Mini-invasive Treatment Research Articles

Мініінвазивне лікування солітарних непаразитарних кіст паренхіматозних органів у дітей

Мініінвазивне лікування солітарних непаразитарних кіст паренхіматозних органів у дітей

The lignans 7-hydroxymatairesinol application in adjuvant therapy of gynecological diseases

The antioxidant effects of lignan - 7-hydroxymatiresinol as complementary therapy for gynecological diseases Relevance. The work is devoted to the study of the antioxidant effect of lignan - 7-hydroxymatairezinol in various gynecological diseases. Materials and methods. The study included 30 women taking lignan - 7-hydroxymatairezinol (in a dose of 30 mg/day for 60 days), which was conducted mini-invasive or surgical treatment. They studied the general antioxidant status and its enzymatic link before and after drug treatment. Results and conclusions. Comparative analysis of the results showed that the drug along with antioxidant has anti-inflammatory action with good portability, which allowed him to recommend for use as a complementary therapy for gynecological diseases various nature: malignant neoplastic diseases, inflammatory diseases, etc), especially after surgery.

A case report of simultaneous mini-invasive treatment of a patient with kidney tumor and tumor thrombus in inferior vena cava

Nowadays, there is a tendency in surgery to use more minimally invasive surgical procedures to decrease the risk of intra- and postoperative complications and to reach a faster rehabilitation period. We report a case of successful simultaneous minimally invasive treatment of a patient with kidney tumor. According to ultrasound examination data, the patient had a tumor in the right kidney. A computed tomography scan of the abdomen verified the tumor and detected a thrombus in the inferior vena cava lumen. Embolization of the right renal artery was performed as the first stage in the hybrid operating room. Right-side nephrectomy and thrombectomy from inferior vena cava, as the second stage, were done by using a robotic surgical system. The feature of this case is that embolization and nephrectomy were simultaneously performed during one surgical procedure. On the 10th day, the patient was discharged from the hospital without any signs of deterioration and complications. Thus, the unique work of two surgical teams proficient in mini-invasive technologies allowed to eliminate tumors and tumor thrombi in a single procedure and to reduce the bleeding, in-hospital stay, and rehabilitation period. This method will help more patients with kidney tumors in the future. Received 28 June 2018. Revised 3 August 2018. Accepted 6 August 2018. Informed consent: The patient’s informed consent to use his records for medical purposes is obtained. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest.

Оцінка ефективності селективної артеріальної емболізації у хворих з доброякісною гіперплазією передміхурової залози та високим операційним ризиком

Мета. Покращити результати хірургічної реабілітації хворих з доброякісною гіперплазією передміхурової залози (ДГПЗ) та високим операційним ризиком, обгрунтувавши диференційований підхід до застосування селективної артеріальної емболізації (САЕ) та монополярної трансуретральної резекції передміхурової залози (ТУРПЗ).
 Матеріали і методи. Досліджено шляхом аналізу ефективність та безпечність САЕ передміхурової залози (ПЗ) як методу лікування симптомів нижніх сечовивідних шляхів (СНСШ) у хворих з ДГПЗ та високим операційним ризиком у порівнянні з ТУРПЗ. Аналіз базувався на систематичному вивченні функціональних результатів та ускладнень у 33 хворих основної групи, яким виконали САЕ, та у 39 хворих порівняльної групи, яким виконали ТУРПЗ.
 Результати. Хворі, яким виконали САЕ, не мали операційної травми, у них був низький ризик виникнення післяопераційних ускладнень, коротший післяопераційний період, покращились показники: Міжнародної шкали оцінки простатичних симптомів (IPSS) - на 47,8%, шкали оцінки якості життя (QoL) - на 53,3%, максимальної об’ємної швидкості струменя сечі (Qmax) - на 58,4% на фоні зменшення об’єму ПЗ на 28,6% та об’єму залишкової сечі на 55,3% протягом 24 міс спостереження, що є підставою вважати САЕ ПЗ ефективним та безпечним методом мініінвазивного лікування ДГПЗ у хворих з високим операційним ризиком. Після монополярної ТУРПЗ результати були подібні: покращення показників IPSS - на 50%, QoL - на 65,1%, Qmax - на 59,2%, зменшення об’єму ПЗ - на 31,6% та об’єму залишкової сечі - на 64,6%, але даний метод супроводжувався статистично більшою частотою післяопераційних ускладнень, що погіршувало рівень періопераційної безпеки.
 Висновки. Результати дослідження засвідчили, що САЕ є ефективним та безпечним методом лікування хворих з ДГПЗ та високим операційним ризиком, за результативністю порівнянним з ТУРПЗ, але з меншим ризиком виникнення післяопераційних ускладнень. САЕ може бути методом вибору у хворих похилого віку з вираженою супутньою патологією, які мають протипоказання до стандартного оперативного втручання або утримуються від нього з інших причин.

P046 Evolution in the mini-invasive treatment of the hepatic cyst from Echinococcus g. in pediatric age

P046 Evolution in the mini-invasive treatment of the hepatic cyst from Echinococcus g. in pediatric age

Miniinvasive vascular interventions as an alternative surgical method for treatment of the patients, suffering hepatic cirrhosis and portal hypertension

Objective. Determination of efficacy of miniinvasive surgical treatment of portal hypertension (PG) in patients, suffering hepatic cirrhosis (HC) in immediate and late postoperative periods.
 Маterials and methods. Results of surgical treatment of 200 patients, suffering HC, were analyzed retrospectively: in 102 of them (Group I) HC and gastro-esophageal varices were diagnosed, in 98 (Group II) - HC with PG.
 Results. There was established, that miniinvasive surgical treatment in volume of the gastric veins embolization, аs well as operations of selective and partial portocaval shunting with the objective to correct a portal hypertension in patients, suffering HC, constitutes effective alternative method of surgical treatment.
 Conclusion. The decompression operations for portal system in patients with HC prevent the esophago-gastric hemorrhage occurrence in late period of follow-up and guarantee good survival of the patients, suffering compensated and subcompensated hepatic function.

Does intraoperative success predict outcome in the treatment of urethral sphincter insufficiency with bulking agent?

Sphincter insufficiency is mostly associated with neurogenic and some structural abnormalities in the pediatric population. As a mini-invasive treatment, urethral bulking agents have been used to treat this problem. The aim was to evaluate if technical success, defined as intraoperative increase in abdominal leak point pressure (ALPP), predicts the outcome of the treatment of sphincter insufficiency with urethral bulking agent. We reviewed all children treated first time with dextranomer/hyaluronic acid (Dx/HA) copolymer (Deflux) for urethral sphincter insufficiency and who intraoperatively had ALPPs measured during 2004-2014. Patient characteristics, change in urinary continence and the duration of the possible response were evaluated in neurogenic and non-neurogenic cases. The median age of the patients was 7.8 years (range 4.1-14.5) at initial treatment and median volume of Dx/HA instilled was 3.5mL (IQR 2-5). Twelve patients had neurogenic disease and 15 had non-neurogenic disease. Median ALPPs before and after the injections were 19 cmH2O (IQR 14-28) and 70 cmH2O (IQR 48-80), p<0.001. Increases in ALPPs were similar in both patient groups (p=0.661) and in 17 patients with any response and 10 patients with no response (p=0.267). In patients with any response the median duration of the response was only 0.8 years (IQR 0.09-2.0). During a median follow-up of 4.9 years (range 1.7-11.8), 15 patients received one to three repeat injections and eight patients went through sling or bladder neck operation (Summary table). During repeat injections, the preoperative ALPPs had returned to the original levels. Currently, 20% are continent or almost continent with one or more Dx/HA injections. In half of the patients with neurogenic bladder, compliance or volume deteriorated slightly in follow-up. Five out of 15 patients who reached puberty become continent spontaneously after failed bladder neck injection. Intraoperative ALPPs increased significantly in most patients during the procedure. However, only 52% of the patients experienced more than 1 month of success after the procedure, and even in those the effect lasted mostly under a year. With one to four injections one-fifth seem to have had a good long-term result. Although the long-term success rate is limited, bulking agent injection allowed the patients with spontaneous voiding to continue it and the injection did not prevent future treatments. Intraoperative increased ALPP does not predict a good long-term outcome after Dx/HA injection. At the end, only a fifth of our patients had good result with one or more Dx/HA injections. A change in bladder behavior is possible after treatment.

Mini-Invasive Treatment for Cellulite Blemishes: 15 Months of Experience

Introduction: In October 2016 I started, as one of the first in Europe, my experience with a new procedure that represents the only FDA-cleared minimally invasive treatment clinically proven to improve the cellulite blemishes for nearly four years in only one session. Materials and Methods: We report our experience after 15 months in 50 patients (48F; 2M) with cellulite treated in a single session. Follow-up were scheduled after 7 days (T7), 14 days (T14), 30 days (T30), 90 days (T90) and 180 days (T150) for all the 50 patients; 13 patients (1M) had a medical check at 12 months and 3 patients (1M) at 15 months. Outcome measures included subject photographs, Cellulite Severity Scale (CSS) and Global Aesthetic Improvement Scale (GAIS) assessment. Patient satisfaction and pain rating were also recorded. The treatment takes 45-60 minutes. Cellulite dimples are marked and the device is applied to stretch and stabilize tissue in a vacuum chamber, while local anesthesia is delivered. Then, a precise minimally-invasive subcutaneous release of the connective bands (TS-GS: stabilized-guided subcision) is performed with a micro-blade, without cuts or incisions. We have safely treated 6 to 45 sites in one session. After treatment, a light compression is applied and patients are able to return promptly to their daily life. Results: The procedure treated successfully the primary structural cause of cellulite blemishes in all the 50 patients. Patient satisfaction was 87% at T90 in 50 patients (48F; 2M), 95% at T180 in 50 patients, 97% at 12 months in 13 patients (1M) and 100% at 15 months in 3 patients (1M). Transient treatment-related adverse events were mild in severity and the most common side effects reported were soreness and bruising. Among 50 patients, 95% had bruising at T7, 23% at T14 and no patient had bruising at T30. Soreness is reported in 100% of patients at T7, 19% at T14, 4% at T30 and 0% at T90. Global Aesthetic Improvement Scale (GAIS) and Visual Analog Scale (VAS) are also reported. Conclusions: This revolutionary FDA-cleared procedure for the cellulite puckering, combines a proven approach with an innovative technology to treat the primary structural cause of cellulite blemishes in posterior thighs and buttocks. This study confirms his safety, and efficacy with vacuum-assisted precise tissue release for the treatment of cellulite, which is also strengthened by patients satisfaction.

A revolutionary mini-invasive treatment for cellulite blemishes: 15 months of initial experience

A revolutionary mini-invasive treatment for cellulite blemishes: 15 months of initial experience

Laser technologies and double balloon enteroscopy in surgery of chronic pancreatitis and mini-invasive treatment of its complications

Laser technologies and double balloon enteroscopy in surgery of chronic pancreatitis and mini-invasive treatment of its complications

Tissue stabilized guided subcision (TS-GS): A revolutionary mini-invasive treatment for cellulite blemishes in 80 consecutive patients

Tissue stabilized guided subcision (TS-GS): A revolutionary mini-invasive treatment for cellulite blemishes in 80 consecutive patients

ДОСВІД ХІРУРГІЧНОГО ЛІКУВАННЯ ПРОТОКОВОГО ПАПІЛОМАТОЗУ ГРУДНОЇ ЗАЛОЗИ ТА ЗВ’ЯЗОК СТУПЕНЯ ПРОЛІФЕРАЦІЇ З ЕКСПРЕСІЄЮ АЛЬФА–РЕЦЕПТОРІВ ЕСТРОГЕНУ

Вступ. Проліферативна доброякісна дисплазія (ДД) грудної залози (ГЗ) належить до передпухлинних станів. Хірургічне втручання з приводу ДДГЗ є основним методом лікування. Мініінвазійні хірургічні технології є затребуваними.&#x0D; Матеріали і методи. Проаналізований 3-річний досвід мініінвазивного хірургічного лікування хворих з приводу протокового папіломатозу ГЗ. Проведений порівняльний аналіз ступеня проліферації дисплазії та експресії альфа–рецепторів естрoгену (EsRα).&#x0D; Результати. Встановлено ефективність запропонованого способу лікування протокового папіломатозу ГЗ. Доведено залежність між ступенем проліферації проток ГЗ і експресією EsRα.&#x0D; Обговорення. Сьогодні універсального способу хірургічного лікування протокового папіломатозу ГЗ немає. Використання сучасних методів імуногістохімії та індивідуалізація способів втручання сприятимуть покращенню результатів лікування.&#x0D; Висновок. Мініінвазивні методи хірургічного лікування забезпечують радикальне лікування протокового папіломатозу ГЗ, естетичне задоволення пацієнток і лікаря.&#x0D; Ключові слова: доброякісна дисплазія грудних залоз; протоковий папіломатоз; EsRα; хірургічне лікування; пластична хірургія; рак грудної залози.

Use of biological mesh in trans-anal treatment for recurrent recto-urethral fistula.

To report the author's experience on a mini-invasive technique using bioprosthetic plug and a rectal wall flap advancement in the treatment of recurrent recto-urethral fistula. Between 2013 and 2015, seven patients with recurrent recto-urethral fistula were referred to the Pederzoli Hospital, Peschiera del Garda, Verona, Italy. Intraoperatively all patients were found to have a rectal wall lesion and were treated with urinary and fecal diversion. For the persistence of the fistula, all the patients underwent a mini-invasive treatment consisting on placement of a bioprosthetic plug in the fistula covered by an endorectal advancement flap through a trans-anal and trans-urethral combined technique. Median operative time was 48min with a median blood loss of 30ml. Median hospital stay was 3days (IQR 1-3). No case of fistula recurrence or plug migration was described. None of the patients experienced fecal or urinary incontinence. All patients obtained complete fistula healing. Recurrent recto-urethral fistula is a challenging postsurgical complication for surgeons and urologists, and its best treatment is still unknown. Our method seems to be feasible and effective for the treatment of complex recto-urethral fistula.

Endoscopic robot-guided disconnection of Hypothalamic Hamartomas: Results in 18 cases and review of the literature

Purpose: To review our experience on the endoscopic disconnection of drug-resistant hypothalamic hamartomas (HHs) and perform a meta-analysis over published data to define the best surgical approach for hypothalamic hamartoma. Method: Our series with a minimum follow-up of 18 months includes 18 patients: 13 males, 5 females; mean age at diagnosis of epilepsy was 2,1 years and 9,5years at first disconnection. Each patient received a complete presurgical assessment, including neurological, endocrinological and neuropsychological evaluation, scalp and video-electroencephalography, and brain MRI. HHs were defined according to the Delalande' classification [type II: 9 (50%); type III: 7 (38%); type IV: 2 (11%)]. In all surgeries, the disconnection was performed by using monopolar (10 cases, 55%) or laser thulium (Revolix) (8 cases, 44%) coagulation. We then review all published article from January 2000 to December 2016 and identified 51 article with 480 patients in which post-surgical outcome for hypothalamic hamarthoma was reported. Results: Postoperative evaluation was performed every 6 months after surgery. No permanent deficits were registered. At a mean follow-up period of 10 months, the Engel class (I–IV) was: I in 11/18 patients (61%); II in 3/18 patients (16%); III in 2/18 patients (11%); IV in 2/18 patients (11%). No significant variations of the neuropsychological status were reported. Six patients underwent a second surgery, with a postoperative improvement of the Engel score. The overall seizure free rate of patient reported in the literature was 45% (218/480). Conclusion: Endoscopic transventricular disconnection is an effective mini-invasive treatment of HHs, with a positive impact on epilepsy and neuropsychological outcome. Neuronavigation stereotactic systems, in association with robotic technology and laser coagulation, allowed to safely manage more difficult cases (e.g. tight ventricles or small lesions). We will discuss this results in relation to the meta-analysis of published patients.

MOrtality and infectious complications of therapeutic EndoVAscular interventional radiology: a systematic and meta-analysis protocol

BackgroundEndovascular interventional radiology (EIR) is an increasingly popular, mini invasive treatment option for patient with symptomatic vascular disease. The EIR practiced by qualified hands is an effective, well-tolerated procedure that offers relief of patient’s symptoms with a low risk of complications. During acute post procedural period, immediate complications may relate to vascular access, restenosis, thromboembolic events, uterine ischemia, infection, necrosis, sepsis, ICU stay, surgical recovery, pain management, treatment failure, and death. Moreover, additional non-life-threatening complications exist, but they are not well described and represent disparate information.Methods/designA range of databases will be screened consulted to identify the relevant studies: PubMed, EMBASE, The Cochrane Library, NosoBase, and Google Scholar (to identify articles not yet indexed). Scientist librarian used Medical Subject Headings (MeSH) and free terms to construct the search strategy in PubMed. This search strategy will be adapted in other databases. Two coauthors will independently select the relevant studies, extract the relevant data, and assess the risk of bias in the included studies. Any disagreements between the two authors will be solved by a third author.DiscussionThis systematic review will provide a synthesis of EIR complications. The spotlighted results will be analyzed in order to provide a state-of-knowledge synopsis of the current evidence base in relation to the epidemiology of the infectious complications after EIR. In the event of conclusive results, our findings will serve as a reference background to assess guidelines on reality of the problem of the infections linked to endovascular interventional radiology and to formulate of assumptions and propose preventive measures, based on the results of our investigations. These propositions will aim to reduce the risk and/or the severity of these complications in the concerned population in favor a positive medical economics report. It will also aim to decrease the antibio-resistance and in fine will improve health status and security of patients.Systematic review registrationPROSPERO CRD42015025594

ASSESSMENT OF EFFICACY AND THE NEAREST RESULTS OF ENDOVENOUS LASER COAGULATION IN THE COMPREHENSIVE TREATMENT OF SEVERE VARICOSE VEINS

The paper describes our approaches to miniinvasive treatment of severe varicose veins of clinical classes С4-6. One shows that in 2 months after interventions there is no evidence between the patients groups in recanalizations and side effects, all analyzed outcomes in certain parameters of EVLC satisfactory. In varicose veins C4-6, and SFJ size less 20 mm it's expedient to perform EVLC without crossectomy. If SFJ above 20 mm, or wellhead aneurysms it's expedient to combine EVLC with crossectomy Performing EVLC causes TU healing in 75 % of cases during nearest 2 months after correction of phlebohaemodynamics.

Pulmonary wedge resection for clinical stage I non-small cell lung cancer: a review of a mini-invasive treatment

Pulmonary wedge resection for clinical stage I non-small cell lung cancer: a review of a mini-invasive treatment

Малоінвазивне лікування дітей з тонкокишковою непрохідністю (огляд літератури)

Малоінвазивне лікування дітей з тонкокишковою непрохідністю (огляд літератури)

Experience and present situation of Western China Gastric Cancer Collaboration

The Western China Gastric Cancer Collaboration (WCGCC) was founded in Chongqing, China in 2011. At the early stage of the collaboration, there were only about 20 centers. While now, there are 36 centers from western area of China, including Sichuan, Chongqing, Yunnan, Shanxi, Guizhou, Gansu, Qinghai, Xinjiang, Ningxia and Tibet. During the past few years, the WCGCC organized routinely gastric cancer standardized treatment tours, training courses of mini-invasive surgical treatment of gastric cancer and the clinical research methodology for members of the collaboration. Meanwhile, the WCGCC built a multicenter database of gastric cancer since 2011 and the entering and management refer to national gastric cancer registration entering system of Japan Gastric Cancer Association. During the entering and collection of data, 190 items of data have unified definition and entering standard from Japan Gastric Cancer Guidelines. Nowadays, this database included about 11 872 gastric cancer cases, and in this paper we will introduce the initial results of these cases. Next, the collaboration will conduct some retrospective studies based on this database to analyze the clinicopathological characteristics of patients in the western area of China. Besides, the WCGCC performed a prospective study, also. The first randomized clinical trial of the collaboration aims to compare the postoperative quality of life between different reconstruction methods for total gastrectomy(WCGCC-1202, ClinicalTrials.gov Identifier: NCT02110628), which began in 2015, and now this study is in the recruitment period. In the next steps, we will improve the quality of the database, optimize the management processes. Meanwhile, we will engage in more exchanges and cooperation with the Chinese Cochrane Center, reinforce the foundation of the clinical trials research methodology. In aspect of standardized surgical treatment of gastric cancer, we will further strengthen communication with other international centers in order to improve both the treatment and research levels of gastric cancer in Western China.

A Clinical Trial Using Attrition Combined with 5-Aminolevulinic Acids Based Photodynamic Therapy in Treating Squamous Cell Carcinoma.

BackgroundSquamous cell carcinoma (SCC) is the second most common type of skin cancer, for which non- or mini-invasive treatment is of critical importance. 5-aminolevulinic acids based photodynamic therapy (ALA-PDT) is a mini-invasive approach that causes focal tumor cell injury, apoptosis, and necrosis through light sensitivity. The efficacy of combining ALA-PDT and surgery in treating SCC, however, has not been demonstrated.Material/MethodsA total of 60 SCC patients were randomly assigned into attrition plus ALA-PDT group (experimental group) and single ALA-PDT treatment group (control group). Clinical efficacy, recurrence rate, and adverse effects were analyzed in conjunction with H&E staining and immunohistochemistry (IHC) staining for p53 expression.ResultsThe overall effective rate of the experimental group was 73.3%, which was significantly higher than that of the control group (46.7%). The experimental group also had a lower recurrence rate (16.6% versus 30.0%, p<0.05). Similar rates of adverse effects existed between the two groups. After treatment, abnormal cells disappeared, while the p53 positive rate after treatment was elevated in the two groups (p<0.05 comparison of before and after treatment). The experimental group had a higher p53 positive rate compared to the control group (p<0.05).ConclusionsCombined therapy of attrition with ALA-PDT significantly elevated the effective treatment rate and can decrease the recurrence rate with reliable safety in treating SCC, thus ALA-PDT can be used as an optimal plan for SCC treatment.