Hirurg (Surgeon)最新文献

{"title":"Possibilities of endovideosurgery to bypass appendicular peritonitis. Literature review","authors":"O. Galimov, V. O. Khanov, T. R. Ibragimov, D. Galimov","doi":"10.33920/med-15-2206-03","DOIUrl":"https://doi.org/10.33920/med-15-2206-03","url":null,"abstract":"An analysis of modern literature and our own clinical experience suggests that the use of laparoscopic methods in the surgical treatment of acute appendicitis complicated by peritonitis has proven advantages over open surgery. The key to successful treatment of patients is reliable elimination of the source of peritonitis — performing an adequate appendectomy. Early laparoscopic debridement for postoperative peritonitis can be an alternative to non-surgical treatment and delayed intervention. The success of the laparoscopic approach depends not only on technical aspects, but also on the correct determination of indications and contraindications for surgery.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121907952","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":"Coronary bypass surgery on the background of Covid-19. A clinical case","authors":"V. S. Ermakov, V. Kravchuk, O. Porembskaya, K. V. Kuznetsov, E. Knyazev, A. V. Belikov, T. V. Garpinchenko, I. Kazakova, K. Lobzhanidze, R. Deev, S. Sayganov","doi":"10.33920/med-15-2206-04","DOIUrl":"https://doi.org/10.33920/med-15-2206-04","url":null,"abstract":"COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a huge impact on the health of the world's population. Due to the high contagiousness and rapid spread of the infection, on March 11, 2020, the World Health Organization (WHO) announced the beginning of a pandemic. Meanwhile, despite the COVID-19 pandemic, coronary heart disease is one of the most common diseases in the world and still ranks first in the structure of mortality. Currently, one of the optimal and most effective methods of surgical treatment of coronary heart disease with atherosclerotic lesions of the coronary bed is direct myocardial revascularization — coronary bypass surgery. However, cardiac surgical interventions during the COVID-19 pandemic are associated with certain risks. Active infection is a serious aggravating factor that can lead to the development of complications and death. This article presents a clinical case of the death of a 65‑year-old patient after elective coronary artery bypass grafting, where previously undiagnosed COVID-19 was detected in the early postoperative period.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121773242","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":"An approach for determination of proteasome activity in small amounts of thyroid tumor samples","authors":"I. R. Sumedi, T. I. Shalaeva, A. S. Plekhanova, N. Sharova, T. Astakhova","doi":"10.33920/med-15-2205-05","DOIUrl":"https://doi.org/10.33920/med-15-2205-05","url":null,"abstract":"The accuracy of preoperative diagnosis of thyroid tumors is still insufficiently high. Determination of proteasome activity is a promising method for preoperative and/or intraoperative diagnosis of tumors of this localization, however, the method of its implementation involved obtaining a rather large tissue sample, from 20 to 70 mg. Separation of such a fragment from the tumor may complicate further histological examination. In this regard, the aim of this work was to determine the smallest amount of tissue sample suitable for measuring proteasome activity and diagnostics. The obtained results allow concluding that samples weighing 4 mg or more are suitable for diagnostic purposes. The approach to diagnosis using small amounts of tissue samples will preserve the structure of the tumor for further histological examination.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"4568 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126469395","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 treatment of mesenteric thrombosis developed in a patient with hypernephroma after nephrectomy with inferior vena cava thrombectomy","authors":"O. Galimov, V. O. Khanov, T. R. Ibragimov","doi":"10.33920/med-15-2205-01","DOIUrl":"https://doi.org/10.33920/med-15-2205-01","url":null,"abstract":"The article presents a clinical case of successful treatment of small intestine gangrene due to mesenteric thrombosis that developed in a patient with hypernephroma after nephrectomy with inferior vena cava thrombectomy.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"180 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116848059","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":"Endoscopic application of incomplete silver salt of poly (acrylic acid) in patients with pulmonary hemorrhage","authors":"N. Chernekhovskaya, I. Korzheva, D. V. Andreev, А. V. Povalyaev, S. G. Tereshchenko","doi":"10.33920/med-15-2205-07","DOIUrl":"https://doi.org/10.33920/med-15-2205-07","url":null,"abstract":"Pulmonary hemorrhage is a severe complication associated with high lethality. One of the main methods of diagnosis and treatment is the endoscopic one. This paper describes the experience of treating 100 patients with pulmonary hemorrhage. Incomplete silver salt of poly (acrylic acid) (ISPA), a new generation biologically active hemostatic with silver nanoparticles, was used as a hemostatic agent, which was injected into the tracheobronchial tree during bronchoscopy in the amount of 3.0 to 10.0 mL depending on the degree of pulmonary hemorrhage. In all patients, hemostasis was achieved within a time interval of 30 seconds to 1 minute with a single injection of the ISPA solution. No complications or bleeding recurrence were registered.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126663255","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":"Evaluation of the effectiveness of buccal ureteroplasty in the late postoperative period","authors":"A. Volkov","doi":"10.33920/med-15-2205-06","DOIUrl":"https://doi.org/10.33920/med-15-2205-06","url":null,"abstract":"Surgical treatment of organic obstruction of the upper urinary tract is a complex problem in modern urology. The aim of the study was to analyze the assessment of the late postoperative period after ureteral replacement with a buccal graft. We followed up 32 patients who underwent buccal ureteroplasty (BU). The effectiveness of this surgical intervention was assessed by the absence of recurrence of the disease and the need to reuse ureteral stenting or percutaneous nephrostomy. Recurrence of urinary tract obstruction was later detected in 3 (9.4 %) patients. Also, after removal of the stent in 18 patients, the following indicators were evaluated: glomerular filtration rate, maximum systolic blood flow velocity in the interlobar arteries of the kidney, thickness of the kidney parenchyma, ureteroscopy, and pain in the lumbar region. After 6 months, the established parameters were re-determined, and in case of improvement or unchanged primary indicators, each of the parameters was scored 1 point, in case of deterioration of the primary indicators, each of the parameters was scored 0 points. If the total score is 3 or more, then the course of the postoperative period after reconstructive surgery on the upper urinary tract using a buccal graft is considered favorable and conservative therapy is continued. Two of the 18 patients had a score of 2, which led to a change in the tactics of postoperative follow-up. Thus, this method for assessing parameters in operated patients allows timely correction of renal dysfunction.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127101297","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":"Results of treatment of acute arterial thrombosis in patients with severe course of coronavirus infection COVID-19","authors":"A. Nikolskiy, V. Kravchuk, A. S. Mukhin, V. S. Ermakov, N. A. Trofimov, D. V. Volkov, D. Petrov, S. I. Chistyakov, A. Rybinskiy, V. Nikolskiy, E. Sharabrin","doi":"10.33920/med-15-2205-03","DOIUrl":"https://doi.org/10.33920/med-15-2205-03","url":null,"abstract":"Acute arterial thrombosis against the background of the novel coronavirus infection COVID-19 is an unfavorable complication. The survival prognosis in this category of patients is much worse than in the rest of the patient population. The aim of the work is to compare the immediate results of various methods of treating acute arterial insufficiency in patients with the novel coronavirus infection COVID-19, complicated by the development of acute arterial thrombosis of various localizations. 42 clinical cases of treatment of acute arterial pathology in patients with confirmed COVID-19 infection were analyzed. The severity of the underlying disease was not considered as a criterion for exclusion from the study. Surgical treatment by open intra-arterial thrombectomy under local anesthesia was used in 9 patients. Endovascular balloon angioplasty of arteries followed by selective catheter-guided thrombolysis with alteplase was performed in 17 patients. Sixteen patients received systemic transvenous thrombolysis with the recombinant human tissue plasminogen activator alteplase at a dose of 100 mg. The development of arterial thrombosis against the background of the coronavirus infection is accompanied by a high risk of death in the absence of timely and active specialized care. In the study group, 18 patients (43 %) with acute arterial thrombosis associated with COVID-19 deceased; of these, eight patients underwent open thrombectomy, eight patients had systemic transvenous thrombolysis with alteplase, and two patients underwent endovascular balloon angioplasty with selective catheter-guided thrombolysis with alteplase. A favorable outcome of the disease was noted in 24 patients (57 %); of these, fifteen patients underwent endovascular balloon angioplasty with selective catheter-guided thrombolysis with alteplase, and 8 patients had systemic thrombolysis with alteplase. Optimal treatment results were achieved in the group of patients using minimally invasive endovascular treatment methods in combination with tissue plasminogen activator. In the group of non-transportable patients with grade 3 respiratory failure and high perioperative risks, positive results were achieved exclusively through the use of systemic transvenous thrombolysis. These data allow us to consider justified the use of options for systemic thrombolysis and selective catheter thrombolysis in combination with endovascular reconstruction as an alternative to «open» surgical methods for thevtreatment of acute arterial insufficiency against the background of COVID-19.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116764336","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":"Stripping vs endovenous thermal ablation in varicose veins: 5 year clinical and hemodynamic results of a randomized study","authors":"E. Burleva, S. Tyurin, A. V. Peshkov","doi":"10.33920/med-15-2205-04","DOIUrl":"https://doi.org/10.33920/med-15-2205-04","url":null,"abstract":"The aim of the study was to analyze the five-year clinical and hemodynamic results after minimally invasive phlebectomy and endovenous thermal ablation in patients with СVD class C2. The study included three groups of patients that differed in the technique of elimination of vertical GSV reflux within the thigh. The patients were stratified according to a certain hemodynamic profile: 1st group (stripping) included 63 patients; 2nd group (EVLC) — 61 patients; 3rd group (RFA) — 61 patients. A number of ultrasound hemodynamic parameters was studied in each group. The comparative study of the course of the late postoperative period was carried out; it included clinical examination, calculation of the total VCSS score, and ultrasound of the veins of lower extremities. As a result, it was found that in certain VV patients, after the removal of the GSV trunk within the thigh, a significant restructuring of the venous bed was observed in 1 year. It developed according to various scenarios. In the 1st group, medial and lateral overflows appeared on the thigh with drainage into the residual trunk; in the 2nd and 3rd group it was not observed, but the perforating reflux to the residual GSV trunk was gradually increasing. The restructuring of the venous bed caused valvular insufficiency of the trunk in 29 % of patients in the 1st group, 17.2 % in the 2nd group, and in 19.3 % of patients in the 3rd group by the 5th year of follow-up. As the pathological process was developing, the diameter of the GSV trunk on the shin was progressively increasing, and the summarized diameter of the PV of the lower leg was also increasing. By the 5th year of follow-up, perforant insufficiency was registered in 32.2 % of patients in the 1st group, 37.9 % in the 2nd group, and in 38.7 % of patients in the 3rd group. The changes detected during ultrasound had no significant effect on the clinic. The overall VCSS score decreased by the 1st year of follow-up after all interventions, and then remained consistently low in all groups over the years.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130169684","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":"Endoscopic stricturotomy of colorectal anastomosis with rendezvous visual control via proximal colostomy","authors":"Y. Vinogradov, O. L. Naumov","doi":"10.33920/med-15-2205-02","DOIUrl":"https://doi.org/10.33920/med-15-2205-02","url":null,"abstract":"Тhe article describes a clinical case of colorectal anastomosis stricture in a patient with a proximal colostomy and the applied surgical tactics. Endoscopic stricturotomy with the rendezvous technique visual control is proposed.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114726359","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":"Surgical antibiotic prophylaxis: current issues of beta-lactams use","authors":"S. Zyryanov, O. Butranova","doi":"10.33920/med-15-2204-07","DOIUrl":"https://doi.org/10.33920/med-15-2204-07","url":null,"abstract":"The most common prescriptions for antibiotics in surgery are in the area of surgical antibiotic prophylaxis. According to clinical guidelines, beta-lactams, in particular, first and second generation cephalosporins, and in some cases aminopenicillins, should be used as drugs of choice. These drugs are leaders with regards to assessing the contribution of drugs of various pharmacological groups to the formation of drug allergies. However, real clinical practice reveals fewer cases of true allergy to beta-lactams compared to self-reported data by patients. Both underestimation and overestimation of the risks of hypersensitivity reactions with cephalosporins and penicillins is critical to the ultimate outcome of patient management. This review includes the main characteristics of drugs used for antibiotic prophylaxis in surgery and highlights topical issues of beta-lactam allergy and management of patients with various types of hypersensitivity reactions.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130366354","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}