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S V Got'e

Publications and source records attributed to S V Got'e.

At least 19 recordsLinked to original sources
PubMed2004

[Transplantation of the liver right lobe from a related donor].

From 1997 to 2003 transplantation of liver's right lobe from alive related donor was performed in 64 patients (28 men, 36 women) aged from 6 to 61 years (mean age was 22.6 +/- 3.2 years). Body weight of recipients ranged from 18 to 92 Kg (52.7 +/- 2.8 Kg on average). Indications for surgery were following: cirrhosis of liver due to Wilson's disease (34), primary sclerotic cholangitis (6), viral cirrhosis of liver (6), primary biliary cirrhosis (4), Bayler's disease (3), Caroly's disease (3), Budd-Chiary syndrome (3), secondary biliary cirrhosis (2), cirrhosis of liver due to deficient of alpha(1)-antitrypsin (1), hepatocellular carcinoma (1), total nodular transformation of liver (1). Intensive care before transplantation was needed for 68.75% potential recipients. Donors of liver's right lobe were relatives of patients similar to blood group. Age of donors ranged from 18 to 49 years, mean age was 37.9 +/- 1.4 years. Donors underwent right-sided hemihepatectomy, there were no complications. Lethal outcome in recipients was seen in 2 (3.1%) cases and was not associated with function of transplant. Lethal outcome in long-term period after transplantation was seen in 4 (6.5%) cases. All the others patients survived and followed from 1 to 73 months (23.8 +/- 2.4 months on average). Quality of life was good. Transplantation of liver's right lobe from related donor is the independent line in orthotopic transplantation of liver and ensure reliable results.

Adolescent↗
PubMed2002

[Reparative regeneration of the human liver grafted from a cadaver and a relative donor].

The morphological features and dynamics of regeneration of the grafted human liver were studied by using data on 609 needle biopsies obtained for morphological monitoring in 38 recipients during transplantation of the liver from cadavers and relative donors. The biopsy specimens of donor organs taken prior to grafting served as a control. Irrespective of the type of grafting, regenerative processes in the grafted liver were shown to have common regularities and to run by using the mechanisms of both intracellular regeneration and proliferation. Their maximum rate was seen within a month after grafting of a cadaverous organ and within 3 months after grafting a part of the liver from a relative donor. In cadaverous transplantation, regenerative processes depended mainly on the degree of ischemic lesions; in relative donor organ transplantation, that depended on the fitness of graft mass (the index K being close to 0.5), proliferative processes and the time of higher hepatocytic ploidity increased. An adequate evaluation of the status of a cadaverous organ, estimation of the optimum mass of a grafted hepatic part from a relative donor, and effective immunosuppressive therapy ensure required reparation rates and a complete recovery of the structure of a graft.

Adolescent↗
PubMed2002

[Transplantation of the right hepatic lobe from an alive relative donor].

The use of relative donors in the transplantation of the liver has shown a good performance as an alternative line in its orthotopical grafting. Shortage of donor organs actively stimulates the development of relative transplantation. The main problem of relative hepatic transplantation is the limited capacity of obtaining a required mass of a hepatic graft for obese recipients. To settle this problem, the Russian Surgery Research Center, Russian Academy of Medical Sciences, has developed an original safe procedure for obtaining the right lobe of the liver from an alive relative donor and for implanting it in a recipient. In November 1997 to October 2001, transplantation of the right hepatic lobe from an alive relative donor was made in 23 recipients (10 males and 13 females aged 9 to 55 (mean 22.3 +/- 3.1) years. Their body weight was 24 to 80 (mean 51.4 +/- 3.0) kg. Indications for surgery were as follows: hepatic cirrhosis (HC) at the end stage of the Wilson-Konovalov disease (n = 10), primary sclerotic cholangitis (n = 4), HC of viral etiology (n = 3), Bailer's disease (n = 2), primary biliary HC (n = 2), HC in the presence of alpha 1-antitrypsin deficiency (n = 1), and secondary biliary HC (n = 1). The donors of the right lobe of the liver were recipients' mothers in 9 cases, their fathers in 6 cases, sisters in 2 cases, sons in 1 cases, their daughter, brother, aunt, cousin in 1 case each. The donors' age ranged from 19 to 49 (mean 37.9 +/- 1.4) years. The donors underwent right hemihepatectomy, complications were absent in them. There were early mortality among the recipients. Two patients died in the late postoperative period. The remaining 21 recipients were survivors and followed up for 1 to 48 (mean 14.9 +/- 2.9) months. Their life quality was good. The use of the right lobe of the liver from an alive relative donor is the optimum alternative to transplantation of the cadaverous liver and partially compensates the shortage of donor organs for children, adolescents, and adults.

Adolescent↗
PubMed2000

[liver portion transplantation from living donor: pilot clinical experience].

The unique in Russia experience of 35 liver transplantations since 1990 has revealed benefits of the method and quite encouraging results with 81% survival of the recipients. But the extreme shortage of cadaveric donor organs followed by more than 60 per cent mortality in waiting list and absence of any real facilities to improve the situation dictate the living related donation to become a considerable alternative. Totally 12 living related liver transplant procedures were performed with no morbidity in donors. In 7 donors the routine surgical technique of harvesting were used to get left lateral segment in five and whole left lobe in two cases. The unique twin-to-twin liver left lobe donation with no consequent immunosuppression was observed in this series. New special technique of living donor surgery was successfully developed for liver right lobe harvesting. The living related liver right lobe replacement was used in 5 cases and appeared to become a real compensation of donor organs shortage for elder children with body weight more than 20 kg and adults.

Adult↗
PubMed1998

[Surgical hepatology: liver transplantation and extensive resections].

During 7 years (from 1990 until now) the only in Russia program of transplantation of the liver is under way in RCS RAMS. Up to now the experience has been accumulated of 24 transplantations in 23 patients, including 1 retransplantation and 6 transplantations from alive relative donor. Indications for the operation were incurable diseases of the liver with fatal prognosis including unresectable primary focal diseases. Long-term survival of the recipients in the last followed up series was obtained in 80% of cases. The longest survival reached 7 years. The quality of life of the recipients is quite satisfactory, 2 patients gave birth to healthy children. At the same time at the background of extreme deficiency of donor organs mortality rate of potential recipients during "waiting" period made up to 60.4%. Parallel development of resectional surgery of the liver made it possible to perform 49 extensive and maximally spacious resections with good results (early postoperative lethality--4.1%, actuarial 5 year survival rate of these patients--64%). Accumulated experience was a basement for the development of program for transplantation of a fragment of the liver from living relative donor.

Adolescent↗
PubMed1998

[Orthotopic liver transplantation].

Orthotopic liver transplantation is the only method of choice for many severe liver diseases with poor prognosis. The development of liver transplantation programmes is based on medical science achievements and high technology in surgery, anesthesiology and perfusiology. The experience of the Surgery Research Center, Russian Academy of Medical Sciences, made it possible to obtain positive results of liver transplantation and posttransplantation management. This in turn provided longer survival for 80% of recipients. At the same time the mortality of potential recipients was 60.4%, which is due to the greater shortage of donor organs and which is the main problem in the development of organ grafting in Russia. The fact that there is a high proportion of children who are recipients for the donor's liver requires that liver transplantation from living related donors should be developed.

Adolescent↗
PubMed1997

[Surgical classification of liver local lesions].

There is a variety of liver focal lesions (LFL) and every clinical case should be considered carefully in deciding the problem of indications to surgical treatment. The existing classifications, including the TNM classification, are limited by the peculiar features of liver anatomy. The authors propose an original surgical classification of LFL that combines TNM principles and segmental characteristics of volume of lesion. The classification takes into account intraorganic and extraorganic location of LFL, and marks it by special letter indices. The indication of nosology of LFL in combination with letter and a B digital indices provides the universality of classification. The authors recommend to use the classification in evaluation of malignant and benign liver lesions, as well as alveococcosis and liver trauma.

Humans↗
PubMed1997

[Orthotopic liver transplantation: surgery research center's experience].

From 1990 to 1996, 178 patients with severe diffuse and advanced focal liver diseases with grave prognosis were observed for indications to orthotopic liver transplantation (OLT). According to the revealed indications and contraindications, 95 patients were enrolled for the procedure. Eighteen patients underwent 19 OLTs, including 1 urgent retransplantation and 3 living related graftings. Surgical techniques were conventional; with these, intraoperative mortality and biliary complications could be avoided. Long-term survival (6 to 68 months) was achieved in 8 recipients, including in those after liver retransplantation. Double or triple suppressive regimens were used. These included corticosteroids, cyclosporin A, azathioprine, antithymocytic globulin. The life quality of recipients promoted restoration of their working capacities. Two recipients gave birth to healthy babies.

Adolescent↗
PubMed1997

[Radical resections in advanced hepatic tumors].

Experience with 32 curative major and extended liver resections performed in 30 patients with different disseminated focal diseases. The scope of resections was 50 to 85% of the liver parenchyma. Owing to the developed criteria for resectability and surgical techniques of operations, there was no hepatic failure due to the small mass of the liver stump. There were no intraoperative deaths. Postoperative complications were observed in 15.6% of cases. Early postoperative mortality was 6.25%, the deaths were caused by fulminant pleuropneumonia and acute cerebrovascular circulatory disorder. Late mortality (at months 2.5 to 28 (mean 17.6 +/- 4.0 months) was 18.75% and it was due to the generalization of cancer diseases. After extensive hepatic resections, survival was observed in 73.3% of cases with the maximum time of 63 months. The authors' own guidelines for extensive and maximum large resections of the liver are presented in the paper.

Adolescent↗
PubMed1997

[Method of treatment of volumetric liver masses].

The authors propose the mode of treatment of volumetric masses of the liver which provides possibility to perform ablastic and atraumatic removal of the tumor with prophylaxis of bleeding by creation of the coagulation pellicle in the bed of the removed tumor. The method is based on the rational combination of cryodestruction, mechanical excision and laser coagulation: evaporation by the disfocused laser beam of the frozen bed of the tumor after its cryodestruction and mechanical excision, the principles of the ablastics are being completely kept; at the surface of the hepatic tissue the coagulation scab is being formed. Bleeding and biliary leakage are absent. This is prophylaxis of abscess, fistulas and haematomas after surgery.

Cryosurgery↗
PubMed1992

[The use of the contact periodic-pulse laser and microwave scalpels in liver surgery].

In use of the laser (CPPLS) and microwave (MWS) scalpels, the reliability of arrest of bleeding and bile leakage has been proved not only at studies on the intact liver but on the models of jaundice with impaired coagulative blood properties as well. After hepatic resection by means of CPPLS and MWS, the impairement in its functional state lasts for a short time. In use of CPPLS, disturbance in tissue blood flow is less than in use of MWS. Healing of the wounds inflicted by CPPLS and MWS occurs in absence of pronounced exudative and inflammatory reactions. In a wound inflicted by a laser scalpel, the necrotic layer is not pronounced. It is expedient to use the CPPLS and MWS in patients with hepatic masses in technically difficult cholecystectomy as they contribute to decrease in intraoperative blood loss and prevention of the development of complications after the operation.

Animals↗
PubMed1991

[Surgical treatment of polycystic disease of the liver].

The authors analyse 60 cases of polycystic disease of the liver; 41 patients underwent operation, 19 were kept under dynamic follow-up. The diagnosis of polycystic disease of the liver is based on the results of ultrasonic examination and computed tomography; serological tests are conducted for differential diagnosis with hydatid disease. Twenty (33.3%) patients had affection of the kidneys, pancreas, ovaries, and brain. As the result of surgery the condition improved in 30 (85.7%) and became worse in 5 (14.3%) patients in follow-up periods of 6 months to 23 years. Complications occurred in the postoperative period in 10 patients, the mortality rate was 4%. Fenestration of the cysts is the main type of intervention, which allows maximum preservation of the functioning hepatic parenchyma. The left hepatic lobe was resected in only 2 patients with its complete cystic degeneration. Defocused laser beam and bipolar rotor electrocoagulator were used for ++de-epithelialization of the cystic walls. Experience shows the expediency of surgical treatment for decompression of the maintained hepatic parenchyma.

Adult↗
PubMed1990

[Methods of correction and prevention of cicatricial strictures and fistulas of the bile ducts].

Two hundred and eighty one patients with cicatricial biliary strictures were examined to reveal external biliary fistulas in 72 of the patients. The strictures and fistulas developed after surgery on the stomach and biliary ducts due to an accidental surgical injury to these organs, or at later terms after a ++hepato-choledochal intervention. The biliary lesions were repaired with 149 operations with formation of a biliodigestive anastomosis without tube drainage, 117 with tube drainage (mostly transhepatic), six plastic operations with reconstruction of the ++hepato-choledochal integrity, and 47 ++radio-endoscopically guided interventions. Complications after cavitary++ operations were observed in 36.9 per cent cases with the fatal outcome in 13 of the patients (4.7 per cent). ++Radio-endoscopically guided interventions included: radioendobiliary prosthetics of the biliary ducts, recanalization, balloon dilatation of short strictures with endoscopic guidance, elimination of concretions by means of external drainage, and endoscopic papillosphincterotomy in distal choledochal strictures. Long-term findings were related to the level of the biliary lesion, the period that had elapsed since the stricture formation, and the number of operations in the medical history. Good or satisfactory results were achieved in 87.9 per cent cases. Considering the results of treatment for biliary strictures and fistulas disappointing, the main effort should be aimed at their prophylaxis. With this purpose, measures to prevent surgical injury to the biliary tract have been elaborated.

Adolescent↗
PubMed1989

[Use of fibrin glue in surgery of parenchymatous organs].

The article discusses the results of one of the first studies conducted in the Soviet Union on the use of various types of fibrinous glue in operations on the parenchymatous organs. The data of 67 experiments on rabbits and 20 clinical cases are reported. The experiments were carried out to test the efficacy of fibrinous glue application for arresting parenchymatous bleeding and appraise the air-tightness of wounds of the liver, spleen, and kidney by the method of hydropressure with morphological control. The effect of fibrinous glue made of Soviet-produced components was also tested in experiment. In the clinic, fibrinous glue was used for arresting bleeding from wounds of the liver and spleen and for ensuring air-tightness of anastomoses and filling residual cavities after removal of hepatic cysts. The hemostatic effect of various types of fibrinous glue was found to be high both in experiments and in the clinic. Essential advantage over synthetic cyanoacrylate glues was proved. It was noted that the use of fibrinous glue in operations on the parenchymatous organs is promising.

Animals↗