X-Ray Computer Simulation of Surgical Accesses in Case of «Hard-To-Reach» Liver Segments Damages

Abstract


The purpose of the study To justify different types of surgical approaches at damages "hard" segments of the liver, taking into account topographic and constitutional human features by using X-ray method computer model. Materials and methods For the study developed a software product for determining the optimum surgical access to "difficult areas" segments of liver, that consists of four modules: _, processing of computer tomograms (CT), classification of 3D models and analyze information. For objectification research results, was decided to use quantitative criteria to be met by surgical approach proposed by A.Iu. Sozonov-Iaroshevich (1954). Results and their discussion The reconstruction of 243 simultaneously performed CT examinations thoracic and abdominal cavities with intravenous contrast were obtained model chest and abdomen _ with vascular system. Then, simulation of damage done "hard» (VII-VIII) and hepatic vein segments by marking them. Conclusion The data, which suggest that the majority (67.5%) patients optimal access to "difficult areas" segments of the liver is torakofreno laparotomy through IX intercostal space

Mechnikov North-West State Medical University, 41 Kirochnaia Str., Saint-Petersburg, 191015,
Russian Federation

Author for correspondence.
Email: dr.sigua@gmail.com

Russian Federation – PhD, docent of the I.I. Grekov faculty surgery department, I.I. Mechnikov North-Western State Medical University.

Mechnikov North-West State Medical University, 41 Kirochnaia Str., Saint-Petersburg, 191015,
Russian Federation

Email: author@vestnik-surgery.com

Russian Federation MD, Prof., head of the I.I. Grekov faculty surgery department, the dean of surgery faculty, I.I. Mechnikov North-Western State Medical University;

Mechnikov North-West State Medical University, 41 Kirochnaia Str., Saint-Petersburg, 191015,
Russian Federation

Email: author@vestnik-surgery.com

Russian Federation PhD, docent of biotechnological systems department in the V.I. Ulianov (Lenin) Leading SaintPetersburg State Electrotechnical University

Mechnikov North-West State Medical University, 41 Kirochnaia Str., Saint-Petersburg, 191015,
Russian Federation

Email: author@vestnik-surgery.com

Russian Federation assistant of biotechnological systems department in the V.I. Ulianov (Lenin) Leading SaintPetersburg State Electrotechnical University;

Mechnikov North-West State Medical University, 41 Kirochnaia Str., Saint-Petersburg, 191015,
Russian Federation

Email: author@vestnik-surgery.com

Russian Federation undergraduate of biotechnological systems department in the V.I. Ulianov (Lenin) Leading SaintPetersburg State Electrotechnical University;

Mechnikov North-West State Medical University, 41 Kirochnaia Str., Saint-Petersburg, 191015,
Russian Federation

Email: author@vestnik-surgery.com

Russian Federation aspirant of the I. I. Grekov faculty surgery department, I.I. Mechnikov North-Western State Medical University, ordinator of the first surgical department Saint-Petersberg State Budget Institution of Health «Elizavetinskaia hospital»;

Mechnikov North-West State Medical University, 41 Kirochnaia Str., Saint-Petersburg, 191015,
Russian Federation

Email: author@vestnik-surgery.com

Russian Federation head of the X-ray diagnostic department, Kirov Military Medical Academy;

Mechnikov North-West State Medical University, 41 Kirochnaia Str., Saint-Petersburg, 191015,
Russian Federation

Email: author@vestnik-surgery.com

Russian Federation applicant of the I.I. Grekov faculty surgery department, I.I. Mechnikov North-Western State Medical University.

  1. Gumanenko E.K. Voenno-polevaya hirurgiya [Military surgery] ucheb. dlya vuzov. M.: GEHOTAR-Media, 2008; 763.
  2. Ermolov A.S. Travma pecheni: monografiya [Trauma of the liver] M.: Medicina, 2003; 191.
  3. Kabanov M.YU. Struktura povrezhdenij zhivota v stacionare skoroj medicinskoj pomoshchi [The structure damage of the abdomen in the hospital ambulance.] Materialy ezhegodnoj nauch. Konferencii "Aktual'nye problemy okazaniya specializirovannoj medicinskoj pomoshchi v mnogoprofil'nom stacionare»". Sankt-Peterburg, 2013; 67-68.
  4. Rozanov V.E. Diagnosticheskaya i lechebnaya videolaparoskopiya pri zakrytoj travme organov bryushnoj polosti [Diagnostic and therapeutic video laparoscopy at the closed trauma of abdominal cavity organs.] Materialy VIII Vserossijskogo s"ezda po ehndoskopicheskoj hirurgii. EHndoskopicheskaya hirurgiya, 2005; 1: 115.
  5. Savel'ev B.C. Rukovodstvo po neotlozhnoj hirurgii organov bryushnoj polosti: prakticheskoe posobie [Manual of emergency surgery of abdominal organs: a practical Handbook.] M.: Triada-H, 2005; 640.
  6. Singaevskij A.B. Puti uluchsheniya iskhodov lecheniya tyazheloj sochetannoj travmy mirnogo i voennogo vremeni [Ways to improve outcomes in the treatment of severe concomitant trauma in peacetime and wartime.] avtoref. dis... d-ra. med. nauk. Sankt-Peterburg: 2003; 40.
  7. Sozon-YAroshevich A.YU. Anatomo-klinicheskoe obosnovanie hirurgicheskih dostupov k vnutrennim organam: prakticheskoe rukovodstvo [Anatomic-clinical substantiation of surgical accesses to the internal organs: a practical guide.] L.: Medgiz, 1954; 180.
  8. Cybulyak G.N. CHastnaya hirurgiya mekhanicheskih povrezhdenij: prakticheskoe rukovodstvo [Private surgery mechanical damage: a practical guide.] SPb.: Gippokrat, 2011; 576.
  9. SHCHedrenok V.V. Kliniko-luchevaya diagnostika cherepno-mozgovyh povrezhdenij pri politravme [Clinical radial diagnostics of craniocerebral injuries in polytrauma.] Vestnik hirurgii, 2012: 2: 41-44.
  10. Asensio J.A., Demetriades D., Chahwan S. et al. Approach to the management of complex hepatic injuries. [ Approach to the management of complex hepatic injuries.] J. Trauma, 2000; 48: 66–69.
  11. Beckingham I.J., Krige J.E.J. Liver and pancreanic trauma. [Liver and pancreanic trauma.] Br. Med. J., 2001; 322: 31: 3: 783-785.
  12. Boggi U. Extracorporeal Repair and Liver Autotransplantation after Total Avulsion of Hepatic Veins and Retrohepatic Inferior Vena Cava Injury Secondary to Blunt Abdominal Trauma. [Extracorporeal Repair and Liver Autotransplantation after Total Avulsion of Hepatic Veins and Retrohepatic Inferior Vena Cava Injury Secondary to Blunt Abdominal Trauma.] J. Trauma, 2006; 60: 405-406.
  13. Brown M.A., Casola G., Sirlin C.B. et al. Blunt abdominal trauma: screening us in 2,693 patients. [Blunt abdominal trauma: screening us in 2,693 patients.] Radiology, 2001; 218: 2: 352-358.
  14. Dagher I., Giuro G., Dubrez J., Lainas P. et al. Laparoscopic versus open right hepatectomy: a comparative study. [Laparoscopic versus open right hepatectomy: a comparative study.] Am. J. Surg., 2009; 198(2): 173-177.
  15. Hirshberg A., Mattox K.L. "Damage control" in trauma surgery. ["Damage control" in trauma surgery.] Brit. J. Surg., 1993; 80: 12: 1501-1502.
  16. Jurkovich GJ., Greiser W.B., Luterman A. et al. Hypothermia in trauma victims: an ominous predictor of survival. [Hypothermia in trauma victims: an ominous predictor of survival.] J. Trauma, 1987; 27: 9: 1019-1024.
  17. Kahdi F., Udobi K.F., Rodrigues A. et al. Role of ultrasonography in penetrating abdominal trauma: a prospective clinical study. [Role of ultrasonography in penetrating abdominal trauma: a prospective clinical study.] J. Trauma, 2001; 50: 3: 475-479.18. Muller G., Little К. The basis and practice of traumatology. London: Heinemann Medical Books, 2001; 33-39.
  18. Sosa J.L., Arrilaga A.N., Puente I.T. et al. Laparoscopy in 121 consecutive patients with abdominal gunshot wounds. [Laparoscopy in 121 consecutive patients with abdominal gunshot wounds.] J. Trauma, 1995; 39: 3: 504-506.

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