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1.
Ter Arkh ; 93(2): 138-144, 2021 Feb 15.
Artigo em Russo | MEDLINE | ID: mdl-36286635

RESUMO

The research was performed at the Loginov Moscow Clinical Scientific Center. It is based on Russian obstructive jaundice (OJ) consensus results, considered at the 45th annual Central Research Institute of Gastroenterology Scientific session Oncological issues in the gastroenterologist practice (1 March 2019). The article objective is to note the diagnostic and conservative treatment current issues in patients with OJ. The increase in the number of patients with OJ of different etiology provides problem actuality. In a large number of cases, medical treatment is delayed due to inadequate diagnostic and management, while correct patients routing today can be provided regardless of medical institution level. In this article the examination steps and conservative treatment role in patients with biliary obstruction management are presented.

2.
Khirurgiia (Mosk) ; (6): 5-17, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32573526

RESUMO

The Russian consensus document on topical issues of the diagnosis and treatment of obstructive jaundice syndrome was prepared by a group of experts in various fields of surgery, endoscopy, interventional radiology, radiological diagnosis and intensive care. The goal of this document is to clarify and consolidate the opinions of national experts on the following issues: timing of diagnosis of obstructive jaundice, features of diagnostic measures, the need and possibility of conservative measures for obstructive jaundice, and strategy of biliary decompression depending on the cause and level of biliary block.


Assuntos
Icterícia Obstrutiva/diagnóstico , Icterícia Obstrutiva/terapia , Consenso , Humanos , Federação Russa
3.
Angiol Sosud Khir ; 22(3): 59-64, 2016.
Artigo em Russo | MEDLINE | ID: mdl-27626251

RESUMO

The authors analysed the immediate outcomes of implanting stents with bioactive coating in treatment of patients presenting with atherosclerotic lesions of the superficial femoral artery. Over the period from January 2014 to December 2015, endovascular interventions on the superficial femoral artery were carried out in a total of 18 patients (mean age 61.3±9.2 years). The implants inserted were stents with bioactive coating based on titanium oxinitride, measuring 6 to 8 mm in diameter and being from 50 to 200 mm long. Prior to operation and 7 days after implantation of the stent, the immunoenzymatic assay was used to determine the level of nitrogen nitric oxide (NO) in blood. The stents' patency was assessed by the findings of ultrasound duplex scanning performed at 30 days, and then 6 and 12 months after the intervention. There were no complications either during the operation or in the early postoperative period. An increase in the ankle-brachial index was observed in all patients: with the average value prior to treatment amounting to 0.4±0.3 and equalling 1.1±0.2 after stenting (p<0.0001). Normalization of the blood NO level was revealed (was noted to normalize): the mean value prior to operation amounted to 18.9±2.3 µmol/L and after operation to 28.9±4.1 µmol/L (p<0.05). Primary patency rate of the stents was 100% at 30 days, 94.5% (1 occlusion) at 6 months and 88.8% (1 restenosis and 1 occlusion) at 12 months. The patients with occlusion or restenosis were subjected to repeat endovascular interventions, with restoration of patency of the construction (with the construction's patency restored). By now all the 18 patients show preserved patency (currently patency was preserved) of lower-limb arteries, with no evidence of restenosis in the zones of operations. It was concluded that using stents with bioactive coating based on titanium oxinitride results in normalization of the level of NO in blood, which may contribute favourably to prolongation of the period of functioning of endovascular constructions. The first data concerning primary patency of stents of this type make it possible to count on betterment of the remote results of treatment of patients presenting with atherosclerotic lesions of the superficial femoral artery.


Assuntos
Arteriopatias Oclusivas , Implante de Prótese Vascular , Stents Farmacológicos , Artéria Femoral , Titânio/uso terapêutico , Idoso , Índice Tornozelo-Braço/métodos , Arteriopatias Oclusivas/diagnóstico , Arteriopatias Oclusivas/metabolismo , Arteriopatias Oclusivas/fisiopatologia , Arteriopatias Oclusivas/cirurgia , Implante de Prótese Vascular/instrumentação , Implante de Prótese Vascular/métodos , Materiais Revestidos Biocompatíveis/uso terapêutico , Angiografia por Tomografia Computadorizada/métodos , Feminino , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/sangue , Desenho de Prótese , Federação Russa , Resultado do Tratamento , Ultrassonografia Doppler Dupla/métodos , Grau de Desobstrução Vascular
4.
Vestn Khir Im I I Grek ; 175(5): 36-40, 2016.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-30422445

RESUMO

The chemoinfusions (310) were carried out in celiac trunk in 167 patients with non-removed pancreas cancer at the period from 2000 to 2015. Locally advanced timorous process (stage III, n=79) was revealed in 79 patients and liver metastases (stage IV, n=88) were noted in 88 cases. The celiac axis infusion by Gemcitabine (1000 mg/m²) was applied for patients and GEMOX (Gemcitabine+Oxaliplatin 75 mg/m²) has been using since 2012. Symptomatic improvement such as decrease of pain, growth of body weight was noted in majority of patients. An average lifetime, median and one-year survival consisted of 7,6 months, 5,8 months and 10%. The patients (133) were treated by 1­2 cycles and after that by course of total body chemotherapeutics. There weren't any serious complications. Toxic manifestations of chemotherapy weren't higher than I­II degree and they were arrested by corrective therapy in 92 patients (55%). The celiac axis infusion is safe in patients with locally advanced and inoperable pancreas cancer. Symptomatic improvement showed the most patients. The objective response to the treatment had 20% patients and performance of repeated cycles led to increase of their survival.


Assuntos
Adenocarcinoma , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Desoxicitidina/análogos & derivados , Neoplasias Hepáticas , Pâncreas , Neoplasias Pancreáticas , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Angiografia/métodos , Antimetabólitos Antineoplásicos/administração & dosagem , Desoxicitidina/administração & dosagem , Feminino , Humanos , Infusões Intra-Arteriais/métodos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Compostos Organoplatínicos/administração & dosagem , Pâncreas/irrigação sanguínea , Pâncreas/diagnóstico por imagem , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/patologia , Sistema Porta/diagnóstico por imagem , Resultado do Tratamento
5.
Vopr Onkol ; 62(6): 783-787, 2016.
Artigo em Russo | MEDLINE | ID: mdl-30695565

RESUMO

PURPOSE: Retrospective efficacy analysis of transcatheter arterial treatment for unresectable liver metastases of uveal melanoma. MATERIALS AND METHODS: There were performed 38 courses: hepatic arterial chemoembolization with Lipiodol (HACE, n 9) and combination of HACE with hepatic artery infusion (HAI, n = 29). In 9 patients we used the following chemotherapeutic agents: doxorubicin (10-50mg), carboplatin (150 to 450 mg), dacarbazine (200-400mg), mustophoran (360-624mg) and mitomycinum C (5-10mg). RESULTS: There were no mortality or serious complication. According to mRECIST, partial response, stabilization and progression of liver metastases was seen in 1, 3 and 5 patients, retrospectively. The mean survival after arterial treatment was 9,4 (2-34) mo. The 6-, 12- and 18- mo survival rates were 56%, 22% and 11% respectively. CONCLUSION: Transcatheter therapy in unresectable liver metastases of uveal melanoma is safe and can prolong survival of selected patients up to 34 mo.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Quimioembolização Terapêutica , Óleo Etiodado/administração & dosagem , Neoplasias Hepáticas , Melanoma , Neoplasias Uveais , Adulto , Idoso , Carboplatina/administração & dosagem , Intervalo Livre de Doença , Doxorrubicina/administração & dosagem , Feminino , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Masculino , Melanoma/mortalidade , Melanoma/patologia , Melanoma/terapia , Pessoa de Meia-Idade , Mitomicina/administração & dosagem , Metástase Neoplásica , Taxa de Sobrevida , Neoplasias Uveais/mortalidade , Neoplasias Uveais/patologia , Neoplasias Uveais/terapia
6.
Vestn Khir Im I I Grek ; 174(2): 25-9, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26234059

RESUMO

The authors analyzed the single-center experience of treatment of 72 patients with abdominal aortic aneurisms and severe accompanied pathology. The aneurisms were repaired by stent-grafts. All the patients had abdominal aortic aneurisms with the diameters from 41 to 84 mm against the background of severe somatic pathology. It was a contraindication to planned open surgery. An installation of stent-graft was successful in all 72 follow-ups. It wasn't necessary to use a conversion to open surgery. The follow-up period consisted of 44,6?2,1 months. Control ultrasound and computer tomography studies hadn't revealed an increase of aneurism sack sizes or "eakages". A reduction of abdominal aortic aneurism sizes was noted in 37 patients on 4-5% during first year after operation. The stent-graft implantation extends the possibilities of abdominal aortic aneurism treatment for patients from a high surgical risk group.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Prótese Vascular , Procedimentos Endovasculares/métodos , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aortografia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
7.
Vestn Khir Im I I Grek ; 174(2): 47-51, 2015.
Artigo em Russo | MEDLINE | ID: mdl-26234064

RESUMO

The article presents an analysis of treatment results of 91 patients with iliac-femoral segment artery occlusion at the period from 2008 to 2014. Patients were divided into 2 groups: main group (n=30) consisted of patients who undergoing a half-closed loop endarterectomy with following implantation of stent-grafts in this area and control group (n=61) had patients whom were performed routine half-closed loop endarterectomy. The II degree of ischemia of lower extremities was in 88 (96,7%) patients and III degree had 3 (3,3%) patients. The areas of abnormalities of intravascular pattern were detected in 100% of cases in intraoperative angiography. They were modified using stent-grafts. A primary vascular patency was 100% in the first group and it numbered 65% in the second group during 5 years. The intraoperative angiography control with stent-graft implantation to the area of endarterectomy allowed reliable improvement of treatment results.


Assuntos
Arteriopatias Oclusivas/cirurgia , Endarterectomia/tendências , Artéria Femoral/cirurgia , Artéria Ilíaca/cirurgia , Extremidade Inferior/irrigação sanguínea , Angiografia , Arteriopatias Oclusivas/diagnóstico por imagem , Arteriopatias Oclusivas/fisiopatologia , Endarterectomia/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Grau de Desobstrução Vascular
10.
Vestn Khir Im I I Grek ; 172(4): 40-3, 2013.
Artigo em Russo | MEDLINE | ID: mdl-24341243

RESUMO

On the basis of the results of treatment of 105 patients with locally advanced ductal adenocarcinoma of the pancreatic head the authors present the results of work over a period of time since 1999 to 2009. In the main group the combined treatment was used for 51 patients: the non-adjuvant selective chemoembolization of the pancreatic head adenocarcinoma was performed, than standard gastropancreatoduodenal resection with lymphodesection and 6 cycles of adjuvant chemoinfusion in celiac trunk were completed. In control group standard gastropancreatoduodenal resection was performed. In the group of combined treatment the 1-, 2-, 3-year survival rates consist of 80.4%, 58.8% and 43.1%, respectively. The average life span was 22.3+/-2.1 months. The average life span of 54 patient of control group was 8.4+/-2.1 months and a common 3-year survival consists of 13%. There was no lethality after the performance of X-ray endovascular procedures and gastropancreatoduodenal resection. Postoperative complications reliably didn't differ in both groups.


Assuntos
Carcinoma Ductal Pancreático/radioterapia , Procedimentos Endovasculares/métodos , Neoplasias Pancreáticas/radioterapia , Terapia por Raios X/métodos , Idoso , Carcinoma Ductal Pancreático/mortalidade , Carcinoma Ductal Pancreático/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/cirurgia , Estudos Retrospectivos , Federação Russa/epidemiologia , Taxa de Sobrevida/tendências , Fatores de Tempo , Resultado do Tratamento
11.
Vestn Khir Im I I Grek ; 172(4): 72-4, 2013.
Artigo em Russo | MEDLINE | ID: mdl-24341250

RESUMO

The development of postoperative ventral hernia was observed in 8 patients from 114, who undergone the liver transplantation operation. The patients were followed in terms up to 14.5 years. The authors consider the indications and features of surgical treatment of such postoperative hernias.


Assuntos
Hérnia Ventral/cirurgia , Herniorrafia/métodos , Transplante de Fígado/efeitos adversos , Telas Cirúrgicas , Feminino , Seguimentos , Hepatite C Crônica/cirurgia , Hérnia Ventral/etiologia , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias
12.
Vestn Khir Im I I Grek ; 172(6): 46-50, 2013.
Artigo em Russo | MEDLINE | ID: mdl-24738202

RESUMO

The postcava tumor thrombosis had about 1/3 of patients with renal cell carcinoma at the initial examination. Reconstructive interventions were performed on the postcava for 38 patients (24 men, 14 women). The postcava thrombectomy was applied in 15 patients. The thrombectomy with postcava resection were carried out in 13 patients and plasty- in 6, prosthetics-in 4. An actuarial 3-year or 5-year survival rate of patients consisted of 59.4% and 42.2%. The performance of reconstructive interventions on postcava with its involvement was justified and provided satisfactory results in patients with renal cell carcinoma.


Assuntos
Implante de Prótese Vascular/métodos , Carcinoma de Células Renais , Neoplasias Renais , Nefrectomia/métodos , Trombectomia/métodos , Veia Cava Inferior/cirurgia , Trombose Venosa/cirurgia , Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/mortalidade , Carcinoma de Células Renais/patologia , Carcinoma de Células Renais/cirurgia , Feminino , Humanos , Neoplasias Renais/complicações , Neoplasias Renais/mortalidade , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Flebografia/métodos , Prognóstico , Federação Russa , Taxa de Sobrevida , Resultado do Tratamento , Veia Cava Inferior/patologia , Trombose Venosa/etiologia , Trombose Venosa/patologia
16.
Vestn Khir Im I I Grek ; 171(1): 21-3, 2012.
Artigo em Russo | MEDLINE | ID: mdl-22645910

RESUMO

The practical relevance of volumetric blood flow in the hepatic artery during orthotopic liver transplantation was determined. From May 2009 to January 2011 25 patients underwent orthotopic liver transplantation. Volumetric blood flow in the hepatic artery is routinely measured using a Doppler flow meter during the operation. In 15 cases out of 25 (60%) the blood flow rate immediately after the formation of arterial anastomosis was 150 ml/min (190 +/- 40 ml/min) and increased to adequate with repeated measurements. In 2 cases out of 25 (8%) the blood flow rate reduced in repeated measurements, but by the end of operation the blood flow to the hepatic artery was at the satisfactory level. Blood flow less than 150ml/min immediately after the formation of arterial anastomosis was found in 8 cases out of 25 (32%). The cause of inadequate blood flow was identified and corrected. There were no cases of hepatic artery thrombosis at the early postoperative period. The routine use of intraoperative blood flow measurements allows timely determination of insufficient arterial blood supply of the transplant and elimination of its causes.


Assuntos
Artéria Hepática/diagnóstico por imagem , Artéria Hepática/cirurgia , Transplante de Fígado/métodos , Fígado/irrigação sanguínea , Fígado/diagnóstico por imagem , Adulto , Feminino , Humanos , Fluxometria por Laser-Doppler/métodos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória/métodos , Procedimentos de Cirurgia Plástica , Ultrassonografia , Adulto Jovem
17.
Vestn Khir Im I I Grek ; 171(1): 24-30, 2012.
Artigo em Russo | MEDLINE | ID: mdl-22645911

RESUMO

The efficacy of angiographic hemostasis in cases of massive arterial bleeding after major pancreatic resection was evaluated. Late life-threatening arterial hemorrhage developed in 3 out of 65 patients (4.6%) within 12, 20 and 42 days after pancreatic carcinoma resection. In all cases emergency roentgenoendovascular procedures were fulfilled for hemostasis. Six therapeutic angiographic procedures (from one to three per a patient) were performed. All of them were clinically and technically successful. Depending on the bleeding localization and the character of vascular lesion, the embolization (n = 5) or stent-grafting (n = 1) were used. The further prognosis was dependent on the success of treatment of complications and the course of the malignant disease. The emergency angiography with endovascular hemostasis appears to be the method of choice in treatment of postoperative visceral bleedings especially in patients with high surgical risk.


Assuntos
Embolização Terapêutica/métodos , Neoplasias Pancreáticas/cirurgia , Hemorragia Pós-Operatória/terapia , Stents , Adulto , Idoso , Angiografia/métodos , Feminino , Hemostasia , Humanos , Masculino , Pessoa de Meia-Idade
20.
Vestn Khir Im I I Grek ; 169(4): 39-43, 2010.
Artigo em Russo | MEDLINE | ID: mdl-20973184

RESUMO

A comparative analysis of surgical and combined treatment of renal carcinoma in 84 patients has shown that preoperative embolization of the renal arteries failed to reduce blood loss and duration of operation, failed to increase recurrence-free period and 3 to 5 years survival of the patients. Specific features of combined interventions are described.


Assuntos
Carcinoma de Células Renais/cirurgia , Neoplasias Renais/cirurgia , Adulto , Idoso , Angiografia , Carcinoma de Células Renais/patologia , Terapia Combinada , Embolização Terapêutica , Feminino , Humanos , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Nefrectomia , Artéria Renal/diagnóstico por imagem , Artéria Renal/cirurgia
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