[Short-term outcomes of mechanical and hand-sewn laparoscopic one-anastomosis mini-gastric bypass]. / Sravnitel'naya otsenka blizhaishikh rezul'tatov laparoskopicheskogo minigastroshuntirovaniya s apparatnym i manual'nym sposobami formirovaniya gastroeyunoanastomoza.

OBJECTIVE: To evaluate the short-term outcomes of mechanical and hand-sewn laparoscopic one-anastomosis mini-gastric bypass. MATERIAL AND METHODS: There were 233 patients who underwent laparoscopic one-anastomosis mini-gastric bypass. Short-term results were analyzed in groups of mechanical (the first group, n=108) and hand-sewn (the second group, n=125) gastrojejunostomy. No significant between-group differences in baseline data were detected (demographic characteristics, body mass index, comorbidity and previous abdominal surgeries). RESULTS: Surgery time and blood loss were similar in both groups. Intraoperative morbidity was 7.2-10.2% (p=0.485). All complications required no surgical conversion (Satava-Kazaryan grade I). Overall postoperative morbidity was 16.0-21.3% (p=0.314). Most events corresponded to Accordion grade I and had no significant effect on hospital-stay. CONCLUSION: This study revealed no significant differences in short-term outcomes after laparoscopic one-anastomosis gastric bypass with mechanical and hand-sewn gastrojejunostomy. Further study of long-term clinical outcomes is necessary.

[Etiology and pathogenesis of infected pancreatic necrosis]. / Etiologiya i patogenez infitsirovannogo pankreonekroza.

Modern literature data confirm the central role of intestinal barrier complex not only as a target in acute necrotizing pancreatitis, but also as a trigger for septic complications. Intra-abdominal hypertension, endothelial dysfunction and gut microbiome changes following necrotizing pancreatitis might have an independent impact on acute intestinal distress syndrome and bacterial translocation. Monitoring of these conditions and early target therapy can improve the outcomes in patients with severe acute pancreatitis. Adverse outcomes of infected pancreatic necrosis including high mortality and morbidity are largely due to the prevalence of multidrug-resistant bacterial pathogens.

[The analysis of synovial fluid: clinical significance of derived results].

The review presents modern data concerning characteristics of drawing of synovial fluid and also informativeness of its particular indices for resolving main clinical differential diagnostic task namely - selection group of septic and micro-crystal arthritis. It is demonstrated that minimal generally available span of analysis of synovial fluid is to include: finding number of leukocytes (threshold level for diagnostic of septic arthritis is 50 000 - 100 000 kl/mkl) and percentage of ploymorpho-nuclear cells (threshold level is 90%); analysis of content of crystals, Gram's stain and culture analysis of synovial fluid using light microscopy; and all this with mandatory registration of clinical data. The common evaluation of content of glucose and protein in synovialfluid is not enough informative. The detection of concentration of procalcitonin and lactate in synovial fluid is perspective for establishing septic genesis of arthritis. The sensitivity and specificity of light microscopy are quite high. Because of it absence of polarized microscope is no obstacle for implementation of crystallographic analysis of synovial fluid.