Experience in endoscopic treatment of patients with adrenal neoplasms

Objective: To summarize the experience of endoscopic surgical treatment of patients with adrenal neoplasms.Methods: The results of treatment of 80 patients (64 women and 16 men) with adrenal neoplasm were retrospectively analyzed in Medical Center, Far Eastern Federal University, from 2014 to 2019.Results: Andrenalectomies were performed via three accesses: laparoscopic (49 cases), retroperitoneoscopic (22 cases) and laparoscopy-assisted (6 cases). Three cases required conversion. 70 benign and 10 malignant neoplasms were removed. Complications, including one death, developed in four cases.Conclusions: Minimally invasive andrenalectomy is safer and more preferable than open surgery due to reduced duration of hospital stay, decreased rate of complications, degree of pain syndrome, extent of blood loss and need for opioid analgesics.

Download Full-text

Result of using a minimally invasive method of surgical treatment of purulent-necrotic complications in a patient with diabetic foot syndrome

Russian Military Medical Academy Reports ◽

10.17816/rmmar64986 ◽

2020 ◽

Vol 39 (3) ◽

pp. 60-64

Author(s):

Sergey Y. Ivanusa ◽

Boris V. Risman ◽

Andrey V. Yanishevskiy

Keyword(s):

Surgical Treatment ◽

Minimally Invasive ◽

Diabetic Foot ◽

Pain Syndrome ◽

Diabetic Foot Syndrome ◽

Military Medical Academy ◽

Results Of Treatment ◽

Medical Academy ◽

Invasive Method ◽

Short Time

The article presents an analysis of the results of treatment of a patient with purulent-necrotic complications of diabetic foot syndrome, who, in the framework of surgical treatment, used a minimally invasive method of treatment of purulent-necrotic complications of diabetic foot syndrome, developed at the departments of general surgery and normal anatomy of the S.M. Kirov Military Medical Academy. The effectiveness of the developed method has been demonstrated, which makes it possible to sanitize the purulent cavity in a short time, stop pain syndrome and restore the support ability of the foot (4 figs, 1 table, bibliography: 7 refs).

Download Full-text

Porous TiNi Implants in Surgery of Spine Degenerative Diseases

KnE Materials Science ◽

10.18502/kms.v2i1.816 ◽

2017 ◽

Vol 2 (1) ◽

pp. 334

Author(s):

A.E. Simonovich ◽

N.G. Fomichev

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Pain Syndrome ◽

Functional Results ◽

Spiral Ct ◽

Bone Block ◽

Results Of Treatment ◽

Block Formation ◽

Osteoplastic Material ◽

Metal Block

Objective. To evaluate the efficacy of using porous TiNi implants for interbody fusion in the treatment of lumbar spine degenerative diseases.Material and Methods. A total of 570 patients with degenerative lumbar spine disease were operated on with porous TiNi implants. Surgical treatment included stabilization and decompression and stabilization operations through posterior and anterior approaches and endoscopic transabdominal operations. Results of surgical treatment were followed-up for the period of 3 to 24 months. The change of pain syndrome was evaluated using a Visual Analogue Scale (VAS) and Oswestry Disability Index. The degree of interbody bone block formation was assessed based on X-ray and spiral CT data.Results. Functional results of treatment were evaluated at 18-24 months after surgery as good and satisfactory in 94.1% of cases, and the formation of interbody bone-metal block was noted in 94.8% of cases.Conclusion. Nikelid Titanium exhibits good osseointegration properties and can be used as osteoplastic material without additions of bone tissue, which simplifies operation, reduces its traumaticity, and provides good and satisfactory treatment results in 94.1% of cases.

Download Full-text

THE USE OF VARIOUS TECHNOLOGIES IN THE SURGICAL TREATMENT OF DECOMPENSATED FORMS OF VARICOSE VEINS OF THE LOWER EXTREMITIES WITH UNILATERAL VALVULAR INCOMPETENCE OF THE GREAT SAPHENOUS AND ANTERIOR ACCESSORY SAPHENOUS VEIN

Modern medical technologies ◽

10.34287/mmt.1(48).2021.10 ◽

2021 ◽

Vol 48 (1) ◽

Author(s):

O. V. Sokolov

Keyword(s):

Surgical Treatment ◽

Radiofrequency Ablation ◽

Varicose Veins ◽

Pain Syndrome ◽

Ulcer Recurrence ◽

Average Area ◽

Results Of Treatment ◽

Group I ◽

Group Ii ◽

One Year

Abstract Purpose of the study. Comparative evaluation of the results of treatment of patients with varicose veins (VVs) in stage C6, with the valve incompetence of the trunks of GSV and ASSV in one lower limb, by traditional venectomy and radiofrequency ablation (RFA). Materials and methods. The study was conducted on the basis of MI «RCH n.a. І.І. Mechnikov», MNE «CCH №16» DCC and MC «JMC Menorah» from 2010 to 2020 yy. Included 43 patients: women – 29 (67,4%), men – 14 (32,6%). Age - from 29 to 74 years (average – 52,7 ± 10,8 years). Patients are divided into 2 groups. The I group (n = 22) included patients who underwent traditional venectomy of GSV and ASSV, the II group (n = 21) – patients who underwent RFA under local anestesia. The observation lasted 12 months. Results. The average area of ulcers ranged from 1 to 12 cm2. The average area of ulcers in group I was 6,3 ± 3,1 cm2, in group II – 6,2 ± 2,7 cm2. Complete epithelialization of ulcers occurred faster with the use of RFA (group II) – 38,1 ± 5,7 days against 44,7 ± 6,2 days in group I. After 3 months. the number of healed ulcers in group I. was 20 (83,3%), in II – 24 (96,0%). Ulcer recurrence one year after surgery occurred in 4 (5,6%) patients of group I, in group II there were no recurrences. After 6 months the difference between the severity of CVI (VSS) was 10,5 ± 2,8 points in group I and 13,9 ± 2,2 points in group II. Conclusions. 1. Surgical treatment of VVs at unilateral defeat of GSV and ASSV with use of RFA differs in the better profile of a postoperative pain syndrome, less traumatism, has the best indicators of recovery in comparison with a traditional venectomy. 2. Treatment with RFA in comparison with traditional phlebectomy one year after surgery had an advantage in the number of recurrences of trophic ulcers Keywords: varicose veins, venectomy, radiofrequency ablation, trophic ulcers.

Download Full-text

Relationship of psychoalgological status and results of neurosurgical treatment of patients with discogenic radiculopathy

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2020-179-3-13-18 ◽

2020 ◽

Vol 179 (3) ◽

pp. 13-18

Author(s):

V. I. Leonov ◽

I. O. Kritskaya ◽

D. V. Svistov ◽

E. V. Litvinenko ◽

T. V. Sergeeva ◽

...

Keyword(s):

Surgical Treatment ◽

Pain Syndrome ◽

Life Assessment ◽

Long Term Results ◽

Discogenic Pain ◽

Neuropsychological Examination ◽

Patient Dissatisfaction ◽

Results Of Treatment ◽

Increased Risk ◽

Neurosurgical Treatment

The OBJECTIVE was to improve the results of surgical treatment of patients with discogenic radiculopathy by preoperative neuropsychological examination of patients with an increased risk of unsatisfactory outcome of the operation.METHODS AND MATERIALS. Neuropsychological status of 77 patients with discogenic radiculopathy in the preoperative period was studied. For this purpose, we assessed the intensity of pain, levels of personal and situational anxiety and the presence and severity of depression. The obtained data were compared with postoperative results of quality of life assessment for the main parameters, which include the level of pain and adaptation to daily activities.RESULTS. Data from neuropsychological tests were revealed, the presence of which in patients with discogenic pain syndrome suggests the risk of an unsatisfactory assessment of the operation performed by the patient. According to the long-term results of neurosurgical treatment, patients were divided into three groups: 1 – with a good result; 2 – patients with a number of preserved complaints, who rated the result of the operation as satisfactory; 3 – unsatisfactory outcome. In patients with unsatisfactory results of surgical treatment of discogenic radiculopathies with pain syndrome, patterns of psychological indices were found that were significantly associated with the outcome of treatment.CONCLUSION. Conducting a neuropsychological examination prior to surgery with the identification of predictors of chronic discogenic pain and patient dissatisfaction with the results of treatment can influence the surgical tactics and optimize the process of further treatment.

Download Full-text

Transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control in surgical treatment of hemorrhoids

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2020.11-12.62 ◽

2020 ◽

Vol 87 (11-12) ◽

pp. 62-66

Author(s):

A. A. Nykonenko ◽

G. I. Okhrimenko ◽

E. I. Haidarzhi ◽

N. G. Golovko ◽

I. V. Zubryk ◽

...

Keyword(s):

Surgical Treatment ◽

Postoperative Period ◽

Pain Syndrome ◽

Main Group ◽

Control Group ◽

Results Of Treatment

Objective. To study the immediate and late follow-up results of treatment in patients, suffering hemorrhoids, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was done, and to compare them with results of treatment in patients, operated in accordance to procedure of standard hemorrhoidectomy. Materials and methods. There were analyzed the results of treatment of 111 patients, suffering hemorrhoids. The main group have consisted of 50 patients, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was performed. Into control group 61 patients were included, who were operated in accordance to Parks procedure. Results. In the main group the average time of the operation have constituted (50.1 ± 1.4) min, the patient stationary stay - (9.9 ± 0.7) days, the pain syndrome intensity in postoperative period was estimated as 2 - 3 points, what have appeared significantly lesser, than in the control group of the patients (p < 0.01). Good late follow-up results were achieved in 100% patients of the main group and in 88% of the control group. Conclusion. There was established, that transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control permits to reduce essentially the average time of the operation, the patients’ stationary stay, to lower the pain syndrome intensity, and to improve late follow-up results of the hemorrhoids treatment.

Download Full-text

Acute Appendicitis: Approaches to Complex Surgical Treatment in Accordance with the Principles of Multimodal Surgical Strategy (Fast-Track Surgery)

Galician Medical Journal ◽

10.21802/gmj.2018.2.10 ◽

2018 ◽

Vol 25 (2) ◽

Author(s):

Adrian Kvit ◽

Olexiy Kushniruk

Keyword(s):

Surgical Treatment ◽

Acute Appendicitis ◽

Hospital Stay ◽

Laparoscopic Appendectomy ◽

Fast Track ◽

Pain Syndrome ◽

Surgical Trauma ◽

Fast Track Surgery ◽

Duration Of Hospital Stay ◽

Response To Stress

The objective of the research was to develop approaches to complex surgical treatment of patients with acute appendicitis taking into consideration the type of surgical approach, perioperative antibiotic therapy, adequate pain relief, duration of inpatient treatment. Materials and methods. The analysis of complex surgical treatment of the group of patients (31) with acute appendicitis, treated in the surgical departments of Lviv Emergency Hospital during 2017 was performed. The age of patients ranged from 18 to 77 years. There were 13 (41.9%) males and 18 (58.1%) females. Duration of hospital stay from the moment of hospitalization varied from 2 to 13 days. The level of pain sensation in patients was assessed on a 10-point visual analog scale of pain 6, 12 and 24 hours after surgery (with four-step stratification of the received data - absent (0-2), weak (3-4), moderate (5-8), strong (9-10 points). All the patients were divided into two groups using blind envelope technique: Group A included 18 patients, who underwent conventional appendectomy, and Group B comprised 13 patients who underwent diagnostic laparoscopy with the transition to laparoscopic appendectomy if the diagnosis of acute appendicitis was confirmed, or laparoscopic appendectomy was initially performed. The analysis of treatment efficacy was performed taking into account the dynamics of pain relief and the duration of inpatient treatment. Results and discussion. As a result of the conducted research it was stated that among all the patients examined, catarrhal acute appendicitis was found in 1 (3.2%) case, acute phlegmonous appendicitis was detected in 20 (64.5%) cases, acute gangrenous appendicitis was seen in 7 (22.6%) cases, acute gangrenous appendicitis with perforation and local peritonitis was diagnosed in 3 (9.7%) cases. Conventional appendectomy was performed in 18 cases; laparoscopic appendectomy was used in 13 cases. All the patients received anti-bacterial treatment in the early perioperative period. According to the prospective analysis, pain syndrome at the site of postoperative wounds was found to be present in patients of both groups. The intensity of pain syndrome was significantly lower in patients who underwent laparoscopic appendectomy. The analysis of treating patients with acute appendicitis allows confirming that the introduction of laparoscopic appendectomy into the complex of surgical treatment of patients with acute appendicitis can significantly reduce the body’s response to stress from surgical trauma and pain, speed up recovery due to early activation of the patient and maximally reduce the duration of hospital stay, which definitely corresponds to the modern principles of fast-track surgery. Conclusions. The use of laparoscopic appendectomy makes it possible to significantly reduce the body’s response to stress from pain and surgical trauma and is an important part of the formation of the patient’s general condition. Complex surgical treatment of patients with acute appendicitis using non-invasive techniques allows shortening the duration of hospital stay (4.62 ± 0.77 days) and reducing the period of disablement. The method of minimally invasive surgical interventions can be considered a “gold standard” for providing medical care to the patients with urgent surgical diseases of the abdominal cavity, which provides an optimal approach to surgical treatment.

Download Full-text

Lumbar Microdiscectomy. Retrospective Analysis of the Results of Treatment of 54 Patients

Visnyk Ortopedii Travmatologii Protezuvannia ◽

10.37647/0132-2486-2021-109-2-34-41 ◽

2021 ◽

pp. 34-41

Author(s):

D.V. Uleshchenko ◽

A.T. Stashkevych ◽

L.O. Bublyk ◽

A.V. Shevchuk

Keyword(s):

Surgical Treatment ◽

Retrospective Analysis ◽

Life Quality ◽

Pain Syndrome ◽

Radicular Pain ◽

Lumbar Pain ◽

Results Of Treatment ◽

Herniated Disk ◽

Poor Outcomes ◽

Surgery Department

Summary. Although the microdiscectomy techniques for surgical treatment of a herniated disk are improved, the share of poor outcomes after the lumbar pain syndrome treatment remains high. Objective: to improve the outcomes of patients with lumbar spine osteochondrosis complicated with a herniated disk. Materials and Methods. The retrospective analysis of 54 patients with a lumbar herniated disk, who underwent surgical treatment from 2019 till 2020 at the Spine Surgery Department of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine”. The age of patients varied from 23 to 78 years (mean age – 41.1±11.7 years). Results. We assessed the outcomes using VAS, Oswestry, and Nurick scales on the first day after the surgery, one month, and six months after it. VAS of the lower back pain syndrome declined on average from 5.9±1.59 to 3.4±1.55 on the first day after the surgery, to 1.7±1.1 in a month, and to 2.5±2.1 six months after the surgical treatment. The surgery eliminates radiculopathy and reduces radicular pain according to VAS on average from 8.5±1.17 to 1.3±1.04 on the first day after the surgery, to 1.5±1.0 in a month, and to 1.4±1.6 six months after it. The quality of life according to ODI improved on average from 74.4±5.12 before the surgery to 29.7±9.6 in a month and to 9.6±9.2 six months postoperatively. As of the discharge, 55.6% of patients demonstrated their nervous system's function recovered to the stage I and 38.9% – to the stage II. The long-term follow-up has shown positive dynamics in all the patients: the complete regress of neurologic symptoms in 74.4% and improved conditions – in 25.6% of patients. Conclusions. Surgical treatment of a herniated lumbar disk with the microdiscectomy method ensures the fulfillment of the fundamental nerve rootlet decompression by fenestrotomy, disctomy, or discectomy, and excision of the hernia, including sequestrated one. The positive dynamics of the pain syndrome scores, life quality, and neurological disorders is significant (р<0.05) and substantiates the efficiency of the treatment.

Download Full-text

SURGICAL TREATMENT OF HEMORRHOIDAL BLEEDING IN PATIENTS WITH CARDIOVASCULAR DISEASES UNDER ANTICOAGULANT AND ANTIPLATELET THERAPY

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2019-178-5-31-35 ◽

2019 ◽

Vol 178 (5) ◽

pp. 31-35

Author(s):

A. Z. Tsitskarava ◽

A. U. Korolkov ◽

G. G. Hubulava ◽

A. N. Demin

Keyword(s):

Surgical Treatment ◽

Cardiovascular Diseases ◽

Antiplatelet Therapy ◽

Antithrombotic Therapy ◽

Pain Syndrome ◽

Minimal Invasive ◽

Control Group ◽

Artery Ligation ◽

Results Of Treatment ◽

The People

The OBJECTIVE was to build an algorithm for medical and surgical treatment of hemorrhoidal bleedings in patients with cardiovascular diseases under anticoagulant and antiplatelet therapy.MATERIAL AND METHODS. The research was based on the analysis of results of treatment of hemorrhoidal bleedings in 86 patients with comorbidity (chronic combined hemorrhoids (2–4 stages) and cardiovascular diseases) under antiplatelet and antithrombotic therapy. Doppler-guided hemorrhoid artery ligation (with or without recto-anal repair) was used for the patients from the study group with no interrupting regular antiplatelet and anticoagulant therapy, whereas, in control group of patients, antithrombotic therapy was rejected for three to seven days in order to implementation of hemorrhoidectomy by Milligan – Morgan.RESULTS. The doppler-guided hemorrhoid artery ligation with recto-anal repair was a minimally invasive method without intra-operative blood loss with lowest pain syndrome at the short in hospital staying in comparison to hemorrhoidectomy by Milligan – Morgan. This fact determined the great clinical and economic effectiveness of the research method for the treatment of hemorrhoidal bleedings in patients with comorbidity.CONCLUSION. The minimal invasive surgical method of treatment hemorrhoidal bleedings – doppler-guided hemorrhoid artery ligation – could be used for patients with cardiovascular diseases and did not require interrupting anticoagulant and antiplatelet therapy.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.

Download Full-text

Lumbar periarticular cysts of arcorray joint

Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery) ◽

10.33920/med-01-2003-06 ◽

2020 ◽

pp. 47-57

Author(s):

Anton Yarikov ◽

Maxim Shpagin ◽

Iliya Nazmeev ◽

Sergey Gorelov ◽

Olga Perlmutter

Keyword(s):

Minimally Invasive ◽

Severe Pain ◽

Pain Syndrome ◽

Long Term Results ◽

Lumbar Region ◽

Results Of Treatment ◽

Invasive Method ◽

Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

Download Full-text

Extrapulmonary Small Cell Cancer: A New Insight into a Rare Disease

Oncology ◽

10.1159/000514520 ◽

2021 ◽

pp. 1-7

Author(s):

Leora Brazg Ferro ◽

Ido Wolf ◽

Shira Peleg Hasson ◽

Inbal Golomb ◽

Ester Osher ◽

...

Keyword(s):

Brain Metastases ◽

Response Rate ◽

Medical Center ◽

Cell Cancer ◽

Small Cell ◽

Ki 67 ◽

Small Cell Cancer ◽

Pathological Characteristics ◽

Results Of Treatment

Introduction: Extrapulmonary small-cell cancer (EPSCC) is a relatively rare malignancy. The management of EPSCC is usually extrapolated from small-cell lung cancer (SCLC). In spite of the morphological similarity of the 2 malignancies, there are many differences in clinical features, prognosis, and recommendations of treatment of these disorders. The data on the correlation of clinical-pathological characteristics of EPSCC and treatment results is scarce. Materials and Methods: This retrospective analysis of 41 consecutively treated patients diagnosed with EPSCC in 2015–2018 was performed in a tertiary medical center. The correlation between the clinical and pathological characteristics and the treatment outcome (response rate, disease-free interval, and overall medial survival) was done using the standard statistics, Kaplan-Meier method, and multivariate analyses. The stratification was done on the stage of the disease, Ki-67 proliferative index, the location of the tumor, and smoking. Results: Forty-one patients were included with a median age of 66.3 years. The most common primary site was the gastrointestinal tract (28, 68.3%) including the pancreas. The most common distant metastasis site was the liver (23, 56.1%). Only 2 patients (4.9%) had brain metastases. Unlike in SCLC, most patients did not have any history of smoking (23, 56.1%). Nineteen patients with metastatic disease received systemic treatment, mostly cisplatin-based chemotherapy, with a response rate of 57.9%. The results of treatment were significantly better in patients with disseminated EPSCC with Ki-67 <55%, while its role in limited disease was nonsignificant. Discussion: The results of our study show the unique entity of EPSCC. The rarity of brain metastases proves that prophylactic brain irradiation should not be recommended in practice. The provocative idea of prophylactic liver irradiation in limited-stage EPSCC of gastrointestinal origin can be evaluated in future studies. The predictive role of Ki-67 is important in metastatic EPSCC. There is probably no role of smoking in developing EPSCC.

Download Full-text