ABSTRACT
OBJECTIVE: To study the immunohistochemical features of various scar tissues in children without connective tissue pathology and with undifferentiated connective tissue dysplasia syndrome. MATERIAL AND METHODS: Tissue biopsy was performed in 217 children who underwent surgical treatment for various lesions, such as injuries, burns, as well as other procedures. There were 127 boys (58.5%) and 90 (41.5%) girls. The main group consisted of 98 (48.2%) children with scar tissue; group of UCTD syndrome - 65 (30.0%) children; control group - 43 (24.8%) patients without pathological scars. Histological examination of scar tissue and intact skin was carried out during primary or redo reconstructive surgery. Immunohistochemical study of antibodies against CD34, CD105, CD140b, PDGFs, COL types I, III and IV was performed. RESULTS: The study showed a quantitative characteristic of expression of COL type I in hypertrophic scar with predominance in the main group (77.5±5.4%; p<0.05), and decrease in COL type IV. Keloid form was associated with predominance of granulation tissue in all layers of dermis and high levels of all types of collagen. In the group of UCTD, COL type III prevailed in all pathological forms of the scar. We determined quantitative indicators of expression of vascularization factors (CD34; CD105) and fibroblastic activity (CD140b; PDGFs). CONCLUSION: Understanding the process of fibrinogenesis and analysis of stages of triggering mechanisms are essential for development of preventive algorithms. Individualized approach should be considered in the treatment. These studies are especially important in children with UCTD syndrome as high-risk group for pathological scarring. Thus, further research is required.
Subject(s)
Cicatrix, Hypertrophic , Keloid , Child , Cicatrix, Hypertrophic/etiology , Collagen , Connective Tissue/pathology , Female , Fibroblasts/pathology , Humans , Keloid/pathology , MaleABSTRACT
The authors describe modern 3D technologies in hepatobiliary surgery. These approaches reduce the risk of intra- and postoperative complications. Virtual 3D reconstruction with clear visualization of parasitic cyst, adjacent vessels and bile ducts is valuable to create 3D-model of liver. This model may be applied for personalized laparoscopic approach and precise surgical intervention.
Subject(s)
Biliary Tract Surgical Procedures/methods , Hepatectomy/methods , Imaging, Three-Dimensional , Liver/surgery , Surgery, Computer-Assisted , Bile Ducts/diagnostic imaging , Bile Ducts/surgery , Humans , Laparoscopy , Liver/diagnostic imaging , Patient-Specific Modeling , Postoperative Complications/prevention & controlABSTRACT
OBJECTIVE: To compare the effectiveness of multi-port and single-port laparoscopic surgery in the treatment of hydatid cyst of the liver. MATERIAL AND METHODS: There were 25 children with solitary hydatid cyst of the liver (CL-CE2) who underwent surgery in 2013-2017. Mean age was 10.1±2.05 years. There were 17 boys and 8 girls. Patients were divided into 2 groups: group 1 (multi-port laparoscopy) - 19 patients, group 2 (single-port laparoscopic surgery) - 6 patients. RESULTS: Duration of ultrasound-assisted laparoscopy (G11 generator) was significantly shorter in the group 1 compared with group 2 (62.2±5.4 vs. 85.3±9.7 min, p<0.05). Intraoperative complications were absent. Biliary fistula in postoperative period was observed in 1 (5.3%) patient of the group 1. External drainage was effective. Residual cavity in 6 months after laparoscopic resection was observed in 1 (16.7%) patient of the group 2. Recurrent liver echinococcosis was not recorded. CONCLUSION: Hydatid cyst (CL-CE2) of the liver is an indication for laparoscopic echinococcectomy. Multi-port laparoscopy is characterized by reduced duration of surgery and postoperative morbidity compared with single-port procedures.
