View №4 (2023)

Bulletin of Surgery of Kazakhstan

№4 (2023)

Статьи

  • 1. Diagnosis and modern treatment methods for hepatic hemangioma (literature review)

    B.B. Baimakhanov, G. Oryngali, Zh.S. Suiindik, A.K. Kydyrbaeva., Y. Y. Barakhan, D.S. Abilkaiyr, Sh.A. Narynbay, А.М. Tolegenova, O.T. Ibekenov, Sh.А. Kaniyev
    Abstract

    Background. Hepatic hemangioma is the most common form among benign liver tumors. The vast majority is asymptomatic, usually detected accidentally during screening. A thorough study is required to distinguish it from other local liver pathologies, therefore, in the review paper below we have analyzed important issues during the diagnosis and treatment of liver hemangioma in international experience. The aim of this study differentiation of modern methods of diagnosis and treatment of liver hemangioma in clinical practice..

    Material and methods. In the review work, a literature review of randomized, meta-analyses, clinical trials and international clinical recommendations in English and Russian, published only from January 2010 to August 2023 in bibliographic and other electronic medical databases such as PubMed, Scopus, Web of Science, GoogleScholarship, Springer, rare clinical cases were carried out. Criteria for inclusion in the study: 1) full-text research published in the database; 2) research in English or Russian; 3) research carried out or published in the last 2010-2023 years. Conclusions. As the most common benign liver tumor, the incidence of hepatic hemangioma during autopsy is from 0.4 to 20%. Most hepatic hemangiomas are asymptomatic, small-sized forms do not require intervention. Liver hemangioma can be easily diagnosed using ultrasound, or cop phase spiral contrast computer tomography. An indication for surgical resection is a feeling of progressive pain in the abdomen and a size of more than 5 cm. Some patients also have giant hemangiomas with minimal symptomatic. Giant hemangiomas (>10cm) are most often manifested by symptoms and require mandatory surgical intervention. The most commonly used method for the treatment of hemangiomas today is transaortic embolization, surgical resection. But to date, there is no consensus on the best treatment for patients with symptomatic and/or large hemangiomas.

    Keywords

    hepatic hemangioma, embolization of hepatic arteries, benign tumor, radiofrequency ablation

  • 2. Analysis of the history of the search for methods of protecting the brain during operations on the internal carotid artery (literature review)

    M.N. Konyssov, V.A. Batrashov, T.V. Sukhareva, E.K. Madeshov, K.M. Morozov, Zh.E. Kadyrov, S.A. Konyssova
    Abstract

    The review covers the first studies of the vessels of the brain. The history of the emergence and development of the doctrine of protecting the brain during operations on the carotid arteries is given. Experience has been accumulated in the development of the doctrine of surgical protection of the brain during primary operations on the carotid arteries and compression of the carotid arteries. The analysis of existing and existing methods was carried out. Based on the above analysis, ways of further development of methods of protecting the brain during operations on the carotid arteries are shown.

    Keywords

    surgery, internal carotid artery, brain protection, compression carotid artery

  • 3. Prospects for the use of PCR in the detection of hepatitis (literature review)

    А.Т. Аубакирова, Л.Е. Ризабекова, Г.Б. Абдилова, . RNA.
    Abstract

    Relevance: According to official WHO data, currently, about 325 million people in the world live with chronic hepatitis B and C, which makes hepatitis one of the most common infectious diseases in the world. There are many scientific studies aimed at a deeper understanding of hepatitis and the development of new methods of treatment and diagnosis. With the help of polymerase chain reaction, more sensitive tests for diagnosing hepatitis have been developed, allowing faster infection detection and treatment initiation. The PCR method for diagnosing hepatitis is justified and relevant, as it is one of the most effective and modern methods for detecting viral infection, which allows you to start treatment earlier and prevent the development of complications. The study aimed to evaluate the PCR method’s efficiency in diagnosing hepatitis.

    Methods: In this review, the causes of hepatitis were investigated, and a comparative assessment of the effectiveness of various laboratory methods for diagnosing hepatitis, including enzyme immunoassay and polymerase chain reaction, was conducted. The analysis of scientific publications revealed the factors associated with the development of hepatitis and compared the effectiveness of ELISA, used for serological analysis of antibodies to hepatitis viruses, with PCR, designed to detect DNA or RNA of hepatitis viruses. The obtained results provide important information for improving the methods of diagnosis of hepatitis and more effective control of this serious infectious pathology.

    Results: The analyzed scientific literature has shown that PCR diagnostics has several advantages over other methods of hepatitis diagnosis, such as ELISA, including higher sensitivity and specificity, the ability to detect hidden infections, and faster. results. In addition, PCR diagnostics can be used to determine a specific strain of the virus, making it possible to take measures to treat and control infection. All these advantages confirm the scientific validity of using the PCR method in detecting hepatitis.

    Conclusion: According to global statistics, PCR has a higher sensitivity and specificity in diagnosing hepatitis than ELISA. PCR can also be used to monitor the effectiveness of hepatitis treatment and determine viral load to make decisions about the need for treatment and evaluate its effectiveness.

    Keywords

    hepatitis, enzyme immunoassay, polymerase chain reaction, sensitivity, detection, DNA, RNA

  • 4. Comparative Assessment of Surgical Treatment Outcomes in Patients with Sacroiliac Joint Injury

    T. Kuandykov, V. Mutagirov, B. Dostarbayev, M. Agzamov, Y. Voronin, A. Akshikeshov, T. Bidaibai, M. Tolepbergen, A. Sharipov
    Abstract

    The aim of the study is to evaluate the results of surgical treatment in patients with sacroiliac joint injury.

    Methods. An analysis of the results of surgical treatment of 60 patients with sacroiliac joint injury was conducted at the Center of polytrauma and orthopedic surgery of the State Public Healthcare Institution “Emergency Hospital” in Abai Region, the Trauma and Endoprosthetics Department of the State Public Healthcare Institution “Multispecialty City Hospital No. 1” in the city of Astana, and the “Shymkent City Clinical Hospital No. 1” from June 2019 to August 2022. Patients were divided into two groups. Patients in the control group underwent surgery using the standard technique, while patients in the experimental group underwent surgery using a device developed by us for minimally invasive locking osteosynthesis of sacroiliac joint injuries. The study was a randomized controlled trial by design..

    Results. The use of the device for minimally invasive locking osteosynthesis of sacroiliac joint injuries leads to a significant reduction in the length of hospitalization for all types of sacroiliac joint injuries regardless of the patient’s initial condition (p=0.001). Correlation analysis revealed a correlation between the observation group and patient pain assessment at 12 months (p=0.001). According to the Majeed Pelvic Score at 12 months, the maximum score in the experimental group was 98 points, while in the control group, it was 70 points. A satisfactory assessment on the Majeed Pelvic Score at 12 months was observed in 3 (10%) of patients in the control group and none in the experimental group. There were no unsatisfactory responses in both groups (significant differences were found, p=0.001). Conclusions. The use of the device developed by us for minimally invasive locking osteosynthesis of sacroiliac joint injuries reduces the length of hospitalization and the time to return to work (12 months in the control group and 8 months in the experimental group). The absence of pain in patients after 12 months in the experimental group was 26 (86.7%) and 20 (66.6%) in the control group. According to the Majeed Pelvic Score in the long term (3, 6, and 12 months), the frequency of excellent results increases from 13.3% to 90.0% in the experimental group and from 10% to 73.4% in the control group.

    Keywords

    trauma, sacroiliac joint, minimally invasive locking osteosynthesis

  • 5. Transabdominal bowel ultrasound as a method of primary diagnosis in acute bowel pathology: literature review and demonstration of clinical cases

    M.V. Fedossina, D.A. Kaybullaeva, A.E. Dzhumabaeva, K.E. Murzalin, Zh.А. Kanash, O.T. Ibekenov
    Abstract

    Currently, transabdominal ultrasound of the bowel is rarely used in daily routine practice to assess bowel condition due to the difficulty of its visualization, lack of awareness of specialists, and also due to the limited number of specialists who know the technique of bowel examination. Patients with acute bowel pathology seek emergency care in more than one third of cases. Gastrointestinal ultrasound is often used as the first imaging modality with good diagnostic accuracy in the setting of acute abdomen and may be the optimal diagnostic strategy in young women because of the radiation burden associated with X-ray and computer tomography scan. The clinician can examine the gastrointestinal tract in the area of greatest pain using ultrasound, thus obtaining more information and pathology data than standard physical examination. Intestinal ultrasound is mainly used for the diagnosis and monitoring of patients with inflammatory bowel disease, which helps to avoid the frequent use of invasive and expensive diagnostic procedures and leads to the early implementation of suitable treatment. This method can also serve to detect other pathological conditions present in the gastrointestinal tract. It is a promising method with high sensitivity and specificity, which has the advantage of being easily accessible, non-invasive, safe, due to the absence of ionising radiation and the need to use contrast agents. In addition, the advantage of this method is the reduction of diagnostic search, which allows the doctor to establish the diagnosis in a shorter time, as well as to reduce the patient’s expenses for expensive examinations.

    Keywords

    Intestinal ultrasound, small bowel, large bowel

  • 6. Clinical case of laser ablation of lingual amygdala

    I.D. Kudabaeva, S.J. Sadykov, A.N. Zhakybaeva
    Abstract

    Hypertrophy of the lingual tonsil is a condition in which the lingual tonsil, located at the base of the tongue, enlarges. This tonsil consists of clusters of follicles separated by a central groove. In children under 5 years old, the number of follicles usually ranges from 10 to 12, while in adults up to 40 years old, it can reach 35 to 40. This structure plays an important role in the immune system, helping the body fight infections and microbes. Like other tonsils in the throat, the lingual tonsil can sometimes cause problems, such as hypertrophy (enlargement) or chronic infections. The causes of lingual tonsil hypertrophy can be diverse. In some cases, it develops as a compensatory process after the removal of the palatine tonsils. The primary cause in adults may be chronic inflammation of the pharynx. Severe degrees of lingual tonsil hypertrophy are very rare but can lead to various symptoms, such as coughing, difficulty swallowing and breathing, a feeling of pressure in the area beneath the tongue, and other nonspecific complaints. These symptoms are not pathognomonic for lingual tonsil hypertrophy. The challenges in diagnosis and the lack of a standardized approach to surgical treatment require detailed consideration and description in each individual case. Sometimes, patients with lingual tonsil hypertrophy complain of coughing paroxysms. In such cases, mechanical irritation of the lingual tonsil with a probe can provide some assistance in diagnosis. In the context of this study, lingual tonsillectomy surgery was performed on a patient using a diode laser. The results obtained confirmed the high level of technological feasibility and appropriateness of using laser ablation for the treatment of lingual tonsil hypertrophy. Laser ablation is one of the possible surgical procedures for treating lingual tonsil hypertrophy. It can be an effective and technologically advanced method, although it requires experience and qualification of specialists.

    Keywords

    hypertrophy of the lingual tonsil, laser ablation of the tonsils, laryngoscopy

  • 7. To the 90th Anniversary of Professor Kukeyev T.K.

    школы Казахской,
    Abstract

    Турар Койшигараевич Кукеев родился в селе Ушарал Таласского района Жамбылской области 15 декабря 1933 года. В 1952 году по окончании семи классов, с отличием закончил медицинское училище в г. Тараз и вне конкурса был зачислен на 1 курс лечебный факультет Казахского Государственного Медицинского института в г. Алматы, который закончил с отличием в 1958 году. Лидерские качества, отличная учеба были залогом того, что начиная со 2 курса Т.К.Кукеев стал Сталинским стипендиатом, членом комитета комсомола ВУЗа. После окончания медицинского института, с отличием, в 1958 году он был направлен заместителем главного врача в Таласскую районную больницу Жамбылской области, где совмещал эту работу с работой практического врача-хирурга. Профессор Брякин М.И. пригласил своего выпускника для поступления в аспирантуру по конкурсу на кафедру госпитальной хирургии КазМИ Поступил в аспирантуру на кафедру своего учителя, аспирант Кукеев Т.К. досрочно написал и защитил диссертацию на соискание ученой степени кандидата медицинских наук, которая вскоре была подтверждена ВАКом СССР. С этого времени вся трудовая и научно- педагогическая деятельность Т.К.Кукеева неразрывно была связана с кафедрой госпитальной хирургии, где он прошел все ступени формирования его, как ученого: аспиранта, ассистента кафедры, доцента кафедры и профессора кафедры, в последующем, по рекомендации своего учителя профессора Брякина М.И. стал заведующим кафедры госпитальной хирургии с 1979 года. Вместе со своим учителем профессором М.И.Брякиным, Т.К.Кукеев является одним из пионеров развития и становления сосудистой хирургии в Казахстане на научной основе. Под руководством М.И.Брякина, Т.К.Кукеевым в Казахстане с 1965 года стали выполнятся реконструктивно-восстановительные операции при окклюзионных заболеваниях артерий нижних конечностей: аорто-бедренное и подвздошно-бедренное шунтирование, аллопротезирование, резекция окклюзированного сегмента артерии с пластикой аутовеной и аллопротезом. Он внедрил в широкую практику такие сложные операции на кровеносных сосудах, как: резекция травматической аневризмы бедренной артерии с аутовенозной пластикой, операции при сложных гемангиомах бедра, ягодичной области, ранениях подвздошной и бедренной артерий, операция тромбинтимэктомии и эндартерэктомии при стенозирующих заболеваниях сосудов, операции при ПТФС. При облитерирующем эндартериите Т.К.Кукеев стал широко, впервые в Республике, применять поясничную и грудную симпатэктомию. Им опубликованы ряд наблюдений успешной антикоагулянтной и фибринолитической терапии при тяжелых илеофеморальных флеботромбозах и синдроме Педжета-Шреттера и продолжительной ремиссии при болезни Бюргера. Впервые в Казахстане Т.К.Кукеевым в 1967 году, вместе с профессором Брякиным, доцентом Г.Н.Андреевым выполнена операция наложения спленоренального анастомоза при портальной гипертензии. Благодаря активной деятельности внедрены сложные ангиографические исследования: транслюмбальная аортография, артериография, восходящая и нисходящая флебография, диагностическая и лечебная лимфография для устранения последствий рожистого воспаления конечности. Работая на кафедре госпитальной хирургии с 1958 года, Т.К.Кукеев внес неоценимый вклад в подготовке практических хирургов через субординатуру и интернатуру. Он является одним из первых организаторов интернатуры в РК, и руководителей хирургической интернатуры в АГМИ. Профессор Т.К.Кукеев был в числе пионеров внедрения преподавания и издания учебных пособий по хирургии на государственном языке. Им подготовлены и изданы на государственном языке «Избранные лекции по госпитальной хирургии», также он был соавтором трех учебников по хирургии для 5 и 6 курсов, двух монографий, 15 учебно-методических пособий. Активная врачебная и научно-педагогическая деятельность Кукеева Т.К. была по достоинству, высоко оценена Родиной. За заслуги в области хирургии Т.К.Кукеев в 1970 году Минздравом СССР награжден нагрудным знаком «Отличник здравоохранения СССР». В 1981 году указом Президиума Верховного Совета Казахской ССР Турару Койшигараевичу Кукееву присвоено почетное звание «Заслуженный работник Высшей школы Казахской ССР». За особые заслуги в учебно–педагогической деятельности АГМИ, вклад в развитие и становление К 90-летию профессора Кукеева Т.К.

    58 ВЕСТНИК ХИРУРГИИ КАЗАХСТАНА №4 2023 ангиохирургии в Казахстане доценту Т.К.Кукееву, в 1994 г. решением ВАК РК было присвоено звание «Профессора медицины». За особые заслуги в организации и развитии неотложной, плановой сосудистой хирургии, подготовки хирургических кадров в РК он, решением Ученого совета НЦХ им. А.Н.Сызганова, в 1997 году избран «Почетным профессором» Национального Научного Центра Хирургии им. А.Н.Сызганова» Республики Казахстан. В 2002 году, общественность, администрация Жамбылской области с чувством глубокой признательности за развитие хирургической службы и в связи с 2000-летием г.Тараза, избрала профессора Т.К.Кукеева «Почетным гражданином Жамбылской области», а в 2013 г.он избран «Почетным гражданином Алма – Атинской области» В 2011 году, на очередном Международном конгрессе хирургов Республики Казахстан, профессор Т.К.Кукеев стал обладателем Золотой медали Национального центра хирургии имени академика А.Н.Сызганова, также стал обладателем золотой медали «Алтын Дәрігер» Национальной Ассоциации врачей и провизоров РК в 2012 году, награжден высшей наградой МОН РК - медалью «Ыбырая Алтынсарина», был избран Академиком общественной академии им. Куртка Табиба, а в 2013 году Т.К. Кукеев избран «Почетным профессором Каз НМУ им. С.Д. Асфендиярова» Профессор Т.К Кукеев скоропостижно ушел из жизни 31 декабря 2016 г. Медицинская наука, хирургия понесла невосполнимую утрату. В честь профессора Кукеева Т.К, и признания его заслуг перед народом Казахстана КазНМУ им. Асфендиярова присвоило одной из учебных аудиторий его имя. Свой богатый, жизненный опыт, практику поливалентного хирурга, педагогический талант и энергию профессор Т.К. Кукеев отдавал своему важнейшему долгу жизни – подготовке научно-практических хирургов и врачебных кадров для РК. Профессор А.С. Ибадильдин

    Keywords

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