Multiple Primary Advanced Metachronous Cancer of Abdominal Organs with Multifocal Obstructive Syndrome: a Clinical Case of Successful Complex Treatment

Impaired patency of the gastrointestinal and urinary tract, and bile ducts is one of the essential problems in oncological practice in patients with tumors of various localizations. Stenoses are one of the most severe complications of the course of tumor diseases.Obstruction is a polyetiological condition that can result from a primary tumor lesion and specific neoplastic processes of nearby organs and structures. Sometimes narrowing of the lumen of organs and ducts can occur as a result of reactive scar tissue changes along the periphery of tumors. In some cases stenosis manifests itself as a complication of certain stages of treatment (surgical, radiation).The development of stenoses of the large intestine, the pylorus, the bile and urinary tracts significantly reduces the quality of life of patients due to the increasing obstruction of the above structures. Elimination of this syndrome is the main aim of treatment, regardless of the presence of tumor or non-tumor complications that have arisen.

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Overview radiography of abdominal organs in dogs and cats

Veterinariya, Zootekhniya i Biotekhnologiya ◽

10.36871/vet.zoo.bio.202004001 ◽

2020 ◽

Vol 1 (4) ◽

pp. 6-14

Author(s):

V. N. Baymatov ◽

◽

A. V. Metelev ◽

Keyword(s):

Barium Sulfate ◽

Bile Ducts ◽

Individual Characteristics ◽

Correct Selection ◽

X Ray ◽

Abdominal Organs ◽

Modern Methods ◽

Extrahepatic Bile Ducts ◽

Selection Of

Today, less attention has been paid to x-ray studies of animals in connection with the advent of more modern methods. At the same time, the quality of radiopaque substances decreased, which is reflected in this article. The Omnipack, Urografin, Visipack, Barium sulfate, Iodipamide, Bilignost and Biligrafin used in radiopaque contrast studies in most cases did not reveal the hepatobiliary system. Only the last two drugs gave satisfactory results. The complexity of the X-ray examination of the biliary system in cats and dogs lies in the features of the location of the extrahepatic bile ducts and the condition of the intestine, the size of the liver, its structure, echogenicity, the state of the vessels and surrounding organs. In this work, we took into account the anatomical variants of the development and location of organs in animals, which may complicate the study or evaluation of the data obtained. These included changes in the contours, shape, location of the gallbladder and its filling. The results obtained were compared with the available general species standards, taking into account the possible individual characteristics of each animal. Other studied drugs gave satisfactory results with an overall assessment of the abdominal organs, but we preferred Omnipack. Survey radiography provides a large amount of information with the correct selection of radiopaque substances.

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Differentiated approach of using extraction balloon catheters in endoscopic biliary surgery

Annaly khirurgicheskoy gepatologii = Annals of HPB surgery ◽

10.16931/1995-5464.2021-3-123-134 ◽

2021 ◽

Vol 26 (3) ◽

pp. 123-134

Author(s):

A. E. Kotovskiy ◽

B. M. Magomedova ◽

K. G. Glebov ◽

A. A. Martyntsov ◽

A. K. Mahmudova ◽

...

Keyword(s):

Bile Duct ◽

Bile Ducts ◽

Balloon Catheter ◽

Main Function ◽

Biliary Surgery ◽

Benign Diseases ◽

Balloon Catheters ◽

Tumor Lesion ◽

Endoscopic Extraction ◽

Design Characteristics

Aim. Expand and determinate indications for using of extraction balloon catheters in endoscopic biliary surgery, as an additional and auxiliary endoscopic technique, which optimizes the technical conditions for performing medical and diagnostic tasks.Material and methods. We used disposable two- and three-lumen extraction balloon catheters with a diameter of 7.5 Fr. The catheters assumed delivery of an extractor balloon along a conductor with a diameter of 0.35 in into the bile duct, and also made it possible to inject a radiopaque substance. 136 retrograde endoscopic interventions were performed on the bile ducts using extraction balloon catheters.Research results. Indications for the use of an extractor balloon have been determined and proposed as a conventional standard. Interventions on the bile ducts were carried out using only a balloon catheter and in combination with a Dormia basket (n = 61). An extraction balloon catheter was used during retrograde endoscopic intervention on the bile ducts as an additional diagnostic endoscopic manipulation to facilitate the performance of the diagnostic task (n = 38). The device was also used to optimize the technical conditions of medical and diagnostic tasks (n = 37). 116 patients had benign diseases, 20 patients had tumor lesion.Сonclusion. The main function of an extraction balloon catheter is to move or displace the contents from the proximal to the distal parts of the bile duct, followed by its extraction into the duodenum. The design characteristics of the instrument make it possible to significantly expand the indications for its use, including not for its intended purpose, but as an additional method, optimizes the technical conditions for performing medical and diagnostic tasks. The endoscopic extraction balloon catheter is a multipurpose instrument that can be used to solve both diagnostic and therapeutic tasks of retrograde interventions on the bile ducts.

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For the 30th anniversary of laparoscopic cholecystectomy: problems remain

Kazan medical journal ◽

10.17816/kmj2019-537 ◽

2019 ◽

Vol 100 (3) ◽

pp. 537-541

Author(s):

I V Fedorov ◽

A N Chugunov ◽

L E Slavin ◽

D A Slavin ◽

V I Fedorov

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Ducts ◽

Perioperative Complications ◽

Open Cholecystectomy ◽

Intrahepatic Bile Ducts ◽

Negative Effect ◽

Iatrogenic Damage ◽

Extrahepatic Bile Ducts ◽

Legal Costs

The review describes perioperative complications of laparoscopic cholecystectomy. Over the past 30 years, laparoscopy has become the «gold standard» for cholecystectomy and one of the most frequently performed procedures in abdominal surgery. Nevertheless, despite the advantages of the method, it has an «Achilles heel» - the frequency of iatrogenic damage to the extrahepatic bile ducts is 3-5 times higher than with an open cholecystectomy. This complication has a negative effect on the survival of patients after surgery, leads to deterioration in the quality of life and is a major source of legal costs in many countries. In general, the total range for any damage to the biliary tract during laparoscopic cholecystectomy is 0.32-0.52%, while the complication rate and mortality rate are 1.6-5.3% and 0.08-0.14%, respectively. Patients who have undergone a complete intersection of the hepaticoholedochus, become «bile cripples» for life. Recurrent cholangitis, strictures of anastomoses with a possible outcome in liver cirrhosis are quite likely in later periods after damage to the intrahepatic bile ducts. Technological efforts to improve the results of laparoscopic cholecystectomy reside. These include the routine use of intraoperative cholangiography, infrared fluorescent cholangiography, etc. Nevertheless, despite the growing number of methods designed to reduce these complications, evidence of their effectiveness remains limited. The most important factors ensuring the safety of laparoscopic cholecystectomy are recognized: understanding of anatomy, adequate exposure when using electrosurgery, psychological readiness to invite a senior colleague in time for help, the ability to recognize a situation that requires conversion and rejection of laparoscopy.

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Quality of life in survivors of multiple primary cancers compared with cancer survivor controls

Cancer ◽

10.1002/cncr.23005 ◽

2007 ◽

Vol 110 (9) ◽

pp. 2101-2109 ◽

Cited By ~ 32

Author(s):

Carolyn C. Gotay ◽

Sean Ransom ◽

Ian S. Pagano

Keyword(s):

Quality Of Life ◽

Cancer Survivor ◽

Multiple Primary Cancers ◽

Multiple Primary

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A Review of the Evidence for and against a Role for Mast Cells in Cutaneous Scarring and Fibrosis

International Journal of Molecular Sciences ◽

10.3390/ijms21249673 ◽

2020 ◽

Vol 21 (24) ◽

pp. 9673

Author(s):

Traci A. Wilgus ◽

Sara Ud-Din ◽

Ardeshir Bayat

Keyword(s):

Mast Cell ◽

Mast Cells ◽

Cell Activation ◽

Social Issues ◽

Critical Role ◽

Large Body ◽

Repair Process ◽

Scar Tissue ◽

Mast Cell Activation

Scars are generated in mature skin as a result of the normal repair process, but the replacement of normal tissue with scar tissue can lead to biomechanical and functional deficiencies in the skin as well as psychological and social issues for patients that negatively affect quality of life. Abnormal scars, such as hypertrophic scars and keloids, and cutaneous fibrosis that develops in diseases such as systemic sclerosis and graft-versus-host disease can be even more challenging for patients. There is a large body of literature suggesting that inflammation promotes the deposition of scar tissue by fibroblasts. Mast cells represent one inflammatory cell type in particular that has been implicated in skin scarring and fibrosis. Most published studies in this area support a pro-fibrotic role for mast cells in the skin, as many mast cell-derived mediators stimulate fibroblast activity and studies generally indicate higher numbers of mast cells and/or mast cell activation in scars and fibrotic skin. However, some studies in mast cell-deficient mice have suggested that these cells may not play a critical role in cutaneous scarring/fibrosis. Here, we will review the data for and against mast cells as key regulators of skin fibrosis and discuss scientific gaps in the field.

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Treatment of Chronic Posttraumatic Leg Injury Using Autologous Fat Graft

Case Reports in Medicine ◽

10.1155/2012/648683 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 10

Author(s):

Fabio Caviggioli ◽

Francesco Maria Klinger ◽

Valeriano Vinci ◽

Guido Cornegliani ◽

Marco Klinger

Keyword(s):

Patient Satisfaction ◽

Surgical Technique ◽

Wound Closure ◽

Scar Tissue ◽

Fat Graft ◽

Caucasian Woman ◽

Autologous Fat ◽

Regenerative Effect ◽

Autologous Fat Graft

We present the results obtained in a case of a 20-year-old Caucasian woman with a posttraumatic injury “hard-to-heal” of the left leg treated using autologous fat graft. Considering our experience in treatment of chronic posttraumatic ulcers by autologous fat graft, we decided to use this surgical technique to induce a regenerative effect in this young patient. We have had complete wound closure with only a single surgical procedure after 1 month; after the second intervention of autologous fat graft we observed an improvement in the quality of the scar tissue. The patient satisfaction was excellent. The results were long lasting and remained virtually unchanged after 1 year.

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Synchronous Primary Anorectal Melanoma, Sigmoid Multiple Early Cancers and Descending Adenocarcinoma: A Case Report

International Surgery ◽

10.9738/intsurg-d-16-00259.1 ◽

2017 ◽

Vol 102 (1-2) ◽

pp. 29-32

Author(s):

Ruiyin Ge ◽

Aixia Gong ◽

Kang Sun ◽

Jingwen Zhang ◽

Jing Ma

Keyword(s):

Laparoscopic Resection ◽

Distant Metastases ◽

Multiple Primary Cancers ◽

Multiple Primary ◽

Anorectal Region ◽

Poorly Differentiated ◽

Descending Colon ◽

Ulcerative Lesions ◽

Standard Colonoscopy

Multiple colorectal cancers are extremely rare, few cases can be searched in the literature. Our group only found 6 cases published. We report a case where 3 diseases coexisted summarize the currently available literature. A 75-year-old man presented with changes in his bowel habits and hematochezia. After a colonoscopy with biopsies in a community hospital, he was diagnosed with a descending adenocarcinoma patient. To get further treatment, he came to our hospital. Colonoscopy revealed ulcerative lesions in the descending colon, 2 polypoid lesions in the sigmoid colon, and a protruded lesions in the anorectal. The ulcerative lesions were already diagnosed as adenocarcinoma at the descending colon. So biopsies were taken in the anorectal region, which revealed poorly differentiated melanoma of the anorectal. Computed tomography did not find distant metastases and regional lymphadenopathy. A laparoscopic resection was undertaken to relieve his symptoms and improve the quality of life. The mass showed descending adenocarcinoma, sigmoid multiple early cancers, and poorly differentiated melanoma of the anorectal region. What we can learn is that endoscopy doctors should always be aware of the possibilities of multiple primary cancers for this is important to the treatment and prognosis of patients, standard colonoscopy examination is necessary and returning a enteroscope from cecum should be more than 8 minutes.

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The role of thematic expertise of medical care quality in improvement of results of its performance in cases of acute pancreatitis

Vestnik of Russian military medical Academy ◽

10.17816/brmma25977 ◽

2020 ◽

Vol 22 (1) ◽

pp. 105-112

Author(s):

O N Scryabin ◽

K N Movchan ◽

V V Tatarkin ◽

O A Klitsenko ◽

Yu M Morozov ◽

...

Keyword(s):

Acute Pancreatitis ◽

Medical Care ◽

Care Quality ◽

Diagnostic Process ◽

Abdominal Organs ◽

Treatment Measures ◽

Medical Diagnostic ◽

Surgical Teams ◽

Operational Activity

The parameters of assessing the quality of medical care provided in 2014 to 416 patients with acute pancreatitis in 9 hospitals in St. Petersburg were expertly studied. All medical institutions were licensed in the format of providing services for the examination and treatment of patients suffering from acute surgical diseases of the abdominal organs. According to the results of the data analysis, a correlation was observed between the consequences of defects in the medical diagnostic process in medical organizations with insufficient regulation and activity in clinical expert work on the profile of “abdominal surgery”. The facts of overdiagnosis of cases of acute pancreatitis in mild variants of the severity of the disease have been established. Preservation of low operational activity indicators in the treatment of patients with acute pancreatitis without a tendency to use (when indicated) modern (primarily, endovideo surgical) technologies has been observed. It was noted that with a positive (in general) trend in the development of emergency pancreatology, in cases of assessing the particular results of the activities of specialists of specific surgical teams involved in providing medical care to patients with acute pancreatitis, compliance with systemic clinical and expert approaches with timely management decisions should be a priority in quality management of diagnostic and treatment measures. It is substantiated that the calculation of the volume of medical care for residents of a metropolis with acute pancreatitis should be based on the quality of the examination and treatment of patients with this disease on the basis of a thematic examination of assessing the conformity of the diagnostic process to the level of modern ideas about the theory of development and course of this disease.

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DIAGNOSTIC IMAGING OF THE BONE TISSUE LESIONS AT THE METASTATIC KIDNEY CANCER

Diagnostic radiology and radiotherapy ◽

10.22328/2079-5343-2019-10-1-86-91 ◽

2019 ◽

pp. 86-91

Author(s):

D. V. Semyonov ◽

B. I. Shirokorad ◽

H. A. Mitrofanov ◽

C. V. Kostritsky ◽

B. Yu. Startsev

Keyword(s):

Quality Of Life ◽

Renal Cell Carcinoma ◽

Bone Tissue ◽

Clinical Importance ◽

Metastatic Lesion ◽

Modern Methods ◽

Tissue Changes ◽

Timely Treatment ◽

Metastatic Rcc

Bone metastases occur in 20–35% of patients with generalized renal cell carcinoma (RCC), and osteoclastic (lytic) metastases prevail. Diagnosis of metastatic lesion of the skeleton during RCC is of clinical importance for timely treatment, improving the quality of life and reducing mortality of patients. The article discusses modern methods of radiation diagnosis of bone tissue changes in metastatic RCC.

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Plastic surgery of extensive soft tissue defects of the lower leg in children with the use of a parotid flap after its prefabrication with tissue expanders (preliminary report)

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors25799 ◽

2020 ◽

Vol 8 (2) ◽

pp. 197-206

Author(s):

Olga V. Filippova ◽

Anton V. Govorov ◽

Yaroslav N. Proshchenko ◽

Konstantin A. Afonichev ◽

Natalia S. Galkina

Keyword(s):

Surgical Treatment ◽

Soft Tissue ◽

Plastic Surgery ◽

Scar Tissue ◽

Lower Leg ◽

Soft Tissue Defects ◽

Tissue Expanders ◽

Donor Area ◽

Tissue Defects

Background. Extensive deep soft tissue defects in children are an indication for the microsurgical reconstruction using autotransplantation of a tissue complex. The use of a flap prefabrication before their microsurgical transplantation to various segments and areas is a promising approach in reconstructive surgery. Aim. The aim of this study was to evaluate the possibilities and immediate results of plastic surgery of extensive soft tissue defects of the lower leg with a tissue complex, after its prefabrication with a tissue expander, and the state of the donor area in different surgical treatment options. Materials and methods. Six patients aged 13 2.3 years were operated on for deep scar deformities of the lower leg and foot. For plastic surgery, a pericarpial flap was used. In two patients, the flap was prefabricated with tissue expanders at a volume of 720 ml. After filling the expander, the second stage of surgical treatment was performed. First, the expander was removed. Next, the flap on the artery surrounding the scapula was isolated. Last, it was transplanted into a soft tissue defect of the lower leg with the imposition of microvascular anastomoses. A layer-by-layer suture was applied to the donor wound. The Vancouver scale was used to assess the quality of the scar tissue in the donor area. Results. The removal of the tissue complex after the prefabrication with expanders made it possible to perform plastic surgery of extensive soft tissue defects of the lower leg in one stage of surgical treatment with the application of a cosmetic suture in the donor area. There were no complications in the postoperative period. At the examination after six months, patients who did not undergo flap prefabrication complained of cosmetic defects and discomfort when moving in the donor area. The evaluation of the quality of scar tissue by the Vancouver scale showed that the scars in patients after flap prefabrication were similar to optimal (total score in two patients is 2). In two patients without flap prefabrication, the total score was 7, and in two patients, it was 9, which indicated unsatisfactory cosmetic parameters of the postoperative scar. Conclusion. The prefabrication of a tissue complex using tissue expanders before microsurgical transplantation enables the collection of a large volume of tissue for plastic surgery of extensive defects. It also reduces the risk of trophic complications in the postoperative period and creates optimal conditions for closing the donor site.

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