Results of application of the PTFE-conduits in the reconstruction of the main veins of the abdominal cavity mesenteric-portal system in locally advanced pancreatic cancer

Aim: study of immediate and long-term results of the surgical treatment of the locally advanced pancreatic cancer with tumor invasion of the main veins of the abdominal cavity. Material and methods. Pancreaticoduodenectomy with resection and plasty of the main veins of the abdominal cavity were performed 315 patients. 143 patients underwent for prosthetics of the main veins at their reconstruction of different vascular prosthesis. Patients have been divided into three groups. Group I (basic) — PTFE-conduits have been used in the reconstruction of the main veins (82 patients). Group II — FLL-conduits have been used in the reconstruction of the main veins (36 patients). Group III — autovenous conduits have been used in the reconstruction of the main veins (25 patients). Comparison of the duration of operation and its reconstruction stage, the quantity of blood loss, frequency of venous thrombosis in the early postoperative period and long-term patency of the reconstructed veins traced ultrasonic method in a period of 6 months, 1, 2, and 3 years after surgery have been carried. The morbidity, the frequency of the infectious complications, the hospital mortality, the mean postoperative hospital stay, median of survival have been studied after surgery. Results. Application of the PTFE-conduits resulted for decrease of the duration of the reconstruction stage of the operation, as well as the duration of the surgery and the amount of intraoperative blood loss. Decrease of the morbidity, of the postoperative hospital stay and the mortality have been noted in the I group of patients compared to groups II and III patients. Thrombosis of the prosthesis after reconstruction of the veins that led for fatal outcome has been marked in 2 patients (5.5%) in group II of the patients. The long-term patency of vascular PTFE-conduits and reconstructed veins in group 1 has been 100% in all period's observations in the postoperative period. Conclusion. PTFE-conduits are universal plastic material. Application of the PTFE-conduits for the reconstruction of the main veins of the mesenteric-portal system can reduce the duration of the reconstruction vascular stage and the operation as a whole. Applications of the PTFE-conduits reduce the morbidity, the frequency of infectious complications, postoperative hospital-stay, hospital mortality, as well as improved performance patency of the reconstructed vessels

Особенности сосудистых реконструкций и результаты 220 родственных трансплантаций правой доли печени взрослым пациентам

Rationale: Adult-to-adult right lobe living donor liver transplantation is a  viable alternative to whole liver transplantation from a  deceased donor. The key aspect of the surgical procedure is the restoration of adequate graft blood flow and maintenance of sufficient volume of well vascularized parenchyma in the donor. Specific features of vascular anatomy in the donor and the recipient can be eventual cause for significant technical difficulties during transplantation. They can also increase the risk of complications and deteriorate graft functioning.Aim: To identify the incidence of various types of afferent and efferent vascularization of right lobe of the liver, potential techniques of vascular reconstructive procedures, rates and types of postoperative complications, as well as immediate surgical results.Materials and methods: We retrospectively analyzed the data on 220 right lobe liver transplantations adult patients, consecutively performed from 2010 to 2017 in one center. Specific characteristics of liver vascularization in donors and recipients were determined by pre-operative computed tomography and intra-operatively. The information on the types of vascular reconstruction, complications and results of surgical procedures was obtained from patients' medical files.Results: The following variants of blood supply to the right liver lobe were seen most frequently: portal vein trifurcation 22%, shortened trunk of the right portal vein branch 13%, supplementary v. hepatica from SgVIII with a diameter of 5 mm 22%, supplementary lower right v. hepatica 17%, isolated venous outflow from all right lobe segments 2%, two arteries 2%. In addition, 17% of the recipients had portal vein thrombosis and 1% portal vein fibrosis. During the follow-up all donors remained alive. The rate of surgical complications was 12.5%, among them bile pocket or biloma 8.5%, intra-abdominal bleeding 2.5%, wound complications 1.5%. The rate of early post-operative complications in the recipients was 31.5%, with 4.5% of them being vascular and 15.5% biliary. The 6-months and 4-years survival of the recipients (Kaplan-Meier) was 98% and 95%, respectively.Conclusion: Immediate and longterm survival of the recipients of living donor right lobe live grafts, as well as absence of fatalities among their donors, confirm high effectiveness and expedience of this type of intervention. The observed anatomic variety of blood supply to the right liver lobe stipulates stringent requirements to the quality of preoperative diagnostics, deliberate donor selection, thorough planning of the procedure and high qualification of the surgical team. A  relatively high rate of postoperative complications warrants the necessity of an intensive diagnostic monitoring in the early post-operative period and active strategies of their correction.Актуальность. Использование для трансплантации взрослым пациентам правой доли печени живых доноров  – полноценная альтернатива пересадке целого органа от посмертного донора. Ключевым аспектом хирургического вмешательства считается восстановление адекватного кровотока в  трансплантате и  сохранение донору достаточного объема нормально кровоснабжаемой паренхимы. Особенности сосудистой анатомии донора и реципиента в ряде случаев становятся причиной значимых технических трудностей при выполнении трансплантации, могут повышать риск осложнений и  компрометировать функцию трансплантата.Цель  – определить частоту встречаемости различных вариантов афферентного и  эфферентного кровоснабжения правой доли печени, возможные способы сосудистых реконструкций, частоту и  структуру послеоперационных осложнений, непосредственные результаты операций.Материал и методы. Ретроспективному анализу подвергнуты данные о  220  трансплантациях правой доли печени взрослым пациентам, выполненных последовательно с 2010 по 2017 г. в одном центре. Особенности кровоснабжения печени доноров и  реципиентов устанавливали, используя результаты предоперационной компьютерной томографии и  интраоперационно. Информацию о видах выполненных сосудистых реконструкций, осложнениях и  исходах операций получали из первичной медицинской документации.Результаты. Наиболее часто встречались следующие варианты кровоснабжения правой доли печени: трифуркация воротной вены  – 22%, короткий ствол правой ветви воротной вены  – 13%, дополнительная печеночная вена от сегмента VIII диаметром более 5 мм – 22%, дополнительная нижняя правая печеночная вена – 17%, изолированный венозный отток от всех сегментов правой доли – 2%, две артерии – 2%. Кроме того, у 17% реципиентов наблюдали тромбоз и 1% – фиброз воротной вены. За период наблюдения летальных исходов среди доноров не было. Частота хирургических осложнений составила 12,5%: желчный затек или билома – 8,5%; внутрибрюшное кровотечение – 2,5%, раневые осложнения – 1,5%. Частота осложнений в  раннем послеоперационном периоде у  реципиентов составила 31,5%, из них сосудистые осложнения – 4,5%, билиарные  – 15,5%. Шестимесячная и  4-летняя выживаемость реципиентов (по методу Каплана – Мейера) – 98 и 95% соответственно.Заключение. Показатели непосредственной и отдаленной выживаемости реципиентов после родственной трансплантации правой доли печени, а также отсутствие летальных исходов среди доноров подтверждают высокую эффективность и  целесообразность таких вмешательств. При этом наблюдаемое разнообразие вариантов кровоснабжения правой доли печени обусловливает высокие требования к  качеству предоперационной диагностики, взвешенной селекции доноров, тщательному планированию вмешательства, квалификации хирургической бригады. Относительно высокая частота послеоперационных осложнений определяет необходимость интенсивного диагностического мониторинга в раннем послеоперационном периоде, активной тактики их коррекции

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical science. © The Author(s) 2019. Published by Oxford University Press