Introduction.
True doubling of great saphenous vein is observed in 1.6–2.1% of patients with varicose veins and may be one of the reasons for the development of postoperative relapse of the disease. ...Performing endovasal laser coagulation (EVLC) of both great saphenous vein trunks makes it possible to increase the radicality of the intervention and reduce the likelihood of a recurrence of varicose veins.
Aim.
Based on the study of immediate and long-term results, to substantiate the expediency of using EVLC of the main and true additional stem of great saphenous vein in patients with varicose veins.
Materials and methods
. From 2014 to 2020, 24 patients with a true doubling of great saphenous vein were treated. Among the applicants there were 12 women and 12 men aged 23 to 62 years with clinical class C2–C4 according to the CEAP (Clinical, Etiologic, Anatomic, Pathophysiologic) classification. All patients under tumescent anesthesia underwent simultaneous EVLC of the main and accessory trunk of the BPV, followed by miniflebectomy or sclerobliteration of varicose tributaries.
Results and discussion
. The use of simultaneous coagulation of both trunks was performed by all patients, thus the technical success of the operation was observed in 100% of cases. There were no intraoperative complications. The use of such a volume of intervention is accompanied by an increase in the duration of the operation by 29.3%. Hyperpigmentation in the projection of the coagulated trunk was observed in 2 (8.3%) patients, neurological disorders – in 1 (4.2%) patient. During the examination of patients 1–2 years after the operation, no relapses of the disease were detected, and the cosmetic result of the intervention on a ten-point scale, patients on average estimated at 7.6 points.
Conclusions
. True doubling of the great saphenous vein is rare and may increase the likelihood of relapses of the disease. EVLC of the main and additional BPV trunks is accompanied by an increase in the duration of surgery by an average of 29.3%, and the number of patients with hyperpigmentation by 1.5 times. Simultaneous EVLC of both tables with true duplication of BPV makes it possible to reliably block a potential source of varicose disease recurrence and reduce the likelihood of recurrent veins.
To analyze the results of redo reconstructions of lower limb arteries in patients with obliterating atherosclerosis, immediate and long-term results in patients who underwent reconstructive ...interventions with occlusion of previous reconstruction and preventive interventions.
The study included 43 patients. The main group (group 1) consisted of 18 patients who underwent preventive vascular reconstructions. The control group enrolled 25 patients who underwent redo interventions for occlusion of previous reconstructions. The control group was divided into 2 parts; 15 patients had chronic limb ischemia (group 2), 10 patients had acute limb ischemia (group 3). Mean age of patients was 56.8±8.2 years; there were 37 (86%) men and 6 (14%) women. Multifocal vascular atherosclerosis was noted in 41 (95.3%) patients, carotid artery lesion - 29 (70.7%), coronary artery disease - 34 (79%). Patients with type II diabetes mellitus were excluded.
We chose each surgical intervention considering preoperative diagnostic data. Open, endovascular and hybrid interventions were performed. There were no deaths and limb amputations in the 1
group. Two (13.3%) amputations were registered in the 2
group, 3 (30%) amputations and 1 (10%) death were registered in the 3
group. The follow-up period was 24 months. An 18-month freedom from amputations was 71.5%, 78% and 38%, respectively (
<0.05 compared to the 1
and 2
groups).
Preventive surgical interventions prevent ischemia and amputation, as well as improves the results of redo surgery.
Introduction
. The wide prevalence of varicose veins of the lower extremities and relapses of this disease causes a frequent combination of this pathology with other surgical and traumatological ...diseases. The expediency of using simultaneous operations is manifested in their obvious economic advantages.
Objective
. To substantiate the expediency and effectiveness of simultaneous laser thermal obliteration of recurrent veins of the lower extremities and Baker’s cyst.
Materials and methods
. 9 patients with recurrent varicose veins and Baker’s cyst were operated on. Of these, there were 7 (77.8%) women and 2 (22.2%) men, the average age was 52.8 ± 0.2 years. The average duration of the incidence of varicose veins was 14.1 ± 0.3 years, Baker’s cyst – 3.5 ± 0.1 years. As planned, patients underwent simultaneous laser endovenous coagulation of recurrent veins and intracavitary thermal obliteration of Baker’s cyst.
Results
. There were no complications, the duration of operations was 40.3 ± 0.4 minutes. The intensity of the pain syndrome in 6–8 hours after surgery was 4.1 ± 0.2 points. On the 10th day, no pain was observed in any patient. The duration of pain was 7.8 ± 0.4 days. Long-term results were studied 12–16 months after completion of treatment in 9 (100%) patients. Recurrent varicose veins were not detected. In 8 (88.9%) patients, complete obliteration of Baker’s cyst was established.
Conclusions
. Reliable obliteration of Baker’s cyst and recurrent varicose veins, 100% technical success, disappearance of clinical symptoms of this pathology, absence of relapses of both diseases in 8 (88.9%) patients after 12-16 months indicates high efficiency and indisputable prospects of such an approach to the treatment of this category of patients. However, the study is based on a small number of observations, so further accumulation of experience is required to generalize the results of the study.
Introduction
. Sclerobliteration of varicose veins of the lower extremities is one of the most common methods of treating patients with varicose veins. However, the main disadvantage of ...echosclerobedation of the trunks of the great and small saphenous veins is the possibility of recanalization of sclerosed veins. In this regard, it is of interest to compare the results of using radiofrequency vein obliteration and endovenous laser coagulation in these patients.
Aim
. To study the effectiveness, advantages and disadvantages of the use of radiofrequency vein obliteration and endovenous laser photocoagulation of recanalized varicose veins in patients undergoing sclerobliteration.
Materials and methods
. 44 patients aged 18 to 62 years underwent radiofrequency obliteration and endovenous laser coagulation of varicose veins after previous sclerobliteration. A comparative assessment of the duration of the operation, technical success, intensity of the pain syndrome, the level of postoperative complications and relapses of the disease after the use of these methods of recanalized saphenous veins after previous sclerotherapy was made.
Results and discussion
. The technical success of endovenous laser coagulation of reknalizirovanny varicose veins was 100%, radiofrequency obliteration of veins – 90.9%. The intensity of postoperative pain on the 7
th
day from the moment of radio wave exposure was 12.1% lower than after the use of endovenous laser coagulation, the average duration of laser thermolysis was 32 ± 0.6 minutes, radio wave – 39 ± 0.7 minutes.
Conclusion
. Laser coagulation compared to radiofrequency is a more reliable and feasible operation, but is accompanied by a higher level of postoperative pain and side effects.
Background
Studies reporting outcomes of endoscopic treatment methods in children who underwent liver transplantation (LT) is very limited. We present our outcomes, as a high-volume transplant center ...where endoscopic methods are preferred as the first choice in the treatment of biliary complications in children.
Methods
Patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) as the first treatment approach for biliary complications after LT between 2005 and 2017 were included. Clinical data included patient demographics, ERCP indications (stricture or leak), and treatment outcomes, including the need for percutaneous and surgical intervention.
Results
ERCP was performed in 49 patients who had a duct-to-duct anastomosis (38 living donor liver transplantation (LDLT), 11 deceased donor liver transplantation (DDLT)). The most common biliary complication was stricture. Our endoscopic success rate was 66.7% (18/27) and 75% (6/8) in LDLT and DDLT patients with stricture (
p
> 0.05), respectively. While our endoscopic success rate was 75% (3/4) in patients with leak alone after LDLT, it was 25% (1/4) in patients with leak and stricture in this group. The endoscopic success rate was 50% in two patients who had leak alone after DDLT.
Conclusions
ERCP should be considered as a preferential treatment option for the management of biliary complications in pediatric liver transplant patients with duct-to-duct anastomosis, as in adults.
We report results on event-by-event fluctuations of transverse momentum, Phi(p(t)), in pi(+)p and K(+)p collisions at 250 GeV/c. For the first time, their dependence on rapidity region, transverse ...momentum acceptance, multiplicity, mean transverse momentum per event, and on the correlation between transverse momentum and multiplicity are systematically presented. The results are compared with those from the PYTHIA Monte Carlo generator. The fluctuations under the same acceptance cuts as used in current heavy-ion experiments are also presented.
The transverse energy carried by charged hadrons and by \({\pi}^-\) mesons is studied in interactions of \({\pi}^+\) and K\(^+\) mesons with protons and nuclei at 250 GeV/c. The data obtained on ...transverse energy flow at mid-rapidity can be described by the FRITIOF7.0 model with tuned parameters.
We present a new measurement of $J/\psi$ production in Pb-Pb collisions at 158 GeV/nucleon, from the data sample collected in year 2000 by the NA50 Collaboration, under improved experimental ...conditions with respect to previous years. With the target system placed in vacuum, the setup was better adapted to study, in particular, the most peripheral nuclear collisions with unprecedented accuracy. The analysis of this data sample shows that the ($J/\psi$)/Drell-Yan cross-sections ratio measured in the most peripheral Pb-Pb interactions is in good agreement with the nuclear absorption pattern extrapolated from the studies of proton-nucleus collisions. Furthermore, this new measurement confirms our previous observation that the ($J/\psi$)/Drell-Yan cross-sections ratio departs from the normal nuclear absorption pattern for semi-central Pb-Pb collisions and that this ratio persistently decreases up to the most central collisions.
Alpha 1 antitrypsin (AAT) deficiency is a hereditary disorder leading to severe lung and liver diseases worldwide. An accumulation of insoluble heterodimer AAT molecules in hepatocytes is the main ...cause of liver disorders. The most commonly detected allele worldwide is the PIMM allele, which fulfills the AAT function. The most common missing variant is PiZZ. Serum AAT level is a beneficial but not a reliable determinant for diagnosis. Liver biopsy yields more reliable results. AAT deficiency has no specific treatment. The only treatment modality in children with end stage liver disease is the hepatic transplant. We wanted to present in our article four cases from same family, diagnosed alpha-1 antitrypsindeficiency in adulthood.
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