Introduction: Lung cancer has been the most common cancer in the world and in Belarus. Aim of the research: To evaluate the epidemiology of non-small cell lung cancer and improvements in diagnostics and treatment for the past 11 years in the Brest Region of Belarus. Material and methods: We conducted a retrospective analysis of statistical data (incidence rate, mortality) in the regional cancer registry of the Brest oncological clinic since 2000 and assessed survival for 652 adult patients with different stages of non-small-cell lung cancer (NSCLC) who underwent surgery in the Thoracic Surgery Department of Brest Regional Hospital in 2002-2010. Results: Lung cancer continues to have the highest incidence rate among malignant neoplasms and because of its high fatality rate is a leading cause of cancer-related mortality in the Brest Region and Belarus. The chest radiography screening programme of lung cancer since 2000 and the implementation of computed tomography (CT)-and ultrasonography (USG)guided needle biopsy and VATS LigaSure pulmonary wedge resection for the evaluation of solitary pulmonary nodules has allowed an increase of diagnostic rates and improved the histological confirmation rate of lung cancer in the Brest Region. Multivariate analysis indicates that male sex, age older than seventy and incomplete surgical resection are independent predictors of poor prognosis for postoperative long-term overall survival. Conclusions: Today it is necessary to carry out low-dose spiral computerized diagnostics in the Brest Region, which would detect a greater proportion of asymptomatic lung cancers. Surgical resection remains the only consistent and successful option of a cure for patients with lung cancer.
Введение. Дренирование брюшной полости-важный завершающий этап многих операций, а иногда и основной метод оперативного вмешательства. Определенные сложности представляет установка дренажей в условиях пневмоперитонеума. Цель. Провести клиническую оценку эффективности применения приспособления для установки дренажей при лапароскопических вмешательствах на органах брюшной полости. Материал и методы. Разработанное нами приспособление выполнено в виде металлического стержня с рукояткой на одном конце и шаровидным утолщением на другом. На стержне установлена подвижная конусовидная втулка, которая позволяет плотно закрыть проксимальный конец дренажной трубки и не допустить выхода углекислого газа из брюшной полости. Использование предлагаемого инструмента придает дренажной трубке жесткость для установки в брюшной полости в требуемое место и в необходимой позиции. Инструмент использован при 20 операциях с установкой трех дренажей во время каждой из них. Результаты. Применение предлагаемого инструмента позволило сократить среднее время операции у пациентов основной группы более чем на 12 минут по сравнению с контрольной группой. Уменьшение продолжительности операции снизило потребность пациентов в респираторной поддержке в раннем послеоперационном периоде. Заключение. Предлагаемый инструмент значительно облегчает установку дренажных трубок при видеолапароскопических операциях, позволяет существенно сократить время операции и может быть успешно использован в абдоминальной хирургии.
The increase in the number of patients requiring liver transplantation raises the question of expanding and clarifying the criteria of hepatic grafts suitability for transplantation, and also shows the need to develop new, fast and noninvasive methods for assessing the functional state of the liver at the stage of donor examination and treatment. Hepatic grafts with severe steatosis, previously considered unsuitable for transplantation due to the higher risk of primary graft failure, are now referred to as potential for transplantation. There are several ways to diagnose and determine the stage of steatosis, but, unfortunately, today none of them can give an accurate and rapid assessment of its grade in a hepatic graft. Currently, the "gold standard" for determining liver steatosis is a biopsy with subsequent examination of samples by a pathomorphologist. There are also prognostic models, non-invasive tests and instrumental methods, the effectiveness of which has been proven - these are ultrasound elastography, contrast computed tomography and contrast computed tomography with liver density measurement. The decision on the suitability of a hepatic graft for transplantation depends on many factors, both on the part of the donor and on the part of the recipient, and it would be correct to assume that these data should be taken into account in aggregate. The review covers all the approaches currently used to quantify and qualitatively assess steatosis in liver transplants from a brain-dead donor.
Background: In traditionally performed fundoplications during the treatment of sliding diaphragmatic hernias, the improvement of surgical techniques to restore acute angle of His remains topical. Aim: To develop a method of surgical treatment of hiatus hernias to restore acute angle of His. Material and methods: Patients (n = 74) were divided into two groups: the main group (I) (n = 45), in which the developed operation method was applied and the control group (II) (n = 29), in which Toupet method was applied to 26 patients, Nissen method-to 3 patients. GERD-Q and GERD-HRQL questionnaires were applied to all patients of the first group before the operation, during discharge from hospital and 6-12 12-18 18-24 months after surgical intervention. Patients of the second group were surveyed 6-12 months after the operation. Results: According to the results of the survey after 6-12 months statistically significant differences were not revealed in the groups: GERD-Q, p<0,386; GERD-HRQL, p<0,1089. In the main group there was a tendency to decrease the points in the GERD-Q survey when compared before and after surgery, p <0.0001. Out of 16 (55%) patients of the second group hospitalized after the operation the relapse was revealed in 9 patients, 7 of them were re-operated. 20(43,3%) patients of group I underwent inpatient examination, 2 relapsed and no one was re-operated. Conclusion: The efficiency of the suggested operation technique is comparable to Toupet method in the early stages, although when assessing the remote results there are a less number of relapses.
Введение. Лече ние пациентов с острым некротизирующим панкреатитом (ОНП) на фоне постоянно растущей заболеваемости и стабильно высокой летальности при тяжелых формах заболевания остается нерешенной задачей в ургентной абдоминальной хирургии. Цель исследования-выявить возможности иммуногистохимических методов в исследовании ранних морфологических изменений забрюшинной клетчатки у пациентов с острым некротизирующим панкреатитом. Материалы и методы. В статье представлены результаты иммуногистохимического исследования биоптатов забрюшинной клетчатки пациентов с острым некротизирующим панкреатитом, взятых в ран
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