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1.
Khirurgiia (Mosk) ; (8): 69-73, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31464278

RESUMO

Percutaneous endoscopic gastrostomy (PEG) was developed in 1980. Since that time this method has become preferable for long-term enteral nutrition. PEG is an effective and relatively safe procedure for enteral nutrition of patients with impaired enteral feeding. However, complications and mortality are also observed. Indications, contraindications and potential complications of PEG are reviewed in the article.


Assuntos
Nutrição Enteral/métodos , Gastrostomia/efeitos adversos , Contraindicações , Nutrição Enteral/efeitos adversos , Gastroscopia , Gastrostomia/métodos , Humanos
2.
Khirurgiia (Mosk) ; (12): 50-56, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30560845

RESUMO

AIM: To study postoperative complications and mortality after minimally invasive biliary decompression in patients with mechanical jaundice. MATERIAL AND METHODS: Prospective analysis included 2.072 patients with mechanical jaundice who underwent differential biliary decompression depending on the cause, level of obstruction, severity of jaundice and patient's condition. RESULTS: Relief of bilirubinemia and stabilization of the state were achieved in 1696 patients of the main group (98,6%) and in 328 (93.18%) patients of the control group. Mortality was similar in both groups: 8 (0.46%) and 2 (0.56%) patients. The best results were obtained in the main group for in-hospital and post-hospital complications after retrograde interventions (χ2=4.440821; df=0.891435; p<0.05) and post-hospital complications after antegrade interventions (χ2=35.52869; df= 1; p<0.05). CONCLUSION: Differentiated approach to minimally invasive biliary decompression is followed by reduced postoperative morbidity.


Assuntos
Descompressão Cirúrgica/métodos , Icterícia Obstrutiva/cirurgia , Descompressão Cirúrgica/efeitos adversos , Humanos , Estudos Prospectivos , Resultado do Tratamento
3.
Khirurgiia (Mosk) ; (9): 24-30, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30307417

RESUMO

AIM: To study immediate results of open, laparoscopic and robot-assisted pancreatoduodenectomy for malignancies. MATERIAL AND METHODS: There were 158 patients with cancer of biliopancreatoduodenal area. Open procedures were performed in 118 cases, laparoscopic in 17, robot-assisted pancreatoduodenectomy - in 23. RESULTS: After 'standard' pancreatoduodenectomy 31 (62.0%) complications were registered, after laparoscopic - 12 (24.0%) and aWfter robot-assisted surgery - 7 (14.0%) complications. Relationship between probability of complications was absent (correlation coefficient 0.10491), however, significant differences in incidence of complications after various surgical approaches were observed (c2=6.8832; df=0.9679; p<0.05). CONCLUSION: Laparoscopic and robot-assisted pancreatoduodenectomy was not followed by advanced early postoperative morbidity. Moreover, minimally invasive approach was associated with improved outcomes.


Assuntos
Neoplasias do Sistema Digestório/cirurgia , Pancreaticoduodenectomia/efeitos adversos , Pancreaticoduodenectomia/métodos , Humanos , Laparoscopia/efeitos adversos , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Resultado do Tratamento
4.
Khirurgiia (Mosk) ; (8. Vyp. 2): 17-23, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30199047

RESUMO

AIM: To increase the effectiveness of treatment of colorectal cancer followed by metastatic liver lesion. MATERIAL AND METHODS: This study included 319 patients with colorectal cancer and metastatic liver lesion Gennari grade I, II, and III for the period from 2002 to 2017. All patients received combined treatment. 107 patients underwent liver resections: right-sided hemihepatectomy - 10, advanced right-sided hemihepatectomy - 7, left-sided hemihepatectomy - 9, triple segmentectomy - 33, bisegmentectomy - 29, segmentectomy - 19 cases. Radiofrequency ablation of liver metastases was performed in 105 patients. Cool tip device with a power of 200 W was used for destruction. Fifty-seven patients underwent microwave destruction of liver tumor (AveCure MWG 881, 34 W). Transarterial chemoembolization by doxorubicin and HepaSpheres 150-250 ng was applied in 34 patients. RESULTS: Annual, 2-, 3- and 5-year survival was 83.1%, 73.5%, 60.2% and 24.6%, respectively after liver resection. RFA of liver metastases was followed by annual, 2- and 3-year survival near 73.5%, 53.3% and 32.1%, respectively. In case of MWA of liver metastases annual survival was 78.5%, 2-year - 63.3%, 3-year - 58.3%. CONCLUSION: Chemotherapy combined with targeted therapy, radiofrequency and microwave ablation is able to increase resectability up to 35-40% in patients with colorectal cancer followed by liver metastases. Minimally invasive procedures (RFA, MWA) reduce surgical risk in critically ill patients.


Assuntos
Ablação por Cateter/métodos , Quimioembolização Terapêutica , Neoplasias Colorretais/cirurgia , Hepatectomia/métodos , Neoplasias Hepáticas/cirurgia , Antibióticos Antineoplásicos/administração & dosagem , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/patologia , Terapia Combinada , Doxorrubicina/administração & dosagem , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Micro-Ondas/uso terapêutico , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Resultado do Tratamento
5.
Phys Rev Lett ; 105(11): 115003, 2010 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-20867578

RESUMO

The experimental conditions leading to substantial reduction of the backscattering decay instability threshold in electron cyclotron resonance heating experiments in toroidal devices are analyzed. It is shown that a drastic decrease of threshold is provided by the nonmonotonic behavior of plasma density in the vicinity of magnetic island and poloidal magnetic field inhomogeneity making possible localization of ion Bernstein decay waves. The corresponding ion Bernstein wave gain and the parametric decay instability pump power threshold is calculated.

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