scholarly journals Infiltrative analgesia of the skin flap in children with craniosynostosis after reconstructive surgery on skull bones

2020 ◽  
Vol 16 (6) ◽  
pp. 37-45
Author(s):  
O. N. Pulkina ◽  
V. P. Ivanov ◽  
V. I. Gurskaya ◽  
E. V. Parshin
Keyword(s):  
Reconstructive Surgery ◽  
Postoperative Period ◽  
Skin Flap ◽  
Opioid Analgesics ◽  
Multimodal Analgesia ◽  
Non Invasive ◽  
Invasive Hemodynamic Monitoring ◽  
Group 2 ◽  
Group 1 ◽  
Skull Bones

The objective of the study is to evaluate the effectiveness of analgesia by infiltration of the skin flap with local anesthetic in children with craniosynostosis after reconstructive surgery.Materials and subjects. 50 children with craniosynostosis, who underwent reconstructive surgery on skull bones, were divided into two groups based on the method of postoperative anesthesia: in Group 1(experimental), the infiltration of the skin flap was used within multimodal anesthesia, while in Group 2, it was standard parenteral use of analgesic drugs. In the postoperative period, pain severity was assessed by FLACC scales, the amount of opioid and non-opioid analgesics consumed was assessed by the formalized Analgesiс Assessment Scale (FSA), and non-invasive hemodynamic monitoring (BP, HR) was performed.Results. The statistical analysis of the results revealed significant differences between groups in the assessment results of FSA and FLACC scales. In Group 1, the level of postoperative pain was significantly lower compared to Group 2. The amount of opioid and non-opioid analgesics consumed was also significantly lower in Group 1.Conclusion. The use of the infiltration of the skin flap as part of multimodal analgesia in children with craniosynostosis, after reconstructive surgery on skull bones significantly reduces the intensity of pain and the amount of opioid analgesics consumed in the postoperative period.

The diagnostics intracranial hypertension using ultrasound of the optic nerve channel in patients with intracranial hemorrhage

2018 ◽  
pp. 6-16
Author(s):  
S. S. Petrikov ◽  
М. I. Andreytseva ◽  
L. Т. Khamidova ◽  
A. A. Solodov
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Healthy Volunteers ◽  
Postoperative Period ◽  
Optic Nerve Sheath Diameter ◽  
Non Invasive ◽  
Optimal Value ◽  
Optic Nerve Diameter ◽  
Group 2 ◽  
Group 1

The purpose.To determine relationshipsbetween the value of intracranial pressure obtained by direct measurement (using ICP sensors), the optic nerve sheath diameter (ONSD), and the optic nerve diameter obtained by ultrasound; to define a threshold for ONSD for diagnosing ICP more than 20 mm Hg.Materials and methods.33 patients with traumatic and non-traumatic intracranial hemorrhages were examined. All patients were continuously monitored by ICP and ultrasound of the optic nerve channel. We evaluated the ONSD and optic nerve diameter (OND) using ultrasound. 16 healthy volunteers were examined to determine the normal values of ONSD and OND.Results.All patients were divided into 2 groups depending on the type of ICP dynamics. Group 1 (n = 26): an initial value of ICP is less than 20 mm Hg, group 2 (n = 7): initially high ICP values. Group 1 was divided into 3 subgroups: 1a (n = 7) – ICP did not increase during the whole monitoring period, 1b1 (n = 10) – ICP transiently increased in the postoperative period and normalized after treating, 1b2 (n = 9) – refractory intracranial hypertension was developed in the postoperative period. Group 2 was divided into two subgroups: 2a (n = 4) – ICP normalized in the postoperative period, 2b (n = 3) – refractory intracranial hypertension was developed in the postoperative period. There was a significant relationship between ICP and ONSD (Spearman n = 318, R = 0.31, p < 0.001; Kruskal– Wallis p < 0.001)in all groups of patients. The diameter of the optic nerve was the same for both groups: healthy volunteers and the experimental group (Spearmann = 334, R = 0.0054, p = 0.96). The optimal value of ONSD for detection the ICP > 20 mm Hg was morethan 5.8 mm.Conclusion.The ultrasound of the optic nerve channel can be an additional screening non-invasive diagnostic method for patients with intracranial hypertension.

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

Usage of 25% albumin solution in the intraoperative and early postoperative periods of liver transplantation from a cadaveric donor.

2021 ◽  
Author(s):  
С.В. Журавель ◽  
Н.К. Кузнецова ◽  
В.Э. Александрова ◽  
П.В. Гаврилов ◽  
А.М. Талызин ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Postoperative Period ◽  
Human Albumin ◽  
Early Postoperative Period ◽  
Hemodynamic Parameters ◽  
Albumin Solution ◽  
Transfusion Therapy ◽  
Group 2 ◽  
Human Albumin Solution ◽  
Group 1

Введение. Терапевтическое использование раствора человеческого альбумина у пациентов в периоперационном периоде трансплантации печени (ТП) представляет интерес в контексте осложнений и исходов операции. Цель исследования: оценить влияние интраоперационной трансфузии 25% раствора человеческого альбумина на течение раннего послеоперационного периода при ортотопической ТП от посмертного донора. Материалы и методы. В исследование включены 47 пациентов, которым была выполнена трупная ТП. Были сформированы 2 группы: пациенты группы 1 (n = 21) получали трансфузию 25% раствора человеческого альбумина в конце операции ТП и через 24 ч после операции; пациенты группы 2 (n = 26) получали трансфузию 25% раствора человеческого альбумина в первые сутки послеоперационного периода. Осуществляли контроль лабораторных параметров крови пациента перед началом оперативного вмешательства, через 24 ч и через 48 ч после операции. Интраоперационно оценивали значения систолического (САД) и диастолического (ДАД) артериального давления, частоту сердечных сокращений (ЧСС), дозу вазопрессоров, объем инфузионно-трансфузионной терапии, кровопотерю и диурез. В послеоперационном периоде фиксировали возможные осложнения, проведенные сеансы заместительной почечной терапии (ЗПТ), а также количество дней в стационаре. Результаты. Оценка значений САД, ДАД и ЧСС в начале и конце операции показала достоверно лучшие показатели гемодинамики и снижение дозировок вазопрессорной поддержки в конце вмешательства в группе 1 по сравнению с группой 2 (p < 0,05). В послеоперационном периоде инфекционные осложнения зарегистрированы у одного пациента группы 1 и у трех пациентов группы 2. Проведение ЗПТ потребовалось двум пациентам из группы 2. Все пациенты обеих групп были выписаны из стационара, при этом число дней госпитализации в группе 2 было статистически значимо больше по сравнению с пациентами группы 1: 26,9 ± 3,9 против 17,2 ± 4,3 (p < 0,05). Заключение. Интраоперационная инфузия 25% раствора альбумина позволяет стабилизировать показатели гемодинамики в конце операции ТП, снизить потребность в кардиотонической поддержке и сократить время госпитализации у пациентов после ТП. Background. The therapeutic use of human albumin solution in patients in the perioperative period of liver transplantation (LT) is of interest in the context of complications and outcomes of surgery. Objectives: to assess the effect of intraoperative transfusion of 25% human albumin solution on the early postoperative period in orthotopic LT from a postmortem donor. Patients/Methods. The study included 47 patients who underwent cadaveric LT. Two groups were formed: patients in group 1 (n = 21) received transfusion of 25% human albumin solution at the end of LT and 24 hours after surgery; patients in group 2 (n = 26) received transfusion of 25% human albumin solution on the first day of the postoperative period. The laboratory parameters of the patient’s blood were monitored before surgery, 24 hours later, and 48 hours after surgery. Intraoperatively, the values of systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), dose of vasopressors, volume of infusion- transfusion therapy, blood loss and diuresis were assessed. In the postoperative period, possible complications, renal replacement therapy (RRT) sessions performed, and the number of days in the hospital were recorded. Results. Assessment of SBP, DBP and HR values showed significantly better hemodynamic parameters and reduced dosages of vasopressor support at the end of surgery in group 1 compared to group 2 (p < 0.05). In the postoperative period, infectious complications were registered in one patient of group 1 and in three patients of group 2. Two patients from group 2 required RRT. All patients were discharged from the hospital, while the number of hospitalization days in group 2 was statistically significantly greater than in patients in group 1: 26.9 ± 3.9 versus 17.2 ± 4.3 (p < 0.05). Conclusions. Intraoperative infusion of 25% albumin solution allows stabilizing hemodynamic parameters at the end of LT surgery, reducing the need for cardiotonic support and shortening the hospitalization time in patients after LT.

scholarly journals Experimental model for low level laser therapy on ischemic random skin flap in rats

2006 ◽  
Vol 21 (4) ◽  
pp. 258-262 ◽  
Author(s):  
Rodrigo Paschoal Prado ◽  
Richard Eloin Liebano ◽  
Bernardo Hochman ◽  
Carlos Eduardo Pinfildi ◽  
Lydia Masako Ferreira
Keyword(s):  
Laser Therapy ◽  
Experimental Model ◽  
Diode Laser ◽  
Skin Flap ◽  
Low Level Laser Therapy ◽  
Low Level ◽  
Low Level Laser ◽  
Level Laser ◽  
Group 2 ◽  
Group 1

PURPOSE: To develop an experimental model to be used in the study of low level Laser therapy on viability of random skin flap in rats. METHODS: The sample was 24 Wistar-EPM rats. The random skin flap measured 10 x 4 cm and a plastic sheet was interposed between the flap and donor site. Group 1 (control) underwent sham irradiation with diode laser (830 nm). Group 2 was submitted to laser irradiation with diode laser (830 nm). The animals were submitted to Laser therapy with 36 J/cm² energy density (72 seconds) immediately after the surgery and on the four subsequent days. The probe was usually held in contact with the skin flap surface on a point at 2.5 cm cranial from the flap base. On the seventh postoperative day, the percentage of necrotic area was measured and calculated. RESULTS: Group 1 reached an average necrotic area of 48.86%, Group 2 - 23.14%. After the statistic analysis, compared with the control group, Group 2 showed a statistically significant increase in survival area (p<0.001). CONCLUSION: The experimental model proved to be reliable to be used in the study of effects of low level laser therapy in random skin flap in rats.

Assessment of myocardial remodeling in the perioperative period of coronary artery bypass grafting: effects of prehabilitation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Argunova ◽  
A Korotkevich ◽  
E Moskin ◽  
S Pomeshkina ◽  
O Barbarash
Keyword(s):  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Postoperative Period ◽  
Artery Bypass ◽  
Perioperative Period ◽  
Control Group ◽  
Bypass Grafting ◽  
Myocardial Remodeling ◽  
Group 2 ◽  
Group 1

Abstract Purpose To assess serial changes in the morphological and functional parameters, and indicators of myocardial perfusion in the perioperative period of coronary artery bypass grafting (CABG), depending on the preoperative management strategy. Methods 60 male patients with stable coronary artery disease (CAD) were randomized into two groups before on-pump CABG. Group 1 patients (n=30, aged of 61.5 [56; 63] years) underwent treadmill training at 80% of VO2max for a 7-day period. Group 2 patients (n=30, aged of 62.0 [56; 64] years) underwent routine management without prehabilitation. Cardiac morphological and functional parameters were evaluated using echocardiography in the preoperative period and 5–7 days after CABG. Adenosine loading single-photon emission computed tomography (SPECT) was used to measure the parameters of myocardial perfusion before and after the indexed CABG. Data were processed using the QPS program (Cedars Sinai Medical Center (USA)) and the 17-segment polar mapping. Statistical analysis was performed using commercially available Statistica 10.0 software package (Statsoft, USA). Results Both groups demonstrated a decrease in LVEF in the postoperative period. However, an LVEF decline in Group 1 patients was less significant (p=0.00015) than in the control group (p=0.000003). LV end-systolic dimension increased by 8.5% and LV end-systolic volume by 18% in patients who underwent prehabilitation as compared to the baseline, whereas these changes were more pronounced in the control group (17% (p=0.00029) and 41% (p=0.00028), respectively). Group 1 patients demonstrated better myocardial perfusion parameters in the postoperative period. Patients in the prehabilitation group reported higher accumulation levels of radiopharmaceuticals in the basal (75.0 [72.5; 80] and 72.0 [70; 75]%, p=0.036), middle (87.0 [83; 91] and 81.0 [77; 84]%, p=0.012) and apical (86.0 [82; 89] and 82.0 [78; 86]%, p=0.037) myocardium as compared with those in the control group. The stress-induced ischemia (SDS) was less pronounced in Group 1 compared to Group 2 (p=0.025). Conclusion Optimized myocardial remodeling parameters and improved myocardial perfusion in the postoperative period have proved the effectiveness of high intensity physical trainings introduced in the prehabilitation program for CABG. Funding Acknowledgement Type of funding source: None

scholarly journals Evaluation of the Clinical Efficacy of Using Thermal Camera for Cryotherapy in Patients with Total Knee Arthroplasty: A Prospective Study

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 661 ◽  
Author(s):  
Zekeriya Okan Karaduman ◽  
Ozan Turhal ◽  
Yalçın Turhan ◽  
Zafer Orhan ◽  
Mehmet Arican ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Thermal Camera ◽  
Prosthesis Infection ◽  
Total Knee ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Background and objectives: Cryotherapy is a method of treatment using cold application. This study aimed to evaluate postoperative clinical and hematological parameters and pain associated with total knee arthroplasty in patients and compared cryotherapy to the conventional method of cold ice pack compressions. Materials and Methods: Between January 2015 and January 2016, 90 patients who underwent total knee arthroplasty for grade 4 gonarthrosis were prospectively evaluated. The patients were divided into three groups (n = 30, each): Group 1, cryotherapy was applied in the pre- and postoperative periods; Group 2, cryotherapy was applied only in the postoperative period; and Group 3 (control group), only a cold pack (gel ice) was applied postoperatively. In all groups, pre- and postoperative evaluations at 6, 24, and 48 h, hemorrhage follow-up, knee circumference measurement, visual analog scale pain score, knee circumference, and temperature measured by thermal camera were recorded. Results: Of the 90 patients, 10% were men and 90% were women. The mean age was 64.3 ± 8.1 (range: 46–83) years. The patella upper end diameter values were significantly lower in the postoperative period in Groups 1 and 2 than in Group 3 (p = 0.003). Hemoglobin levels at 24 and 48 h postoperatively were significantly lower in Group 3 than in Group 1 (p < 0.001, each) and Group 2 (p = 0.038, p < 0.001). At 6, 24, and 48 h follow-ups, pain values were significantly lower in Group 2 than in Group 3 (p < 0.001). Preoperative 6, 24, and 48 h temperature values were significantly lower in Group 1 than in Group 3 (p < 0.001 for each). It was found that the difference between preoperative and postoperative knee flexion measurements was significantly different in both groups or the difference between the groups was changed in each period (p < 0.001). Conclusions: Postoperative cryotherapy is a potentially simple, noninvasive option and beneficial for the reduction of reducing pain, bleeding, length of stay, analgesic requirement and swelling after total knee arthroplasty. Moreover, there was no early or late prosthesis infection in cryotherapy groups, which may be considered as an additional measure to prevent prosthesis infection.

A Comparison of Arterial and Venous Flaps

1992 ◽  
Vol 17 (3) ◽  
pp. 359-364 ◽  
Author(s):  
S. P. CHOW ◽  
D. Z. CHEN ◽  
Y. D. GU
Keyword(s):  
Survival Rate ◽  
Elastic Properties ◽  
Perfusion Pressure ◽  
Skin Flap ◽  
Sprague Dawley ◽  
Venous Flaps ◽  
Sprague Dawley Rats ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The survival rate and elastic properties of the anterior abdominal skin flap in Sprague-Dawley rats were studied in three groups of animals. In group 1 where the flaps were supplied by a normal artery, arterial flaps (1A) had better survival rate and elastic properties than venous flaps (1B). In group 2, where the flaps were supplied by an artery with diminished perfusion pressure, the arterial flaps (2A) still had slightly better results than venous flaps (2B). However, in group 3 where the flaps were supplied by a vein, venous flaps (3B) had better results than arterial flaps (3A).

Detailed pathologic evaluation of low dose CT (LDCT) detected stage I/0 lung adenocarcinomas (ADCA).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 8543-8543
Author(s):  
Eric Burks ◽  
Jacob Sands ◽  
Travis B. Sullivan ◽  
Kimberly M. Rieger-Christ
Keyword(s):  
Lymphatic Invasion ◽  
Stage I ◽  
Non Invasive ◽  
Pathologic Evaluation ◽  
Lower Stage ◽  
Stage Ia ◽  
Group 2 ◽  
Lung Adenocarcinomas ◽  
Lung Screening ◽  
Group 1

8543 Background: Although LDCT lung screening improves survival, some worry that indolent BAC-like ADCA may be over-detected/treated. Comprehensive histologic subtyping has recently been adopted to improve grading and thus risk stratification in lung ADCA. We report a detailed pathologic comparison of stage I/0 lung ADCAs detected by LDCT screening vs. incidentally discovered ADCAs stratified by NCCN risk criteria. Methods: We performed comprehensive histologic subtyping on 35 consecutive stage I/0 LDCT screen detected ADCAs in patients meeting NCCN group 1/2 high risk (HR) criteria and compared to incidentally detected stage I/0 ADCAs meeting HR (n = 41) or low-risk (LR, n = 28) criteria. Results: Screen detected and incidentally detected ADCAs from HR groups show an equally low-rate of indolent, non-invasive/minimally invasive ADCAs (9%) compared to LR patients (36%). Aggressive solid predominant ADCAs were equally more frequent in HR patients from screen and incidentally detected patients (19%) compared to LR patients (6%). The rate of angiolymphatic invasion (59%) and air space invasion (32-34%) were similarly elevated in HR screen and incidental patients compared to LR patients (39% & 17% respectively). A collection of lepidic predominant (BAC-like) ADCAs associated with aggressive non-predominant cribriform and/or solid patterns, elevated mitotic rates, and high proportion of lymphatic invasion were uniquely observed in the screen-detected group (12%). Subgroup analysis of screen detected NCCN group 1 vs. 2 shows group 2 tumors exhibit histologic features which are at least as aggressive as group 1 tumors, albeit at smaller invasive sizes (1.2 cm vs. 1.5 cm) and lower stage (IA 75% vs. 61%). Conclusions: This is the first detailed pathologic comparison of LDCT screen detected vs incidentally discovered stage I/0 ADCA. Tumors from HR patients are pathologically more aggressive than LR tumors. Not all BAC-like tumors in LDCT screen detected patients should be presumed indolent given that approximately half of these bear histologic features of aggressive ADCAs while still in a lepidic predominant phase. NCCN group 2 tumors are similar to group 1 and should be further studied.

scholarly journals Socioeconomic Status and COVID-19 Related Outcomes in India: Hospital Based Study

2021 ◽  
Author(s):  
Arvind K Sharma ◽  
Rajeev Gupta ◽  
Vaseem N Baig ◽  
Tejaveer Singh ◽  
Surabhi Chakraborty ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Tobacco Use ◽  
Educational Status ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
High Flow Oxygen ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACT Background & Objective: COVID-19 infection has disproportionately affected ethnic minorities and deprived populations in Europe and North America. Influence of socioeconomic status on COVID-19 related outcomes has not been studied in India. To determine association of educational status, as marker of socioeconomic status, with COVID-19 related outcomes we performed a study. Methods: Clinically and virologically confirmed successive patients of COVID-19 presenting at a government hospital in India were recruited. Demographic and clinical details were recorded. The cohort was classified according to educational status into Group 1- illiterate or < primary, Group 2- higher secondary, and Group 3- some college. To compare outcomes among groups we performed univariate and multivariate logistic regression and odds ratios (OR) and 95% confidence intervals (CI) were calculated. Results: From March-September 2020 we recruited 4645 patients (men 3386, women 1259) with laboratory confirmed COVID-19. Mean age was 46+18y, most lived in moderate or large households and 30.5% had low educational status. Smoking or tobacco use was in 29.5%, co-morbidities in 28.6% and low oxygen concentration (SpO2 <95%) at admission in 30%. Average length of hospital stay was 6.8+3.7 days, supplemental oxygen was provided in 18.4%, high flow oxygen or non-invasive ventilation 7.1%, and mechanical ventilation in 3.6%. 340 patients (7.3%) died. Group 1 patients were younger, more women, larger households, higher tobacco use and were more hypoxic at admission with lower lymphocyte counts, elevated liver enzymes and greater kidney dysfunction. In Group 1 vs Groups 2 and 3 requirement of oxygen (21.6 vs 16.7 and 17.0%), non-invasive ventilation (8.0 vs 5.9 and 7.1%), invasive ventilation (4.6 vs 3.5 and 3.1%) and deaths (10.0 vs 6.8 and 5.5%) were significantly greater (p<0.05). Compared to Group 3, OR for deaths were significantly higher in Group 1 (1.91, 1.46-2.51) and Group 2 (1.24, 0.93-1.66). Adjustment for age, sex, household size, risk factors and comorbidities led to attenuation in OR in Groups 1 (1.44, 1.07-1.93) and 2 (1.38, 1.02-1.85) that remained with adjustments for clinical and laboratory parameters and oxygen support in Groups 1 (1.38, 0.99-1.93) and 2 (1.52, 1.01-2.11). Conclusion: Illiterate and less educational (socioeconomic) status patients with COVID-19 in India have significantly greater adverse in-hospital outcomes and mortality. This is related to more severe disease at presentation.

scholarly journals Pathomorphology of adaptive changes in the remaining kidney in the early postoperative period after nephrectomy

2020 ◽  
Vol 10 (1) ◽  
pp. 19-24
Author(s):  
Igor Sergeevich Shormanov ◽  
Marina S. Los ◽  
Maxim V. Kosenko ◽  
Natalia S. Shormanova
Keyword(s):  
Postoperative Period ◽  
Morphological Changes ◽  
Renal Tissue ◽  
Early Postoperative Period ◽  
Left Group ◽  
White Rats ◽  
Group 3 ◽  
Group 2 ◽  
Single Kidney ◽  
Group 1

Objective. To study the adaptive capacity of a single remaining kidney in the early postoperative period of nephrectomy in an experiment. Materials and methods. The experiment involved 35 laboratory white rats, which were divided into three experimental groups. Group 1 (n = 5) intact animals, group 2 (n = 15) animals underwent nephrectomy on the left; group 3 (n = 15) animals underwent nephrectomy and additionally were created 90 minute hypoxic hypoxia. Histological material was collected on the 5th, 21st and 60th days after surgery. Results. Characteristic morphological changes in the only remaining kidney were an increase in the size of the glomeruli and a decrease in their number. Nephron fibrosis was detected, accompanied by increased production of antigens by the tubular epithelium, which is likely a response to a cascade increase in oxidative stress and increased release of cytokines that stimulate the production of intrarenal collagen. Conclusion. Nephrectomy and hypoxia are provocateurs for the development of systemic distress syndrome, the result of which is the formation of a vicious pathogenetic circle, which reduces the functionality of the renal tissue. This can be considered as one of the early preclinical mechanisms for the initiation of single kidney disease in the future.

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