Vol 13, No 4 (2020)

Cancer of the fallopian tube is a rare and difficult condition to be treated. It is often clinically simulated by ovarian epithelial cancer or primary ovarian and peritoneal carcinomas. Most of relapses in these tumors are observed in the small pelvis. Extrapelvic relapses and metastases to other organs are rather uncommon. Surgical cytoreduction and platinum-based chemotherapy are the mainstay of treatment.
The authors present a rare and noteworthy clinical case of recurrence of high-grade serous carcinoma of the right fallopian tube involving the caecum dome and rectum in a 65-year-old female patient. There was demonstrated the choice of surgical treatment tactics in this clinical case that allowed obtaining a 62-month survival result.

Backgraund. Spleen surgery is mainly aimed to achieve effective hemostasis. The increasing popularity of topical hemostatic drugs is limited by their common side effect associated with the development of adhesions.
The aim of study was to develop a new hemostatic drug with anti-adhesion activity. To achieve this, the authors have investigated 6% sodium carboxymethylcellulose gel with the addition of 5% aminocaproic acid.
Materials and methods. The efficacy of the sample was studied experimentally in laboratory animals (rats, n = 87). The time of bleeding arrest, the amount of blood loss, the severity of the adhesion process, morphological and histological changes in tissues in the area of material implantation were assessed.
Results. The study results evidenced that the new hemostatic drug reduced bleeding time by 68% (222.27 sec) and blood loss by 69% (285.6 mg) (p <0.01) after partial splenectomy, and prevented the development of adhesive process compared to the results obtained in the animals of the control group. On the 3rd day of the experiment application of the sample demonstrated that adhesions were completely absent, the coefficient of the severity of the adhesive process was 0 points; on the 7th and 14th days it was minimal - 0.481 and 0.486 points, respectively (p <0.05). A morphological study showed that the use of the new composite reduced the white pulp immunological reactivity associated with postoperative inflammatory processes, which is manifested by smaller lymphoid follicles and lower CD4 + T-lymphocytes expression.
Conclusions. Thus, 6% sodium carboxymethylcellulose gel with the addition of 5% aminocaproic acid is an effective combined hemostatic and anti-adhesion agent that can be effectively applied in spleen surgery.

Background. Chest deformities occur in 7% of the population, of them funnel deformation of the thorax constitutes more than 80%. Surgical correction appears to be the only way to change the configuration of the chest. The Nuss procedure is the "gold standard" to correct this deformity. This technique was modified in the clinic of the Department of Pediatric Surgical Diseases, Siberian State Medical University, Tomsk. The necessity to compare the Nuss procedure and its modified option has arisen due to accumulated experience in surgical interventions performed.
The aim of the study was to describe a modified technique of the funnel deformation of the thorax and assess its effectiveness compared to the classical Nuss procedure.
Material and methods. The study included results of surgical treatment of 94 children, both sexes, aged 10 to 17 years, who had the funnel deformation of the thorax. All patients were divided into two groups: the main group (45 patients), where a modified technique of surgical correction was applied, and the comparison group (49 patients), where the classical Nuss procedure was applied for the deformity correction. For the surgical correction of the funnel deformity of the thorax, improved plates made of smooth titanium nickelide were used to fix the sternocostal complex in children of the main group. The following criteria were selected to compare the effectiveness of two surgical options of the funnel deformation correction: intraoperative parameters, Gizycka index, the scale of role functioning SF-36, VAS of pain and the number of complications. The arithmetic mean number was derived based on the above criteria - the total efficiency coefficient; clinical results were defined depending on this coefficient - good, satisfactory and unsatisfactory.
Results. The number of good results in patients of the main group, where modified surgery technique was applied, was 62.3% compared to 38.8% in patients who were exposed to the Nuss procedure. The number of satisfactory results in patients of the main group was 35.5% compared to 34.7% in patients of the comparison group. It should be noted that the use of the modified technique had unsatisfactory results in 2.2% of cases (in 1 patient), while the use of the conventional Nuss procedure resulted in unsatisfactory outcomes in 26.5% of cases.
Conclusions. Clinical outcomes of surgical correction performed using modified technique of the Nuss procedure are more beneficial in terms of the duration of intervention, the volume of blood loss, and the number of postoperative complications. This technique allows minimizing invasiveness of the procedure and starting early rehabilitation.

Impaired patency of the gastrointestinal and urinary tract, and bile ducts is one of the essential problems in oncological practice in patients with tumors of various localizations. Stenoses are one of the most severe complications of the course of tumor diseases.
Obstruction is a polyetiological condition that can result from a primary tumor lesion and specific neoplastic processes of nearby organs and structures. Sometimes narrowing of the lumen of organs and ducts can occur as a result of reactive scar tissue changes along the periphery of tumors. In some cases stenosis manifests itself as a complication of certain stages of treatment (surgical, radiation).
The development of stenoses of the large intestine, the pylorus, the bile and urinary tracts significantly reduces the quality of life of patients due to the increasing obstruction of the above structures. Elimination of this syndrome is the main aim of treatment, regardless of the presence of tumor or non-tumor complications that have arisen.

Introduction. The choice of treatment options of foot deformity in children is the most acute in the first years of life. In this regard, the need for hospital stay of a child is debatable today. A number of interventions in the treatment of foot pathology can be performed on an outpatient basis.
The aim of this study was to improve clinical outcomes of pes equino-varus treatment using the Ponseti procedure, and the Dobbs vertical talus correction combined with massage, physiotherapy and exercise therapy on the outpatient and inpatient basis in pediatric population.
Methods. The study included 106 children who were examined and treated at N.F. Filatov Children's City Clinical Hospital in 2015-2020.
Results. The study revealed that, if left untreated, the orthopedic pathology of the feet in children is often accompanied by pain, functional changes and a high risk of disability, the fact evidencing high social significance of the studied nosology. In all examined children a congenital deformity of the foot was completely eliminated after a comprehensive assessment and a combination of conservative and surgical correction techniques.
Conclusions. Careful adherence to the Ponseti procedure is required to achieve a complete pes equino-varus correction. Early beginning of correction is the most beneficial due to its effectiveness.

The paper provides an overview of various treatment options for chronic hemorrhoids based on current national and international recommendations. The publication describes the basic principles of effective conservative therapy of the disease. Methods of minimally invasive treatment options for chronic hemorrhoids are given in details: sclerotherapy, infrared coagulation, latex ligation; advantages and disadvantages of each of these methods are highlighted. Literature data indicate that surgical removal of hemorrhoids remains an effective method of treatment for patients with hemorrhoids stage III – IV, who underwent unsuccessful minimally invasive procedures. The characteristics of possible complications after hemorrhoidectomy and the frequency of their occurrence are also given. The authors analyze results of using stapler hemorrhoidopexy and the technique of Doppler-controlled ligation of hemorrhoidal arteries. Despite the variety of techniques, it remains relevant to search for further treatment options for chronic hemorrhoids in order to choose an effective individual treatment tactics for each patient, taking into account various manifestations of hemorrhoidal disease.

-

-