Kreativnaia khirurgiia i onkologiia最新文献

{"title":"First Robot-Assisted Ivor Lewis Operation with Manual Intrapleural Anastomosis for Corrosive Esophageal Stricture","authors":"A. M. Avzaletdinov, V. N. Pavlov, T. D. Vildanov, A. I. Gimazova, N. A. Zdorik, K. R. Musakaeva","doi":"10.24060/2076-3093-2023-13-3-191-197","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-3-191-197","url":null,"abstract":"Introduction . Esophageal pathology constitutes a small share in general morbidity, however, it remains highly relevant due to its social and clinical significance. Corrosive strictures account for a large proportion among benign esophageal diseases. Treatment of the disease starts with intraluminal surgery. However, it provides only short-term effect due to the tendency of esophageal strictures to restenosis. In case of treatment failure, esophagoplasty is performed. The esophagoplasty according to Ivor Lewis with the formation of manual intrapleural anastomosis was performed in the BSMU Clinic. The abdominal and thoracic phases were performed using Da Vinci Si robotic surgical system. By the time of publication of this paper, the authors have gained experience of 15 successfully performed surgeries of this kind. Materials and methods . The paper presents a clinical case of robot-assisted esophagoplasty according to Ivor Lewis performed on patient Y., born in 1978, with the clinical diagnosis: corrosive strictures of the lower third of the esophagus with dysphagia of III–IV degree. The pathology developed as a result of surrogate alcohol consumption in September 2017. Since October 2017, the patient has been regularly treated in the Thoracic Surgery Unit of the BSMU Clinic, where she underwent a number of endoscopic surgeries, which appeared to provide a little effect. The patient underwent a subsequent surgical treatment including esophagoplasty according to Ivor Lewis with the formation of manual intrapleural anastomosis using Da Vinci Si robotic system. Results and discussion . First three days of the postoperative period, the patient remained in the Anaesthesiology and Intensive Care Unit. She received step-by-step parenteral and enteral nutrition. Control fl uoroscopic examinations revealed timely, disturbances-free evacuation and no contrast leakage from the formed anastomosis. The patient was discharged on day 11 in satisfactory condition. Conclusion . Using Da Vinci robot-assisted system in Lewis esophageal plastic surgery has a number of specific features. It provides more precise tissue extraction with preservation of stomach and esophageal vessels, moreover, mobility of the instruments enables the key phase to be performed, namely — manual suturing in the esophagoanastomosis. As a result, the risk of postoperative complications is reduced.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135646357","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":"Predictors of Adverse Clinical Outcomes after Endovascular Thrombectomy in Acute Ischemic Stroke","authors":"T. R. Vildanov, V. V. Plechev, M. S. Zagidulina, L. G. Chudnovets, E. M. Kolchina, I. M. Karamova, D. V. Plecheva, G. L. Chudnovets","doi":"10.24060/2076-3093-2023-13-3-203-209","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-3-203-209","url":null,"abstract":"Introduction . Stroke is recognized as one of the most significant global socio-economic issues. Endovascular interventions, including mechanical thrombectomy of cerebral arteries, have been increasingly performed during the past decade to restore impaired cerebral blood flow in the first hours from the onset of the disease. However, it has been observed that the technical success of the procedure does not always imply an improvement in the clinical condition of a patient. Materials and methods . The study retrospectively analyzes the outcomes of interventions in 86 acute ischemic stroke patients in order to identify factors that can exert an adverse effect on the first hours of the disease and potentially worsen the results of reperfusion therapy. The study involves patients aged 35–85 years (mean age 66.82±1.52 years), predominantly males (57 males versus 29 females). 42 patients (49%) suffered atrial fibrillation, of which 28 (66.7%) had permanent, 11 (26.2%) — paroxysmal, 3 — persistent atrial fibrillation (7.1%), and 27 (31.4%) suffered diabetes mellitus. Results and discussion . Based on the study, factors affecting outcome and one-year long-term results were identified. The predictors included severity of neurological deficit according to Rankin and NIH Stroke scales, time between symptom onset and reperfusion, TICI thrombectomy score, age, diabetes mellitus, and haemorrhagic transformation after thrombectomy. Conclusion . In order to ensure better outcomes, medical specialists should develop an efficient patient routing, pay special attention to the initial severity of neurological deficit, time from the onset of the disease, age of patients, concomitant diabetes mellitus, development of hemorrhagic transformation after endovascular thrombectomy, and, which is particularly important, to the combination of adverse factors.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135646360","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 Treatment of Traumatic Liver Injury with Development of Biloma, Destructive Cholecystitis and Pseudoaneurysm: a Clinical Case","authors":"V. Panteleev, M. A. Nartailakov, I. Z. Salimgareev, M. Loginov, S. Y. Samohodov, A. Petrov","doi":"10.24060/2076-3093-2023-13-2-171-177","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-2-171-177","url":null,"abstract":"   Introduction. Traumatic liver injury is associated with the danger of developing various insidious complications, with some of them appearing immediately and others — eventually against a background of apparent clinical recovery. Modern sophisticated methods enable the character and localization of liver complications to be accurately revealed and those complications to be stopped by means of minimally invasive techniques.   Materials and methods. A clinical case of the traumatic hepatic rupture caused by a fall from height and the subsequent development of successive complications, which, except for the primary surgery — suturing of the liver rupture through laparotomy — were stopped by minimally invasive techniques.   Results and discussion. All complications that occurred and were subsequently treated have been divided into seven stages. Stage 1: rapid transfer of the patient to a multidisciplinary hospital. Stage 2: diagnostic laparoscopy followed by laparotomy and suturing of the liver rupture. Stage 3: puncture of the infected biloma. Stage 4: minilaparotomy cholecystectomy. Stage 5: antegrade percutaneous transhepatic drainage of the bile ducts. Stage 6: angiography of the hepatic artery and its branches. Stage 7: endovascular embolization of the pseudoaneurysm cavity.   Conclusion. The authors presented the clinical case in order to demonstrate the feasibility and proper application of minimally invasive techniques to manage various complications of liver injury, avoid resection, save life, and preserve quality of life.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49125618","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":"Bile Duct Reconstruction after Failed Laparoscopic Cholecystectomy: Literature Review","authors":"M. V. Timerbulatov, M. M. Aziev, E. Grishina, T. M. Ziganshin","doi":"10.24060/2076-3093-2023-13-2-159-164","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-2-159-164","url":null,"abstract":"   Today, the incidence of iatrogenic bile duct injury in laparoscopic cholecystectomy averages 0.4 % worldwide. In Russia, it accounted for 0.6 % in 2020. Side-to-side hepaticojejunostomy is the operation of choice with complete injury of the common bile duct. It is considered the safest operation, which preserves blood supply, provides wider anastomosis, ensures complete rehabilitation in 75–98 % of cases. Even in the centers of hepatobiliary surgery, the development of strictures after hepaticojejunostomy with traditional access after iatrogenic injury to the bile ducts occurs in 10–20 % of cases. Bile leakage develops in 3.0–3.3 % of cases. The success of reconstructive surgery largely depends on the precision technique of performing anastomosis, which can be ensured mainly by the quality of imaging. The possibility of laparoscopic hepaticojejunostomy after a common bile duct injury is currently a subject of debate, and only few publications report on its successful performance. Most surgeons prefer open anastomosis due to insufficient space for laparoscopic instruments. Although the advantages of laparoscopic surgery over traditional interventions are essential for this category of patients no less than for the others. Robotic laparoscopic surgery with its additional space for instruments in the complete absence of tremor, a twenty-fold increase in three-dimensional image, which increases the accuracy of tissue dissection and the precision of anastomotic sutures, can be an excellent option for working on thin tubular structures in the porta hepatis.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45485384","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":"Case of Treatment of Solid Pseudopapillary Pancreatic Tumor","authors":"F. S. Rakhimova, N. Mamashev, O. Shimkina, B. Bebezov","doi":"10.24060/2076-3093-2023-13-2-178-185","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-2-178-185","url":null,"abstract":"   Introduction. A solid pseudopapillary pancreatic tumor accounts for less than 3 % of all pancreatic tumors. It is more common in young women aged 20 to 30. The prognosis for this pathology is favorable. Complete removal of the tumor leads to full recovery in more than 85 % of patients.   Materials and methods. The paper presents a clinical case which demonstrates the surgical outcome of a patient with a malignant pancreatic tumor. Patient M., female, born in 1998, underwent inpatient treatment at the I.K. Akhunbaev Clinic of National Hospital, Kyrgyzstan, from January 12, 2015 to January 26, 2015 with a clinical diagnosis — pancreatic head mass, which was found intraoperatively. Due to this, the decision was made to expand the scope of the surgery. Histopathological examination revealed a solid pseudopapillary tumor.   Results and discussion. This tumor is extremely rare and is usually detected accidentally during preventive examinations, or when the tumor becomes large. Against the background of treatment, the dynamics of observation for 7 years revealed no signs of progression and relapse of this pathology.   Conclusion. Solid pseudopapillary tumor is a rare, highly differentiated malignancy, which develops most oft en in young women. It is characterized by a relatively favorable clinical course, which is demonstrated by this case report.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48142773","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":"Extracorporeal Detoxification Methods and Hemostasis System for Ovarian Cancer Patients. Clinical Case","authors":"A. Safonov, M. Zabelin, A. Izmailov, Z. A. Valiullina, A. R. Mukhametkulova, A. Vasilchenko, K. Zolotukhin","doi":"10.24060/2076-3093-2023-13-2-165-170","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-2-165-170","url":null,"abstract":"   Introduction. Malignant tumors dominate in the picture of disability and mortality worldwide. One of the most frequent and dangerous comorbid conditions is kidney injury. At the same time, the most unfavorable incidence of acute kidney injury is recorded in multiple myeloma, leukemia, lymphoma and kidney and/or liver cancer and malignant ovarian neoplasms. In this regard, of vital importance is the choice of tactics in the prevention of thrombosis and thromboembolic complications, as well as the individual approach to of the anticoagulant therapy regimen during renal replacement therapy sessions, depending on the underlying disease and the state of the hemostatic system.   Aim. To evaluate the effect of calcium citrate veno-venous hemodiafi ltration sessions on the hemostatic system of a patient with progressive organ dysfunctions associated with malignant ovarian neoplasm.   Materials and methods. The methodology involved literature review and a case study to assess the effect of veno-venous hemodiafi ltration on hemostasis.   Results and discussion. The clinical case was assessed in terms of P-selectin (CD62), which characterizes platelet activation processes. It should be noted that in this patient, the expression of P-selectin increased with each session of renal replacement therapy, while the platelet aggregation values remained at the level of the lower thresholds, which indicates a low probability of coagulation initiation. However, due to aggressive regulation of ovarian cancer by the hemostatic system in the form of production of inflammatory mediators, microvesicles, tissue factor expression and endothelial activation, attention should be paid to the molecular aspects of platelet activation in renal replacement therapy with regional citrate coagulation.   Conclusion. The widespread use of extracorporeal detoxification methods is an independent risk factor not only for bleeding events, but may potentially contribute to thrombosis and thromboembolic complications, which requires a further detailed study of molecular mechanisms of hemostasis regulation by tumor and clinical evaluation of various anticoagulation methods.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43275658","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":"Review of Small Molecule Anticancer NF-κB Inhibitors","authors":"S. Kzyrgalin, R. S. Yamidanov, K. A. Nazmieva, S. Gantsev","doi":"10.24060/2076-3093-2023-13-2-143-150","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-2-143-150","url":null,"abstract":"   Cancer is one of the most common diseases in the world. Th e transcription factor NF-κB plays a key role in various physiological processes including immune response, cell proliferation, cell apoptosis and inflammation. Due to participation of NF-kappa B signaling pathways in carcinogenesis, angiogenesis, and tumor resistance to chemo- and radiotherapy, the factor is considered to be the ideal target for pharmacological treatment of cancer. Th e paper presents a literature review of the RSCI, PubMed, Scopus, Web of Science, Chemical Abstracts NCCN databases and other open access data. The carcinogenesis inhibitors were selected from all NF-κB inhibitors found. Inhibitors with antitumor activity of analytical interest include Bruton tyrosine kinase (BTK) inhibitors, cellular inhibitors of apoptosis proteins (c-IAP), proteasome inhibitors, and one inhibitor of NF-κB translocation to the nucleus. Th e authors analyzed products of diff erent development stages with recorded antitumor activity to varying degrees. NF-κB inhibitors are promising drug candidates, but since NF-κB is involved in most biological processes and the broad spectrum of action can cause side eff ects, the selective action of these compounds is to be explored.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48358644","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":"Efficacy of Off-Label Use of Anticancer Drugs in Oncology","authors":"E. Karabina, D. Sakaeva, O. Lipatov","doi":"10.24060/2076-3093-2023-13-2-151-158","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-2-151-158","url":null,"abstract":"   The off-label use of anticancer drugs is widespread in modern oncology. The potential advantages of such prescriptions are associated with exceeding the expected clinical benefi ts over the risks of complications. The off-label use of anticancer drugs demonstrates the inconsistent efficacy of this approach depending on the type of malignancy, the reasons for prescribing these agents and their belonging to a particular pharmacological group. In a number of situations, the clinical benefits of off-label drugs are more convincing than in case of authorized indications. Currently, prescribing the “old” registered anticancer drugs, used in everyday clinical practice, is seen routine. However, labeling does not reflect the full range of indications with strong evidence of safety and efficacy. The paradigm shift toward molecularly targeted therapy and immunotherapy in various malignancies may increase the off-label use of the specified agents. Lack of treatment options for rare forms of malignancies and exhaustion of the possibilities for registered therapy are the major reasons for off-label prescribing targeted drugs based on the identifi ed molecular genetic disorders. In such cases, the concept of precision therapy is oft en implemented by using agents, the clinical efficacy of which is confi rmed by data with a low level of evidence or with no evidence. Studying the eff ectiveness of the off-label use of anticancer agents is necessary to systematize information and develop algorithms for making decisions about the prescription of these drugs in routine clinical practice.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41563422","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":"Personalized Approach to the Surgical Treatment of Benign Prostatic Hyperplasia by Bipolar Transurethral Resection of the Prostate","authors":"I. A. Chekhonatskii, O. Loran","doi":"10.24060/2076-3093-2023-13-2-125-130","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-2-125-130","url":null,"abstract":"","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43208764","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":"Characteristics of Professional Burnout of Oncologists","authors":"T. S. Klimenko","doi":"10.24060/2076-3093-2023-13-2-119-124","DOIUrl":"https://doi.org/10.24060/2076-3093-2023-13-2-119-124","url":null,"abstract":"   Introduction. The present paper considers the issue of emotional burnout among doctors of oncology departments. The profession of a doctor refers to so-called socionomic professions, which are associated with higher socio-psychological requirements as well as mental and psycho-emotional stress.   The relevance of the study stems from the persistent psycho-emotional problems that arise in the process of professional activity of oncologists.   Aim. To study theoretical aspects of professional burnout, to carry out experimental evaluation of professional burnout among oncologists and to develop the preventive measures contributing to reduction in symptoms of emotional burnout in oncologists.   Materials and methods. The author conducted an experimental study of the emotional burnout among oncologists and explored the diagnostics aspects of emotional burnout. The experiment was carried out by means of the questionnaire “Diagnostics of the level of emotional burnout” (V. V. Boyko). The study sample consisted of 50 oncologists.   Results and discussion. The author revealed that the symptom “experiencing psychotraumatic circumstances” is highly expressed at the stress stage in the group of oncologists with developed emotional burnout (24, 58). The symptom shows preventive reaction to the influencing aspects for emotional burnout: “emotional response” (24, 6), “reduced job performance” (31, 66), characterizing the methods of mental support; the “emotional defi cit” (25, 33), “emotional detachment” (28,12), reflecting the state of parasympathetic nervous system, are considered as the main symptom at the overstrain stage. It was found that the work with critically ill patients demands high level of professional competence, considering the increased responsibility and constant emotional stress.   Conclusion. The results of the study confi rm the presence of leading symptoms in developing emotional burnout. In order to prevent the development of emotional burnout syndrome, the author proposes to introduce psychological training programs on various topics in medical institutions to minimize professional burnout and to develop soft skills, including self-regulation in communication.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47353697","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}