The lecture provides relevant information for doctors of various specialties: oncologists, surgeons, mammologists, general practitioners on the problems of diagnosis and treatment of benign breast formations. The issues of etiology and pathogenesis, classification and clinical picture of various formations are highlighted, diagnostic methods, differential diagnostics, treatment tactics and methods of surgical treatment are described in detail.
The article deals with the problems of surgical treatment of skin melanoma. Modern surgical treatment of skin melanoma includes various surgical interventions: wide excision of primary skin melanoma, amputation of the finger or disarticulation of the phalanx of the finger, resection of the auricle with its reconstruction, and other operations. The paper discusses the importance of assessing the state of regional lymph nodes in skin melanoma to decide whether to perform lymph node dissection. In addition to adequate excision of primary skin melanoma, to ensure the radicalness of surgical treatment, according to indications, lymph node dissection is performed in case of met astatic lesions of regional lymph nodes. A modern approach to detecting latent metastases involves performing a biopsy of sentinel lymph nodes. The information obtained is extremely important not only in assessing the damage to regional lymph nodes, determin ing the stage of the disease, but also in choosing the tactics of treatment and predicting the course of the tumor. Significant in the work is the conclusion that regional lymph node dissection is performed only in case of met astatic lesions of regional lymph nodes, confirmed morphologically. Accordingly, the best option is to perform regional lymph node dissection simultaneously with excision of primary skin melanoma. Prophylactic lymph node dissection for skin melanoma is not recommended. In conclusion, the latest trends in the surgical treatment of skin melanoma are indicated: an adequate reduction in the indentation and volume of operations when removing primary melanomas, an increase in the role of sentinel lymph node biopsy, the need for morphological verification of lymph node involvement in justifying lymph node dissection, and an increase in the number of metastasectomy.
The lecture provides information for medical practitioners on the problems of modern diagnosis of breast pathology. The methods of the research, the advantages and disadvantages of each method are described in detail. The questions of differential diagnosis are presented, the optimal schemes and approaches in the diagnosis of the most common diseases of the mammary gland are described.
The article is devoted to the diagnosis and treatment of focal formations mammary gland. To clarify the diagnosis, it is important complex research: ultrasound, x-ray mammography, fine needle aspiration biopsy, magnetic resonance imaging, etc. Traditionally, the last stage of diagnosis and conventional treatment in clinical practice remains a sectoral resection with urgent histological examination of the surgical material. The proposed method of vacuum aspiration-resection biopsy is a promising minimally invasive technology and allows you to delete all visualized by means sonography the non-palpable tumors up to 2 cm. The advantage of this method is its minimal invasiveness, the use of local anesthesia and outpatient settings. According to the authors, in the future, the method of vacuum aspiration-resection biopsy can significantly reduce the number of traditional sectoral resections with lower financial costs. The authors emphasize the predominance in perspective the method of vacuum aspiration-resection biopsy to clarify the diagnosis of focal formations up to 1 cm, especially non-palpable character.
Percutaneous endoscopic gastrostomy is the most common method for long-term enteral nutrition in patients with organic and functional diseases of the esophagus, with severe neurogenic oropharyngeal dysphagia as a result of acute cerebral circulatory disorders, oropharyngeal cancer, severe facial injuries, etc. The advantages of endoscopic surgery are the minimally invasive nature and speed of the intervention, an insignificant percentage of postoperative complications. The review article analyzes data on the relevance of the problem, indications and contraindications, technique of execution, complications of percutaneous endoscopic gastrostomy. Measures aimed at minimizing risks during this operation, including correction of the general condition and concomitant somatic diseases in patients, a thorough assessment of the risk of surgery, which have the greatest impact on the immediate results of the operation, are identified.
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