Kreativnaia khirurgiia i onkologiia最新文献

{"title":"Comparative Assessment of Isolated Liver Chemoperfusion Techniques","authors":"A. Kaprin, V. Unguryan, L. Petrov, S. A. Ivanov, V. V. Nazarova, Y. Pobedintseva, E. V. Filimonov, E. Kruglov","doi":"10.24060/2076-3093-2022-12-1-5-12","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-1-5-12","url":null,"abstract":"Background. Metastatic liver injury is a  distinct oncological problem, irrespective of primary malignancy. Resection surgery is not always feasible in such patients. Isolated liver chemoperfusion is a promising treatment option in multiple small-focal metastatic organic lesions. This technique is technically complex, which limits its broader evaluation and adoption in clinical practice. The diversity of isolated liver chemoperfusion techniques does not allow an adequate assessment of world experience and requires further research. The important considerations with introducing isolated liver chemoperfusion are: an optimal surgical technique, liver isolation control method, as well as physiological arterial and portal blood flow maintenance.Materials and methods. A total of 21 patients were surveyed over June 2020 — December 2021. The patients were divided into 3 prospective cohorts: A) arteriocaval chemoperfusion, midline laparotomy access, technical-guided liver isolation, B) arteriocaval chemoperfusion, “in J laparotomy” access, ICG-guided liver isolation, C) arterio-porto-caval chemoperfusion, “in J laparotomy” access, ICG-guided liver isolation. A procedure’s tolerance was assessed with: the duration of surgery, postoperative ICU bed-days, total postoperative bed-days, hepatic cytolysis rates, chemotherapy side-effects severity.Results and discussion. The duration of surgery shortened with “in J laparotomy”. Haemotoxicity did not differ between cohorts A and B, albeit appearing significantly lower in cohort C. The cytolytic syndrome duration statistically significantly reduced in C vs. A and B cohorts.Conclusion. All the isolated liver chemoperfusion techniques employed are patient-safe. In ICG-guided liver isolation, the agent leakage into systemic blood flow is less likely, indicating a lower haemotoxicity. Arterioportal isolated chemoperfusion is more physiological compared to other techniques, thus facilitating lower hepatotoxicity. The use of “in J laparotomy” significantly reduces liver mobilisation and vascular cannulation times. ","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43575330","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":"3D Conformal Radiotherapy in Cervical Metastasis to Brain","authors":"R. K. Minyazeva, G. Battalova, I. Sakhautdinova, I. M. Tayupova, I. Gilyazova","doi":"10.24060/2076-3093-2022-12-1-67-73","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-1-67-73","url":null,"abstract":"Background. Cervical cancer is among the commonest malignancies and a top fourth leading cause of cancer death in women worldwide. The five-year survival rate in locally advanced cervical cancer is 91.5%, and only 17.2% — in distant metastasis. Primary cervical cancer metastasis to brain is very rare. Report and analysis of quite rare clinical cases may shed light on this issue, helping formulate relevant therapeutic and diagnostic interventions.Materials and methods. The article describes a case of cervical cancer metastasis to brain. The patient received modern 3D conformal intensity-modulated (IMRT) and image-guided (IGRT) radiation therapies on an Elekta Synergy highenergy linear digital accelerator instrument.Results. Clinical effect has been achieved by end of treatment. Time since diagnosis of primary cervical cancer was 13 months, and 7 months — since diagnosis of brain metastasis.Discussion. The survival rate in brain metastasis is marginal-low and depends on the patient’s age, primary tumour state, presence of extracranial metastases, as well as volume, number and location of metastases in brain parenchyma. An integrated approach including surgery, radiation and chemotherapy is considered superior to improve survival and the quality of life.Conclusion. Despite sheer coverage of therapies available, the mean survival rate in intracranial metastasis remains subtle. Thereby, research and discovery of relapse and metastasis biomarkers of cervical cancer is relevant. ","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45980044","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":"Cytoreductive HIPEC-Combined Surgery in Treatment of Advanced Ovarian Cancer","authors":"M. Zabelin, A. Safonov, N. V. Kuznetsov","doi":"10.24060/2076-3093-2022-12-1-28-34","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-1-28-34","url":null,"abstract":"Background. Ovarian cancer ranks 5th in the structure of female oncological mortality in the Russian Federation, with a first-year post-diagnosis rate of almost 35%. In 75% cases, ovarian cancer is diagnosed at stages III—IV. The disease usually represents as peritoneal carcinomatosis regarded as an advanced form that demands attention, which renders the issue highly relevant. We present a literature review and analysis of combined treatment outcomes in ovarian cancer patients hospitalised at the Kuvatov Republican Clinical Hospital within period 2020—2021.Materials and methods. The article reviews foreign and national scientific literature, as well as reports the case data on 18 patients diagnosed with ovarian cancer and treated at the Department of Oncology of the Kuvatov Republican Clinical Hospital within period 2020—2021.Results and discussion. A complete cytoreductive surgery was performed in 100% cases. In cohort I, mean operation time was 256 vs. 364 min, mean intraoperative blood loss — 1200 vs. 1050 mL, mean hospital stay — 14.6 vs. 18.7 bed-days. Postoperative complications were 16.7 vs. 50% in cohort I vs. II. A 30-day mortality rate was 0 vs. 16.6% in cohort I vs. II. The monitoring and enrolment of patients currently continues.Conclusion. A  HIPEC procedure is not a  radical measure and can only achieve a  maximum efficacy if coupled with a complete cytoreduction. The treatment of stage III—IV ovarian cancer patients in a concurrent combined approach is promising and requires further in-depth research and a more robust statistics.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46577748","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":"Challenges of Diagnosis and Treatment Choice in Riedel‘s Fibrosing Thyroiditis: Clinical Case Examples","authors":"M. Davydovich, R. V. Ipaeva, K. Derevyanko","doi":"10.24060/2076-3093-2022-12-1-74-80","DOIUrl":"https://doi.org/10.24060/2076-3093-2022-12-1-74-80","url":null,"abstract":"Background. Clinically distinct Riedel’s fibrosing thyroiditis is extremely rare, accounting for only 0.05 % of histologically verified thyroiditis cases, as follows from the real clinical practice and literature. Classic Riedel’s thyroiditis is typified by a marked compression syndrome, which may lack at initial disease stages. A problematic verification often conduces to a diagnostic and, especially, therapeutic malpractice, as illustrated by the two hereby analysed clinical cases.Materials and methods. The article presents two clinical cases of fibrosing thyroiditis, specifying the diagnosis and treatment choice in patients with this pathology. Diagnosis verification and therapy correction facilitated a favourable outcome.Results and discussion. Riedel’s fibrosing thyroiditis can be reluctant to diagnosis due to asymptomatic thyroid dysfunction, the lack of strict radiological diagnostic criteria and rarity in clinical practice. This provokes diagnostic and later therapeutic malpractices, which correction permitted a favourable outcome.Conclusion. Since treatment for compression syndrome-aggravated Riedel’s fibrosing thyroiditis is exclusively surgical, it continues posing a challenge as associated with likely severe complications. Essentially, the first treatment stage was inadequate in both cases. In the first case, the patient withdrew a thyroid hormone therapy already in 4 days, which precluded serious iatrogenic complications, while in the second case, the long-term drug misuse had conduced to cardiovascular pathology. ","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41983399","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":"Alloplastic and Implant Materials for Bone Grafting: a Literature Review","authors":"U. Mukhametov, S. Lyulin, D. Borzunov, I. Gareev, O. Beylerli, G. Yang","doi":"10.24060/2076-3093-2021-11-4-343-353","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-343-353","url":null,"abstract":"Bone reconstruction aft er trauma, infection, tumour or congenital genetic disorder is an important subject of modern medicine usually relying on bone graft ing materials. Autologous bone or autograft is still considered the “gold standard” most eff ective in bone defect reconstruction and osseous regeneration. Having the advantages of autograft ing, a series of issues remain related to a limited donor material, painful graft taking and the risk of putative complications (nonunions, graft rejection, infection, iatrogenic fractures, post-microsurgery arteriovenous shunt thrombosis, etc.). Th erefore, improved biomaterials are demanded to adequately meet the autograft criteria. Choosing optimal graft materials becomes relevant, aside to the rationale of selecting new surgical techniques. Th e osteoconductive and osteoinductive property evaluation in modern osteoplastic materials comprises a research avenue into optimal graft development for osseous correction in maxillofacial surgery, neurosurgery, traumatology and orthopaedics. Such biomaterials can be combined with alloplastic graft s to attain the required properties of osteoconduction, osteoinduction and osteogenesis. Th is analytic literature review focuses on current state-of-the-art in alloplastic graft ing that, in our opinion, grounds the progress of auto- and allograft innovative development.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49160070","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 Gastric Malignancy in Chronic Kidney Disease Patient with Long-Term Haemodialysis","authors":"N. Kovalenko, A. I. Ivanov, S. R. Galeev, Viktoria V. Zhavoronkova, Alexey U. Nikolaev, M. Postolov, V. A. Suvorov, A. A. Klimchenko","doi":"10.24060/2076-3093-2021-11-4-337-342","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-337-342","url":null,"abstract":"Background. Gastric cancer is the world 5th top malignancy, with treatment success largely conditioned by comorbidity. Patients with end-stage renal failure developed with chronic kidney disease could not expect a specialty cancer treatment before the advent of long-term haemodialysis.Aim. A case description of successful perioperative therapy and surgery in a long-term haemodialysis patient performed by a multi-specialty team of oncologists and transplantologists.Materials and methods. We case-illustrate surgical treatment options in a gastric cancer patient with long-term haemodialysis.Results and discussion. A specialty oncological treatment of end-stage renal failure patients requiring long-term haemodialysis is a complex multidisciplinary task feasible in hospitals equipped for different haemodialysis regimens. The treatment plan should be laid out by a multi-specialty team, as chronic kidney disease influences the choice of the drug class, dosage and administration mode. Moreover, such patients need laboratory (control of acid-base balance, haemoglobin, electrolytes, creatinine and urea) and clinical (body weight, liquid balance, etc.) monitoring.Conclusion. Perioperative management studies in gastric cancer and chronic kidney disease-comorbid patients under long-term haemodialysis is a promising area of combining eff ort in oncology and transplantation science. Further research is needed in this topic for data enrichment and analysis in complex comorbidity patients.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44113741","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":"Overhaul of Radiological Mammography Check-ups for Early Malignancy Diagnosis during COVID-19 Pandemic","authors":"Marina S. Ermakova, Sergey M. Demidov, Denis A. Demidov","doi":"10.24060/2076-3093-2021-11-4-316-322","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-316-322","url":null,"abstract":"Background. The article reports the number of examinations with stationary mammography systems, in outpatient screenings, as well as in a mobile mammography survey across the Sverdlovsk Region.Aim. A study of expedience and design of radiological breast check-ups (exemplified by mammography) for early cancer diagnosis under the COVID-19 pandemic situation.Materials and methods. A survey based at the Sverdlovsk Regional Oncology Dispensary’s Department of Diagnostic Radiology analysed the expedience and design of non-invasive diagnostic procedures in a case study of breast X-ray checkups (mammography) in the Sverdlovsk Region during 2019—2020. Th e survey used the Sverdlovsk Region population statistics on breast malignancy incidence for 2019—2020.Results. According to reports, the number of outpatient screening surveys significantly decreased in 2020 vs. 2019 due to the coronavirus pandemic and effective ban on screenings and medical check-ups. Th e mobile mammography screening numbers increased more than twice in 2020 vs. 2019.Discussion. Screening measures continued during the COVID-19 pandemic. Clinicians adhered to local guidelines, while fully complying with the recommendations to contain SARS-CoV-2 infection. Th e growth of mobile mammography screenings enabled completion of the annual check-up plan, however, the breast malignancy detection rate slightly dropped in 2020 compared to 2019.Conclusion. Mammography screenings at the Sverdlovsk Regional Oncology Dispensary in 2019--2020 demonstrate the expedience and good organisation of breast radiological check-ups (mammography) in Sverdlovsk Region. Accounting for the epidemiological state of coronavirus infection, a positive trend is evident towards growing examinations and improved breast malignancy detection, which lowers mortality accordingly among the female population of Sverdlovsk Region.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41800783","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 Surgery in Urethral Cancer (a Clinical Case)","authors":"N. Kholopova, V. B. Venskel, N. Kovalenko, V. Zhavoronkova, A. I. Ivanov, A. G. Chuhnin, A. A. Klimchenko","doi":"10.24060/2076-3093-2021-11-4-323-327","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-323-327","url":null,"abstract":"Background. Despite low incidence, malignant urethral neoplasms are among the most aggressive tumours. Prevalence of muscle-invasive and metastatic cancer at diagnosis, as well as a high relapse rate compel adherence to the most radical treatment. At the same time, the high incidence of urethral tumours in elderly and senile patients and high postoperative complication rates warrant the development of organ-preserving treatment.Aim. A case description to verify the organ-preserving treatment applicability in urethral cancer.Materials and methods. We report the treatment experience in a senile patient with concomitant chronic kidney disease at the Volgograd Regional Clinical Oncology Dispensary’s Oncourology Unit. Accounting for the age, concomitant pathology and tumour histology factors, a minimally invasive organ-preserving surgical intervention was performed as laparoscopic urethral resection with ureterocystoneostomy.Results and discussion. Renal function was assessed in postoperative period with dynamic nephroscintigraphy and blood creatinine monitoring. Control cysto-, ureteroscopy and contrast-enhanced CT scanning in areas of interest were performed to rule out relapse and progression.Conclusion. No report of disease relapse or progression at follow-up indicates the oncological safety of organ-preserving surgery in this patient category. Th is approach also gains support from immediate and long-term outcomes of the patient’s improved renal function and sustained good quality of life.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68976255","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":"Role of Microenvironment in Ovarian Tumourisation","authors":"L. Khalikova, N. Shevlyuk, S. Gantsev, A. A. Khalikov, I. R. Khasanova","doi":"10.24060/2076-3093-2021-11-4-278-283","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-278-283","url":null,"abstract":"Background. Metastasis is a formidable complication of malignant neoplasms, with therapy not always effective in advanced malignancy. Metastasis is a multistep process involving the cancer cell detachment from primary tumour, intravasation, extravasation and invasion into the target organ. Early metastasis stages are well understood, whilst the impact of tumour microenvironment on the disease progression and advancement remains a matter of debate.Aim. An immunohistochemical study of the adaptive and reactive properties of greater omentum with metastatic involvement in ovarian cancer.Materials and methods. We examined greater omentum tissue samples from 40 patients with verifi ed stage 3a and b ovarian cancers. For light microscopy, samples were fi xed in 10 % formalin, dehydrated, paraffi n-embedded and stained with Mayer’s haematoxylin and eosin. Immunohistochemical assays used monoclonal antibodies against CD7, CD4, CD8, CD 68, VEGF, D2-40 and CD44 proteins. Statistical data analysis was performed with Statistica v. 7.0 soft ware.Results and discussion. Analyses of the greater omentum tissues revealed cases of leucocyte-bank encapsulation of metastatic foci. Higher CD7+ and CD8+ cell counts were observed in encapsulation, possibly influencing the greater omentum reactive and adaptive properties. Higher CD44-expressing cell counts were also detected in greater omentum samples lacking encapsulation. Angiogenesis marker-expressing cells (e.g., VEGF and CD34) predominated in greater omentum tissues lacking leucocyte-bank encapsulation of metastatic foci.Conclusion. Events in tumour microenvironment may be indicative of a preserved or reduced organ adaptivity, the latter facilitating disease progression.","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44655553","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":"Geneti c Traits of Brachiocephalic Atherosclerosis","authors":"A. F. Nurimanshin, R. Bogdanov, P. Mironov, A. A. Khusaenova","doi":"10.24060/2076-3093-2021-11-4-293-299","DOIUrl":"https://doi.org/10.24060/2076-3093-2021-11-4-293-299","url":null,"abstract":"Background. According to the World Health Organization, the atherosclerosis development depends on the quality of life and lifestyle (60 %), genetic (20 %), environmental factors (10 %) and quality of medical aid (5 %). The routes to defeat atherosclerosis generally and certain systemic enzyme disorders in particular pertain in research into the population genetic predispositions to this pathology.Materials and methods. A comparative study of genetic predispositions to malignant brachiocephalic atherosclerosis analysed the renin—angiotensin system gene association in 60 patients. Th e renin—angiotensin system allelic and polymorphic loci haplotype frequencies have been determined.Results and discussion. Patients with atherosclerotic brachiocephalic vascular lesions revealed a statistically significant frequency of the AGT gene’s allele C involved in coronary heart disease development.Conclusion. Th e study suggests a putative involvement of the angiotensinogen system genes in mediating the development of brachiocephalic atherosclerosis and coronary heart disease","PeriodicalId":52846,"journal":{"name":"Kreativnaia khirurgiia i onkologiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43932997","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}