Novosti
Khirurgii
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indexed in Scopus



Year 2018 Vol. 26 No 3

HISTORY

DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.263   |  

A.V. VARABEI 1, D.A. CHEPIK 2, E.I. VIZHYNIS 1, A.M. MAKHMUDOV 1

HISTORY OF CREATION OF A VIABLE INTESTINAL GRAFT FOR BRIDGING ESOPHAGOPLASTY TO THE 105TH ANNIVERSARY OF KELLING OPERATION. PART I

Belarusian Medical Academy of Postgraduate Education 1,
Minsk Regional Clinical Hospital 2, Minsk,
The Republic of Belarus

The article is devoted to the history of the development of shunting plastic of the esophagus after its post-burn cicatricial strictures and esophageal cancer. The experimental idea of Wullstein with the retrosternal jejunal transplant (1904) and the original Tavel (1906) gastrostomy allowed Roux in 1906 laying the foundation for the esophagus plasty with the small intestine. It remained popular for more than 40 years, despite the work of Kelling and Vuillet (1911) on the use of the colon for the esophagus plasty. In the 50-s of the twentieth century, thanks to the achievements of French surgeons, interest in esophagocoloplasty was revived. This was due to the worldwide rise in the incidence of esophageal cancer and its congenital and acquired benign diseases, and many disadvantages in esophagojejunoplasty.
In the second half of the twentieth century, the technique of esophagocoloplasty, indications for it, and its shortcomings were thoroughly worked out. The retrosternal way of carrying a small and large intestine graft to the neck today is the method of choice. The problem of connecting the distal end of the intestinal esophagus graft with the stomach, discussed in the first half of the twentieth century, appeared to be exaggerated.
In general, intrathoracic esophagocoloplasty, both shunting and after the subtotal resection of the esophagus, has gained wide popularity among surgeons around the world.

Keywords: cicatricial esophageal stricture, shunting esophagojejunoplasty, esophagocolotransplant, retrosternal tunnel
p. 263-275 of the original issue
References
  1. Wullstein L. Ueber antethorakale osophagojejunostomie und operationen nach gleichem prinzip. Deutsche Med Wchnschr. 1904;30:734-36. doi: 10.1055/s-0029-1187515
  2. Tavel E. Nouvelle methode de gastrostomie. Arch Prov Chir. 1906;15:317.
  3. Roux CL. L-Oesophago-jejuno-gastrostomose, nouvelle operation pour retrecissement infranchissable de L?oesophage. Semaine Med. 1907;27:37-40.
  4. Herzen P. Eine Modofication der Roux?schem osophago-jejunogastrostomie. Zentralbl f Chir. 1908;35:219-22.
  5. Bircher E. Ein Beitrag zur Plastischen Bildung eines Neuen osophagus. Zentralbl Chir. 1907;34:1479.
  6. Braitsev VR. Opyt plasticheskogo obrazovaniia iskusstvennogo pishchevoda iz kozhi. Novaia Khirurgiia. 1927;(7-8):251-58. (in Russ.)
  7. Kelling GE. Osophagoplastik mit Hilte das Querkolons. Zentralbl Chir. 1911;38:1209-12.
  8. Vuillet H. De l?osophagoplastie et des diverses modifications. Semaine Med. 1911;31:529-34.
  9. Von Hacker V. Uber oesophagoplastik in allgemeinen under uber den ersatz der speiserohre durch antethorakle hautdickdarmschlauchbildung im besonderen. Arch Klin Chir. 1914;105:973-18.
  10. Shalimov AA, Saenko VF. Khirurgiia pishchevaritelnogo trakta. Kiev, Zdorov?ia; 1987. 567 p. (in Russ)
  11. Lundblad O. über antetoracale ösophagoplastik. Acta Chir Scand. 1921;53:535-38.
  12. Roith O. Die einzeitige antethorakale ösophagoplastik aus dem dickdarm. Deutsche Ztschr f Chir. 1923 Dec;183(Is 5-6):419-23. https://link.springer.com/article/10.1007%2FBF02798744
  13. Ochsner A, Owens N. Anterothoracic oesophagoplasty for impermeable stricture of the oesophagus. Ann Surg. 1934 Dec;100(6):1055-91.
  14. Yudin SS. The Surgical construction of 80 cases of artificial esophagus. Surg Ginecol Obstet. 1944;78:561-83.
  15. Iudin SS. Vosstanovitelnaia khirurgiia pri neprokhodimosti pishchevoda. Moscow, SSSR: Medgiz; 1954. 272 p. (in Russ.)
  16. Androsov PI. Iskusstvennyi pishchevod iz tolstoi kishki. Vestn Khirurgii im II Grekova. 1959;82(2):9-17. (in Russ.)
  17. Stelmashonok IM. Operativnoe lechenie rubtsovykh suzhenii pishchevoda i zheludka: monogr. Minsk, RB: Belarus; 1970. 272 p. (in Russ.)
  18. Neuhof H, Ziegler J M. Experimental reconstruction of osophagus by granulation tubes. Surg Gynecol Obstet. 1922;34:767-75.
  19. Berman EF. A plastic prosthesis for resected esophagus. AMA Arch Surg. 1952 Dec;65(6):916-19. doi: 10.1001/archsurg.1952.01260020910018
  20. Javid H. Bridging of esophageal defects with fresh and preserved aorta grafts. Surg Forum. 1953;(38th Cong):83-86.
  21. Petrov BA, Sytnik AP. Iskustvennyi pishchevod iz tonkoi i tolstoi kishki. Moscow, SSSR: Meditsina; 1972. 184 p. (in Russ.)
  22. Renzulli P, Joeris A, Strobel O, Hilt A, Maner C, Uhl W, Buchler M. Colon interposition for esophageal replacement: a single center experience. Langenbecks Arch Surg. 2004 Apr;389(Is 2):128-33. doi: 10.1007/s00423-003-0442-y
  23. Ripley AR, Olsen AM, Kirklin J W. Esophagitis after esophagogastric anastomosis. Surgery. 1952 Jul;32(1):1-9. http://www.surgjournal.com/article/0039-6060(52)90296-1/References
  24. Robertson R, Sarjeant TR. Reconstruction of esophagus. J Thorac Surg. 1950 Nov;20(5):689-705.
  25. Sherman CD, Mahoney EB, Dale WA, Stabins SI. Intrathoracic transplantation of the right colon for esophageal reconstruction. Cancer. 1955;8(Is 6):1198-205. doi: 10.1002/1097-0142(1955)8:6<1198::aid-cncr2820080617>3.0.co;2-0
  26. Urschel JD. Does the interponat affect outcome after esophagectomy for cancer? Dis Esophagus. 2001;14(2):124-30. doi: 10.1046/j.1442-2050.2001.00169.xLI>
  27. Hüttl TP, Wichmann MW, Geiger TK, Schildberg FW, Fürst H. Techniques and results of esophageal cancer surgery in Germany. Langenbecks Arch Surg. 2002 Jul;387(3-4):125-29. doi: 10.1007/s00423-002-0294-x
  28. Mes GM. New method of esophagoplasty. J Int Coll Surg. 1948 May-Jun;11(3):270-77.
  29. Wain JC, Wright CD, Kuo EY, Moncure AC, Wilkins EW. Long-segment colon interposition for acquired esophageal disease. Ann Thorac Surg. 1999;67:313-318. doi: 10.1016/s0003-4975(99)00029-6">10.1016/s0003-4975(99)00029-6
  30. Orsoni P, Toupet A. Use of the descending colon and the left part of the transverse colon for prethoracic esophagoplasty. Presse Med. 1950 Jul 8;58(44):804.
    [Article in Undetermined Language]
  31. Lafargue P, Dufour R, Cabanie H, Chavannaz J. Prethoracic esophagoplasty using the right colon and the terminal ileum. Mem Acad Chir (Paris). 1951 Apr 11-18;77(12-13):362-72. [Article in Undetermined Language]
  32. Lortat-Jacob JJ. Isoperistaltic transthoraco-mediastinal esophagoplasty with the transverse colon. Mem Acad Chir (Paris). 1951 May 23-30;77(18-19):586. [Article in Undetermined Language]
  33. Sherman C, Waterson D. Esophageal reconstruction in children using intrathoracic colon. Arch Dis Child. 1957 Feb; 32(161):11-16. doi: 10.1136/adc.32.161.11
  34. De Meester T R. Esophageal replacement with colon interposition. Oper Tech Cardiac Thorac Surg. 1997 Feb;2(Is 1):73-86. doi: 10.1016/s1085-5637(07)70090-6
  35. Thomas P, Fuentes P, Giudicelli R, Reboud E. Colon interposition for esophageal replacement: current indications and long-term function. Ann Thorac Surg. 1997 Sep;64(3):757-64. doi: 10.1016/s0003-4975(97)00678-4
  36. Knezević JD, Radovanović NS, Simić AP, Kotarac MM, Skrobić OM, Konstantinović VD, Pesko PM. Colon interposition in the treatment of esophageal caustic strictures: 40 years of experience. Dis Esophagus. 2007;20(6):530-34. doi: 10.1111/j.1442-2050.2007.00694.x
  37. Choi RS, Lillehei CW, Lund DP, Healy GB, Buonomo C, Upton J, Hendren WH. Esophageal replacement in children who have caustic pharyngoesophageal strictures. J Pediatr Surg. 1997 Jul;32(7):1083-87; discussion 1087-88. doi: 10.1016/S0022-3468(97)90404-8
  38. Huang MH, Sung CY, Hsu HK, Huang BS, Hsu WH, Chien KY. Reconstruction of the esophagus with the left colon. Ann Thorac Surg. 1989 Nov;48(5):660-64. doi: 10.1016/0003-4975(89)90784-4
  39. Kim YT, Sung SW, Kim JH. Is it necessary to resect the diseased esophagus in performing reconstruction for corrosive esophageal stricture? Eur J Cardiothorac Surg. 2001 Jul;20(1):1-6. doi: 10.1016/s1010-7940(01)00747-3
  40. Gerzic Z, Knezevic J, Miliaevic M, Jovanovic BK. Esophagocoloplasty in the management of postcorrosive strictures of the esophagus. Ann Surg. 1990 Mar;211(3):329-36. doi: 10.1097/00000658-199003000-00004
  41. Orringer MB, Sloan H. Esophagectomy without thoracotomy. J Thorac Cardiovasc Surg. 1978 Nov;76(5):643-54.
  42. Maiat VS. Ozhogi zheludka i ikh lechenie. Moscow, SSSR: Medgiz; 1949. 124 p. (in Russ.)
  43. Abakumov MM, Kabanova SA, Bogopolskii PM. Istoriia tonkokishechnoi plastiki pishchevoda. K 100-letiiu operatsii Ru-Gertsena. Ch 2. Khirurgiia Zhurn im NI Pirogova. 2008;(1):72-75. (in Russ.)
  44. Kolomiichenko MI. Rekonstruktivnaia khirurgiia pishchevoda. Kiev: Zdorovia; 1967. 410 p. (in Russ.)
  45. Varabei AV, Chepik DA, Vizhinis EI, Ermak VV, Sikorin SA, Rusak NI. Kliniko-eksperimentalnaia otsenka tselesoobraznosti kologastroanastomoza pri odnoetapnoi zagrudinnoi ezofagokoloplastike. Med Panorama. 2009;(10):22-25. (in Russ.)
  46. Davis EA, Heitmiller RF. Esophagectomy for benign disease: trends in surgical results and management. Ann Thorac Surg. 1996 Aug;62(2):369-72. doi: 10.1016/0003-4975(96)00235-4
  47. Orringer MB, Marshall B, Stirling MC. Transhiatal esophagectomy for benign and malignant disease. J Thorac Cardiovasc Surg. 1993 Feb;105(2):265-76; discussion 276-77.
  48. Isolauri J, Markkula H, Autio V. Colon interposition in the treatment of carcinoma of the esophagus and gastric cardia. Ann Thorac Surg. 1987 Apr;43(4):420-24. doi: 10.1016/S0003-4975(10)62819-6
  49. De Meester R. Colon interposition for benign disease. Oper Tech Thorac Cardiovasc Surg. 2006 Autumn;11(Is 3):232-49. doi: 10.1053/j.optechstcvs.2006.08.003
  50. Ochsner A, Owens N. Anterothoracic oesophagoplasty for impermeable stricture of the oesophagus. Ann Surg. 1934 Dec;100(6):1055-91. doi: 10.1097/00000658-193412000-00002
  51. Waters PF, Pearson FG, Todd TR, Patterson GA, Goldberg M, Ginsberg RJ, Cooper JD, Ramirez J, Miller L. Esophagectomy for complex benign esophageal disease. J Thorac Cardiovasc Surg. 1988 Mar;95(3):378-81.
  52. Shalimov AA, Saenko VF, Shalimov SA. Khirurgiia pishchevoda. Moscow, SSSR: Meditsina; 1975. 368 p. (in Russ.)
  53. Kümmell HJ. Ueber intrathorakale oesophagus plastic. Beitr Klin Chir. 1922;126:264.
  54. Turner GG. Excicion of thoracic esophagus for carcinoma with construction of extra thoracic gullet. Lancet. 1933 Dec 9;222(5754):1315-16. doi: 10.1016/S0140-6736(01)18863-X
  55. Savinykh AG. Iz istorii razvitiia khirurgii raka kardii v SSSR. Vestn Khirurgii im II Grekova. 1961;87(10):82-86. (in Russ.)
  56. Orringer MB. Reversing esophageal discontinuity. Semin Thorac Cardiovasc Surg. 2007 Spring;19(1):47-55. doi: 10.1053/j.semtcvs.2006.11.004.
  57. Chernousov AF, Cherniavskii AA, Domrachev SA. Ekstirpatsiia pishchevoda s odnomomentnoi ezofagoplastikoi. Khirurgiia Zhurn im NI Pirogova. 1991;(5):3-9. https://cyberleninka.ru/article/n/ekstirpatsiya-pischevoda-s-odnomomentnoy-ezofagogastroplastikoy (in Russ.)
  58. Fry W. The evolution of esophagoplasty. Tex Rep Biol Med. 1953;11(2):236-56.
  59. Sandblom P. The treatment of congenital atresia of the esophagus from a technical point of view. Acta Chir Scand. 1948 Sep 30;97(1):25-34.
  60. Lortat-Jacob JL. Results of surgical treatment of cancer of the esophagus. Mem Acad Chir (Paris). 1957 Mar 20-27;83(10-11):348-55. [Article in French]
  61. Camara-Lopes LH. The intrathoracic use of the large bowel after subtotal esophagectomy for cancer; report of one case. J Thorac Surg. 1953 Feb;25(2):205-14.
  62. Shalimov AA. Polupan VN. Atlas operatsii na pishchevode, zheludke i dvenadtsatiperstnoi kishke. Moscow, SSSR: Meditsina; 1975. 304 p. (in Russ.)
  63. Montenegro EB, Cutait D E. Construction of a new esophagus by means of the transverse colon and its application for caustic atresia, carcinoma, and varices of the esophagus; report of 26 cases. Surgery. 1958 Nov;44(5):785-94.
  64. Machabeli A. One-stage total retrosternal oesophagoplasty with the large intestine. Br J Plast Surg. 1960;13:280-83. doi: 10.1016/S0007-1226(60)80048-3
  65. Orsoni P, Lemaire M. Esophagoplasty technique using the transverse and descending colon. J Chir (Paris). 1951 Jun-Jul;67(6-7):491-505. [Article in Undetermined Language]
  66. Maccas M. Case of retrosternal cervical esophagoplasty with the right colon; complete success. Mem Acad Chir (Paris). 1953 Jun 17-Jul 8;79(21-22-23-24):540-44. [Article in Undetermined Language]
  67. Rogacheva VS. Rak pishchevoda i ego khirurgicheskoe lechenie. Moscow, SSSR: Khirurgiia; 1968. 328 p. (in Russ.)
  68. Mahoney EB, Sherman CD Jr. Total esophagoplasty using intrathoracic right colon. Surgery. 1954 Jun;35(6):937-46.
  69. Thomas PA, Gilardoni A, Trousse D, DJourno XB, Avaro JP, Doddoli C, Giudicelli R, Fuentes P. Colon interposition for oesophageal replacement. Multimed Man Cardiothorac Surg. 2009 Jan 1;2009(603):mmcts.2007.002956. doi: 10.1510/mmcts.2007.002956
  70. Rice TW. Right colon interposition for esophageal replacement. Oper Tech Thorac Cardiovasc Surg. 1999;4(3):210-21. doi: 10.1016/s1522-2942(07)70118-6
  71. Sundaresan SR. Left colon swing for esophageal replacement. Oper Tech Thorac Cardiovasc Surg. 1999 Aug;4(3):222-39. doi: 10.1016/s1522-2942(07)70119-8
  72. Hamza AF, Abdelhay S, Sherif H, Hasan T, Soliman H, Kabesh A, Bassiouny I, Bahnassy AF. Caustic esophageal strictures in children: 30 years experience. J Pediatr Surg. 2003 Jun;38(6):828-33. doi: 10.1016/s0022-3468(03)00105-2.
Address for correspondence:
223040, The Republic of Belarus,
Minsk region, Lesnoy-1,
Minsk Regional Clinical Hospital,
Department of Surgery,
Tel. office.: +375 17 265-22-13,
e-mail: dept-surg@hotmail.com,
Aliaksandr V. Varabei
Information about the authors:
Varabei Aliaksandr V., Corresponding Member of NAS of Belarus, MD, Professor, Head of the Department of Surgery, Head of the Republican Center for Reconstructive Surgical Gastroenterology and Coloproctology, Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus.
http://orcid.org/0000-0003-4710-5996
Chepik Dmitriy A., Head of the Surgical Unit 1, Minsk Regional Clinical Hospital, Minsk region, Borovlyany, Republic of Belarus.
http://orcid.org/0000-0001-6299-5486
Vizhinis Egi I., PhD, Associate Professor, the Department of Surgery, Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus.
http://orcid.org/0000-0002-9185-7119
Makhmudov Anvar M., Associate Professor, the Department of Surgery, Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus.
http://orcid.org/0000-0001-7833-5829

SCIENTIFIC PUBLICATIONS
EXPERIMENTAL SURGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.276   |  

I.N. KLIMOVICH 1, S.S. MASKIN 1, G.L. SNIGUR 1, 2, P.V. ABRAMOV 1, A.V. PAVLOV 1

INTESTINAL INSUFFICIENCY IN PATHOGENESIS OF ENDOTOXICOSIS IN HEMORRHAGIC HYPOTENSION

Volgograd State Medical University 1,
Volgograd Medical Scientific Center 2, Volgograd,
The Russian Federation

Objective. To clarify the role of the intestine in the potentiation of the systemic endotoxicosis with medium molecular peptides and the products of lipid peroxidation when modeling in animals severe bleeding from the upper sections of the gastrointestinal tract.
Methods. Severe bleedings from the upper gastrointestinal tract were modeled in Wistar rats. In dynamics, after 4 hours, 16 and 28 hours from the beginning of the experiment, the reperfusion injuries of the small intestine wall were studied as well as the integral indices of endotoxicosis severity in different regions of the blood stream - in the peripheral (inferior vena cava) blood and the blood flowing from the intestine (portal vein).
Results. 4 hours after the beginning of the experiment, the animals were observed the effects of reperfusion injury of the intestinal wall in the form of oxidative stress. However, no death and desquamation of enterocytes in the mucosal layer were noted. After 16 hours, the level of endotoxicosis was significantly higher (<0.05) in the blood flowing from the intestine, in comparison with the peripheral blood flow. In the mucous layer the foci of death and desquamation of enterocytes with the exposure of the basal membrane were found. After 28 hours the level of endotoxicosis increased, but the difference in endotoxicosis rates in different regions of the blood flow decreased, due to saturation of peripheral blood flow with the intestine toxins. Histological studies revealed necrotic changes in 2/3 of the mucosal layer of the intestine with partial necrosis of the surface sections of the villi. Correlation analysis between the total index of endotoxicosis in the blood from the portal vein and the degree of morphometric disturbances in the wall of the small intestine revealed a close relationship between the damage of the cellular elements of the small intestine wall and the toxicity of the blood flowing from it.
Conclusions. It has been established that as a result of reperfusion injury of the small intestine wall, pronounced inflammatory changes occur in it and its barrier function is violated. Products of the blood hydrolysis discharged into the lumen of the intestine and the products of lipid peroxidation, freely enter the mesenteric bloodstream, thereby substantially potentiating systemic endotoxicosis.

Keywords: gastrointestinal tract bleeding, reperfusion injury, small intestine wall, barrier function, endotoxicosis, mucous layer
p. 276-283 of the original issue
References
  1. Stepanov IuM, Zalevskii VI, Kosinskii AV. Zheludochno-kishechnye krovotecheniia. Dnepropetrovsk, Ukraina: Lira; 2011. 270 p. (in Russ.)
  2. Feinman M, Haut ER. Upper gastrointestinal bleeding. Surg Clin North Am. 2014 Feb;94(1):43-53. doi: 10.1016/j.suc.2013.10.004
  3. Gelfand BR, Saltanov AI. (red). Intensivnaia terapiia: nats ruk. Moscow, RF: GEOTAR-Media; T. I; 2009. 960 p. (in Russ.)
  4. Fishman JE, Levy G, Alli V, Sheth S, Lu Q, Deitch EA. Oxidative modification of the intestinal mucus layer is a critical but unrecognized component of trauma hemorrhagic shock-induced gut barrier failure. Am J Physiol Gastrointest Liver Physiol. 2013 Jan 1;304(1):G57-63. doi: 10.1152/ajpgi.00170.2012
  5. Diebel ME, Diebel LN, Manke CW, Liberati DM, Whittaker JR. Early tranexamic acid administration: A protective effect on gut barrier function following ischemia/reperfusion injury. J Trauma Acute Care Surg. 2015 Dec;79(6):1015-22. doi: 10.1097/TA.0000000000000703
  6. Grootjans J, Hundscheid IH, Lenaerts K, Boonen B, Renes IB, Verheyen FK, Dejong CH, von Meyenfeldt MF, Beets GL, Buurman WA. Ischaemia-induced mucus barrier loss and bacterial penetration are rapidly counteracted by increased goblet cell secretory activity in human and rat colon. Gut. 2013 Feb;62(2):250-58. doi: 10.1136/gutjnl-2011-301956
  7. Zutphen LF, Baumans V, Beynen AC. Principles of laboratory animal science. Amsterdam: Elsevier; 1993. 389 p.
  8. Malakhova MIa. Metod registratsii endogennoi intoksikatsii: posobie dlia vrachei. S-Petersburg, RF; 1995. 33 p. (in Russ.)
  9. Bilenko MV. Ishemicheskie i reperfuzionnye povrezhdeniia organov (molekuliarnye mekhanizmy, puti preduprezhdeniia i lecheniia). Moscow, RF: Meditsina; 1989. 368 p. (in Russ.)
  10. Vladimirov IuA, Azizova OA, Deev AI, i dr. Svobodnye radikaly v zhivykh sistemakh. Itogi nauki i tekhniki. Biofizika. 1992;29. p. 3-250. (in Russ.)
  11. Kostiuk VA, Potapovich AI, Kovaleva ZhV. A simple and sensitive method of determination of superoxide dismutase activity based on the reaction of quercetin oxidation. Vopr Med Khimii. 1990;36(2).88-91. http://pbmc.ibmc.msk.ru/index.php/ru/article/PBMC-1990-36-2-88-ru (in Russ.)
  12. Petri A, Sebin K. Nagliadnaia meditsinskaia statistika. Leonov VP, red. Moscow, RF: GEOTAR-Media; 2009. 168 p. (in Russ.)
  13. Sarkisov DS, Perov IuL. Rukovodstvo po gistologicheskoi tekhnike. Moscow, RF: Meditsina; 1996. 242 p. (in Russ.)
  14. Ke S, Liu F, Zhu Z. Resveratrol improves intestinal injury in hemorrhagic shock rats by protection of mitochondria and reduction of oxidative stress. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014 Dec;39(12):1259-65. doi: 10.11817/j.issn.1672-7347.2014.12.007 [Article in Chinese]
Address for correspondence:
400131, The Russian Federation,
Volgograd, Pavshix Borcov Square, 1,
Volgograd State Medical University,
Department of Hospital Surgery,
Tel. office: 8(442) 71-87-62,
Tel. mobile.: +7 905-336-23-69
e-mail: klimovichigor1122@yandex.ru,
Igor N. Klimovich
Information about the authors:
Klimovich Igor N., MD, Associate Professor of the Department of Hospital Surgery, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0002-7933-2635
Maskin Sergej S., MD, Professor, Head of the Department of Hospital Surgery, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0002-5275-4213
Snigur Grigory L., MD, Associate Professor, Head of the Department of Biology, Volgograd State Medical University, Senior Researcher of the Laboratory of Morphology, Immunohistochemistry and Carcinogenesis, Volgograd Medical Scientific Center, Volgograd, Russian Federation.
http://orcid.org/0000-0002-8612-6186
Abramov Pavel V., Post-Graduate Student, the Department of Hospital Surgery, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0002-8673-2581
Pavlov Alexandr V., Post-Graduate Student, the Department of Hospital Surgery, Volgograd State Medical University, Volgograd, Russian Federation.
http://orcid.org/0000-0002-1497-4231
DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.284   |  

N.A. SHCHUDLO, T.N. VARSEGOVA, M.M. SHCHUDLO, L.I. SBRODOVA, T.A. STUPINA

INTERRELATION BETWEEN PRIMARY AND SECONDARY CONTRACTION WITH HISTOLOGICAL STRUCTURE OF FASCIOCUTANEOUS FLAP

Russian Ilizarov Scientific Center of Restorative Traumatology and Orthopedics, Kurgan,
The Russian Federation

Objective. To conduct histomorphometric assessment of the skin in fasciocutaneous flap with regard to its primary and secondary contraction degree.
Methods. The experiments were carried out on 28 rats of the Wistar line. In animals a fasciocutaneous flap was formed according to a template with the area of 18 cm2 on the basis of a superficial epigastric artery that was clipped; after 1.5 hours the flap was reperfused and re-donated. The animals were euthanized 12 days after the operation. The methods used in the study were the analysis of the leukocyte blood formula, computerized planimetry of the digital images of flaps, histomorphometry, immunohistochemistry.
Results. Right after the flap reposition in four rats, its area increased by 6-30% compared to the template and decreased by 9-34% in 24 rats. At the end of the experiment, rats were divided into 4 groups: 1 an increase in the flap area (+ 5-19%), 2 a decrease in primary contraction (up to -1-14%), 3 significant primary (-22-34%) and secondary -20-25%) contraction, 4 expressed secondary contraction (-30-59%). Defects of the epidermis associated with delayed wound healing and partial necrosis in groups 1-3 did not exceed 3%, and in group 4 varied from 8 to 41% of the area of the flap. The highest degree of epidermal hypoplasia was registered in group 1 (47% of thickness measurements), hyperplasia in group 4 (67%). In comparison with a normal skin, the numerical densities of the skin appendages and the volume density of the adipocytes of the dermis progressively decreased in groups 1-4, the severity of postnecrotic changes in the dermis and hypodermis increased.
Conclusions. The obtained results substantiate the necessity for monitoring of the primary and secondary contraction of the vascularized fasciocutaneous flaps to elaborate individually oriented therapy protocols in order to modulate the proliferative activity of epidermis and revascularization of the vascular plexus of the skin.

Keywords: rats, diseases models, skin, contraction, tissue engraftment, histomorphometry
p. 284-292 of the original issue
References
  1. Harrison CA, MacNeil S. The mechanism of skin graft contraction: an update on current research and potential future therapies. Burns. 2008 Mar;34(2):153-63. doi: 10.1016/j.burns.2007.08.011
  2. Stell PM. Retraction of skin flaps. Clin Otolaryngol Allied Sci. 1982 Feb;7(1):45-49. doi: 10.1111/j.1365-2273.1982.tb01560.x
  3. Seo H, Kim S, Cordier F, Choi J, Hong K. Estimating dynamic skin tension lines in vivo using 3D scans. Computer Aided Design. 2013 Feb;45(Is 2):551-55. doi: 10.1016/j.cad.2012.10.044
  4. Schudlo NA, Schudlo MM, Sbrodova LI, Varsegova TN. Correlation of the degree of contraction of a fasciocutaneous fat flap with its engraftment quality after 1,5-hour ischemia and reperfusion. Uspekhi Sovrem Estestvoznaniia. 2015;(6):86-90. https://www.natural-sciences.ru/ru/article/view?id=35461 (in Russ.)
  5. Pakhrova OA, Krishtop VV, Kurchaninova MG, Rumyantseva TA. Changes of blood leukocyte indices under acute experimental cerebral hypoxia in rats with different levels of stress resistance. Sovrem Problemy Nauki i Obrazovaniia. 2016;(6): 231. https://www.science-education.ru/ru/article/view?id=25925 (in Russ.)
  6. Gonohova MN, Lanicheva AH, Stepanov SS, Semchenko VV. Structurally functional changes of white rats skin epidermis and derma after high kinetic mechanical damage. Vestn Omsk Gos Agrar Un-ta. 2011;(2):41-45. https://cyberleninka.ru/article/v/strukturno-funktsionalnye-izmeneniya-epidermisa-i-dermy-kozhi-belyh-krys-posle-vysokokineticheskogo-mehanicheskogo-povrezhdeniya (in Russ.)
  7. Arner M, Möller K. Morbidity of the pedicled groin flap. A retrospective study of 44 cases. Scand J Plast Reconstr Surg Hand Surg. 1994 Jun;28(2):143-46. doi: 10.3109/02844319409071192
  8. Lie KH, Barker AS, Ashton MW. A classification system for partial and complete DIEP flap necrosis based on a review of 17,096 DIEP flaps in 693 articles including analysis of 152 total flap failures. Plast Reconstr Surg. 2013 Dec;132(6):1401-8. doi: 10.1097/01.prs.0000434402.06564.bd
  9. Luccioli GM, Kahn DS, Robertson HR. Histologic study of wound contraction in the rabbit. Ann Surg. 1964 Dec;160(6):1030-40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1408875/?page=1
  10. Stephenson AJ, Griffiths RW, La Hausse-Brown TP. Patterns of contraction in human full thickness skin grafts. Br J Plast Surg. 2000 Jul;53(5):397-402. doi: 10.1054/bjps.2000.3335
  11. Coban YK, Kurutas EB, Ciralik H. Ischemia-reperfusion injury of adipofascial tissue: an experimental study evaluating early histologic and biochemical alterations in rats. Mediators Inflamm. 2005 Oct 24;2005(5):304-308. doi: 10.1155/MI.2005.304
Address for correspondence:
640014, The Russian Federation,
Kurgan, M. Ulyanova Str., 6,
Russian Ilizarov Scientific Center
of Restorative Traumatology and Orthopedics,
Clinical and Experimental
Laboratory of Reconstructive-Plastic
Microsurgery and Hand Surgery,
Tel. office: +7-3522 45-18-12
e-mail: nshchudlo@mail.ru,
Nathalia A. Shchudlo
Information about the authors:
Shchudlo Nathalia A., MD, Chief Researcher of the First Scientific and Clinical Department, Russian Ilizarov Scientific Center of Restorative Traumatology and Orthopedics, Kurgan, Russian Federation.
http://orcid.org/0000-0001-9914-8563
Varsegova Tatyana N., PhD, Senior Researcher of the Morphology Laboratory, Russian Ilizarov Scientific Center of Restorative Traumatology and Orthopedics, Kurgan, Russian Federation.
http://orcid.org/0000-0001-5430-2045
Shchudlo Michael M., MD, Leading Researcher of the First Scientific and Clinical Department, Russian Ilizarov Scientific Center of Restorative Traumatology and Orthopedics, Kurgan, Russian Federation.
http://orcid.org/0000-0003-0661-6685
Sbrodova Lyudmila I., PhD, Researcher of the Scientific and Clinical Laboratory of Microbiology and Immunology, Russian Ilizarov Scientific Center of Restorative Traumatology and Orthopedics, Kurgan, Russian Federation.
http://orcid.org/0000-0002-7407-6791
Stupina Tatyana A., DS, Senior Researcher of the Morphology Laboratory, Russian Ilizarov Scientific Center of Restorative Traumatology and Orthopedics, Kurgan, Russian Federation.
http://orcid.org/0000-0003-3434-0372

GENERAL & SPECIAL SURGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.293   |  

I.S. IVANOV 1, V.I. TEMIRBULATOV 1, 2, M.E. KLETKIN 2, O.A. OKUNEV 1, I.A. IVANOVA 1

CORRELATION OF COLLAGEN TYPE I AND III IN THE SKIN AND LUNGS IN PATIENTS WITH BULLOUS EMPHYSEMA COMPLICATED BY SPONTANEOUS PNEUMOTHORAX

Kursk State Medical University 1,
Kursk regional clinical hospital 2, Kursk
The Russian Federation

Objective. To study the correlation of type I and III collagens of the connective tissue in the skin and lungs in patients with the bullous emphysema complicated by spontaneous pneumothorax and without it.
Methods. A comparative analysis of the content of type I and III collagens in the skin and lung in 32 patients with the lung bullous emphysema complicated by spontaneous pneumothorax and control group (autopsy material from 30 people without obvious pathology of the lungs) was carried out. The study of type I and III collagens in the skin and lungs was carried out using polarization microscopy, which allows revealing the correlation of collagen types in patients of the studied groups.
Results. It has been found out that patients with the bullous emphysema have a significantly lower ratio of type I and III collagens in both the skin and lung preparations in comparison with the control group. A high direct correlation has been registered between the correlation of collagen types of the skin and lungs connective tissue in both groups.
Conclusions. The patients with the bullous emphysema have a significantly lower ratio of type I and III collagens in the skin and lungs. The presence of a high direct correlation between the content of different types of collagen in the skin and lungs, both in the main and control groups, allows identifying the systemic pathology of the connective tissue only by its changes in the skin of patients. Determination of the relative ratio of type I and III collagens in preparations of the skin and lung with the use of polarization microscopy has high informative value in the verification of the bullous emphysema as one of the manifestations of connective tissue dysplasia.

Keywords: bullous emphysema, spontaneous pneumothorax, collagen type I, collagen type III, polarized microscopy
p. 293-300 of the original issue
References
  1. Vershinina MV, Grinberg LM, Nechaeva GI, Govorova SE, Gershevich VM, Neretin AV, Filatova AS. Spontannyi pnevmotoraks i displaziia soedinitelnoi tkani: fenotipicheskie osobennosti patsientov. Pulmonologiia. 2011;(6):43-47. doi: 10.18093/0869-0189-2011-0-6-43-47 (in Russ.)
  2. Luh SP. Review: Diagnosis and treatment of primary spontaneous pneumothorax. J Zhejiang Univ Sci B. 2010 Oct;11(10):735-44. doi: 10.1631/jzus.B1000131
  3. Beliaeva IV, Stroev IuI, Churilov LP. Pervichnyi spontannyi pnevmotoraks i displaziia soedinitelnoi tkani. Med Alians. 2014;(1):43-53. (in Russ.)
  4. Vershinina MV, Nechaeva GI, Grinberg LM, Skripkin DA, Ignatev IuT, Govorova SE, Drokina OV. Displaziia soedinitelnoi tkani v geneze bulleznoi emfizemy: ostanetsia li pervichnym pervichnyi spontannyi pnevmotoraks? Lechashchii Vrach. 2012;(9):14. https://www.lvrach.ru/2012/09/15435522 (in Russ.)
  5. Rokicki W, Rokicki M, Wojtacha J, Filipowski M, Dzejlili A, Czyzewski D. Is it possible to standardize the treatment of primary spontaneous pneumothorax? Part 1: etiology, symptoms, diagnostics, minimally invasive treatment. Kardiochir Torakochirurgia Pol. 2016 Dec; 13(4): 322-27. Published online 2016 Dec 30. doi: 10.5114/kitp.2016.64874
  6. Tsai TM, Lin MW, Li YJ, Chang CH, Liao HC, Liu CY, Hsu HH, Chen JS. The size of spontaneous pneumothorax is a predictor of unsuccessful catheter drainage. Sci Rep. 2017;7:181. Published online 2017 Mar 15. doi: 10.1038/s41598-017-00284-8
  7. Vershinina MV, Nechaeva GI, Grinberg LM, Govorova SE, Gershevich VM, Neretin AV. Retsidiviruiushchii i peremezhaiushchiisia pervichnyi spontannyi pnevmotoraks u patsientov s displaziei soedinitelnoi tkani. Tuberkulez i Bolezni Legkikh. 2012;89(5):15-19. (in Russ.)
  8. Nechaeva GI, Iakovlev VM, Konev VP, Druk IV, Morozov SL. Displaziia soedinitelnoi tkani: osnovnye klinicheskie sindromy, formulirovka diagnoza, lechenie. Lechashchii Vrach. 2008;(2):22-28. https://www.lvrach.ru/2008/02/4828890/ (in Russ.)
  9. Smirnov GO, Manturova NE, Topchieva GV, Stupin VA. Aging skin mechanisms and collagen ratio I/III types in prediction of aesthetic surgery. Fundam Issledovaniia. 2012;(7-1):190-94. https://www.fundamental-research.ru/ru/article/view?id=30065 (in Russ.)
  10. Malkusch W, Rehn B, Bruch J. Advantages of Sirius Red staining for quantitative morphometric collagen measurements in lungs. Exp Lung Res. 1995 Jan-Feb;21(1):67-77. doi: 10.3109/01902149509031745.
  11. Tseluyko SS, Krasavina NP. Immunocytochemical characteristic of bronchi bioptats conjunctive tissue collagen types in patients with respiartory apparatus dysplasia. Biul Fiziologii i Patologii Dykhaniia. 2010;(38):36-42. https://cyberleninka.ru/article/n/immunotsitohimicheskaya-harakteristika-tipov-kollagena-soedinitelnoy-tkani-bioptatov-bronhov-bolnyh-s-displaziey-organov-dyhaniya (in Russ.)
  12. Vershinina MV, Grinberg LM, Nechaeva GI, Filatova AS, Neretin AV, Khomenia AA, Govorova SE. Pervichnyi spontannyi pnevmotoraks i displaziia soedinitelnoi tkani: kliniko-morfologicheskie paralleli. Pulmonologiia. 2015;25(3):340-49. doi: 10.18093/0869-0189-2015-25-3-340-349 (in Russ.)
  13. Pimenov LT, Smetanin MYu, Remnyakov VV, Suslonova SV. Primary spontaneous pneumothorax as a manifestation of connective tissue dysplasia (literature review). CardioSomatika. 2014;(2):43-46. http://www.rosokr.ru/magazine/KS-2014-2.pdf (in Russ.)
  14. Veligotskii NN, Komarchuk VV, Komarchuk EV, Kasumba K. Khirurgicheskoe lechenie gryzh na fone displazii soedinitelnoi tkani. Ukr Zhurn Khirurgii. 2011;(3):236-239. http://www.ujs.dsmu.edu.ua/journals/2011-03/2011-03.pdf (in Russ.)
  15. Ivanov IS, Lazarenko VA, Ivanov SV, Goryainova GN, Ivanov AV, Tarabrin DV, Litvyakova MI. Correlation of collagen type I and III in the skin and aponeurosis in patients with ventral hernias. Novosti Khirurgii.
    2013; 21(3):33-36. doi: 10.18484/2305-0047.2013.3.33 (in Russ.)
Address for correspondence:
305007, The Russian Federation,
Kursk, Sumskaya Str., 45 ,
Kursk Regional Clinical Hospital,
Thoracic Surgery Unit,
Tel.: +7 903 875-30-58,
e-mail: kletkin-max@mail.ru,
Maxim E. Kletkin
Information about the authors:
Ivanov Ilia S., MD, Professor of the Department of Surgical Diseases 1, Kursk State Medical University, Kursk, Russian Federation.
https://orcid.org/0000-0003-4408-961X
Temirbulatov Vladimir I., MD, Professor of the Department of Surgical Diseases FPED, Kursk State Medical University, Head of the Thoracic Surgery Unit, Kursk Regional Clinical Hospital, Kursk, Russian Federation.
https://orcid.org/0000-0003-3757-924X
Kletkin Maxim E., Physician of the Thoracic Surgery Unit, Kursk Regional Clinical Hospital, Kursk, Russian Federation.
https://orcid.org/0000-0003-3886-5272
Okunev Oleg A., PhD, Assistant of the Department of Surgical Diseases 1, Kursk State Medical University, Kursk, Russian Federation.
https://orcid.org/0000-0002-2298-1546
Ivanova Inna A., PhD, Associate Professor of the Department of Clinical Immunology and Allergology, Kursk State Medical University, Kursk, Russian Federation. https://orcid.org/0000-0001-5175-6586
DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.301   |  

I. YA. KLETSKO, O.I. KUSHNIRUK

RISK FACTORS OF ACUTE PANCREATITIS AFTER THERAPEUTIC ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

Danylo Halytsky Lviv National Medical University, Lviv,
Ukraine

Objective. To identify significant risk factors for the development of acute pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography.
Methods. The significance of risk factors for post-manipulation pancreatitis was analyzed based on the results of 1801 therapeutic endoscopic retrograde cholangiopancreatographies performed in the clinic. To confirm the diagnosis of pancreatitis, to assess the severity stage the Cotton criteria were used. We analyzed the age and gender factors, the influence of the sphincter of Oddi syndrome in association with microlithiasis and parapapillary diverticulum, the ways of the transpapillary access, papillosphincterotomy and balloon dilatation. Possibilities of the intervention were evaluated in the absence of signs of biliary hypertension, and concrements more than 10 mm. The ratio of the chances of occurrence of the event in different periods was determined, with a calculation of 95% confidence interval.
Results. Acute pancreatitis developed in 19 (1.05%) patients. Among them, 7 (36.8%) had a severe destructive form. All cases of pancreatitis were diagnosed after primary intervention (OR 11.81, 95% CI 0.71-196.06, p = 0.011). Significant predictors of pancreatitis after transpapillary interventions were: young patients <40 years (OR 7.54, 95% CI 3.10-18.43, p = 0.00007), more often it occurred in women (OR 5.58, 95 % CI 1.22-17.35, p = 0.008), the presence of microcholedocholithiasis and concrements up to 10 mm in size (OR 4.42, 95% CI 1.23-12.44, p = 0.01), the syndrome of sphincter of Oddi dysfunction (OR 2.80, 95% CI 1.05-6.88, p = 0.03), interventions in the absence of obvious diagnostic signs of biliary hypertension (OR 2.80, 95% CI 1.16-6.96; p = 0.02).
Conclusions. Patient-related risk factors for pancreatitis development after therapeutic cholangiopancreatography remain a weak spot for its comprehensive prevention. The risk of developing acute pancreatitis rises 5-10 times if the patient has three or more factors. Atypical methods of papillosphincterotomy are not the significant risk factors for the development of pancreatitis when performed by an experienced specialist. It is necessary to adhere to the principle of multistage in carrying out complex or prolonged transpapillary X-ray endoscopic operations.

Keywords: endoscopic retrograde cholangiopancreatography, complications, post-ERCP pancreatitis, risk factors; guidewire-assisted cannulation
p. 301-310 of the original issue
References
  1. Dumonceau JM, Andriulli A, Deviere J, Mariani A, Rigaux J, Baron TH, Testoni PA. European Society of Gastrointestinal Endoscopy (ESGE) Guideline: prophylaxis of post-ERCP pancreatitis. Endoscopy. 2010 Jun;42(6):503-15. doi: 10.1055/s-0029-1244208
  2. Dumonceau JM, Andriulli A, Elmunzer BJ, Mariani A, Meister T, Deviere J, Marek T, Baron TH, Hassan C, Testoni PA, Kapral C. Prophylaxis of post-ERCP pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Guideline updated June 2014. Endoscopy. 2014 Sep;46(9):799-15. doi: 10.1055/s-0034-1377875
  3. Mantserov MP, Moroz YeV. Secondary pancreatitis after endoscopic manipulations on the major duodenal papilla. Ros Zhurn Gastroenterologii Gepatologii Koloproktologii. 2007;17(3):14-23. http://www.gastro-j.ru/files/s2_1297619598.pdf (in Russ.)
  4. Anderson MA, Fisher L, Jain R, Evans JA, Appalaneni V, Ben-Menachem T, Cash BD, Decker GA, Early DS, Fanelli RD, Fisher DA, Fukami N, Hwang JH, Ikenberry SO, Jue TL, Khan KM, Krinsky ML, Malpas PM, Maple JT, Sharaf RN, Shergill AK, Dominitz JA. Complications of ERCP. Gastrointest Endosc. 2012 Mar;75(3):467-73. doi: 10.1016/j.gie.2011.07.010
  5. Christensen M, Matzen P, Schulze S, Rosenberg J. Complications of ERCP: a prospective study. Gastrointest Endosc. 2004 Nov;60(5):721-31. doi: 10.1016/S0016-5107(04)02169-8
  6. Donnellan F, Byrne MF. Prevention of Post-ERCP Pancreatitis. Gastroenterol Res Pract. 2012;(2012):Article ID 796751. 12 p. doi: 10.1155/2012/796751
  7. Kaliev AA. Analiz letalnykh iskhodov bolnykh s destruktivnymi formami ostrogo pankreatita [Elektronnyi resurs]. Sovrem Problemy Nauki i Obrazovaniia. 2013;(5) [data obrashcheniia: 2017 Iiul 28]. Available from: https://www.science-education.ru/ru/article/ view?id=10270 (in Russ.)
  8. Elmunzer BJ. Reducing the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis. Dig Endosc. 2017 Jun 21. doi: 10.1111/den.12908
  9. Cotton PB, Lehman G, Vennes J, Geenen JE, Russell RC, Meyers WC, Ziguory C, Nickl N. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc. 1991 May-Jun;37(3):383-93. doi: 10.1016/S0016-5107(91)70740-2
  10. Matviichuk BO, Kushniruk OI, Kletsko IIa, Salo VM, Tumak IIa. Kompleksnaia profilaktika ostrogo pankreatita posle rentgenendoskopicheskikh transpapilliarnykh vmeshatelstv. Ukr Zhurn Khirurgii. 2013;(3):84-89. http://www.mif-ua.com/archive/article/36668 (in Russ.)
  11. Masci E, Mariani A, Curioni S, Testoni PA. Risk factors for pancreatitis following endoscopic retrograde cholangiopancreatography: a meta-analysis. Endoscopy. 2003 Oct;35(10):830-34. doi: 10.1055/s-2003-42614
  12. Freeman ML, DiSario JA, Nelson DB, Fennerty MB, Lee JG, Bjorkman DJ, Overby CS, Aas J, Ryan ME, Bochna GS, Shaw MJ, Snady HW, Erickson RV, Moore JP, Roel JP. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc. 2001 Oct;54(4):425-34. doi: 10.1067/mge.2001.117550
  13. DArpa F, Tutino R, Battaglia EO, Orlando G, Salamone G, Licari L, Gulotta G. Post-ERCP pancreatitis. A single center experience and an update on prevention strategies. Ann Ital Chir. 2015 May-Jun;86(3):234-38. https://www.researchgate.net/profile/Giuseppe_Salamone/publication/275585536_Post-ERCP_pancreatitis
  14. Skude G, Wehli L, Maruyma T, Ariyama J. Hyperamylasemia after duodenoscopy and retrograde Cholangiopancreatography. Gut. 1976 Feb;17(2):127-32. doi: 10.1136/gut.17.2.127
  15. George S, Kulkarni AA, Stevens G, Forsmark CE, Draganov P. Role of osmolality of contrast media in the development of post-ERCP pancreatitis: a metanalysis. Dig Dis Sci. 2004 Mar;49(3):503-8. doi: 10.1023/B:DDAS.0000020511.98230.20
Address for correspondence:
290059, Ukraine,
Lviv, Mikolaychuk Str., 9,
Danylo Halytsky Lviv
National Medical University,
Department of Radiation Diagnostics
of the Faculty of Postgraduate Education
Tel. mobile: +380 93 750-98-24,
e-mail: iv17@ukr.net,
Ivan Ya. Kletsko
Information about the authors:
Kletsko Ivan Ya., Assistant of the Department of Radiation Diagnostics of the Faculty of Postgraduate Education, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0001-8942-0754
Kushniruk Oleksiy I., PhD, Associate Professor of the Department of Surgery and Endoscopy of the Faculty of Postgraduate Education, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0003-3812-9339
DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.311   |  

A.A. GLUKHOV 1, V.A. SERGEEV 2

ASSESSMENT OF EFFICIENCY OF THE PROGRAMMED ASPIRATION AND IRRIGATION REHABILITATION METHOD IN SUPPURATIVE NECROTIC COMPLICATIONS OF DIABETIC FOOT SYNDROME

Voronezh State Medical University named after N.N. Burdenko 1, Voronezh,
Orel Regional Clinical Hospital 2, Orel
The Russian Federation

Objective. To assess the efficiency of the programmed aspiration and irrigation rehabilitation (PAIR) method in the combined treatment of patients with suppurative necrotic complications of diabetic foot syndrome (DFS).
Methods. The treatment results of 84 patients with suppurative necrotic complications of DFS without critical ischemia of 52 to 63 years of age have been analyzed. The patients with DFS were divided into two groups depending on the way of postoperative rehabilitation of the suppurative focus. In the reference group, conventional therapy was carried out with the use of iodophors and polyethylene glycol ointments. In the study group, postoperative rehabilitation of the suppurative foci was performed using the programmed technique with the original equipment. The device was equipped with a pressure switch providing automatic setting and maintenance of a definite vacuum level in the cavity of a suppurative focus.
Results. In the study group, the reduction below the threshold levels in the bacterial load for suppurative necrotic foci proved to occur earlier than in the reference group (p<0.001). Alkalinization of the wound effluent and reduction in the protein amount in the wound discharge were faster in the study group (p<0.001). Hospital length of stay in the study group was significantly lower compared to the reference group (p<0.001). The number of suppurative complications was significantly smaller (p=0.014) than in the reference group. The frequency of high amputations performed in the study group was less than in the reference group.
Conclusions. The results of the conducted investigations confirmed the efficiency of programmed aspiration and irrigation rehabilitation method in the combined treatment of patients with suppurative necrotic tissue injury in diabetic foot syndrome, which significantly improves the rehabilitation of the suppurative focus, providing in turn the significant improvement of the treatment efficacy.
Keywords: diabetic foot syndrome, suppurative necrotic complications, active surgical approach, programmed aspiration and irrigation rehabilitation, surgical treatment of suppurative focus, plastic resection of the foot

Keywords: diabetic foot syndrome, suppurative necrotic complications, active surgical approach, programmed aspiration and irrigation rehabilitation, surgical treatment of suppurative focus, plastic resection of the foot
p. 311-320 of the original issue
References
  1. Dedov II, Omelyanovskiy VV, Shestakova MV, Avksentieva MV, Ignatieva VI. Diabetes mellitus as an economic problem in Russian Federation. Sakhar Diabet. 2016;19(1):30-43. (in Russ.)
  2. Mezhdunarodnoe soglashenie po diabeticheskoi stope. Moscow, RF: Bereg; 2000. 96 p. (in Russ.).
  3. Striapukhin VV, Lishchenko AN. Surgical treatment of the diabetic foot. Khirurgiia Zhurn im NI Pirogova. 2011;(2):73-78. https://www.mediasphera.ru/issues/khirurgiya-zhurnal-im-n-i-pirogova/2011/2 (in Russ.)
  4. Reiber GE, Boyko EJ, Smith DG. Lower extremity foot ulcers and amputation in diabetes. In: Harris MI, Cowie CC, Stern MP, Boyko EJ, Reiber GE, Bennett PH, eds. Diabetes in America. 2nd ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 1995. . 409-28. NIH publication 95-1468.
  5. Ragnarson-Tennvall G, Apelqvist J. Cost-effective management of diabetic foot ulcers. A review. Pharmacoeconomics. 1997 Jul;12(1):42-53. https://link.springer.com/article/10.2165/00019053-199712010-00005
  6. Gök ü, Selek ö, Selek A, Güdük A, Güner Mç. Survival evaluation of the patients with diabetic major lower-extremity amputations. Musculoskelet Surg. 2016 Aug;100(2):145-48. doi: 10.1007/s12306-016-0399-y
  7. Chekmareva IA, Mitish VA, Paklina OV, Blatun LA, Paskhalova YuS, Ushakov AA, Terekhova RP, Gordienko EN, Sokov SL, Munos Sepeda PA, Kachanzhi AP. Morphological evaluation of the effectiveness of hydrosurgical system VersaJet in conjunction with combined antibiotic therapy in the treatment of necrotic complications of diabetic foot syndrome with biofilm forms of bacteria. Rany i Ranevye Infektsii. 2015;2(3):8-21. doi: 10.17650/2408-9613-2015-2-3-8-20 (in Russ.)
  8. Krishnan S, Nash F, Baker N, Fowler D, Rayman G. Reduction in diabetic amputations over 11 years in a defined U.K. population: benefits of multidisciplinary team work and continuous prospective audit. Diabetes Care. 2008 Jan;31(1):99-101. doi: 10.2337/dc07-1178
  9. Argoff CE, Cole BE, Fishbain DA, Irving GA. Diabetic peripheral neuropathic pain: clinical and quality-of-life issues. Mayo Clin Proc. 2006 Apr;81(4 Suppl):S3-11. doi: 10.1016/S0025-6196(11)61474-2
  10. Holman N, Young RJ, Jeffcoate WJ. Variation in the recorded incidence of amputation of the lower limb in England. Diabetologia. 2012 Jul;55(7):1919-25. doi: 10.1007/s00125-012-2468-6
  11. Galstyan GR, Tokmakova AYu, Egorova DN, Mitish VA, Paskhalova YuS, Antsiferov MB, Komelyagina EYu, Udovichenko OV, Gureva IV, Bregovskiy VB, Eroshkin IA, Eroshenko AnV, Eroshenko AlV. Klinical guidelines for diagnosis and treatment of diabetic foot syndrome. Rany i Ranevye Infektsii. 2015;(3):63-83. doi: 10.17650/2408-9613-2015-2-3-63-83 (in Russ.)
  12. International best practice guidelines: wound management in diabetic foot ulcers [Electronic resource]. Wounds International publication; 2013. 27 . Available from: http://www.woundsinternational.com/best-practices/view/best-practice-guidelines-wound-management-in-diabetic-foot-ulcers
  13. Bondarenko ON, Galstyan GR, Dedov II. The clinical course of critical limb ischaemia and the role of endovascular revascularisation in patients with diabetes. Sakhar Diabet. 2015;18(3):57-69. https://cyberleninka.ru/article/v/osobennosti-klinicheskogo-techeniya-kriticheskoy-ishemii-nizhnih-konechnostey-i-rol-endovaskulyarnoy-revaskulyarizatsii-u-bolnyh (in Russ.)
  14. Graziani L1, Piaggesi A. Indications and clinical outcomes for below knee endovascular therapy: review article. Catheter Cardiovasc Interv. 2010 Feb 15;75(3):433-43. doi: 10.1002/ccd.22287.
  15. Zaitseva EL, Doronina LP, Molchkov RV, Voronkova IA, Mitish VA, Tokmakova AYu. Features of angenesis against the background of negative pressure wound therapy in patients with neuropathic and neuroischemic forms of diabetic foot ulcers. Vestn Khirurgii im II Grekova. 2014;173(5):64-72. doi: 10.24884/0042-4625-2014-173-5-64-72 (in Russ.)
Address for correspondence:
302000, The Russian Federation,
Orel, Pobedy Boul., 10,
Orel Regional Clinical Hospital,
Coloproctological unit,
Tel: +7 905 165 09 92,
e-mail: sergeevdoc60@yandex.ru
Vladimir A. Sergeev
Information about the authors:
Glukhov Alexksandr A., MD, Professor, Head of the Department of General Surgery, Director of the Institute of Surgical Infection, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russian Federation.
https://orcid.org/0000-0001-9675-7611
Sergeev Vladimir A., PhD, Surgeon, the Coloproctological Unit, Orel Regional Clinical Hospital, Orel, Russian Federation.
https://orcid.org/0000-0002-6201-2440

MILITARY FIELD SURGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.321   |  

IE.V. TSEMA 1, 2, A.A. BESPALENKO 1, 3, A.V. DINETS 1, B.M. KOVAL 1, V.G. MISHALOV 1

STUDY OF DAMAGING FACTORS OF CONTEMPORARY WAR, LEADING TO THE LIMB LOSS

A.A. Bogomolets National Medical University 1, Kiev
National Military Medical Clinical Center of Ministry of Defense of Ukraine 2, Kiev,
Military Medical Clinical Center for Occupational Pathology of Personnel of the Ministry of Defense of Ukraine 3, Irpin,
Ukraine

Objective. To study the main damaging factors and causes of limb amputations in the contemporary war conflict.
Methods. 191 cases of limb amputations in 159 injured persons from 01.06.2014 to 30.06.2016 have been analyzed. The mean age of patients at the moment of getting a wound was 338.9 years (Mσ) (ranging from 18 to 60). There were 158 (99.4%) males and 1 (0.6%) female. The mean term of military service at the moment of injury was 2.03.7 years (Mσ) (ranging from 11 days to 25 years).
Results. One limb amputation was performed in 130 (81.8%) injured persons, two limbs in 27 (17.0%), three/four limbs in 2 (1.3%) patients. 62 upper limb amputations were carried out: 18 (29.0%) of the arm, 25 (40.3%) of the forearm, 19 (30.7%) of the hand. 129 lower limb amputations were performed: 55 (42.6%) of thigh, 53 (41.1%) of the leg, 21 (16.3%) of the foot. In 140 (73.3%) cases, the reason for the limb amputation was mine-explosive injury which in 93 (66.4%) cases caused traumatic limb avulsion. In 16 (8.4%) cases, multiple shrapnel wounds were the main cause of the limb loss; 15 (7.9%) frostbit injuries; 11 (5.8%) bullet gunshot wounds; 4 (2,1%) explosive behind-armor injuries; 3 (1.6%) cases train accident with traumatic limb avulsion; 2 (1.0%) concrete constructions collapse.
Conclusions. In the modern war conflict, limb amputation is determined by both combat (90.6%) and non-combat damaging factors (9.4%). The causes of limb amputations in 69.1% cases were associated with simultaneous occurrence of severe irreversible changes which were inevitable; potential opportunity to prevent limb amputation (or change amputation level) was in 28.8% cases.

Keywords: war-related injuries, armed conflicts and wars, limbs, amputation
p. 321-331 of the original issue
References
  1. Bertani A, Mathieu L, Dahan JL, Launay F, Rongiéras F, Rigal S. War-related extremity injuries in children: 89 cases managed in a combat support hospital in Afghanistan. OrthopTraumatol Surg Res. 2015;101(3):365-68. doi: 10.1016/j.otsr.2015.02.003
  2. Bodalal Z, Mansor S. Gunshot injuries in Benghazi-Libya in 2011: the Libyan conflict and beyond. Surgeon. 2013 Oct;11(5):258-63. doi: 10.1016/j.surge.2013.05.004
  3. Chandler H, MacLeod K, Penn-Barwell JG. Extremity injuries sustained by the UK military in the Iraq and Afghanistan conflicts: 2003-2014. Injury. 2017 Jul;48(7):1439-43. doi: 10.1016/j.injury.2017.05.022
  4. Rathore FA, Ayaz SB, Mansoor SN, Qureshi AR, Fahim M. Demographics of lower limb amputations in the Pakistan military: a single center, three-year prospective survey. Cureus. 2016 Apr;8(4):e566. doi: 10.7759/cureus.566
  5. Beranger F, Lesquen H, Aoun O, Roqueplo C, Meyrat L, Natale C, Avaro JP. Management of war-related vascular wounds in French role 3 hospital during the Afghan campaign. Injury. 2017 Sep;48(9):1906-10. doi: 10.1016/j.injury.2017.06.004
  6. Holt E. Health care collapsing amid fighting in east Ukraine. Lancet. 2015 Feb7;385(9967):494. doi: 10.1016/S0140-6736(15)60186-6
  7. Schoenfeld AJ, Dunn JC, Bader JO, Belmont PJ Jr. The nature and extent of war injuries sustained by combat specialty personnel killed and wounded in Afghanistan and Iraq, 2003-2011. J Trauma Acute Care Surg. 2013 Aug;75(2):287-91. doi: 10.1097/TA.0b013e31829a0970
  8. Khomenko I, Shapovalov V, Tsema I, Makarov G, Palytsia R, Zavodovskyi I, IshchenkoI, Dinets A, Mishalov V. Hydrodynamic rupture of liver in combat patient: a case of successful application of damage control tactic in area of the hybrid war in East Ukraine. Surg Case Rep. 2017 Aug 15;3(1):88. doi: ">10.1186/s40792-017-0363-6
  9. Ebrahimzadeh MH, Moradi A, Khorasani MR, Hallaj-Moghaddam M, Kachooei AR. Long-term clinical outcomes of war-related bilateral lower extremities amputations. Injury. 2015 Feb;46(2):275-81. doi: 10.1016/j.injury.2014.10.043
  10. Jacobs N, Rourke K, Rutherford J, Hicks A, Smith SR, Templeton P, Adams SA, Jansen JO. Lower limb injuries caused by improvised explosive devices: proposed Bastion classification and prospective validation. Injury. 2014 Sep;45(9):1422-28. doi: 10.1016/j.injury.2012.05.001
  11. Schwartz D, Glassberg E, Nadler R, Hirschhorn G, Marom OC, Aharonson-Daniel L. Injury patterns of soldiers in the second Lebanon war. J Trauma Acute Care Surg. 2014 Jan;76(1):160-66. doi: 10.1097/TA.0b013e3182a9680e
  12. Smith S, Devine M, Taddeo J, McAlister VC. Injury profile suffered by targets of antipersonnel improvised explosive devices: prospective cohort study. BMJ Open. 2017 Aug 7;7(7):e014697. doi: 10.1136/bmjopen-2016-014697
  13. Rivera JC, Greer RM, Spott MA, Johnson AE. The Military Orthopedic Trauma Registry: The potential of a specialty specific process improvement tool. J Trauma Acute Care Surg. 2016 Nov;81(5 Suppl 2 Proceedings of the 2015 Military Health System Research Symposium):S100-S103
  14. Allami M, Mousavi B, Masoumi M, Modirian E, Shojaei H, Mirsalimi F, Hosseini M, Pirouzi P. A comprehensive musculoskeletal and peripheral nervous system assessment of war-related bilateral upper extremity amputees. Mil Med Res. 2016;3:34. doi: 10.1186/s40779-016-0102-5
Address for correspondence:
01601, Ukraine,
Kiev, Shevchenko Boul., 13,
A.A. Bogomolets National Medical University,
Department of Surgery 4,
tel.: +38 063 731-59-95,
e-mail: hemorrhoid@ukr.net,
Ievgen V. Tsema
Information about the authors:
Tsema Ievgen V., MD, Associate Professor, Associate Professor of the Department of Surgery 4, A.A. Bogomolets National Medical University, Surgeon of the Abdominal Surgery Department, National Military Medical Clinical Center of Ministry of Defense of Ukraine, Kiev, Ukraine.
http://orcid.org/0000-0002-1178-7529
Bespalenko Artem A., Post-graduate Student, the Department of Orthopedics and Traumatology, A.A. Bogomolets National Medical University, Head of the Traumatology Department, Military Medical Clinical Center for Occupational Pathology of Personnel of Ministry of Defense of Ukraine, Irpin, Ukraine
http://orcid.org/0000-0003-2498-4334
Dinets Andrii V., PhD, Associate Professor of the Department of Surgery 4, A.A. Bogomolets National Medical University, Kiev, Ukraine.
http://orcid.org/0000-0001-9680-7519
Koval Boris M., PhD, Associate Professor of the Department of Surgery 4, A.A. Bogomolets National Medical University, Kiev, Ukraine.
http://orcid.org/0000-0003-0166-8603
Mishalov Vladimir G., MD, Professor, Head of the Department of Surgery 4, A.A. Bogomolets National Medical University, Kiev, Ukraine.
http://orcid.org/0000-0001-7263-7375

TRAUMATOLOGY & ORTHOPEDICS

DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.332   |  

G.P. KOTELNIKOV, YU.V. LARTSEV, I.G. TRUKHANOVA, A.D. GUREEV, O.V. FIRSTOVA, D.S. KUDASHEV

POSTOPERATIVE PROLONGED INFILTRATION ANESTHESIA FOR MMULTIMODAL PERIOPERATIVE PAIN MANAGEMENT IN PATIENTS WITH HIP REPLACEMENT ARTHROPLASTY

Samara State Medical University, Samara,
The Russian Federation

Objective. To improve the efficiency of multimodal perioperative pain management in patients in case of the hip replacement arthroplasty using postoperative prolonged infiltration anesthesia in the area of surgical intervention.
Methods. A prospective comparative analysis of the treatment results of 78 patients underwent the primary hip replacement arthroplasty was performed. The patients were divided into two groups: (1) the first group of patients was treated with prolonged epidural analgesia in the postoperative period, while (2) in the second group, the patients were treated with prolonged 24-hour infiltration anesthesia at the area of the surgical intervention by 0.2% of the ropivacaine hydrochloride solution, administered using microinfusion pump with a constant rate of 8 ml per hour. All patients were assessed for intensity of the pain syndrome, plasma concentrations of the cortisol and blood glucose levels. Also, trimeperidine consumption rate and the start of patients activity were assessed. The evaluation was conducted 24 hours prior to the surgical intervention, as well as 6 and 24 hours after.
Results. 24 hours after the surgery, the pain intensity scores assessed by the VAS were 2.20.35 and 1.50.42 points in the first and second clinical groups, respectively; the cortisol plasma levels 24 hours after the surgical intervention were 768.545.8 nmol/l and 584.654.2 nmol/l in the first and second clinical groups, respectively; the blood glucose levels after the surgical intervention were 7.030.34 mmol/l and 5.910.27 mmol/l in the first and second clinical groups, respectively. Trimeperidine consumption rates for the first 24 hours after the surgical intervention were 38.62.95 mg and 21.33.17 mg in the first and second clinical groups, respectively. The first sitting and complete verticalization of patients in the first group were performed in 24.82.4 and 281.4 hours, while in the second clinical group, these activities were performed in 4.50.5 and 6.30.7 hours respectively.
Conclusions. The use of the prolonged infiltration anesthesia allowed by 46.7% more effectively arresting pain syndrome, by 55.2% reducing trimeperidine consumption rate for the first 24 hours after the surgical intervention and by 20.31.4 hours earlier starting activation of patients if compared to the prolonged epidural analgesia.

Keywords: hip replacement arthroplasty, epidural anesthesia, infiltration anesthesia, ropivacaine hydrochloride, microinfusion pump
p. 332-339 of the original issue
References
  1. Borisov DB, Krylov OV, Uvarov DN. Perioperative analgesia during total hip replacement. Anesteziologiia i Reanimatologiia. 2009;(4):70-73. (in Russ.)
  2. Babaiants AV, Kirienko PA, Gelfand BR. Anesteziia pri operatsiiakh totalnogo endoprotezirovaniia tazobedrennogo sustava u patsientov pozhilogo vozrasta. Anesteziologiia i Reanimatologiia. 2010;(2):66-70. (in Russ.)
  3. Gerbershagen HJ, Aduckathil S, van Wijck AJ, Peelen LM, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013 Apr;118(4):934-44. doi: 10.1097/ALN.0b013e31828866b3
  4. Zaitsev AYu, Svetlov VA, Kozlov SP, Mikayelyan KP. Pharmacology of nociception. Anesteziologiia i Reanimatologiia. 2009;(4):66-69. (in Russ.)
  5. Zagrekov VI. Regional anesthesia for total hip arthroplasty. Regionarnaia Anesteziia i Lechenie Ostroi Boli. 2013;7(4):5-13. https://cyberleninka.ru/article/n/regionarnaya-anesteziya-pri-endoprotezirovanii-tazobedrennogo-sustava. (in Russ.)
  6. Mukutsa IG, Tsarenko SV, Lyadov KV, Koneva ES, Voloshin AG. Multimodal analgesia after total hip arthroplasty. Travmatologiia i Ortopediia Rossii. 2012;(4):72-75. doi: 10.21823/2311-2905-2012--4-72-75. (in Russ.)
  7. Benhamou D, Berti M, Brodner G, De Andres J, Draisci G, Moreno-Azcoita M, Neugebauer EA, Schwenk W, Torres LM, Viel E. Postoperative Analgesic Therapy Observational Survey (PATHOS): a practice pattern study in 7 central/southern European countries. Pain. 2008 May;136(1-2):134-41.
  8. Ovechkin AM, Bastrikin SIu. Protokol spinalno-epiduralnoi anestezii i posleoperatsionnoi epiduralnoi analgezii pri operatsiiakh totalnogo endoprotezirovaniia krupnykh sustavov nizhnikh konechnostei. Regionarnaia Anesteziia i Lechenie Ostroi Boli. 2007;1(1):79-81. (in Russ.)
  9. Rawal N. Epidural technique for postoperative pain: gold standard no more? Reg Anesth Pain Med. 2012 May-Jun;37(3):310-7. doi: 10.1097/AAP.0b013e31825735c6
  10. Ilfeld BM, Duke KB, Donohue MC. The association between lower extremity continuous peripheral nerve blocks and patient falls after knee and hip arthroplasty. Anesth Analg. 2010 Dec;111(6):1552-54. doi: 10.1213/ANE.0b013e3181fb9507
  11. Werner MU, Mjöbo HN, Nielsen PR, Rudin A. Prediction of postoperative pain: a systematic review of predictive experimental pain studies. Anesthesiology. 2010 Jun;112(6):1494-502. doi: 10.1097/ALN.0b013e3181dcd5a0
  12. Kerr DR, Kohan L. Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: a case study of 325 patients. Acta Orthop. 2008 Apr;79(2):174-83. doi: 10.1080/17453670710014950
  13. Place K, Scott NB. Enhanced recovery for lower limb arthroplasty. Continuing Education in Anaesthesia Critical Care and Pain (CEACCP). 2014 Jun;14(Is 3,1):95-99. https://doi: org/10.1093/bjaceaccp/mkt037
  14. Koriachkin VA, Geraskov EV, Korshunov DIu. Evaluation of Infiltration Anesthesia Safety in Total Knee Joint Arthroplasty. Novosti Khirurgii. 2015;23(4):436-39. doi: 10.18484/2305-0047.2015.4.436 (in Russ.)
Address for correspondence:
443099, The Russian Federation,
Samara, Chapayevskaya Str., 89,
Samara State Medical University,
Department of Traumatology,
Orthopedics and Extreme Surgery
named after Acad. of RAS A.F. Krasnov,
Tel.: +79276076209,
e-mail: dr.kudashev@gmail.com,
dmitrykudashew@mail.ru,
Dmitrij S. Kudashev
Information about the authors:
Kotelnikov Gennady P., Academician of RAS, MD, Professor, Head of the Department of Traumatology, Orthopedics and Extreme Surgery named after Acad. of RAS A.F. Krasnov, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0001-7456-6160
Lartsev Yuri V., MD, Head of the Traumatology and Orthopedics unit 2 of Clinic of Samara State Medical University, Professor of the Department of Traumatology, Orthopedics and Extreme Surgery named after Acad. of RAS A.F. Krasnov, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0003-4450-2486
Trukhanova Inna G., MD, Head of the Department of Anesthesiology, Reanimatology and Emergency Medical Care of the Institute of Vocational Education, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0002-2191-1087
Gureev Anton D., Head of the Anaesthesiology-Resuscitation Unit of Clinic of Samara State Medical University, Assistant of the Department of Anesthesiology, Reanimatology and Emergency Medical Care of the Institute of Vocational Education, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0001-8389-7244
Firstova Olga V., Anesthetist-Resuscitator of the Anaesthesiology-Resuscitation Unit of Clinic of Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0002-8920-0433
Kudashev Dmitrij S., MD, Traumatologist-Orthopedist of the Traumatology and Orthopedics unit 2 of Clinics of Samara State Medical University, Assistant of the Department of Traumatology, Orthopedics and Extreme Surgery named after Acad. of RAS A.F. Krasnov, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0001-8002-7294

ONCOLOGY

DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.340   |  

I.A. ILYIN

RESULTS OF THREE-STAGE ESOPHAGECTOMY WITH ONE-PHASE ESOPHAGOCOLONOPLASTY IN ESOPHAGEAL AND GASTROESOPHAGEAL JUNCTION CARCINOMAS TREATMENT

N.N. Alexandrov National Cancer Centre of Belarus, Minsk,
The Republic of Belarus

Objective. To evaluate the results of three-stage esophagectomy with one-phase esophagocolonoplasty in surgical treatment of esophageal and gastroesophageal junction carcinomas depending on graft translocation route to the neck.
Methods. sophagectomy with one-phase esophagocolonoplasty was performed in 30 patients. Depending on the graft translocation route to the neck, two groups of patients were formed: the 1st group with retrosternal route (n=13) and the 2nd with posterior mediastinal one (n=17). The groups did not differ in morphology, pT and pN, stages, age, body mass index and sex.
Results. Time of procedures in the 1st and 2nd groups was 435.0 (390.0, 477.5) and 425.0 (352.5, 467.5) minutes (p=0.691), blood loss volume 400 (325.0, 525.0) and 500.0 (475.0, 725.0) ml (p=0.020), in-hospital stay 30.0 (23.0, 36.0) and 32.0 (20.0, 57.5) days respectively (p=0.900). Esophago-colonic anastomotic leakage and graft proximal necrosis was detected by physical examination and X-rays on 7th day after the procedure. Anastomotic leakage in the 1st and 2nd groups developed in 2 (15.4%) and 2 (11.8%) cases (p=0.776), graft necrosis in 1 (7.7%) and 1 (5.9% %) (p=0.846). Late anastomotic stricture of the esophageal-colonic anastomosis, determined endoscopically 3 months after the procedure developed in 2 (15.4%) and 1 (5.9%) patients respectively (p=0.398). Hospital and 30-day mortality did not differ 1 (7.7%) and 1 (5.9%) (p=0.846); overall 5-year survival made up 18.6 and 20.6% respectively (plogrank=0.804).
Conclusions. Esophagectomy with one-stage esophageal replacement by primary coloplasty in surgical treatment of esophageal and gastroesophageal junction carcinomas regardless of graft translocation route to the neck is a complex procedure that allows achieving long-term treatment results comparable to those in the standard procedures.

Keywords: esophageal carcinoma, gastroesophageal junction carcinoma, three-stage esophagectomy, one-phase esophageal replacement by primary coloplasty, graft translocation route, posterior mediastinal route, retrosternal route
p. 340-347 of the original issue
References
  1. Reslinger V, Tranchart H, DAnnunzio E, Poghosyan T, Quero L, Munoz-Bongrand N, Corte H, Sarfati E, Cattan P, Chirica M. Esophageal reconstruction by colon interposition after esophagectomy for cancer analysis of current indications, operative outcomes, and long-term survival. J Surg Oncol. 2016 Feb; 113(2):159-64. doi: 10.1002/jso.24118
  2. Awsakulsutthi S, Havanond C. A retrospective study of anastomotic leakage between patients with and without vascular enhancement of esophageal reconstructions with colon interposition: Thammasat University Hospital experience. Asian J Surg. 2015 Jul;38(3):145-49. doi: 10.1016/j.asjsur.2015.01.005
  3. Chakiev AM. Vozmozhnost primeneniia mikrokhirurgicheskikh sosudistykh anastomozov pri ezofagoplastike. Vestn KRSU. 2008;8(5):26-28. (in Russ.)
  4. Vorobei AV, Chepik DA, Vizhinis EI, Lure VN. Klinicheskoe obosnovanie odnoetapnoi zagrudinnoi ezofagokoloplastiki v lechenii bolnykh s posleozhegovoi rubtsovoi strikturoi pishchevoda. Meditsina. 2009;(4):52-56. (in Russ.)
  5. Uchiyama H, Shirabe K, Morita M, Kakeji Y, Taketomi A, Soejima Y, Yoshizumi T, Ikegami T, Harada N, Kayashima H, Morita K, Maehara Y. Expanding the applications of microvascular surgical techniques to digestive surgeries: a technical review. Surg Today. 2012 Jan;42(2):111-20. doi: 10.1007/s00595-011-0032-5
  6. Averin VI, Podgaiskii VN, Nesteruk LN, Grinevich IuM, Ryliuk AF. Pervyi opyt revaskuliarizatsii transplantata pri plastike pishchevoda u detei v nestandartnykh situatsiiakh. Novosti Khirurgii. 2012;20(1):80-84. http://www.surgery.by/pdf/full_text/2012_1_14_ft.pdf (in Russ.)
  7. Kesler KA, Pillai ST, Birdas TJ, Rieger KM, Okereke IC, Ceppa D, Socas J, Starnes SL. Supercharged isoperistaltic colon interposition for long-segment esophageal reconstruction. Ann Thorac Surg. 2013 Apr;95(4):1162-68; discussion 1168-9. doi: 10.1016/j.athoracsur.2013.01.006
  8. Bakshi A, Sugarbaker DJ, Burt BM. Alternative conduits for esophageal replacement. Ann Cardiothorac Surg. 2017 Mar;6(2):137-43. doi: 10.21037/acs.2017.03.07
  9. Ilyin IA, Malkevich VT. Repeated and delayed esophagoplasty in esophageal and gastroesophageal cancer treatment. Vesti NAN Belarusi. Ser Med Nauk. 2016;(2):15-22. (in Russ.)
  10. Blackmon SH, Correa AM, Skoracki R, Chevray PM, Kim MP, Mehran RJ, Rice DC, Roth JA, Swisher SG, Vaporciyan AA, Yu P, Walsh GL, Hofstetter WL. Supercharged pedicled jejunal interposition for esophageal replacement: a 10-year experience. Ann Thorac Surg. 2012 Oct;94(4):1104-11; discussion 1111-13. doi: 10.1016/j.athoracsur.2012.05.123
  11. Chernousov AF, Khorobrykh TV, Chernousov FA, Vychuzhanin DV. Khirurgicheskoe lechenie raka kardii. Moscow, RF: Prakt Meditsina; 2016. 128 p. (in Russ.)
  12. Reslinger V, Tranchart H, DAnnunzio E, Poghosyan T, Quero L, Munoz-Bongrand N, Corte H, Sarfati E, Cattan P, Chirica M. Esophageal reconstruction by colon interposition after esophagectomy for cancer analysis of current indications, operative outcomes, and long-term survival. J Surg Oncol. 2016 Feb;113(2):159-64. doi: 10.1002/jso.24118
  13. Saeki H, Morita M, Harada N, Egashira A, Oki E, Uchiyama H, Ohga T, Kakeji Y, Sakaguchi Y, Maehara Y. Esophageal replacement by colon interposition with microvascular surgery for patients with thoracic esophageal cancer: the utility of superdrainage. Dis Esophagus. 2013 Jan;26(1):50-56. doi: 10.1111/j.1442-2050.2012.01327.x
  14. Ceroni M, Norero E, Henríquez JP, Viñuela E, Briceño E, Martínez C, Aguayo G, Araos F, González P, Díaz A, Caracci M. Total esophagogastrectomy plus extended lymphadenectomy with transverse colon interposition: a treatment for extensive esophagogastric junction cancer. World J Hepatol. 2015 Oct 8;7(22):2411-17. doi: 10.4254/wjh.v7.i22.2411
Address for correspondence:
223040, The Republic of Belarus,
Minsk region, Lesnoy village 2,
N.N. Alexandrov National Cancer
Centre of Belarus
Surgical Department,
Tel. office: 8 017 389 95 32,
e-mail: ileus@tut.by,
Ilya A. Ilyin
Information about the authors:
Ilyin Ilya A., PhD, Leading Researcher of the Surgical Department, N.N. Alexandrov National Cancer Centre of Belarus Minsk, Republic of Belarus.
http://orcid.org/0000-0002-5314-7618

ANESTHESIOLOGY-REANIMATOLOGY

DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.348   |  

D.P. MARKEVICH 1, A.V. MAROCHKOV 2

FEATURES OF ELECTROENCEPHALOGRAPHIC MONITORING IN ANESTHESIOLOGICAL SUPPORT OF NEUROSURGERICAL INTERVENTIONS IN THE HEAD

Mogilev Emergency City Hospital 1,
Mogilev Regional Hospital 2, Mogilev,
The Republic of Belarus

Objective. To determine the diagnostic importance of electroencephalographic (EEG) monitoring together with different methods of anesthesia and at different stages of the surgery during neurosurgical interventions in the head.
Methods. Perioperative EEG monitoring of 34 patients operated because of the intracranial hematomas, brain tumors, and postoperative skull defects was analyzed. The first group consisted of 16 patients with the combined anesthesia (general with conductor blockades of the peripheral nerves of the scalp part of the head), the second group 18 patients with the general anesthesia. The groups did not differ by sex, age, body weight. General anesthesia in groups was total intravenous with the mechanical ventilation with fentanyl and propofol. Blockade of nerves was performed with 0.5% bupivacaine or 0.75-1.0% ropivacaine. Cerebral state monitor was used for electroencephalographic monitoring and the cerebral state index (CSI) was monitored.
Results. There were no significant differences between CSI groups. CSI parameters at the moment of the surgery onset were 45.75.9 un. in 1-st group, in the 2-nd group 54.217.5 un.; at trepanation: 1-st group 51.215.1 un., 2-nd group 63.118.3 un.; main stage of the surgery: 1-st group 43.06.3 un., 2-nd group 44.88.9 un.; end of operation: 1-st group 48.19.9 un., 2-nd group: 52.113 un.
In 5 (31.2%) patients of the 1-st group and 8 (44.4%) of 2-st group, during the skull trepanation, CSI increased more than 60 un., which required additional deepening of anesthesia by bolus injections of fentanyl and propofol.
Conclusions. There were no significant differences in CSI between the groups with the combined and general anesthesia. Taking into account the increase in CSI by more than 60 un. in 5 (31.2%) patients in the 1-st group and 8 (44.4%) of the 2-st group, preliminary additional deepening of anesthesia is necessary 3-5 minutes before the braincase trepanation.

Keywords: electroencephalographic monitoring, conductor blockades, general anesthesia, neuroanesthesiology, cerebral state index in neurosurgery, anesthetic depth monitoring
p. 348-357 of the original issue
References
  1. Zhang L, Xu L, Zhu J, Gao Y, Luo Z, Wang H, Zhu Z, Yu Y, Shi H, Bao H. To clarify features of photoplethysmography in monitoring balanced anesthesia, compared with Cerebral State Index. Med Sci Monit. 2014 Mar 25;20:481-86. doi: 10.12659/MSM.889924
  2. Drummond DK, Patel PM. Anesteziologicheskoe obespechenie v neirokhirurgii. V kn: Miller R, red. Anesteziia. S-Petersburg, RF: Chelovek; 2015. p. 2197-42. (in Russ.)
  3. Jensen EW, Litvan H, Revuelta M, Rodriguez BE, Caminal P, Martinez P, Vereecke H, Struys MM. Cerebral state index during propofol anesthesia: a comparison with the bispectral index and the A-line ARX index. Anesthesiology. 2006 Jul;105(1):28-36. doi: 10.1097/00000542-200607000-00009
  4. Sinha PK, Koshy T. Monitoring devices for measuring the depth of anaesthesia an overview. Indian J Anaesth. 2007;51(5):365-81. Available from: http://www.ijaweb.org/text.asp?2007/51/5/365/61166
  5. Loskota W. Intraoperative EEG monitoring. 2005 Dec;24(Is 4):176-85. doi: org/10.1053/j.sane.2005.10.007
  6. Lipnitskii AL, Reznikov MV, Lipnitskaia VV, Iurtsev AN, Khizhniak AV, Kustrei AV. Diagnosis of cerebral death using CSI-monitoring. Zdravookhranenie. 2013;(6):57-60. http://www.zdrav.by/pdf/2013/Zdrav6.pdf (in Russ.)
  7. Anderson RE, Jakobsson JG. Cerebral state monitor, a new small handheld EEG monitor for determining depth of anaesthesia: a clinical comparison with the bispectral index during day-surgery. Eur J Anaesthesiol. 2006 Mar;23(3):208-12. doi: 10.1017/S0265021505002206
  8. Fazel MR, Fakharian E, Akbari H, Mahdian S, Yadollahi S, Mahdian M. Agreement of cerebral state index and glasgow coma scale in brain-injured patients. Arch Trauma Res. 2014 Mar;3(1):e15892. Published online 2014 Mar 30. doi: 10.5812/atr.15892
  9. Etezadi F, Orandi AA, Orandi AH, Najafi A, Amirjamshidi A, Pourfakhr P, Khajavi MR, Abbassioun K. Trigeminocardiac reflex in neurosurgical practice: An observational prospective study. Surg Neurol Int. 2013 Sep 18;4:116. doi: 10.4103/2152-7806.118340. eCollection 2013
  10. Osborn I, Sebeo J. Scalp block during craniotomy: a classic technique revisited. J Neurosurg Anesthesiol. 2010 Jul;22(3):187-94. doi: 10.1097/ANA.0b013e3181d48846
  11. Markevich DP, Marochkov AV. Blokady perifericheskikh nervov v anesteziologicheskom obespechenii neirokhirurgicheskikh vmeshatelstv na golove. Regionarnaia Anesteziia i Lechenie Ostroi Boli. 2017;11(4):270-78. (in Russ)
  12. Weber F, Kriek N, Blussé van Oud-Alblas HJ. The effects of mivacurium-induced neuromuscular block on Bispectral index and cerebral state index in children under propofol anesthesia a prospective randomized clinical trial. Paediatr Anaesth. 2010 Aug;20(8):697-703. doi: 10.1111/j.1460-9592.2010.03327.x
Address for correspondence:
212030, The Republic of Belarus,
Mogilev, Botkin Str., 2,
Mogilev Emergency City Hospital,
Anesthesiology and Intensive Care Unit.
Tel./fax: +375(222) 22-16-26,
+375(222) 29-16-42,
e-mail: snyter1977@gmail.com,
Denis P. Markevich
Information about the authors:
Markevich Denis P., Head of Anesthesiology and Intensive Care Unit, Mogilev Emergency City Hospital, Mogilev, Republic of Belarus.
http://orcid.org/0000-0002-1117-3877
Marochkov Alexey V., MD, Professor, Anesthesiologist-Resuscitator, Mogilev Emergency City Hospital, Mogilev, Republic of Belarus.
http://orcid.org/0000-0001-5092-8315

REVIEWS

DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.358   |  

A.I. CHERNOOKOV 1, A.YU. BOZHEDOMOV 2, A.A. ATAYAN 1, 2, E.N. BELYKH 1, E.S. SYLCHUK 3, E.O. KHACHATRYAN 1

NEW BIOMARKERS OF ACUTE MESENTERIC ISCHEMIA

I.M. Sechenov First Moscow State Medical University (Sechenov University) 1,
City Clinical Hospital 29 named after N. E. Bauman, Moscow Healthcare Department 2,
Center of Phlebology 3, Moscow,
The Russian Federation

The acute mesenteric ischemia is one of the most complex problems in the urgent surgery because of the high mortality, the cause of which is late diagnosis. The operation treatment is often provided in the phase of diffuse peritonitis.
This literature review is done in order to identify the most accessible and accurate methods of early diagnosis of the acute mesenteric ischemia.
At present time rather a small number of biomarkers for diagnosing the acute mesenteric ischemia are used, such as α-glutamate-S-transferase, D-dimers, procalcitonin, D-lactate, intestinal fatty acid binding protein (I-FABP), ischemia-modified albumin. According to the literature the highest sensitivity and specificity were found in I-FABP (75-85% and 70-80% respectively), α-glutamate-S-transferase (67.8% and 84.2%), ischemia-modified albumin (94.7% and 86.4%). In addition, expensive and invasive methods are currently used for early diagnosis, such as CT angiography, contrast-enhanced MRI, selective angiography. However, these technologies are not available to all medical institutions.
We should continue further search of various biomarkers and their more widespread introduction to clinical practice in order to solve the problem of early acute mesenteric ischemia diagnostics.

Keywords: acute mesenteric ischemia, biomarkers, diagnostics, mesenteric thrombosis, intestinal fatty acid binding protein (I-FABP)
p. 358-365 of the original issue
References
  1. Lubyansky VG, Zharikov AN, Kanteeva IuL. Surgical treatment of patients with acute mesenteric thrombosis with necrosis of the intestine and peritonitis. Kuban Nauch Med Vestn. 2013;(3):85-90. https://cyberleninka.ru/article/n/hirurgicheskoe-lechenie-bolnyh-ostrym-mezenterialnym-trombozom (in Russ)
  2. Baeshko AA, Klimchuk SA, Iushkevich VA. Prichiny i osobennosti porazhenii kishechnika i ego sosudov pri ostrom narushenii bryzheechnogo krovoobrashcheniia. Khirurgiia Zhurn im NI Pirogova. 2005;(4):57-63. (in Russ.)
  3. Lock G. Acute mesenteric ischemiafrequently overlooked and often fatal. Med Klin (Munich). 2002 Jul 15;97(7):402-9. [Article in German]
  4. Isaev YuA. Mesenteric thrombosis and embolism in surgical practice (clinical observation). Verkhnevolzh Med Zhurn. 2016;15(1):40-42. http://medjournal.tvergma.ru/239/1/16_1stat8.pdf. (in Russ.)
  5. Ivanov IuV, Chupin AV, Sazonov DV, Lebedev DP. Sindrom khronicheskoi abdominalnoi ishemii v praktike obshchego khirurga. Klin Praktika. 2014;(2):61-72.
    http://clinpractice.ru/upload/iblock/e92/e92cf68d604f5e0885bc46c4fde17fbd.pdf (in Russ.)
  6. MacDonald PH, Hurlbut D, Beck IT. Ischemic Disease of the Intestine. Shaffer AB, Astra EA, eds. First Principles of gastroenterology: the basis of disease and an approach to management. 5th ed. Canadian Association of Gastroenterology Staff Thomson; 2005. . 258-88.
  7. Kozachenko AV. Narushenie mezenterialnogo krovoobrashcheniia kak problema neotlozhnoi praktiki. Meditsina Neotlozh Sostoianii. 2007; (4):51-54. http://www.emergencymed.org.ua/j_pdf/2007_4_51_54.pdf (in Russ.)
  8. Acosta S, Ogren M, Sternby NH, Bergquist D, Bjorck M. Incidence of acute thromboembolic occlusion of superior mesenteric artery-a population based study. Eur J Vasc Endovasc Surg. 2004 Feb;(27):145-50. doi: 10.1016/j.ejvs.2003.11.003
  9. Yun WS, Lee KK, Cho J, Kim HK, Huh S. Treatment outcome in patients with acute superior mesenteric artery embolism. Ann Vasc Surg. 2013 Jul;27(5):613-20. doi: 10.1016/j.avsg.2012.07.022
  10. Bagdasarov VV, Bagdasarova EA, Chernookov AI, Ramishvili VSh, Ataian AA, Iarkov SA. Tactics by the acute intestinal ischemia. Khirurgiia Zhurn im NI Pirogova. 2013;(6):44-50. https://www.mediasphera.ru/issues/khirurgiya-zhurnal-im-n-i-pirogova/2013/6/downloads/ru/030023-1207201368 (in Russ.)
  11. Iushkevich DV, Khryshchanovich VIa, Ladutko IM. Diagnostika i lechenie ostrogo narusheniia mezenterialnogo krovoobrashcheniia: sovremennoe sostoianie problemy. Med Zhurn. 2013;(3):38-44. http://rep.bsmu.by/handle/BSMU/1702 (in Russ.)
  12. Hong J, Gilder E, Blenkiron C, Jiang Y, Evennett NJ, Petrov MS, Phillips ARJ, Windsor JA, Gillham M. Nonocclusive mesenteric infarction after cardiac surgery: potential biomarkers. J Surg Res. 2017 May 1;211:21-29. doi: 10.1016/j.jss.2016.12.001
  13. Basarab DA, Bagdasarov VV, Bagdasarova EA, Zelenskii AA, Ataian AA. Patofiziologicheskie aspekty problemy ostroi intestinalnoi ishemii. Infektsii v Khirurgii. 2012;10(2):6-13. (in Russ.)
  14. Sise MJ. Acute mesenteric ischemia. Surg Clin North Am. 2014 Feb;94(1):165-81. doi: 10.1016/j.suc.2013.10.012
  15. Ozkan O, Fahri Y, Ebru SS, Zeybek ND, Onal CO, Yurekliet B, Celik HT, Sirma A, Kilic M. Prophylactic ozone administration reduces intestinal mucosa injury induced by intestinal ischemia-reperfusion in the rat. Mediators Inflamm. 2015 (2015); 792016. doi: 10.1155/2015/792016/LI>
  16. Gadzhiev MM, Gavrilov EN, Vasilev IuG. K diagnostike i lecheniiu ostrykh trombozov verkhnikh mezenterialnykh sosudov. Voen-Med Zhurn. 2001;322(9):42-44. (in Russ)
  17. Dementieva II, Morosov UA, Charnaya MA. Cardiac protein, binding aliphatic acids in myocardial damage evaluation in cardiology and cardiosurgery. Vrach Skoroi Pomoshchi. 2010;(1):53-58. http://docplayer.ru/30091450-Serdechnyy-belok-svyazyvayushchiy-zhirnye-kisloty-v-ocenke-povrezhdeniy-miokarda-v-kardiologii-i-kardiohirurgii.html (in Russ.)
  18. Iureva EV, Taraban TA. Problemy sovremennoi laboratornoi diagnostiki ostrogo infarkta miokarda. Zdravookhranenie Chuvashii. 2007; (2):86-94. http://giduv.com/journal/2007/2/problemy_sovremennoj (in Russ.)
  19. Dundar ZD, Cander B, Gul M, Karabulut KU, Kocak S, Girisgin S, Mehmetoglu T, Toy H.. Serum intestinal fatty acid binding protein and phosphate levels in the diagnosis of acute intestinal ischemia: an experimental study in rabbits. J Emerg Med. 2012 Jun;42(6):741-47. doi: 10.1016/j.jemermed.2011.05.051
  20. Evennett NJ, Petrov MS, Mittal A, Windsor JA. Systematic review and pooled estimates for the diagnostic accuracy of serological markers for intestinal ischemia. World J Surg. 2009 Jul;33(7):1374-83. doi: 10.1007/s00268-009-0074-7
  21. Treskes N, Persoon AM, van Zanten ARH. Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis. Intern Emerg Med. 2017 May 6. doi: 10.1007/s11739-017-1668-y
  22. Block T, Nilsson TK, Björck M, Acosta S. Diagnostic accuracy of plasma biomarkers for intestinal ischaemia. Scand J Clin Lab Invest. 2008;68(3):242-48. doi: 10.1080/00365510701646264
  23. Karaca Y, Gündüz A, Türkmen S, Menteşe A, Türedi S, Eryiğit U. Diagnostic value of procalcitonin levels in acute mesenteric ischemia. Balkan Med J. 2015 Jul;32(3):291-5. doi: 10.5152/balkanmedj.2015.15661
  24. Cosse C, Sabbagh C, Kamel S, Galmiche A, Regimbeau JM. Procalcitonin and intestinal ischemia: a review of the literature. World J Gastroenterol. 2014 Dec 21;20(47):17773-78. doi: 10.3748/wjg.v20.i47.17773
  25. Markogiannakis H, Memos N, Messaris E, Dardamanis D, Larentzakis A, Papanikolaou D, Zografos GC, Manouras A. Predictive value of procalcitonin for bowel ischemia and necrosis in bowel obstruction. Surgery. 2011 Mar;149(3):394-403. doi: 10.1016/j.surg.2010.08.007
  26. Priamikov AD, Khripun AI, Shurygin SN, Mironkov AB, Movsesiants MIu, Latonov VV. D-dimery v diagnostike tromboza bryzheechnykh arterii. Annaly Khirurgii. 2010;(4):20-22. (in Russ.)
  27. Cudnik MT, Darbha S, Jones J, Macedo J, Stockton SW, Hiestand BC. The diagnosis of acute mesenteric ischemia: a systematic review and meta-analysis. Acad Emerg Med. 2013 Nov;20(11):1087-100. doi: 10.1111/acem.12254
  28. Minaev SV, Kirgizov IV, Obedin AN, Isaeva AV, Bolotov IuN, Tovkan EA, Lukianenko EV, Khoranova TA, Timofeev SI, Gudiev ChG, Getman NV. Monitoring razvitiia vospalitelnykh oslozhnenii u novorozhdennykh s vrozhdennoi patologiei zheludochno-kishechnogo trakta. Med Vestn Sever Kavkaza. 2013;8(2):30-33. https://cyberleninka.ru/article/n/monitoring-razvitiya-vospalitelnyh-oslozhneniy-u-novorozhdennyh-s-vrozhdennoy-patologiey-zheludochno-kishechnogo-trakta (in Russ.)
  29. Gunduz A, Turkmen S, Turedi S, Mentese A, Yulug E, Ulusoy H, Karahan SC, Topbas M. Time-dependent variations in ischemia-modified albumin levels in mesenteric ischemia. Acad Emerg Med. 2009 Jun;16(6):539-43. doi: 10.1111/j.1553-2712.2009.00414.x
  30. Shi H, Wu B, Wan J, Liu W, Su B. The role of serum intestinal fatty acid binding protein levels and D-lactate levels in the diagnosis of acute intestinal ischemia. Clin Res Hepatol Gastroenterol. 2015 Jun;39(3):373-78. doi: 10.1016/j.clinre.2014.12.005
  31. Pal AK, Ansari MM, Islam N. Combination of Serum C-reactive Protein and D-lactate: prediction of strangulation in intestinal obstruction. Pan Am J Trauma Crit Care Emerg Surg. 2016;5(3):134-39. doi: 10.5005/jp-journals-10030-1156
  32. Karabulut KU, Narci H, Gul M, Dundar ZD, Cander B, Girisgin AS, Erdem S. Diamine oxidase in diagnosis of acute mesenteric ?schemia. Am J Emerg Med. 2013 Feb;31(2):309-12. doi: 10.1016/j.ajem.2012.07.029
  33. Zhang FX, Ma BB, Liang GZ, Zhang H. Analysis of serum enzyme levels in a rabbit model of acute mesenteric ischemia. Mol Med Rep. 2011 Nov-Dec;4(6):1095-99. doi: 10.3892/mmr.2011.553
  34. Jones P, Elangbam B, Williams NR. Inappropriate use and interpretation of D-dimer testing in the emergency department: an unexpected adverse effect of meeting the 4-h target. Emerg Med J. 2010 Jan;27(1):43-47. doi: 10.1136/emj.2009.075838
  35. Derikx JP, Schellekens DH, Acosta S. Serological markers for human intestinal ischemia: A systematic review. Best Pract Res Clin Gastroenterol. 2017 Feb;31(1):69-74. doi: 10.1016/j.bpg.2017.01.004
  36. Acosta S, Nilsson T. Current status on plasma biomarkers for acute mesenteric ischemia. J Thromb Thrombolysis. 2012 May;33(4):355-61. doi: 10.1007/s11239-011-0660-z
  37. Terrin G, Stronati L, Cucchiara S, De Curtis M. Serum Markers of Necrotizing Enterocolitis: A Systematic Review. J Pediatr Gastroenterol Nutr. 2017 Apr 5. doi: 10.1097/MPG.0000000000001588 [Epub ahead of print]
  38. Sun DL, Cen YY, Li SM, Li WM, Lu QP, Xu PY. Accuracy of the serum intestinal fatty-acidbinding protein for diagnosis of acute intestinal ischemia: a meta-analysis. Sci Rep. 2016;(6):34371. doi: 10.1038/srep34371
  39. Gunduz A, Turedi S, Mentese A, Karahan SC, Hos G, Tatli O, Turan I, Ucar U, Russell RM, Topbas M. Ischemia-modified albumin in the diagnosis of acute mesenteric ischemia: a preliminary study. Am J Emerg Med. 2008 Feb;26(2):202-5. doi: 10.1016/j.ajem.2007.04.030
  40. Polk JD, Rael LT, Craun ML, Mains CW, Davis-Merritt D, Bar-Or D. Clinical utility of the cobalt-albumin binding assay in the diagnosis of intestinal ischemia. J Trauma. 2008 Jan;64(1):42-5. doi: 10.1097/TA.0b013e31815b846a
  41. Schellekens DHSM, Reisinger KW, Lenaerts K, Hadfoune M, Olde Damink SW, Buurman WA, Dejong CHC, Derikx JPM. SM22 a plasma biomarker for human transmural intestinal ischemia. Ann Surg. 2017 May 18. doi: 10.1097/SLA.0000000000002278
Address for correspondence:
111020, The Russian Federation,
Moscow, Hospital Square, 2,
City Clinical Hospital 29
named after N. E. Bauman,
Moscow Healthcare Department,
Endovascular Surgery Unit,
Tel. office: +7(499) 263-21-30,
e-mail: alecso_84@mail.ru,
Aleksey Yu. Bozhedomov
Information about the authors:
Chernookov Alexandr I., MD, Professor, Head of the Department of Hospital Surgery 2, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation. http://orcid.org/0000-0003-3124-4860
Bozhedomov Aleksey Yu., PhD, Surgeon of the Surgical Unit 3, City Clinical Hospital 29 named after N. E. Bauman, Moscow Healthcare Department, Moscow, Russian Federation. http://orcid.org/0000-0002-8544-932X
Atayan Andrey A., PhD, Assistant of the Department of Hospital Surgery 2, I.M. Sechenov First Moscow State Medical University (Sechenov University), Surgeon of the Endovascular Surgery Unit, City Clinical Hospital 29 named after N. E. Bauman, Moscow Healthcare Department, Moscow, Russian Federation.
http://orcid.org/0000-0001-8914-7735
Belyx Elena N., PhD, Associate Professor of the Department of Hospital Surgery 2, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
http://orcid.org/0000-0001-5864-7892
Silchuk Evgenii S., PhD, Surgeon, Head of the Lymphology Unit, Center of Phlebology, Moscow, Russian Federation. http://orcid.org/0000-0003-4018-4468
Hachatryan Edita O., FourthYear Medical Student, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
http://orcid.org/0000-0003-2636-3945
DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.366   |  

V.E. MILYUKOV 1, A.V. BOGDANOV 2

THE ROLE OF ADRENAL GLANDS IN THE MECHANISMS OF STRESS EFFECTS ON PATHOGENESIS
OF COMPLICATIONS IN ACUTE SMALL BOWEL OBSTRUCTION (REVIEW)

I.M. Sechenov First Moscow State Medical University (Sechenov University)1,
Medical-Sanitary Unit of the Ministry of Internal Affairs of the Russian Federation in Moscow2, Moscow,
The Russian Federation

The aim of this review is a detailed description of the alleged mechanisms of involving the adrenal glands, as a key element of the system of nonspecific protection of an organism and adaptation to stress, in the pathogenesis of clinical manifestations of acute small bowel obstruction and developing complications, including peritonitis, sepsis and multiple organ failure.
In the discussion of the pathogenesis of clinical manifestations of acute small bowel obstruction and its complications, leading to the disappointing results of treatment of patients on a large sample of contemporary scientific publications, it is noted that many researchers see a close connection between the influence of various stress effects on humans and the functioning of internal organs and systems. It is demonstrated that in the literature there is growing evidence of the negative effects of stress and related affective disorders on the course of inflammatory bowel diseases and gastrointestinal tract, which is one of the targets of stress, and hormones of the hypothalamic-pituitary-adrenal system, especially the adrenal glands take an active part in the mediation of these reactions.
The conducted analysis of the current literature demonstrates a large number of unsolved issues in this direction, that proves the need for a comprehensive experimental and morphological studies to clarify and detail all pathogenetic links of dependent morpho-functional transformations in the dynamics of development of acute small bowel obstruction which may lead to adrenal insufficiency and disruption of adaptation mechanisms that maintain the stability of homeostasis.

Keywords: acute small bowel obstruction, peritonitis, sepsis, stress, adrenal insufficiency
p. 366-375 of the original issue
References
  1. Altiev BK, Atadzhanov ShK, Isabaev ShB. Problemy diagnostiki i lecheniia ostroi spaechnoi tonkokishechnoi neprokhodimosti. Vestn Ekstr Meditsiny. 2010;(1):88-91. (in Russ.)
  2. Bagnenko SF, Sinenchenko GI, Chupris VG. Laparoscopic diagnostics and treatment of acute adhesive small bowel obstruction. Vestn Khirurgii im II Grekova. 2009;168(1):27-30. (in Russ.)
  3. Rybachkov VV, Kostiuchenko KV, Maevskii SV. Peritonit. Iaroslavl, RF: IarMediaGrup; 2010. 304 p. (in Russ.)
  4. Baranov GA, Karbovskii MIu. Quality of life among patients, operated on the reason of the adhesive ileus. Khirurgiia Zhurn im NI Pirogova. 2012;(9):70-74. https://www.mediasphera.ru/issues/khirurgiya-zhurnal-im-n-i-pirogova/2012/9 (in Russ.)
  5. Gostishchev VK, Afanasev AN, Kruglianskii IuM, Sotnikov DN. Bakterialnaia translokatsiia v usloviiakh ostroi neprokhodimosti kishechnika. Vestn RAMN. 2006;(9-10):34-38. (in Russ.)
  6. Malkova OG, Leiderman I.N., Levit A.L., Alasheev A.M. Changes in lipid and carbohydrate metabolism in patients with severe sepsis of different etiology. Anesteziologiia i Reanimatologiia. 2014;(2):15-21. (in Russ.)
  7. Savelev VS, Gelfand BR, Filimonov MI, Podachin PV, Sergeeva NA. Criteria for the selection of effective surgical treatment of widespread peritonitis. Annaly Khirurgii. 2013;(2):48-54. https://cyberleninka.ru/article/v/kriterii-vybora-effektivnoy-taktiki-hirurgicheskogo-lecheniya-rasprostranennogo-peritonita (in Russ.)
  8. Tomniuk ND, Danilina EP, Chernykh AN, Parno AA, Shurko KS. Peritonit, kak odna iz osnovnykh prichin letalnykh iskhodov. Sovrem Naukoemkie Tekhnologii. 2010;(10):81-84. https://www.top-technologies.ru/ru/ article/view?id=26032 (in Russ.)
  9. Grinberg AA (red/), Abakumov MM, Bogdanov AE, Shapovaliants SG, Mikhailusov SV. Neotlozhnaia abdominalnaia khirurgiia. Moscow, RF: Triada-Kh; 2010. 496 p. (in Russ)
  10. Selye H. Stress and the general adaptation syndrome. Br Med J. 1950 Jun 17;1(4667):1383-92. doi: 10.1136/bmj.1.4667.1383
  11. Korkmaz C. The country of residence affects the phenotype of familial Mediterranean fever: is it real or a selection bias? Ann Rheum Dis. 2014 Aug;73(8):e52. doi: 10.1136/annrheumdis-2014-205795
  12. Contoreggi C, Lee MR, Chrousos G. Addiction and corticotropin-releasing hormone type 1 receptor antagonist medications. Ann N Y Acad Sci. 2013 Apr;1282:107-18. doi: 10.1111/nyas.12007
  13. Glaser R, Kiecolt-Glaser JK. Stress-induced immune dysfunction: implications for health. Nat Rev Immunol. 2005 Mar;5(3):243-51. doi: 10.1038/nri1571
  14. Borsook D, Maleki N, Becerra L, McEwen B. Understanding migraine through the lens of maladaptive stress responses: a model disease of allostatic load. Neuron. 2012 Jan 26;73(2):219-34. doi: 10.1016/j.neuron.2012.01.001.
  15. Zaichik ASh, Churilov LP. Patokhimiia (endokrinno-metabolicheskie narusheniia). S-Petersburg, RF: ELBI-SPb; 2007. 768 p. (in Russ.)
  16. Romero-Grimaldi C, Berrocoso E, Alba-Delgado C, Madrigal JL, Perez-Nievas BG, Leza JC, Mico JA. Stress increases the negative effects of chronic pain on hippocampal neurogenesis. Anesth Analg. 2015 Oct;121(4):1078-88. doi: 10.1213/ANE.0000000000000838
  17. Krishnan V, Nestler EJ. Animal models of depression: molecular perspectives. Curr Top BehavNeurosci. 2011;7:121-47. doi: 10.1007/7854_2010_108
  18. Hahner S, Loeffler M, Bleicken B, Drechsler C, Milovanovic D, Fassnacht M, Ventz M, Quinkler M, Allolio B. Epidemiology of adrenal crisis in chronic adrenal insufficiency: the need for new prevention strategies. Eur J Endocrinol. 2010 Mar;162(3):597-602. doi: 10.1530/EJE-09-0884
  19. Kverka M, Zakostelska Z, Klimesova K, Sokol D, Hudcovic T, Hrncir T, Rossmann P, Mrazek J, Kopecny J, Verdu EF, Tlaskalova-Hogenova H. Oral administration of Parabacteroidesdistasonis antigens attenuates experimental murine colitis through modulation of immunity and microbiota composition. Clin Exp Immunol. 2011 Feb;163(2):250-59. doi: 10.1111/j.1365-2249.2010.04286.x
  20. Walker JJ, Terry JR, Tsaneva-Atanasova K, Armstrong SP, McArdle CA, Lightman SL. Encoding and decoding mechanisms of pulsatile hormone secretion. J Neuroendocrinol. 2010 Dec;22(12):1226-38. doi: 10.1111/j.1365-2826.2010.02087.x
  21. Lazarus RS. Toward better research on stress and coping. AmPsychol. 2000 Jun;55(6):665-73. http://bccp.bspu.by/files/Lazarus.pdf
  22. Reshetnyak TM, Seredavkina NV, Dydykina IS, Nasonov EL. Glucocorticoids in the therapy of systemic lupus erythematosus. Klinitsist. .2013; (3-4):14-26. http://klinitsist.abvpress.ru/Klin/article/viewFile/6/20 (in Russ.)
  23. Zubritskiy V, Zemlyanoi A, Koltovich A, Zabelin M, Pokrovskiy K, Airapetyan A, Golubev I, Gardashov N, Rozberg Ye, Korenev D. Intra-abdominal hypertension or abdominal sepsis: what is primary? Med Vestn MVD. 2016;81(2):21-25. (in Russ.)
  24. Kozlov VI, Gurova OA, Ryzhakin SM, Kuchuk AV, Garibov AG. Blood microcirculation: clinico-morphological aspects of study. Morfologiia. 2016;149(3):105. (in Russ.)
  25. Saunders PR, Santos J, Hanssen NP, Yates D, Groot JA, Perdue MH. Physical and psychological stress in rats enhances colonic epithelial permeability via peripheral CRH. Dig Dis Sci. 2002 Jan;47(1):208-15. https://link.springer.com/article/10.1023/A:1013204612762
  26. Im E, Rhee SH, Park YS, Fiocchi C, Taché Y, Pothoulakis C. Corticotropin-releasing hormone family of peptides regulates intestinal angiogenesis. Gastroenterology. 2010 Jun;138(7):2457-67, 2467.e1-5. doi: 10.1053/j.gastro.2010.02.055
  27. Jappelli R, Perrin MH, Lewis KA, Vaughan JM, Tzitzilonis C, Rivier JE, Vale WW, Riek R. Expression and functional characterization of membrane-integrated mammalian corticotropin releasing factor receptors 1 and 2 in Escherichia coli. PLoS One. 2014 Jan 17;9(1):e84013. doi: 10.1371/journal.pone.0084013. eCollection 2014.
  28. Chesnokova NP, Ponukalina EV, Zhevak TN, Afanaseva GA, Bizenkova MN. Rol nadpochechnikov v reguliatsii vodno-solevogo gomeostaza v usloviiakh normy i patologii. Nauch Obozrenie. Med Nauki. 2016;(1):61-64. https://science-medicine.ru/ru/article/ view?id=871 (in Russ.)
  29. Ait-Belgnaoui A, Bradesi S, Fioramonti J, Theodorou V, Bueno L. Acute stress-induced hypersensitivity to colonic distension depends upon increase in paracellular permeability: role of myosin light chain kinase. Pain. 2005 Jan;113(1-2):141-47. doi: 10.1016/j.pain.2004.10.002
  30. Jackson PG, Raiji MT. Evaluation and management of intestinal obstruction. Am Fam Physician. 2011 Jan 15;83(2):159-65.
  31. Gain IuM, Bogdan VG, Popkov OV. Abdominalnyi kompartment-sindrom. Novosti Khirurgii. 2009;17(3):168-82. (in Russ.) https://surgery.by/pdf/full_text/2009_3_2
  32. Plotkin LL, Bespalov AM, Smirnov DM. Endotelialnaia disfunktsiia u patsientov c tiazhelym abdominalnym sepsisom. Infektsii v Khirurgii. 2012;10(4):21-24. (in Russ)
  33. Roberts DJ, Ball CG, Kirkpatrick AW. Increased pressure within the abdominal compartment: intra-abdominal hypertension and the abdominal compartment syndrome. Curr Opin Crit Care. 2016 Apr;22(2):174-85. doi: 10.1097/MCC.0000000000000289
  34. Borisov AE, Krasnov LM, Fedorov EA, Batalov I Kh, Krichinevsky AA Chronic and acute adrenal insufficiency in surgical practice. Vestn Khirurgii im II Grekova. 2006;165(6):59-62. (in Russ.)
  35. Moroz GA. Morfofunktsionalnye izmeneniia nadpochechnykh zhelez 2-mesiachnykh krys pri sistematicheskom vozdeistvii gipergravitatsii v usloviiakh fizicheskoi zashchity. Klnchna Anatomia ta Operativna Khrurgia. 2012;11(4):14-17. https://www.bsmu.edu.ua/files/CAS/CAS-2012-11-04/CAS-11-04-12-14-17-619.pdf (in Russ.)
  36. Camilleri M, Buéno L, Andresen V, De Ponti F, Choi MG, Lembo A. Pharmacologic, pharmacokinetic, and pharmacogenomic aspects of functional gastrointestinal disorders. Gastroenterology, 2016;150(6):1319-31e20. doi: 10.1053/j.gastro.2016.02.029
  37. Wade PR, Palmer JM, Mabus J, Saunders PR, Prouty S, Chevalier K, Gareau MG, McKenney S, Hornby PJ. Prokineticin-1 evokes secretory and contractile activity in rat small intestine. Neurogastroenterol Motil. 2010 May;22(5):e152-61. doi: 10.1111/j.1365-2982.2009.01426.x
  38. Rodiño-Janeiro BK, Alonso-Cotoner C, Pigrau M, Lobo B, Vicario M, Santos J. Role of corticotropin-releasing factor in gastrointestinal permeability. J Neurogastroenterol Motil. 2015 Jan; 21(1):33-50. doi: 10.5056/jnm14084
  39. Maung AA, Johnson DC, Piper GL, Barbosa RR, Rowell SE, Bokhari F, Collins JN, Gordon JR, Ra JH, Kerwin AJ. Evaluation and management of small-bowel obstruction: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012 Nov;73(5 Suppl 4):S362-69. doi: 10.1097/TA.0b013e31827019de
  40. Golbraikh VA, Maskin SS, Bobyrin AV, Karsanov AM, Derbentseva TV, Lopasteiskii DS, Tadzhieva AR. Ostrye perforativnye iazvy tonkoi kishki u bolnykh s rasprostranennym gnoinym peritonitom. Vestn Eksperim i Klin Khirurgii. 2012;5(1):51-53. (in Russ.)
  41. Cichon AC, Brown DR. Nrf-2 regulation of prion protein expression is independent of oxidative stress. Mol Cell Neurosci. 2014 Nov;63:31-37. doi: 10.1016/j.mcn.2014.09.001
  42. Keita AV, Söderholm JD. The intestinal barrier and its regulation by neuroimmune factors. Neurogastroenterol Motil. 2010 Jul;22(7):718-33. doi: 10.1111/j.1365-2982.2010.01498.x
  43. Salim SY, Söderholm JD. Importance of disrupted intestinal barrier in inflammatory bowel diseases. Inflamm Bowel Dis. 2011 Jan;17(1):362-81. doi: 10.1002/ibd.21403
  44. Guerville M, Boudry G. Gastrointestinal and hepatic mechanisms limiting entry and dissemination of lipopolysaccharide into the systemic circulation. Am J Physiol Gastrointest Liver Physiol. 2016 Jul 1;311(1):G1-G15. doi: 10.1152/ajpgi.00098.2016
  45. Petukhov VA, Semenov ZhS. Peritonit i endotelialnaia disfunktsiia. Moscow, RF: MAKS Press; 2011. 152 p. (in Russ)
  46. Dhabhar FS. Enhancing versus suppressive effects of stress on immune function: implications for immunoprotection and immunopathology. Neuroimmunomodulation. 2009;16(5):300-17. doi: 10.1159/000216188
  47. Emelianov SI, Briskin BS, Demidov DA, Kostiuchenko MV, Demidova TI. Khirurgicheskii endotoksikoz kak problema klinicheskoi gasroenterologii. Eksperim i Klin Gastroenterologiia. 2010;(7):67-73. (in Russ.)
Address for correspondence:
103904, The Russian Federation,
Moscow, Mokhovaya Str., 11, b.10,
I.M. Sechenov First Moscow
State Medical University,
Department of Human Anatomy,
Tel. mobile: +7-916-156-41-27,
e-mail: Milyucov@mail.ru,
Vladimir E. Milyukov
Information about the authors:
Milyukov Vladimir E., MD, Professor of the Department of Human Anatomy of the Medical Faculty, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
http://orcid.org/0000-0002-8552-6727
Bogdanov Alexandr V., Surgeon, Head of the Admission Unit, Medical-Sanitary Unit of the Ministry of Internal Affairs of the Russian Federation in Moscow, Moscow, Russian Federation
http://orcid.org/0000-0002-3222-9462

CASE REPORTS

DOI: https://dx.doi.org/10.18484/2305-0047.2018.3.376   |  

M.A. AKSELROV 1, 2, V.N. EVDOKIMOV 1, V.V. SVAZYAN 1, A.V. STOLYAR 2, P.A. GOROKHOV 2

FOURNIER GANGRENE IN ADOLESCENT

Tyumen State Medical University 1,
Regional Clinical Hospital 2, Tyumen 2,
The Russian Federation

Acute infectious necrotizing fasciitis with the lesion of the external genitalia and perineum (Fournier gangrene) refers to a rare disease that develops mainly in elderly male people with a burdened comorbid background, and as a rule, has a fulminant course. The prognosis for this disease directly depends on the timing of the qualified surgical care rendering. The delay in treatment, even for only a few hours, leads to an increase in mortality, which reaches 88% in this pathology. In children, the cases of Fournier gangrene are extremely rare and are represented by single descriptions in the literature. The article presents the clinical observation of the surgical treatment of a 15-year-old child with Fournier gangrene of the scrotum. This clinical case is given by us with the purpose of acquaintance with a rarely observed pathology in childhood, which can be met by every pediatric surgeon or a pediatric urologist. Perhaps the suggested approach to diagnosis and treatment can help in a timely manner to determine the diagnosis and make the right decision concerning surgical tactics.

Keywords: Fournier gangrene, fulminant gangrene of the scrotum, necrotizing fasciitis, rare diseases, prognosis, child
p. 376-379 of the original issue
References
  1. Aliev SA, Aliev éS, Zeinalov BM. Fournie?s disease in the light of modern ideas. Khirurgiia Zhurn im NI Pirogova. 2014;(4):34-39. https://www.mediasphera.ru/issues/ khirurgiya-zhurnal-im-n-i-irogova/2014/4/downloads/ru/ 030023-1207201448 (in Russ.)
  2. Grinev MV, Soroka IV, Grinev KM. Fourniers gangrene a model of necrotizing fasciitis (clinical and pathogenetic aspects). Urologiia. 2007;(6):69-73. (in Russ.)
  3. Gromov AI, Prokhorov AV. Fulminant gangrene of the scrotum (literature review). Ural Med Zhurn. 2016;(1):63-71. http://www.urmj.ru/archive/2016/89 (in Russ.)
  4. Novoshinov GV, Sheremeteva AA, Starchenkova LP. Fournier gangrene in a 1 month old child. Det Khirurgiia. 2016;20(1):51-52. doi: 10.18821/1560-9510-2016-20-1-51-52 (in Russ.)
  5. Prokhorov AV. Fournier gangrene. Kazan Med Zhurn. 2016;97(4):256-61. doi: 10.17750/KMJ2016-256 (in Russ.)
  6. Temiz M. Fourniers Gangrene. Emergency Med. 2014;4:183. doi: 10.4172/2165-7548.1000183
  7. Timerbulatov VM, Khasanov AG, Timerbulatov MV. The Fourniers gangrene. Khirurgiia Zhurn im NI Pirogova. 2009;(3):26-28. (in Russ.)
  8. Martinschek A, Evers B, Lampl L, Gerngro? H, Schmidt R, Sparwasser C. Prognostic aspects, survival rate, and predisposing risk factors in patients with Fourniers gangrene and necrotizing soft tissue infections: evaluation of clinical outcome of 55 patients. Urol Int. 2012;89(2):173-79. doi: 10.1159/000339161
  9. Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current concepts in the management of necrotizing fasciitis. Front Surg. 2014 Sep 29;1:36. doi: 10.3389/fsurg.2014.00036. eCollection 2014.
  10. Sarvestani AM, Zamiri M, Sabouri M. Prognostic factors for Fourniers gangrene; a 10 year experience in Southeastern Iran. Bull Emerg Trauma. 2013 Jul;1(3):116-22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779172
  11. Shyam DC, Rapsang AG. Fourniers gangrene. Surgeon. 2013 Aug;11(4):222-32. doi: 10.1016/j.surge.2013.02.001
  12. Efimenko NA, Privolnev VV. Fourniers gangrene. Klin Mikrobiologiia i Antimikrob Khimioterapiia. 2008;10(1):34-42. http://www.antibiotic.ru/cmac/pdf/10_1_034.pdf (in Russ.)
  13. Digai LK. Prognosticheskaia znachimost luchevykh metodov issledovanii (MRT I UZI). Med Nauka i Obrazovanie Urala. 2012;13(2):117-18. (in Russ.)
Address for correspondence:
625007, The Russian Federation,
Tyumen, Odesskaya Str., 38,
Tyumen State Medical University,
Department of Pediatric Surgery,
Tel. mobile: +7961-207-63-10,
+7 (3452) 28-71-23,
e-mail: evn-tym@mail.ru,
Vladimir N. Evdokimov
Information about the authors:
Akselrov Mikhail A., MD, Associate Professor, Head of the Department of Pediatric Surgery, Tyumen State Medical University, Tyumen, Russian Federation.
http://orcid.org/0000-0001-6814-8894
Svazyan Vadim V., PhD, Associate Professor of the Department of Pediatric Surgery, Tyumen State Medical University, Tyumen, Russian Federation.
http://orcid.org/0000-0002-6217-8600
Evdokimov Vladimir N., PhD, Assistant of the Department of Pediatric Surgery, Tyumen State Medical University, Tyumen, Russian Federation. http://orcid.org/0000-0002-0331-3438
Stolyar Aleksandr V., Pediatric Urologist-Andrologist, Physician of the Pediatric Surgery Unit 1, Regional Clinical Hospital 2, Tyumen, Russian Federation. http://orcid.org/0000-0002-0704-5418
Gorokhov Pavel A., Pediatric Urologist-Andrologist, Physician of the Pediatric Surgery Unit 1, Regional Clinical Hospital 2, Tyumen, Russian Federation. http://orcid.org/0000-0001-6830-1094
Contacts | ©Vitebsk State Medical University, 2007