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To evaluate an effectiveness of simultaneous laparoscopic procedures in patients with synchronous multiple primary cancer (SMPC).
We observed 3 patients (2 men and 1 woman) aged 61-78 years with synchronous multiple primary gastric and kidney cancer. Gastric tumors were localized in the lower third of the body (1) and the antrum (2), histological structure corresponded to adenocarcinoma G1 (1) and G2 (2). Kidney tumors were verified as light cell carcinoma and localized in the upper segment of the left kidney in 2 patient and right kidney in one patient. Mean dimension of tumor scheduled for resection was 4.65 cm, nephrectomy - 10.3 cm. Complexity of resection according to the RENAL scale was equal to 8 and 10.
Three patients underwent laparoscopic Billroth-I distal gastrectomy, 2 - kidney resection and one patient - nephrectomy. Mean surgery time was 265±37 min, blood loss - 175±29 ml. There were no conversion and redo interventions within 30 days after surgery. Mean hospital-stay was 11±2 days.
Minimally invasive technologies in patients with SMPC reduces blood loss, ICU- and hospital-stay. Earlier rehabilitation ensures the next stage of treatment in early postoperative period, while quality of life is better in comparison with traditional interventions.
Minimally invasive technologies in patients with SMPC reduces blood loss, ICU- and hospital-stay. Earlier rehabilitation ensures the next stage of treatment in early postoperative period, while quality of life is better in comparison with traditional interventions.
To study the outcomes of fast-track recovery in patients with perforated duodenal ulcer (PDU).
There were 138 patients with PDU who underwent surgical treatment for the period from January 1, 2015 to December 31, 2019. Patients were divided into 3 groups main group, control group 1 (CG-1) and control group 2 (CG-2). The main group (fast-track group, FT-group) included 51 patients who underwent laparoscopic suturing of PDU followed by enhanced recovery (fast-track). CG-1 comprised 44 patients who underwent open suturing of PDU and conventional perioperative treatment. CG-2 consisted of 43 patients who underwent laparoscopic suturing and conventional perioperative treatment. Complications were assessed using Clavien-Dindo grading system.
In the FT group, postoperative complications were observed in 2 patients (3.92%). Anemia of mixed genesis (Clavien-Dindo grade II) was diagnosed in 1 patient and left-sided lower lobe pneumonia in another one (grade II). There were no deaths. Mean length of hospital-stay ital-stay was 6.7 days.
Treatment outcomes in patients with perforated duodenal ulcer confirmed an effectiveness of laparoscopic suturing and complete abdominal sanitation. These measures create the prerequisites for fast track recovery in urgent surgical practice. FT-protocol of inpatient management is followed by reduced hospital-stay and less incidence of postoperative complications. selleck chemicals llc Moreover, this approach promotes early and safe discharge of patients.
Treatment outcomes in patients with perforated duodenal ulcer confirmed an effectiveness of laparoscopic suturing and complete abdominal sanitation. These measures create the prerequisites for fast track recovery in urgent surgical practice. FT-protocol of inpatient management is followed by reduced hospital-stay and less incidence of postoperative complications. Moreover, this approach promotes early and safe discharge of patients.
To summarize an experience of endoscopy-assisted dilatational tracheostomies in patients with COVID-19.
There were 31 endoscopy-assisted dilatational tracheostomies in patients with COVID-19 for the period from April 17 to June 10, 2020 (11 women and 19 men). Mean age of patients was 66.7 years (range 48-87). Tracheostomy was performed using Ciaglia (22) and Griggs (9) techniques. All procedures were carried out at the intensive care unit in elective fashion.
Tracheostomy was performed in 19.8% of ICU patients or 36.9% of all patients on mechanical ventilation within 6.5±2.5 days [min 3, max 11]. There were 22 survivors with tracheostomy (70.9%) that is comparable with survival of patients without mechanical ventilation (79.7%) and slightly higher than in patients on ventilation without tracheostomy (65.4%). No complications during the procedure were noted.
Endoscopy-assisted dilatational tracheostomy is preferred for prolonged mechanical ventilation, including patients with COVID-19. The undeniable advantages of this operation are fewer intraoperative complications due to endoscopic control, and lower risk of tracheal strictures.
Endoscopy-assisted dilatational tracheostomy is preferred for prolonged mechanical ventilation, including patients with COVID-19. The undeniable advantages of this operation are fewer intraoperative complications due to endoscopic control, and lower risk of tracheal strictures.
A systematic review of the world literature data on surgical management and preoperative screening of cancer patients within the COVID-19 pandemic, as well as prevention of SARS-CoV-2 transmission and resumption of elective surgery.
Literature data searching included Pubmed, MedLine, Scopus, Web of Science, and RSCI databases. We enrolled literature data published for the period from March 2020 to June 2020.
Retrospective and prospective clinical trials have been analyzed. The review ensures up-to-date data on surgical management of cancer patients under the pandemic, recommendations for resuming the elective surgery, preoperative screening and prevention of COVID-19.
To date, the COVID-19 pandemic is still not resolved, and infection continues spreading around the world. Thus, there is an urgent need for more thorough research of the strategies for mitigating the effects of pandemic. To date, the recommendations for optimal surgical management of cancer patients within the pandemic are still activelyents eligible for surgical treatment should be carefully selected according to stratification of risk factors. Thorough preoperative screening, monitoring of symptoms of infection, and use of appropriate adapted personal protective equipment are extremely important.
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