Pub Date : 2018-09-28DOI: 10.18499/2070-478X-2018-11-3-179-182
I. Moshurov, O. Andreeva
Relevance.The col lective concept of" incidence " of the adrenal glands includes a group of neoplasms of more than 1 cm in diameter, accidentally revealed by radiation methods of research. With the development of methods of instrumental diagnostics, the number of adrenal glands detected by the incident is steadily increasing, including in patients with a history of malignant neoplasm (ZNO). Objective.Study of the frequency of occurrence metastaties of adrenal tumors in cancer patients. Materials and methods. Made 137 fine-needle aspiration biopsies (TAB) of adrenal tumors in the patients in whom during follow-up were detected adrenal incidence. Results. According to the results of morphological verification in 44(32%) cases of adrenal tumors were metastatic. Conclusion. Adrenal tumors, detected in patients with malignant neoplasms of different localization, can be provided as metastatic and benign tumors. However, each revealed a tumor in the adrenal glands of patients undergoing treatment after testing shall be considered as potentially metastatic.
{"title":"Metastatic adrenal lesions in cancer patients.","authors":"I. Moshurov, O. Andreeva","doi":"10.18499/2070-478X-2018-11-3-179-182","DOIUrl":"https://doi.org/10.18499/2070-478X-2018-11-3-179-182","url":null,"abstract":"Relevance.The col lective concept of\" incidence \" of the adrenal glands includes a group of neoplasms of more than 1 cm in diameter, accidentally revealed by radiation methods of research. With the development of methods of instrumental diagnostics, the number of adrenal glands detected by the incident is steadily increasing, including in patients with a history of malignant neoplasm (ZNO). \u0000Objective.Study of the frequency of occurrence metastaties of adrenal tumors in cancer patients. \u0000Materials and methods. Made 137 fine-needle aspiration biopsies (TAB) of adrenal tumors in the patients in whom during follow-up were detected adrenal incidence. \u0000Results. According to the results of morphological verification in 44(32%) cases of adrenal tumors were metastatic. \u0000Conclusion. Adrenal tumors, detected in patients with malignant neoplasms of different localization, can be provided as metastatic and benign tumors. However, each revealed a tumor in the adrenal glands of patients undergoing treatment after testing shall be considered as potentially metastatic.","PeriodicalId":283981,"journal":{"name":"Vestnik of Experimental and Clinical Surgery","volume":"414 6861 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124434367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-28DOI: 10.18499/2070-478x-2018-11-3-218-223
I. Kurganskiy, E. Inozemtsev, S. Lepekhova, O. A. Goldberg, K. Apartsin, Evgeniy Georgievich Grigor'yev
Relevance: despite the improvement of surgical techniques, the number of postoperative complications in surgical interventions on the trachea remains high. One of the ways to improve the results of treatment is the development and study of new surgical interventions. Aim: The work is devoted to the study of the topographic and anatomical features of the structure of the rat trachea Materials and methods: The study was performed using rats of the Wistar line and was approved by a local ethical committee. Methods of descriptive anatomy and morphology were used. Results: the obtained results made it possible to reveal features of the topographic-anatomical structure of the rat trachea: the presence of hyaline cartilages in the form of a ring; grown-up cartilaginous rings forming the fusion of the X, Y, W forms; in the submucosal layer of the trachea there are multiple clusters of mucoses associated with lymphatic tissue; pronounced venous traheoidesis plexus; developed, dense adventitia of the trachea. In rats, the epithelial transition from a multilayer flat non-coronary to a single-stranded thief-synchoid occurs below the vocal cords. According to the histological structure, the rat trachea wall is close to the human trachea, has adventitia, a cartilaginous framework, a submucosal osseous and a mucous membrane. Conclusion: these features of the structure of the trachea of Wistar rats allow them to be used to model pathology of the trachea and to develop surgical interventions.
{"title":"Features of the topographic anatomy of the rat trachea and the possibility of performing surgical interventions.","authors":"I. Kurganskiy, E. Inozemtsev, S. Lepekhova, O. A. Goldberg, K. Apartsin, Evgeniy Georgievich Grigor'yev","doi":"10.18499/2070-478x-2018-11-3-218-223","DOIUrl":"https://doi.org/10.18499/2070-478x-2018-11-3-218-223","url":null,"abstract":"Relevance: despite the improvement of surgical techniques, the number of postoperative complications in surgical interventions on the trachea remains high. One of the ways to improve the results of treatment is the development and study of new surgical interventions. \u0000Aim: The work is devoted to the study of the topographic and anatomical features of the structure of the rat trachea \u0000Materials and methods: The study was performed using rats of the Wistar line and was approved by a local ethical committee. Methods of descriptive anatomy and morphology were used. \u0000Results: the obtained results made it possible to reveal features of the topographic-anatomical structure of the rat trachea: the presence of hyaline cartilages in the form of a ring; grown-up cartilaginous rings forming the fusion of the X, Y, W forms; in the submucosal layer of the trachea there are multiple clusters of mucoses associated with lymphatic tissue; pronounced venous traheoidesis plexus; developed, dense adventitia of the trachea. In rats, the epithelial transition from a multilayer flat non-coronary to a single-stranded thief-synchoid occurs below the vocal cords. According to the histological structure, the rat trachea wall is close to the human trachea, has adventitia, a cartilaginous framework, a submucosal osseous and a mucous membrane. \u0000Conclusion: these features of the structure of the trachea of Wistar rats allow them to be used to model pathology of the trachea and to develop surgical interventions.","PeriodicalId":283981,"journal":{"name":"Vestnik of Experimental and Clinical Surgery","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121604886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-28DOI: 10.18499/2070-478x-2018-11-3-213-217
M. Kovalevskaya, Ковалевская Мария Александровна, L. A. Filina, Филина Лилия Алексеевна, V. L. Kokorev, Кокорев Владимир Леонидович
Relevance. At the present stage, cataract surgery techniques perfectly cope with the task of restoring the transparency of the optic system of the eye, which makes it possible to quickly restore visual functions and patient performance. Throughout the world, there is a trend of cataract surgery in the initial stages, recommending that patients do not wait for cataract ripening. However, as practice has shown, this leads to an increase in the number of patients with secondary cataract.Goal. To develop recommendations and ways of preventing secondary cataract.Materials and methods. A comparative analysis of two groups of patients who applied for laser dyssia (192) and operated on cataracts (2590) for one calendar year was carried out. The interrelation of a type of a cataract and development of opacifications of a back capsule is analyzed.Results. In patients with myopia, which is a sign of complicated cataracts, the risk of developing secondary cataract is 3.5 times higher with a high degree of statistical significance (p <0.005). The following is the risk of diabetes mellitus of both types, as a sign of complicated cataract with concomitant pathology, which increases the risk of developing a secondary cataract up to 3 times (p <0.01). Immature cataract stages according to our observations also with statistical reliability (p <0.01) increase the risk of secondary cataract development by 1.4 times.Conclusions. Taking into account the revealed clinical risk factors for the development of secondary cataracts, we proposed recommendations for the primary posterior capsulorhexis with a transparent posterior capsule: myopia, diabetes mellitus of both types, initialandimmaturecataracts
{"title":"Factors of the Risk of Developing a Secondary Cataract and Recommendations for Conducting a Primary Posterior Capsulorhexis","authors":"M. Kovalevskaya, Ковалевская Мария Александровна, L. A. Filina, Филина Лилия Алексеевна, V. L. Kokorev, Кокорев Владимир Леонидович","doi":"10.18499/2070-478x-2018-11-3-213-217","DOIUrl":"https://doi.org/10.18499/2070-478x-2018-11-3-213-217","url":null,"abstract":"Relevance. At the present stage, cataract surgery techniques perfectly cope with the task of restoring the transparency of the optic system of the eye, which makes it possible to quickly restore visual functions and patient performance. Throughout the world, there is a trend of cataract surgery in the initial stages, recommending that patients do not wait for cataract ripening. However, as practice has shown, this leads to an increase in the number of patients with secondary cataract.Goal. To develop recommendations and ways of preventing secondary cataract.Materials and methods. A comparative analysis of two groups of patients who applied for laser dyssia (192) and operated on cataracts (2590) for one calendar year was carried out. The interrelation of a type of a cataract and development of opacifications of a back capsule is analyzed.Results. In patients with myopia, which is a sign of complicated cataracts, the risk of developing secondary cataract is 3.5 times higher with a high degree of statistical significance (p <0.005). The following is the risk of diabetes mellitus of both types, as a sign of complicated cataract with concomitant pathology, which increases the risk of developing a secondary cataract up to 3 times (p <0.01). Immature cataract stages according to our observations also with statistical reliability (p <0.01) increase the risk of secondary cataract development by 1.4 times.Conclusions. Taking into account the revealed clinical risk factors for the development of secondary cataracts, we proposed recommendations for the primary posterior capsulorhexis with a transparent posterior capsule: myopia, diabetes mellitus of both types, initialandimmaturecataracts","PeriodicalId":283981,"journal":{"name":"Vestnik of Experimental and Clinical Surgery","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114190501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-28DOI: 10.18499/2070-478X-2018-11-3-173-178
M. Aralova, A. Glukhov, A. Ostroushko
Urgency. Objective indicators of the dynamics of the wound process are planimetric methods, including the determination of the area of ulcerative defects and the rate of their epithelialization. The aim of the work is to assess the kinetics of the wound process in venous, ischemic and neurotrophic ulcers of the lower extremities using various methods of stimulating regeneration in wounds. Materials and methods. 4 blocks of studies were carried out: in the first block, the healing of venous trophic ulcers up to 20 cm2 was evaluated; in the second - more than 20 cm2; in the third block, the course of the wound process was studied in patients with ischemic trophic ulcers of the lower extremities on; in the fourth - with neurotrophic ulcers of the lower extremities. In each block, patients were divided into 4 groups according to the methods of stimulation of regeneration: combination of platelet-rich donor plasma and collagen preparations was used; interactive bandages; collagen preparations; platelet-rich donor plasma. To assess changes in the area of wounds in time used the exponential function and the parameter τ (the characteristic time of wound healing), allowing a single number to characterize the kinetics of healing and to measure the period of wound healing. Results and their discussion. For venous trophic ulcers up to 20 cm2 complex use of collagen preparations and platelet-rich donor plasma provides the shortest reduction of the wound area in comparison with other considered methods. For venous trophic ulcers of large and giant size (more than 20 cm2), stimulation of regeneration before autodermoplasty with a split skin flap only using collagen-containing preparations (14.4 days) or platelet-rich donor plasma (11.6 days) provided a greater percentage of survival of the autodermograft. The complex use of collagen preparations and platelet-rich donor plasma is most effective among other methods in reducing the area of neurotrophic ulcers, the characteristic time of reducing the wound area is 48.9 days, which is faster than other methods by 1.25 - 2, 93 times. The healing process of ischemic trophic ulcers is more difficult to Express by mathematical formulas. However, among the compared methods, the use of the complex of drugs leads to a statistically faster decrease in the area of wounds - 24.3 days against 31.6, 29.3 and 88 days. Summary. The complex of preparations provides in General the best kinetics of healing of venous, ischemic and neurotrophic ulcers in comparison with the use of modern dressings and separate use of collagen-containing preparations and platelet-rich donor plasma.
{"title":"Kinetics of wound process with various methods of stimulation of regeneration in wounds","authors":"M. Aralova, A. Glukhov, A. Ostroushko","doi":"10.18499/2070-478X-2018-11-3-173-178","DOIUrl":"https://doi.org/10.18499/2070-478X-2018-11-3-173-178","url":null,"abstract":"Urgency. Objective indicators of the dynamics of the wound process are planimetric methods, including the determination of the area of ulcerative defects and the rate of their epithelialization. \u0000The aim of the work is to assess the kinetics of the wound process in venous, ischemic and neurotrophic ulcers of the lower extremities using various methods of stimulating regeneration in wounds. \u0000Materials and methods. 4 blocks of studies were carried out: in the first block, the healing of venous trophic ulcers up to 20 cm2 was evaluated; in the second - more than 20 cm2; in the third block, the course of the wound process was studied in patients with ischemic trophic ulcers of the lower extremities on; in the fourth - with neurotrophic ulcers of the lower extremities. In each block, patients were divided into 4 groups according to the methods of stimulation of regeneration: combination of platelet-rich donor plasma and collagen preparations was used; interactive bandages; collagen preparations; platelet-rich donor plasma. To assess changes in the area of wounds in time used the exponential function and the parameter τ (the characteristic time of wound healing), allowing a single number to characterize the kinetics of healing and to measure the period of wound healing. \u0000Results and their discussion. For venous trophic ulcers up to 20 cm2 complex use of collagen preparations and platelet-rich donor plasma provides the shortest reduction of the wound area in comparison with other considered methods. \u0000For venous trophic ulcers of large and giant size (more than 20 cm2), stimulation of regeneration before autodermoplasty with a split skin flap only using collagen-containing preparations (14.4 days) or platelet-rich donor plasma (11.6 days) provided a greater percentage of survival of the autodermograft. \u0000The complex use of collagen preparations and platelet-rich donor plasma is most effective among other methods in reducing the area of neurotrophic ulcers, the characteristic time of reducing the wound area is 48.9 days, which is faster than other methods by 1.25 - 2, 93 times. \u0000The healing process of ischemic trophic ulcers is more difficult to Express by mathematical formulas. However, among the compared methods, the use of the complex of drugs leads to a statistically faster decrease in the area of wounds - 24.3 days against 31.6, 29.3 and 88 days. \u0000Summary. The complex of preparations provides in General the best kinetics of healing of venous, ischemic and neurotrophic ulcers in comparison with the use of modern dressings and separate use of collagen-containing preparations and platelet-rich donor plasma.","PeriodicalId":283981,"journal":{"name":"Vestnik of Experimental and Clinical Surgery","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122450499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-28DOI: 10.18499/2070-478X-2018-11-3-193-201
M. A. Rayhan, V. V. Bulynin, A. I. Zhdanov, Y. Parkhisenko, B. Leibovich
Relevance. Spontaneous esophageal rupture (Boerhaave syndrome) is observed relatively rare ranging from 2.9% to 12% of all cases of damage of the esophagus. Today, there is not any categorical opinion about the effectiveness of different treatments among surgeons, there are not any single algorithms for the diagnosis and evaluation of treatment. Spontaneous esophageal rupture is a real threat for the life of patient: mortality up to 75% in the prehospital period and more than 90% in the postoperative period, and depends on the time interval between the rupture of the esophageal wall and the operation time, and also complications (suppurative esophagitis, suppurative mediastinitis, bilateral suppurative lobular pneumonia, sepsis). Purpose. To improve results of surgical treatment of patients with spontaneous esophageal rupture using the results obtained in the experiment. Materials and methods. Since 2004 till 2017 twelve patients with spontaneous esophageal rupture were treated in our hospital. Ways of treatment of lower third of esophageal rupture: drainage of pleural cavity – 2 patients; closure of the defect, fundoplication with covered stitches by the bottom of the stomach – 2 patients; perforated hole was not sutured, and a cuff, covering the perforation, was formed from the bottom of the stomach (fundoplication by Chernousov) – 8 patients. These methods of surgical treatment were applied in the experiments on 120 rats. Each group consisted of 40 rats. Results and discussion. The pleural cavity drainage, lethality – 1 (50%) patient. The suturing of the defect of the esophageal walls, the fundoplication with the stitches, covered by the bottom of the stomach, failure of stitches – 2 patients, lethality – 1 (50%) patients. The perforated hole was not sutured, and the cuff was shaped from the bottom of the stomach, covering the perforation. Lethality – 2 (25%) patients, caused by bilateral pneumonia in contrast to progressive sepsis. Other patients operated on this method didn’t have any failure of stiches. In the experiment: in the 1st group the failure of stitches was 87.5% and lethality – 100%; in the 2nd group the failure of stitches was 85% and lethality – 100%; in the 3rd group there was not any failure of stitches, lethality – 17.5%. Conclusions. The most effective method of treatment is the restoration of rupture esophagus without suturing, and forming a cuff from the bottom of the stomach, covering the perforation. Drainage of pleural cavity and nutrition through a nasogastric tube.
{"title":"A New Method of Boerhaave Syndrome Surgical Treatment and Its Experimental Justification","authors":"M. A. Rayhan, V. V. Bulynin, A. I. Zhdanov, Y. Parkhisenko, B. Leibovich","doi":"10.18499/2070-478X-2018-11-3-193-201","DOIUrl":"https://doi.org/10.18499/2070-478X-2018-11-3-193-201","url":null,"abstract":"Relevance. Spontaneous esophageal rupture (Boerhaave syndrome) is observed relatively rare ranging from 2.9% to 12% of all cases of damage of the esophagus. Today, there is not any categorical opinion about the effectiveness of different treatments among surgeons, there are not any single algorithms for the diagnosis and evaluation of treatment. Spontaneous esophageal rupture is a real threat for the life of patient: mortality up to 75% in the prehospital period and more than 90% in the postoperative period, and depends on the time interval between the rupture of the esophageal wall and the operation time, and also complications (suppurative esophagitis, suppurative mediastinitis, bilateral suppurative lobular pneumonia, sepsis). \u0000Purpose. To improve results of surgical treatment of patients with spontaneous esophageal rupture using the results obtained in the experiment. \u0000Materials and methods. Since 2004 till 2017 twelve patients with spontaneous esophageal rupture were treated in our hospital. Ways of treatment of lower third of esophageal rupture: drainage of pleural cavity – 2 patients; closure of the defect, fundoplication with covered stitches by the bottom of the stomach – 2 patients; perforated hole was not sutured, and a cuff, covering the perforation, was formed from the bottom of the stomach (fundoplication by Chernousov) – 8 patients. These methods of surgical treatment were applied in the experiments on 120 rats. Each group consisted of 40 rats. \u0000Results and discussion. The pleural cavity drainage, lethality – 1 (50%) patient. The suturing of the defect of the esophageal walls, the fundoplication with the stitches, covered by the bottom of the stomach, failure of stitches – 2 patients, lethality – 1 (50%) patients. The perforated hole was not sutured, and the cuff was shaped from the bottom of the stomach, covering the perforation. Lethality – 2 (25%) patients, caused by bilateral pneumonia in contrast to progressive sepsis. Other patients operated on this method didn’t have any failure of stiches. \u0000In the experiment: in the 1st group the failure of stitches was 87.5% and lethality – 100%; in the 2nd group the failure of stitches was 85% and lethality – 100%; in the 3rd group there was not any failure of stitches, lethality – 17.5%. \u0000Conclusions. The most effective method of treatment is the restoration of rupture esophagus without suturing, and forming a cuff from the bottom of the stomach, covering the perforation. Drainage of pleural cavity and nutrition through a nasogastric tube.","PeriodicalId":283981,"journal":{"name":"Vestnik of Experimental and Clinical Surgery","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125527083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-28DOI: 10.18499/2070-478x-2018-11-3-186-192
I. Babushkina, A. Bondarenko, S. Shpinyak, I. Mamonova, Ervin Serveevich Kuzmin
Background. The system of accurate microbiological diagnostics of PJI for timely identification of infectious inflammatory complications after total joint replacement and distinguishing between PJI and aseptic infection has not been yet defined which is associated with the pathogenesis of PJI. The Aim of the study is to define valuable microbiological diagnostic criteria for PJI and estimate diagnostic value of various clinical specimens with the account to pathogenetic features of infectious complications after primary total knee replacement. Material and Methods. We analyzed 412 specimens of various clinical origin obtained from 182 patients with deep PJI after primary total knee replacement treated at the Research Institute of Traumatology, Orthopedics and Neurosurgery of Razumovsky Saratov State Medical University in 2014-2018, both retro- and prospectively. Results and Discussion. Fistula, aspirate and superficial wound specimens taken from the joint cavity have not been proven to have any diagnostic value for PJI. Optimized microbiological algorithm included prolonged culture time, the complex of 3-5 tissue bioptate cultures and implant sonication which allowed obtaining more valuable results for PJI diagnostics. Tissue bioptates and lavage fluid specimens tests were the most sensitive methods for PJI diagnostics with sensitivity of 81% and 95% and specificity of 96% and 97% respectively, especially in case of coagulase-negative Staphylococcus and Gram-negative bacteria frequently appearing in the biofilm form at PJI. Conclusions. Complex assessment of obtained results and optimization of microbiological methods allow obtaining sufficient diagnostic accuracy of PJI.
{"title":"Microbiological diagnostic criteria of infectious inflammatory complications after total knee replacement in the aspect of periprosthetic joint infection (PJI) pathogenesis","authors":"I. Babushkina, A. Bondarenko, S. Shpinyak, I. Mamonova, Ervin Serveevich Kuzmin","doi":"10.18499/2070-478x-2018-11-3-186-192","DOIUrl":"https://doi.org/10.18499/2070-478x-2018-11-3-186-192","url":null,"abstract":"Background. The system of accurate microbiological diagnostics of PJI for timely identification of infectious inflammatory complications after total joint replacement and distinguishing between PJI and aseptic infection has not been yet defined which is associated with the pathogenesis of PJI. \u0000The Aim of the study is to define valuable microbiological diagnostic criteria for PJI and estimate diagnostic value of various clinical specimens with the account to pathogenetic features of infectious complications after primary total knee replacement. \u0000Material and Methods. We analyzed 412 specimens of various clinical origin obtained from 182 patients with deep PJI after primary total knee replacement treated at the Research Institute of Traumatology, Orthopedics and Neurosurgery of Razumovsky Saratov State Medical University in 2014-2018, both retro- and prospectively. \u0000Results and Discussion. Fistula, aspirate and superficial wound specimens taken from the joint cavity have not been proven to have any diagnostic value for PJI. Optimized microbiological algorithm included prolonged culture time, the complex of 3-5 tissue bioptate cultures and implant sonication which allowed obtaining more valuable results for PJI diagnostics. Tissue bioptates and lavage fluid specimens tests were the most sensitive methods for PJI diagnostics with sensitivity of 81% and 95% and specificity of 96% and 97% respectively, especially in case of coagulase-negative Staphylococcus and Gram-negative bacteria frequently appearing in the biofilm form at PJI. \u0000Conclusions. Complex assessment of obtained results and optimization of microbiological methods allow obtaining sufficient diagnostic accuracy of PJI.","PeriodicalId":283981,"journal":{"name":"Vestnik of Experimental and Clinical Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113978500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.18499/2070-478X-2018-11-2-126-133
A. A. Kinzerskiy, V. Dolgikh, M. Korzhuk, D. A. Kinzerskaya, Valeriya Zaytseva
Background. Testing a new method of hemostasis in surgery often goes through the experimental stage. The key point is selecting animals, and eligibility of the obtained experimental results extrapolating to humans. Experimental rats are often used for studying the hemostasis system indicates in modeling various pathologies in surgery. The emergence of the low-frequency piezothromboelastography (LFPTEG) technique in combination with the coagulogram findings, general blood test, protein C, and plasminogen indicators has been able to detail the available knowledge about the hemostasis system originality at these animals and to help avoiding errors in interpreting the results obtained in the experiment. Aim. To determine the features of the Wistar line rats hemostasis system parameters in comparison with the same human ones being important for experimental surgery. Materials and methods. The research was conducted on Wistar male rats (n=32) weighing 349 ±33 g (M±σ). Blood was taken from the left carotid artery under conditions of anesthesia with tiletamine / zolazepam (20-40 mg / kg intramuscularly) + xylazine (5-10 mg / kg intramuscularly). Eight seconds before blood without citrate in a volume of 0.45 ml was placed in a cuvette of the LFPTEG technique ARP-01M “Mednord” in settings of which the delta was used to take a maximum point equal to 1, and the waiting time of the curve rising was 20 minutes. The next blood sample was collected in a test tube with 3.8% citrate in a volume of 4.5 ml (9:1) for investigating the fibrinogen level at the Thrombotimer 4 Behnk Elektronik semi-automatic coagulometer, the activated partial thromboplastin time (APTT) values, prothrombin time (PT), thrombin time (TT) and antithrombin III at the automatic blood coagulation analyzer Sysmex CA 600, and activity of plasminogen and protein C at the semi-automatic Riele 5010 v5 + photometer with a wave length of 405 nm. Studying the hematocrit indicators, and determining the platelet count were performed at the automatic hematological analyzer ABX Micros ES 60. The reagents of Ltd "Tekhnologiya standart" were used for detecting the parameters of the hemostasis system. Parameters of the LFPTEG technique for human had been taken from the cited literature, the other indicators had been obtained from 120 healthy adult volunteers. Statistical processing was implemented in the programming language R with using the statistical packages “VIM”, “mice”, “car”, “sm”, “coin”, “boot”. The LFPTEG technique reference values in rats were refined by the nonparametric bootstrap method. The comparison between the groups was carried out by Mann- Whitney's test and rechecked by the Permutation test with the level p correction for multiple comparisons by the Benjamin-Yekutili method. After correction the α level was assumed to be 0.05. Resul
{"title":"The Wistar rat line hemostatic system characteristics to be important for experimental surgery.","authors":"A. A. Kinzerskiy, V. Dolgikh, M. Korzhuk, D. A. Kinzerskaya, Valeriya Zaytseva","doi":"10.18499/2070-478X-2018-11-2-126-133","DOIUrl":"https://doi.org/10.18499/2070-478X-2018-11-2-126-133","url":null,"abstract":"Background. Testing a new method of hemostasis in surgery often goes through the experimental stage. The key point is selecting animals, and eligibility of the obtained experimental results extrapolating to humans. Experimental rats are often used for studying the hemostasis system indicates in modeling various pathologies in surgery. The emergence of the low-frequency piezothromboelastography (LFPTEG) technique in combination with the coagulogram findings, general blood test, protein C, and plasminogen indicators has been able to detail the available knowledge about the hemostasis system originality at these animals and to help avoiding errors in interpreting the results obtained in the experiment. \u0000Aim. To determine the features of the Wistar line rats hemostasis system parameters in comparison with the same human ones being important for experimental surgery. \u0000Materials and methods. The research was conducted on Wistar male rats (n=32) weighing 349 ±33 g (M±σ). Blood was taken from the left carotid artery under conditions of anesthesia with tiletamine / zolazepam (20-40 mg / kg intramuscularly) + xylazine (5-10 mg / kg intramuscularly). Eight seconds before blood without citrate in a volume of 0.45 ml was placed in a cuvette of the LFPTEG technique ARP-01M “Mednord” in settings of which the delta was used to take a maximum point equal to 1, and the waiting time of the curve rising was 20 minutes. The next blood sample was collected in a test tube with 3.8% citrate in a volume of 4.5 ml (9:1) for investigating the fibrinogen level at the Thrombotimer 4 Behnk Elektronik semi-automatic coagulometer, the activated partial thromboplastin time (APTT) values, prothrombin time (PT), thrombin time (TT) and antithrombin III at the automatic blood coagulation analyzer Sysmex CA 600, and activity of plasminogen and protein C at the semi-automatic Riele 5010 v5 + photometer with a wave length of 405 nm. Studying the hematocrit indicators, and determining the platelet count were performed at the automatic hematological analyzer ABX Micros ES 60. The reagents of Ltd \"Tekhnologiya standart\" were used for detecting the parameters of the hemostasis system. Parameters of the LFPTEG technique for human had been taken from the cited literature, the other indicators had been obtained from 120 healthy adult volunteers. Statistical processing was implemented in the programming language R with using the statistical packages “VIM”, “mice”, “car”, “sm”, “coin”, “boot”. The LFPTEG technique reference values in rats were refined by the nonparametric bootstrap method. The comparison between the groups was carried out by Mann- Whitney's test and rechecked by the Permutation test with the level p correction for multiple comparisons by the Benjamin-Yekutili method. After correction the α level was assumed to be 0.05. \u0000Resul","PeriodicalId":283981,"journal":{"name":"Vestnik of Experimental and Clinical Surgery","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116950760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.18499/2070-478X-2018-11-2-134-143
Y. Ivanov, V. Sharobaro, D. Panchenkov, Y. Khabarov, D. Astakhov
SUMMARY The surgical stage of treatment remains the main one in the complex therapy of breast cancer. The review of modern reconstructive plastic surgery, performed by single-step and delayed after radical mastectomy. Against the background of a huge number of existing methods of breast reconstruction, three main types have become the most popular among surgeons to date: the use of own tissues, silicone endoprostheses and their combination. The final choice of the option of breast reconstruction depends on the volume of cancer surgery, plastic tissue, somatic condition of the patient and her desire. Reconstructive plastic surgery for breast cancer does not affect the course of the disease and are not an obstacle to chemotherapy.
{"title":"Modern possibilities of reconstructive plastic surgery of breast cancer","authors":"Y. Ivanov, V. Sharobaro, D. Panchenkov, Y. Khabarov, D. Astakhov","doi":"10.18499/2070-478X-2018-11-2-134-143","DOIUrl":"https://doi.org/10.18499/2070-478X-2018-11-2-134-143","url":null,"abstract":"SUMMARY \u0000The surgical stage of treatment remains the main one in the complex therapy of breast cancer. The review of modern reconstructive plastic surgery, performed by single-step and delayed after radical mastectomy. Against the background of a huge number of existing methods of breast reconstruction, three main types have become the most popular among surgeons to date: the use of own tissues, silicone endoprostheses and their combination. The final choice of the option of breast reconstruction depends on the volume of cancer surgery, plastic tissue, somatic condition of the patient and her desire. Reconstructive plastic surgery for breast cancer does not affect the course of the disease and are not an obstacle to chemotherapy.","PeriodicalId":283981,"journal":{"name":"Vestnik of Experimental and Clinical Surgery","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124648365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.18499/2070-478X-2018-11-2-101-104
V. Panteleev, Пантелеев Владимир Сергеевич, Vitalii A Zavarukhin, Заварухин Виталий Анатольевич, M. Pogorelova, Погорелова Мария Павловна
Relevance. Infection of mesh implants ("mesh") is a serious problem during hernioplasty, which does not have an unambiguous approach to its solution. Having decided on surgical intervention associated with the removal of the failed implant, the surgeon will face certain technical difficulties associated with the presence of fibrous-granulation fusions that do not allow performing the operation without injuring healthy surround tissue implants. Goal. Improve the results of surgical interventions associated with the removal of reticular implants with ultrasonic cavitation. Methods. We have analyzed our own experience in the treatment of patients who under the conditions of the Republican Clinical Hospital named after. G.G. Kuvatova, Ufa from 2000 to 2017, surgical interventions were carried out related to the removal of infected mesh implants, previously established for ventral hernias of different locations. Almost all patients "prosthetic" hernioplasty was performed in other medical organizations - central district and city hospitals (CRH and TSGB) of the Republic of Bashkortostan. The study included 89 patients who were divided into two groups: the main one (41 patients) where ultrasound and a comparison group (48 people) were used during the implant separation stage from the abdominal wall tissue and subsequent treatment of the wound surface in which all steps of the surgical manual were performed only with the help of conventional surgical instruments. Results. The study showed that the use of ultrasound cavitation of the antiseptic solution allows to achieve a delicate separation of infected mesh implants from the abdominal wall without damaging it with a good bactericidal effect, and to reduce the occurrence of recurrent hernias. Conclusions. Thus, the separation of the "mesh" without damaging the underlying abdominal wall tissue allows to preserve their skeleton, and hence to prevent the subsequent recurrence of hernia formation.
{"title":"Ultrasonic excision of infected mesh implants after hernioplasty","authors":"V. Panteleev, Пантелеев Владимир Сергеевич, Vitalii A Zavarukhin, Заварухин Виталий Анатольевич, M. Pogorelova, Погорелова Мария Павловна","doi":"10.18499/2070-478X-2018-11-2-101-104","DOIUrl":"https://doi.org/10.18499/2070-478X-2018-11-2-101-104","url":null,"abstract":"Relevance. Infection of mesh implants (\"mesh\") is a serious problem during hernioplasty, which does not have an unambiguous approach to its solution. Having decided on surgical intervention associated with the removal of the failed implant, the surgeon will face certain technical difficulties associated with the presence of fibrous-granulation fusions that do not allow performing the operation without injuring healthy surround tissue implants. \u0000Goal. Improve the results of surgical interventions associated with the removal of reticular implants with ultrasonic cavitation. \u0000Methods. We have analyzed our own experience in the treatment of patients who under the conditions of the Republican Clinical Hospital named after. G.G. Kuvatova, Ufa from 2000 to 2017, surgical interventions were carried out related to the removal of infected mesh implants, previously established for ventral hernias of different locations. Almost all patients \"prosthetic\" hernioplasty was performed in other medical organizations - central district and city hospitals (CRH and TSGB) of the Republic of Bashkortostan. The study included 89 patients who were divided into two groups: the main one (41 patients) where ultrasound and a comparison group (48 people) were used during the implant separation stage from the abdominal wall tissue and subsequent treatment of the wound surface in which all steps of the surgical manual were performed only with the help of conventional surgical instruments. \u0000Results. The study showed that the use of ultrasound cavitation of the antiseptic solution allows to achieve a delicate separation of infected mesh implants from the abdominal wall without damaging it with a good bactericidal effect, and to reduce the occurrence of recurrent hernias. \u0000Conclusions. Thus, the separation of the \"mesh\" without damaging the underlying abdominal wall tissue allows to preserve their skeleton, and hence to prevent the subsequent recurrence of hernia formation.","PeriodicalId":283981,"journal":{"name":"Vestnik of Experimental and Clinical Surgery","volume":"142 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122864810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-30DOI: 10.18499/2070-478x-2018-11-2-93-96
E. Zakurdaev, A. V. Chernyh, E. F. Cherednikov, Vladimir Georgievich Vetchinkin
Purpose. Research of features of topography of the arcuate line of the rectus sheath. Materials and methods. There were studied 30 corpses of both sexes without signs of pathology of the anterior abdominal wall. During the autopsy of corpses, the muscular aponeurotic layer of the medial section of the anterior abdominal wall with fragments of the pubic bones, breast and costal arches was taken. On the prepared anatomical preparations was determined localization of the arcuate line of the rectus sheath in the midline relatively to the umbilical ring and the upper edge of the pubic symphysis. Results. In this studied autopsy material the arcuate line of the rectus sheath was more located below the umbilical ring (93%), by the way part of the upper third of the segment from the lower edge of the umbilical ring and the upper edge of the pubic symphysis (50%). In females, the arcuate line of the rectus sheath relative to the umbilical ring was located more lower (5,4±0,8 cm), compared to males (3,5±0,7 cm). Conclusion. The obtained data can be used in performing hernioplasty of variously localized hernias for the prevention of intra- incisional and incisional complications.
{"title":"New facts about variant anatomy of the arcute line (arcute line by J. Douglas) of the rectus sheats and their importance in herniology","authors":"E. Zakurdaev, A. V. Chernyh, E. F. Cherednikov, Vladimir Georgievich Vetchinkin","doi":"10.18499/2070-478x-2018-11-2-93-96","DOIUrl":"https://doi.org/10.18499/2070-478x-2018-11-2-93-96","url":null,"abstract":"Purpose. Research of features of topography of the arcuate line of the rectus sheath. \u0000Materials and methods. There were studied 30 corpses of both sexes without signs of pathology of the anterior abdominal wall. During the autopsy of corpses, the muscular aponeurotic layer of the medial section of the anterior abdominal wall with fragments of the pubic bones, breast and costal arches was taken. On the prepared anatomical preparations was determined localization of the arcuate line of the rectus sheath in the midline relatively to the umbilical ring and the upper edge of the pubic symphysis. \u0000Results. In this studied autopsy material the arcuate line of the rectus sheath was more located below the umbilical ring (93%), by the way part of the upper third of the segment from the lower edge of the umbilical ring and the upper edge of the pubic symphysis (50%). In females, the arcuate line of the rectus sheath relative to the umbilical ring was located more lower (5,4±0,8 cm), compared to males (3,5±0,7 cm). \u0000Conclusion. The obtained data can be used in performing hernioplasty of variously localized hernias for the prevention of intra- incisional and incisional complications.","PeriodicalId":283981,"journal":{"name":"Vestnik of Experimental and Clinical Surgery","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114903929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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