Saratov JOURNAL of Medical and Scientific Research

Naydenov E.V.

Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Department of Surgery, Laboratory of New Surgical Technologies, Senior Research Assistant, Candidate of Medical Sciences

Effect of different pancreatic stump closure techniques during distal pancreatectomy to the frequency and severity of acute postoperative pancreatitis

Year: 2018, volume 14 Issue: №2 Pages: 260-265
Heading: Surgery Article type: Original article
Authors: Voskanyan S.E., Naydenov E.V., Uteshev l.Yu., Artemiev A.l.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The Aim: to study the effect of different pancreatic stump closure techniques, including depending on the diameter of the main pancreatic duct to frequency and severity of acute postoperative pancreatitis after distal pancreatectomy. Material and Methods. Distal pancreatectomies were performed in 126 patients with neoplasms of the body and/or tail of the pancreas. Patients were divided into 4 groups depending on the pancreatic stump closure techniques. Group 1 (control): isolated suturing of the main pancreatic duct of the pancreatic stump with its sealing by gastrocolic omentum or hemostatic sponge; group 2: isolated suturing of the main pancreatic duct of the pancreatic stump with its sealing by biological glue 2-octylcyanoacrylate; group 3: pancreatic stump closure were performed by Endoscopic Linear Cutter; group 4: after distal pancreatectomy were performed external transduodenal transnasal drainage of the enlarged main pancreatic duct of pancreatic stump. Results. The frequency of acute postoperative pancreatitis in the control group of patients was 45.8%, in the group 2 of patients — 44.4%, in the group 3 of patients — 9.7%, in the group 4 of patients — 15.0%. The use of the proposed pancreatic stump closure techniques after distal pancreatectomy resulted in a decrease of the frequency of moderate form of acute postoperative pancreatitis. The use of Endoscopic Linear Cutter and external transduodenal transnasal drainage of the enlarged main pancreatic duct resulted in decrease of frequency of acute postoperative pancreatitis in patients with a diameter of the main pancreatic duct of the pancreatic stump up to 5 mm. Conclusion. The use of the proposed pancreatic stump closure techniques after distal pancreatectomy resulted in the decrease of frequency and severity of acute postoperative pancreatitis.

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Computer tomography in the diagnosis of leiomyosarcoma of an inferior vena cava (case report)

Year: 2016, volume 12 Issue: №4 Pages: 702-705
Heading: Radiology Article type: Case report
Authors: Shikunov D.A., Bashkov A.N., Voskanyan S.E., Naidenov E.M., Grigorieva O.O., Orekhova N.V., Zabelin M.V.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The review considered a rare case of leiomyosarcoma of the inferior vena cava, multiphase protocol disclosed value of multislice computed tomography for evaluation of tumor resectability

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Results of application of the PTFE-conduits in the reconstruction of the main veins of the abdominal cavity mesenteric-portal system in locally advanced pancreatic cancer

Year: 2015, volume 11 Issue: №4 Pages: 668-672
Heading: Surgery Article type: Original article
Authors: Voskanyan S.E., Artemiev A.l., Naydenov E.M., Shabalin M.V., Zabezhinsky D.A., Kolyshev l.Yu.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Aim: study of immediate and long-term results of the surgical treatment of the locally advanced pancreatic cancer with tumor invasion of the main veins of the abdominal cavity. Material and methods. Pancreaticoduodenectomy with resection and plasty of the main veins of the abdominal cavity were performed 315 patients. 143 patients underwent for prosthetics of the main veins at their reconstruction of different vascular prosthesis. Patients have been divided into three groups. Group I (basic) — PTFE-conduits have been used in the reconstruction of the main veins (82 patients). Group II — FLL-conduits have been used in the reconstruction of the main veins (36 patients). Group III — autovenous
conduits have been used in the reconstruction of the main veins (25 patients). Comparison of the duration of operation and its reconstruction stage, the quantity of blood loss, frequency of venous thrombosis in the early postoperative period and long-term patency of the reconstructed veins traced ultrasonic method in a period of 6 months, 1, 2, and 3 years after surgery have been carried. The morbidity, the frequency of the infectious complications, the hospital mortality, the mean postoperative hospital stay, median of survival have been studied after surgery. Results. Application of the PTFE-conduits resulted for decrease of the duration of the reconstruction stage of the operation, as well as the duration of the surgery and the amount of intraoperative blood loss. Decrease of the morbidity, of the postoperative hospital stay and the mortality have been noted in the I group of patients compared to groups II and III patients. Thrombosis of the prosthesis after reconstruction of the veins that led for fatal outcome has been marked in 2 patients (5.5%) in group II of the patients. The long-term patency of vascular PTFE-conduits and reconstructed veins in group 1 has been 100% in all period's observations in the postoperative period. Conclusion. PTFE-conduits are universal plastic material. Application of the PTFE-conduits for the reconstruction of the main veins of the mesenteric-portal system can reduce the duration of the reconstruction vascular stage and the operation as a whole. Applications of the PTFE-conduits reduce the morbidity, the frequency of infectious complications, postoperative hospital-stay, hospital mortality, as well as improved performance patency of the reconstructed vessels.

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The clinical efficacy of the water jet dissection at the thyroid surgery (immediate results; quality of life)

Year: 2015, volume 11 Issue: №4 Pages: 663-667
Heading: Surgery Article type: Original article
Authors: Voskanyan S.E., Naydenov E.V., Korsakov I.N., Bazhanova Yu.A.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Aim: reduction of the morbidity, disability and improved quality of life after surgery on the thyroid gland. Material and methods. Surgical treatment of the thyroid diseases have been performed to 56 patients. Mobilization of the thyroid gland and the separation of the pretracheal, preguttural and paratracheal tissues were performed by standard techniques using electrocoagulation and blunt separation of tissues in the control group. Mobilization of the thyroid gland and the separation of pretracheal, preguttural and paratracheal tissues were performed using a water-jet dissector ERBEjet 2 and the pressure of the water jet 25 bars in the main group of patients. Violations of voice (dysphonia), swallowing difficulties (dysphagia), the overall incidence of postoperative complications, length of postoperative hospital stay were markers of the effectiveness of the prevention of the damage of the recurrent laryngeal nerve afterthyroid surgery. Assessment of the quality of life of patients after surgery on the thyroid gland was performed before surgery, at 3 and 6 months after surgery. Results. Damage of the recurrent laryngeal nerve was not identified in any of the patient as a result of water jet dissection with pressure of the water jet 25 bars during the operation. Nerve function in the postoperative period were preserved in 100% (p

Influence of antacids operations at histamine concentration in plasma and the risk of malignancies of the colon

Year: 2015, volume 11 Issue: №4 Pages: 659-662
Heading: Surgery Article type: Original article
Authors: Korsakov I.N., Voskanyan S.E., Naydenov E.M.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Aim; identify communication between antacid operations and malignant tumors of the digestive system. Material and methods. The study was conducted on the 72 Wistar rats. The effect of the stem vagotomy and resection of the distal 2/3 of the stomach and antrumectomy to the concentration of gastrin in plasma were investigated. The effect of intraperitoneal injection of the azoksimetan on the incidence of malignant tumors of the colon was investigated. Re-sults. Increase of the plasma concentration of the gastrin in the postoperative period after stem vagotomy was found. Reduction of the concentration of the gastrin after distal gastrectomy to values close to zero with slight its rise and subsequent stabilization was found. The incidence of colon tumors in animals after stem vagotomy in conjunction with intraperitoneal injection of the chemical carcinogen azoximetan was higher compared to the animals after isolated injection of the azoximetan. The incidence of tumors in animals after resection of the distal 2/3 of the stomach differed not statistically significant from control animals. Conclusion. Vagal denervation of the abdominal cavity leads for significant increase of the concentration of the histamine of the blood plasma. Resection of the 2/3 distal stomach causes a significant reduction in the production of the gastrin. Truncal vagotomy increases the risk of neoplazms of the peritoneal cavity in the rats.

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Clinical results of the complex prevention of the acute postoperative pancreatitis at the surgical gastroenterology

Year: 2013, volume 9 Issue: №4 Pages: 962-968
Heading: Surgery Article type: Original article
Authors: Kotenko К.V., Voskanyan S.Е., Korsakov I.N., Naydenov Е.V., Timashkov D.A., Gavrilyuchenko R.B., Zhangazinov A.L., Sayapin D.A., Voronina I.V.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The article aims to study the results of the complex prevention of the acute postoperative pancreatitis in the surgical gastroenterology. Material and methods. 2968 patients with various disorders of the digestive system were operated. Empirical preventing of the acute postoperative pancreatitis was used in the control group. Complex prevention of the acute postoperative pancreatitis in the main group of patients included the use of Dalargin, intravenous infusion of Octreotide, duodenal trypsin enzyme inhibition; intraduodenal reversal of pancreatic secret; intraductal injection of Lidocaine and external transnasal drainage of the pancreatic and biliary ducts. Results. The frequency of acute postoperative pancreatitis was 12.2% in the main group. The frequency of acute postoperative pancreatitis was 36.9% in the control group. Increased frequency of a mild form of the acute postoperative pancreatitis observed in the main group compared with the control. At the same time reducing the frequency of the moderate severity and severity forms of the acute postoperative pancreatitis observed in the main group compared with the control. Reduction of the morbidity (13.6% vs. 25.1%), hospital mortality (1.6% vs. 3.5%), the duration of the postoperative hospital bed-day (12.1±0.4 vs. 16.7±0.6) were identified in the main group patients compared with the control group. Conclusion. The use of the given scheme for the complex prevention of the acute postoperative pancreatitis allowed significantly reduce the frequency and severity of illness, morbidity, reduce the duration of postoperative hospital bed-day and hospital mortality, as well as the frequency of both mild and severity, and fatal postoperative complications in all investigated groups of patients.

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Effect of the acute postoperative pancreatitis at the postoperative period in the abdominal surgery

Year: 2013, volume 9 Issue: №4 Pages: 957-962
Heading: Surgery Article type: Original article
Authors: Kotenko К.V., Voskanyan S.Е., Korsakov I.N., Naydenov E.V.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The study aims the influence of development of the acute postoperative pancreatitis at the early postoperative period; determine its influence at the frequency and spectrum of complications after abdominal surgery. Material and methods. The work is based on the results of the complex examination and surgical treatment of 1934 patients with various disorders of the digestive system (complicated duodenal ulcer and gastric ulcer, gastric cancer, the proximal and distal pancreatic cancer, colon cancer and postgastrectomy syndromes). The dependence of the overall incidence of postoperative complications, the number of complications per patient, and the number of infectious and inflammatory complications per patient, hospital mortality and length of postoperative hospital days for the development of acute postoperative pancreatitis were studied. Results. Acute postoperative pancreatitis is a leading cause of morbidity postoperative intra-abdominal operations. 97,8% of the cases of complicated early postoperative period of the operations on the organs of the abdominal cavity caused by the development of acute postoperative pancreatitis. Specific complications for the acute postoperative pancreatitis (satellite complications) were identified. Satellite complication had a clearly defined correlation with the development of the acute postoperative pancreatitis. The negative effect of acute postoperative pancreatitis on the severity of the postoperative period, on the morbidity, on the number of complications per patient, on the number of the infectious and inflammatory complications per patient, hospital mortality and on the duration of the postoperative hospital stay were found.

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Correlation between the frequency of the infectious complications of abdominal surgery and the level of immune response to the surgical trauma

Year: 2013, volume 9 Issue: №4 Pages: 954-957
Heading: Surgery Article type: Original article
Authors: Korsakov I.N., Voskanyan S.E., Naydenov E.V., Timashkov D.A., Chervov A.Yu., Volkov A.A., Bolshakov M.S.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Aim: to evaluate the correlations between the frequency of the infectious complications of abdominal surgery and the level of immune response to the surgery. Material and methods. The study has been conducted on 53 patients, who were undergone to pancreaticoduodenal resection with lymphadenectomy. Concentrations of interleukin-4 (IL-4) and interleukin-8 (IL-8) in blood serum were studied. Results. The concentrations of IL-8 were higher in patients with complications compared to those without complications. No statistically significant differences in the concentrations of IL-4 were revealed between the studied groups of patients. Conclusion. Concentrations of pro-and anti-inflammatory cytokines can be used to assess the risk of postoperative complications.

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. Effect of the venous outflow ways from pancreatic transplant on carbohydrate metabolism after autotransplantation of pancreas in the experiment

Year: 2013, volume 9 Issue: №4 Pages: 951-954
Heading: Surgery Article type: Original article
Authors: Voskanyan S.E.., Degtyarev V.S., Korsakov I.N., Naydenov E.V., Artemiev A.I.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The aims: to compare the state of carbohydrate metabolism in animals after pancreatectomy with autotransplantation of the pancreatic segment and with organization of the venous outflow in the inferior vena or portal vein. Material and methods. Proximal resection of the pancreas (group 1), pancreatectomy with autologous transplantation of the pancreas and with reconstruction of the venous outflow from the transplant into the inferior vena cava (group 2) and pancreatectomy with autologous transplantation of the pancreas and with reconstruction of the venous outflow from the transplant into the portal vein (group 3) were performed in 45 animals in the experiment. Examining the status of carbohydrate metabolism was performed by intravenous test for glucose tolerance. Results. Primary higher increase in glucose concentrations as compared to the values obtained at the intact animals and its slower decrease have been observed in animals after pancreatectomy with autotransplantation of the segment of the pancreas on iliac vessels (group 2), as well as on the mesenteric vessels (group 3). Higher blood glucose compared to animals subjected proximal pancreatectomy after 40 minutes after administration of glucose was detected in animals undergoing autotransplantation of the pancreas on iliac vessels (group 2) and in animals after autotransplantation of the pancreas on mesenteric vessels (group 3)— 11.82 (11,39-12,26) mmol/l and 10.65 (10,03-11,32) mmol/l, respectively. The glucose concentration in the blood plasma was lower in the animals of groups 2 and 3 below in comparison with the animals in group 1 to 120 minutes of the experiment. Significant differences in plasma glucose concentration between animals of groups 2 and 3 were not found. Conclusion. Significant effects of the ways of organization of the venous outflow from pancreatic transplant on the concentration of the glucose in the blood plasma by the carbohydrate load after pancreatectomy with autotransplantation of the pancreas were not found.

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