Khirurgiia
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Postmastectomy syndrome often follows the radical surgery oа the breast cancer. The intersection of the branches of the intercostal nerve is an infrequent cause of the postmastectomy syndrome development. We studied the long-term follow up results in 30 patients after radical mastectomy by Madden with preservation of the branches of the intercostal nerve on the level of Th1-Th3. The method demonstrated the decrease of the postmastectomy syndrome and the improvement of quality of life.
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Two-stage liver surgery with preliminary right portal vein occlusion procedure (ligation or embolisation) became standard in clinical practice and allows liver resections in 60-82% of initially inoperable patients. Right portal vein ligation with concomitant liver partition in situ (in situ splitting, ISS) is innovatory and promising approach. Right portal vein ligation and in situ splitting was performed in 40 years old male with two metachronous rectal metastases in right liver lobe and insufficient volume of future liver remnant (22%). ⋯ There were no signs of postoperative liver failure. Conclusion. New two-stage surgery approach (ISS) can decrease number of patients who were inoperable because of insufficient volume of future liver remnant and high risk of postoperative liver failure.
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Randomized Controlled Trial Comparative Study
[The efficacy of the moisture and warmed CO(2) for laparoscopic surgery].
A prospective, randomized study comparing 150 patients undergoing laparoscopic operations (110 patients undergoing laparoscopic cholesystectomy and 40 patients laparoscopic fundoplication) with standard CO2 insufflation vs those receiving warmed, humidified CO2 was performed. All patients were randomized into 2 groups - 84 receiving standard CO2 insufflation (control group) and 66 receiving warmed, humidified CO2 (main group). ⋯ We revaeled that warmed, humidified CO2 has advantages that were statistically significant. Patients undergoing warmed, humidified carbon dioxide (CO2) insufflation for maintain a warmer intraoperative core temperature, and have less postoperative pain and need less analgesic requirements than patients with standard CO2 insufflation.
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The study aimed to work out the method of cryodestruction of brain tumors. 10 patients with neuroepithelial brain tumors were prospectively operated on with the use of cryodestruction. MRI was performed before and after the operation. ⋯ The study demonstrated that ultrasound navigation is an effective means of the cryodestruction control on all stages. The cryodestruction itself is a miniinvasive, easily controlled and effective method, applicable for tumors, located in functionally important regions of the brain, where major surgery could be mutilating.