scholarly journals Epidemiology of tumors of the spinal cord and spine in Ukraine in 2000-2019

2021 ◽  
Vol 27 (1) ◽  
pp. 11-20
Author(s):  
Eugene G. Pedachenko ◽  
Ievgenii I. Slynko ◽  
Oleksii S. Nekhlopochyn ◽  
Anna N. Nikiforova ◽  
Viacheslav S. Botev ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Practice ◽  
Surgical Treatment ◽  
Incidence Rate ◽  
Postoperative Mortality ◽  
Advanced Treatment ◽  
Intramedullary Tumors ◽  
Surgical Interventions ◽  
Rate Of Increase ◽  
Cns Neoplasms

Objective. To determine the dynamics and state of neurosurgical care for tumors of the spinal cord and spine (TSCS) in Ukraine. Materials and methods. The work is based on the analysis of hospitalizations and surgical treatment of patients with TSCS in neurosurgical departments of Ukraine in 2000-2019. Results. In 2019, 1,325 patients with TSCS were hospitalized in neurosurgical departments of Ukraine, which is 2,3 times more than in 2000 (567), per 1 million population - almost 3 times (34,7 vs. 11, 6 ). Over 20 years, the number of operated patients increased 2,8 times (from 385 to 1079), per 1 million population - 3,6 times (from 7,9 to 28,3), there was an increase in surgical activity by 20% (from 67,9 to 81,4%), a decrease in the general and postoperative mortality - twice (from 2,6 to 1,2% and from 2,6 to 1,3% respectively). Patients with TSCS account for 1,5% of all patients hospitalized in neurosurgical departments of Ukraine, 12,8% of all CNS neoplasms and 5,2% of all spinal pathology. Vertebral tumors account for 42,64% of all TSCS and extramedullary tumors have an incidence rate similar to vertebral tumors (42,64%), intramedullary tumors account for 14,72%. In 2019, 74.4% more patients with extramedullary tumors were hospitalized than in 2000 (565 and 324 respectively), and 84.5% more were operated on (463 and 251 respectively). The rate of increase is even higher per 1 million population. In 2019, there were 14.8 hospitalizations per 1 million population for extramedullary tumors, which is 2.2 times greater than in 2000 (6,6 hospitalizations), and 12,1 operations, which is 2,4 times greater than in 2000 (5,1 operations). In 2019, patients with intramedullary tumors were hospitalized 2,2 times more than in 2000. (195 and 89 respectively), were operated 2,5 times more (151 and 61 respectively). The rate of increase is even 4higher per 1 million population. In 2019, there were 5,1 hospitalizations for intramedullary tumors per 1 million population, which is 2,8 times greater than in 2000 (1,8 hospitalizations), and 4,0 operations, which is 3,2 times greater than in 2000 (1,2 operations). In 2019, patients with vertebral tumors were hospitalized 3.7 times more than in 2000 (565 and 154 respectively), were operated 6,4 times more (465 and 73 respectively). The rate of increase is even higher per 1 million population. In 2019, there were 14,8 hospitalizations per 1 million population for vertebral tumors, which is 4,7 greater than in 2000 (3,1 hospitalizations), and 12,2 surgeries, which is 8,2 greater than in 2000 (1,5 operations). Сonclusions. The introduction of modern neuroimaging methods and advanced treatment methods into clinical practice has contributed to an increase in the number of hospitalizations and surgical interventions in TSCS.

NEUROMONITORING IN CLINICAL PRACTICE: WITH CEREBRAL-SOMATIC PARA INFRARED OXIMETER SYSTEM

2021 ◽  
pp. 15-19
Author(s):  
Ж.Б. Тұрлығазы ◽  
Д.Ж. Байділлаева ◽  
Р.А. Бакриев
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Practice ◽  
Surgical Treatment ◽  
Cerebral Ischemia ◽  
Neurological Examination ◽  
Infrared Light ◽  
Surgical Interventions ◽  
Arterial Blood ◽  
Continuous Application ◽  
Chronic Pulmonary Embolism

Нейромониторинг рассматривается в широком понятии, включая динамическую оценку неврологического статуса, дискретное или непрерывное использование электрофизиологических, биохимических, ультразвуковых, рентгеновских, изотопных и других методов. Несмотря на современные технологические возможности, динамическая неврологическая оценка продолжает оставаться одним из наиболее простых и важных способов оценки адекватности интенсивной терапии. Более того, данные инструментальных методов всегда должны рассматриваться только в сопоставлении с клинической картиной. Нарастание степени угнетения сознания, глубины двигательных и тонических расстройств, увеличение числа симптомов «выпадения» ЧМН отражает неэффективность терапии. Neuromonitoring is broadly considered including dynamic neurological examination, discrete and continuous application of electrophysiological, biochemical, ultrasonic, X-ray, isotope and other methods. The dynamic neurological examination continues to remain as one of the easiest and the most important ways of adequate assessment of intensive treatment despite modern technological capabilities. Moreover, the instrumental procedure data shall be always considered just within the comparison with clinical practice. The increase of the depression of consciousness degree, the depth of movement and tonic disorders, multiplication of the incidence of SBN (Skull Brain Nerves) "loss" symptoms reflect the ineffectiveness of treatment. Cerebral - corporal para infrared oxymetrical system is suitable for estimating the patient’s (infantschildren-adults) condition with possible disorder of cerebral and/or corporal oxygenation even with keeping normal degrees of Arterial blood pressure and SpO2. rSO2 index is indicative of the balance between oxygen delivery and intake within the regions of interest. This method is used as intraoperative neuromonitoring in cases of high risk of hypoxic brain damage during surgical interventions on the vessels of the neck, surgical treatment of chronic pulmonary embolism, aneurysm and aortic dissection, as well as to assess the severity of cerebral ischemia in patients with chronic cerebral ischemia, pathology of the arteries of the head and neck, chronic pulmonary embolism. The method is based on the principle of optical spectroscopy using infrared light with a range from 650 to 1100 nm. The sensor of the device is located in the frontotemporal part at the border of the scalp. The saturation of the brain with oxygen is determined at rest in the supine position while breathing atmospheric air at all stages of surgical treatment in a continuous monitoring mode.

scholarly journals Management of intramedullary astrocytomas

2013 ◽  
Vol 20 (2) ◽  
pp. 153-158
Author(s):  
Daniel Serban ◽  
Florin Exergian ◽  
R.M. Gorgan
Keyword(s):  
Spinal Cord ◽  
Neurological Outcome ◽  
Cns Tumors ◽  
Surgical Team ◽  
Intramedullary Tumors ◽  
Clinical Imaging ◽  
Primary Tumors ◽  
Surgical Interventions

Abstract Primitive IMT represent 8-10% of all primary tumors of the spinal cord. Only 2- 4% of all CNS tumors in adults are IMT. Adult astrocytomas are 25-35% of total IMT (1). We prospectively analyzed clinical, imaging and pathological data from all consecutive patients operated for intramedullary tumors in our department (Neurosurgery I Clinic, Ward II) between January 2003 and August 2009 (80 months). All surgical interventions were performed by the same surgical team. We emphasized the technical difficulties raised by ablation of IMT depending on the type of the tumor and postoperative neurological outcome.

scholarly journals Surgical treatment of patients with descending purulent mediastinitis

2021 ◽  
Vol 26 (4) ◽  
pp. 118-123
Author(s):  
I.M. Shevchuk ◽  
S.S. Snizhko
Keyword(s):  
Surgical Treatment ◽  
Pleural Cavity ◽  
Comparison Group ◽  
Postoperative Mortality ◽  
Complete Removal ◽  
Main Group ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Minimally Invasive Surgical ◽  
Surgical Tactics

The aim of the study was to improve the results of treatment of patients with descending purulent mediastinitis by means of individualized surgical tactics with the priority use of minimally invasive surgical interventions and developed methods of drainage of the mediastinum and pleural cavity. Examination and treatment of 73 patients with descending purulent mediastinitis receiving treatment in the department of thoracic surgery of Ivano-Frankivsk regional clinical hospital was carried out. Treatment of patients in the main group included intramediastinal administration of antibiotics, the use of the developed method of cascade drainage of the mediastinum and pleural cavity, the priority use of video-assisted thoracoscopy and surgical tactics aimed at anticipating the spread of the purulent process in the mediastinum. The rapid and reliable decrease in the indices of endogenous intoxication in the main group confirms the effectiveness of the developed tactics of surgical treatment of patients with mediastinitis, adequate sanation of purulent mediastinatis, complete removal of the purulent substrate from the mediastinum and pleural cavity. The developed tactics of surgical treatment of purulent mediastinitis allowed reducing the overall postoperative mortality from 26.3% in the comparison group to 11.4% in the main group of patients.

scholarly journals SURGICAL TREATMENT FOR NON-TUMOROUS DISEASES OF CRANIOVERTEBRAL REGION

2018 ◽  
pp. 36-41 ◽  
Author(s):  
A. A. Kuleshov ◽  
A. N. Shkarubo ◽  
I. S. Gromov ◽  
M. S. Vetrile ◽  
I. N. Lisyanskiy ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Fatal Outcome ◽  
Cord Compression ◽  
Long Term Results ◽  
Surgical Interventions ◽  
Custom Made ◽  
Spinal Cord Decompression ◽  
Ventral Spinal Cord

Purpose:to evaluate the efficacy of surgical treatment for the non-tumorous diseases of the craniovertebral region.Patients and Methods. Forty five patients aged 4 – 63 years (mean age 27 years) with non-tumorous diseases of the craniovertebral region were operated on. Either one- or two-step surgical interventions for spinal cord decompression were performed. Early and long term results were evaluated by Frankel, JAO and River scales. In 5 cases the assessment of volumetric craniovertebral interrelationships (VCVI).Results.Good results were obtained in 43 (96%) patients at terms from 1 to 15 years. In 1 patient with mucopolysaccharidoses the aggravation of neurologic symptoms was observed and in 1 case a fatal outcome occurred. VCVI analysis showed a significant improvement of liquor dynamics right up to its normalization in the zone of decompression.Conclusion.Treatment of craniovertebral region diseases requires a differential approach. When necessary to eliminate ventral spinal cord compression it is expedient to perform either transoral or endoscopic transnasal decompression, or transoral spinal cord (myelencephalon) decompression with anterior stabilization by custom-made device (plate).

scholarly journals Surgical treatment for nontumorous diseases of craniovertebral region

2018 ◽  
Vol 25 (1) ◽  
pp. 36-41
Author(s):  
A. A Kuleshov ◽  
A. N Shkarubo ◽  
Il’ya S. Gromov ◽  
M. S Vetrile ◽  
I. N Lisyanskiy ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Fatal Outcome ◽  
Cord Compression ◽  
Long Term Results ◽  
Surgical Interventions ◽  
Custom Made ◽  
Spinal Cord Decompression ◽  
Ventral Spinal Cord

Purpose: to evaluate the efficacy of surgical treatment for the non-tumorous diseases of the craniovertebral region. Patients and Methods. Forty five patients aged 4 - 63 years (mean age 27 years) with non-tumorous diseases of the craniovertebral region were operated on. Either one- or two-step surgical interventions for spinal cord decompression were performed. Early and long term results were evaluated by Frankel, JAO and River scales. In 5 cases the assessment of volumetric craniovertebral interrelationships (VCVI). Results. Good results were obtained in 43 (96%) patients at terms from 1 to 15 years. In 1 patient with mucopolysaccharidoses the aggravation of neurologic symptoms was observed and in 1 case a fatal outcome occurred. VCVI analysis showed a significant improvement of liquor dynamics right up to its normalization in the zone of decompression. Conclusion. Treatment of craniovertebral region diseases requires a differential approach. When necessary to eliminate ventral spinal cord compression it is expedient to perform either transoral or endoscopic transnasal decompression, or transoral spinal cord (myelencephalon) decompression with anterior stabilization by custom-made device (plate).

scholarly journals Surgical tactics in patients with pancreatic necrosis and its complications

2016 ◽  
Vol 97 (6) ◽  
pp. 898-903
Author(s):  
D M Krasil’nikov ◽  
A V Abdul’janov ◽  
I V Zajnullin ◽  
M A Borodin ◽  
R A Zefirov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Pancreatic Necrosis ◽  
Treatment Options ◽  
Postoperative Mortality ◽  
Surgical Interventions ◽  
Surgical Tactics ◽  
Medical University ◽  
Surgical Clinic

Aim. Improving the results of surgical treatment of patients with pancreatic necrosis and its complications based on developing optimal variants of surgical interventions for each case.Methods. The article presents experience of surgical treatment of 344 patients with pancreatic necrosis admitted to surgical clinic №1 of Kazan state medical university in Republican clinical hospital (Kazan) during the period from 2009 to 2015. According to the developed procedure of choosing the optimal treatment options for patients with pancreatic necrosis, depending on the stage, degree of involvement of pancreas and retroperitoneal space and the presence of complications, patients underwent a variety of options and combinations of types of surgical interventions. Under the guidance of X-ray 124 surgeries were performed, in 69 (20.1%) cases surgical interventions under ultrasound (US) guidance were completed with open surgical intervention.Results. Videolaparoscopic interventions with therapeutic and diagnostic purposes were performed in 198 patients with lethal outcomes in 3 (3.1%) cases. As a completed intervention videolaparoscopy was performed in 49 (24.7%) cases. 226 (65.7%) patients underwent open surgery. Most patients required combined surgical treatment, which included a combination of minimally invasive procedures and open surgery in 199 (57.9%) patients.Conclusion. Use of combined methods of surgical treatment in patients with infected pancreatic necrosis greatly improves treatment outcomes; a combination of minimally invasive and open surgery can significantly reduce postoperative mortality in pancreatic necrosis from 17.8% to 12.5%.

Surgical treatment of intramedullary tumors (spinal cord and medulla oblongata). Analysis of 16 cases

1990 ◽  
Vol 13 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Alireza Ahyai ◽  
Ulrich Woerner ◽  
Evangelos Markakis
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Medulla Oblongata ◽  
Intramedullary Tumors

scholarly journals The choice of surgical treatment in patients with infected pancreonecrosis

2018 ◽  
Vol 177 (6) ◽  
pp. 20-26
Author(s):  
E. A. Tseimakh ◽  
V. A. Bombizo ◽  
P. N. Buldakov ◽  
A. A. Averkina ◽  
D. N. Ustinov ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Inpatient Treatment ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Group Comparison ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Minimally Invasive Surgical

The objectiveis to study the results of different methods of surgical treatment of patients with infected pancreonecrosis and to conduct a comparative analysis of minimally invasive and traditional surgical interventions.Material and methods.The results of treatment of 206 patients with infected pancreonecrosis were analyzed. In accordance with the used method of surgical treatment, the patients were divided into 2 groups: 105 (51.0%) patients with “traditional” open interventions were included in the first group (comparison), and 101 (49.0%) patients treated with various miniinvasive technologies, or a combination of minimally invasive and “open” interventions were included in the second group.Results.It was found that the mortality rate in the second group was less than in the first group by 12.8% (p<0.05).Conclusion.Minimally invasive surgical techniques are the method of choice for delimited pancreatogenic ulcers. The use of combined surgical interventions leads to a significant reduction of postoperative mortality and duration of inpatient treatment.

scholarly journals LONG-TERM RESULTS OF SURGICAL TREATMENT IN PATIENTS WITH INTRADURAL SPINAL TUMORS

2018 ◽  
Vol 73 (2) ◽  
pp. 88-95 ◽  
Author(s):  
V. A. Byvaltsev ◽  
I. A. Stepanov ◽  
E. G. Belykh ◽  
M. A. Aliyev
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Long Term Results ◽  
Neurophysiological Monitoring ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Neurological Outcomes ◽  
Factors Influencing ◽  
Significant Difference

Background: Intradural spinal cord tumors include extramedullary and intramedullary tumors. The search for literature sources in the Pubmed, Medline, and E-Library databases detected a little number of researches on the long-term results of the surgical treatment of intradural spinal cord tumors. These clinical series include a small number of patients and do not consider the factors influencing clinical outcomes of surgical treatment.Aim: To evaluate the long-term results of surgical treatment in patients with intradural spinal cord tumors, to identify the main factors influencing the clinical and neurological outcomes of surgical interventions in this group of patients.Materials and methods: The study included 277 medical records of 244 patients with intradural extramedullary and 33 patients with intradural intramedullary tumors of the spinal cord. Clinical-neurological outcomes of surgical treatment in patients with intradural spinal cord tumors and factors influencing the outcomes were analyzed.Results: When comparing the degree of neurologic deficit in patients with intradural extramedullary tumors prior to surgery, no significant differences were found (p=0.241) both in the early postoperative period and 6 months after the surgery. Nevertheless, when comparing these indicators in a period of 12, 24, 36, 48, and 60 months after the surgery, statistically significant differences were revealed (p0.001). There was no statistically significant difference (p=0.437) between the scores in patients with intramedullary tumors on the modified McCormick Scale preoperatively, at the 6-month and one-year follow-up; however, comparison of the clinical and neurological indicators at 24, 26, 48, and 60 months revealed a significant difference (p0.001). The surgery outcomes in considered groups of patients were significantly influenced by the following indicators: the ASA risk level (odds ratio (OS) 2.138; 95% confidence interval (95% CI) 3.346–12.145) and intraoperative neurophysiological monitoring (OR 2.84; 95% CI 1.67–9.56).Conclusion: The study registered good and excellent long-term outcomes in most cases of intradural spinal cord tumors when the maximum possible tumor excision was performed. Analysis of the influence of various factors on the clinical and neurological outcomes in the study group of patients showed that the use of intraoperative neurophysiological monitoring and the degree of operational and anesthetic risk according to the ASA scale have a significant effect.

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