Hirurg (Surgeon)最新文献_第5页

Target therapy for venous thrombosis: experimental extravagance or tangible future? 静脉血栓的靶向治疗:实验性的奢侈还是切实的未来?

Hirurg (Surgeon) Pub Date : 2022-07-30 DOI: 10.33920/med-15-2204-05

О. Y. Porembskaya, E. Starikova, К. V. Lobastov, D. T. Mammedova, L. Laberko, V. Kravchuk, S. Saiganov

{"title":"Target therapy for venous thrombosis: experimental extravagance or tangible future?","authors":"О. Y. Porembskaya, E. Starikova, К. V. Lobastov, D. T. Mammedova, L. Laberko, V. Kravchuk, S. Saiganov","doi":"10.33920/med-15-2204-05","DOIUrl":"https://doi.org/10.33920/med-15-2204-05","url":null,"abstract":"Anticoagulant therapy is considered to be a treatment and prophylaxis standard for venous thrombosis (VT). Despite the high efficacy and safety of modern anticoagulants, bleeding as the side effect remains a prominent unresolved problem that can limit their use. As interrelation between immune system and coagulation is the basis of immunothrombosis, immunosuppression could be considered an alternative in the target therapy for venous thrombosis. Endothelial activation due to the blood stasis and vein wall hypoxia together with proinflammatory mediators promote essential conditions for venous thrombosis. The key points of this process are also the platelets and leukocytes activation and neutrophil extracellular traps secretion. Inhibition of intercellular interactions by the adhesion and signal molecules deletion (P-selectins, galectins, HMGB1) can fully prevent thrombosis or significantly reduce the thrombus. The same effect is observed when platelets function is suppressed by GPIbα transformation, CLEC-2 deletion or von Willebrand factor deficiency. Neutropenia contributes to a change in the thrombus structure and density, and less often prevents its formation. In addition, one of the options for the VT prevention in the experiment is the introduction of resorption mediators, which are secreted by effector cells in the process of thrombosis resolution. Target therapy appears to be a promising method based on key links in the VT pathogenesis, which may allow avoiding typical complications of anticoagulant therapy.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"10 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":"129234988","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: 1

The role of dilatation methods and lateral subcutaneous sphincterotomy in the internal anal sphincter spasm treatment (systematic literature review and meta-analysis) 扩张法和外侧皮下括约肌切开术在肛门内括约肌痉挛治疗中的作用(系统文献综述和meta分析)

Hirurg (Surgeon) Pub Date : 2022-07-30 DOI: 10.33920/med-15-2204-03

Z. Z. Kamaeva, A. Titov, A. Ponomarenko, R. Y. Khrukin, I. S. Anosov, Y. Shelygin

{"title":"The role of dilatation methods and lateral subcutaneous sphincterotomy in the internal anal sphincter spasm treatment (systematic literature review and meta-analysis)","authors":"Z. Z. Kamaeva, A. Titov, A. Ponomarenko, R. Y. Khrukin, I. S. Anosov, Y. Shelygin","doi":"10.33920/med-15-2204-03","DOIUrl":"https://doi.org/10.33920/med-15-2204-03","url":null,"abstract":"The main link in the pathogenesis of anal fissure is a spasm of the internal sphincter of the rectum, in connection with which many methods of muscle relaxation have been developed. A special place is occupied by dilatation methods, which are quite diverse. To assess their effectiveness and safety, the authors carried out a systematic review and meta-analysis of 9 selected randomized clinical trials comparing the results of treatment of chronic anal fissure using dilatation methods of internal anal sphincter relaxation and the traditionally used method of lateral subcutaneous sphincterotomy. The results of treatment of 716 patients were analyzed with an assessment of such indicators as the frequency of fissures epithelialization, postoperative complications, and the development of anal sphincter insufficiency and relapses of the disease. There were no statistically significant differences in the frequency of fissure healing in the groups with the use of dilatation methods of internal sphincter relaxation and lateral subcutaneous sphincterotomy (OR=1; CI=0.34;2.96; p=1). When assessing the risk of the disease recurrence in both groups, there were also no statistically significant differences (OR=0.93; CI=0.56;1.56; p=0.79). Postoperative complications were also comparable in both groups (OR=0.81; CI=0.4;1.63; p=0.55). There were no statistically significant differences in the incidence of anal incontinence (OR=1; CI=0.34;2.96; p=1). It should be noted that the use of uncontrolled dilatation is associated with a high risk of developing anal incontinence, while the introduction of controlled dilatation reduces the risk of this complication to a minimum. The use of controlled dilatation methods for relaxation of the internal sphincter is a safe alternative to lateral subcutaneous sphincterotomy, including in the treatment of anal fissures in combination with hemorrhoids.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"75 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":"124250216","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

A clinical case of intraoperative tracheal injury during endoscopic transaxillary hemithyroidectomy 内镜下经腋窝甲状腺切除术术中气管损伤1例

Hirurg (Surgeon) Pub Date : 2022-07-30 DOI: 10.33920/med-15-2204-06

P. Glushkov, R. Azimov, K. A. Shemyatovskiy, V. Gorskiy

引用次数: 0

Imposition of bypass enteroenteroanastomosis with disconnection of the small intestine loop with an enterovaginal fistula. A clinical case description 小肠袢断开伴肠阴道瘘的旁路肠肠吻合术的实施。1例临床病例描述

Hirurg (Surgeon) Pub Date : 2022-07-30 DOI: 10.33920/med-15-2204-02

G. Rodoman, Y. Vinogradov, E. K. Naumov

引用次数: 0

The role of variant anatomy of the inferior mesenteric artery in segmental colon resections with lymphodissection in patients with colorectal cancer 肠系膜下动脉变异解剖在结直肠癌患者节段性结肠切除术合并淋巴清扫中的作用

Hirurg (Surgeon) Pub Date : 2022-07-30 DOI: 10.33920/med-15-2204-01

K. I. Seurko, I. A. Vinоkurоv, M. U. Kasymov

{"title":"The role of variant anatomy of the inferior mesenteric artery in segmental colon resections with lymphodissection in patients with colorectal cancer","authors":"K. I. Seurko, I. A. Vinоkurоv, M. U. Kasymov","doi":"10.33920/med-15-2204-01","DOIUrl":"https://doi.org/10.33920/med-15-2204-01","url":null,"abstract":"During laparoscopic surgery for colorectal cancer, vascular structures may be incorrectly identified and damaged due to ignorance of the variant anatomy of the inferior mesenteric artery (IMA), lack of tactile sensations, narrowed field of vision, which leads to complications such as massive bleeding and intestinal ischemia. Therefore, the preoperative study of the variant anatomy of the IMA is of paramount importance. Knowing the variant anatomy of the vessels before surgery, you can make an operation plan in advance, which will ensure fast and safe vascular ligation at the required level and lymph node dissection. Aim: To develop a classification of IMA variability for practical use in operations for colorectal cancer. Material and methods: From February 2013 to March 2022, 214 computed tomograms (CT) of abdominal organs with intravenous contrast were analyzed. We studied the variant anatomy of the IMA. Results: We proposed the classification of structure of the IMA and its branches. This is especially important when the safe lymph node dissection along the IMA is necessary. I type — several colonic branches derivate from the IMA by independent trunks (54,2 %); II type — all colon branches derivate from the IMA in one point like a “goose paw” (25,2 %); III type — one colon branch departs from the IMA by a single trunk; then it divides into colonic branches (20,6 %). The frequency of coincidence of intraoperative data with preoperative CT data was 95.8 %. The sensitivity of the method is 95.8 %, the specificity of the method is 100%. Conclusion: CT with 3D vascular reconstruction allows the surgeon to perform extended lymph node dissection in colorectal cancer with minimal risk of complications.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"7 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":"132692618","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

Comparative assessment of questionnaire and fecal immunochemical test efficacy in colorectal cancer screening 问卷调查与粪便免疫化学试验在大肠癌筛查中的比较评价

Hirurg (Surgeon) Pub Date : 2022-07-30 DOI: 10.33920/med-15-2204-04

D. P. Kulovskaya, Y. Shelygin, S. Achkasov, E. Nikonov, A. Veselov, S. Frolov

{"title":"Comparative assessment of questionnaire and fecal immunochemical test efficacy in colorectal cancer screening","authors":"D. P. Kulovskaya, Y. Shelygin, S. Achkasov, E. Nikonov, A. Veselov, S. Frolov","doi":"10.33920/med-15-2204-04","DOIUrl":"https://doi.org/10.33920/med-15-2204-04","url":null,"abstract":"The aim of the study: to estimate the efficacy of the colorectal cancer (CRC) risk assessment according to the questionnaire and the fecal immunochemical test (FIT). The pilot study included 2,324 respondents over 40 years of age, without severe comorbidities, who filled out the original questionnaire and had the FIT. Risk stratification (high, moderate, low) was done using the original software for automatic data processing. Occult blood detection in feces was done using the fecal immunochemical test. Colonoscopy was proposed for all persons included in the screening program. The questionnaire revealed the high CRC risk in 272 (11.7 %) respondents, moderate risk — in 1,349 (58.0 %), and low risk — in 703 (30.0 %) respondents. The respondents with the high CRC risk had positive FIT results significantly more often — 199 (73.2 %) respondents, with 148 (11.0 %) respondents in the moderate-risk group, and 21 (3.0 %) respondents in the low-risk group (р<0.0001). Colonoscopy was performed in 28 (10.3 %) persons in the high-risk group, 76 (5.6 %) — in the moderate-risk group and in 50 (7.1 %) respondents in the low-risk group. The clinically important colon diseases (CRC, colorectal polyps, and IBD) were revealed significantly more often in the high-risk group than in moderate- and low-risk groups (82.1 % vs 68.0 %; p=0.02) and in those with positive FIT (87.5 % vs 60.5 %; p=0.01). Conclusion: the preliminary results showed that risk stratification by questionnaire is not inferior in the detection of clinically significant diseases of the colon than the fecal immunochemical test. It is necessary to continue the screening project with increasing the proportion of colonoscopies in all risk groups to obtain valid results.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"1 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":"127166571","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: 1

Safety of antithrombotic therapy in elderly patients: analysis of the Russian Pharmacovigilance Database 老年患者抗血栓治疗的安全性:俄罗斯药物警戒数据库的分析

Hirurg (Surgeon) Pub Date : 2022-06-14 DOI: 10.33920/med-15-2203-05

K. Zatolochina, S. Zyryanov, E. Ushkalova

引用次数: 0

Surgery in deep space travel 深空旅行中的外科手术

Hirurg (Surgeon) Pub Date : 2022-06-14 DOI: 10.33920/med-15-2203-06

N. V. Lebedev, A. Klimov, Vladimir Aleksandrovich Ivanov, V. S. Popov, A. A. Barkhudarov

引用次数: 0

Immediate results of surgical myocardial revascularisation in COVID-19 survivors COVID-19幸存者手术心肌血运重建的即时结果

Hirurg (Surgeon) Pub Date : 2022-06-14 DOI: 10.33920/med-15-2203-03

V. S. Ermakov, V. Kravchuk, O. Porembskaya, K. V. Kuznetsov, Evgenii Alekseevich Knjazev, A. V. Belikov, T. V. Garpinchenko, I. Kazakova, K. Lobzhanidze, Aleksandr Viktorovich Nikol’skij, S. Sayganov

{"title":"Immediate results of surgical myocardial revascularisation in COVID-19 survivors","authors":"V. S. Ermakov, V. Kravchuk, O. Porembskaya, K. V. Kuznetsov, Evgenii Alekseevich Knjazev, A. V. Belikov, T. V. Garpinchenko, I. Kazakova, K. Lobzhanidze, Aleksandr Viktorovich Nikol’skij, S. Sayganov","doi":"10.33920/med-15-2203-03","DOIUrl":"https://doi.org/10.33920/med-15-2203-03","url":null,"abstract":"The novel coronavirus infection (COVID-19) is caused by the SARS-CoV-2 virus. First registered at the end of December 2019 in Wuhan, China. Due to the high contagiousness of the virus, the infection quickly spread throughout the world, and on March 11, 2020, the World Health Organization announced the beginning of the COVID-19 pandemic. During the pandemic, the number of cardiac surgeries was sharply reduced due to the repurposing of hospitals to receive and treat patients with COVID-19. Today, however, diseases of the circulatory system remain the leading cause of death in the developed world. At the same time, there are more and more reports of extremely unfavorable outcomes of cardiac surgery in patients with active infection. Unfavorable outcomes were associated with the development of acute respiratory distress syndrome in the early postoperative period and high hospital mortality. Two years after the beginning of the COVID-19 pandemic, 98 % of the patients had an infection, and today this group of patients is increasingly common in cardiac surgery practice. At the same time, there is evidence that the transferred COVID-19 has long-term adverse effects, including pathological effects on the cardiovascular and respiratory systems. This retrospective study was aimed at studying and analyzing the immediate results of surgical myocardial revascularization, namely coronary artery bypass grafting on a beating heart, in patients with COVID-19 convalescents with coronary heart disease.","PeriodicalId":437500,"journal":{"name":"Hirurg (Surgeon)","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126412984","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

Comparative analysis of the results of minimally invasive methods of surgical treatment of patients with postnecrotic pancreatic cysts using percutaneous transgastric and laparoscopic cystogastrostomy 经皮经胃与腹腔镜囊胃造口术治疗坏死性胰腺囊肿的微创手术效果比较分析

Hirurg (Surgeon) Pub Date : 2022-06-14 DOI: 10.33920/med-15-2203-01

J. N. Prazdnikov, V. P. Shevchenko, G. A. Baranov, M. S. Khoptyar, Vladimir Vladimirovich Naletov, D. R. Zinatulin, Rifat Khamitovich Umyarov

引用次数: 0