Hirurg (Surgeon)最新文献

{"title":"Questionnaire as a stratification method in organizing colorectal cancer screening","authors":"D. P. Kulovskaya, Y. Shelygin, S. A. Frolov","doi":"10.33920/med-15-2401-04","DOIUrl":"https://doi.org/10.33920/med-15-2401-04","url":null,"abstract":"The purpose of the study: to compare the efficacy of questionnaires and fecal immunochemical tests in stratification of risk groups during colorectal cancer screening. A non-randomized comparative study was conducted to evaluate the effectiveness of two stratification methods for colorectal cancer screening as part of pilot projects in the regions of the Central Federal District of the Russian Federation. In the first group, the stratification method was the original questionnaire, and in the second group — the fecal immunochemical test (FIT). All participants included in the first and second groups underwent colonoscopy at the second stage of screening. A total of 250 respondents participated in the study, 128 in the questionnaire group and 122 in the FIT group. In the questionnaire group, a high risk of colorectal cancer was found in 91 (71.1 %) individuals, while 37 (28.9 %) respondents had a low risk. Based on colonoscopy results, colorectal cancer and colorectal polyps were diagnosed in 65 (50.8 %) participants, and no significant pathology was found in 63 (49.2 %). In the FIT group, 102 (83.6 %) participants tested positive (FIT+) and 20 (16.4 %) tested negative (FIT-). According to the results of the performed colonoscopy, colorectal cancer and colon polyps were diagnosed in 75 (61.5 %) individuals, while no significant pathology was detected in 47 (38.5 %) participants. The sensitivity of the questionnaire was 86.2 % (95 % CI 75.3–93.5 %) and specificity was 44.4 % (95 % CI 31.9–57.5 %); the predictive value of a positive result was 61.5 % (95 % CI 50.7–71.6 %), and the predictive value of a negative result was 75.7 % (95 % CI 58.8–88.2 %). The FIT sensitivity was 86.7 % (95 % CI 76.8–93.4 %), the specificity was 21.3 % (95 % CI 10.7–35.7 %), the predictive value of a positive result was 63.7 % (95 % CI 53.6–73.0 %), and the predictive value of a negative result was 50.0 % (95 % CI 27.2–72.8 %). In conclusion, the questionnaire method in the colorectal cancer screening model is comparable in sensitivity and specificity to those of the FIT. It is essential to emphasize that questionnaires, along with ease of implementation, do not entail significant economic costs.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"68 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455288","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":"Clinical and economic rationale for cervicalcancer screening program. Literature review","authors":"V. N. Zhurman, T. Y. Maslennikova, E. Eliseeva, L. S. Matyushkina, S. G. Rychkova","doi":"10.33920/med-15-2401-06","DOIUrl":"https://doi.org/10.33920/med-15-2401-06","url":null,"abstract":"Cervical cancer ranks among the first in morbidity and mortality in female population of working age not only in the Russian Federation, but also in many countries worldwide. Moreover, in recent years there has been a tendency towards a decrease in the average age of mortality from this pathology, which may be due to the imperfection of the ongoing cytological screening programs. An analysis of the literature data on the clinical and economic feasibility of cervical cancer screening programs allows evaluating the information about their necessary frequency, the age category of women, and the ef fectiveness of timely detection of the pathology.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"426 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454139","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":"Use of laser technologies in the treatment of hemorrhoids (Literature review)","authors":"M. G. Yusova, V. Korolik, A. M. Kuzminov","doi":"10.33920/med-15-2401-03","DOIUrl":"https://doi.org/10.33920/med-15-2401-03","url":null,"abstract":"Hemorrhoids are one of the most common diseases of the anorectal region, representing a serious medical and socio-economic problem that significantly affects the quality of life of patients. Surgical treatment of this pathology is necessary in cases where the patient complains of bleeding and prolapse of internal hemorrhoids, which cannot be treated with conservative methods. Traditional methods of surgical treatment of this pathology, despite their effectiveness, have a number of significant disadvantages, such as severe pain after surgery, prolonged healing of anal canal wounds, a long period of incapacity for work, as well as possible complications in the form of strictures of the anal canal, insufficiency of the rectal obturator, and anal fistulas. Recently, due to the active development of medical technology in the surgical treatment of hemorrhoids, many new minimally invasive treatment methods have appeared, including the use of lasers with different wavelengths, which have demonstrated high efficiency along with such advantages as reducing the intensity of postoperative pain syndrome, decreasing the frequency of intraoperative and early postoperative complications, as well as the possibility of outpatient implementation of these techniques. Depending on the stage of hemorrhoidal disease, as well as the type of laser radiation, various methods that affect one or both (vascular and mechanical) links in the pathogenesis of the disease are used. This article provides a review of modern literature data and analyzes the experience of using various lasers in the treatment of hemorrhoidal disease.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"590 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454165","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":"Selection of surgery type for patients with inguinal hernias","authors":"S. V. Kharitonov, S. S. Kharitonov, G. A. Petrosyan, E. V. Miroshnikov","doi":"10.33920/med-15-2401-01","DOIUrl":"https://doi.org/10.33920/med-15-2401-01","url":null,"abstract":"The purpose of the study: to investigate the quality of life of patients with inguinal hernias after Lichtenstein’s surgery using the implants with a tissue-gripping system and conduct a comparative assessment of this technique and the results of classical laparoscopic surgery. The prospective controlled clinical study included the results of follow-up of 99 patients with inguinal hernias. The first group included the patients who underwent LHR surgery of the inguinal canal using a composite self-fixing polypropylene mesh. In the patients of the second group, LHR was performed using a composite polypropylene mesh, which was fixed with polypropylene suture material. The third group consisted of the patients operated on using the technique of laparoscopic transabdominal preperitoneal surgery. Indicators of physical and psychological health components were studied in the patients using the SF-36 questionnaire in the preoperative period and 3, 6, and 12 months after surgery. Results: The patients with inguinal hernias in the long-term postoperative period had different periods of restoration of quality of life, which were determined by the type of surgical intervention and the type of fixation of the synthetic implant. Three months after surgery, significant signs of normalization of indicators of the physical health component were recorded only in groups of the patients after LHR using self-fixing implants and TAPP. In the patients with suture fixation of implants during LHR, the first signs of restoration of the physical component of health, comparable to self-fixing meshes, were observed 6 months after surgery. Changes in indicators of the psychological health component in the patients of the LHR and TAPP groups did not differ at all study intervals. Conclusion: The use of implants with a tissue-gripping system when performing LHR leads to optimization and reduction of physical rehabilitation in patients with inguinal hernias, which makes it possible to recommend the use of self-fixing meshes for open repair in cases of relative and absolute contraindications to TAPP.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"78 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454833","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":"Changes in hormonal status after restrictive bariatric interventions","authors":"O. Galimov, V. O. Khanov, K. V. Nasyrova, D. Galimov, T. R. Ibragimov, A. Safargalina","doi":"10.33920/med-15-2401-02","DOIUrl":"https://doi.org/10.33920/med-15-2401-02","url":null,"abstract":"The purpose of the work was to study the impact of bariatric surgeries on hormonal status in patients with morbid obesity. The ghrelin levels were evaluated in 26 morbidly obese patients who underwent restrictive bariatric surgeries (13 gastric plications and 13 gastric sleeve resections). The initial level of ghrelin in the blood of the patients with morbid obesity was lower compared to the levels observed with normal body weight. We did not observe the reduction of ghrelin level expected after the resection of the fundus ghrelin-producing part of the stomach. The clinical study indicates that changes in gastric volume after restrictive bariatric interventions (sleeve resection or gastric plication) are accompanied by a slight increase in blood ghrelin levels. This increase is greater the higher the percentage of body weight loss after surgery. More in-depth study of this topic will help identify new strategies for treating morbid obesity in the future.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"70 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455015","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":"Organ-preserving technologies of surgical treatment of pulmonary tuberculosis using VAC therapy","authors":"M. Sinitsyn, T. Tokaev, A. Bikbaev, A. O. Shtykhno, D. Plotkin, A. V. Itskov","doi":"10.33920/med-15-2401-05","DOIUrl":"https://doi.org/10.33920/med-15-2401-05","url":null,"abstract":"This article demonstrates the possibilities of vacuum-assisted closure (VAC therapy) in surgical treatment of one of the most severe categories of patients — patients with chronic pulmonary tuberculosis with widespread drug resistance. The authors show the effectiveness of VAC therapy in various clinical situations: VAC therapy in combination with endoscopic valvular bronchoblocation, as an independent treatment method in a patient with bilateral fibrous-cavernous pulmonary tuberculosis, as well as a combination of VAC therapy with retrograde occlusion of bronchial fistula. The special feature of these cases is the performance of low-trauma organ-preserving operations in patients with no prospect of cure by conservative methods.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"260 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454364","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 evolution of the Caprini score","authors":"K. Lobastov, A. V. Kovalchuk, I. Schastlivtsev, L. Laberko","doi":"10.33920/med-15-2306-08","DOIUrl":"https://doi.org/10.33920/med-15-2306-08","url":null,"abstract":"The article is a narrative review of the literature that addresses the issues of individual risk assessment of hospital-acquired VTE using the Caprini score. It provides modern epidemiological data confirming the high medical and social significance of the problem of hospital venous thrombosis. The questions of the natural evolution of the Caprini score since the publication of the initial version in 1991 are discussed, a comparative analysis of the modifications of 2005, 2010 and 2013 is carried out, and the features of validation studies that have proven the superiority of the classical version of 2005 are discussed. Attention is paid to the problem of integrating the Caprini score into medical documentation with automation of the process of risk assessment and the appointment of preventive measures. The issue of heterogeneity of approaches to dividing patients into risk groups for developing VTE in accordance with the assessed scores is discussed separately; data from modern studies are presented confirming the existence of very high (9–10 points) and extremely high (≥11 points) risk groups that require an individual approach to prevention of thrombotic complications. Summary data are provided on the frequency of registration of VTE in accordance with Caprini scores in patients of various medical profiles based on a meta-analysis of 68 validation studies. The possibility of using patient-oriented questionnaires based on the Caprini score is discussed, which demonstrate high consistency with the original scale, but have not yet been studied in prospective studies. Revised algorithms are proposed to individually assess the risk of VTE using the 2005 vers of the Caprini score and prescribe adequate prophylaxis. It is concluded that the Caprini score still continues to improve and evolve in accordance with general trends in the development of medicine and healthcare, while maintaining the status of the most studied and in demand system for individual assessment of the risk of developing hospital-acquired VTE.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"554 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139177475","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":"Safety of strictureplasty compared with bowel resection in the surgical treatment of patients with Crohn’s disease","authors":"A. Vardanyan, I. S. Anosov, O. Sushkov, S. Achkasov","doi":"10.33920/med-15-2303-02","DOIUrl":"https://doi.org/10.33920/med-15-2303-02","url":null,"abstract":"The article presents a comparative analysis of the small intestine strictureplasty and the resection method for the treatment of patients with Crohn's stricture. The results obtained showed the absence of any statistically significant differences between the two methods of surgical treatment. Thus, we can confidently speak about the safety of strictureplasty in patients with a complicated form of Crohn's disease.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122794476","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":"Vaccination strategies and adoptive immunotherapy for ovarian cancer. Literature review","authors":"V. N. Zhurman, E. Eliseeva","doi":"10.33920/med-15-2303-06","DOIUrl":"https://doi.org/10.33920/med-15-2303-06","url":null,"abstract":"The review considers modern cancer vaccines consisting of autologous whole cells, dendritic cells loaded with autologous tumor-specific antigens, or plasmids, which lead to antigen expression and immune activation after repeated exposure. Each vaccination strategy can be supplemented with various immunomodulatory agents. Engineering autologous immunotherapy of tumor cells is an approach to restoring the effector function of T cells. Other tumor-associated antigens (TAAs) are also of interest in ovarian can cer. Adoptive immunotherapy is based on infusion of autologous or allogeneic tumor-targeted immune cells that have been expanded and/or activated exvivo. Adoptive immunotherapy can be based on antigen-dependent (innate immunity, for example, natural killer (NK) and cytokine-induced killer (CIK) cells) or antigen-independent (adaptive immunity, for instance, TILs, chimeric antigen receptor (CAR) T cells) strategies. NK cells can kill tumor cells without prior sensitization and play an important role in tumor immunosuppression. Adoptive T-cell immunotherapy, CAR-T-cell immunotherapy, allows combining antigen specificity through conjugation of a specific antibody with T-cell activating properties in a single fused molecule. CARs bypass the immune mechanism of cancer cell release as they endow T-lymphocytes with cytotoxic effector properties. In order to reduce mortality and improve prognosis, further study and refinement of immunotherapeutic strategies for the treatment of ovarian cancer is required.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"175 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128351631","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":"Minimally invasive laser technologies in the surgical treatment of hemorrhoidal disease: problems and prospects (literature review)","authors":"N. D. Yartseva, L. V. Kornev, E. K. Naumov, G. Rodoman, L. Laberko","doi":"10.33920/med-15-2303-03","DOIUrl":"https://doi.org/10.33920/med-15-2303-03","url":null,"abstract":"Based on the literature data, the article reviews the latest advances in the surgical treatment of patients with hemorrhoids. The methods of historical significance, as well as current surgeries are analyzed.The literature review focuses on laser technologies, in particular, laser hemorrhoidoplasty. The paper considers the historical aspects of the development of this approach in proctology, the main surgical techniques, indications and contraindications, possible intra- and postoperative complications, among which the most common are intraoperative bleeding, delayed bleeding, and pain syndrome. The analysis of clinical efficacy and the structure of recurrences and adverse outcomes are presented. Different regimes of laser exposure are analyzed as well. According to the literature data, laser hemorrhoidoplasty is a relatively clinically effective and safe minimally invasive surgical intervention, characterized by short postoperative rehabilitation and a low number of complications. Laser hemorrhoidoplasty is characterized by a low severity of pain syndrome both during the intervention and in the postoperative period. The high economic efficiency of the considered surgical intervention was noted. Meanwhile, the question of the optimal dosing and parameters of the laser energy used in the course of laser hemorrhoidoplasty remains open and should be answered in the upcoming clinical and experimental studies.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129962714","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}