[Early outcomes of robot-assisted liver resection]. / Robot-assistirovannye rezektsii pecheni. Otsenka blizhaishikh rezul'tatov.

AIM: To assess an experience of robot-assisted liver resection using CUSUM-test. MATERIAL AND METHODS: The results of 46 robot-assisted liver resections were retrospectively analyzed by using of CUSUM-test. RESULTS: There were 3 periods in development of the technology. The 1st period - procedures with the lowest index of difficulty (n=16), the 2nd period - expansion of the indications for difficult resections (n=18) and the 3rd period - stabilization of the results (n=12). The dynamics of difficulty index, intraoperative blood loss, duration of procedure and morbidity (Clavien-Dindo Grade II-V) were evaluated. Five liver resections were needed to decrease blood loss and duration of the procedure. Expansion of indications was feasible after 16 procedures. Stable results were obtained after 34 liver resections.

[Intrahepatic cholangiocarcinoma followed by vascular invasion: is surgical treatment justified?] / Vnutripechenochnaia kholangiokartsinoma s invaziei v sosudy: opravdano li khirurgicheskoe lechenie?

Intrahepatic cholangiocarcinoma (ICC) is one of the most aggressive tumors associated with poor prognosis. Radical surgery is still the main method of treatment in resectable cases. Certain difficulties are observed in case of locally advanced tumors followed by inferior vena cava (IVC) and portal vein (PV) invasion. AIM: To analyze safety of advanced liver resections combined with great vessels repair for locally advanced large and multiple cholangiocellular carcinoma. MATERIAL AND METHODS: Since January 2014 till April 2017 eighty ICC patients have undergone advanced liver resection. There were 62 patients with portal cholangiocarcinoma and 18 with ICC. 4 ICC patients required vascular repair: IVC replacement in 2 cases (i.e. under venous bypass in 1 of them), tangential and circular resection of portal vein bifurcation - in 2 cases. RESULTS: Postoperative complications Clavien-Dindo IIIa developed in all cases. There were no vascular complications. The length of hospital-stay was 14 - 35 days. There were no lethal outcomes. Annual survival was 50%, 2-year - 25%. Adjuvant chemotherapy was used in all patients. CONCLUSION: Advanced liver resection followed by IVC and PV repair for locally advanced ICC may be safely performed and subsequently allows chemotherapeutic treatment.

Coinheritance of HbD-Punjab/ß+-thalassemia (IVSI+5 G-C) in patient with Gilbert's syndrome.

Thalassemia and qualitative hemoglobinopathy are hereditary disorders of Hb synthesis that lead to change in the Hb conformation or a decrease in the synthesis of structurally normal Hb, and consequently, to erythron pathology. Many variants of Hb are unstable or have altered affinity for oxygen, and, in heterozygous form can be associated with clinical and hematological manifestations (hemolytic anemia, hypochromic microcytic anemia, erythrocytosis). HbD-Punjab [ß121 (GH4) Glu → Gln; HBB: C.364G> C] is variant of Hb carrying the amino acid substitution in the 121 position of ß-globin chain. In all cases reported so far, patients with HbD-Punjab/ß+-thalassemia (IVSI+5 G-C) combination experienced typical thalassemia with hypochromic microcytosis. HbD-Punjab was detected by electrophoresis from 37 to 94% of total Hb. The article describes rare clinical case of the cohabitation of HbD-Punjab/ß+-thalassemia (IVSI+5 G-C) in a patient with homozygous variant of Gilbert's syndrome observed in AS Loginov Moscow Clinical Scientific Center.

[Comparative analysis of static scintigraphy and computerized tomography in assessment of remnant liver volume after advanced hepatic resection]. / Cravnitel'nyi analiz staticheskoi stsintigrafii i komp'iuternoi tomografii v otsenke ob''ema ostatochnoi parenkhimy pri obshirnykh porazheniiakh pecheni.

AIM: To perform a comparative analysis of computerized tomographic volumetry and scintigraphic liver volumetry in assessment of remnant liver volume after advanced hepatic resection. MATERIAL AND METHODS: Static hepatobiliary scintigraphy and CT volumetry were performed in 45 patients with various liver tumors who underwent advanced hepatectomies (more than three segments). RESULTS: There were no any significant differences in volumetric parameters obtained by CT and scintigraphic volumetry. CONCLUSION: Scintigraphic volumetry data are similar to those of CT volumetry in evaluation of future remnant liver volume. Scintigraphic volumetry may be used as an alternative in assessment of future remnant liver volume after advanced hepatic resections.

[Defects in conducting case histories in urgent abdominal surgery and their importance].

Information available in case histories is of great importance, e.g. for court examinations on "medical suits". So, we have investigated 472 case histories for the period from 2000 through 2004. It was found that the number of errors and short-comings in case histories still remains rather great. High professional and juridical competence is thought to be the way to avoid the patient's complains and improve effectiveness of treatment.

Antimalarial activity of new gossypol derivatives.

Gossypol, a disesquiterpene extracted from cotton seeds, is known to inhibit strongly the Plasmodium falciparum lactate dehydrogenase, but its high toxicity has stopped any antimalarial drug development. A series of Schiffs bases was synthesized from gossypol by modification of the aldehyde groups responsible for its toxicity. A total of 13 compounds showing low cytotoxicity were then selected and were compared with gossypol for activity against 2 chloroquine-resistant strains of P. falciparum (PFB, FCB1). These in vitro activities were evaluated using an isotope-based drug-susceptibility semiautomated microdilution test followed by determination of IC50 values (50% inhibitory concentration). In all, 12 of the 13 compounds tested were active; 3 of them displayed antimalarial activity comparable with that of gossypol itself.