The analysis of the clinical case in the stepped treatment of multiple choledocholithiasis and locally advanced kidney cancer

This article is devoted to the analysis of the clinical case which includes the clinical manifestations and treatment of multiple choledocholithiasis and locally advanced kidney cancer. A staged surgery was performed. Retrograde papillosphincterotomy with cholechocholitholite extraction was done at the first stage. The second stage includes laparotomy, removal of the tumor of the right kidney / adrenal gland as a single block, cholecystectomy after preliminary angiography and embolization of the vessels feeding the tumor. The presented successful observation demonstrates one of the modern approaches in the treatment of patients with comorbid pathology.

THE STRUCTURE AND OUTCOMES OF SURGICAL TREATMENT OF LIVER ECHINOCOCCOSIS IN A SPECIALIZED CENTER

Background. An increase in the incidence of hepatic echinococcosis is noted annually, surgery remaining its main treatment option. Objective. To analyze the treatment structure and evaluate the treatment outcomes of the patients operated for hepatic echinococcosis in the Surgical department №2 of SAHI "KCEH named after M.A. Podgorbunsky" over the period of 2016 - 2020. Material and methods. The analyzed group included treatment outcomes of 58 patients (22 men (38%), 36 women (62%)), who underwent 76 surgical interventions for liver echinococcosis in the Surgical department №2 on the basis of SAHI "KCEH named after M.A. Podgorbunsky". The difference between the number of operations performed and that of actual patients is explained by the use of staged surgery in a number of cases. Results. The majority of the 76 operations performed over the period of 2016 - 2020 were open resections - 50 (65.8%) cases. Of these, extensive anatomic segmental hepatic resections were performed in 22 cases (44%). In 14 (24%) of all patients staged surgery was used, making it possible to exclude a number of patients from the category of "non-resectable" and to perform surgery with good outcomes. A fatal outcome was noted in one case. Conclusions. The use of various surgical techniques including staged minimally invasive and laparoscopic ones in a specialized surgical department allows achieving good treatment outcomes.

STAGED SURGERY TREATMENT OF TETRALOGY OF FALLOT AND HEPATOBLASTOMA IN A CHILD

In order to achieve good long-term results of combination treatment in children with malignant neoplasms, continuity of stages of the therapy and adherence to the time intervals between the stages are necessary. Severe accompanying pathology can make it difficult or impossible to complete all the necessary steps. The presented clinical case of a child with hepatoblastoma and Tetralogy of Fallot demonstrates the importance of the interdisciplinary work of oncologists, surgical oncologists and cardiac surgeons to ensure the optimal treatment algorithm for such patients.

A 60-year-old female with asymptomatic total thoracic-abdominal aortic aneurysm

Total thoracic-abdominal aortic aneurysm is a rare disease in cardiovascular surgery, with high surgical risk and high mortality. Surgery is considered the most effective treatment for total aortic aneurysms. Recently, our group admitted a 60-year-old female patient with asymptomatic full thoracic-abdominal aortic aneurysm, and successfully performed staged surgery, namely Bentall + Sun’s operation in the first stage and thoraco-abdominal aortic replacement in the second stage. The results of the operation were satisfactory.