The human hand is an organ of labor, self-service, touch. According to Kaplan E. V. the hand is an extension of our brain in the environment around us. However, being one of the most functionally loaded systems, the hand and its bone segments are damaged quite often. The purpose of this work is to analyze a literary review of modern prostheses in the treatment of diseases of the bones and joints of the hand.
Material and methods. We systematically searched the literature and selected sources from MEDLINE, Cochrane databases, Google Scholar, PubMed, as well as research papers and online educational publications in English and Russian. Forty papers that met the inclusion criteria were included.
Results. The review article presents methods of treating patients with defects and injuries of the bones and joints of the hand, the causes of the development of this pathological condition.
Conclusion. Thus, the existing types of prostheses currently do not fully meet the needs of patients and do not have a 100% positive effect from their use in modern reconstructive surgery. The number of unsatisfactory results of reconstructive operations and disability rates remain high.
Keywords
endoprosthesis replacement, bioprosthesis, bioprinting, hand joints, hand injuries
Fat embolism is a polyetiological disease and still remains common, which is an urgent problem of our time. It occurs due to the ingress of adipose tissue into the lumen of the vessel, which causes its blockage. At the same time, a trend towards an increase in the incidence is observed everywhere. The purpose of this work is to analyze the literature data on the topic: fat embolism in plastic surgery after surgery - abdominoplasty in combination with liposuction.
Material and methods. We systematically searched the literature and selected sources from MEDLINE, Cochrane databases, Google Scholar, PubMed, as well as research papers and online educational publications in English and Russian. Forty papers that met the inclusion criteria were included.
Results. The review article presents methods for the prevention and treatment of patients with fat embolism, pathogenesis and stages of development of this pathological condition, as well as methods for choosing treatment tactics.
Conclusion. Thus, there are many opinions on the treatment of fat embolism and there is no single standardized protocol for managing patients. After analyzing the reviewed information, we came to the conclusion that therapeutic measures should be aimed at stopping the main clinical manifestations of an injury or disease.
In this study, we present the results of a retrospective comparative analysis of the results of hemorrhoidectomies by traditional methods and the «HAL-RAR» method. The purpose of the study. To conduct a retrospective comparative analysis of the results of traditional hemorrhoidectomies and «HAL-RAR» in patients treated in surgical departments of “A. N. Syzganov National Scientific Center for Surgery” JSC, Almaty, Kazakhstan.
Material and methods. In the period from June 2018 to April 2021, 108 patients were operated on as planned for chronic hemorrhoids at A. N. Syzganov National Scientific Center for Surgery, and all patients were divided into 2 main groups: those operated by traditional methods and the «HAL-RAR» method.
Results. The analysis data suggest that the «HAL-RAR» method has an advantage over traditional methods of hemorrhoidectomy.
Conclusion. Based on a comparative analysis of the indicators of patients of both groups, it can be concluded that the duration of surgery with the minimally invasive «HAL-RAR» method is 40.6 minutes, which is significantly longer than with traditional methods, amounting to 48.4 minutes. Despite this, the duration of hospital stay after surgery by the «HAL-RAR» method is 2.6 days, which is much less than with traditional methods, in which the duration of hospital stay after surgery is 3.5 days. Local infiltration anesthesia during operations by the «HAL-RAR» method was performed by 77.7% of patients, when with traditional methods 25.9% of patients. This analysis shows that the «HAL-RAR» method has an advantage over traditional methods.
Sinus venosus defectis an unusual type of interatrial communication and is almost always combined with partial abnormal pulmonary vein drainage (PAPVD) into the superior vena cava (SVC) or right atrium (RA). Different types of venous outflow through the vena cava occur: the presence of an additional left vena cava with different drainage loci to both right and left atriaor, as in our case, the dominant unpaired vein directly draining into the right atrium with outprior communication with the superior right vena cava. This paper describes a clinical case of radical correction of partial anomalous pulmonary vein drainage combined with sinus venosus atrial septal defect (ASD) in a 14-year-old child with dominant venous outflow from the upper half of the body via innominate vein, by combined biplasty from auto pericardial patches, showing adequate upper-venous outflow under cardiopulmonary bypass. It is necessary to provide clear information about congenital heart disease and optimal timing of its surgical correction to a wide audience, not only to the professional medical community, but importantly, to the entire population of the Republic. The provision of publicly available professional information should be highlighted on the official websites of clinics and all available media opportunities, where parents and patients could be fully acquainted with the specific soft entire treatment processing an accessible and convenient information platform.
The overwhelming majority of thoracic and pediatric surgeons are of the opinion that it is necessary to perform early surgeries for congenital bronchiectasis, since bronchial dilatation leads to infection of bronchial contents and repeated exacerbations of the inflammatory process, but some pediatricians express a reserved attitude to operations in childhood, adhering to long-term follow-up tactics. Purpose. To present statistical data on the situation of patients with congenital bronchiectasis of different age categories and to offer separate recommendations for the treatment and diagnosis of patients with congenital bronchiectasis.
Material and methods. 433 patients with congenital bronchiectasis were operated in our clinic, which was 50.9% of all congenital lung malformations. The patients’ age ranged from 2 to 65 years. There were more children and adolescents (60.9%) than adults (39.1%).
Results. The article presents the results of diagnostics and surgical treatment of 433 patients with congenital bronchiectasis. It was found that the immediate and long-term results of surgical treatment of children are better than those of adult patients.
Keywords
congenital bronchiectasis, bronchi, period of remission
Patient K., male, 65 years old, suffering from type 2 diabetes, adhering to basic therapy, in year 2018 underwent isolated internal mammary bypass surgery for coronary artery disease. In 2022, due to a deterioration in general well-being in the form of stabbing pains behind the sternum, shortness of breath during physical exertion, pain and numbness of the left upper limb, he was scheduled for coronary angiography with shuntography. During routine shuntography through the left radial access, the presence of retrograde filling of the LIMA graft was established, indicating the presence of the phenomenon of coronary-subclavian steal. Elimination of hemodynamically significant stenosis of the left subclavian artery with a peripheral balloon-expandable stent led to successful remodeling of left coronary hemodynamics, relief of angina symptoms, and restoration of adequate blood flow in the left upper limb in the early postoperative period.
The article discusses the issues of predicting the likelihood of a postoperative complication in cardiac surgery patients by stratifying the risks associated with surgical intervention. The author used the Aristotle Basic Score and EuroSCORE scales, the most common in the practice of a cardiac surgeon, showed the feasibility and effectiveness of their use, and an assessment of the results obtained. IntroductionAs a rule, when assessing the risks associated with cardiac surgery, factors such as compensation, comorbidity, age, complexity of anatomy, time of artificial circulation, time of aortic compression, depth of hypothermia, methods of protection of ischemic myocardium, experience of the surgeon, category of complexity of surgery, hospital equipment and others
Aim of the study – Evaluate the value of multispiral computed tomography (MSCT) with intravenous contrast in the diagnosis of congenital heart disease (CHD) at the stage of preoperative preparation and choice of surgical tactics.
Methods. Between January 2021 and June 2022, 30 CT cardiographies were performed in our center, of different age and mediastinal pathology. A 64-slice Somaton Siemens sensation 64 CT scanner complete with digital processing systems was used. The main vessels of the heart were examined with intravenous bolus injection of contrast agent. Image analysis included study of anatomy of the defect by three-plane tomograms and construction of multiplanar 3-D reconstructions.
Results. Modern approaches to the imaging diagnosis of CHD in all age groups are presented. The role of CT-angiography with intravenous contrast in the diagnosis of congenital, acquired cardiovascular and thoracic pathology is shown. Qualitative assessment of CT-angiographic picture of CHD was performed.
Conclusion. Our experience with CT cardiography in the examination of patients with CHD, in contrast to traditional ultrasound and invasive techniques, in most cases allows to obtain more valuable diagnostic information, especially extracardiac structures, which determines its significance in the examination of CHD. It details anatomy of malformations in reliable morphometric indices, diagnosis of aortic, pulmonary artery, right ventricular pathology, including pathology of its outflow tract, to assess ventricular-artery connections and atrial-ventricular connections.
The PAIR operation (Punction, Aspiration, Injection, Reaspiration) is a minimally invasive method for treating echinococcosis cysts (EC) of the liver at the CE1 stage. Since in this method of surgical treatment the echinococcosis cyst is not removed from the liver, constant monitoring of patients using complex radiation diagnostic methods is necessary - ultrasound and CT diagnostics. RelevanceOperation PAIR (PUNCTION, ASPIRATION, INJECTION, REASPIRATION) is a minimally invasive method of treatment of echinococcal cysts (EC) of the liver at stage CE1. Since the echinococcal cyst is not removed from the liver in this method of surgical treatment, constant monitoring of patients using complex radiation diagnostic methods is necessary. - Ultrasound and CT diagnostics. The purpose of the study: dynamic observation of patients after PAIR surgery, evaluation of the effectiveness of the treatment method, identification of postoperative complications. Materials and methodsFoundation for the material is a retrospective analysis of 76 patients who underwent PAIR from December 2017 to December 2021 in the conditions of the NSCS named after A. N. Syzganov for every three months. ResultsBrief Ultrasound overview of the PAIR operation. Ultrasound picture of EC at the CE1 stage before surgery. A rounded homogeneous liquid formation with a clear 2-contour capsule is visualized (Fig.1).
