[Selecting the most appropriate surgical treatment of true splenic artery aneurysm]. / Vybor sposoba khirurgicheskogo lecheniya istinnykh anevrizm selezenochnoi arterii.

OBJECTIVE: To analyze the results of diagnosis and treatment of true splenic artery aneurysms. MATERIAL AND METHODS: We analyzed the results of diagnosis and treatment of 27 patients with true splenic artery aneurysm. All ones underwent surgical treatment at the Botkin Municipal Clinical Hospital between 2017 and 2021. Splenic artery aneurysm >1 cm was an indication for surgical treatment. Surgical option depended on aneurysm location. Laparoscopic splenectomy and aneurysmectomy were performed in 4 cases (14.8%), 5 (18.5%) patients underwent endovascular intervention, laparoscopic clipping was performed in 18 (66.7%) cases. Methods of surgical treatment, general and specific postoperative complications according to the Clavien-Dindo and ISGPS classifications were analyzed. RESULTS: Laparoscopic clipping was accompanied by fewer general and specific postoperative complications. Specific complications after laparoscopic splenectomy occurred in 2 patients (BL according to the ISGPS 2016 classification). There was one case of acute pancreatitis after endovascular interventions. In long-term postoperative period, aneurysm recanalization after endovascular intervention was observed in 1 case. CONCLUSION: Surgical treatment of splenic artery aneurysms requires a differentiated approach based on topographic and anatomical assessment of aneurysm relative to the arterial vessel.

[Potential of endovascular embolization, chemoembolization and chemoimmunoembolization based at a multidisciplinary hospital].

The paper is devoted to a topical problem of modern roentgenovascular surgery, i.e. endovascular embolization. The results of its application in S.P. Botkin City Clinical Hospital demonstrate high efficacy of this method for the arrest of hemorrhage and treatment of various diseases.

[Methods of correcting hepatic arterial blood supply for subsequent implantation of the "port-catheter" infusion system].

The study was undertaken to investigate the feasibility of using surgical and roentgenoendovascular redistribution of the hepatic arterial blood flow for adequate implantation of the "port-catheter" infusion system. Between December 2001 and March 2008, we performed surgical (n = 25) or transcutaneous (n = 22) implantations of the infusion systems for carrying out regional chemotherapy in a total of forty-seven patients presenting with hepatic metastases of colorectal carcinoma. Anatomical variants of the hepatic arteries were observed in eleven cases. The blood stream was corrected by means of either transcatheter embolization (n = 7), ligation (n = 2), or transposition (n = 2) of the aberrant arteries. No complications were encountered. In all the cases, the "port-catheter" system was implanted successfully, with adequate hepatic perfusion achieved. Both transcatheter embolization and surgical reconstruction turned out to be efficient methods in correction of the blood flow in various anatomical structures of the hepatic arteries, thus favourably contributing to increased efficacy of regional chemotherapy.

[Level of sanitary-hygienic knowledge and habits of tuberculosis patients and ways of raising it]. / Uroven' sanitarno-gigienicheskikh znanii i navykov bol'nykh tuberkulezom i puti ego povysheniia.

The anonymous questionnaire method was used for the study of the level of sanitary-hygienic awareness and habits of 236 tuberculosis patients on admission and during their stay in a antituberculosis dispensary. Studies among the newly-admitted patients have revealed significant differences in the level of tuberculosis awareness. More than 40% of the patients had no idea of the infectious nature of the disease on the day of admission, two-thirds of them did not know about a source of infection, factors and ways of tuberculosis transmission and nearly 90% could not handle sputum and use spitoons, toilet accessories and disinfectants. The level of patients' awareness and habits related to tuberculosis prophylaxis undergoes basic changes and reaches 98-100% provided all forms and methods of sanitary education and training are fully employed during their stay at antituberculosis hospitals. Interestingly, the more time the patient stays at a hospital, the less he believes in his cure. Questionnaires revealed a high-risk group of patients (29.7%) who present danger for the subjects around in respect to tuberculosis dissemination due to the infringement of the sanitary-hygienic and therapeutic and preventive requirements and recommendations.