scholarly journals Invasive technologies in the complex treatment of tuberculosis in children and adolescents: from the past to the present (literature review)

2021 ◽  
pp. 94-100
Author(s):  
E. S. Ovsyankina ◽  
L. V. Panova
Keyword(s):  
Surgical Treatment ◽  
Children And Adolescents ◽  
New Technologies ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Injury Rate ◽  
High Energy ◽  
Comprehensive Treatment ◽  
Complex Treatment ◽  
Tuberculosis In Children

Invasive technologies in the complex treatment of tuberculosis in children and adolescents have a long history, which began in the pre-antibiotic period. This is the way of their improvement from independent use of artificial pneumothorax and pneumoperitoneum to the use of these techniques in the complex treatment of respiratory tuberculosis during the development of chemotherapy for the disease. New technology uses valvular bronchial blocking. That procedure creates hypoventilation and atelectasis in the affected region of the lung with preservation of drainage function of the blocked bronchus and destruction cavity, which allow reducing indications for surgical treatment as a method with a high level of injury rate. The approaches to surgical intervention in children and adolescents with respiratory tuberculosis have also changed. It is also part of the comprehensive treatment of the disease. Minimally invasive accesses under the control of video-assisted thoracoscopy are used, which significantly reduced the risk of surgery and increased the immediate efficiency of surgical treatment. New technologies combined with all types of surgeries are being widely developed: electro- and argon plasma coagulation and pleurodesis, vaporization of the tuberculous lesion, and encapsulated pleura by high-energy CO2 laser, new materials (polypropylene implants) are used. Further development of invasive technologies with multiple and extensively drug-resistant Mycobacterium tuberculosis, to children and adolescents compensates for the lack of efficiency of conservative chemotherapy and is an urgent problem at the present stage of pediatric phthisiology.

scholarly journals ADJUVANT TREATMENT WITH BIPHOSPONATES IN COMPLEX THERAPY OF PAPILLARY THYROID CANCER BONE METASTASES

2017 ◽  
Vol 4 (3) ◽  
pp. 93-99
Author(s):  
A. D. Kaprin ◽  
A. P. Polyakov ◽  
P. O. Rumiantsev ◽  
K. S. Nizegorodova ◽  
M. V. Degtiarev ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Surgical Treatment ◽  
Zoledronic Acid ◽  
Bone Metastases ◽  
Distant Metastasis ◽  
Injury Rate ◽  
Pain Syndrome ◽  
Complex Treatment ◽  
Cost Of Treatment ◽  
Skeletal Involvement

Distant metastasis of thyroid cancer are founded in 10% of all metastases. Bone metastases are founded in 23% of distant metastasis. Complications associated with metastatic skeletal involvement often lead to a deterioration in the overall condition and a decrease in the quality of life of patients. Surgical treatment, chemotherapy are less effective, provide a higher injury rate and toxicity. This is a reason of increasing of cost of treatment. Bisphosphonates are a class of drugs that prevent the loss of bone mass, which can prolong the time to releasing bone complications: bone fracture, spine column fracture with spinal medulla compression, which decrease the QoL. Surgical treatment and chemotherapy have worse outcomes, higher injury rate, toxicity and increase cost of treatment. Bisphosphonates decrease the level of pain syndrome. Bisphosphonates are used in treatment of oncological patients since 1990. First medication was Fosamax (Aledronat). Later more medications with better efficacy and more useful were synthesised. The last one was Zoledronic acid. Rezorba (zoledronic acid) was synthesised in 2006 in Russia. Rezorba has a same efficacy with other bisphosphonates, it was shown in clinical studies with groups of breast cancer and prostatic cancer. Clinical case of 67 y.o. male patient with diagnosis: Thyroid cancer IV c st pT1bN1bM1, right neck, paratraсheal, bone and lung metastasis. Complex treatment (surgery + radioiodine therapy + 5 courses of Rezorba) was presented. After 3 courses the level of pain was decreased from 3 to 1,5. After 5 courses the ECOQ score was decreased from 2 to 1 point. Inclusion of Resorba in complex treatment of patients with bone metastasis after thyroid cancer at all stages of treatment decreases the score of pain syndrome and bone tissue reparation.

scholarly journals Innovative Endoscopic Technologies in the Complex Treatment of Patients with Unstable Stopped Gastroduodenal Bleeding

2021 ◽  
Vol 11 (1) ◽  
pp. 24-28
Author(s):  
Evgeniy Cherednikov ◽  
Sergey Barannikov ◽  
Igor Yuzefovich ◽  
Galina Polubkova ◽  
Yuri Maleev ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Length Of Hospital Stay ◽  
Aminocaproic Acid ◽  
Endoscopic Hemostasis ◽  
Recurrent Bleeding ◽  
Complex Treatment ◽  
Plasma Coagulation ◽  
Hemostatic Agents

Background: The aim of our research was to improve the results of treatment of patients with unstable bleeding gastroduodenal ulcers (GDUs) through the use of innovative endoscopic technologies in the complex treatment of gastroduodenal bleeding (GDB). Methods and results: The study included 132 patients with unstable ulcerative GDB. Among all patients with GDB, there were 95(71.96%) men and 37(28.04%) women. The average age of patients was 56.1±18.45 years. Among the sources of gastroduodenal ulcer bleeding, duodenal ulcers complicated by bleeding predominated were observed in 77(58.3%) patients, bleeding gastric ulcers and ulcers of gastroenteroanastomosis areas in 49(37.7%) and 6(4.6%) patients, respectively. According to the endoscopic classification (J. Forrest, 1974), continued bleeding (Forrest Ia-Ib) was observed in 44(33.3%) patients, threat of rebleeding (Forrest IIa-IIb) in 88(66.7%) patients. All patients were divided, by random sampling, into two equivalent groups: the main group (MG, n=66) and the comparison group (CG, n=66). In the treatment of MG patients, an individual approach was applied that used the injection of ε-aminocaproic acid, argon-plasma coagulation, and the endoscopic pneumatic applications of hemostatic agents (Zhelplastan and the patient's platelet-rich auto-plasma) and granular sorbents (Aseptisorb-A, Aseptisorb-D). In CG, traditional methods of endoscopic hemostasis (injection method with ε-aminocaproic acid and vasoconstrictor drugs, argon plasma coagulation, etc.) were used without granular sorbents and innovative hemostatic agents. In patients with the Forrest Ia-Ib bleeding, primary EH was achieved in 95.2% of cases in the MG and in 91.3% of cases in the CG (P>0.05). In patients with the Forrest IIa-IIb bleeding, effectiveness of endoscopic prevention of recurrent bleeding was achieved in 95.5% of cases in the MG and in 81.4% of cases in the CG (P=0.047). Mortality rate was 1.5% in the MG and 4.5% in the CG (P>0.05). In the MG and CG, the overall frequency of recurrent bleeding from GDUs, the operational activity, and the length of hospital stay were 15.2% and 4.5% (P=0.041), 12.1% and 1.5% (P=0.033), and 11.1±0.6 days and 9.2±0.4 days (P<0.01), respectively. Conclusion: The developed method for the complex treatment of patients with unstable GDB, based on the optimization of emergency and preventive endoscopic hemostasis, indicates that the use of therapeutic endoscopy to prevent bleeding recurrences with hemostatic agents and granular sorbents improves the reliability of endoscopic hemostasis, reduces the frequency of hemorrhage relapses and the number of emergency operations, as well as a length of hospital stay.

scholarly journals Modern aspects of treatment of hiatal hernia and its main complications

2021 ◽  
Vol 23 (2) ◽  
pp. 207-213
Author(s):  
A. Yu. Usenko ◽  
O. S. Tyvonchuk ◽  
О. P. Dmytrenko ◽  
I. S. Tereshkevych ◽  
I. V. Babii
Keyword(s):  
Surgical Treatment ◽  
Hiatal Hernia ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Esophageal Stricture ◽  
Laparoscopic Fundoplication ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Type I ◽  
Two Stage

The aim. To evaluate the features and results of minimally invasive surgical treatment of patients with hiatal hernia (HH) and its main complications using modern endoscopic and laparoscopic technologies. Materials and methods. The treatment results of 244 patients with HH and its main complications are given. 28 (11.5 %) patients had a combination of HH with Barrett’s esophagus, and 34 (13.9 %) patients had a combination of HH with esophageal stricture. In 62 patients with complications of HH, two-stage treatment tactics was used. Complete laparoscopic fundoplication was performed in 185 (75.8 %) patients, posterior partial Toupet fundoplication – in 59 (24.2 %) patients. Laparoscopic posterior crurography was performed in 198 (81.1 %) patients. In 7 (2.9 %) posterior crurography was supplemented by anterior. Teflon gaskets were used in 25 (10.3 %) patients during posterior crurography. Synthetic mesh prostheses were implanted in 14 (5.7 %) patients. Results. In patients with esophageal stricture, the effect was observed after the second session of bougienage or hydro-dilation in 70.6 % of cases, after the third session - in the remaining cases. In Barrett's esophagus, a single session of argon plasma coagulation was radical in 100 % of patients with a lesion size less than 1 cm and in 85 % of patients with lesions of 1 cm to 2 cm in size. Recurrence of type III HH occurred more often than type I. The surgery required sufficient mediastinal dissection and mobilization for an adequate esophagus pull-through. In the surgical treatment of type IV HH, the use of composite diaphragmatic meshes was considered. The effectiveness of antireflux surgical intervention, as well as prevention of specific complications was depended on the technical features of the fundoplication cuff formation. Conclusions. In the treatment of Barrett’s esophagus or esophageal stricture in combination with HH, the two-stage tactics is optimal: stage I – ablation or dilatation, and stage II – laparoscopic antireflux surgery. Laparoscopic fundoplication is an effective and safe method for treatment of patients with HH.

scholarly journals NEW TECHNOLOGIES IN THE TREATMENT OF A CHILD WITH PLEURAL EMPYEMA AFTER SEVERE CATATRAUMA

2018 ◽  
Vol 8 (2) ◽  
pp. 75-83 ◽  
Author(s):  
S. M. Bataev ◽  
G. A. Chogovadze ◽  
R. S. Molotov ◽  
M. V. Afaunov ◽  
S. F. Pilyutik ◽  
...  
Keyword(s):  
Soft Tissues ◽  
New Technologies ◽  
Argon Plasma Coagulation ◽  
Left Lung ◽  
Argon Plasma ◽  
Pleural Empyema ◽  
Treatment Result ◽  
First Time ◽  
The Brain ◽  
Surgical System

Observation of successful treatment of a 12‑yearold child with severe catatrauma obtained at falls from over 50 m is presented. It was required to perform a number of surgeries including splenectomy during treatment. A pneumococcal empyema of the left lung that determined the patient’s severity developed against the background of a traumatic disease. The child underwent two procedures of thoracoscopic pleural cavity sanation. VersaJet hydrosurgical system was used to debride and decorticate the lungs. Plasma Jet surgical system of argon plasma coagulation was used to arrest the bleeding caused by rib fractures and air stasis. It was found out for the first time that the techniques could be combined. This enabled to achieve a favorable treatment result for a child with a severe injury to the brain, multiple injuries to the skeletal bones and soft tissues complicated with destructive pleuropneumonia and sepsis.

scholarly journals Comprehensive Treatment Plan for Idiopathic Neurovasculitis

2021 ◽  
Vol 7 (4) ◽  
pp. 176-185
Author(s):  
V. Usenko ◽  
M. Umetalieva
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Immune Status ◽  
Treatment Plan ◽  
Comprehensive Treatment ◽  
Symptomatic Therapy ◽  
Retinal Vessels ◽  
Complex Treatment ◽  
Treatment Results ◽  
Severe Degree

Goal is to develop a comprehensive treatment plan for patients with idiopathic retinovasculitis, taking into account etiopathogenetic and clinical data from the retina. 86 patients (172 eyes) with retinal angiitis of idiopathic genesis were examined and were subject to treatment. The average age of the patients was 22.0 ± 0.17. Clinical forms of retinal changes: angioretinopathy — 16 eyes, 8 patients — 9.3%; neuroretinopathies — 104 eyes, 52 patients — 60.5%; neurovasculitis — 24 eyes, 12 patients — 14%; retinal angiopathy — 28 eyes, 14 patients — 16.2%. According to the severity of fundus changes: mild — 33 patients (66 eyes) — 38.4%; average — 30 patients (60 eyes) — 34.9%; severe — 23 patients (46 eyes) — 26.7%. The special methods of examining patients included: autoperimetry, eye biomicroscopy, direct and reverse ophthalmoscopy, OST of the optic nerve disc and macula, autofluorescent OCT of the retinal vessels, and optic disc with calibrometry, ultrasound dopplerography of the retinal vessels. The main principles of the therapy: 1. Suppression of immune inflammation in the acute phase and in the relapsing phase (treatment with HA, the appointment of immunosuppressants and immunostimulants in a prolonged course). 2. Correction of hemostasis and hemocirculatory disorders in the vessels of the retina. 3. Drug, symptomatic therapy and surgical treatment. Discussion of treatment results: Significant increase in visual acuity: in angioretinopathy from 0.45±0.24 to 0.9±0.14 (P <0.01); with neuroretinopathies from 0.34±0.2 to 0.85±015 (P <0.01); with concomitant maculopathy from 0.44±0.2 to 0.7±0.23 (P <0.01) and macular degeneration from 0.02±0.063 to 0.3±0.24 (P <0.05). There was an increase in visual acuity after treatment with a severe degree from 0.02±0.054 to 0.3±0.24 (P<0.05), with an average - from 0.5±0.24 to 0.9±0.13 (P<0.01), with mild — from 0.7±0.23 to 1.0±0.10. A significant decrease in the frequency of retinal changes after treatment was revealed: angioretinopathies up to 3.5% versus 9.3%; neuroretinopathies up to 11.6% versus 60.5%; maculopathy up to 8.7% versus 26.2%. The effectiveness of the treatment is due to the normalization of indicators of the immune status and hemocirculatory disorders in the retinal vessels according to calibrometry data. Thus: Complex treatment aimed at the main pathogenetic links in the development of idiopathic retinovasculitis contributes to the relief of pathological processes, reduction of complications, and eye disability.

Endoscopic mucosal resection for recurrent gastric antral vascular ectasia

VASA ◽  
2008 ◽  
Vol 37 (3) ◽  
pp. 289-292 ◽  
Author(s):  
Katsinelos ◽  
Chatzimavroudis ◽  
Katsinelos ◽  
Panagiotopoulou ◽  
Kotakidou ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Deficiency Anemia ◽  
Gastric Antral Vascular Ectasia ◽  
Therapeutic Approaches ◽  
Plasma Coagulation ◽  
Vascular Ectasia ◽  
Mucosal Resection ◽  
First Case

Gastric antral vascular ectasia (GAVE) is an overt or occult source of gastrointestinal bleeding. Despite several therapeutic approaches have been successfully tested for preventing chronic bleeding, some patients present recurrence of GAVE lesions. To the best of our knowledge, we report the first case, of a 86-year-old woman who presented severe iron-deficiency anemia due to GAVE and showed recurrence of GAVE lesion despite the intensive argon plasma coagulation treatment. We performed endoscopic mucosal resection of bleeding GAVE with resolution of anemia.

Argon-Plasma-Coagulation (APC) zur lokalablativen Therapie des Cholangiokarzinoms

2015 ◽  
Vol 28 (01) ◽  
Author(s):  
A Genthner ◽  
A Eickhoff ◽  
J Albert ◽  
MD Enderle ◽  
W Linzenbold
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Plasma Coagulation
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