Saratov JOURNAL of Medical and Scientific Research

Surgery

The role of connective tissue dysplasia in aetiopathogenesis of varicose disease and acute varicothrombophlebitis

Year: 2019, volume 15 Issue: №2 Pages: 302-307
Heading: Surgery Article type: Review
Authors: Tsarev O.A., Anisimov A.Yu., Prokin F.G., Zakharov N.N., Senin A.A., Kulikova A.N.
Organization: Saratov State Medical University
Summary:

The academic literature review presents the analysis of recent publications which focus on the role of connective tissue dysplasia in aetiopathogenesis of lower extremity varicose vein disease (LEVVD) and acute varicothrombophle-bitis (AVTPh). The ways of predicting the variants of LEVVD and AVTPh clinical course on the basis of analyzing the combination of phenotypic characteristics are examined. Key words: varicose disease, varicothrombophlebitis, connective tissue dysplasia.

Biliary anastomotic strictures after liver transplantation

Year: 2019, volume 15 Issue: №2 Pages: 296-301
Heading: Surgery Article type: Review
Authors: Popov M.V., Voskanyan S.E., Dunaev A.P., Bashkov A.N., Maltseva A.P.
Organization: Moscow City Oncologic Hospital N. 62, Imaging Department, State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The literature review presents the data on a current state of the problem of anastomotic strictures of the bile ducts in patients after living donor liver transplantation, called the «Achilles» heel» of transplantology. The data on the frequency and timing of the development of strictures, their causes and risk factors are given. The role of imaging methods in the diagnosis of this group of complications is shown. Methods for treating biliary post-transplantation strictures are described: antegrade, retrograde, and open. The themes of the prospects of percutaneous and endoscopic techniques and the choice of stricture treatment methods are also touched upon.

AttachmentSize
2019_02_296-301.pdf1.05 MB

Experience of endovideosurgical hemithyroidectomy use for patients with benign thyroid diseases

Year: 2019, volume 15 Issue: №2 Pages: 290-295
Heading: Surgery Article type: Original article
Authors: Vertyankin S.V., Turlykova I.A., Meshcheryakov V.L., Grekov V.V., Chupakhin N.V., Vanzha Ya.E., Ivanova V.A., Zhurkin K.I..
Organization: Saratov State Medical University
Summary:

Objective: development and assessment of the way of an endoscopic hemithyroidectomy improving visualization of anatomical structures and excluding «the confict of tools». Material and Methods. Results of treatment of 103 patients who transferred hemithyroidectomy from endoscopic and traditional approaches to the period from 2014 to 2018 on the basis of the Hospital of S. R. Mirotvortsev (Saratov) are analyzed. According to access option patients were divided into 2 groups. The compression syndrome, functional autonomy of a thyroid gland and results of a puncture biopsy were indications to operation. Results. Unilateral paresis of a throat is diagnosed for 1 patient after traditional intervention, stopped within 1.5 months, after an endovideosurgical hemithyroidectomy — for 3 patients, and was stopped in terms from 7 days up to 1.5 months. Signs of hypoparathyrosis were not found in the groups of patients. The complications connected with administration of carbon dioxide did not arise. Conversionwas not required in any case. Conclusion. Development and assessment of a new way of an endoscopic hemithyroidectomy which is feasible, safe and provides high degree of esthetic result.

AttachmentSize
2019_02_290-295.pdf467.52 KB

Experimental substantiation of the results of combined techniques in treatment of soft tissue abscess

Year: 2019, volume 15 Issue: №2 Pages: 287-290
Heading: Surgery Article type: Original article
Authors: Alipov V.V., Kulikova A.N., Musaelyan A.G., Mustafayeva D.R.
Organization: Saratov State Medical University
Summary:

Objective: to develop a model of purulent abscess of soft tissues and experimentally substantiate the efectiveness of the use of nanoparticles of zinc oxide (ZОN) and a drug based on lanthanum nitrate in the combined treatment of purulent abscess of soft tissues. Material and Methods. The purulent abscess of soft tissues modeling was performed using a modifed Fogarty catheter using a culture of Staphylococcus aureus in an experiment on 80 white laboratory rats of males weighing 190±25 g. Four groups of animals (20 each) were selected, which, after surgical dissection and laser rehabilitation of the cavity, carried out local therapy. In the frst (control) group, standard treatment was used, in the second group a drug based on lanthanum nitrate was used, in the third — ZОN, in the fourth — a combination of the drug with lanthanum nitrate + ZОN. Results. By the 10th day, 87±4.9 % of animals of the fourth group showed activation of the processes of collagenosis and epithelialization and complete obliteration of the abscess cavity. Conclusion. The developed purulent abscess of soft tissues modeling method is low-impact and allows optimizing the time of abscess formation with specifed characteristics. The combined treatment of animals of the fourth group due to the synergism of action creates optimal conditions for the accelerated obliteration of the purulent abscess of soft tissues cavity, shortening the treatment time by two times compared with the standard techniques.

AttachmentSize
2019_02_287-290_1.pdf309.64 KB

Comparative analysis of the quality of life before and after various methods of invasive treatment of esophageal cancer

Year: 2018, volume 14 Issue: №3 Pages: 408-411
Heading: Surgery Article type: Original article
Authors: Tolstokorov A.S., Ramazanov E.N., Dergunova S.A.
Organization: Saratov State Medical University
Summary:

The aim of the work is to assess the quality of life before and after multistage and one-stage operations, palliative interventions performed with malignant neoplasms of the esophagus. Material and Methods. The quality of life was evaluated in 565 patients with esophageal cancer at various stages of surgical treatment by means of questionnaires for assessing the quality of life of GIQLI, GSRS, MOS SF-36 questionnaire. Results. When performing multi-stage operations before the end of treatment, the quality of life changes insignificantly, and is comparable with the quality of life after palliative operations. The study of the quality of life after the end of treatment with the use of endoscopic minimally invasive technologies in these questionnaires convincingly showed the advantage of this category of surgical interventions due to less trauma, better cosmetic effect, quick activation and rehabilitation in the postoperative period. Conclusion. Taking into account the results of the research, preference is given to one-stage operations with the use of minimally invasive endoscopic techniques, which in a short time can save the patient from cancer and significantly improve the quality of life.

AttachmentSize
2018_3_408-411.pdf302.47 KB

Efficacy of surgical treatment of renal form of hyperparathyroidism

Year: 2018, volume 14 Issue: №2 Pages: 265-267
Heading: Surgery Article type: Original article
Authors: Kovalenko Yu.V., Tolstokorov A.S., Rossolovsky A.N., Kravchenya A.R., Manakhov G.A.
Organization: Saratov State Medical University
Summary:

Objective: to study the efficacy of surgical treatment of primary hyperparathyroidism in risk of uronephrolithiasis progression. Material and Methods. The research involved 55 patients, the biochemical and clinical parameters before and after treatment with retrospective-prospective method of analysis were studied and analyzed. Results. It is established that the surgical treatment of patients with uronephrolithiasis is proved to be effective in 96,4% of the cases, as it allows to eliminate the classic symptoms of primary hyperparathyroidism, and urolithiasis. Improvement of laboratory hormonal and biochemical indices of mineral metabolism, and, consequently, reducing the severity of risk factors of urolithiasis is marked. Conclusion. Surgical treatment of renal forms of primary hyperparathyroidism is a pathogeneti-cally reasonable method. Parathyroidectomy performed in an adequate amount prevents relapses and progression of diseases that are the consequence of primary hyperparathyroidism.

AttachmentSize
2018_2_265-267.pdf245.79 KB

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.

AttachmentSize
2018_2_260-2651.pdf652.22 KB

A case report of appendicular abscess resulted in hernial sac phlegmon

Year: 2018, volume 14 Issue: №1 Pages: 94-96
Heading: Surgery Article type: Case report
Authors: Shapkin Yu.G., Katalnikov A.E., Starchikhina D.V.
Organization: Saratov City Hospital No6 n.a. V. N. Koshelev, Saratov State Medical University
Summary:

An abnormal clinical case of break of appendicular abscess in incisional ventral hernia complicated phlegmon of
anterior abdominal wall is reported. The observation is of significant importance due to rare frequency of occurrence
in clinical practice, formation of a dangerous complication (phlegmon of anterior abdominal wall), difficult differential
diagnostics (Richter’s strangulatoin bowel or epiploon in hernia with necrosis complicated hernial sac phlegmon or
break of appendicular abscess in incisional ventral hernia). The surgical management was performed followed by a
patient’s recovery.

AttachmentSize
2018_1_094-096.pdf227.88 KB

Acute varicothrombophlebitis: modern approach to the problem

Year: 2018, volume 14 Issue: №1 Pages: 87-94
Heading: Surgery Article type: Review
Authors: Tsarev О.А., Anisimov A.Yu., Prokin F.G., Zakharov A.A., Lobanov A.V., Senin A.A.
Organization: Saratov State Medical University
Summary:

Acute varicothrombophlebitis, or thrombosis of superficial veins (TSV), is a dangerous complication of lower extremity varicose vein disease, as it is a frequent cause for pulmonary artery thromboembolism. The survey states the modern approach to pathogenesis, diagnostics, clinical findings and therapeutic approach to patients with TSV.

AttachmentSize
2018_1_087-094.pdf319.96 KB

Primary hyperpara-thyroidism: current state of the problem

Year: 2017, volume 13 Issue: №4 Pages: 849-853
Heading: Surgery Article type: Review
Authors: Kovalenko Yu.V., Tolstokorov A.S., Rossolovsky A.N., Kravchenya A.R., Manakhov G.A., Velikanova M.G.
Organization: Saratov State Medical University
Summary:

 The review is devoted to current state of the problem of primary hyperparathyroidism. One of the important steps in the study of pathology of parathyroid glands and their decision value in development of primary hyperparathyroidism was introduction of automated screening of the ionized calcium of plasma of blood to all patients asking for medical care. Understanding of the nature of this process allowed the doctors of many specialities to unite the efforts in the analysis of results of the already accumulated experience and extend possibilities of early preclinical exposure of this disease.

AttachmentSize
2017_04_849-8531.pdf278.36 KB