ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ РЕЦИДИВИРУЮЩИХ КИСТ БЕЙКЕРА С ПРИМЕНЕНИЕМ ЭНДОСКОПИЧЕСКОЙ ТЕХНИКИ

Purpose of the study - to study the causes of synovitis in patients with recurrent Baker’s cyst, to evaluate the effectiveness of endoscopic treatment of popliteal cysts . Materials and methods. From 2009 till 2013 we observed 34 patients with Baker's cyst. In 18 (52.9%) patients of the main group endoscopic technique was applied, in 16 (47.1%) patients of the comparison group a cystic bag was isolated and dissected with open technique, and then cystic gate was sutured. Results. In 10 (55,6%) patients of the main group the pain disappeared in the first postoperative day (pЦель исследования: изучить причины синовита у пациентов с рецидивирующей кистой Бейкера, оценить эффективность эндоскопического метода лечения кист подколенной области. Материалы и методы. С 2009 по 2013 г. наблюдали 34 пациента с кистами Бейкера, которые были разделены на две группы. У 18 (52,9%) больных основной группы применялась эндоскопическая техника лечения, у 16 (47,1%) пациентов в группе сравнения кистозный мешок выделяли и иссекали открыто, а затем ушивали кистозные ворота. Результаты. У 10 (55,6%) пациентов основной группы в послеоперационном периоде болевой синдром купировался в первые сутки после операции (

Features of the Restoration of Arterial Circulation in Liver Transplantation

Objectives. Violations of tissue blood supply remain one of the most serious complications after liver transplantation. Design. To improve the surgical technique of performing reconstructive interventions on the arteries of the donor and the recipient in order to reduce the frequency of its thrombosis after liver transplantation. We studied 25 donors, 20 men and 5 women, the mean age was 56± 4 years, eighteen of them had left aberrant supplementary artery, which in fifteen departed from the left gastric artery and in three from the aorta above the ventricular stem. Seventeen had the right aberrant artery moving away from the upper mesenteric artery. Twenty recipients with liver cirrhosis (eleven with primary biliary cirrhosis, five with primary sclerosing cholangitis, five with viral etiology C cirrhosis, and three of the lower cirrhosis-cirrhosis disseminated within the Milan criteria. All recipients had standard anatomical branching of the arteries of the liver. The average age was 50±6. All recipients had standard anatomical branching of the liver arteries. Patients underwent liver transplantation with new methods of reconstructive interventions on the donor and recipient arteries. The developed technique provides the shortest pathway of the recipient's arterial blood to the liver transplant, through the superior mesenteric artery provides an alternative source of arterial blood supply from the aorta in which this transplant additionally needs. Presented method of blood circulation restoration at liver transplantation at abnormal structure of arterial channel of the liver transplant is performed inside the recipient's abdominal cavity. At first, blood flow is restored along the reconstructed common hepatic artery, after the right or left aberrant arteries liver transplant. Such technique provides the shortest route of the recipient's arterial blood to the liver transplant, through the upper mesenteric artery provides an alternative source of arterial blood supply from the aorta for which the transplant is additionally needed. This new method of blood circulation restoration provides an opportunity to avoid the formation of "kinking" syndrome, in the occurrence of which the blood vessels are lengthened, the angulation and location of the blood vessel in relation to the grafts and other abdominal organs. This reduces the risk of thrombosis of the arteries of the transplanted liver

Функциональные результаты хирургической реконструкции передней крестообразной связки коленного сустава в сочетании с латеральной стабилизацией

The objective was to compare the effectiveness of isolated anatomical antegrade reconstruction of the anterior cruciate ligament (ACL) with bonetendon-bone autograft (BTB autograft) and in combination with lateral extra-articular tenodesis (LEAT) graft from the iliotibial tract (ITT).Material and methods. We analyzed 187 arthroscopic ACL reconstructions in patients with a Pivot shift test - 3+ degree. We performed an isolated ACL-R in 118 (63.1 %) patients in group 1 and added the LEAT from ITB to it in group 2.Results. According to IKDC-2000: 176 (94.1 %) patients were included in categories A and B, 11 (5.9 %) - in C. Significant differences in these groups appeared 15 months after the operation. According to KOSS: in group 2, the anterior and rotational knee stability, as well as the level of sports activity were higher, and pathological symptoms were less common.Conclusion. LEAT from ITB increases stability and functionality of the knee joint in patients with anatomical antegrade ACL reconstructions with BTB-autograft for terms over 15 months after the operation, and is an economically procedure.Цель. Сравнить эффективность изолированной анатомической антеградной реконструкции передней крестообразной связки (ПКС) костно-сухожильно-костным аутотрансплантатом (ВТВ-трансплантатом) и в сочетании с латеральным экстраартикулярным тенодезом (ЛЭАТ) трансплантатом из илиотибиального тракта (ИТТ).Материал и методы. Проанализированы 187 артроскопических реконструкций ПКС у пациентов с Pivot shift-тестом 3+ степени. В 1-й группе в 118 (63,1 %) случаях выполняли изолированную реконструкцию ПКС, во 2-й группе - дополняли ее ЛЭАТ из ИТТ.Результаты. По IKDC-2000: 176 (94,1 %) пациентов вошли в категории А и В, 11 (5,9 %) - в С. Достоверно значимые различия в группах проявились спустя 15 месяцев после операции. По KOSS: во 2-й группе передняя и ротационная стабильность колена, а также уровень спортивной активности были выше, а патологические симптомы встречались реже.Заключение. ЛЭАТ из ИТТ повышает стабильность и функциональность коленного сустава у пациентов с анатомической антеградной реконструкцией ПКС ВТВ-трансплантатом на сроках свыше 15 месяцев после операции и является экономически не затратной процедурой

ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ БОЛЬНЫХ С НЕБЛАГОПРИЯТНЫМИ ПОСЛЕДСТВИЯМИ ПОЗВОНОЧНО-СПИННОМОЗГОВОЙ ТРАВМЫ

The article is dedicated to the vital problem of the consequences caused by negligent surgical treatment of those who suffered spinal and vertebral trauma. The authors carried out a cooperative survey of the results of the previous treatments of patients with traumas with and without complications and they came up with the algorythm of surgical methods, based on the data analysis. Vast database of 614 clinical case treatments with post-operative observations of 1 to 10 years long have been used. The work is aimed at raising the standarts of surgical treatments and improvement of neurological anatomo-functional results.Статья посвящена актуальной проблеме лечения последствий неудовлетворительного хирургического лечения пострадавших с позвоночно-спинномозговой травмой. Авторы провели двухцентровое исследование результатов предшествовавшего хирургического лечения пациентов с осложнённой и неосложнённой травмой позвоночника и на основании анализа данных выработали алгоритм оперативных пособий. Использован богатый клинический материал в виде 614 наблюдений с катамнезом от 1 до 10 лет. Работа направлена на улучшение качества хирургического лечения, неврологических и анатомо-функциональных результатов

The role of optimal nutrition in the prevention of cardiovascular diseases

A balanced diet has always been part of a set of preventive measures with cardiovascular diseases (CVD). The aim of the research is to present relevant international data on the role of nutrients in reducing the risk of CVD. Results. This article discusses current data on the effect of consumption of saturated and unsaturated fatty acids, trans fats, cholesterol, dietary fiber, protein, edible salt potassium, magnesium and vitamins on the state of the cardiovascular system and the prevention of CVD. Recommendations on optimal nutrition are given to reduce cardiovascular risks, including those according to the new 3rd edition of the Guide to Cardiovascular Medicine (The ESC Textbook of Cardiovascular Medicine, 3 edn). Conclusion. When managing patients with cardiovascular diseases, it is necessary not only to take into account international nutritional recommendations, but also to focus the patient's attention on how to comply with them. Copyright© GEOTAR-Media Publishing Group