bluuebunny/crossref_metadata_2025 huggingface dataset:
SUBSTANTIATION OF SURGICAL APPROACH IN IATROGENIC INJURIES OF THE BILE-EXCRETING DUCTS
Authors: Maistrenko N. A. , Romashchenko P. N. , Pryadko A. S. , Aliev A. K.
Published: July 2019

The results of examination and treatment were analyzed in 51 patients with iatrogenic injuries of the bile-excreting ducts. Patients were divided into 5 groups according to international classification (EAES, 2013). It depended on the time of detection, the nature and scale of damage of the bile ducts, mechanism of injury, development of infectious and septic complications. Injuries of the main bile duct were detected intraoperatively (n=14). The complete intersection was in 10 patients (the first group) and the edge intersection - in 4 cases (the second group). Iatrogenic injuries of the bile-excreting ducts were revealed in 37 patients in postoperative period. There were the complete intersections in 28 cases (the third group) and the edge intersections - in 7 cases (the fifth group). Injuries of additional bile ducts were determined in 2 patients (the fifth group). An analysis of the main qualifying features of iatrogenic injuries of the bile-excreting ducts allowed defining indications to reconstructive-restorative surgery in 60,8% patients, restorative operations - in 29,4%, an external drainage - in 5,8% and reclipping of additional bile ducts in relaparoscopy - in 3,9%. The rational surgical approach allowed obtaining perfect results in 65,8% and good, satisfactory results in immediate and long-term period with low postoperative lethality of 1,95%. The study of diagnostics results and treatment of the patients with iatrogenic injuries of the bile-excreting ducts indicated about reasonability of assessment of main factors, which are based on iatrogenic injuries according to the EAES classification. An individual program of examination and more rational variant of surgery could be chosen due to this approach, which provides minimization of negative results and good quality of life.
TRANSPLANTATION OF TRACHEAL-LUNG COMPLEX IN EXPERIMENT
Authors: Khubutiya M. Sh. , Tarabrin E. A. , Golovinskiy S. A. , Stan Yu. A. , Guseva T. V. , Dydykin S. S.
Published: July 2019

The article described the developed and patented method of removal of trancheal-lung complex from dead body and its transplantation to the recipient-corps.
EFFICACY OF CLASSICAL CAROTID ENDARTERECTOMY USING TEMPORARY SHUNT
Authors: Mikhailov I. V. , Gusinskiy A. V. , Shlomin V. V. , Orlova O. V. , Rakhmatillaev T. B. , Mohan P. D.
Published: July 2019

The study generalized the 15-year experience of classical carotid endarterectomy performance with application of a temporary carotid shunt and an autovenous path in 325 patients. There were analyzed the more frequent complications in standard groups. Advantages of given method were determined and it was specified the ways, which facilitated to reduction of intraoperative risks and increase of technical quality realization of different stages of surgery.
FEATURES OF DIAGNOSTICS AND TREATMENT OF EXTREMELY SEVERE COMBINED INJURY
Authors: Tulupov A. N. , Besaev G. M. , Sinenchenko G. I. , Taniya S. Sh. , Bagdasar’Yants V. G.
Published: July 2019

The data of examination and treatment of 356 victims with extremely severe combined injury and shock of III degree were analyzed. All the patients had a medical unfavorable life prognosis. On the basis of the research, it was proved, that the modern approach of treatment of such trauma should include an adequate anti-shock treatment in conditions of the first-level trauma center. The operative activity should be increased in cases of combined trauma of bones by their early external fixation. The authors re commend an application of up-to-date prevention sepsis treatment, late reconstructive - restorative operation performance after its full relief and nutritive metabolic therapy. This approach allowed reducing of the rate of life-threaten infectious complications on 32,4% and noninfectious - on 31,7%, the lethality - on 24%.
VARIANT OF HEMOSTATIC SUTURE IN MILLIGAN-MORGAN OPERATION
Authors: Krasnobaev A. E. , Ishchenko V. N. , Grigoryuk A. A. , Matveev A. V.
Published: July 2019

On the basis of great clinical experience, the authors developed the method of choice of optimal surgical aid and suggested an original surgical method of treatment of complicated hemorrhoid. The results obtained were analyzed. There was reliably noted, that the quantity of early postoperative complications decreased, an expression of pain syndrome was lower and there were no relapses during three-year of follow-up. Given technologies allowed an introduction of them as stationary substituting operations on the basis of private medical centers with one day of hospital stay.
OPTIMIZATION OF SURGICAL APPROACH IN PATIENTS WITH TUMORS OF MOTOR ZONE OF THE CEREBRAL CORTEX ON THE BASIS OF TRANSCRANIAL MAGNETIC STIMULATION AND MAGNETIC RESONANCE TRACTOGRAPHY
Authors: Shcherbuk A. Yu. , Eroshenko M. E. , Shcherbuk Yu. A.
Published: July 2019

Preoperative planning on the basis of combined data of navigated transcranial magnetic stimulation and MR-tractography give an opportunity to choose an optimal treatment approach in each clinical case. There were performed the examinations in 52 patients with tumors situated in projection of central gyrus. The neurosurgical interference was admitted as inappropriate in 3 (5,8%) patients. The volume of planned operation was reduced in 14 (26,9%) cases. The examination of 15 (28,9%) patients allowed choice of the correct access trajectory. The navigated transcranial magnetic stimulation assisted in performance of more safe removal of neoplasms closed to the functionally meaningful zones of the brain in 20 (38,4%).
CLINICAL AND EPIDEMIOLOGICAL FEATURES OF INTRACRANIAL COMPLICATIONS OF INFLAMMATORY DISEASES OF THE ENT ORGANS IN CONDITIONS OF THE EAST-SIBERIAN REGION OF RUSSIAN FEDERATION
Authors: Yanov Yu. K. , Krivopalov A. A. , Shatalov V. A. , Shcherbuk A. Yu. , Vakhrushev S. G. , Tuzikov N. A. , Iskhakov Sh. D. , Gryaznov A. V.
Published: July 2019

The authors investigated the epidemiological and clinical features of otogenic and rhinosinusogenic intracranial complications in East-Siberian region of Russian Federation. The rate of intracranial complications consisted of 0,2±0,1% in patients of ENT hospitals in Sakha- Yakutia, Krasnoyarsk Territory, Irkutsk Region, Republic of Tuva. The intracranial inflammatory pathology of otogenic nature was diagnosed two times more frequent than rhinosinusogenic. Meningitis was revealed at the same rate as lesions of brain substance (encephalitis, epi- and subdural abscesses). The high clinical efficacy was shown in surgical treatment of purulent polysinusitis using W. Messerklinger method of functional endoscopic rhinosinusosurgery (FESS). The method of transtemporal incision and drainage of otogenic abscess of the brain temporal lobe has a number of essential defects, because of them, the indications for application of this method should be considered and specified. It is necessary to have an interdisciplinary approach and use the modern achievements of medical science in order to develop the efficacy of treatment of given category of patients.
STRUCTURE FUNCTIONAL STATE OF DAMAGED SPLEEN IN CHILDREN AFTER NONOPERATIVE TREATMENT
Authors: Podkamenev V. V. , Pikalo I. A. , Andaeva T. M. , Boiko T. N.
Published: July 2019

The results of treatment of 75 children with spleen damage were studied. The conservative treatment was applied in 69 (92%) cases. A restoration of spleen structure was noted in case of spleen injury on 3-4 weeks. The complete normalization of the spleen structure occurred in terms of 3-4 months after trauma. Posttraumatic cysts appeared in case of large defects and hematomas after 2-3 weeks and disappeared by 5-6 months. The regenerative process of shallow ruptures was registered after 3-10 weeks, but the deep ruptures were healed after 6-30 weeks. The preservation of the spleen after trauma have led to structure and function recovery and could be considered as primary prevention of asplenism.
TRACHEO-ESOPHAGEAL STENTING IN THEIR TUMOR STENOSIS
Authors: Drobyazgin E. A. , Chikinev Yu. V. , Sudovykh I. E. , Anikina M. S.
Published: July 2019

The article presents the results of diagnostics and treatment of 6 patients, whom the trachea-esophageal stenting was performed (5 men, 1 woman). The age of patients was from 49 to 78 years old. The indication to stent implantation was in cases of esophageal cancer in 4 patients. Metastatic lesions of the lymph nodes of the mediastinum was the reason of esophageal stenosis after previously performed surgery (type of Lewes operation) in one case. Another reason of surgery was central cancer of the right lung with invasion to the mediastinum, trachea and esophagus compression in one patient. Treatment management was determined by presence of respiratory failure and dysphagia evidence. The trachea stenting was carried out as the first stage of treatment in case of respiratory failure. The esophageal stenting was made in case of dysphagia. There weren’t any complications. The trachea-esophageal patency was restored.
CYTOREDUCTIVE OPERATIONS IN TREATMENT OF THE PATIENTS OF ELDERLY AND SENILE AGE WITH DISSEMINATED FORMS OF COLORECTAL CANCER
Authors: Maistrenko N. A. , Khvatov A. A. , Sazonov A. A.
Published: July 2019

Late diagnostics of colon cancer along with high specific weight of the patients of elder age groups indicated the urgency of study of application of cytoreductive surgery in elderly and senile patients of with colorectal cancer. A comparative assessment of the results of cytoreductive operations (primary tumor resection) was made in two groups of patients with disseminated colon cancer (younger and older than 60 years old). It was stated, that the performance of palliative resection allowed them to obtain of encouraging remote results, provide more higher survival rates than in patients of young and mean age groups. The more frequent development of complications after cytoreductive operations was associated with decompensation of accompanying pathology in patients of elder age groups. These data confirmed the need of their adequate correction in preoperative period. The application of cytoreductive surgery significantly improved the quality of life of the patients of elder age groups with disseminated forms of colon cancer.
SOCIAL AND ECONOMIC ASPECTS OF SIMULTANEOUS OPERATIONS ON ABDOMINAL ORGANS
Authors: Kurygin Al. A. , Semenov V. V.
Published: July 2019

The article presents an analysis of 107 cases of simultaneous operations of big volume with main stage as gastric resections (gastrectomy) or large intestine resections and mean volume interferences as cholecystectomy and removal of abdominal hernias. It was stated, that simultaneous operations compared with two steps treatment of combined surgical diseases obtained the high economical efficacy. This efficacy was determined by a single - stage routine presurgical examination, single anesthetic management, less medical expenses for medication and laboratory - instrumental studies in postoperative period, significant shortening the terms of hospitalization and disability terms. The authors proposed formulas to evaluate the economiс efficacy of simultaneous operations in system of paid medical service and system of rendering medical aid using paid medical insurance. The efficacy of large operations was 40 766 rubles and in case of mean volume interventions - 25 382 rubles for the paid medical system. The economical efficacy of simultaneous operations of large and mean volume was the same in the system of obligatory medical insurance. It consisted of 19 737,5 or 22 920,1 rubles and depended on the degree of operative anaesthetic risk of the second intervention in two steps treatment of patients.
CRITERIA OF SURGICAL RISK IN PATIENTS WITH DIFFUSE LUNG EMPHYSEMA WITH LARGE AND GIANT BULLAS
Authors: Gorbunkov S. D. , Varlamov V. V. , Chernyi S. M. , Kiryukhina L. D. , Lukina O. V. , Agishev A. S. , Romanikhin A. I. , Akopov A. L.
Published: July 2019

The article presents an assessment of postoperative period in patients with diffuse lung emphysema with large and giant bullas on the basis of surgical risk criteria, which were developed for the patients with diffuse emphysema without bullas. Retrospective study determined the group of patients who had high rate of surgical complications after bullectomy. The patients (46) were divided into 2 groups and it depended on the initial condition of the patients. There was stated, that the main criterion of surgical risk was a decrease of the level of OFL lower than 20% of the proper level in patients with large and giant bullas.
RESULTS OF HIP ARTHROPLASTY AFTER OSTEOSYNTHESIS OF PROXIMAL FEMUR
Authors: Minasov B. Sh. , Yakupov R. R. , Khairov T. E. , Gafarov I. R. , Sirodzhov K. Kh. , Karimov K. K. , Filimonov G. N. , Trubin A. R.
Published: July 2019

The hip arthroplasty in case of destructive - dystrophic affection is considered as the most effective method, which provided social and home reintegration. A modern science development facilitates to this technique. However, specialists noted that the rate of endoprosthesis complication increased in the patients after osteosynthesis of proximal femur. The authors compared the results of patient’s treatment that applied hip arthroplasty methods after osteosynthesis of proximal femur. The main group consisted of 38 patients who underwent hip arthroplasty after osteosynthesis of proximal femur. The control group had 43 patients with hip idiopathic osteoarthrosis, who underwent primary arthroplasty. The endoprothesis replacement was associated with increase of the rate of intraoperative and postoperative complications in the main group of patients. According to the results, given group of patients requires a special approach to diagnostics and treatment.
ASSESSMENT OF EFFICACY OF THE METHOD OF PROGRAMMED IRRIGATION ASPIRATION SANATION IN COMPLEX TREATMENT OF PATIENTS WITH CHRONIC POSTTRAUMATIC OSTEOMYELITIS OF THE LONG BONES
Authors: Glukhov A. A. , Sergeev V. A.
Published: July 2019

The analysis of treatment results of 128 patients aged from 21 to 62 years old with chronic posttraumatic osteomyelitis of the long bones was made at the period from 2006 to 2013. The main group included 67 patients and the method of programmed irrigation aspiration sanation was applied for them. The comparison group consisted of 61 patients and drainage was performed for these patients using the conventional ways. The authors noted good immediate results in the main group in 56 (83,58%) out of 67 patients and in the comparison group - in 43 (70,49%) out of 61 patients. The long-term results were analyzed in 116 (90,6%) out of 128 patients in terms from two to five years after treatment. The rate of recurrences such as formation of purulent fistula were twice less in patients of the main group, than in the comparison group. According to the results of questionnaire SF-36, there was noticed, that patients of the main group got better mean indices of quality of life on all 8 scales compared with the other group.
BLOOD TRANSFUSION IN LUNG OPERATIONS
Authors: Pashkova I. A. , Porkhanov V. A. , Polyakov I. S. , Sitnik S. D. , Mozheiko M. P. , Zueva Z. Yu. , Sholin I. Yu.
Published: July 2019

The authors admit the risks of blood transfusion, as well as the fact that the blood is a limited resource. These conclusions became the basis of the research in order to make an analysis and develop transfusion strategies in the hospital. An assessment of blood components application was performed in specific cases. There was changed the management of blood transfusion and further monitoring was continued. It was shown that the efficacy of an introduction of a new transfusion strategy confirmed the decrease of the rate of inappropriate blood transfusions, the quantity of patients who obtained transfusion of allogenic blood components and as a result, the new methods reduced the number of blood transfusions.
LEVEL OF THE GUALITY OF LIFE OF THE PATIENTS AFTER ESOPHAGOPLASTY ON THE BASIS OF GASTROINTESTINAL INDEX ASSESSMENT
Authors: Sudovykh I. E. , Drobyazgin E. A. , Chikinev Yu. V.
Published: July 2019

The article presents the interview results of 55 patients after esophagoplasty (30 cases - after esophagogastroplasty, 25 cases - after esophagoplasty) using questionnaire GIQLI. The authors came to conclusions about advantages of extirpation of esophagus with esopagogastroplasty compared with subtotal shunt esophagocoloplasty because of high rate of gastrointestinal index of the quality of life and their components in patients after esophagogastroplasty compared with results of patients after esophagoplasty. There was noted an expessed growth in the scales and rise of gastrointestinal index in patients who underwent esophagogastroplasty after 3 years of follow-up.
LOW-INVASIVE TECHNOLOGIES OF INITIAL SURGICAL D-BRIDEMENT IN POLYTRAUMA AT THE FIRST STAGE OF PROGRAMMED MULTISTAGED SURGICAL TREATMENT
Authors: Shcherbuk Yu. A. , Kozlov V. A. , Golovko K. P. , Gaivoronskiy I. V. , Badalov V. I. , Madai O. D. , Bagnenko A. S. , Golinskiy Yu. F. , Yakimchuk D. A. , Madai D. Yu.
Published: July 2019

The authors described the variants of initial surgical d-bridement on the basis of experience of treatment of 183 patients of multistaged treatment program.
EFFICACY OF FREE AUTOVENOUS TRANSPLANT IN FEMORAL-POPLITEAL BYPASS BELOW THE JOINT SPACE OF THE KNEE
Authors: Sykovatykh B. S. , Belikov L. N. , Sykovatykh M. B. , Sidorov D. V. , Inarkhov M. A. , Inikhodova E. B.
Published: July 2019

The article presents an analysis of complex examination and treatment of 60 patients with critical ischemia of the lower extremities due to atherosclerotic lesions of femoral-poplitealtibia segment. Typical traditional autovenous bypass of reverse big saphena was performed for the first (control) group of patients. The operation, which used an original technology by free autovenous transplant with collapsed valves without vein reverse, was completed for the second (experimental) group of patients. An application of original treatment technology allowed an increase of blood flow volume in the extremity in 1,5 times, an arterial blood flow - in 1,6 times, rate of microcirculation - in 1,3 times. An early postoperative complications were decreased on 23,4%, the late shunt thrombosis - on 40%. Long-term shunt passability was improved in 2,6 times and physical component of health - on 10,6%, psychological - on 4,3%. The shunt functioned in 36,7% of the first group and in 83,3% patients of the second group after two years since operation. The extremity was saved in 60% of the first group and 90% patients of the second group.
URGENT DIAGNOSTICS OF CEREBRAL VENOUS TROMBOSIS
Authors: Tibekina L. M. , Shumakova T. A. , Nikolaeva A. A. , Shcherbuk Yu. A.
Published: July 2019

Investigations were carried out in 24 patients in order to evaluate information value of the data of clinical, laboratory, neuroradiological methods of research and develop the diagnostic algorithm in case of cerebral venous thrombosis (CVT). The main group consisted of 11 patients (7 male, 4 female, average age 49,1±4,3) with CVT. The comparison group included 13 patients (6 male, 7 female; average age 68,1±9,5) with ischemic stroke (IS) of moderate severity. There were revealed changes in blood and cerebrospinal fluid (CSF) as form of leukocytosis of blood and moderately increased cell count with elevated protein in CSF and blood in case of CTV. The authors noted an elevated protein in CSF and blood and leukocytosis with predominant lymphopenia in blood and neurophilic predominance in CSF within the reference range of CSF in patient with ischemic stroke. The epileptic attacks, meningeal syndromes, headaches were more often among clinical syndromes at CTV than in case of ischemic stroke. The algorithm of neuroimaging research methods and modes of MRI were determined and allowed an effective diagnostics of damages of venous sinuses, superficial and deep cerebral veins in case of urgent hospitalization of patients. It was possible to suggest the venous pathology in 7 (63,6%) cases due to SKT (without contrast) and in case of application of MR venography (2D TOFmode), there were revealed 100% of cases.
TRANSTHORACIC PUNCTURE BIOPSY IN DIAGNOSTICS OF FOCAL LESIONS OF THE LUNG
Authors: Drobyazgin E. A. , Kudryavtsev A. S. , Chikinev Yu. V. , Zheravin A. A. , Blagitko E. M. , Shtofin S. G. , Shumkov O. A.
Published: July 2019

The transthoracic puncture biopsy was performed under surveillance of X-ray computed tomography in order to verify diagnoses in 80 patients with lung tumors. This procedure allowed verification of diagnosis and choice of treatment strategy in 95% of cases. The complications obtained as result of intervention didn’t bring severe character and were arrested in term of two days.
PHARMACOECONOMIC ANALYSIS OF EFFICACY OF DIFFERENT MODES OF ANTIBIOTIC PROPHYLAXIS IN CHOLECYSTECTOMY
Authors: Poborskiy A. N. , Ponamarev N. I. , Asutaev Sh. D.
Published: July 2019

Pharmacoeconomic assessment of efficacy of different modes of antibiotic prophylaxis was made in 27 patients with diagnosis of acute calculous cholecystitis using method of «cost-efficacy». Patients have taken ampicillin/sulbactam intravenously in the dose of 1,5 g or cephazolin intravenously in the dose 2,0 g. Medicine should be taken in 30 min. before the operation. The most expensive was antibiotic prophylaxis by cephazolin. The coefficient of «cost-efficacy» was 774,2 rubles on 1 unit of efficacy in case of cephazolin and it was 506,1 rubles on 1 unit of efficacy in other group with antibiotic prophylaxis by ampicillin/sulbactam. The authors noted the economical and clinical advantage of antibiotic prophylaxis by ampicillin /sulbactam.
PREDICTION OF TUMOR DEVELOPMENT OF MAMMARY GLANDS IN WOMEN OF VARIOUS AGE GROUPS
Authors: Zhirnova A. S. , Kurlaev P. P. , Shevlyuk N. N.
Published: July 2019

The article provides the data of information value of risk factors of disease development of mammary glands in women of various age. The authors presents the method of assessment of individual risk of pathology development of mammary glands with following choice of personal examination program, which allowed timely detection of pre-cancerous condition and early forms of tumorous processes in mammary glands. This method would facilitate to decrease of the rate of advanced forms in given pathology, morbidity and at the same time would improve prognosis and increase the quality of life for women.
CLINICAL VALUE OF MEASURMENT OF INTRA- ABDOMINAL PRESSURE AND ITS MONITORING IN EMERGENCY SURGERY
Authors: Timerbulatov V. M. , Timerbulatov Sh. V. , Timerbulatov M. V. , Gareev R. N. , Smyr R. A.
Published: July 2019

The article presents an analysis of modern methods of the measurement, including classical and original methods and devices developed by the authors. The results of examination and treatment were analyzed in 397 patients with acute obturation intestinal obstruction and acute destructive pancreatitis, who had the abdominal compartment syndrome from I to IV degree. The authors showed that on-time decompressive laparotomy allowed the decrease of lethality from 25% to 15-17,8%.
TREATMENT RESULTS OF PATIENTS WITH COMPLICATED COLORECTAL CANCER IN ORDINARY HOSPITAL AND HOSPITAL ON REGIONAL LEVEL
Authors: Shchaeva S. N. , Narezkin D. V.
Published: July 2019

The article analyzed the results of surgical treatment of 1098 patients with urgent complications of colon cancer (acute intestinal obstruction, enterorrhagia, perforation, perifocal inflammation) in patients from Smolensk and Smolensk Region at the period from 2001 to 2013. The volume of surgical intervention depended on the age of patients, terms of hospital admission from the moment of complication development, common condition of patients, presence of severe accompanying pathology, localization of malignant tumor, presence of locally advanced process, regional metastasis, kind of urgent complication.
METABOLIC SURGERY IN CORRECTION OF FATTY LIVER DISEASE
Authors: Fishman M. B. , Karev V. E. , Yan V. , Sokolova D. A. , Mitsinskaya A. I. , Mitsinskiy M. A.
Published: July 2019

The article presents the results of treatment of 68 patients who underwent laparoscopic sleeve gastric resection (LSG) and laparoscopic gastric bypass (LGB) at the period from 2014 to 2015. The efficacy of operations on the course of nonalcoholic fatty liver disease (NAFLD) was estimated. There were performed a liver biopsy and histological studies with determination of histological activity index, the rate of severity of fibrosis according R. G. Knodell scale and METAVIR system, nature and degree of manifestation of steatosis of hepatocytes and intrahepatic cholestasis. NAS activity scale was used to evaluate morphological changes. The results of 1,5-year follow-up study were assessed in dynamics. Fibro Test results were in the range from 0 to 1 depending of fibrosis severity using METAVIR system (from F0 to F4), Knodell and Ishak scales. It was stated that there was an improvement of histological and functional findings in cases of hepatic steatosis, inflammation and fibrosis. All the patients (100%) initially had the signs of NAFLD and 12 patients (22,6%) - fibrosis. The complete regression of NAFLD was noted in 43(81,1%) cases and signs of previous fibrosis were smoothed over in 6 patients (41%). Liver function tests have deteriorated at 6-month period, but tests improved to normal rates at the end of 1-year period. The bariatric surgeries are effective methods of NAFLD treatment and Fibro Test is non-invasive and reliable method of liver state assessment.
DIFFICULTIES OF DIAGNOSTICS AND CHOICE OF SURGICAL APPROACH IN PATIENTS WITH DUCTAL CHOLANGIOCARCINOMA
Authors: Granov D. A. , Timergalin I. V.
Published: July 2019

Diagnostics and treatment of ductal cholangiocarcinoma is an actual and complicated problem of modern hepatopancreatobiliary surgery. The data of preoperative examination using modern methods weren’t always well-defined. This fact didn’t allow clinicians to choose the common treatment strategy and improve the prognosis. The main problem of diagnostic stage was a low morphological verification of the disease, so the diagnosis was confirmed in 17,5% patients. The article presents the results of examination and surgical treatment of 40 patients with suggested diagnosis of ductal cholangiocarcinoma. Indications to operation were based on examination data (CT, MRI, cholangiography, angiography, tumor markers tests) and signs of complications (jaundice, cholangitis, liver abscess). The absence of morphological verification couldn’t be the reason for rejection from the operation. Radical operative intervention had a distinctive advantage. The surgery gave the chance for positive long-term prognosis in case of cancer and allowed doctors to cure patients in case of benign tumor. Functional state of the liver and morphological changes of the removed share should be considered in case of hilus carcinoma. This approach has to be strictly individual and medical care should be applied in special medical centers.
SUBSTANTIATION OF REAMBERIN APPLICATION IN COMPLEX TREATMENT OF PATIENTS WITH ACUTE SMALL BOWEL OBSTRUCTION
Authors: Skripko V. D. , Kovalenko A. L. , Zaplutanov V. A.
Published: July 2019

The study evaluated the efficacy of reamberin in complex treatment of patients with acute small bowel obstruction. Methods. The research is based on the results of complex examination of 202 patients with acute small bowel obstruction (ASBO). The patients were hospitalized in Ivano-Frankovsk central municipal clinical hospital at the period from 2009 to 2015. The patients were divided into two groups according to the method of treatment. The complex treatment using common method was applied for the first group of 100 patients with ASBO. The complex treatment using common method and reamberin intravenously (800 ml/day) during 7 days was applied for the second group of 102 patients. Results. The application of reamberin reduced a lot of indices such as leukocytic intoxication, intoxication index, level of middle mass molecule, formation of malonic dialdehyde. The drug stimulated antioxidant system and normalized organ-specific liver enzymes. Conclusions. The application of reamberin is pathogenetically validated in cases of ASBO.
ROBOTIC INTERVENTIONS IN THORACIC TUMORS (EXPERIENCE OF 30 PRIMARY OPERATIONS)
Authors: Kudryavtsev A. S. , Yarmoshchuk S. V. , Zheravin A. A. , Drobyazgin E. A. , Chikinev Yu. V.
Published: July 2019

OBJECTIVE. The research evaluated the data of robotic thoracoscopic interventions. MATERIALS AND METHODS. The article presents the results of robotic surgery in 30 patients aged 41 to 78 years with lung tumors of various localization and tumors of anterior mediastinum. The non-typical resection of the upper lobe was performed on 17 patients and extended lobectomy was conducted in 10 cases. The removal of anterior mediastinal tumor was made in 3 patients. RESULTS. There weren’t noted any complications in early postoperative period. The length of non-typical resection consisted of 40-50 min, but in case of removal of lung lobe with lymphodissection the duration of surgery was 3-3,5 hours. The removal of tumor from the anterior mediastinum took from 80 min to 1,5 hours. The diagnosis was made according to postmortem examination in all cases. All the patients were discharged from hospital in order to continue treatment. CONCLUSIONS. The results obtained showed the safety and efficacy of robotic interventions.
ASSESSMENT OF THE RESULTS OF ESOPHAGOGASTROPLASTY OF SCARRY STRICTURE OF THE ESOPHAGUS AND ESOPHAGEAL ACHALASIA
Authors: Chikinev Yu. V. , Drobyazgin E. A. , Sudovykh I. E. , Anikina M. S. , Nurlanbaev E. K.
Published: July 2019

Department of hospital and pediatric surgery, Novosibirsk State Medical University OBJECTIVE. The authors made a complex assessment of functioning of the artificial esophagus, which was formed from the stomach. The pathological study of biopsy material of mucous coat of the stomach was carried out at different terms after surgery. MATERIALS AND METHODS. The research analyzed the results of esophagogastroplasty in cases of scarry strictures of the stomach after burns and esophageal achalasia in 101 patients. All the patients underwent extirpation of the esophagus with the gastric tube plasty. RESULTS. There weren’t noted any complications with gastric graft functioning. These data were confirmed by X-ray and endoscopy. The structural reorganization of the mucous coat with signs of atrophy was revealed according to the data of pathologic research. CONCLUSIONS. The authors indicated the necessity of the dynamic follow-up of the patients after esophagoplasty.
SIMULTANEOUS REVASCULARIZATION OF AORTOFEMORAL AND FEMOROPOPLITEAL ARTERIAL SEGMENTS BY SEMICLOSED LOOP ENDARTERECTOMY
Authors: Shlomin V. V. , Gusinskiy A. V. , Gordeev M. L. , Mikhailov I. V. , Maistrenko D. N. , Rakhmatillaev T. B. , Nikolaev D. N. , Shatravka A. V. , Solov’Ev A. V. , Korotkov I. V. , Komissarov K. A. , Mamedova A. I.
Published: July 2019

OBJECTIVE. The authors would like to consider the possibility and feasibility of simultaneous revascularization of two arterial segments in patients with lower extremity arterial occlusive disease by method of semiclosed loop endarterectomy. MATERIALS AND METHODS. The research included 143 patients. Revascularization of aortofemoral segment was performed on 67 patients. The simultaneous revascularization of aortofemoral and femoropopliteal segments was carried out for 76 patients. The follow-up period was 5 years. RESULTS. There was revealed that the long-term results of multilevel reconstruction were worse that single-level reconstruction. This method requires an individual approach. The best results of simultaneous interventions were obtained in patients aged 60 and older with the III stage of chronic limb ischemia and 2 or 3 working shin arteries. The worst results were observed in patients younger than 50 year old with IV stage of critical limb ischemia and significant lesions of shin arteries.
DIAGNOSTIC VALUE OF DEFINITION OF FRACTIONS OF PROSTATIC SPECIFIC ANTIGEN AND PROSTATE HEALTH INDEX
Authors: Al-Shukri A. S. , Yakovlev V. D. , Boriskin A. G. , Borovets S. Yu. , Rybalov M. A.
Published: July 2019

OBJECTIVE. The authors investigated the value of comprehensive assessment of clinical and laboratory factors including prostate specific antigen (PSA) fractions and prostate health index (PHI) in diagnostics of prostate cancer. MATERIALS AND METHODS. The study numbered 148 patients who were examined for suspected prostate cancer. Clinicians made the measurement of total PSA and fractions, PHI, multifocal transrectal biopsy of prostate. The statistical data were analyzed. RESULTS. The formulas obtained used the discriminant analysis of all clinical and laboratory factors (PSA fractions and PHI). These formulas showed the high possibility (77-80 %) to predict the presence of prostate cancer with sensitivity 70-78 % and specificity 77-83 %. Percentage of [-2]proPSA depended on PHI value and had the significant influence on the possibility of prostate cancer detection.
PLASTY OF DURA MATER DEFECTS BY COLLAGEN IMPLANTS USING NON-SUTURE CONTACT DIRECT BONDING METHOD
Authors: Alekseev D. E. , Svistov D. V. , Matsko D. E. , Alekseev E. D.
Published: July 2019

OBJECTIVE. The study investigated and compared the efficacy of plasty of dura mater using different collagen materials in the experiment. MATERIALS AND METHODS. The experimental study in vivo was carried out on 60 laboratory animals. Rabbits were divided into 4 groups after performing the craniotomy and dura mater opening. It depended on the material used for plasty of dural defects such as Duraform, Lyostypt and Russian prototype of collagen matrix for dural grafting. The fourth group was the control group. The presence and severity of meningo-cerebral adhesion, histological and immunological researches of duraplasty areas were performed after the experiment. RESULTS. The severity of meningo-cerebral adhesion was significantly higher in control group, but there wasn’t noted any meaningful difference in the groups with different collagen matrices. These groups had similar histological and immunohistochemical features. CONCLUSIONS. An application of collagen matrix improved the results of duraplasty and prevented formation of meningo-cerebral adhesions in the experiment. This data predict the high clinical efficacy of the method.
PROVISION OF SURGICAL SAFETY
Authors: Timerbulatov V. M. , Timerbulatov Sh. V.
Published: July 2019

OBJECTIVE. The research assessed the efficacy of WHO checklist for prevention of avoidable complications in surgery. MATERIALS AND METHODS. The article presents the results of implementation of WHO recommendations (checklist of measures) for prevention of so-called avoidable complications in surgery during performance of 35300 operations in 3-year period. The authors included two additional issues in the checklist about prevention of thromboembolic complications and temperature control in the operating unit. RESULTS. The number of preventable complications decreased in clinic after the implementation of WHO recommendations. The rate of thromboembolic and different postoperative complications also reduced in comparison with other clinic, where these recommendations haven’t been applied. CONCLUSIONS. The introduction of principles of prevention of complications in surgery according to WHO recommendations allowed significant decrease of the number of avoidable complications.
POSTOPERATIVE COMPLICATIONS OF COMBINED SURGERIES IN PATIENTS WITH DISSEMINATED FORMS OF COLON CANCER
Authors: Maistrenko N. A. , Khvatov A. A. , Sazonov A. A.
Published: July 2019

OBJECTIVE. The authors investigated the peculiarities and character of complications in gerontological patients with disseminated forms of colon cancer after combined and extended operative interventions. MATERIALS AND METHODS. A retrospective analysis of treatment results of 154 patients was made. The single-stage combined operations were performed on 32 patients of the first group with IV stage of colon cancer. The operation included removing of primary tumor and liver metastases. Combined and extended operative interventions were carried out on 122 patients of the second group with locally-advanced colorectal cancer (T3-4N1-3M0). The patients of both groups were divided into 2 subgroups according to the age: subgroup A - over 60 years of age, subgroup B - younger than 60. Comparison of parameters of postoperative period was made separately in each group between subgroups. RESULTS. There weren’t noted any reliable increase in rate of surgical complication in patients of elderly and senile age with disseminated forms of colon cancer after combined operations. These operations accompanied by high risk of development of functionally-somatic complications as a rule connected with decompensation of concurrent pathology. CONCLUSIONS. The authors recommend to make the careful assessment of general somatic status of gerontological patients with disseminated forms of colorectal cancer and apply the multidiscipline approach in order to balance on time the concurrent pathology after combined operations.
Chemical pleurodesis using bleomycin in treatment of patients with transsudative pleural effusion in hepatic failure
Authors: Akopov A. L. , Carlson A. .. , Gorbunkov S. D. , Agishev A. S. , Romanikhin A. I.
Published: July 2019

OBJECTIVE. The authors analyzed the efficacy of bleomycin application as sclerosing agent in patients with transudative pleural effusion in consequence of hepatic failure. MATERIAL AND METHODS. The research included 7 patients with right side hepatic transudative pleural effusion who didn’t respond to conservative medical treatment. Drainage of the right pleural cavity with following injection of bleomycin were performed for all the patients. RESULTS. This procedure was effective in 6 out of 7 patients (86 %). There was a single case of recurrence and lethal outcome (14 %) due to hepatic coma. There weren’t noted any severe side effects during 6 months after induction of bleomycin. CONCLUSIONS. Pleurodesis using bleomycin appeared to be effective and safe method of treatment for patients with hepatic transudative pleural effusions.
Technical features of laparoscopic prosthetic hernioplasty of inguinal hernia
Authors: Guslev A. B. , Cherepanov D. F. , Rutenburg G. M. , Yeltsin S. S.
Published: July 2019

OBJECTIVE. The authors investigated different methods of hernioplasty. MATERIAL AND METHODS. Endovideosur gical inguinal hernioplasty was performed in 3900 patients at the period from 1994 to 2016. The article described the developed and implemented techniques, strategy of surgical treatment, the choice of the type and size of prostheses in patients with different variants and complex forms of inguinal hernias. RESULTS. Specific postoperative complications were analyzed and suggested the methods of their prevention. CONCLUSIONS. The analysis of results was made. The authors gave recommendations concerning the technique of operative intervention.
Surgical treatment of chronic pancreatitis complicated by bleeding in cystic cavity
Authors: Bazhenova N. A. , Vasilevskiy D. I. , Sedov V. M. , Fetyukov A. I.
Published: July 2019

OBJECTIVE. The authors studied the rate of bleeding from cystic cavity of the pancreas and analyzed the completed treatment. MATERIAL AND METHODS. The article presented an experience of treatment of 155 patients with chronic cystic pancreatitis. Pseudocysts complicated by hemorrhage into their cavity in 8 patients. The signs of gastroduodenal and intraabdominal bleeding had 5 patients. RESULTS. Suturing of bleeding vessels, extirpation of the stomach, external drainage of pancreatic cysts and gastrocystoanastomosis were immediately performed in 5 patients. Diagnostic angiography was conducted in order to localize a source of bleeding with subsequent attempt of endovascular occlusion of this vessel in 3 patients. Endovascular occlusion stopped bleeding in 2 cases, though it caused a spiral migration and lethal outcome in one case. CONCLUSIONS. Bleeding from the pancreatic cysts was difficult to diagnose. This pathology left the only surgical method of saving patient in most cases.
Endovideo-assisted emergency surgeries in system of multiple-stage treatment of victims with severe craniofacial trauma
Authors: Shcherbuk Yu. A. , Madai D. Yu. , Golovko K. P. , Madai O. D. , Shcherbuk A. Yu. , Gavrilin S. V. , Sidorov P. S. , Gorshkov E. A. , Bumai A. O. , Absava K. A.
Published: July 2019

OBJECTIVE. The article presents the complex management of treatment in multiple trauma using endovideoassisted surgeries. MATERIAL AND METHODS. The authors demonstrated minimally invasive methods of treatment for victims with multiple trauma on the second stage of programmed multiple-stage surgery in order to eliminate life-threatening consequences and fix fractures of facial skeleton. These operations were performed during 12 hours after trauma. RESULTS. Programmed multiple stage treatment included the prevention or stop of asphyxia, bleeding and temporary fixation of fractures using extrafocal osteosynthesis and elements of primary plasty of soft tissues. Surgeons created conditions for intensive therapy (tracheostomy) using minimally invasive methods. CONCLUSIONS. Endovideo-assisted technique decreased trauma of surgical approach and allowed doctors to perform revision of complex anatomical structures, which were difficult to access. It expanded the volume and possibilities of surgical manipulations. Surgeons differentially removed foreign bodies and areas of necrosis. The method increased an accuracy of reconstructive surgeries and facilitated to monitoring of damaged structures.
Analysis and planning of correction of midfoot deformity located in sagittal plane of X-ray
Authors: Solomin L. N. , Ukhanov K. A. , Boichenko A. V. , Khertsenberg D. ..
Published: July 2019

OBJECTIVE. The authors developed a new method of assessment and planning of correction of sagittal midfoot deformity, which is based on original reference lines and angles. MATERIAL AND METHODS. X-ray lateral foot projections without deformities were analyzed in 64 adult volunteers. There was determined the angle between articular line of talus trochlea joint and the first metatarsal mechanical axis. It was estimated the ratio of segment length which was limited by distal point of the head of first metatarsal bone and distal edge of articular surface of talus trochlea joint (AC) to segment length, which was limited by edge of articular line of talus trochlea joint (AB). RESULTS. The target angle was 23,6 ± 3,2. The ratio coefficient of segment length AC to AB consisted of 4,3 ± 0,9. The method of planned foot correction was based on data obtained. It allowed doctors to determine the deformity apex and normal position of the first metatarsal head. CONCLUSIONS. The developed method facilitates to plan surgical correction of midfoot deformity in sagittal plane. It gives an opportunity to assess correction results independently from presence of equinus foot position in ankle joint and (or) hindfoot deformity.
Experimental clinical substantiation of application of immobilized forms of sodium hypochlorite in treatment of infected pancreatonecrosis
Authors: Sukovatykh B. S. , Zhukovskiy V. A. , Blinkov Yu. Yu. , Itinson A. I. , Elenskaya E. A. , Pashkov V. M.
Published: July 2019

OBJECTIVE. The study substantiated the possibility of application of sodium hypochlorite for treatment of infected pancreatonecrosis. MATERIAL AND METHODS. The experimental study was conducted on 288 rats. Clinical research was carried out on 94 patients who were divided into two statistically homogenous groups. «Levomecol» ointment was used in the first group for sanation of omental bursae (lesser sac). The immobilized form of sodium hypochlorite was applied for the second group. RESULTS. Anti-inflammatory activity of immobilized form of sodium hypochlorite exceeded this activity in case of «Levomecol» application in 1,2-1,4 times. Anti-microbial activity was higher in 1,6-1,8 times at different terms of treatment of experimental animals. The proposed method of treatment of infected pancreatonecrosis allowed doctors to decrease the number of postoperative complications in patients on 11,2 % and lethality - on 9,2 %. CONCLUSIONS. It was stated that the application of immobilized forms of sodium hypochlorite for sanation of the omental bursae was pathogenically justified and efficient.
Urinary dysfunction in patients with unsatisfactory results of surgical treatment of benign prostatic hyperplasia
Authors: Al-Shukri S. Kh. , Giorgobiani T. G. , Amdiy R. E. , Al-Shukri A. S.
Published: July 2019

OBJECTIVE. The study aimed to develop diagnostics and treatment of urinary dysfunction in patients with unsatisfactory results of surgery of benign prostatic hyperplasia (BPH). MATERIAL AND METHODS. The urodynamic studies were made for 93 (72,7 %) patients after transurethral resection of the prostate and 35 (27,3 %) patients after open adenomectomy. All the patients had urinary dysfunctions after surgery of BPH. RESULTS. Detrusor hyperactivity was revealed in 51 (39,9 %) patients. Detrusor hypoactivity was noted in 21 (16,4 %) patients. Combination of detrusor hyperactivity during storage phase and detrusor hypoactivity during emptying phase had 25 (19,5 %) patients. Infravesical obstruction was detected in 22 (17,2 %). Urgent incontinence was diagnosed in 10 cases. There were 9 patients with signs of stress and condition combined with predomination of stress component. Treatment depended on the causes of urination dysfunction. CONCLUSIONS. Results of urodynamic studies allowed doctors to implement pathogenically verified therapy of urinary dysfunction after surgery of benign prostatic hyperplasia and improve its efficacy.
Application of derinat and titanium glycerosolvate aquacomplex in treatment of destructive forms of erysipelas
Authors: Brazhnik E. A. , Glukhov A. A. , Aralova M. V.
Published: July 2019

OBJECTIVE. The authors researched the ways of improvement of treatment results in patients with complicated forms of erysipelas. MATERIAL AND METHODS. There were examined 68 patients with erysipelas complicated by abscess, phlegmon or necrosis of soft tissues. Basic treatment was used for the first group of patients. Combination of basic treatment and application of titanium glycerosolvate aquacomplex were carried out in the second group. Basic treatment and immunomodulator Derinat were applied in the third group. Combined therapy including titanium glycerosolvate aquacomplex and Derinat was used in the fourth group. RESULTS. Prescription of Derinat for patients with erysipelas allowed doctors to eliminate symptoms of general intoxication in more earlier terms compared with сonventional treatment. The application of Derinat stimulated T-and B-сomponents of immune system. The local application of Tizol facilitated to earlier decrease of inflammation and it stimulated regeneration processes in the wound. CONCLUSIONS. The therapy of destructive forms of erysipelas which included Derinat and Tizol shortened the terms of cleansing and repair of purulent wounds. This method increased the efficacy of treatment of given class of patients.
Selective Staining and Quantification of Intracellular Lipid Droplets with CBD-Fluor, a New and Versatile Push-Pull Fluorophore
Authors: Suarez S. Israel , Warner Caroline C. , Brown-Harding Heather , thooft andrea , VanVeller Brett , Lukesh John
Published: July 2019

A novel lipophilic dye, based on the structures of benzothiadiazole heterocycles, was shown to be an effective fluorescent stain for the imaging of lipid droplets (LDs) within both fixed and live cells. Its high photo stability, large Stokes shift, and improved staining and specificity over that of commercial dye Nile Red highlight its great potential as a versatile chemical tool for facilitating LD imaging and research.