Objective: to perform a comparative analysis of postoperative complications and hospital stay terms of in-patients with malignant liver tumors after atypical liver resection and locoregional radiofrequency ablation of liver metastases.Material and methods. We analyzed the data of 295 patients with malignant liver tumors who had undergone surgical resection or radiofrequency ablation of tumor nodes.Results. We have systemized the direct results of locoregional radiofrequency ablation under sonographic control and liver resection. 45 patients (17.8 %) after liver resection and 1 (2.3 %) patient after radiofrequency ablation developed grade III–IV complications according to the Clavien-Dindo classification. The frequency of complications is statistically significantly lower after radiofrequency ablation. The duration of hospital stay after radiofrequency ablation therapy was 4.5 ± 2.5 days. After surgical liver resection, patients stayed in hospital for 10.7 ± 2.3 days.Conclusion. Locoregional therapy provides a statistically significant reduction in the incidence of complications and reduces the duration of hospital stay compared to liver surgery.
Objective. To evaluate the effectiveness of preoperative coagulation of the vein adjacent to a tumor nodule in sonographically-guided percutaneous radiofrequency thermal ablation of perivascular liver metastases of colorectal cancer.Materials and methods. To address the issue, we compared the results of sonographically-guided percutaneous radiofrequency thermal ablation of perivascular liver metastases of colorectal cancer in 27 patients (aged 60.5 (58; 68) years) without prior coagulation of the adjacent vein (control group) and 26 patients (62.0 (60; 74)) with prior coagulation of the adjacent vein (experimental group).Results. Lower incidence of residual tumor in the ablation area in the patients with prior coagulation of the adjacent vein (14.3 % vs. 29 % of the patients in the control group) and a higher relapse-free survival of such patients (65.2 % vs. 53.6 % and 55.6 % vs. 33.3 %) were reported as compared to the group without prior coagulation of the adjacent vein (after 6 and 12 months, respectively).Conclusion. Preoperative coagulation of the vein adjacent to colorectal cancer liver metastasis allows reducing the effect of heat removal from the RFA zone, thereby contributing to higher radicality of the treatment and resulting both in a lower incidence of residual tumor in the ablation zone and a higher relapse-free survivalof patients, notably without signifcant concomitant changes in the affected part of the liver (segment atrophy).
Objective. To present a clinical case of diagnosis and surgical treatment of one of the forms of extragenital endometriosis – umbilical ring endometriosis.Materials and methods. A clinical case of patient M., 33 years old, female, with diagnosed and operated endometrial heterotopia in the projection of the soft tissues of the umbilical region.Results. The probable role of the migration theory of the pathogenesis of endometriosis is demonstrated due to the lack of a history of surgical treatment in this area.Conclusion. The migration theory of the pathogenesis of endometriosis can be explained by the mechanism of retrograde penetration of endometrial cells through blood and/or lymphatic vessels from the pelvic cavity.
Objective: to systematize the existing techniques of ultrasound-guided percutaneous radiofrequency ablation.Materials. The research subjects were 34 patients with focal liver malignancies who had undergone radiofrequency ablation at Gomel Regional Clinical Oncology Center from 2014 to 2019.Results. The data about the existing techniques of ultrasound-guided percutaneous radiofrequency ablation have been systematized. The possibilities to increase the ablation efficiency of the liver tumor foci have been determined. The main components of the treatment algorithm that allow to achieve the best ablation results have been identified.Conclusion. Strict adherence to the described techniques of radiofrequency ablation which takes into account tumor vascularisation makes it possible to achieve complete necrosis of the foci with no complications in 82.4 % of the patients, and minor complications that do not require therapy in 17.7 % of the patients [9].
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