государственный электротехнический университет «ЛЭТИ», 2 Первый Санкт-Петербургский государственный медицинский университет им. акад. И. П. Павлова

Introduction: A sentinel lymph node biopsy (SLNB) is a standard procedure for surgical staging in the early stage of breast cancer, avoiding excess lymphadenectomy in most patients. Among the new methods of SLNB, there is a prospective method based on the use of indocyanine green (ICG) as a contrast medium. Numerous studies to assess the possibility of the routine use of ICG fluorescence method generally favored the use of ICG. The main issue discussed is whether it can be used alone or in combination with the RI method. In this work, using the specified device, we conducted a study aimed at intercomparing of ICG fluorescence imaging and the radioactivity detection methods in order to assess prospects for the use of the ICG method of imaging for SLN detection in early-stage breast cancer. Material and Methods: A prospective, non-randomized single-center study was conducted at the oncological breast unit Pavlov State Medical University, Russia. The study included 32 patients aged from 34 to 78 (median-55.2 years) with breast cancer (cTis-3, N0-2). 4 patients underwent surgery after neoadjuvant systemic treatment. 30-45 minutes before the surgery, additionally, 2 ml of the ICG solution was administered near the tumor margin via single skin puncture. The solution was prepared by dissolving 25 mg ICG in 20% of human albumin. Then the place of injection was massaged for at least 5 minutes. SLN biopsy was performed by two criteria by the presence of radioactivity in the axillary region, which was monitored using a handheld gamma-detector or by the ICG fluorescence, location of which was visualized using the ICG-Scope system. The lymph node was recognized as a sentinel if its intensity exceeded the background radioactivity level of 99mTc or exceeded the threshold value upon the ICG fluorescence, which was 1% of the standard sample intensity.

Background. In two-stage deep periprosthetic infection treatment, many authors describe mechanical complications associated with the implantation of a spacer in the first stage that affect the functional outcome of the treatment.Purpose. To evaluate the functional results of using 3D spacers for IIIA and IIIB defects according to the classification system described by W.G. Paprosky during the first stage treatment of hip deep periprosthetic joint infection (PJI).Methods. From 2017 to 2020, 24 patients underwent first-stage revision arthroplasty with hip PJI and IIIA and IIIB acetabular bone defects according to the classification system described by W.G. Paprosky. The patients were divided into 2 groups: group 1 received articulating spacers, and group 2 received custom-made spacers made using 3D technology. Function was evaluated by the Harris Hip Score, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and VAS (visual analogue scale). Statistical analyses were performed using IBM SPSS Statistics version 22.0 for Windows. Student's t-test, Wilcoxon's signed-rank test (to compare parameters before and after surgery) and the Mann-Whitney rank-sum test were used.Results. In the first group, the average VAS score was 3.3 (± 1.4), the Harris Hip Score was 51.3 (± 9.4), and the WOMAC score was 42.9 (± 5.9); in the second group, the VAS score was 1.3 (± 0.9), the Harris Hip Score was 69.7 (± 3.6), and the WOMAC score was 30.1 (± 2.4). The rating scale data showed a statistically significant improvement in the function of patients in the second group (p <0.05).Conclusion. Custom-made 3D spacers used during the first stage of treatment for deep periprosthetic hip infection yield larger improvements in function and quality of life than do articulating spacers.Trial registration. Local Ethics Committee at the Sechenov First Moscow State Medical University Ministry of Health of Russia (Sechenov University) № 386 13.12.2016.