DIAGNOSIS AND RECONSTRUCTIVE MICROSURGERY IN CASE OF THE LYMPHATIC SYSTEM LESION OF THE UPPER LIMB AFTER MASTECTOMY

2018 ◽  
Vol 64 (2) ◽  
pp. 211-217
Author(s):  
Vladimir Ivashkov ◽  
Vladimir Sobolevskiy ◽  
Yuriy Yegorov ◽  
Olga Krokhina
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Indocyanine Green ◽  
Treatment Algorithm ◽  
Early Period ◽  
Long Term Results ◽  
Complex Treatment ◽  
Results Of Treatment

Purpose: To improve the results of treatment of secondary lymphatic edema in patients after complex treatment of breast cancer and to introduce a method of fluorescent lymphography to assess the stage of lymphedema. Materials and methods: The analysis of the results of examination and treatment of female patients with secondary lymphatic edema of the upper limbs, which appeared after the complex treatment of breast cancer in 2012-2016 was performed. To estimate the prevalence and stage of lymphatic edema all patients underwent fluorescent lymphography with indocyanine green. Based on fluorescent lymphography for each patient treatment algorithm was individually substantiated. Of 40 patients with secondary lymphatic edema 20 (50%) patients underwent surgical and 20 (50%) conservative treatment. The results were divided into early (up to 6 months) and long-term results (6-12 months). Results: In the early period after treatment (up to 6 months) the results of treatment in the surgical and conservative groups were comparable. Long-term results (6-12 months) were significantly higher in the group of patients after inguinal lymph node transplantation in combination with conservative methods than the isolated use of conservative methods. Conclusion: The method of fluorescent lymphography with indocyanine green is modern and accurate for the diagnosis of lymphatic edema. It allows determining the stage and prevalence of lymphatic edema. It is an indispensable tool for visualization of lymph nodes in the allocation of the inguinal lymphatic flap and postoperative control of the functional activity of the transplanted lymph nodes. The combination of lymph node transplant with conservative therapy gives better results than the isolated use of conservative methods.

The use of Dimexide in the complex treatment of Peyronie's disease

1980 ◽  
Vol 61 (6) ◽  
pp. 53-54
Author(s):  
M. G. Muhamadeev ◽  
M. P. Trofimova
Keyword(s):  
Clinical Manifestations ◽  
Disease Recurrence ◽  
Peyronie’S Disease ◽  
Long Term Results ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Peyronie's Disease

We observed 9 patients with plastic induration of the penis (Peyronie's disease), 3 of them interrupted treatment. Long-term results of treatment were traced in 6 patients (age - from 48 to 60 years): in 5 patients, complaints and clinical manifestations of disease recurrence were not noted for 2-4 years.

scholarly journals THE MODERN VIEW ON THE COMPLEX TREATMENT OF PATIENTS WITH UTERINE FIBROIDS

2010 ◽  
Vol 1 (3) ◽  
pp. 15-20
Author(s):  
S A Levakov ◽  
A G Kedrova ◽  
K V Kojurina ◽  
N S Vanke
Keyword(s):  
Uterine Artery ◽  
Combined Therapy ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Long Term Results ◽  
Complex Treatment ◽  
Female Pelvis ◽  
Results Of Treatment ◽  
Risk Of Relapse

Uterine fibroids are the most common solid tumours in the female pelvis. The purpose was to examine the long term results of treatment uterine myoma through combined therapy in 54 patients. To assess the reproductive health of patients with uterine fibroids after treatment included to use ana logues of gonadotropinreleasing hormone (GnRH) with or without embolization of uterine artery(UAE) and myomectomies. . The introduction of gonadotrophinreleasing hormone agonists (GnRHa) has been found to be useful in the management of patients of reproductive age with uterine fibroids for minimization of risk of relapse.

scholarly journals ALGORITHM OF COMPLEX TREATMENT OF DESTRUCTIVE FORMS OF PULMONARY TUBERCULOSIS AND ITS RATIONALE

2021 ◽  
Vol 19 (1) ◽  
pp. 36-39
Author(s):  
Yu. A. Sheifer ◽  
◽  
I. S. Gelberg ◽  
Keyword(s):  
Drug Resistance ◽  
Pulmonary Tuberculosis ◽  
Comparison Group ◽  
Main Group ◽  
Long Term Results ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Artificial Pneumothorax ◽  
Cavity Closure

Background. In destructive forms of pulmonary tuberculosis, especially in the presence of drug resistance of mycobacteria, one of the ways to increase the effectiveness of therapy is the use of collapse therapeutic techniques in various modifications. Purpose of the study: to develop and substantiate an algorithm for complex treatment of destructive forms of pulmonary tuberculosis, using artificial pneumothorax (AP). Material and methods: A cohort of 84 people with destructive pulmonary tuberculosis was formed. It was divided into two groups: 42 patients in the main group (chemotherapy (ChT) + AP) and 42 in the comparison group (ChT). Results: an algorithm for the treatment of patients with destructive forms of pulmonary tuberculosis was formulated. Within a period of up to 6 months, abacillation was achieved in 61.9% of cases in the main group (MG), and in 18.9% (p <0.05) in the comparison group (CG). By the 10th month of treatment, the closure of decay cavities was achieved in 78.7% of cases in the MG and in 42.8% (p <0.05) in the CG. By 12 months the closure of decay cavities was observed in 92.1 and 52.4% of cases respectively (p <0.05). Conclusions: The use of the algorithm for the complex treatment of destructive forms of pulmonary tuberculosis makes it possible to achieve abacillation at an earlier time (up to 6 months - in 61.9%). It also allows to increase the frequency of cavity closure by 39.6% as well as achieve an increase in clinical cure (according to long-term results of treatment) by 23.8% and a decrease in the amplification of drug resistance and mortality by 14.3% and 11.9% correspondingly.

P14.53 Immunotherapy in the complex treatment of HGG

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii47-ii48
Author(s):  
A Rynda ◽  
V Olyushin ◽  
D Rostovtsev
Keyword(s):  
Malignant Gliomas ◽  
Long Term Results ◽  
Complex Treatment ◽  
Average Life ◽  
Average Life Expectancy ◽  
Standard Methods ◽  
Results Of Treatment ◽  
Antitumor Immunotherapy

Abstract BACKGROUND To improve the long-term results of complex treatment of patients with malignant gliomas MATERIAL AND METHODS The long-term results of treatment of 220 patients with malignant gliomas of supratentorial localization (anaplastic astrocytomas, glioblastomas, giant cell glioblastomas, gliosarcomas) were evaluated. Of these patients, in addition to standard treatment methods (surgery, radiation therapy and chemotherapy), 110 patients underwent specific antitumor immunotherapy. In 110 patients, only standard methods were used in the complex treatment structure. Follow-up results were considered follow-up data, and a relapse-free period was also evaluated. RESULTS The implementation of specific antitumor immunotherapy in patients with malignant gliomas was safe and did not lead to an increase in the number of complications compared with the control group. It was revealed that the use of immunotherapy based on autologous dendritic cells, in addition to standard methods of treating patients, increases the average life expectancy (in patients with anaplastic astrocytomas up to 40.5 months (p = 0.001), in patients with glioblastomas up to 21.8 months (p = 0.002)) and the value of the relapse-free period (in patients with anaplastic astrocytomas up to 17.4 months (p = 0.002), in patients with glioblastomas up to 14.3 months (p = 0.003)), provided that three or more courses are carried out. Conducting 1 or 2 courses of immunotherapy does not significantly affect the average life expectancy and median survival of patients. CONCLUSION The development and use in clinical practice of specific antitumor immunotherapy based on autologous dendritic cells seems to be a very promising direction for further research, the development of which will improve the long-term results of treatment of patients.

scholarly journals Long-term results of treatment for patients with locally advanced external ear skin cancer

2021 ◽  
Vol 11 (1) ◽  
pp. 12-23
Author(s):  
A. M. Mudunov ◽  
E. G. Khazarova ◽  
M. V. Bolotin
Keyword(s):  
Skin Cancer ◽  
Temporal Bone ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Long Term Results ◽  
External Ear ◽  
Complex Treatment ◽  
Free Survival ◽  
Results Of Treatment

The study objective is to assess long-term results of treatment for patients with locally advanced external ear skin cancer.Materials and methods. This research work based on a retrospective and prospective analysis case history for patients with locally advanced external ear skin cancer. These are 45 patients, who received treatment in surgical department of head and neck tumors in Blokhin National Medical Research Center of Oncology between 1994 and 2020. Patient observation time averaged 30.0 ± 32.3 months (from 0.7 to 117.4 months, median 12.0 months). We divided patients into 3 groups depending on treatment methods. Group 1 consisted of patients who received combined or complex treatment (33.3 %, n = 15). Treatment for first group patients involved subtotal, lateral temporal bone resection or incomplete lateral resection and postoperative radiation therapy on the area of primary tumor and regional metastasis zone (total focal dose from 60 Gy). In the case of complex treatment, radiation therapy had carried out against background cisplatin introduction. The second group consisted of patients who received only surgical treatment (40.0 %, n = 18). Temporal bone resections were not performed for patients of the third group (26.7 %, n = 12). Treatment for patients of the third group involved one of the treatment methods: cryodestruction, laser destruction, photodynamic therapy, radiotherapy or chemoradiation treatment.Results. Five-year survival without signs of progression in a group of patients with locally advanced of the ear skin cancer, who received combined or complex treatment was 73.8 ± 13.1. Median progression-free survival not achieved. In the surgical treatment group 5 year progression-free survival was 40.4 ± 13.0, median was 34.1 months. In a group of patients who did not undergo temporal bone resection (3rd group) median progression-free survival was 4.5 months. Group differences are statistically significant (p <0.05). The most significant adverse prognosis factors that reduce overall survival for patients with locally advanced external ear skin cancer are positive histological margin (p = 0.0001, hazard ratio (HR) = 10.611, 95 % confidence interval (CI) 3.058-36.820), signs of destruction branch of the lower jaw/ zygomatic bone (p = 0.027, HR = 4.65, 95 % CI 1.193-18.116). Facial paralysis is the most unfavorable prognosis factor, reducing tumor-specific survival in patients with locally advanced outer ear skin cancer (p = 0.0001, HR = 19.146, 95 % CI 4.056-90.388).Conclusion. Combined/complex treatment of patients with locally advanced ear skin cancer (surgery with postoperative radiotherapy/chemoradiotherapy) provides better long-term results compared to other treatment options.

scholarly journals Az indociánzöld-fluoreszcencia hasznosítása az emlőrák miatt végzett őrszemnyirokcsomó-biopsziában

2021 ◽  
Vol 162 (8) ◽  
pp. 293-297
Author(s):  
László Venczel ◽  
Róbert Maráz ◽  
Éva Ambrózay ◽  
Gábor Cserni ◽  
László Sikorszki
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Indocyanine Green ◽  
Detection Rate ◽  
Sentinel Lymph Nodes ◽  
Blue Dye ◽  
Green Fluorescence ◽  
Indocyanine Green Fluorescence

Összefoglaló. Bevezetés: Napjainkban az őrszemnyirokcsomó felkeresésének legelterjedtebb módszere a radioizotópos és kék festékes kettős jelölés, emellett azonban több más jelölés is alkalmazható. Az indociánzöld-fluoreszcencia ígéretes nyirokút-térképezési módszer, mely a találati arányát tekintve – irodalmi adatok alapján – összevethető a radioizotópos módszerrel. Módszer: Osztályunkon 2020. 03. 31. és 2020. 04. 15. között 10, emlőrák miatt operált betegünknél alkalmaztuk az indociánzöld és a kék festékes kettős jelölés módszerét az őrszemnyirokcsomó felkeresésére. Eredmények: A 10 operált betegünknél összesen 17 őrszemnyirokcsomót azonosítottunk és távolítottunk el. 16 őrszemnyirokcsomó jól festődött indociánzölddel (találati arány: 0,94; 95%-os konfidenciaintervallum [CI ]: 0,73–0,99), míg kék festékkel 9 jelölődött (találati arány: 0,53; 95%-os CI: 0,31–0,74). A szövettani feldolgozás során összesen 2 őrszemnyirokcsomó bizonyult áttétesnek, ezek közül 1 kék és fluoreszcens volt, 1 pedig csak kék festékkel jelölődött. Következtetés: Kezdeti, kis esetszámnál nyert tapasztalataink alapján az indociánzöld jelölés emlőrák során végzett őrszemnyirokcsomó-biopszia esetén jól használható kettős jelölési módszer részeként, kék festékkel kiegészítve. A módszer találati aránya, valamint fals negatív aránya irodalmi adatok alapján nem különbözik szignifikánsan a radioizotópos jelölés módszerétől. Orv Hetil. 2021; 162(8): 293–297. Summary. Introduction: The current practice in sentinel lymph node biopsy for breast cancer is the radioisotope and blue dye dual labelling technique, however, other mapping methods are also available. Indocyanine green fluorescence is one of the best alternatives of the standard technique, with detection rates comparable to those of the radioisotope method. Method: Between 31. 03. 2020 and 15. 04. 2020, a total of 10 sentinel lymph node biopsies for breast cancer were performed using the indocyanine green fluorescence and blue dye dual technique. Results: 17 sentinel lymph nodes were detected and removed in total, from which 16 showed explicit fluorescence activity (detection rate: 0.94; 95% confidence interval [CI]: 0.73–0.99), whilst 9 where blue (detection rate: 0.53; 95% CI: 0.31–0.74). During histopathological examination, 2 sentinel lymph nodes proved to be metastatic, from which 1 was fluorescent and blue, the other was blue only. Conclusion: Regarding our early experience based on a small number of patients, indocyanine green fluorescence, used together with blue dye as part of a dual technique, is a usable method for sentinel lymph node mapping. Based on data from the literature, the detection rate and the false-negative rate of the indocyanine green fluorescence method shows no significant difference from the radioisotope mapping technique. Orv Hetil. 2021; 162(8): 293–297.

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