Biomedical subjects

A Iu Tsukanov

Publications and source records attributed to A Iu Tsukanov.

13 recordsLinked to original sources

PubMed2006

[Transinguinal ligation of the internal seminal vein in varicocele through the mini-approach].

The protocol of ultrasonic examination of patients with varicocele is proposed. The method of endoscopic ligation of the internal seminal vein through open mini-approach has been developed. Forty-five endoscopic transinguinal procedures for left-sided varicocele have been performed. The age of the patients was 17.5+/-0.9 years. Renospermatic reflux was diagnosed in 40 patients, mixed one--in 5 cases. Varicocele of the second grade was revealed in 38 patients, the third grade--in 7. One patient has been operated for varicocele recurrence. Depth of surgical wound was 9.1+/-1.2 mm, number of trunks--from 2 to 8. There was no blood loss. Duration of surgery was 31.5+/-4.4 min. All the patient were examined on day 10 and one month after the surgery with mandatory ultrasonic examination. Neither complications nor recurrences were observed.

Adolescent↗

PubMed2005

[Precision surgery of varicosity: techniques and results].

The paper describes an experience gained with surgical treatment of 211 patients suffering from different forms of varicosity, seen between 1998 and 2003. In these patients, use was made of the technical procedures that provide for application of microaccesses. The complex of such procedures was in a good agreement with the notion "precision surgery of the veins" which implied: 1) the high precision of the topical diagnosis of varicose veins; 2) the use of a specialized kit of miniaturized tools and local bias lighting adapted to microaccesses; 3) primary use of microaccesses for venectomies of varicose vessels; 4) location of microaccesses above the involved veins, first of all, in the area of their tributaries. For integral evaluation of the degree of skin lesion the authors propose the use of an objective characterization, namely "the total length of skin incisions". It is determined by summarization of the lengths of all surgical incisions performed. In patients who underwent operation on one leg, it accounted for 15 to 50 mm (28+/-3 mm.). The precision approach to venous surgery provided for rapid painless return to the initial status after operation and complete rehabilitation of the patients for the first week, with positive rememberances evidencing the high easiness of the treatment carried out. All the patients operated on in such a way noted the high level of the quality of life both on the day of operation and subsequently in the immediate postoperative period.

Adolescent↗

PubMed2004

[Varicosis of the lower extremities as a consequence of connective tissue dysplasia].

An analysis was made of two groups of patients presenting with varicosis. The first group comprised 82 patients aged 15 to 30 years without risk factors. The second group accrued 85 patients with traditional risk factors: pregnancy and birth, overweight, considerable dynamic and physical loading, age from 30 to 50 years, and intake of hormonal contraceptives. It has been established that the key role in the development of varicosis is played by connective tissue dysplasia (CTD), the intensity of which predetermines the origination of phlebopathy and varicosis as well as the rate of their progression. The most frequently occurring is the mechanism of the development of phlebopathy as structural and functional defectiveness of all venous vessels of the extremity, leading to the rise of the deposited blood volume in the leg because of the high elasticity of venous walls. Secondly, CTD that initially impairs valve morphology, results in local varicosis under the effect of reflux hydrodynamic strokes at the weakened venous wall.

Adolescent↗

PubMed2003

[Clinical assessment of phlebopathy severity by specification of leg heaviness symptom].

The paper presents the first attempt to differentiate phlebopathy severity on the basis of subjective information, which serves a key parameter of decompensation assessment reflecting individual range of daily living activity and functional load. Phlebopathy is defined as structural and functional insufficiency of venous wall, decreased ability to maintain stable volume both of particular veins and leg venous system as a whole during prolonged orthostasis. From 1995 to 2001 different forms of leg varices were diagnosed and treated in 583 patients. The most common complaint expressed by 567 patients (97.0%) was the heaviness and bursting pain in legs caused by daily orthostasis. Four clinical groups were clearly defined: 0 grade - no heaviness in legs; 1 grade - episodes of heaviness after excess daily load; 2 grade - regular heaviness in legs not demanding obligate evening rest with updrawn legs; 3 grade - permanent heaviness in legs demanding rest with legs updrawn. Permanent symptom (the last 2 groups) can be subdivided according to timing of symptom onset: a) in the afternoon, b) in the forenoon. The data analysis demonstrated that the symptom of leg heaviness during orthostasis caused by increased creep of venous walls was be a subjective equivalent to phlebopathy severity. The time of symptom onset and degree of manifestation correlated with the severity of venous wall incompetence. This method can be used to evaluate functional status of leg venous circulation both during initial assessment and for treatment or rehabilitation monitoring.

Female↗

PubMed2003

[Lateral extraperitoneal mini-approach for adrenalectomy].

The techniques of adrenalectomy from lateral extraperitoneal mini-approach are described. This approach creates necessary space and ensures adrenalectomy in organic diseases of the adrenal glands. Fourteen operations with good short- and long-term results were performed. Limiting factors of this approach are the following: depth of the surgical wound 15 cm and more due to stage IV obesity and acute costal angle, sclerosis of retroperitoneal fat, significant splenomegaly, size of adrenal tumor more 6 cm. The "assisting hand" and endovideoscopy expand possibilities of the method.

Adolescent↗

PubMed2003

[Quality of life in surgical treatment of varicose disease].

A decrease of surgical trauma and improvement of anesthesia quality are the key points in quality life improvement after surgical treatment of varicose disease. Two variants of incisions were used: mini approaches of length not more than 20 mm and micro approaches of length to 2 - 3 mm. During surgery instruments of decreased sizes were applied. Direct and distant mini approaches were used for crossectomy. Disjunction of Coccett's perforated veins in trophic disorders was performed through distant mini approach, valvuloplasty of the femoral vein - through two mini approaches. Removal of subcutaneous and communicated veins was performed through few micro approaches. One hundred and seventy-four patients with various forms of varicose disease underwent surgery under combined (general - fentanil, sibazon, propofol and local - lidocain, novocain) anesthesia. Total length of cutaneous incisions ranged from 15 to 85 mm. Fast achievement of primary state after surgery and complete recovery during first week was seen. High index of quality of life both in the surgery day and nearest days after it was noted.

Adult↗

PubMed2002

[Stomach resection from mini-approach in complicated ulcers of duodenal posterior wall].

6 cases of Bilrot-I stomach resection from mini-approach for ulcers of duodenal posterior wall complicated by pyloric stenosis and penetration into pancreatic head are described. Precise technique was used. Orientation of the incision to pancreatic head and suprapyloric gastrotomy create good conditions for orientation, precise dissection of the affected part of the duodenum and creation of one-layer gastroduodenoanastomosis. Tunnelization of retrobulbar fat tissue and alternating traction up by dissected stomach made surgery easier. The operated patients were followed up from 1 months to 2 years: function of anastomosis was satisfactory.

Duodenal Ulcer↗

PubMed2002

[Operation of cross-section and extravasal correction of the femoral vein valves in varicose disease using minimal access].

Taking into account the heightened demands of patients for the quality of life the aesthetics of upper incisions in varicose disease gains significance. The authors adduce the depiction of the procedure and results of application of two original operations: cross-sectomy with application of public approach and extravasal correction of femoral vein valves using proper fascial tunics by inguinal mini-access. Endosurgical manipulations are performed inside operative space, created by hook-elevator with endoillumination, permitting to reduce cutaneous incision and remove it to aesthetically less significant zones. The 2 cm long incision in the hair-bearing part of public region in inside and horizontal direction was applied in cross-sectomy. The transverse cutaneous incision 2-2.5 cm long 6-7 cm down inguinal ligamentum and medially about femoral vessels projection was proposed for valvuloplasty. Cross-sectomy using mini-access was done in 49 patients, valvuloplasty of femoral vein--in 41. Estimation of immediate and late follow-up results witnesses, that elaborated endosurgical procedures of cross-sectomy and valvuloplasty of femoral vein in patients with varicose disease using mini-access corresponds to aesthetical demands of modern phlebology.

Adolescent↗

PubMed2002

[Minimally invasive valvuloplasty of the femoral vein in varicose disease].

Length of incisions in varicose surgery is one of the main factor of surgery quality. Method and results of extravasal correction of femoral valves with own fascial tunics from mini-approach are presented. Endosurgical manipulations are performed within operative space created by hook-levator with endolight. It permitted to shorten incision of skin to 2-2.5 cm. Mini-invasive valvuloplasty was performed in 43 patients. The developed method meets esthetic criteria of modern phlebology.

Femoral Vein↗

PubMed2002

[Search for the recurrent nerves during thyroid gland surgery].

The authors proposed in performance of operation on thyroid gland (TG) to disclose the recurrent nerves before doing the TG mobilization in subthyroid space--from the lower border of TG to the incisure of sternum. The operations were performed with good results in 308 patients, using this method, including the one-sided lobectomy with resection of isthmus of the thyroid--in 242, in 18--the additional resection of the lower end of the TG opposite lobe was performed, in 48--the double-sided lobectomy.

Humans↗

PubMed2001

[Method of surgical treatment of the thyroid gland from mini-approach].

Two variants of mini-approach 2 cm long were developed. They permitted to perform safe 39 various operations on thyroid gland with favorable short- and long-term results. The procedure may include recurrent nerve imaging. Binocular vision is necessary. Using this technique, unilateral lobectomy with isthmus removal for solitary and multinodular unilateral goiter was performed in 15 patients, bilateral subtotal lobectomies--in 18 patients with bilateral nodular goiter. Bilateral lobectomy (thyreoidectomy) was performed in 6 patients because of advanced disease.

Adult↗

PubMedDate not supplied

[Gas-free lateral retroperitoneoscopy from an open mini-approach for adrenalectomy].

The aim of the study was assessment of efficacy of gas-free lateral retroperitoneoscopy from the open mini-approach for adrenalectomy. Arguments are given for location of the mini-cut in the anterior segment of the 10th intercostal space and analysis was made of operative space parameters in retroperitoneoscopy from open mini-approach. The wound aperture 5.0 cm in size and 15.0 cm in depth is good as it provides the diameter of the monofocal zone 16.0 cm and bifocal zone 4.0 cm. If the size of the wound increases to 7.0 cm, the above parameters rise to 20.0 and 7.9 cm, respectively. Such visualized space is sufficient for adrenalectomy. Variants of the intervention are proposed depending on the side and kind of the lesion. A total of 21 patients with various adrenal pathology were operated. The operation lasted for 114.7 +/- 1.5 min. Overall blood loss reached 22.0 +/- 3.2 ml, transfusion--137.8 +/- 1.0 ml. The intestinal function normalized on day 1-2. In the postoperative period mean number of narcotic analgetics injections made up 4.9 +/- 1.5. Body temperature returned to normal on day 5.3 +/- 1.6 after the intervention. The length of the scar was 4.2 +/- 0.6 cm. None lethal cases were registered. Conversion to the classic open procedure had to be made in four cases. Gas-free lateral retroperitoneoscopic adrenalectomy from open mini-approach is minimally invasive operation. In well selected cases this is a safe and effective alternative to conventional and endovideoscopic gas surgery.

Adolescent↗

PubMedDate not supplied

[Quality of life in endoscopic treatment of varicocele].

A total of 46 patients with varicocele aged 15-28 years (mean age 17.1 +/- 1.3 years) were operated endoscopically by means of ligation of the internal seminal vein from an open gas-free mini-approach. The intervention was on the left side (n = 45) and right side (n = 1). Varicocele of the first, second and third degree was diagnosed in 2 (4.3 +/- 3.0%), 35 (76.0 +/- 6.3%) and 9 (19.6 +/- 5.9%) patients, respectively. There were no conversions. Duration of the operation was 28.4 +/- 2.7 min. Early after surgery anesthesia with ketorolac trometamine (2.1 +/- 1.1 injections, on the average) was made in 37 (80.4 +/- 5.9%) patients. Seven (15.2 +/- 5.3%) patients refused anesthesia. Control examination was made on day 7. Hydrocele developed in one case (2.2 +/- 2.2%). It was managed conservatively. A mean length of the scar was 2.8 +/- 0.34 cm. The second postoperative examination was conducted 6.7 +/- 1.6 months after the first one. The recurrence arose in one patient (2.1 +/- 2.1%). The patient was reoperated from an open mini-approach. A mean level of pain syndrome was 1.8 +/- 0.5 points. It had no influence on the patients' condition. On postoperative day 3-5 the patients were discharged. Thus, good quality of life in use of the proposed endoscopic operation of ligation of the internal seminal vein from an open gas-free approach makes this surgery an operation of choice in surgical treatment of varicocele.

Adolescent↗