scholarly journals Modern approaches to the treatment of retrosternal goiter

2021 ◽  
Vol 88 (1-2) ◽  
pp. 45-49
Author(s):  
V. V. Grubnik ◽  
R. S. Parfentiev ◽  
V. M. Kosovan ◽  
N. D. Parfentieva
Keyword(s):  
Massive Bleeding ◽  
Parathyroid Glands ◽  
Recurrent Nerve ◽  
Endoscopic Techniques ◽  
Results Of Treatment ◽  
Retrosternal Goiter ◽  
Duration Of Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Standard Techniques

Objective. To analyze the results of treatment of patients with retrosternal goiter. Materials and methods. During the period from 2010 to 2019, 62 patients with thoracic goiter were operated on, which was 6.2% of all patients operated in relation to goiter. There were 48 women (77.4%) and 14 men (22.6%). Age of patients varied from 21 to 87 years (average age - 47 years). Computed tomography was mandatory in terms of research. The size of the sternal goiter and the degree of operative risk were determined by G. Mercante (2011). Results. In 39 patients (1st group) the operation was performed by cervicotomy according to standard techniques. Video endoscopic support was used in 23 patients, thanks to which in 15 patients (group 2) it was able to cross all blood vessels with the help of an electro coagulator and isolate nerve structures and parathyroid glands. In 8 patients (group 3) there was a massive bleeding after attempts of finger dissection. They underwent tamponade and temporarily stopped bleeding. After that, a video endoscope was inserted into the wound and hemostasis was performed with the help of an electrocoagulation. Bleeding from the surgical wound, which required revision, was not observed. Temporary tracheostomy in the postoperative period was imposed in 3 patients, later it was closed. Hypocalcemia occurred in 12 (19.3%) patients (in 11 it was transient). Transient paresis of the recurrent nerves was observed in 3 patients of the 1st, 2 of the 2nd and 2 of the 3rd groups. Permanent paresis of the recurrent nerve occurred in only 1 patient of the 3rd group. According to histological examination, 21 patients were diagnosed with cancer (19 - papillary, 2 - follicular). They subsequently underwent standard treatment for highly differentiated thyroid cancer. Conclusions. The use of cervical access with video endoscopic support during surgery for thoracic goiter avoids performing a sternotomy, reduces blood loss and operational trauma, improves the nerve structures and parathyroid glands identification, and reduces the duration of surgery. The use of modern methods of electrocoagulation significantly expands the capabilities of endoscopic techniques.

scholarly journals Effective use of various minimally invasive technologies eliminating vertical reflux in the treatment of chronic diseases of the lower limb veins

2020 ◽  
Vol 73 (2) ◽  
pp. 329-331
Author(s):  
Serhiy I. Savolyuk ◽  
Valentyn A. Khodos ◽  
Roman A. Herashchenko ◽  
Vladyslav S. Horbovets
Keyword(s):  
Lower Limb ◽  
High Frequency ◽  
Long Term Results ◽  
Laser Coagulation ◽  
Results Of Treatment ◽  
Functional Classes ◽  
Group 3 ◽  
Group 2 ◽  
Effective Use

The aim: To analyze and evaluate the efficacy of CDLLV treatment, using high-frequency endovascular welding (EVW), endovenous laser coagulation (EVLC) and catheter microfoam echosclerotherapy. Materials and methods: We have treated 329 patients with CDLLV C2-C6 functional classes according to the Clinical Etiological Anatomical Pathophysiology. Of these, 102 patients had vertical reflux eliminated by EVW, in 112 – by EVLC, and in 115 – by catheter microfoam echosclerotherapy. Results: In the EVW group 3 patients (2.94%) had a partial recanalization of coagulated veins 3 months after the procedure. In EVLC group 2 patients (1.79%) also had partial recanalization group after 6 months. In the group of catheter microfoam echosclerotherapy partial recanalization occurred in 3 patients during 3 months of observation, in the period of 6 months – in 2, in the period of 12 months – in 9, in total – in 14 patients (12.17%). The EVW and EVLC methods showed high efficacy of vertical reflux elimination on the great and small subcutaneous veins (GSV/SSV) in CDLLV and have no fundamental differences in the immediate and long-term results of treatment. Microfoam catheter echosclerotherapy leads to a greater number of recanalisations, compared with EVW and EVLC. Conclusions: High-frequency endovenous welding results in complete fibrotic GSV/SSV transformation in 97.06% of patients. Endovascular laser coagulation results in complete fibrotic GSV/SSV transformation in 98.21% of patients. Elimination of vertical reflux by microfoam echosclerotherapy results in complete fibrotic GSV/SSV transformation in 87.83% of patients.

scholarly journals Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery

2018 ◽  
Vol 119 (4) ◽  
pp. 148-155 ◽  
Author(s):  
Abdulcabbar Kartal ◽  
Hüseyin Onur Aydın ◽  
Mehmet Oduncu ◽  
Murat Ferhat Ferhatoğlu ◽  
Taner Kıvılcım ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Transposition Flap ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Our study aims to compare the surgical outcome of Limberg transposition flap, Karydakis flap, and primary closure after excision to treat sacrococcygeal pilonidal sinus disease. A total of 634 patients with pilonidal sinus who underwent surgery were evaluated retrospectively from January 2014 to January 2016. The patients were divided into three groups. Limberg transposition flap (LTF) was performed in 131 patients (group 1), Karydakis flap (KF) was performed in 232 patients (group 2) and primary closure (PC) after excision was performed in 271 patients (group 3). Patient demographics, operative and postoperative outcomes were recorded and analyzed retrospectively. The mean age (p=0.98), sex ratio (p=0.74) and removed sinus volume (p=0.67) were not statistically different between groups. Mean operative time was 54.3 ± 6.4 min for group 1, 46.8 ± 10.5 min for group 2, and 26.9 ± 5.8 min for group 3 respectively (p=0.01). When the length of hospital stay was compared, there was a significant difference in favor of primary closure (p=0.01). Regarding early surgical complication, Karydakis flap technique was superior to other groups (p<0.001). The recurrent rate was higher in the primary closure group (p<0.001). In our study, the primary closure method regarding the duration of surgery and hospitalization; Karydakis method regarding postoperative complications (seroma, hematoma, wound dissociation, infection, recurrence) were superior to the other two methods.

scholarly journals Comparative Evaluation of Aortic Valve Replacement Methods in Patients Over 70 with Aortic Stenosis

2018 ◽  
Vol 7 (3) ◽  
pp. 227-233 ◽  
Author(s):  
V. V. Sokolov ◽  
M. V. Parkhomenko ◽  
A. I. Kovalyov ◽  
V. V. Vladimirov ◽  
O. L. Shiryayeva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Hospital Mortality ◽  
Heart Diseases ◽  
Surgical Techniques ◽  
Results Of Treatment ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

BackgroundAs life expectancy and quality of health improve, more and more people reach old age, and so does the number of heart diseases. One of the most urgent problems among elderly patients is degenerative stenosis of the aortic valve (AV). The conservative treatment of symptoms of chronic heart failure with AV stenosis improves the patient’s condition only for a while, whereas surgical treatment such as replacement of AV is recognized as the main effective method of treating a defect. Recently, alternative technologies for prosthetic AV have been developed, aimed at reducing adverse effects of artificial circulation (AC) in high-risk patients and minimizing the scope of surgical intervention.Aim of studyThe aim of the study was to evaluate the immediate results of surgical treatment of aortic stenosis using different methods in patients over 70.Material and methodsThe article presents the results of treatment of 64 patients over 70 with isolated AV stenosis, operated with different surgical techniques from July, 2016 to January, 2018. All patients were divided into three groups, differing in the severity of the initial condition and the method treatment. Group 1 (transcatheter implantation of the prosthetic AV, EuroSCORE II — 21.81%) consisted of 19 patients, Group 2 (non-suture implantation of a Perceval prosthetic valce under the AC, EuroSCORE II — 13.81%) consisted of 13 patients and Group 3 (“standard” prosthetics, EuroSCORE II — 9.89%) consisted of 32 patients.ResultsIn Group 1, two patients died, the hospital mortality was 10.5%. In Group 2 and Group 3, one patient died, the hospital mortality was 7.6 and 3.1%, respectively. Implantation of a permanent pacemaker was required in three patients (15.7%) from the TAVI group after installation of Medtronic Core Valve and two patients (15.3%) from the Perceval group.ConclusionThe obtained results of AV replacement by various methods allowed to expand indications for the management of AV stenosis in patients of the older age group with a high surgical risk of operation under AC conditions who had not previously been considered candidates for surgical treatment of aortic malformation due to the age and severity of the concomitant pathology.

scholarly journals Treatment of osteoarthritis of large and small joints using an injectable complex action chondroprotector

2021 ◽  
Author(s):  
И.В. Меньшикова ◽  
В.И. Сороцкая
Keyword(s):  
Adverse Reactions ◽  
Joint Stiffness ◽  
Complex Action ◽  
Womac Index ◽  
Results Of Treatment ◽  
Group 3 ◽  
Inflammatory Drugs ◽  
Group 2 ◽  
Group 1

В многоцентровом исследовании «КОЛИБРИ» оценивали эффективность и переносимость инъекционного средства замедленного действия для терапии остеоартроза крупных и мелких суставов. Исследуемую группу составили 49 больных (87,8% женщин, 12,2% мужчин, медиана возраста – 63,4 [52,3; 75,2] года, длительность болезни – 5,86 [3,07; 11,4] года, индекс массы тела – 30,06 [23,1; 41,4] кг/м2): 14,6% – с поражением мелких суставов кистей (1-я группа), 62,5% – с поражением крупных суставов, получавшие препарат внутримышечно (2-я группа), и 22,9% – с поражением крупных суставов, получавшие препарат внутрисуставно (в/с) и внутримышечно (в/м) (3-я группа). В течение года проведено 2 курса инъекций с интервалом 6 мес и последующим наблюдением в течение 3 мес. Результаты лечения оценивали в динамике по визуально-аналоговой шкале (ВАШ) боли, индексам AUSCAN и WOMAC, удовлетворенности пациента и врача по 5-балльной шкале и потребности в нестероидных противовоспалительных препаратах (НПВП). После первого курса лечения отмечено статистически значимое уменьшение боли по шкале ВАШ на 45,4-57,7%, индекса AUSCAN– на 49,3%, индекса WOMACво 2-й группе – на 44,9%, в 3-й группе – на 53,2%. Около 1/3 больных отказались от приема НПВП. К началу второго курса указанные показатели возросли, но не до исходного уровня. После второго курса терапии отмечено дальнейшее улучшение показателей боли по ВАШ – на 20,2-30,8%, индекса AUSCAN – на 28,4%, индекса WOMAC во 2-й группе – на 20,5%, в 3-й группе – на 22,9%. Через 3 месяца наблюдения отмечено уменьшение по сравнению с исходными показателями боли по ВАШ на 60,8-64,8%, индекса AUSCAN – на 34,3%, WOMAC во 2-й группе – на 51,3%, в 3-й группе – на 35,4%. Наиболее выражена была динамика скованности в суставах. 50% пациентов отказались от приема НПВП. Нежелательные реакции (дерматит в месте инъекции и синовит после внутрисуставного введения препарата) выявлены у 2 больных. The aim of the study was to assess the efficacy and tolerability of slow-acting injectable agent for the treatment of osteoarthritis in the treatment of osteoarthritis of large and small joints. The study group consisted of 49 patients (87,8% women, 12,2% men, whose median age – 63,4 [52,3; 75,2] years, the duration of the disease – 5,86 [3,07; 11.4] years, body mass index – 30,06 [23,1; 41,4] kg/m2): 14,6% – with damage to small joints of the hands (group 1), 62,5% with damage to large joints, who received the drug only intramuscularly (group 2) and 22,9% with lesions of large joints, who received the drug intra-articularly and intramuscularly (group 3). During the year, 2 courses of injections were carried out with an interval of 6 months. 3 months follow-up period was held. The results of treatment were assessed by the dynamics of the VAS of pain, AUSCAN and WOMAC indices, patient and doctor satisfaction on a 5-point scale, and the need for non-steroidal anti-inflammatory drugs (NSAIDs). After 1 course of treatment, there was a statistically significant decrease in pain according to VAS in all groups by 45,4-57,7%, in the AUSCAN index – by 49,3%, in the WOMAC index in group 2 – by 44,9%, in group 3 – by 53,2%. About 1/3 of patients refused to take NSAIDs. By the beginning of the 2nd course, these indicators increased, but not to the initial level. After the 2nd course of therapy, further improvement was noted pain according to VAS – by 20,2-30,8%, AUSCAN index – by 28,4%, WOMAC index in group 2 – by 20,5%, in group 3 – by 22 ,9%. After 3 months of follow-up there was a decrease in comparison with the initial indicators: pain according to VAS – by 60,8-64,8%, AUSCAN index – by 34,3%, WOMAC in group 2 – by 51,3%, in group 3 – by 35,4%. The dynamics of joint stiffness was most pronounced. Half of the patients stopped taking NSAIDs. Adverse reactions (dermatitis at the injection site and synovitis after i/a administration of the drug) were detected in 2 patients.

Sequential Pneumatic Compression-An Effective Method Of Preventing Deep Venous Thrombosis

1981 ◽  
Author(s):  
J H Scurr ◽  
T E Bucknall ◽  
H Ellis ◽  
C Wastell
Keyword(s):  
Compression Stocking ◽  
Compression Stockings ◽  
Heparin Group ◽  
Compression Device ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group 3 ◽  
Graduated Compression Stockings ◽  
Group 2 ◽  
Uptake Test

195 patients undergoing major surgical operations over 40 years of age were randomly allocated into 3 groups. In Group 1 the patients were given subcutaneous Heparin 5000 units b.d. for 7 days. Group 2, graduated compression stockings were applied on admission to hospital, being removed for the duration of surgery and replaced by a pneumatic sequential compression device. Group 3, graduated compression stockings were applied on admission to hospital, were removed during surgery and replaced with a seouential compression device which remained until the patient was fully ambulant and then replaced with a graduated compression stocking. Patients were studied daily using the I125 fibrinogen uptake test, doppler, strain guage plethysmography and venography to confirm positive or doubtful results. The incidence of DVT in the Heparin and extended compression group is 9%. The incidence in the compression group is 14.2%. Blood loss and haematoma were significantly greater in the Heparin group. Although there is no significant difference between the incidence of DVT in either group, there were significantly less problems in the compression groups. Sequential compression presents an effective method of preventing DVT.

scholarly journals The role of transurethral resection of prostatic gland in treatment of prostatic іntraepithelial neoplasia

2018 ◽  
Vol 85 (4) ◽  
pp. 32-34
Author(s):  
М. P. Melnychuk
Keyword(s):  
Transurethral Resection ◽  
Central Zone ◽  
Intraepithelial Neoplasia ◽  
Occurrence Rate ◽  
Results Of Treatment ◽  
Group 3 ◽  
Group 2 ◽  
Prophylactic Method ◽  
Prostatic Gland

Objective. To establish the efficacy of transurethral resection of prostatic gland (TURPG) in patients, suffering prostatic intraepithelial neoplasia (PIN) of central zone. Маterials and methods. Results of treatment of 72 patients, suffering benign hyperplasia of prostatic gland Stages І–ІІІ and PIN of central zone, are adduced. Depending on the treatment tactic applied, the patients were divided into 3 Groups: dynamical follow–up (Group 1), medicinal therapy, using dutasterid (Group 2), and TURPG (Group 3). Follow–up period have constituted 3 years. Results. Among the patients, suffering PIN of the prostatic gland central zone, prostatic gland cancer (PGC) was revealed in 15 (20,8%). In the treatment absence, the PGC occurrence rate have constituted 42,9%. At the same time the pancreatic gland adenocarcinoma after ТURPG during follow–up period was not revealed. Conclusion. Оperative intervention, using TURPG, constitutes an effective prophylactic method for the PIN malignant transformation. Treatment of patients, suffering PIN, is directed to prophylaxis of the PGC occurrence.

Morphological Changes in the Rat Granulosa Cell Surface During Differentiation Induced by Estradiol and Gonadotropins

1977 ◽  
Vol 35 ◽  
pp. 484-485
Author(s):  
P. Bagavandoss ◽  
JoAnne S. Richards ◽  
A. Rees Midgley
Keyword(s):  
Cell Surface ◽  
Granulosa Cell ◽  
Morphological Changes ◽  
Follicular Development ◽  
Female Rats ◽  
Functional Changes ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2

During follicular development in the mammalian ovary, several functional changes occur in the granulosa cells in response to steroid hormones and gonadotropins (1,2). In particular, marked changes in the content of membrane-associated receptors for the gonadotropins have been observed (1).We report here scanning electron microscope observations of morphological changes that occur on the granulosa cell surface in response to the administration of estradiol, human follicle stimulating hormone (hFSH), and human chorionic gonadotropin (hCG).Immature female rats that were hypophysectcmized on day 24 of age were treated in the following manner. Group 1: control groups were injected once a day with 0.1 ml phosphate buffered saline (PBS) for 3 days; group 2: estradiol (1.5 mg/0.2 ml propylene glycol) once a day for 3 days; group 3: estradiol for 3 days followed by 2 days of hFSH (1 μg/0.1 ml) twice daily, group 4: same as in group 3; group 5: same as in group 3 with a final injection of hCG (5 IU/0.1 ml) on the fifth day.

Correlation of γ-radioactivity and Scanning Electron Microscopy in measurement of retention of 111Indium-labeled canine endothelial cells on synthetic vascular grafts

1989 ◽  
Vol 47 ◽  
pp. 886-887
Author(s):  
E.J. Prendiville ◽  
S. Laliberté Verdon ◽  
K. E. Gould ◽  
K. Ramberg ◽  
R. J. Connolly ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ex Vivo ◽  
Vascular Grafts ◽  
Retention Data ◽  
Vascular Prostheses ◽  
Group 4 ◽  
Human Fibronectin ◽  
Insufficient Time ◽  
Group 3 ◽  
Group 2

Endothelial cell (EC) seeding is postulated as a mechanism of improving patency in small caliber vascular grafts. However the majority of seeded EC are lost within 24 hours of restoration of blood flow in previous canine studies . We postulate that the cells have insufficient time to fully develop their attachment to the graft surface prior to exposure to hemodynamic stress. We allowed EC to incubate on fibronectin-coated ePTFE grafts for four different time periods after seeding and measured EC retention after perfusion in a canine ex vivo shunt circuit.Autologous canine EC, were enzymatically harvested, grown to confluence, and labeled with 30 μCi 111 Indium-oxine/80 cm 2 flask. Four groups of 5 cm x 4 mm ID ePTFE vascular prostheses were coated with 1.5 μg/cm.2 human fibronectin, and seeded with 1.5 x 105 EC/ cm.2. After seeding grafts in Group 1 were incubated in complete growth medium for 90 minutes, Group 2 were incubated for 24 hours, Group 3 for 72 hours and Group 4 for 6 days. Grafts were then placed in the canine ex vivo circuit, constructed between femoral artery and vein, and subjected to blood flow of 75 ml per minute for 6 hours. Continuous counting of γ-activity was made possible by placing the seeded graft inside the γ-counter detection crystal for the duration of perfusion. EC retention data after 30 minutes, 2 hours and 6 hours of flow are shown in the table.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

Abnormal Haemostasis and Blood Viscosity in Malignant Hypertension

1984 ◽  
Vol 52 (03) ◽  
pp. 253-255 ◽  
Author(s):  
C Isles ◽  
G D O Lowe ◽  
B M Rankin ◽  
C D Forbes ◽  
N Lucie ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Viscosity ◽  
Renal Damage ◽  
Antithrombin Iii ◽  
Plasma Viscosity ◽  
Malignant Hypertension ◽  
Fibrin Deposition ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

SummaryWe have previously shown abnormalities of haemostasis suggestive of intravascular coagulation in patients with malignant hypertension, a condition associated with retinopathy and renal fibrin deposition. To determine whether such abnormalities are specific to malignant hypertension, we have measured several haemostatic and haemorheological variables in 18 patients with malignant hypertension (Group 1), 18 matched healthy controls (Group 2), and 18 patients with non-malignant hypertension (Group 3) matched for renal pathology, blood pressure and serum creatinine with Group 1. Both Groups 1 and 3 had increased mean levels of fibrinogen, factor VIIIc, beta-thrombo- globulin, plasma viscosity and blood viscosity (corrected for haematocrit); and decreased mean levels of haematocrit, antithrombin III and platelet count. Mean levels of fast antiplasmin and alpha2-macroglobulin were elevated in Group 1 but not in Group 3. We conclude that most blood abnormalities are not specific to malignant hypertension; are also present in patients with non-malignant hypertension who have similar levels of blood pressure and renal damage; and might result from renal damage as well as promoting further renal damage by enhancing fibrin deposition. However increased levels of fibrinolytic inhibitors in malignant hypertension merit further investigation in relation to removal of renal fibrin.

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