OBJECTIVE. The article analyzed the experience of treatment of endometriosis-related pneumothorax (ERP). MATERIAL AND METHODS. The diagnosis of ERP was detected in 30 women at the period from 2004 to 2015. A control group consisted of 149 women. RESULTS. Statistically significant differences associated with presence of ERP were the elder age, right-side localization and recurrence course of disease. Diaphragmatic fenestrations and endometriotic ectopy and their combinations were specific findings in ERP-group. This group of patients characterized by frequent recurrences and higher rate of complications. The most effective method of treatment of ERP was diaphragm resection with pleurectomy and hormone therapy from 3 to 6 months after surgery. CONCLUSIONS. Endometriosis-related pneumothorax could cause up to 34 % cases of spontaneous pneumothorax in women of reproductive age. Diaphragmatic fenestrations and endometriotic lesions were specific signs of EAP. Direct visual examination of the pleural cavity was inevitable for reliable diagnostics of the disease. Surgical treatment of ERP was determined by higher rates of complication and recurrence. Postoperative hormone therapy could significantly improve the results of surgical treatment of ERP.
Введение. Триада Карнея-редкий синдром, характеризующийся сочетанием гастроинтестинальной стромальной опухоли желудка, функционирующей экстраадренальной параганглиомы и легочной хондромы, впервые описанный J. A. Carney, патологом клиники Мейо, в 1977 г. у 7 пациентов [1]. Заболевание развивается в основном у молодых женщин, средний возраст проявления синдрома около 20 лет. Строгого хронологического порядка появления образований не существует, поэтому наличие двух из трех опухолей принято рассматривать как проявление триады Карнея, которая в таких случаях 97
The article presents an initial Russian experience of video-thoracoscopic bronchoplastic lobectomies performed in 2 clinical cases of centric lung tumors. The upper bronchoplastic lobectomies with right lymphodissection were carried out on two patients in 2012. Complications weren’t observed in intraoperative and postoperative periods. There wasn’t relapse during two years after operation. Thus, the authors came to conclusion that thoracoscopic bronchoplastic lobectomies turned out to be safe and effective interventions in individual patients with centric tumor location, which wasn’t extended outside mouth of the lobar bronchus. The choice of candidates for thoracoscopic bronchoplasty was made using video-bronchoscopy, angio-computer tomography of the thorax and PET. This allowed avoiding an invasive staging and excluded patients with substantial extra-bronchial lesions.
Nowadays, robotic systems are becoming an important part of our lives, and medicine is no exception. Since lung cancer is in the first place in the number of deaths from cancer, doctors do not stop looking for new ways of treating it. To reduce the number of relapses after surgical removal of the tumor, it was proposed to use the method of intraoperative radiotherapy (IORT). To make it possible, the surgeon have to be equipped with a convenient device that he can use directly in the operating room after surgical resection. IORT after surgical removal of a tumor using a low-voltage x-ray source is a relatively new method used in the treatment of lung cancer. This article discusses a robotic system for performing IORT and the method of its use. Currently, there is a working prototype of this system and we are still improving it. The paper presents the main technical characteristics of the robot manipulator and the working tool, namely the x-ray tube mounted on the manipulator. Moreover, the software and its architecture are described, as well as a method for managing the manipulation system. A comparison of our development with foreign ones is also performed.
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