PROSPECTIVE NON-RANDOMIZED CASE-CONTROL STUDY: IMMEDIATE RESULTS OF RADICAL LAPAROSCOPIC INTERVENTIONS FOR GASTRIC CANCER, THE EXPERIENCE OF A SINGLE CENTER

2017 ◽  
Vol 63 (2) ◽  
pp. 247-255
Author(s):  
Aleksey Karachun ◽  
Yuriy Pelipas ◽  
Pavel Sapronov ◽  
O. Kozlov ◽  
D. Asadchaya
Keyword(s):  
Gastric Cancer ◽  
Tnm Classification ◽  
Long Term Results ◽  
Control Group ◽  
R0 Resection ◽  
7Th Edition ◽  
Results Of Treatment ◽  
Oncology Center

The aim of this study was to define safety and oncological adequacy of radical laparoscopic interventions in gastric cancer (GC) in the conditions of a specialized oncology center. Materials and methods. The study included 193 (108 men and 85 women) with a histologically verified gastric adenocarcinoma of varying degrees of differentiation or cricoid-cell carcinoma with stage T1b-T4a cN0-N1 according to the UICC / TNM classification (7th edition). The study was prospective. The main group (laparoscopic interventions) included 81 patients: 54 underwent distal subtotal resections of the stomach (DSRS) and 27 underwent gastrectomies (GE); 101 patients (66 DSRSs and 35 GEs) contained the control group (open interventions). Separate group of 11 patients were with a conversion access. Results. The average duration of the laparoscopic DSRS was 209.6 ± 50.4 minutes, the open DSRS - 168.9 ± 44.1 minutes (p <0.05). The mean duration of laparoscopic GE was 241.7 ± 60.3 min, while the open GE was 185.1 ± 48.9 min (p <0.05). The average volume of intraoperative blood loss for laparoscopic DSRS was 100 ± 65.4 ml, with open DSRS - 217.4 ± 102.5 ml (p <0.05) and for laparoscopic and open GE it was 105.5 ± 45.2 ml and 247.1 ± 87.4 ml, respectively (p <0.05). The average number of removed lymph nodes in laparoscopic DSRS was 24,7 ± 5,1, with open DSRS - 25,4 ± 6,7 (p> 0,05), while in laparoscopic and open GE it was 25,1 ± 6, 4 and 26.8 ± 5.3, respectively (p> 0.05). In all cases of laparoscopic interventions R0 resection was performed. In the structure of postoperative complications the specific gravity of severe complications (IIIb - V degree according to the classification of Clavien-Dindo) in the subgroup of laparoscopic DSRS was 5.6%, in the subgroup of open DSRS - 6% (p> 0.05), and in subgroups of laparoscopic and open GE - 11.1% and 8.6%, respectively (p> 0.05). Postoperative lethality in the group of laparoscopic interventions was 1.2%, in the open surgery group - 2.9% (p> 0.05). The analysis of training curves in the performance of laparoscopic interventions demonstrated that the experience of 30 laparoscopic DSRSs and 15 laparoscopic GEs did not allow promoting an access to the plateau but it demonstrated the trend in reducing the duration of operations when accumulating experience. Conclusions. Radical laparoscopic operations for stomach cancer are safe and oncologically adequate. The absence of long-term results of treatment dictates the necessity of continuing the study.

scholarly journals Long-term results of treatment of pharmacoresistant temporal lobe epilepsy

2021 ◽  
Vol 23 (3) ◽  
pp. 23-29
Author(s):  
V. V. Krylov ◽  
A. B. Gekht ◽  
I. S. Trifonov ◽  
O. O. Kordonskaya ◽  
M. V. Sinkin
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Long Term Results ◽  
Control Group ◽  
Pharmacoresistant Epilepsy ◽  
Conservative Group ◽  
Results Of Treatment ◽  
The Mean ◽  
Group 2

The aim of the study wasto evaluate the long-term results ofsurgicaltreatment of patients with pharmacoresistant epilepsy.Materials and methods. A retrospective analysis of treatment outcomes in patients with drug-resistant temporal lobe epilepsy was performed. According to the inclusion and exclusion criteria, 96 patients were selected for the study. Group 1 contained 49 operated patients with MR-positive epilepsy and Group 2 contained 47 operated patients with MR-ne‑ gative epilepsy. The control group consisted of 53 unoperated patients. The outcomes ofsurgical treatment were assessed after 6, 12, and 24 months. Results. Unfavorable outcomes occurred more frequently among nonoperated patients compared to both surgical groups (p <0.001). The probability of the 2-year remission after surgery in operated MRI positive patients was 60 %, in MRI negative group was 45 %, and in conservative group – only 2 %. The mean duration of the seizures-free period was greatest̆in the MRI positive surgical group (15.4 ± 1.5 months), and shortest in the control group (3.3 ± 0.9 months).Conclusion. The presented results prove the effectiveness and safety of surgical treatment of patients with temporal lobe epilepsy.

scholarly journals Modern principles of hepatocellular carcinoma treatment

2020 ◽  
Vol 25 (2) ◽  
pp. 15-26
Author(s):  
V. A. Vishnevsky ◽  
Kh. A. Ayvazyan ◽  
R. Z. Ikramov ◽  
D. A. Ionkin ◽  
O. I. Zhavoronkova ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Outcomes ◽  
Long Term Results ◽  
R0 Resection ◽  
Actuarial Survival ◽  
Results Of Treatment ◽  
Unresectable Tumor ◽  
Advanced Tumor ◽  
Group I

Aim. To improve the treatment outcomes, quality and life expectancy, prognosis in patients with hepatocellular carcinoma based on an analysis of treatment outcomes.Materials and methods. The analysis of the long-term results of treatment of 114 patients with hepatocellular carcinoma for 2015–2020 was carried out. Two groups of patients were distinguished: 41 (35.9%) patients were included in group I (a potentially resectable tumor with R0 surgery), and 63 (55.2%) patients were included in group II (advanced tumor does not suggest R0 resection).Results. Actuarial survival for patients with R0 surgery (48) was: 1 year – 85%, 3 years – 65%, 5 years – 55%; in patients with unresectable tumor after transarterial chemoembolization: 1 year – 65%, 3 years – 29%, 5 years – 11%; after local destruction methods – 0.5 years – 75%, 1 year – 36%, 1.5 years – 22%.Conclusions. The results of treatment of patients with hepatocellular carcinoma confirm the feasibility and effectiveness of a rational multidisciplinary approach. It allows you to achieve satisfactory results in multidisciplinary hospitals. The results are consistent with the data of large surgical centers.

scholarly journals The Results of Cytoreductive Operations in Patients with Colorectal Cancer with Simultaneous Liver Polymetastases

2018 ◽  
Vol 3 (2) ◽  
pp. 54-59
Author(s):  
SV V Kozlov ◽  
OI I Kaganov ◽  
AE E Orlov ◽  
AM M Kozlov
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Metastases ◽  
Cytoreductive Surgery ◽  
Stage Iv ◽  
Long Term Results ◽  
Control Group ◽  
Results Of Treatment ◽  
Cytoreductive Treatment

Aim - to improve the long-term results of cytoreductive treatment of patients with simultaneous multiple bilobar liver metastases of colorectal cancer by the use of RFTA. Materials and methods. The study presents the results of treatment of 168 patients diagnosed with colorectal cancer of stage IV with simultaneous bilobar metastases in the liver. In the main group, cytoreductive tumor removal was accompanied by radiofrequency thermal ablation (RFTA) of metastatic formations. In the control group only the primary tumor was removed. Results. The use of RFTA during cytoreductive surgery does not worsen the immediate results of surgical treatment, in comparison with patients, where the effect on liver metastases has not been performed, but allows to increase medians of uneventful and overall survival from 9 and 22 months to 17 and 29 months, respectively. Conclusions. The use of RFTA for simultaneous multiple bilobar metastases in the liver during cytoreductive surgery makes it possible to achieve 22.7% of the three-year uneventfulness and 4.3% of the five-year overall survival.

scholarly journals WAYS TO IMPROVE RESULTS OF ENDOSURGICAL TREATMENT OF ACHALASIA

2020 ◽  
pp. 5-9
Author(s):  
O. V. Galimov ◽  
V. O. Khanov ◽  
M. R. Bakirov ◽  
R. R. Saifullin ◽  
D. O. Galimov
Keyword(s):  
Distal Part ◽  
New Technologies ◽  
Esophageal Achalasia ◽  
Original Method ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Medical University ◽  
Oncology Center

Aim. To improve the method of Heller cardiomyotomy for best immediate and long-term results of treatment of esophageal achalasia.Materials and methods. Analyzing the results of surgical treatment of 280 patients with esophageal achalasia who were treated in the Department of Surgical Diseases and New Technologies of the Bashkir State Medical University (Ufa) and the Department of Surgery and Stomach of the Republican Clinical Oncology Center (Kazan) for a period from 2000 to 2019. We conducted a cohort retrospective study in 2 groups (laparoscopic esophagocardiomyotomy according to Heller, supplemented by anterior modified hemifundoplication according to Dor (n = 74) and traditional laparoscopic interventions (n = 206).Results. The authors have developed an original method of laparoscopic esophagocardiomyotomy, including the use of devices that facilitate the mobilization of cardia and the formation of fundoplication cuffs. Patients were examined by performing esophagogastroduodenoscopy, contrast X-ray scopy of the esophagus and stomach, esophagomanometry, pH-measurement in distal part of esophagus. Long-term results of up to 2 years were tracked. Surgically treated patients were tested by special application forms. Received results showed the restoration of quality of life in most of the subjects.Conclusion The developed technique of laparoscopic esophagocardiomyotomy, including the use of intra-esophageal transillumination and a device for measuring the esophagus, prevents damage to the esophagus wall and postoperative complications associated with insufficient or excessive narrowing of the esophagus. Of the 74 patients, 66 (89.2 %) rated the result as excellent and good, 6 (8.1 %) as satisfactory, and 2 (2.7 %) as unsatisfactory.

scholarly journals Epidemiology and Surgical Treatment of Gastric Cancer in Latvia

2009 ◽  
Vol 63 (4-5) ◽  
pp. 249-252
Author(s):  
Armands Sīviņš ◽  
Jānis Misiņš ◽  
Corrado Pedrazzani ◽  
Guntis Ancāns ◽  
Aivars Stengrēvics ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Long Term Results ◽  
R0 Resection ◽  
Curative Intent ◽  
Operative Complications ◽  
Short And Long Term ◽  
Oncology Centre ◽  
Histopathologic Confirmation

Epidemiology and Surgical Treatment of Gastric Cancer in Latvia The aim of the study was to evaluate short- and long-term results of surgical treatment of gastric cancer performed in Latvia Oncology Centre. Retrospectively data was collected from 461 patients who underwent gastrectomy with curative intent in the Latvia Oncology Centre from January 2001 to December 2005. The data was subjected to statistical analysis. On average, 92.2 (range 81-102) R0-R1 gastrectomies were performed each year. Post-operative complications occurred in 75 patients (16.3%); in-hospital mortality was 3.3%. The overall 5-year survival was 50.8%. In 444 cases (96.3%) there was histopathologic confirmation of R0-resection with a 5-year survival of 52.5% (P < 0.001). Considering pT category, 5-year survival (median) was 88.6% (not reached) for pT1 patients, 65% (not reached) for pT2, 42.3% (35.7 months) for pT3 and 27% (14.2 months) for pT4 (P < 0.001). Considering the pN category, 5-year survival (median) was 67% (not reached) for pN0 patients, 30% (22.1 months) for pN1 and 29% (14.2 months) for pN2-3 (P < 0.001). Short- as well as long-term results are comparable with Western experiences, but not for pN+ patients where no difference between pN1 and pN2 cases was observed.

LONG - TERM RESULTS FROM CURABLE GASTRECTOMY AND D2, D3 LYMPHADENECTOMY IN GASTRIC CANCER TREATMENT

2012 ◽  
pp. 80-85
Author(s):  
Manh Ha Le ◽  
Quang Bo Nguyen
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Tnm Classification ◽  
Subtotal Gastrectomy ◽  
Long Term Results ◽  
D3 Lymphadenectomy ◽  
Third Stage ◽  
Keywords Gastric Cancer ◽  
Centre Hospital

Objectives: Evaluation of pathological characteristics, motality rate and five-year survival rate from curable gastrectomy and D2, D3 lymphadenectomy in gastric cancer at Hue Centre Hospital. Materials and methods: Consist of 119 patients underwent curable gastrectomy and D2, D3 lymphadenectomy from May 2005 to May 2012. Results: Age: average 56.2 ± 11.8 (19-81), male/female 1.83/1. Distal subtotal gastrectomy 88.24%, total gastrectomy 7.56%, proximal subtotal gastrectomy 4.2% Lymphadenectomy: D2 62.18%, D3 37.82%. TNM classification: first stage 4.20%, second stage 29.41%, third stage 61.34% và fourth stage 5.04%. Intraoperative splenic rupture was the most common 5.88%, overall five-year survival rate 28.8%, overall D2 five-year survival rate 47.9%; overall D3 five-year survival rate 63.1% (not significant with p = 0.1137) and non relatively operative motality. Conclusion: Curable gastrectomy and D2, D3 lymphadenectomy in gastric cancer is safety, five-year survival rate is long-term, and oncologically effective procedure. Keywords: Gastric cancer, Gastrectomy, D2, D3 Lymphadenectomy. Key words: Gastric cancer, Gastrectomy, D2, D3 Lymphadenectomy

scholarly journals STATE OF PROSTHETIC BED TISSUES AND LONG-TERM RESULTS OF DENTAL PROSTHETICS IN PATIENTS WITH DISEASES OF THE HEPATOBILIARY SYSTEM

2020 ◽  
Vol 16 (3) ◽  
pp. 147-154
Author(s):  
konstantin Koshelev ◽  
Nikolay Belousov ◽  
Ekaterina Pushkareva ◽  
Ilya Baranov
Keyword(s):  
Biliary Tract ◽  
Dental Treatment ◽  
Modern Medicine ◽  
Diagnostic Methods ◽  
Long Term Results ◽  
Control Group ◽  
Results Of Treatment ◽  
Hepatobiliary System ◽  
Biliary Tract Diseases

Background. Predicting the immediate and long-term results of treatment is an urgent problem of modern medicine. The prognosis of complex dental treatment is influenced by many factors. Among the main ones: features of the individual's anatomy and physiology, the type and method of the chosen treatment, the doctor's qualification, features of the patient's psychological profile, the presence of concomitant pathology, and so on. Each of the factors must be considered separately to understand the mechanism and the strength of its impact. Relevance. Finding out the influence of diseases of the hepatobiliary system on the prognosis of dental orthopedic treatment. Objectives. We studied the indicators of patients who re-applied for replacement of an existing dental prosthesis. The study group consisted of patients with liver and biliary tract diseases, and the control group consisted of patients without concomitant General somatic pathology. The terms of use of the prosthesis, the number and severity of treatment complications, and the state of the prosthetic bed were evaluated. Standard clinical and paraclinical diagnostic methods, corresponding pathology, cone-beam computed tomography and statistical analysis methods were used as research methods. Results. The correlation of the terms of use of various types of dentures with the presence of liver and biliary tract diseases in the anamnesis was determined. The dependence of the structure of bone tissue and its density on the presence of the considered pathology was revealed. Conclusion. The obtained data can be applied by orthopedic dentists in the near and long-term prognosis of the result of treatment of patients with partial loss of teeth and concomitant diseases of the hepatobiliary system.

scholarly journals LONG-TERM RESULTS AFTER BONE PLASTY AT KNEE REPLACEMENT

2010 ◽  
Vol 16 (3) ◽  
pp. 21-27
Author(s):  
R. M. Tikhilov ◽  
A. V. Kazemirsky ◽  
P. M. Preobrazhensky ◽  
I. I. Kroitoru ◽  
T. A. Kulyaba ◽  
...  
Keyword(s):  
Standard Technique ◽  
Long Term Results ◽  
Control Group ◽  
Control Groups ◽  
Aseptic Necrosis ◽  
Joint Replacements ◽  
Results Of Treatment ◽  
Significant Difference ◽  
And Control

From 1999 to the present time in the Russian RITO n.a. R.R. Vreden 28 knee joint replacements were performed using bone autoplasty in patients with stage V aseptic necrosis of the tibial condyles. The control group included 150 patients who underwent knee arthroplasty using a standard technique. All the patients were monitored in the preoperative and postoperative periods in time from 3 to 7 years. Results of treatment were assessed using a 100-point Josef and Kaufman scale, as well as the scale of WOMAC. Among the patients were 128 (71,9%) women and 50 (28,1%) males, mean age was 67 years old. If comparing experimental and control groups in the preoperative period showed a significant difference, the postoperative results were identical. Bone autotransplantation during arthroplasty of the knee is a simple and effective method used in large defects condyles of the femur and tibia (more than 1/3 of the condyle, the depth of the defect over 10 mm).

MODIFIED LAPAROSCOPIC ESOPHAGOGASTRIC DEVASCULARIZATION

2021 ◽  
Vol 19 (4) ◽  
pp. 434-443
Author(s):  
E. V. Mohiliavets ◽  
Keyword(s):  
Esophageal Varices ◽  
Standard Technique ◽  
Long Term Results ◽  
Control Group ◽  
Recurrent Bleeding ◽  
Results Of Treatment ◽  
General Surgeons ◽  
Endoscopic Sclerosis ◽  
Technological Methods

Background. Transabdominal gastroesophageal devascularization is a technically feasible backup operation for most general surgeons in case of failure of endoscopic prophylaxis of bleeding from esophageal varices. There is an emerging trend in the development of laparoscopic technologies in the surgical correction of complications of portal hypertension. Purpose. Assessment of the clinical efficacy of laparoscopic esophagogastric devascularization in its own modification. Material and methods. In the period from 2009 to 2020, the results of treatment of 31 patients were studied. The patients were divided into 2 groups by the method of simple randomization. In the control group, surgery was performed in a standard way, in the main group - in the modification we proposed. Results. The use of our proposed technological methods when performing the stage of transection of the abdominal esophagus during laparoscopic esophagogastric devascularization in its own modification reduced the frequency of technical difficulties at this stage, which caused conversions, anastomotic leakage and other intra and postoperative complications. In the long-term period, there was a decrease in the degree of esophageal varices, a decrease in the frequency of recurrent bleeding and mortality, as well as an improvement in the quality of life in patients after a modified operation in comparison with the standard technique. Laparoscopic esophagogastric devascularization in our modification shows better results as a method of secondary prevention of bleeding from esophageal varices in cirrhosis of the liver in patients with a high risk of recurrence than the use of endoscopic sclerosis of esophageal varices, is characterized by a lower incidence of repeated episodes of bleeding from esophageal varices and less lethality. Conclusions. Based on the analysis of the immediate and long-term results of the use of laparoscopic esophagogastric devascularization in its own modification in the clinic, it should be noted the reproducibility of the surgical intervention, its effectiveness and safety.

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