scholarly journals A clinical case of surgical treatment of calyx diverticulum in a 12-year-old child

2021 ◽  
Vol 24 (6) ◽  
pp. 413-416
Author(s):  
A. A. Oganisyan ◽  
S. G. Vrublevskij ◽  
A. S. Vrublevskij ◽  
R. Yu. Valiev ◽  
I. S. Ahmetzhanov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Clinical Observation ◽  
Left Kidney ◽  
Rational Approach ◽  
Differential Diagnostics ◽  
Cystic Kidney ◽  
Pediatric Practice ◽  
Plasma Ablation ◽  
The Right

Introduction. Calyx diverticulum is a rather rare pathology in pediatric practice. In the structure of cystic kidney malformations, it amounts up to 12-15%. In most cases, the disease is asymptomatic. To make a differential diagnostics and to define a technique for surgical treatment, computed tomography or magnetic resonance imaging are used. Currently, puncture-sclerotic method and endosurgical (laparoscopic, retroperitoneoscopic) one can be successfully applied. The main purpose of this clinical observation is to illustrate that little-traumatic laparoscopic access to the kidney and plasma ablation of the diverticulum epithelial lining can be used to have successful outcomes.Material and methods. The authors describe a clinical case of renal cavities in a 12-year-old boy - calyx diverticulum of the right kidney and a cyst of the left kidney - which were successfully treated with a combined approach when puncture and laparoscopic corrections were used depending on lesion’s chracteriatics.Conclusion. A rational approach and substantiation of the applied surgical technique with plasma ablation of calyx diverticulum cavity allowed to obtain good results - cavity size was reduced and renal parenchyma was preserved what is important for future organ functioning.

A case of successful surgical treatment of patient with adrenal cyst using 3-d modeling

2020 ◽  
Vol 28 (4) ◽  
pp. 530-535
Author(s):  
Ivan Andreev ◽  
Alexander Kolsanov ◽  
Sergey Katorkin ◽  
Evgeniy Shestakov ◽  
Leonid Lichman
Keyword(s):  
Surgical Treatment ◽  
Surgical Resection ◽  
3D Modeling ◽  
Clinical Observation ◽  
Preoperative Planning ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Adrenal Cyst ◽  
The Right ◽  
Medical University

Aim. Demonstration of potentials of preoperative planning and implementation of surgical resection in patients with adrenal cysts. A clinical observation of a successful surgical treatment of a rare pathology cyst of the right adrenal is presented. The choice of surgical treatment tactics is determined by the size of tumor and clinical presentation of the disease. The surgical treatment was accomplished laparoscopically which permitted to reduce the time of recovery and rehabilitation of the patient. In this clinical observation, the benefit of using 3D-modeling of the surgical area was shown for visualization of topographic and anatomic peculiarities and facilitation of the intraoperative navigation with the help of Avtoplan program developed by Samara State Medical University. Conclusion. Preoperative 3D-modeling permits to prepare to surgical intervention taking into account individual anatomic peculiarities of a patient, and to determine the optimal volume of the operation.

scholarly journals Organ-preserving operation in case of massive testicular rupture

2019 ◽  
Vol 20 (4) ◽  
pp. 52-58
Author(s):  
T. Kh. Nazarov ◽  
I. V. Rychkov ◽  
K. E. Trubnikova ◽  
A. S. Lepekhina ◽  
Kh. U. Khaknazarov
Keyword(s):  
Blood Flow ◽  
Clinical Case ◽  
Clinical Observation ◽  
Color Doppler ◽  
Traumatic Injury ◽  
Blunt Injury ◽  
Hormonal Status ◽  
Lower Pole ◽  
Testicular Rupture ◽  
The Right

The objective is to present a clinical case of blunt trauma of the scrotum with a massive testicular crush. The presented nosology, methods of diagnosis and surgical treatment is highlighted.Clinical case. Patient, 18 years old, was admitted to the clinic with acute symptoms and complaints of pain and increased size of the right part of the scrotum. Questioning revealed that 48 hours prior the patient received a blunt injury of the scrotum. Ultrasound of the scrotal organs showed that in the right part of the scrotum testicle is not clearly differentiated, in the lower pole hypoechogenic signal is observed, no blood flow was evident using the color Doppler mode, but examination of the upper pole showed weak blood flow, the epididymis was partially differentiated. Hematocele was observed. The diagnosis of injury of the scrotal organs was confirmed, traumatic injury of the right testicle. Emergency surgery was performed: necrotized areas of the lower pole of the testicle were resected, plastic sealing of the upper pole of the right testicle to the epididymis was performed. Postoperative period was free of complications. The patient was discharged on day 6 after the surgery. Control ultrasound after 3 months showed that the right testicle was smaller, its echostructure was homogenous, blood flow in the testicular parenchyma was observed. Hormonal status, blood testosterone levels, ejaculate parameters were normal.Conclusion. The presented clinical observation confirms that organ-sparing interventions for massive crush injury of the testicle with minimal volume of viable tissue are possible but patient’s age and time after injury should be taken into account.

scholarly journals Surgical treatment of Lhermitte–Duclos disease (dysplastic gangliocytoma of the cerebellum)

2020 ◽  
Vol 22 (1) ◽  
pp. 77-82
Author(s):  
A. A. Bimurzin ◽  
A. V. Kalinovsky
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Right Hemisphere ◽  
Surgical Removal ◽  
Study Objective ◽  
Dysplastic Gangliocytoma ◽  
Satisfactory Condition ◽  
Suboccipital Craniotomy ◽  
Intact Brain ◽  
The Right

The study objective is to describe a clinical case of a rare disorder of the cerebellum, Lhermitte–Duclos disease.Clinical case. The Federal Neurosurgical Center (Novosibirsk) admitted a male patient, 40 years old. Medical history showed that in 2017 he underwent ventriculoperitoneal shunt due to hypertensive hydrocephalus syndrome caused by space-occupying mass of the right hemisphere of the cerebellum. In June of 2017, the patient was consulted by a neurosurgeon. Later, an increase in the mass, partial atrophy of the optic disks were observed. Due to the patient’s complaints of headache, ataxia, vertigo, as well as insufficient effect of the shunt, microsurgical removal of the space-occupying mass in the cerebellum by right paramedian suboccipital craniotomy was performed. Gangliocytoma removal was performed under constant neurophysiological control which allowed to fully resect the gangliocytoma inside intact brain tissue. Histological and immunohistological examinations allowed to diagnose grade I dysplastic gangliocytoma of the cerebellum (Lhermitte–Duclos disease). In the postoperative period, brain symptoms regressed fully, vestibulocerebellar syndrome persisted. The patient was discharged in satisfactory condition. No negative dynamics were observed in 7 months of follow-up.Conclusion. Due to the rareness of Lhermitte–Duclos disease, currently there are no established approaches to treatment, however, in symptomatic course there are indications for surgical removal of the gangliocytoma. Radicality of resection should be correlated with the risk of neurological defects. In our case, surgical treatment allowed to improve the patient’s condition, prevent further progression of the gangliocytoma and obtain an accurate histological diagnosis.

scholarly journals Renal Cancer with Tumor Thrombus of the Inferior Vena Cava and the Right Atrium

2020 ◽  
Vol 13 (3) ◽  
pp. 214-226
Author(s):  
Yulia Aleksandrovna Stepanova ◽  
Aleksandr Anatolevich Gritskevch ◽  
Amiran Shotaevich Revishvili ◽  
Madina Valerevna Kadirova ◽  
Egor Sergeyevich Malyshenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Inferior Vena Cava ◽  
Kidney Cancer ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Clinical Case ◽  
Inferior Vena ◽  
Vena Cava ◽  
Radical Treatment ◽  
The Right

ntroduction. A distinctive feature of kidney cancer is a frequent, compared with other tumors, spread of the tumor through the venous collectors (in the renal and inferior vena cava up to the right atrium), along the path of least resistance to invasive growth.The aim of the study was to present a clinical case of radical treatment of kidney cancer involving extensive IVC thrombosis.Materials and methods. The study describes a clinical case of radical treatment of patient M. with kidney cancer involving extensive IVC thrombosis, extending to the right atrium (written informed consent for patient information and images to be published was obtained prior to the study). During preoperative examination, the patient was diagnosed with renal cell carcinoma with non-occlusive hypervascular tumor thrombus of the renal vein, the inferior vena cava and the right atrium based on the findings of ultrasound examination (transabdominal and transthoracic, and transesophageal), multislice computed tomography (MSCT) and magnetic resonance imaging (MRI).Results and discussion. Surgical treatment remains the main method of treatment of renal cell cancer, moreover, the inferior vena cava thrombosis cannot serve as a cause for refusing surgical treatment. The thrombus spreading along the venous collectors is an important factor in determining the tactics of surgical treatment. The length of the tumor thrombus, as well as the degree of its fixation and ingrowth into the vein wall is of great significance for planning surgical techniques and predicting clinical outcomes. Based on various methods of radiological examination, patient M. was diagnosed with cancer of the right kidney, 3 stage T3cNxM0, IVC tumor thrombus, paraneoplastic syndrome (hyperthermia), right-sided nephrectomy with aortocaval lymphadenectomy, thrombectomy from the IVC, vascular isolation of the liver, resection of the IVC, thrombectomy from the right atrium combined with cardiopulmonary bypass.Conclusion. Despite the technical complexity of nephrectomy with thrombectomy from the IVC, especially in the presence of a massive supradiaphragmatic thrombus, these interventions have no alternatives if a radical treatment is to be achieved. Step-by-step support using radiological methods of investigation is an important aspect of patients preparation; this allowing determining the exact volume of the damage and non-invasively assessing clinical outcomes of surgical treatment.

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

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.

scholarly journals A CLINICAL OBSERVATION OF THE COMBINATION OF OMPHALOCELE WITH ATRESIA OF THE SMALL INTESTINE OF TYPE 3A IN A NEWBORN

2019 ◽  
Vol 23 (5) ◽  
pp. 285-287
Author(s):  
Kapan T. Tursunov ◽  
S. A. Myrzakhmet ◽  
U. B. Alseitov ◽  
E. G. Nasirova
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Abdominal Wall ◽  
Clinical Case ◽  
Clinical Observation ◽  
Congenital Defect ◽  
Surgical Correction ◽  
Type Iii ◽  
Rare Combination ◽  
Treitz Ligament

The authors present a clinical case of an extremely rare combination of the congenital defect of the front abdominal wall as omphalocele, congenital evolution defect of the small intestine - atresia of the small intestine type III, agenesis of the ileum with ileocecal angle and malrotation syndrome. Surgical treatment was as follows: T-shaped ileocolic «end-to-side» anastomosis with an unloading colostomy by the Bishop-Koop technique and intestinal intubaton till the Treitz ligament. Outcomes of such surgical correction are good.

scholarly journals A clinical case of surgical treatment of a knife-penetrated wound of the right atrium and the aortic root 2 years after the injury

2021 ◽  
Vol 25 (2) ◽  
pp. 80
Author(s):  
K. A. Petlin ◽  
E. A. Kosovskikh ◽  
B. N. Kozlov ◽  
V. A. Tomilin
Keyword(s):  
Surgical Treatment ◽  
Coronary Sinus ◽  
Conflict Of Interest ◽  
Right Atrium ◽  
Clinical Case ◽  
Surgical Care ◽  
Right Atrial ◽  
Stab Wounds ◽  
Pseudo Aneurysm ◽  
The Right

<p>Chest injury is an acute, extremely life-threatening condition. Among penetrating heart wounds, approximately 85% are stab wounds. In the case of stab and cut injuries, the lethality, according to various sources, reaches 90% and directly depends on the time of delivery of the victim to the hospital. In the overwhelming majority of cases, emergency operations for stab wounds of the chest are conducted in general surgical hospitals. As a rule, when providing emergency surgical care, only superficial heart wounds are sutured, excluding the correction of damage to the intra-cardiac structures. Aorto-right atrial fistula is a rather rare clinical condition that is formed due to the action of a traumatic factor and is characterised by the formation of a communication between the aorta and the right atrium with the discharge of arterial blood into the venous system. Considering that this pathology is accompanied by an increase in pressure in the right atrium, signs of stagnation are found in the systemic circulation, followed by compensatory dilatation of the right atrium and then dilatation of the right ventricle. The only effective method to treat this problem is surgery.<br />The presented clinical case demonstrates the surgical treatment of chronic post-traumatic aorto-right atrial fistula, pseudo-aneurysm between the non-coronary sinus and the right atrium and pseudo-aneurysm of the left coronary sinus 2 years after the stab wound. Echocardiography performed after surgery indicated a positive trend, i.e., a decrease in the size of the right- and left-sided heart and normalisation of pressure in the pulmonary artery. No inter-chamber shunts were found. This case shows that clinicians must remember that after providing emergency surgical care to patients with penetrating chest wounds, it is necessary to conduct an additional examination of the heart after stabilisation of the condition to detect hidden damage to the intra-cardiac structures.</p><p>Received 2 February 2021. Revised 2 March 2021. Accepted 3 March 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

scholarly journals COMPLETE THORACIC ESOPHAGUS OBLITERATION: CLINICAL CASE REPORT

2021 ◽  
Vol 74 (1) ◽  
pp. 155-160
Author(s):  
Serhii O. Savvi ◽  
Alla Yu. Korolevska ◽  
Serhii Yu. Bityak ◽  
Yevhen A. Novikov
Keyword(s):  
Surgical Treatment ◽  
Chest Wall ◽  
Esophageal Stricture ◽  
Clinical Case ◽  
Middle Colic Artery ◽  
Thoracic Esophagus ◽  
Colic Artery ◽  
Treatment Results ◽  
Food Passage ◽  
The Right

Using the example of a clinical case, to present the management features of a patient with complete esophageal obliteration as a chemical burn result, the surgical intervention features in case of a non-standard situation during the operation, and the treatment results analyze. It was described a clinical case of 41-year-old patient with thoracic esophagus obliteration due to extended post-burn cicatricial esophageal stricture, dysphagia of IV degree in very severe general condition. Stamm-Senn-Kader’s gastrostomy was performed as a first step of surgical treatment. Angiography and embolization of the right colic artery and it’s branches was performed in 8 months while preserving the middle colic artery. In 20 days the cologastroanastomosis and feeding colostomy on the right chest wall were performed. In 10 days after the colostomy was disattached from the chest wall, the end-to-side esophagocoloanastomosis was performed intrapleurally. In one month after the third surgery and restoration of the food passage by the natural way, closure of the contact gastrostomy was performed. During the observation over the patient (8 years) the postoperative complications were not observed. The patient survived. The proposed staged surgical treatment tactics of patients with complete esophageal obliteration due to post-burn esophageal stricture, dysphagia of IV degree presents effective treatment results and a significant improvement in the patient’s life quality.

scholarly journals Surgical treatment of ruptured right middle cerebral artery mycotic aneurysm and central nervous system aspergillosis: Clinical case and literature review

2021 ◽  
Vol 12 ◽  
pp. 555
Author(s):  
Anton Konovalov ◽  
Oleg Sharipov ◽  
Oleg Shekhtman ◽  
Vadim Gadzhiagaev ◽  
Pavel Kalinin
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Surgical Treatment ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Immune Suppression ◽  
Mycotic Aneurysm ◽  
Clinical Case ◽  
High Rate ◽  
The Right

Background: Central nervous system (CNS) aspergillosis is more often met in patients with expressed immune suppression. Still, in 50% of cases of meningitis caused by Aspergillus spp., it is observed in patients without expressed immune suppression. The prognosis of CNS aspergillosis is unfavorable with the general rate of lethality around 70%. Case Description: Clinical case of a 58-year-old man who developed an Aspergillus abscess in the chiasmosellar region and an associated mycotic aneurysm of the right middle cerebral artery (MCA) and intracerebral hemorrhage. Microsurgical clipping of the fusiform-ectatic aneurysm of the right MCA in the conditions of rupture was performed. An extra-intracranial micro anastomosis was formed on the right. An open biopsy of the neoplasm in the chiasmosellar region was made. The neoplasm was yellow and destroyed the bone plate of the skull base. Biopsy results: Mycotic lesion (aspergillosis). The analysis of surgical treatment for mycotic aneurysms in the acute period of hemorrhage in patients with aspergillosis revealed a high rate of lethality. The issue of the feasibility and effectiveness of complicated revascularization interventions in the patients with hemorrhage and aspergillosis remains unsolved. Conclusion: The lack of generally accepted tactics of the treatment of this pathology requires further studies and systemic analysis. A high risk of the lethal outcome in patients with invasive mycotic infection and rupture of mycotic aneurysm highlight the importance of timely diagnostics and the beginning of antimycotic therapy. WThe issue of the evaluation of the revascularization methods effectiveness in patients after surgical treatment of a mycotic aneurysm associated with cerebral aspergillosis remains poor.

scholarly journals Clinical observation: giant uterine myoma. The tactic of surgical treatment and postoperative management

2018 ◽  
pp. 22-26
Author(s):  
N. A. Buralkina ◽  
G. A. Vlasov ◽  
A. V. Veredchenko ◽  
V. V. Chursin ◽  
A. V. Asaturova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Clinical Observation ◽  
Surgical Intervention ◽  
Postoperative Management ◽  
Uterine Myoma ◽  
Reproductive Outcomes ◽  
Uterine Myomas

The article deals with the clinical case of a patient with giant uterine myoma. It presents the features of surgical intervention and postoperative management of the patient. In the publication, the authors discuss the issues concerning the scope of the surgery in patients with large and giant uterine myomas and prognosis of reproductive outcomes in this cohort of women.

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