Khirurgiia
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Multicenter Study Observational Study
[Caprini score as individual risk assessment model of postoperative venous thromboembolism in patients with high surgical risk].
The aim of this study was to estimate the role of Caprini model in forecasting of postoperative venous thromboembolism (VTE) in patients with high surgical risk and to determine patients with extremely high risk of venous thrombosis by using of this scale. It was performed prospective multicenter observational study involving 140 high risk patients who underwent large abdominal (48%) or neurosurgical (52%) intervention. All patients were assessed with the Caprini model and had a mean score of 9.5±2.7 (range: 5-15). ⋯ There is significant correlation between Caprini scores and frequency of postoperative venous thromboembolism in patients with high surgical risk. Score 11 and more can identify patients with extremely high risk. These patients need for more effective prevention.
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[Simulation technologies in anesthesiology, resuscitation and intensive care: state of the problem].
The foundation of simulation technologies application in educational process is presented in the article. It is described difficulties during anesthesiologists-resuscitators training and education of physicians of not intensive care specialty in intensive care methods. ⋯ It is simulation stage between preclinical and clinical stages. Theoretical foundation and practical evidence of efficiency of simulation training are expressed in detail.
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It was analyzed own experience of diagnosis and treatment of catamenial (menstrual) pneumothorax and thoracic endometriosis and literature review. It is shown that catamenial pneumothorax has specific clinical and instrumental signs allowing to establish the diagnosis before surgery. ⋯ It was demonstrated that this volume of surgery can be successfully implemented by using of thoracoscopic access. Relapse prevention includes hormonal therapy for the 6 months after surgery under the supervision of an obstetrician-gynecologist.
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Major hepatic resection is often necessary for cure in patients with multiple colorectal cancer metastases but low future liver remnant (FLR) volume makes surgery risky because of the posthepatectomy liver failure (PHLF). Right portal vein ligation/embolization and two-stage hepatectomy were proposed previously to overcome this problem. Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel approach aimed for FLR volume hypertrophy. ⋯ All patients are alive and they have not disease relapse after 17, 15 and 15 months after surgery. ALPPS is promising technique that allows rapid FLR hypertrophy and enables curative liver resections in initially unresectable patients. But it is necessary more data concerning ALPPS safety and long-term results.