scholarly journals ONCOPLASTIC RESECTION OF THE MAMMARY GLAND WITH A SLIDING DERMOGLANDULARY FLAP WITH A Z-SHAPED INCISION

2017 ◽  
Vol 4 (2) ◽  
pp. 68-74 ◽  
Author(s):  
E. A. Rasskazova ◽  
A. D. Zikiryakhodzhayev ◽  
E. K. Saribekyan
Keyword(s):  
Surgical Treatment ◽  
Clinical Observation ◽  
Triple Negative ◽  
Distant Metastases ◽  
Aesthetic Results ◽  
Luminal Type ◽  
Cosmetic Effect ◽  
Patient Localization ◽  
Observation Period ◽  
Triple Negative Subtype

Oncoplastic resections are a radical surgical treatment for breast cancer, as well as a method for the rehabilitation of patients, since operations are classified as organ preserving. When the tumor node is localized in the upper-inner quadrant of the breast, it is difficult to achieve good aesthetic results. One of the solutions to the problem is the use of a sliding flap with a Z-shaped incision. In P. Hertsen MORI from 2014 to 2016, the operation with the use of a sliding flap was performed in 13 patients. The prevalence of the process, patients were distributed as follows: ТisN0 М0–1, Т1N0 М0–7, Т2N0 М0–3, Т1N1 М0–2 .Molecular subtypes distribution was the following — luminal type A— 8, luminal type B — 3, triple-negative subtype — 1 patient. Localization of the tumor site in the breast: the upper-internal quadrant — 9, upper — 1, lowerinner quadrant — 3 .The upper Zshaped flap was used in 10 patients, the lower Zshaped flap in 3 cases. Postoperative period in all patients was without com plications. The wound healed by primary intention in all patients. Cosmetic effect was good. The observation period is from 6 months to 2 years, the median is 1.1 years. Data for local recurrence and distant metastases were not detected. 2 patients had only surgical treatment, in the remaining 8 cases, radiation therapy with or without drug therapy. In all cases the operation is performed on one breast, correction of the second breast was not required.The article presents the clinical observation of patients with oncoplastic resection of the Zshaped flap, a detailed procedure of the operation.

scholarly journals Prevalence of Molecular Subtypes of Breast Cancer in a University Hospital of Nepal

2020 ◽  
Vol 42 (1) ◽  
pp. 75
Author(s):  
Suzita Hirachan ◽  
Yogendra P Singh
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Triple Negative ◽  
Molecular Subtypes ◽  
University Hospital ◽  
Personalized Treatment ◽  
Breast Cancer Patients ◽  
Luminal A ◽  
Luminal Type ◽  
Triple Negative Subtype

Introduction Breast cancer is the second most common malignancy in Nepalese women. It represents a group of heterogenous disease with diverse biologic, clinical and molecular characteristics requiring personalized treatment. Based on Immunohistochemical markers, breast cancer is classified into distinct molecular subtypes. The aim of the study was to analyze the incidence of molecular subtypes of all breast cancer patients treated at University Hospital of Nepal in the period over 3 years. MethodsA retrospective observational study was carried out in Breast Unit of Tribhuvan University Teaching Hospital, Kathmandu. Electronic medical records of all breast cancer patients treated between January 2017 to December 2019 were retrieved from the hospital database. Patient’s characteristic, histological features and molecular subtypes were collected and analyzed. ResultsA total of 156 surgically treated breast carcinoma patients were studied. The median age of study population was 55 years (range 28–82years). Among these, 69 (44%) were of ≤45 years and 87 (56%) were over 45 years. The mean tumor size was 29 mm (range 50-140 mm). The most common histology was invasive ductal carcinoma (93.5%). Luminal type A was positive in 68 (43%) patients while luminal type B was present in 12 (7.6%) patients. Triple negative subtype was observed in 50 (32%) patients while HER2 rich subtype was seen in 25(16%). Incidence of Triple negative subtype was highest in patients less than 45 years (42%). Luminal A subtype was correlated with low tumor grade and less positive lymph nodes metastasis. ConclusionThe most common molecular subtype of breast cancer in Nepal is Luminal A having favorable features. The incidence of triple negative breast cancer is higher in Nepal, having an aggressive and clinically distinct subtype and is important for personalized treatment plan.

scholarly journals Repeated fracture of the femoral neck. Tactics of treatment. Clinical observation

2015 ◽  
Vol 3 (2) ◽  
pp. 48-51
Author(s):  
Pavel Igorevich Bortulev ◽  
Yaroslav Nikolaevich Proshchenko ◽  
Anatoliy Vasilievich Ovsyankin ◽  
Alexey Polikarpovich Drozdetskiy ◽  
Oksana Vyacheslavovna Bortuleva
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Femoral Neck ◽  
Clinical Observation ◽  
Multiple Fractures

The article presents a case report of surgical treatment of multiple fractures of the femoral neck in 15-year old child.

scholarly journals Surgical treatment of «dry» forms of central chorioretinal dystrophy with the use of platelet-rich blood autoplasma

2017 ◽  
Vol 98 (3) ◽  
pp. 390-393
Author(s):  
D G Arsjutov
Keyword(s):  
Surgical Treatment ◽  
Pigment Epithelium ◽  
Vitreoretinal Surgery ◽  
Internal Limiting Membrane ◽  
Hyaline Membrane ◽  
The Impact ◽  
Observation Period ◽  
Subretinal Injection ◽  
Sodium Solution

Aim. To study the impact of platelet-rich blood autoplasma on the capability of the retinal regeneration in nonexudative forms of central chorioretinal dystrophy with the use of microinvasive vitreoretinal surgery. Methods. Surgical treatment was performed on 14 patients with central chorioretinal dystrophy aged 29 to 87 years. The surgery technique consisted of 3-port 25+, 27 Ga vitrectomy with posterior hyaline membrane and internal limiting membrane peel with subsequent central retinal exfoliation with 38 Ga cannula and balanced sodium solution and subretinal injection to the formed in macule space 0.1-0.2 ml of platelet-rich autolplasma. Results. As a result of the treatment according to this technique during the long-term period after the surgery (1 to 9 months) thickness of fovea reduced to 85-150 µm in average staying stable during the whole observation period. In 9 patients pigment epithelium thickened from 24 to 38 µm in parafoveolar area and fovea area. Corrected vision in 3 patients reached 0.1, and in the rest it did not exceed 0.06, herewith, all patients noted consistently improved vision. All patients had favorable evolution of photosensitivity according to microperimetry in average from 0.1-0.5 to 8.5-11 dB with a tendency of fixation point movement from periphery to the center. Conclusion. Vitreoretinal surgery 25+, 27 Ga for nonexudative forms of central chorioretinal dystrophy with the use of subretinal injection of platelet-rich autoplasma is a microinvasive, safe, effective method of the treatment of such pathology improving vision characteristics and anatomical and physiological characteristics of the eye involved.

scholarly journals Possibilities of minimally invasive treatments of hemorrhoidal disease

2018 ◽  
pp. 77-82 ◽  
Author(s):  
M. V. Abritsova
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Harmonic Scalpel ◽  
Hemorrhoidal Disease ◽  
Single Center ◽  
Narcotic Analgesics ◽  
Group I ◽  
Minimally Invasive Treatments ◽  
Observation Period

The article presents the results of surgical treatment of patients with stages III to IV hemorrhoids followed by an observation period of 45 days, which is designed to improve the results of surgical treatment of this category of patients. The surgical treatment methods included doppler-guided transanal hemorrhoiddearterialization with mucopexy (DDM) (Group I) and harmonic scalpel hemorrhoidectomy (HSH) (Group II). Operated patients underwent all necessary examinations according to the “per protocol” principle. Study Design: single-center controlled randomized prospective. The effectiveness of DDM was comparable to that of hemorrhoidectomy (HE), which made it possible to significantly reduce the duration of the operation (DDM 17.9 ± 6.1 min, GE 34.5 ± 10.1 min (p <0.01) ), reduce the level of pain in the postoperative period (DDM an average of 2.5 points, HE 4.8 points (p <0.01)), reduce the frequency of narcotic analgesics (DDM an average of 1.3 doses, HE an average of 6.1 doses (p <0.01)) and shorten the period of disability (DDM 14.4 ± 5.2 days, HE 30.3 ± 5.4 days (p <0.01)) patients with stages III to IV disease.

scholarly journals SURGICAL TREATMENT OF CHRONIC VENOUS DEFICIENCY OF LOWER EXTREMITIES

2020 ◽  
pp. 68-73
Author(s):  
I. B. Babynkina ◽  
A. A. Novikova ◽  
G. P. Babynkina
Keyword(s):  
Surgical Treatment ◽  
Lower Extremities ◽  
Outpatient Basis ◽  
Perforating Veins ◽  
Results Of Treatment ◽  
Cosmetic Effect ◽  
Modern Economic ◽  
Surgical Tactics ◽  
Tissue Trauma ◽  
Standard Operations

Summary. The aim. Improving the results of treatment of patients with decompensated forms of chronic venous insufficiency in post-thrombophlebitic and varicose diseases based on the use of differentiated pathogenetically substantiated surgical tactics. Materials and methods. The basis of the work is the study of the results of surgical treatment of 102 patients not previously operated on with postthrombophlebitic disease of the lower extremities in the decompensated stage of CVI. All patients underwent combined surgical treatment, including the elimination of perforating insufficiency and various modifications of the operation on the superficial veins to eliminate vertical reflux. Results and discussion. The combined operation for clipping perforating veins allows the operation to interrupt blood circulation through insolvent perforating veins, including on an outpatient basis, minimizing tissue trauma during puncture rather than sectional access to a vein. The cosmetic effect of the operation is significantly increased, which is especially important in the treatment of women. Since the operation can be performed on an outpatient basis, the number of days of incapacity for work is significantly reduced compared to standard operations on perforating veins, which is a particularly important circumstance in modern economic conditions. Conclusion. Using the proposed method allows to achieve optimal conditions for the restoration of trophism of affected tissues, leading to a decrease in the number of complications and a reduction in hospitalization.

scholarly journals CONSERVATIVE TREATMENT OF HEMORRHOIDS. AN ALTERNATIVE TO SURGICAL METHODS OR COMPONENTS? CHORUS PROGRAM RESULTS

2018 ◽  
pp. 27-35
Author(s):  
E. A. Zagryadskiy ◽  
A. M. Bogomazov ◽  
E. B. Golovko
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Clinical Manifestations ◽  
Entire Observation Period ◽  
Surgical Methods ◽  
Micronized Purified Flavonoid Fraction ◽  
Flavonoid Fraction ◽  
Observational Group ◽  
Grade Iii ◽  
Observation Period

OBJECTIVE. Determine the frequency of clinical manifestations of hemorrhoids and constipation in people seeking advice about hemorrhoids. In the course of the treatment of patients with hemorrhoids phlebotropic evaluate the effectiveness of therapy micronized purified flavonoid fraction (MPFF). MATERIALS AND METHODS. This multicenter study, including screening and observation part, which is part of the International Research «CHORUS» (Chronic venous and hemorrhoid diseases evaluation and scientific research), conducted in nine centers in different regions of Russia, 80 doctors of Coloproctology. In the screening group included 2668 patients who had investigated the incidence of constipation, as a risk factor for hemorrhoids. Conservative treatment, the foundation of which was, Moffitt therapy, received 1952 patients with stage I-IV hemorrhoids. Evaluating the effectiveness of the treatment was evaluated on the basis of a questionnaire. RESULTS. The questionnaire shows that constipation suffered - 766 (28,8 %) patients. Violation of defecation patterns and changes in stool consistency was observed in 1155 (43,9%) and 633 (25.5 %), respectively. At the same time, 288 (11,1 %) indicated a tendency to loose stools and diarrhea. Conservative treatment, the foundation of which is phlebotropic MPFF therapy conducted in patients of observational group has shown its efficiency in all grades of hemorrhoids. During the entire observation period of conservative treatment was effective in 1489 (76,3 %) patients. Surgical treatment was performed in 463 (23 %) patients grade I-IV hemorrhoids, the main part of patients with grade III -199 (43,1 %) and grade IV hemorrhoids - 68 (64,2 %). CONCLUSION. Conservative treatment of hemorrhoid disease, which is the basis on phlebotropic MPFF therapy, is effective at all stages of hemorrhoids, but in patients with grade III and grade IV disease requires surgical treatment.

scholarly journals Preoperative evaluation of the venous system during the surgery of parasagittal meningioma

2019 ◽  
Vol 10 (1) ◽  
pp. 79-83
Author(s):  
Yury G. Yakovlenko ◽  
Vladimir A. Moldovanov ◽  
Larisa V. Araslanova ◽  
Igor M. Blinov ◽  
Olga P. Suhanova
Keyword(s):  
Surgical Treatment ◽  
Clinical Observation ◽  
Superior Sagittal Sinus ◽  
Preoperative Evaluation ◽  
Successful Outcome ◽  
Main Task ◽  
Sagittal Sinus ◽  
Minimally Invasive Methods ◽  
Parasagittal Meningioma ◽  
Angiographic Diagnosis

Clinical observation of the patient with parasagittal meningioma at the level of the middle third of the superior sagittal sinus and falx is presented. When such tumors are removed, the main task is to prevent damage to the parasagittal veins, the injury of which can cause a persistent neurological defi cit in the postoperative period. A feature of this case is the complex use of advanced minimally invasive methods of angiographic diagnosis when planning surgical treatment, which signifi cantly increases the chances of a successful outcome of the operation.

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