Original Effective, Safe Technique of Obtaining Platelet Rich Plasma by Centrifugation of the Blood Plasma in Modified Syringe Containers

The aim: to develop, substantiate an effective and safe technology for producing PRP (platelet rich plasma). To quantify the substrate based on the recommended centrifugation protocols.Materials and methods: the effectiveness of the original harvesting protocol was evaluated by quantifying the number of platelets. The proposed technique is formed basing on the basic principles of double centrifugation of whole blood in test tubes with anticoagulant, separation with the release of a plasma layer with a high content of platelets.The centrifuging mode for quantifying the effectiveness of the substrate was selected according to recommendations based on a study confirming maximum efficiency (160g×10min + 250g×15min).For quantitative evaluation, blood was collected from 10 healthy volunteers (7 men, 3 women) with an average age of 26.0±2.6, and centrifuged in standard mode. Quantitative evaluation of platelets of whole blood and the obtained PRP substrate was carried out with a semi-automatic analyzer.Results: the proposed technique is based on the use as a container for centrifuging a syringe with a LuerLock design, which is hermetically sealed with a congruent plug, adapted by the external size of the centrifuge rotor bowl. Phase selection after centrifugation was performed by aspiration of the syringe contents after centrifugation is performed through a three-way valve. The substrate was obtained by repeated centrifugation of the contents, which allows obtaining a variable volume and platelet concentration in PRP. The amount of platelets (PLT) of whole blood is 227.0±57.0 thousand per ml. PLT PRP 945.0±279.0 thousand per ml.Conclusions: the proposed method of separation of whole blood with the release of the platelet rich plasma demonstrates high efficiency, which corresponds to the level of increasing the number of platelets in reducing the volume at the level of the best ready-made solutions.The equipment is economical and does not require highly specialized equipment and consumables. The proposed technique provides a wide choice to the performer in the received volume of the substrate

Magnetic Resonance Imaging with Diffuse Weighted Imaging and Computed Tomography with Intravenous Contrast in Staging of Disseminated Ovarian, Stomach, Colorectal Cancer

The aim of the research. Development and implementation of new methods for pre-operative staging of advanced ovarian, gastric and colorectal cancer to improve patient selection for cytoreductive surgery and increase its radicality.Materials and methods. Data from 120 patients with advanced ovarian cancer, 28 with advanced gastric cancer and 119 with advanced colorectal cancer were analyzed. Preoperative detection of the incidence of peritoneal carcinoma and the possibility of surgery in radical or cytoreductive volume performed by CT with intravenous contrast (72 patients with ovarian cancer, 17 patients with gastric cancer, and 69 patients with colorectal cancer), and MR T1 and T2, contrast-enhanced T1, and diffuse-weighted sequences (48 patients with ovarian cancer, 11 patients with gastric cancer, and 50 patients with colorectal cancer). Subsequently, preoperative and intraoperative assessment of the prevalence of the tumour process with peritoneal carcinoma index (PCI) by Sugarbaker was performed.Results. A statistically significant increase in the informativeness of the preoperative assessment of the incidence of tumour process in peritoneum and the presence of distant metastases using DWI / MRI compared with CT with intravenous contrast was determined. Patients from all groups were categorized according to the completeness index of cytoreduction achieved by preoperative staging and patient selection using DWI / MRI and CT. The use of DWI / MRI allowed to significantly reduce the number of suboptimal and non-optimal cytoreductive interventions.Conclusions. DWI / MRI has made it possible to significantly improve the preoperative incidence of advanced ovarian, gastric, and colorectal cancer compared to CT, predict the radicality of future surgery, and detect inoperable cases

Original effective, safe technique of obtaining platelet rich plasma by centrifugation of the blood plasma in modified syringe containers

The aim: to develop, substantiate an effective and safe technology for producing PRP (platelet rich plasma). To quantify the substrate based on the recommended centrifugation protocols. The effectiveness of the original harvesting protocol was evaluated by quantifying the number of platelets. The proposed technique is formed basing on the basic principles of double centrifugation of whole blood in test tubes with anticoagulant, separation with the release of a plasma layer with a high content of platelets. The centrifuging mode for quantifying the effectiveness of the substrate was selected according to recommendations based on a study confrming maximum effciency (160 g×10 min + 250 g×15 min). For quantitative evaluation, blood was collected from 10 healthy volunteers (7 men, 3 women) with an average age of 26.0±2.6, and centrifuged in standard mode. Quantitative evaluation of platelets of whole blood and the obtained PRP substrate was carried out with a semi-automatic analyzer. The proposed technique is based on the use as a container for centrifuging a syringe with a LuerLock design, which is hermetically sealed with a congruent plug, adapted by the external size of the centrifuge rotor bowl. Phase selection after centrifugation was performed by aspiration of the syringe contents after centrifugation is performed through a three-way valve. The substrate was obtained by repeated centrifugation of the contents, which allows obtaining a variable volume and platelet concentration in PRP. The amount of platelets (PLT) of whole blood is 227.0±57.0 thousand per ml. PLT PRP 945.0±279.0 thousand per ml. The proposed method of separation of whole blood with the release of the platelet rich plasma demonstrates high effciency, which corresponds to the level of increasing the number of platelets in reducing the volume at the level of the best ready-made solutions. The equipment is economical and does not require highly specialized equipment and consumables. The proposed technique provides a wide choice to the performer in the received volume of the substrate

Evaluation of centrifuging regimes for the purpose of optimizing the platelet rich plasma harvesting protocol

Aim: Based on the classical principles, to determine the optimal conditions for centrifugation, PRP harvesing (platelet-rich plasma). To conduct a quantitative assessment of the substrate obtained under different conditions of centrifugation. Based on the basic principles of obtaining platelet-rich plasma (PRP) by centrifuging in containers with an anticoagulant followed by phase separation to obtain the fnal substrate, the effciency of the technique under the conditions of single and double centrifugation as well as under different conditions of acceleration and centrifugation was evaluated. Blood for follow-up was collected from 20 healthy volunteers (11 men, 9 women) average 25.3±4.1 in syringes of LuerLock design with ACD-A anticoagulant solution, and centrifuged. Centrifugation was carried out under controlled conditions using a centrifuge with rotating bowls of the rotor. Centrifugation was performed at an acceleration of 100–400 g in time intervals up to 20 minutes. Activation of the substrate was performed with calcium chloride solution. Quantitative evaluation of platelets of whole blood and the fnal substrate of PRP was carried out with a semi-automatic analyzer. The obtained results demonstrate the maximum level of harvesting effciency when performing double centrifugation in the 150g × 15 min+250g × 10 min mode. Subject to this centrifugation protocol, it is possible to obtain a substrate that complies with the standardized requirements for PRP. The maximum level of an increase in the number of platelets in the substrate in comparison with whole blood is determined at the level of ×4.36 with concentration (volume reduction) ×5 in comparison with the volume of whole blood. This study demonstrated the advantage of double centrifuging modes over single modes. According to the results of the study, it was possible to determine the conditions for an optimal double-centrifugation mode (acceleration and duration), which allows us to achieve the most effcient concentration of the substrate

Циторедуктивна хірургія при хіміорезистентній лейоміосаркомі матки

Циторедуктивна хірургія при хіміорезистентній лейоміосаркомі матк

Дифференцированный выбор малоинвазивного хирургического доступа в хирургическом лечении желчнокаменной болезни

In 2009 at the University Clinic of the Odessa National Medical University with minilaparoscopic and single-port technology we have operated 47 patients with cholelithiasis. 26 patients were performed minilaparoscopic cholecystectomy, 21 — laparoscopic cholecystectomy using a single laparoscopic access. All surgical interventions had no intraoperative complications. In 5 patients because of anatomic difficulties in removing the gallbladder, we were used to installing an additional trocar in the epigastric region. Time used for interventions ranged from 30 to 130 minutes. Patients were hospitalized after the surgery from 1 to 4 days. Technically, the performance of single-port laparoscopic cholecystectomy was more difficult than the traditional laparoscopic or minilaparoscopic operations due to lack of conditions for the quality triangulation, visualization of anatomical structures in the area of operation and the small angle between the operating instruments. Particular attention was devoted to adequate closure of the abdominal wall defect after installing the port. Pain after use minilaparoscopic surgery was significantly less than with traditional laparoscopic approach. The intensity of pain after single-port operations, was comparable with that of conventional traditional laparoscopy. At follow-up of patients during the first months after surgery separated complications were not observed, marked by a beautiful cosmetic effect. 8 months after surgery 1 patient was diagnosed trocar-site hernia after a single port laparoscopic cholecystectomy.С 2009 г. в клинике Одесского национального медицинского университета прооперировано 47 больных с желчнокаменной болезнью. У 26 больных выполнена минилапароскопическая холецистэктомия, у 21 – однопортовая. Все оперативные вмешательства прошли без интраоперационных осложнений. У 5 пациентов из-за анатомических сложностей мы вынуждены были прибегнуть к установке дополнительного троакара в эпигастральной области. Время, использованное для проведения вмешательств, варьировалось от 30 до 130 мин. Больные находились в стационаре от 1 до 4 сут. При наблюдении за пациентами в течение первых месяцев после операции отдаленных осложнений не наблюдалось, отмечен хороший косметический эффект. Спустя 8 месяцев после операции у 1 пациента после однопортовой лапароскопической холецистэктомии диагностирована троакарная грыжа в месте установки порта

Применение обогащенной тромбоцитами плазмы с целью профилактики поздних осложнений и болевого синдрома после герниопластики

Цель. За счет применения обогащенной тромбоцитами плазмы (ОTП) снизить степень выраженности поздних осложнений у больных, оперированных по поводу инцизионных вентральных грыж. Материалы и методы. В клиническое исследование, проведенное в условиях хирургического отделения Центра реконструктивной и восстановительной медицины (Университетская клиника) Одесского национального медицинского университета с 2013 по 2019 г., включены 84 больных, оперированных по поводу послеоперационных вентральных грыж. Средний возраст больных составил (60,1 ± 7,6) года, размер грыжевых дефектов - 8,2 см, средний индекс массы тела – 31,8 кг/м2. Больным по показаниям выполнен стандартный объем оперативного вмешательства: грыжесечение, герниопластика передней брюшной стенки облегченным (80 г/м2) полипропиленовым имплантатом. Пациентам основной группы после выполнения пластики зону имплантации протеза инфильтрировали активированной аутологичной ОТП, которая была заготовлена путем двойного центрифугирования, в объеме 14 – 38 мл. Пациентам контрольной группы инфильтрацию ОТП не выполняли. Качество жизни пациентов оценивали с помощью стандартизированного опросника SF-36 до операции, а также в послеоперационном периоде. С целью дифференцирования нейропатической боли применяли опросники DN4 и ID Pain. Результаты. У пациентов обеих групп в послеоперационном периоде отмечали повышение показателей качества жизни. Статистическая достоверность различий показателей была выше у пациентов с надапоневротическим расположением протеза. Показатели физического здоровья и ассоциированные с ними показатели социальной активности, общего состояния здоровья демонстрировали значимо более высокий уровень качества жизни у пациентов основной группы. Показатель общего состояния здоровья у больных после надапоневротической герниопластики с применением ОТП был достоверно выше, чем в контрольной группе – соответственно 69,3 ± 3,8 и 59,7 ± 4,1 (p < 0,05). Выводы. Техника инфильтрации мягких тканей, контактирующих с полипропиленовым протезом, безопасна, достоверно не увеличивает риск возникновения локальных или системных осложнений. Предложенная методика за счет модификации репаративных процессов в зоне герниопластики способствует интеграции протеза, снижает риск развития и степень выраженности биомеханических нарушений, хронического болевого синдрома, что положительно сказывается на качестве жизни пациентов. Эффективность техники статистически достоверно выше у пациентов после надапоневротической герниопластики