Computer Modeling of Carotid Endarterectomy With the Different Shape Patches and Prediction of the Atherosclerotic

Objective: The article describes a method for constructing geometric models of the carotid bifurcation and computer simulation of endarterectomy surgery with the patches of various configurations. The purpose of this work is to identify the areas of the greatest risk of restenosis in the constructed models and to conduct a comparative analysis of risk factors when using the patches of different widths and shapes. Methods: The method is demonstrated on a reconstructed model of a healthy vessel. Its building is based on a preoperative computed tomography study of a particular patient's affected vessel. The flow in the vessel is simulated by computational fluid dynamics using data from the patient's ultrasound Doppler velocimetry. Risk factors are assessed through the hemodynamic indices on the vessel wall associated with Wall Shear Stress. Results: The distribution of risk zones in the healthy vessel, presumably leading to its observed lesion (plaque), is analyzed. Comparative evaluation of 10 various patches implantation results is carried out and the optimal variant is determined. The proposed method can be used to predict the hemodynamic results of surgery using patches of various sizes and shapes.

Surgical management of pancreatoduodenal tumors: the experience of using the developed operation technique

Relevance: The results of surgery in patients with pancreaticoduodenal cancer remain unsatisfactory. This complicates the choice of an optimal surgical technique in modern oncology. Surgery in the pancreaticoduodenal zone is associated with complications due to anatomical and physiological features of the pancreas and technical challenges of this surgical intervention. Despite preventive actions and innovative technologies, such a traumatic operation as pancreatoduodenal resection often produces complications, though recently fewer. This article describes a pancreaticoduodenal resection technique that reduces postoperative complication frequency and lethality in operable pancreaticoduodenal cancer. The purpose of the study was to assess the efficiency of an authorial pancreaticoduodenal resection technique (pancreaticojejunal invagination anastomosis) in pancreaticoduodenal cancer. The proposed pancreaticojejunal anastomosis-forming technique allowed reducing the postoperative complication frequency from 54.2% to 38,0% and postoperative lethality from 22.8% to 9,5%. Conclusion: This highly traumatic surgery is associated with postoperative complications (up to 50-70% of cases), which are quite severe and difficult to resolve and result in high fatality. The proposed pancreaticojejunal anastomosis forming technique has efficiently reduced postoperative complications and fatality to a significant extent.

Surgical management of pancreatoduodenal tumors: the experience of using the developed operation technique

Relevance: The results of surgery in patients with pancreaticoduodenal cancer remain unsatisfactory. This complicates the choice of an optimal surgical technique in modern oncology. Surgery in the pancreaticoduodenal zone is associated with complications due to anatomical and physiological features of the pancreas and technical challenges of this surgical intervention. Despite preventive actions and innovative technologies, such a traumatic operation as pancreatoduodenal resection often produces complications, though recently fewer. This article describes a pancreaticoduodenal resection technique that reduces postoperative complication frequency and lethality in operable pancreaticoduodenal cancer. The purpose of the study was to assess the efficiency of an authorial pancreaticoduodenal resection technique (pancreaticojejunal invagination anastomosis) in pancreaticoduodenal cancer. Results: The proposed pancreaticojejunal anastomosis forming technique allowed reducing the postoperative complication frequency from 54.2% to 38.0% and postoperative lethality from 22.8% to 9.5%. Conclusion: This highly traumatic surgery involves quite severe and difficult to resolve postoperative complications (up to 50-70% of cases) and the resulting high fatality. The proposed pancreaticoduodenal anastomosis forming technique has efficiently reduced postoperative complications and fatality to a significant extent

Cataract surgery in children with congenital aniridia

Purpose. Analysis of clinical and functional results of cataract surgery in children with congenital aniridia. Material and methods. Retrospective analysis of treatment results of 46 children and adolescents up to 18 years (92 eyes), whose average age was 6.2±5 years. In the postoperative period, the dynamics of visual functions, the state of the corneal surface and changes in intraocular pressure were assessed. Results. The average age of surgical interventions for lens opacities was 14±3 years. The improvement in visometry data, observed in the first years after the removal of lens opacity, decreased 4 years after surgery, and visual acuity indices did not significantly differ from preoperative values (p=0.07). Regardless of the method of correcting postoperative aphakia, cataract surgery in children was associated with the risks of progression of keratopathy (45%), development of secondary glaucoma (15%) and retinal detachment (10%). In 70% of cases, regardless of the choice of the method of intraocular correction, the debut of the glaucomatous process occurred on average 13.7±5.25 years after cataract surgery. Conclusion. Cataract surgery is not a routine procedure and carries postoperative risks associated with the features of the aniridic eye (development of keratopathy, secondary glaucoma, aniridic fibrosis syndrome), which worsen the long-term functional results of surgery. Key words: congenital cataract, aniridia, keratopathy.

Breast cancer in Egypt:a review of disease presentation and detection strategies

Carcinoma of the breast is the most prevalent cancer among Egyptian women and constitutes 29% of National Cancer Institute cases. Median age at diagnosis is one decade younger than in countries of Europe and North America and most patients are premenopausal. Tumours are relatively advanced at presentation. The majority of tumours are invasive duct subtype and the profile of hormone receptors is positive for estrogen receptors and /or progesterone receptors in less than half of cases. This overview examines genetic changes, potential and established predictive and prognostic markers and end results of surgery, radiotherapy and systemic therapy for early, locally advanced and metastatic disease stages. Disease presentations common to the region and early detection strategies are presented

DIAGNOSTICS AND SURGICAL TREATMENT OF THE AORTA DISSECTING ANEURISM TYPE A, RESULTS OF SURGERY

The purpose – to evaluate the results of the surgical treatment experience of the aortadissecting aneurysms of type A.Material and methods. Surgical treatment of stratified aortic aneurysms of type Aremains one of the most difficult problems in cardiac surgery. The article presentsall experience (947 stratifying aneurysms of type A) of surgical treatment of suchaneurysms by one team. Factors that could have caused the formation of an aorticaneurysm (aortic dissection) have been identified.Results. The total hospital mortality during surgical treatment of a stratified aorticaneurysm type A was 9.7%, in addition to that – 10.1% in the acute stage and 8.4% inthe chronic stage.Conclusions. Accumulation of surgical experience, improvement of methods ofprotection of heart, brain during surgical treatment of a stratifying aortic aneurysm oftype A made it possible to achieve 4.8% of hospital mortality.

Prognostic factors of functional results of surgery for idiopathic (primary) epimacular membranes: morphology of outer and inner layers of the macula. Part 3

The third part of the review (for the first part, see ROJ 2020; 13 (2): 99–104, for the second part — ROJ 2020; 13 (4): 105–110) discusses the structure of the outer and inner layers of normal macula in optical coherence tomography, their pathomorphology as well as its impact on the state of visual functions in epimacular membranes (EMM).