Background: Pancreatogenic splenic pseudocysts are a relatively rare condition. Intra-splenic localization is of the splenic pseudocysts is dangerous because of the possibility of massive haemorrhage and organ rupture. Aim: To analyse our experience in the diagnosis and treatment of pancreatogenic pseudocysts of the spleen. Materials and Methods: The analysis of the short and long-term results of treatment of the 34 patients with pancreatogenic splenic pseudocysts (extrapancreatic localization) (1985-2019) was performed. In the study, the majority of male patients - 88.2%, the age of patients was 45 ± 7 years. Results: Percutaneous drainage under US-control was performed in 11 (32.4%) patients, distal pancreatic resection with splenectomy was performed in 23 (67.6%) in the cases of pancreatic tail calcific pancreatitis. In all cases of percutaneous treatment, a high level of amylase was found in the fluid from pseudocysts. Bacteriological confirmation of the growth of any bacteria in the content was not obligatory. Suppuration of the fluid of the pseudocyst was observed in 85.3% of the cases. Conclusion: Pancreatogenic pseudocysts of the spleen are one of the complications of destructive pancreatitis. They can remain undiagnosed for a long time, become infected and aggravate the course of the disease. They are often the cause of the development of sepsis and peritonitis due to the rupture of the organ capsule and bleeding into the abdominal cavity. The use of percutaneous minimally invasive methods of treatment for intra-organ pancreatogenic pseudocysts makes it possible to improve the results of treatment in this group of patients, and also, in the optimal case, be the final method of treatment.
Intraoperative ultrasound (IOUS) is a diagnostic technique that allows obtaining additional information about the number and localization of colorectal cancer (CRC) metastases in the liver (especially with their intraparenchymal location), determining their relationship with the arteries and veins of the liver, navigating for puncture biopsy and / or performing minimally invasive treatment of lesions, and adjusting the amount of resection intervention on the liver during surgery. When performing minimally invasive medical procedures, IOUS application helps to avoid injuries to blood vessels, bile ducts and adjacent organs, and also allows evaluating the effectiveness of treatment and identifying potential complications. An important component of IOUS is the support of surgical procedures with a staged assessment of the liver hemodynamics, providing an immediate correction of the surgical situation. Thus, IOUS is a safe, inexpensive and highly informative diagnostic option, which should be a mandatory diagnostic step in the surgical treatment of CRC liver metastases.Based on literature data and personal experience, the authors present indications, technical aspects and features of application of various IOUS options and modalities in the surgical treatment of CRC liver metastases.
Background: Сombined treatment for patients with metastatic liver damage offers better long-term outcome, and laser ablation can increase the indications for liver resection for somatically burdened patients. Methods: The Results of treatment of 28 patients with metastatic liver damage and using laser ablation technique for the period from March 2017 to 2018, women 17, men 11, average age was 61 AE 2.7 years. All patients in the preoperative stage performed removal of the primary focus in the volume of R0 and lymphadenectomy D1, D2 and are at different stages of chemotherapy. Laser ablation of liver formations was performed percutaneously transhepatic, under the control of ultrasonic scanning in real time. For laser ablation, ECHO LASER, manufactured in Italy, was used, a 4-channel multiple source with a complex ultrasound system, using laser radiation with a wavelength of 1064 nm. Control of the effectiveness of the effect was carried out by ultrasound, MRI and CT with intravenous bolus enhancement in dynamics. Result: In the early postoperative period pain syndrome was noted, within 3 days, stopped with the use of analgesics, biochemical analyzes (ALT, AST, AP) were observed for 10 days. In the early postoperative period, formation under the capsular hematoma, in the area of "h"hthe light guide, was not required, which did not require surgical intervention. In 4 patients, at 6 months, progression of the disease was noted, followed by liver resection. Morphological examination of the ablation zone shows pathomorphosis of the fourth degree (according to Lushnikov). The average bed-day was 4 days. Conclusion:The use of laser ablation allows several nodes to act simultaneously. Due to low traumatism and
Цель. Улучшение результатов лечения, качества и продолжительности жизни, прогноза у пациентов с метастазами колоректального рака в печени. Материал и методы. Анализировали отдаленные результаты лечения 94 пациентов с метастазами колоректального рака в печени (2014-2019). В 87 (92,6%) наблюдениях выполнили различные оперативные вмешательства. Сегментэктомию выполнили 23 больным, сегментэктомию с радиочастотной абляцией (РЧА)-7, сегментэктомию с криоабляцией-3, сегментэктомию с РЧА и криоабляцией-3. Также гемигепатэктомию выполнили 15 больным, расширенную гемигепатэктомию-13, гемигепатэктомию с РЧА-1, расширенную гемигепатэктомию с РЧА-2. РЧА и криоабляцию выполнили в 8 наблюдениях, трансартериальную химиоэмболизацию-в 12. Средний возраст пациентов составил 56,3 ± 3 года. Всем больным в дальнейшем проводили адъювантную химиотерапию; в 9 наблюдениях ее дополнили регионарной химиоэмболизацией. Результаты. В ближайшем послеоперационном периоде отмечено 30 (34,5%) осложнений. Актуариальная однолетняя выживаемость оперированных пациентов составила 63%, трехлетняя-34%, пятилетняя-28%. Заключение. Дифференцированный подход к локальной деструкции колоректальных метастазов в печени позволяет добиться удовлетворительных отдаленных результатов при множественных билобарных поражениях. Залогом успеха является мультидисциплинарный подход к лечению.
Aim. To improve the treatment outcomes, quality and life expectancy, prognosis in patients with hepatocellular carcinoma based on an analysis of treatment outcomes.Materials and methods. The analysis of the long-term results of treatment of 114 patients with hepatocellular carcinoma for 2015–2020 was carried out. Two groups of patients were distinguished: 41 (35.9%) patients were included in group I (a potentially resectable tumor with R0 surgery), and 63 (55.2%) patients were included in group II (advanced tumor does not suggest R0 resection).Results. Actuarial survival for patients with R0 surgery (48) was: 1 year – 85%, 3 years – 65%, 5 years – 55%; in patients with unresectable tumor after transarterial chemoembolization: 1 year – 65%, 3 years – 29%, 5 years – 11%; after local destruction methods – 0.5 years – 75%, 1 year – 36%, 1.5 years – 22%.Conclusions. The results of treatment of patients with hepatocellular carcinoma confirm the feasibility and effectiveness of a rational multidisciplinary approach. It allows you to achieve satisfactory results in multidisciplinary hospitals. The results are consistent with the data of large surgical centers.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.