Ivan Stepanovich Kolesnikov (1901-1985) - Soviet surgeon, Doctor of Medical Sciences, Professor, Academician of the Academy of Medical Sciences of the USSR, Major General of the Medical Service, Honored Scientist of the RSFSR (1964); Hero of Socialist Labor (1976). Laureate of the Lenin Prize and the USSR State Prize. November 4, 1968 at the Department of Hospital Surgery Professor IS Kolesnikov, together with Academician of the Academy of Medical Sciences of the USSR Colonel-General of Medical Service A. A. Vishnevsky performed the first in our country heart transplantation (1 figs, bibliography: 15 refs).
Semen Semenovich Girgolav was born on February 2, 1881 in Tiflis, Georgia, Russia. In 1904 he graduated from the Imperial Military Medical Academy with honors. Under the guidance of Prof. M.S. Subbotin, Dr. S. Girgolav prepared and in 1907 successfully defended his doctoral dissertation “Experimental findings on the use of isolated omentum in the abdominal surgery”. Later, he headed the chairs of general surgery, hospital surgery of the Military Medical Academy; he also was a scientific director of the Leningrad Research Institute of Traumatology and Orthopedics, head of the surgical department of the medical faculty of the 2nd Leningrad Medical Institute.In the 30s. Prof. Girgolav started a comprehensive work on thermal injuries and continued it until the last days of his life, while basic efforts of the staff of departments and laboratories which he headed were focused on studying local and general effects of low temperatures. From the first to the last days of the Great Patriotic War, he was the Deputy Chief Surgeon of the Red Army, and when Academician Burdenko (Chief Surgeon) fell ill (from October 1941 to May 1942 and in 1945) he acted as Chief Surgeon. During the Great Patriotic War, Prof. Girgolav regularly underlined the priority of the issues of military field surgery management as well as the issues of collecting and sharing the battle experience in surgery.Academician Girgolav’s list of works includes more than 140 scientific papers, which can be schematically divided into the following topics: “Military field surgery”, “Wounds”, “Frostbites”, “Issues of Special Surgery”, “Traumatology”, “Asepsis and antiseptics”, “Pain relief”, “Neurosurgery”, “Endocrinology and oncology”, “Manuals and Guidelines”. Professor V. G. Weinstein (an outstanding Soviet traumatologistorthopedist who worked under Acad. Girgolav’s guidance) suggests the following sections: 38 works are devoted to comprehensive researches on wounds, 17 – to infections, 16 – to military field surgery, 14 – abdominal and thoracic surgery, 13 – traumatology, 12 – problems of low-temperature injuries. Fewer works in urology, plastic surgery, asepsis and antiseptics, vascular and operative surgery, history of medicine.As a result of Acad. Girgolav’s research and educational activities, one of the largest surgical schools in the USSR has been created. More than 20 doctoral and 45 candidate dissertations were prepared and defended under his supervision. Academician, Lieutenant-General of the Medical Service .S. Girgolav, was awarded the Stalin Prize, two Orders of Lenin, three Orders of the Red Banner, Order of the Red Banner of Labor, Order of the Red Star as well as many medals and honorary prizes for his outstanding contribution to the medical sphere of the Motherland in peacetime and wartime.
A clinical case of endovascular surgical removal of ectopic thymoma in the hospital surgery clinic of S. M. Kirov Military Medical Academy performed a planned surgical intervention - thymomtectomy from left-side thoracoscopic access. 4 thoracoports used. The time of surgical intervention was 125 minutes, the volume of intraoperative blood loss was less than 50 ml. The postoperative period was uneventful. Drainage removed the next day. There were no postoperative complications. Discharged on the 5th day of the postoperative period in satisfactory condition. It is believed that ectopic thymomas arise from scattered ectopic thymus tissue, which could not migrate to the anteroposterior mediastinum. Currently, the surgical method is the «gold standard» in the treatment of patients with thymus neoplasms. Complete surgical removal of the thymus gland is a prerequisite for the effective treatment of thymic tumors. The basic principle of radicalism is the complete excision of the tumor surrounding the tissue with the lymph nodes. Particular care should be exercised when removing the spurs of the gland, which often go high on the neck, as the left tissue can cause a relapse of the disease. To remove the thymus, various «open» (transcervical, full, partial and oblique partial transsternal, right-, left- and bilateral transpleural), video-assisted (thoracoscopic, transcervical and subciphoidal, transoral) and robot-assisted surgical approaches are proposed. In this case, the choice of surgical access should be approached individually in each case.
Various surgical approaches was proposed to remove the thymus. At the same time, the choice of surgical approach in each patient should have been differential. We presented the clinical case of the removal of thymus tumor using combined (subxyphoid and transthoracic) surgical approach.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.
ОБЗОРЫЭпителиальные опухоли вилочковой железы (тимомы и карциномы) являются самыми частыми первичными новообразованиями переднего средостения и нередко сочетаются с различными аутоиммунными заболеваниями и паранеопластическими синдромами [17,18,25,26,30,32]. Тимэктомия является необходимым условием эффективного лечения опухолей вилочковой железы [33,34]. В последнее время все чаще появляются сообщения о выполнении тимэктомии из торакоскопического доступа при удовлетворительных показателях онкологической эффективности и выживаемости [2,10,19,20,31,40].Целью данного обзора явился сравнительный анализ результатов хирургического лечения тимом из «открытого» (ОД) и видеоторакоскопического доступов (ВТС).В анализ включены результаты лечения 1175 больных с тимомами. Из них тимэктомия из «открытых» торакотомного и продольно-стернотомного доступов с дополнительным разрезом или без него в области яремной вырезки выполнена в 587 случаях, а видеоторакоскопические вмешательства предприняты в 588 наблюдениях. Больные обеих групп сопоставимы по возрасту (р = 0,651). Генерализованная миастения имела место у 136 (23,1 %) больных, перенесших малоинвазивное оперативное вмешательство, и у 104 (17,7 %) оперированных «открыто».Для оценки морфологии опухоли использовалась гистологическая классификация опухолей вилочковой железы ВОЗ от 2004 г. [25]. Преобладали тимомы типа АВ -около половины наблюдений (46,2 %), в равной степени определялись тимомы типов В1 и В2 -16,5 и 18,02 %, реже типов А и В3 -10,76 и 7,14 %, соответственно. Рак вилочковой железы (карцинома, тип С) встречался в единичных случаях.Для стадирования тимом во всех случаях применялась классификация Masaoka -Koga, 1994 [12]. Абсолютное большинство хирургических вмешательств выполнены при I-II стадии прогрессии (99,2 % в группе с ВТС и 98,3 % с «открытым»).Диаметр опухоли в группе с ВТС колебался от 30 до 60 мм. В группе ОД размеры тимом были достоверно больше -35-80 мм (р < 0,001). Длительность малоинвазивных операций колебалась от 65 до 208 мин, «открытых» -от 88 до 227 мин (табл. 1).Достоверной тенденции к снижению продолжительности оперативного вмешательства при использовании ВТС в большинстве работ не отмечено (р = 0,845). Однако два исследования демонстрировали статистически значимое снижение длительности вмешательства в группе ВТС [14,28], и лишь в одном случае авторы отметили уменьшение продолжительности операции из стернотомного доступа [15].Объем интраоперационной кровопотери колебался от 100 до 200 мл в группе с эндовидеохирургическими вмешательствами и от 150 до 450 мл в группе с традиционными доступами. Во всех случаях наблюдалось отчетливое уменьшение интраоперационной кровопотери при малоинвазивных операциях (р = 0,003).Частота конверсий доступа с ВТС на ОД, по данным различных авторов, колебалась от 1,3 до 11,8 %. Наиболее частым показанием для перехода с ВТС на стерно-торакотомию являлись интраоперационное кровотечение (11 случаев) и инвазия опухоли в крупные сосуды средостения (5 наблюдений).В послеоперационном периоде длительность дренирования плевральных...
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