing pancreatic tissue will be useful for primary care physicians, thoracic surgeons, oncologists and morphologists.","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":"139724325","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

[Advisability of carotid endarterectomy in asymptomatic patients]. [无症状患者颈动脉内膜切除术的可取性]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202403145

D A Korshunov, V A Kulbak, A V Chupin

{"title":"[Advisability of carotid endarterectomy in asymptomatic patients].","authors":"D A Korshunov, V A Kulbak, A V Chupin","doi":"10.17116/hirurgia202403145","DOIUrl":"10.17116/hirurgia202403145","url":null,"abstract":"Objective: To determine the optimal treatment strategy for patients with asymptomatic carotid stenosis.Material and methods: The authors reviewed clinical guidelines for the management of patients with asymptomatic carotid stenosis 60-99%, as well as medical studies and meta-analyses comparing carotid endarterectomy and optimal drug therapy in asymptomatic patients between 1993 and 2023.Results: The choice of treatment strategy for patients with asymptomatic carotid artery stenosis is still a controversial issue. There were several large randomized clinical trials comparing carotid endarterectomy with optimal medical therapy in asymptomatic patients at the end of the 20th century. However, drug therapy has undergone significant changes calling into question the relevance of previous results. This review highlights the evolution of management of patients with asymptomatic carotid stenosis and also presents modern approaches to the treatment of these patients.Conclusion: Patients younger 75 years old gain an advantage from carotid endarterectomy with small perioperative risk compared to optimal drug therapy and yearly risk of cerebral embolism. Patients with asymptomatic carotid stenosis 80-99% are candidates for carotid endarterectomy due to higher risk of acute cerebrovascular accident at least until more data are available. The choice of the best tactics for a particular patient should be made individually depending on own experience and patient's adherence to therapy and lifestyle correction. The results of the ACTRIS (2025) and CREST-2 (2026) studies are expected to clarify this issue.","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":"140111733","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

[Da Vinci robotic complex in hernia repair surgery]. [达芬奇机器人在疝修补手术中的应用]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202403114

A V Kolygin, M I Vyborny, D I Petrov

{"title":"[Da Vinci robotic complex in hernia repair surgery].","authors":"A V Kolygin, M I Vyborny, D I Petrov","doi":"10.17116/hirurgia202403114","DOIUrl":"10.17116/hirurgia202403114","url":null,"abstract":"Objective: To review the first robotic hernia repairs performed at the Ilyinsky Hospital, evolution of this technology, learning curve and early outcomes.Material and methods: There were 17 procedures at the Ilyinskaya Hospital between 2021 and 2023 (13 men and 4 women). Mean age was 60 years, body mass index 28 kg/m2. ASA grade 1 was observed in 1 patient, grade 2 - 14 ones, grade 3 - 2 patients. Ventral, inguinal and umbilical hernias were diagnosed in 7, 8 and 2 cases, respectively. Ventral hernias required IPOM+ procedure in 3 cases, eTEP-RS procedure in 2 cases and eTEP-RS-TAR procedure in 2 cases. Patients with inguinal hernia underwent transabdominal preperitoneal hernia repair. In case of umbilical hernia, TARUP procedure was performed in 1 case and vTAPP procedure in 1 case.Results: Mean surgery time was 2 hours 38 min (min 1 hour 35 min, max 10 hours 11 min). There was one intraoperative complication (bleeding from epigastric artery). The follow-up period ranged from 3 months to 3 years. There were no recurrent hernias. Postoperative complications were noted in 2 cases. One patient was diagnosed with epididymitis after TAPP, 1 patient - with seroma after eTEP-RS procedure. All complications were relieved by conservative treatment. Bleeding from a. epigastrica inferior was diagnosed after removal of the trocar at the end of surgery. This event required suturing.Conclusion: Robotic hernia repair appears to be technically feasible and safe. This approach provides favorable results regarding quality of life and recurrence rate.","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":"140111738","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

[Endoscopic stenting for malignant pancreatobiliary strictures]. [恶性胰胆管狭窄的内镜支架治疗]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202401129

Yu D Kulikov, Yu S Teterin, A S Mironova, P A Yartsev, T E Rohas Tadevosyan, K A Nugumanova

引用次数: 0

[Efficacy and safety of surgical treatment of patients with pathological tortuosity of the internal carotid artery]. [颈内动脉病理性迂曲患者手术治疗的有效性和安全性]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202401164

A V Gavrilenko, A V Abramyan, V A Kochetkov, E A Tarabrin

{"title":"[Efficacy and safety of surgical treatment of patients with pathological tortuosity of the internal carotid artery].","authors":"A V Gavrilenko, A V Abramyan, V A Kochetkov, E A Tarabrin","doi":"10.17116/hirurgia202401164","DOIUrl":"10.17116/hirurgia202401164","url":null,"abstract":"No multicenter randomized clinical trial has been conducted worldwide to date on indications, types of surgery and their comparison with conservative treatment in patients with PI BSA.Objective: Of the study is to improve the results of surgical treatment in patients with pathological tortuosity of the internal carotid artery.Material and methods: The study included 119 patients (41 (34%) men and 78 (66%) women) with PI ICA aged 34 to 71 years (average age 53.2±7.5 years) divided into 2 groups. 64 patients (54%) of group I underwent BSA resection with lower mouth and 55 patients (46%) of group II underwent BSA prosthetics. Depending on the degree of neurological disorders, patients were distributed according to the classification of A.V. Pokrovsky.Results: In the early postoperative period, TIA was noted in one patient, and transient lesions of the cranial nerves were observed in 5 patients. During 5 years of follow-up, none of the patients developed TIA, IS or other vascular events. In the early surgical period, there were no significant differences in effectiveness between the groups of patients. In the long-term period (5 years after surgery), a higher frequency of asymptomatic patients was noted in group I.Conclusion: Resection and replacement of a pathologically tortuous internal carotid artery (ICA) is a safe and effective surgical treatment. A multicenter randomized trial should be conducted to compare the effectiveness of surgical treatment of PI ICA with a conservative approach to effectively treat patients.","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":"139521889","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

[First experience of applying domestic video fluorescent equipment for visualization and blood flow evaluation of the parathyroid glands]. [应用国产视频荧光设备对甲状旁腺进行可视化和血流评估的首次经验]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202401171

M B Saliba, V A Zhivova, F P Vetshev, D I Gabaidze, K T Efendiev, A M Udeneev, E A Pavlova, A A Shiryaev

{"title":"[First experience of applying domestic video fluorescent equipment for visualization and blood flow evaluation of the parathyroid glands].","authors":"M B Saliba, V A Zhivova, F P Vetshev, D I Gabaidze, K T Efendiev, A M Udeneev, E A Pavlova, A A Shiryaev","doi":"10.17116/hirurgia202401171","DOIUrl":"10.17116/hirurgia202401171","url":null,"abstract":"In recent years, predictive methods for assessing the preservation of the parathyroid glands have been actively implemented. The article describes the first experience of evaluating the blood supply of the parathyroid glands by quantitative determination of the indocyanine green (ICG) accumulation index in real time in 6 patients before and after a thyroidectomy with central neck lymph node dissection for papillary thyroid cancer. Intraoperative fluorescent angiography was performed by using domestic equipment with a fluorescent module, as well as by using a domestic medication of ICG. Intraoperative values of the ICG accumulation index were compared with the levels of ionized calcium and parathyroid hormone perioperatively. No clinical manifestations of hypocalcemia were detected in the postoperative period. The obtained results showed the informativeness of the numerical assessment of the intensity of ICG fluorescence. The evaluation of the distribution (accumulation) of ICG has prospects for practical application in thyroid surgery in the formation of tactics for preserving the parathyroid glands and predicting postoperative hypoparathyreosis.","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":"139521922","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

[Successful treatment of severe purulent peritonitis against the background of intraperitoneal hypertension syndrome (clinical case)]. [成功治疗腹腔内高压综合征背景下的严重化脓性腹膜炎（临床病例）]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202406188

M G Gamzalaeva, Kh D Magomedova, M M-R Salavatova, T S Magomedkasumova, A R Magomedov

引用次数: 0

[Thoracoscopic resection of azygos vein aneurysm]. [胸腔镜下zygos静脉动脉瘤切除术]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia2024071124

A N Lednev, A A Pechetov, N V Gulova

引用次数: 0

[Redo right ventricular outflow tract repair for destruction of xenopericardial patch with monocusp]. [右心室流出道修补术因单克隆抗体破坏异位心包补片而重做]。

Khirurgiya Pub Date : 2024-01-01 DOI: 10.17116/hirurgia202410197

A V Lysenko, G I Salagaev, A V Vavilov, Yu S Gilevskaya, Yu V Belov