Surgical treatment for common hepatic aneurysm. Original one-step technique

AbstractIntroductionHepatic artery aneurysms are rare, and their treatment represents a challenge for the surgeons.Materials and methodsA new technique is presented for common hepatic artery (CHA) aneurysm: it requires minimal vascular surgical dissection and only one linear vascular stapler is applied at the bottom of aneurysm. Aneurysm exclusion is easily obtained, which allowed retrograde thrombosis. Liver blood supply is ensured to the right and left hepatic artery, through the gastroduodenal artery, and can be previously monitored, with temporary clamping of the section area, by visual control, enzyme evaluation and intraoperative ultrasound examination. We reported an open surgical treatment, with simultaneous removal of hepatic and adrenal metastases, secondary to colon cancer.ResultsThe duration of vascular surgery was 30 min and did not involve complications. Postoperative controls confirmed the efficacy of the procedure.DiscussionThis original technique can be added to the various open and endovascular techniques so far described for the treatment of a CHA aneurysm. It is advisable as open surgery, mostly in case of associated pathologies.ConclusionsThe authors believe that this “one shot” technique by vascular staple of the distal part of CHA is minimally invasive and effective to obtain the exclusion of the aneurysm.

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The results of open surgical treatment of bilateral staghorn and multiple nephrolithiasis

Kazan medical journal ◽

10.17816/kmj2018-722 ◽

2018 ◽

Vol 99 (4) ◽

pp. 722-729

Author(s):

S B Imamverdiev ◽

T A Talibov ◽

I F Makhmudov

Keyword(s):

Surgical Treatment ◽

Renal Artery ◽

Open Surgery ◽

Left Kidney ◽

The Other ◽

Before And After ◽

The Status ◽

Group 2 ◽

Open Surgical Treatment ◽

The Right

Aim. To determine the status and to increase the effectiveness of open surgical treatment of bilateral staghorn nephrolithiasis. Methods. We studied the results of surgical treatment of 250 patients who underwent open surgery for severe forms of bilateral staghorn nephrolithiasis. The patients were divided into four groups according to the features of changes in both kidneys and ureters - group 1 included 125 (50.0%) patients with bilateral staghorn nephrolithiasis, group 2 - 35 (14.0%) patients with staghorn nephrolithiasis of solitary or the only functioning kidney, 70 (28.0%) patients with unilateral staghorn nephrolithiasis and solitary or multiple kidney or ureter stones on the other side were included into group 3, and group 4 inlcuded 20 (8.0%) patients with unilateral staghorn nephrolithiasis and nonobstructive hydronephrosis and other diseases on the other side. The age of patients ranged from 7 to 76 years old, ranging among children from 7 to 18 years (average age 12.1±0.4 years) and among adults from 19 to 76 years (average age 46.4±0.6 years). Among patients, 121 (48.4%) were males and 129 (51.6%) were females. Results. Surgical tactics and the results of performed surgeries in certain groups were studied. Overall, 127 (50.8±3.8%) of 250 patients underwent surgery on the right kidney, and 123 (49.2±3.2%) - on the left kidney. To achieve minimal blood loss during the surgery, in 20% of cases renal artery was clamped. To protect kidneys from ischemia, 3 mg/kg of furosemide, 0.2 mg/kg of verapamil and 1 mg/kg of methylethylpiridinol were used before and after clamping of the renal artery. Open surgical treatment of 250 patients with bilateral staghorn nephrolithiasis was successful in 246 (98.4±0.8%) patients. In case of residual stones, extracorporeal or ureterorenoscopic shock wave lithotripsy was performed. Conclusion. Despite the wide application of modern endoscopic methods of therapy in the treatment of this group of patients, in complex forms of staghorn nephrolithiasis open surgery is more effective.

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MINILAPAROTOMIC ACCESS UNDER INTRAOPERATIVE ULTRASOUND NAVIGATION. EXPERIENCE IN THE DEVELOPMENT AND APPLICATION

Science and Innovations in Medicine ◽

10.35693/2500-1388-2016-0-1-67-71 ◽

2016 ◽

Vol 1 (1) ◽

pp. 67-71

Author(s):

DB B Demin ◽

YuYu Yu Solodov ◽

AV V Laykov ◽

MS S Funigin ◽

NS S Gusev

Keyword(s):

Surgical Treatment ◽

Ultrasound Guidance ◽

Abdominal Cavity ◽

Intraoperative Ultrasound ◽

Postoperative Mortality ◽

Retroperitoneal Space ◽

Additional Equipment ◽

One Step ◽

Equipment Application ◽

Navigation Experience

Aim - to evaluate the effectiveness of minilaparotomic access under intraoperative ultrasound navigation in the surgical treatment of liquid formations in the abdominal cavity and retroperitoneal space in comparison with the puncture-draining interventions under ultrasound guidance. Material and methods. The analysis covered the treatment of 77 patients with interventions for liquid formations of the abdominal cavity and retroperitoneal space using minimally invasive ultrasound-controlled technologies. Among them, 33 patients underwent puncture-draining interventions under ultrasound navigation (I group). Group II consisted of 44 patients with minilaparotomic surgery under intraoperative ultrasound guidance. Results. It is shown that minilaparotomic access under intraoperative ultrasound navigation allows performing one-step sanitation and drainage of abdominal structures of the abdominal cavity and retroperitoneal space, containing in the lumen not only liquid, but also dense necrotic tissues. Conclusion. The process is technically feasible in any surgical hospital, economically relevant, since it does not require the purchase of additional equipment. Application of this method can significantly reduce postoperative mortality.

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CLOSING OF INTERVENTRICULAR SEPTUM DEFECT IN ONE-STEP AND STEPWISE SURGICAL TREATMENT IN PATIENTS WITH PULMONARY ATRESIA AND AORTO-PULMONARY COLLATERALS

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2015-174-4-9-12 ◽

2015 ◽

Vol 174 (4) ◽

pp. 9-12

Author(s):

A. A. Morozov ◽

R. R. Movsesyan ◽

V. G. Lyubomudrov

Keyword(s):

Blood Flow ◽

Surgical Treatment ◽

Pulmonary Blood Flow ◽

Interventricular Septum ◽

Pulmonary Arteries ◽

Pulmonary Atresia ◽

Definitive Repair ◽

One Step ◽

Pulmonary Arterial ◽

The Right

Pulmonary atresia with defect of interventricular septum and collateral pulmonary blood flow refers to complicated congenital malformation of the heart. Surgical treatment represents itself as very difficult task because of anatomical variability of this abnormality. The main problem of surgery is a definitive repair of the defect including correction of maldistributions of pulmonary arterial bed (unifocalization of pulmonary blood flow), reconstruction of outflow tract of the right ventricle and closing of interventricular septum defect. The performance of closing interventricular septum defect could be successful in patients with pulmonary atresia and collateral pulmonary blood flow in case of stepwise and one-step surgical treatment. The combination of maximal number of pulmonary segments and sufficient development of central pulmonary arteries facilitates to progress of assigned task. Patients with the level of pulmonary-arterial index more than 170 mm/m² and integrity of pulmonary arterial bed, centralization of pulmonary segments (minimum 15) could be considered as a candidate for definite repair of the defect.

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Methodology for determining the anthrofundal border of the stomach in the surgical treatment of peptic ulcer disease

Kazan medical journal ◽

10.17816/kazmj70744 ◽

1986 ◽

Vol 67 (6) ◽

pp. 405-407

Author(s):

V. F. Naumov ◽

V. Ya. Popov

Keyword(s):

Peptic Ulcer ◽

Surgical Treatment ◽

Peptic Ulcer Disease ◽

Mucous Membrane ◽

Distal Part ◽

The Body ◽

Selective Proximal Vagotomy ◽

Gastric Stump ◽

Ulcer Disease ◽

The Right

Special methods allowing during the operation to establish the boundary between the mucous membrane of the body and the antral part of the stomach have an important practical value. Knowledge of gastric secretory topography provides clear performance of organ-saving operations (antrumectomy and selective proximal vagotomy). We propose to "cut out" the gastric stump so that it retains a part of the vagal nerve branches (in the area of cardia, esophagus, along the right gastroesophageal artery) and in its distal part it is represented by the antral part of the stomach.

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Congenital Clubfoot Associated with an Accessory Soleus Muscle

Journal of the American Podiatric Medical Association ◽

10.7547/0980408 ◽

2008 ◽

Vol 98 (5) ◽

pp. 408-413 ◽

Cited By ~ 3

Author(s):

Levent Karapinar ◽

Ahmet Kaya ◽

Taskin Altay ◽

Hasan Ozturk ◽

Fatih Surenkok

Keyword(s):

Magnetic Resonance Imaging ◽

Surgical Treatment ◽

Soleus Muscle ◽

Distal Part ◽

Surgical Results ◽

Resonance Imaging ◽

Congenital Clubfoot ◽

Normal Appearance ◽

The Right

A 16-month-old male with previously untreated bilateral clubfeet was admitted to S.B. Izmir Tepecik Education and Research Hospital, Izmir, Turkey. Both feet underwent surgical treatment. During surgery, an accessory soleus muscle was detected on the right side. The accessory soleus muscle had a distinct distal insertion at the superior anteromedial border of the calcaneus and also anterior and medial to the Achilles tendon. He was treated by bilateral complete subtalar release with Cincinnati incision, and the accessory soleus was also cut and the distal part resected. At the final follow-up visit, when the patient was 6 years and 9 months old, both feet had a normal appearance and appeared normal on radiograph and magnetic resonance imaging, with no presence of the accessory soleus muscle or its remnant. In our opinion, awareness of the association between an accessory soleus muscle and clubfoot, and sectioning of this muscle during surgery may improve surgical results. (J Am Podiatr Med Assoc 98(5): 408–413, 2008)

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Surgical treatment without revascularization of a massive hepatic artery aneurysm with obstructive jaundice

Chirurgia ◽

10.23736/s0394-9508.19.05026-5 ◽

2020 ◽

Vol 33 (4) ◽

Author(s):

Chang-Bing Wu ◽

Hong Cao ◽

He Yu ◽

Ping Wan

Keyword(s):

Surgical Treatment ◽

Obstructive Jaundice ◽

Hepatic Artery ◽

Artery Aneurysm ◽

Hepatic Artery Aneurysm

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VD14 OPEN SURGICAL TREATMENT OF GIANT CORONARY ARTERY ANEURYSMS

Journal of Cardiovascular Medicine ◽

10.2459/01.jcm.0000549938.84819.06 ◽

2018 ◽

Vol 19 ◽

pp. e34

Author(s):

M.L.S. Matteucci ◽

M. Cefarelli ◽

M. Pierri ◽

F. Capestro ◽

P. Berretta ◽

...

Keyword(s):

Coronary Artery ◽

Surgical Treatment ◽

Coronary Artery Aneurysms ◽

Open Surgical Treatment

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Three-Component [1+1+1] Cyclopropanation with Ruthenium(II)

10.26434/chemrxiv.6025772 ◽

2018 ◽

Author(s):

Tanner C. Jankins ◽

Robert R. Fayzullin ◽

Eugene Khaskin

Keyword(s):

Quaternary Carbon ◽

Poor Control ◽

One Step ◽

Synthetic Routes ◽

Mechanistic Investigations ◽

Chiral Centers ◽

Metal Catalyzed ◽

The Right ◽

Substituted Cyclopropanes

We report a one-step, Ru(II)-catalyzed cyclopropanation reaction that is conceptually different from the previously reported protocols that include Corey-Chaykovsky, Simmons-Smith, and metal catalyzed carbene attack on olefins. Under the current protocol, various alcohols are transformed into sulfone substituted cyclopropanes with excellent isolated yields and diastereoselectivities. This new reaction forms highly congested cyclopropane products with three new C–C bonds, three or two new chiral centers and one new quaternary carbon center. 22 examples of isolated substrates are given. Previously reported synthetic routes for similar substrates are all multi-step, linear routes that proceed with overall low yields and poor control of stereochemistry. Experimental mechanistic investigations suggest initial metal-catalyzed dehydrogenation of the alcohol substrate and catalyst independent stepwise attack of two equivalents of sulfone on the aldehyde under basic conditions. While the Ru(II) is only responsible for the initial dehydrogenation step, the rate of aldehyde formation is crucial to maintaining the right balance of intermediates needed to afford the cyclopropane product.

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