scholarly journals RETROSPECTIVE STUDY AND CURRENT REALITIES AND POSSIBILITIES OF SURGICAL TREATMENT OF OVARIAN CANCER

2020 ◽  
pp. 201-207
Author(s):  
S. M. Kartashov ◽  
T. V. Bazarіnska ◽  
M. Ye. Tymchenko ◽  
S. M. Gramatyuk
Keyword(s):  
Ovarian Cancer ◽  
Surgical Treatment ◽  
Ovarian Tumor ◽  
Comparison Group ◽  
Main Group ◽  
Greater Omentum ◽  
Benign Tumors ◽  
Borderline Ovarian Tumor ◽  
Childbearing Age ◽  
Increased Risk

Summary. The aim of the study was to study the effect of clinical and morphological factors on diagnosis and onset of disease recurrence. Materials and methods. To achieve this goal, we formed a sample of postoperative samples of ovarian tumor tissue, which were divided into 3 groups: comparison group — ovarian cancer (T1-3N0M0, T1-3N0M1) (РЯ n = 261) main group 1 — borderline ovarian tumor (T1-3N0M0) (singing n = 100); the main group 2 — benign tumors of the ovaries (DOYA n = 40). The age of patients ranged from 23 to 62 years. Of these, 50 % were women of childbearing age — from 23 to 36 years (n = 26). The comparison group included 46 patients diagnosed with ovarian cancer aged 35 to 78 years. Among them, the age group from 30 to 40 years old was 14 % (n = 6). Most of the observations — 56 % (n = 24) — occurred in patients aged 40-60 years. Women over 60 made up 30 % (n = 14). Results and discussion. Ovarian cancer in the structure of the female genital organs malignancy is characterized by an ambiguous forecast and the highest mortality rate. The leading factors determining this phenomenon are the features of tumor metastasis. Metastasis of ovarian cancer occurs at the early stages of the disease and runs a variety of ways: contact, intraperitoneal, haemacirculatory and through the lymphatic system. Such features are determined by the topography of metastatic disease, anatomy, blood supply and lymphatic channel of the female reproductive gland. The greater omentum plays the barrier role in the development of the pathological process of the abdomen. At present poor prognosis and poor treatment outcomes require reviewing approaches to the surgical treatment of ovarian cancer. In this connection defining the features of ovarian cancer metastasis provides an opportunity to find new ways to disable malignant cells distribution. Conclusions. A key role in the treatment of ovarian cancer has surgery, chemotherapy, and targeted therapy. Adequate staging is important in choosing treatment tactics and assessing the prevalence of the disease. The importance of genetic and molecular studies is growing, according to the results of which it is possible to predict an increased risk of developing OC, to individualize and adjust treatment regimens.

scholarly journals ІМУНОГІСТОХІМІЧНІ КРІТЕРІАЛЬНО-ВАЖЛИВІ ПОКАЗНИКИ ЛІМФАНГІОГЕНЕЗУ РАКУ ЯЄЧНИКІВ

2020 ◽  
Vol 24 (3-4) ◽  
pp. 6-10
Author(s):  
С.М. Карташов ◽  
Т.В. Базарінська ◽  
І.Ю. Багмут ◽  
С.М. Граматюк
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Tumor ◽  
Cancer Metastasis ◽  
Comparison Group ◽  
P53 Protein ◽  
Morphological Characteristics ◽  
Disease Stage ◽  
Borderline Ovarian Tumor ◽  
Protein Activity ◽  
Morphological Studies

An in-depth study of the biology of tumor growth will help to identify factors that allow us to understand the pathogenetic mechanisms of the development of ovarian cancer metastasis and progression, as well as to become a theoretical basis for developing new approaches to the treatment of this disease. The aim of this study was to determine immunohistochemical and endothelial criteria for ovarian cancer. The postoperative samples of ovarian tumor tissues were divided into 3 groups: comparison group - ovarian cancer; main group - borderline ovarian tumor; benign ovarian tumors. The study was conducted according to the FIGO 2009 classification. The International Histological Classification of WHO 2013 Female Genital Tumors was used for morphological characteristics. Level of growth factors - sVEGF-A was performed by ELISA using standard test systems (BenderMedSystem, Austria). IGC material studies were performed on serial paraffin sections using a standard method with murine monoclonal antibodies to p53 (clone D0-7. Dilution 1: 100. "Dako"). Ventana Medical Systems, Inc. was used as the detection system. Positive and negative control reactions were performed. The label index (MI) was used to evaluate p53 nuclear expression. WCIF ImageJ and Aperio Image Scope were used to estimate the number and degree of cell staining. Statistical analysis of the obtained data was performed using Statistica 6.0. The results of morphological studies of ovarian cancer showed that in our study patients with serous cancer predominated - 78.5%. The second most frequently diagnosed cancer was undifferentiated. In the second stage of our study, we conducted a comparative analysis of the concentration of p53 in the serum and tissue of patients in the study groups, which showed the existence of significant differences. In patients of the POY and DOY groups, both total and local p53 protein activity were significantly higher than in the comparison group, p <0.05. There was a positive correlation between p53 protein activity in serum and ovarian tissue. Serum VEGF A scores were statistically significantly correlated with the disease stage: Spearman rank correlation coefficient rho = 0.30; 95% CI = 0.02 - 0.536, p <0.05. There were no correlations with patients' age, histological subtype, and degree of tumor differentiation. Considering the results of our study, we can conclude that the criterion-important indicators of QA are serum levels of p53 and the index of serum VEGF A, which is confirmed by the results of ROC analysis p = 0.0026, and indicates a good informativeness of the method.

scholarly journals Ex vivo Retrieval of Mature Oocytes for Fertility Preservation in a Patient with Bilateral Borderline Ovarian Tumor

2021 ◽  
Author(s):  
Bruno Ramalho de Carvalho ◽  
Geórgia Fontes Cintra ◽  
Taise Moura Franceschi ◽  
Íris de Oliveira Cabral ◽  
Leandro Santos de Araújo Resende ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Ovarian Stimulation ◽  
Ovarian Tumor ◽  
Ex Vivo ◽  
Oocyte Retrieval ◽  
Ovarian Response ◽  
Malignant Cell ◽  
Borderline Ovarian Tumor ◽  
Increased Risk

AbstractWe report a case of ultrasound-guided ex vivo oocyte retrieval for fertility preservation in a woman with bilateral borderline ovarian tumor, for whom conventional transvaginal oocyte retrieval was deemed unsafe because of the increased risk of malignant cell spillage. Ovarian stimulation with gonadotropins was performed. Surgery was scheduled according to the ovarian response to exogenous gonadotropic stimulation; oophorectomized specimens were obtained by laparoscopy, and oocyte retrieval was performed ∼ 37 hours after the ovulatory trigger. The sum of 20 ovarian follicles were aspirated, and 16 oocytes were obtained. We performed vitrification of 12 metaphase II oocytes and 3 oocytes matured in vitro. Our result emphasizes the viability of ex vivo mature oocyte retrieval after controlled ovarian stimulation for those with high risk of malignant dissemination by conventional approach.

Surgical treatment of patients with deep infiltrating endometriosis of the rectovaginal septum

2021 ◽  
Vol 20 (4) ◽  
pp. 5-11
Author(s):  
E.A. Galliamov ◽  
◽  
L.N. Aminova ◽  
V.A. Alimov ◽  
A.G. Kozub ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Comparison Group ◽  
Chronic Pelvic Pain Syndrome ◽  
Main Group ◽  
Pelvic Pain Syndrome ◽  
Deep Infiltrating Endometriosis ◽  
Rectovaginal Septum ◽  
Infiltrating Endometriosis

Objective. To optimize the tactics of surgical treatment of deep infiltrating endometriosis of the rectovaginal septum, including with bowel involvement. Patients and methods. The study included 122 patients diagnosed with deep infiltrating endometriosis of the rectovaginal septum, who underwent surgical interventions of different volumes using laparoscopy. The patients were divided into a main group and a comparison group. The main group consisted of 92 patients with deep infiltrating endometriosis of the rectovaginal septum who underwent surgical treatment using the original technique of systematic approach; the comparison group consisted of 30 patients who were operated using the generally accepted technique. Results. There was a statistically significant decrease in the operation duration, intraoperative blood loss, as well as more effective relief of dysmenorrhea and chronic pelvic pain syndrome, less complications and relapses in the main group compared to the comparison group. In addition, it was found that the combination of three symptoms such as dysmenorrhea, dyspareunia and chronic pelvic pain increase the likelihood of deep infiltrating endometriosis up to 93%. Conclusion. Based on the results obtained, the proposed method of surgical treatment of deep infiltrating endometriosis is more efficient and safer in comparison with the generally accepted technique, which can be considered as a valid reason for its wide introduction into clinical practice. Key words: deep infiltrating endometriosis, bowel endometriosis, surgical treatment of endometriosis, treatment algorithm

THE USE OF THORACOPLASTY IN THE TREATMENT OF DESTRUCTIVE PULMONARY TUBERCULOSIS

2021 ◽  
pp. 18-28
Author(s):  
Andrey V. Ivanov ◽  
Alexey A. Malov ◽  
Vadim A. Kichigin ◽  
Vasily A. Ivanov ◽  
Larisa V. Tarasova
Keyword(s):  
Drug Resistance ◽  
Body Weight ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Pulmonary Tuberculosis ◽  
Comparison Group ◽  
Main Group ◽  
Negative Reaction ◽  
Normal Body ◽  
Normal Body Weight

Despite a decrease in the incidence of pulmonary tuberculosis in the Russian Federation in recent years, among the newly diagnosed patients there remains a significant proportion of patients with bacterial excretion and destructive pulmonary tuberculosis. In patients with destructive pulmonary tuberculosis, surgical treatment is often the only possible method for saving lives. We studied the results of extrapleural posterosuperior thoracoplasty in 42 patients with destructive pulmonary tuberculosis. The comparison group consisted of 30 patients who received medicamentous therapy. The mortality rate for 3 years of follow-up in the conservative treatment group was 36.7%, in the surgical treatment group it was 23.8%, p = 0.237. Among patients with more than 2 years of disease experience, mortality was 45% in the main group, 88% in the comparison group, p = 0.070. In the absence of drug resistance, mortality in the main group was 4%, that in the comparison group – 14.2%, p = 0.283. Mortality in individuals with normal body weight was lower in the group of patients who underwent thoracoplasty than in the comparison group: 17.6% vs. 33.3% (p = 0.202). Among those who did not achieve sputum negative reaction, mortality was lower, and passing to the 3rd group of dispensary care was more common in the surgical treatment group – 41.7% vs. 71.4% (p = 0.077) and 33.3% vs. 21.4% (p = 0.426). Among patients with drug resistance or low body weight or unachieved sputum negative reaction, mortality rates were comparable in both groups. Thus, thoracoplasty, in comparison with conservative therapy, makes it possible to improve treatment results in patients regardless of the length of the disease in groups with Mycobacterium tuberculosis sensitive process, with normal body weight, with preservation of elimination of bacilli. The effectiveness of thoracoplasty decreases in patients with an increase in the disease duration.

scholarly journals Mucinous borderline ovarian tumor versus invasive well-differentiated mucinous ovarian cancer: Difference in characteristics and outcomes

2019 ◽  
Vol 153 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Koji Matsuo ◽  
Hiroko Machida ◽  
Rachel S. Mandelbaum ◽  
Brendan H. Grubbs ◽  
Lynda D. Roman ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Tumor ◽  
Borderline Ovarian Tumor ◽  
Well Differentiated

scholarly journals Surgical tactics for victims of gunshot wounds of the diaphragm specialized stage of medical care in conditions of a modern armed conflict

2019 ◽  
Keyword(s):  
Surgical Treatment ◽  
Medical Care ◽  
Comparison Group ◽  
Care Delivery ◽  
Abdominal Cavity ◽  
Surgical Care ◽  
Gunshot Wounds ◽  
Main Group ◽  
Lung Capacity ◽  
Combat Injuries

Introduction. The diaphragm gunshot wounds are serious combat injuries. The main functions of the diaphragm are to change the intra-abdominal pressure and the outflow of lymph and blood from the abdominal cavity due to the constant contraction and relaxation. Therefore, when it is injured at the same time with a powerful painful impulse, cardiopulmonary disorders quickly arise. Purpose: To improve the results of surgical treatment of patients with gunshot wounds through the introduction of new video endoscopic technologies at the stage of specialized surgical care. Materials and methods. The article analyzes the features of specialized surgical care in 64 patients with gunshot wounds who were treated at the surgical clinic of the Military Medical Clinical Center of the Northern Region (III level of medical care). New minimally invasive methods are proposed to improve the outcomes of surgical treatment of victims with diaphragm gunshot wounds at level III of health care delivery. Results. Thus, the use of video thoracoscopic technique in the surgical treatment of the diaphragm wound and its suturing in the proposed method allowed to improve the results of treatment by increasing the average value of diaphragmatic excursion in deep breath in the main group to 3.73 ± 0.31 cm, whereas in the comparison group 2.21 ± 0.38 cm. The severity of the pain syndrome on the of Visual Аnalogue Scale 5 days after surgical treatment was 5.2 ± 2.3 points in the injured main group, 6.7 ± 2.1 points in the comparison group. The ratio of vital lung capacity to the required vital lung capacity in the main group was 75.3 ± 2.2%, in the comparison group 64.1 ± 1.7%. Conclusions. The use of video thoracoscopy increases the efficiency of the diagnosis of gunshot wounds of the diaphragm. The use of laser imaging and fluorescence diagnosis of diaphragm wounds ensure the adequacy of the removal of paravulary necrotic tissues. The suturing of the wounds in accordance with the anatomical and functional structure of the diaphragm with the use of plaques improves the immediate postoperative results of surgical treatment.

scholarly journals URGICAL TACTICS IN WOUNDS OF PHARYNX AND CERVICAL ESOPHAGUS

2019 ◽  
pp. 95-98
Author(s):  
M. Yu Syzyi
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Surgical Intervention ◽  
Main Group ◽  
Cervical Esophagus ◽  
Penetrating Injuries ◽  
Twofold Decrease

Summary. The results of surgical treatment of 98 patients with penetrating injuries to the pharynx and cervical esophagus are presented. The patients were divided into the main and the comparison group. In the comparison group, the traditional principles of intervention were used. In the main group, surgical intervention was performed with a mini access on the neck 3-4 cm in length using a ring-shaped retractor. In the main group there was a twofold decrease in the frequency of purulent complications after surgical treatment of penetrating injuries to the pharynx and cervical esophagus, in comparison with the comparison group.

scholarly journals Dynamics of quality of life in patients with morbid obesity after biliopancreatic diversion and sleeve gastrectomy

2018 ◽  
Vol 22 (3) ◽  
pp. 548-552
Author(s):  
O.V. Perekhrestenko
Keyword(s):  
Quality Of Life ◽  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Sleeve Gastrectomy ◽  
Surgical Treatment ◽  
Biliopancreatic Diversion ◽  
Comparison Group ◽  
Main Group ◽  
The Impact

The rapid progress of obesity surgery dictates the necessity to study the quality of life of patients after bariatric procedures. The aim of the study is to assess the dynamics of quality of life of patients with morbid obesity after biliopancreatic diversion in the modification of Hess-Marceau and the sleeve gastrectomy in order to improve the results of surgical treatment of the specified category of patients. The results of surgical treatment of 205 patients with morbid obesity who performed sleeve gastrectomy (main group — 105 patients) or biliopancreatic diversion by Hess-Marceau (comparison group — 100 patients) were analyzed. The study of the dynamics of quality of life of patients was performed in according the Moorehead-Ardelt II method. Statistical data processing was performed using the methods of variational and descriptive statistic using Statistica 6.0 statistical analysis package. Installed that biliopancreatic diversion by Hess-Marceau and sleeve gastrectomy allowed to significantly improve the quality of life of patients with an increase of the quality of life index with -1.5±0.7 in the comparison group and -1.6±0,6 in the main group up to 1.8±0.3 and 2.0±0.4 respectively (p<0.05 compared to pre-operative data) 60 months after surgery. A more pronounced positive dynamics of quality of life in patients of the main group in the time interval of 12–24 months after the operation was achieved due to the absence of severe late metabolic complications and undesirable side effects of biliopancreatic diversion and laparoscopic access for sleeve gastrectomy in 54.3% of patients. Thus, the quality of life of patients with morbid obesity before performing bariatric surgery is critically low and significantly improved after biliopancreatic diversion by Hess-Marceau as well as sleeve gastrectomy. The impact of bariatric surgery on the duration and quality of life of patients requires further multicenter randomized trials.

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