The Ukrainian Journal of Clinical Surgery最新文献

{"title":"Views on university training of medical students under martial law","authors":"V. I. Lupaltsov","doi":"10.26779/2786-832x.2023.5.51","DOIUrl":"https://doi.org/10.26779/2786-832x.2023.5.51","url":null,"abstract":"Views on university training of medical students under martial law","PeriodicalId":489121,"journal":{"name":"The Ukrainian Journal of Clinical Surgery","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140212775","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":"Important aspects of the experience of isolated work of a multidisciplinary medical institution in Ukraine in the context of a sudden outbreak of hostilities","authors":"O. Usenko, I. Lurin, A. M. Dovgopol, M. Y. Krestianov, R. Salyutin, A. V. Dynets, P. T. Ksenik, I. V. Komisarova, A. O. Alekseev, D. V. Okley","doi":"10.26779/2786-832x.2023.5.44","DOIUrl":"https://doi.org/10.26779/2786-832x.2023.5.44","url":null,"abstract":"Important aspects of the experience of isolated work of a multidisciplinary medical institution in Ukraine in the context of a sudden outbreak of hostilities","PeriodicalId":489121,"journal":{"name":"The Ukrainian Journal of Clinical Surgery","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140217645","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 use of the modified Clavien–Dindo scale for the assessment of postoperative complications in elderly and senile patients with acute peritonitis","authors":"M. B. Danilyuk, S. M. Zavgorodny, A. Rylov, M. Kubrak","doi":"10.26779/2786-832x.2023.5.20","DOIUrl":"https://doi.org/10.26779/2786-832x.2023.5.20","url":null,"abstract":"Objective. To evaluate postoperative complications using the modified Slavien–Dindo scale in elderly and senile patients with acute peritonitis. \u0000Materials and methods. The results of treatment of 145 patients with gastric and duodenal ulcer complicated by perforation were analysed. The modified Slavien–Dindo scale (2004, 2009) was used to assess postoperative complications. \u0000Results. The analysis of the results of treatment of elderly and senile patients with acute peritonitis showed that a significant proportion of them had postoperative complications – 76 (52.4%): 53 (36.6%) had non–surgical complications, 23 (15.9%) – surgical complications (p = 0.00027). \u0000Conclusions. The Slavien–Dindo scale makes it possible to establish the presence of postoperative complications, but does not allow to find out why they occurred and prevent them. Assessment of postoperative complications using the modified Slavien–Dindo scale is possible only for analysis for the purpose of collecting statistical data, but it cannot be used in general clinical practice to analyse the quality of treatment of elderly and senile patients with acute peritonitis.","PeriodicalId":489121,"journal":{"name":"The Ukrainian Journal of Clinical Surgery","volume":" 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140220519","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":"Prevention of purulent and inflammatory complications of the soft tissues of the abdominal wall in patients with peritonitis","authors":"I. Karol","doi":"10.26779/2786-832x.2023.5.24","DOIUrl":"https://doi.org/10.26779/2786-832x.2023.5.24","url":null,"abstract":"Objective. To learn about measures to prevent purulent and inflammatory complications of the soft tissues of the abdominal wall in patients with peritonitis. \u0000Materials and methods. Based on the purpose of the study, 2 groups of patients were formed. The main group included 23 patients in whom a variable–height polyurethane wound dilator in combination with an application sorbent was used intraoperatively to prevent surgical wound suppuration. The control group included 27 patients who were treated with polyurethane wound dilator alone. \u0000Results. Suppuration of the surgical wound occurred in 2 (8.7%) patients of the main and 6 (22.2%) patients of the control group, seroma – in 1 (4.3%) and 2 (7.4%) patients, respectively, haematoma – in 1 (3.7%) patient of the control group, inflammatory infiltration – in 2 (8.7%) patients of the main and 3 (11.1%) patients of the control group. \u0000Conclusions. The use of a polyurethane wound dilator in combination with an application sorbent for the prevention of postoperative wound suppuration in patients with spilled and general peritonitis in the toxic and terminal stages allowed to reduce the number of purulent and inflammatory complications of the soft tissues of the abdominal wall in the main group by 2 times compared to the corresponding indicator in the control group.","PeriodicalId":489121,"journal":{"name":"The Ukrainian Journal of Clinical Surgery","volume":" 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140215992","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":"A new approach to the treatment of large and giant hiatal hernia","authors":"V. Grubnik, V. Ilyashenko, V. Grubnik, D. V. Korchovyi, R. Parfentiev","doi":"10.26779/2786-832x.2023.5.16","DOIUrl":"https://doi.org/10.26779/2786-832x.2023.5.16","url":null,"abstract":"Objective. To retrospectively analyse the results of a new technique of laparoscopic surgery for large and giant hiatal hernias of the esophageal orifice of the diaphragm, which consists in the use of diaphragmatic incisions and mesh implants to reduce the incidence of recurrence and complications. \u0000Materials and methods. During the period from 2010 to 2023, laparoscopic interventions were performed in 62 patients, 43 (69.4%) women and 19 (30.6%) men, with large and giant hiatal hernias of the esophageal orifice of the diaphragm. The average age of the patients was 62.8 years. The diagnostic criteria used to select patients were the size of the hiatal opening and clinical symptoms. Fibroesophagogastroduodenoscopy, abdominal computed tomography, and contrast radiography were used to assess the size of the hernia and plan surgical intervention. During the operation, we performed loosening incisions of the diaphragm to reduce the tension during suturing of hiatus defects. Progrip self–locking meshes were also used to close the diaphragmatic defects, which allowed them to be securely fixed without tension and reduce the risk of recurrence. \u0000Results. Most patients had comorbidities that required a special approach during surgery. The average duration of the operations was 132 minutes, which indicates their technical complexity. The postoperative course in most patients was uncomplicated with a minimal recovery period. The average hospital stay was 5.2 days. Recurrence of hernia was detected in 2 (3.2%) of 62 patients, which indicates the effectiveness of the new technique. \u0000Conclusions. The use of a new concept of laparoscopic surgery for large and giant hernias of the esophageal orifice of the diaphragm, which involves the performance of laxative incisions of the diaphragm and the use of self–locking mesh, significantly reduces the incidence of recurrence and complications, which ensures high treatment efficiency and improves the quality of life of patients. The results of the study confirm the importance of an individual approach to the treatment of hiatal hernias and the possibility of optimising laparoscopic techniques to improve their effectiveness.","PeriodicalId":489121,"journal":{"name":"The Ukrainian Journal of Clinical Surgery","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140217517","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":"Reconstruction of a combined defect of the lateral surface of the torso after an explosive injury","authors":"А. O. Zhernov, D. M. Sydorenko, I. L. Brylenko","doi":"10.26779/2786-832x.2023.5.67","DOIUrl":"https://doi.org/10.26779/2786-832x.2023.5.67","url":null,"abstract":"Reconstruction of a combined defect of the lateral surface of the torso after an explosive injury","PeriodicalId":489121,"journal":{"name":"The Ukrainian Journal of Clinical Surgery","volume":" 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140216615","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":"Retrospective analysis of hand and foot function after application of cellular technologies in patients with post–traumatic ischemic and denervation–reinervation injuries of limb muscles","authors":"Y. Polyachenko, O. Kostrub, O. V. Dolgopolov, R. I. Blonsky, I. Zasadnyuk","doi":"10.26779/2786-832x.2023.5.37","DOIUrl":"https://doi.org/10.26779/2786-832x.2023.5.37","url":null,"abstract":"Objective. To determine the effect of cell therapy on the function of the hand and foot in patients with ischemic and denervation–reinervation injuries of the limb muscles. \u0000Materials and methods. Over 9 years (2014 – early 2023), 47 patients with posttraumatic ischaemia and/or peripheral nerve damage were treated at the Institute of Traumatology and Orthopedics. Cell therapy, namely the injection of bone marrow aspirate and adipose tissue suspension (cell substrates) into the target muscles, was used in 32 (68.1%) patients (main group), while 15 (31.9%) patients did not undergo cell therapy (control group). In 16 (50%) patients, cell therapy was applied to the upper limb, and in 16 (50%) – to the lower limb. Patients in the control and intervention groups were divided into three subgroups: with ischaemic contracture, peripheral nerve damage, and a combination of these pathologies. \u0000Results. The treatment with the use of cellular technology in patients with ischaemic and denervation–reinervation injuries of the muscles of the hand and foot had a statistically significant positive effect. In patients with ischaemic contracture of the hand 12 months after the introduction of cell substrates, the loss of its function decreased to less than 30%. \u0000Conclusions. Cell therapy helps to restore hand and foot function in patients with ischemic and/or denervation–reinervation injury of the limb muscles.","PeriodicalId":489121,"journal":{"name":"The Ukrainian Journal of Clinical Surgery","volume":" 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140213979","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 magnets in minimally invasive surgery of shrapnel wounds","authors":"O. Usenko, A. Sydiuk, A. Klimas, O. Sydiuk, A. S. Sukach","doi":"10.26779/2786-832x.2023.5.63","DOIUrl":"https://doi.org/10.26779/2786-832x.2023.5.63","url":null,"abstract":"Use of magnets in minimally invasive surgery of shrapnel wounds","PeriodicalId":489121,"journal":{"name":"The Ukrainian Journal of Clinical Surgery","volume":" 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140215982","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":"Modern principles of diagnosis and treatment of post–pancreatic resection bleeding","authors":"V. Kopchak, L. Pererva, V. A. Kondratiuk, I. Mazanovych, P. Azadov, V. Khanenko, V. Trachuk","doi":"10.26779/2786-832x.2023.5.09","DOIUrl":"https://doi.org/10.26779/2786-832x.2023.5.09","url":null,"abstract":"Objective. To improve the results of treatment of patients with post–pancreatic resection bleeding. \u0000Materials and methods. The results of treatment of 827 patients who underwent radical resection of the pancreas for malignant tumours in the period from 2010 to 2021 were analysed. The patients were divided into two groups: the main group – 449 patients who were treated at the clinic from 2016 to 2021, and the control group – 378 patients who were treated in the clinic from 2010 to 2015. Postpancreatectomy bleeding occurred in 27 (6.0%) patients in the main group who were treated according to the developed diagnostic and therapeutic algorithm with the maximum use of endovascular techniques, and in 20 (5.3%) patients in the control group who received standard treatment. \u0000Results. X–ray endovascular bleeding control was performed in 14 (51.9%) of 27 patients in the main group: X–ray endovascular occlusion – in 9, by means of stent graft placement – in 5. In 3 (11.1%) patients of the main group, the source of bleeding was not detected during angiography, and they underwent laparotomy with subsequent bleeding control. Complications after X–ray endovascular occlusion occurred in 1 (11.1%) patient, and there were no complications after stent graft placement. Open surgical interventions were performed in 13 (48.1%) patients. One (3.7%) patient died after laparotomy with bleeding control due to the development of further purulent–septic complications. In the control group, X–ray endovascular bleeding control was performed in 3 (15%) patients, and relaparotomy with bleeding control in 17 (85%) patients. 6 (30%) patients died after open reoperative interventions. \u0000Conclusions. Endovascular techniques for stopping post–pancreatic transplantation bleeding are highly effective and safe with favourable technical and clinical results. They are advisable as the first step in the treatment of postpancreatic surgery bleeding with stent grafts in case of bleeding from the great vessels.","PeriodicalId":489121,"journal":{"name":"The Ukrainian Journal of Clinical Surgery","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140216369","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":"Overexpression of CD44 as a predictor of metastatic potential in patients with colorectal cancer","authors":"O. Kostovski, R. Jovanovic, I. Kostovska","doi":"10.26779/2786-832x.2023.5.32","DOIUrl":"https://doi.org/10.26779/2786-832x.2023.5.32","url":null,"abstract":"Objective. To correlate CD44 expression with the clinicopathological characteristics of patients with colorectal carcinoma (CRC). \u0000Materials and methods. This study included 90 patients with CRC who underwent curative surgical resection. Standard histopathological techniques and immunohistochemistry analysis was used to investigate CD44 expression. Semi–quantitative scoring was used to categorize CD44 expression levels. Patients' clinicopathological characteristics were retrospectively examined. \u0000Results. Overexpression of CD44 was found in 46.7% of all patients with CRC. Patients with right colon cancer had the highest CD44 expression (54,6%). Overexpression of CD44 was present in 69.6% of patients with metastatic lesions in visceral organs. We found statistically significant differences between CD44 overexpression and the presence of visceral metastases (p = 0.015), different T categories (p = 0.011), N status (p = 0.006), and G differentiation (p = 0.011). Our results showed that the disease stage has the greatest effect on CD44 overexpression (p <0.001). \u0000Conclusion. Overexpression of CD44 could be a reliable predictor of metastatic potential and poor prognosis in patients with CRC.","PeriodicalId":489121,"journal":{"name":"The Ukrainian Journal of Clinical Surgery","volume":" 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140216608","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}