Saratov JOURNAL of Medical and Scientific Research

Surgery

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.

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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.

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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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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.

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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.

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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.

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A rare cause of small bowel obstruction (case report)

Year: 2017, volume 13 Issue: №4 Pages: 846-848
Heading: Surgery Article type: Case report
Authors: Khmara M.B., Kozlov V.V., Samarina D.V.
Organization: Saratov State Medical University
Summary:

The article presents a rare case of obstructive ileus caused by a silicone cylinder that is installed within a stomach to treat obesity. Purpose: to show the possibility of developing intestinal obstruction by foreign body (silicone balloon) and to draw the attention of professionals involved in intragastric ballooning to the possibility of the development of this complication.

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Sclerosurgical and surgical treatment of patients with lower extremity varicose vein disease: analysis of results in a long-term period of observation

Year: 2017, volume 13 Issue: №4 Pages: 839-845
Heading: Surgery Article type: Original article
Authors: Gafurova D.R., Kulikova A.N., Chabbarov R.G., Pyatnitsky A.G.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University, Saratov «Omega-clinic»
Summary:

Aim: to analyze and evaluate the long-term results of sclerosurgical and surgical treatment of patients with lower extremity varicose vein disease (VVD). Material and Methods. Diagnostics and treatment findings of 228 patients are presented. The main group consists of 153 patients (189 extremities) after intraoperative trunk catheter sclerotherapy of the great saphenous vein (GSV) with a crossectomy. The comparison group consists of 75 patients (96 extremities) after the GSV phlebectomy by Babcock — Narat. Long-term results (5-9 years) of treatment were evaluated by comparing the quality of life (QL) parameters of patients, the ultrasonic characteristics of venous bed for operated extremities, and the progression of VVD. Results. There was not found any considerable differences in respondents' QL during the comparison. Duplex ultrasound scanning of the lower extremities in most cases revealed a wide spectrum of pathological ultrasound signs (6 of 13 signs, the differences in which are statistically significant, but not specific for stem sclerotherapy and phlebectomy). Investigation of VVD dynamics after correction of the varicose syndrome revealed three variants of the disease course: regression, lack of dynamics, progression. Conclusion. The effectiveness of sclerosurgical interference in the long-term observation period is comparable with the surgical one, which is confirmed by the total number of positive (good and satisfactory) treatment results after using both methods (93.7 and 81.3% respectively), ultrasound diagnosis results, absence of significant differences in QL of patients.

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Variants of clinical manifestation of retroduodenal perforation at endoscopic papillosphincterotomy

Year: 2017, volume 13 Issue: №3 Pages: 544-548
Heading: Surgery Article type: Original article
Authors: Osumbekov R.B.
Organization:
Summary:

Objective: to study clinical manifestations of retroduodenal perforations in conducting ES and instrumental revision of the bile ducts, the study of predisposing factors, determining the optimal equipment trial cannulation. Material and Methods. On the experience of 41 observations was studied manifested symptoms, anatomical features, technology ES. Results. Retroduodenal perforation manifests progressive subcutaneous emphysema in the first 12 hours after EPST, acute dynamic ileus in the same period, pain with preserved peristalsis and more remote: hepatoduodenal ligament abscess, duodenal fistula of retroperitoneal space and pneumomediastinum. The use of conductors reduces the occurrence of perforation in 40%. Conclusion. It is revealed that retroduodenal perforation may occur in 6 clinical variants predisposing factors are atypical anatomical variants, trial cannulations without the use of conductors.

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Clinical and morphological features of diagnosis and treatment of various forms of primary hyperparathyorosis

Year: 2017, volume 13 Issue: №3 Pages: 541-543
Heading: Surgery Article type: Original article
Authors: Kovalenko Yu.V., Tolstokorov A.S., Kravchenya A.R., Khubolov A.M., Manakhov G.A.
Organization: Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky
Summary:

Objective: optimization of the diagnostic algorithm and treatment methods for different clinical forms of the primary hyperparathyroidism. Material and Methods. The article presents the results of examination and operative treatment of 59 patients diagnosed with the primary hyperparathyroidism, such patients having symptoms specific for the disease or having no symptoms of the same. Results. We have not revealed intraoperative complications after surgical interference; laboratory findings have been normalized in 96.6% of cases. The patients having undergone the surgery have been followed up for 12 months with no relapse. 11.9% of the patients have been diagnosed with the asymptomatic primary hyperparathyroidism. Conclusions. Parathyroidectomy is the only radical and effective treatment for the primary hyperparathyroidism. Parathyroidectomy performed surgically to the proper extent, prevents the relapse as well as development of diseases resulting from the primary hyperparathyroidism.

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