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Biomedical subjects

V G Pishchik

Publications and source records attributed to V G Pishchik.

6 recordsLinked to original sources
PubMed2005

[Comparative assessment of the effectiveness of traditional and videothoracoscopic thymectomies in complex treatment of myasthenic thymomas].

A retrospective matched-pair comparison was undertaken to evaluate the surgical and neurological outcomes after open and VATS thymectomy for patients with myasthenia gravis (MG) and thymoma. Ten women and seven men aged 14-77 years were operated upon in St. Petersburg Center of intensive pulmanology and thoracic surgery during the years 1995-2002. Results of two groups were compared: 1 - operated by VATS (9 patients) and 2 - operated via sterno- or thoracotomy (8 patients). The first step evaluated the distribution of age, gender, myasthenia severity, size, type of thymoma and Masaoka's stage. No difference between the groups was found. At the same time, the length of chest tube, blood loss, severity of postoperative pains were significantly lower in the first group as compared with the second one: 1.3+/-0.9 vs 6.2+/-4.5 days; 82.5+/-22.7 vs 557.1+/-212 ml; and 1.9+/-0.8 vs 6.1+/-1.2 points respectively. The number of postoperative complications was almost the same. All the patients were followed up during 24-96 months. There were no thymoma recurrences in the both groups. No statistical differences were found in MG course between the groups. A conclusion is made that VATS removing of noninvasive thymoma is technically feasible and safe for the patients. VATS thymectomy can provide the same results in MG treatment as the open approaches.

Adolescent↗
PubMed2005

[A technique of videothoracoscopic thymectomy in diseases of the thymus].

Intensive development of thoracoscopic thymectomy (Tthy) has been initiated during the last decade. Unfortunately very few instances of using the procedures have been described in Russian medical literature. So, the paper describes in detail the technique and results obtained in our clinic. At the period from 1998 through 2004 37 Tthy operations were performed in the St. Petersburg Center of intensive pulmonology and thoracic surgery. There were 21 female and 15 male patients with mean age 41.5+/-18.9 years. Myasthenia gravis (MG) was diagnosed in 19 of those patients. Different thoracoscopic approaches were used for Tthy: 20 from the right side, 15 from the left side and 2 combined approaches with neck incision. In 2 cases when invasive thymoma was suspected, sternotomy had to be used. There were 6 postoperative complications (1 haemothorax and 5 myasthenia cases). One patient died in 45 days after operation because of the ventilation-associated pneumonia. The results of treatment were followed up in 34 patients during 6-34 months. The MG course was followed up in 17 out of 19 patients, 9 (52.9%) being asymptomatic, 6 (35.3%) improved and 2 (11.8%) stable. Tthy is a novel technical possibility for a removal of the thymus gland. The procedure is quite safe and radical in the hand of a surgeon experienced in mediastinal and thoracoscopic surgery. Treatment of thymoma using Tthy requires meticulous technique and longer follow-up.

Adolescent↗
PubMed2005

[Diagnostic and treatment strategy for patients with the first episode of primary spontaneous pneumothorax].

A retrospective analysis of 198 patients (164 men and 28 women) with the first episode of primary spontaneous pneumothorax (PSP) was made. All the patients underwent diagnostic thoracoscopy (DT) under local anesthesia before insertion of a chest tube. For 115 patients the chest tube thoracoscopy was the only treatment procedure (group I) and 77 patients underwent video-assisted thoracoscopic (VATS) wedge (atypical) resection and pleurectomy (group II). The patients were followed-up from 13 through 77 months. In group I there were 19 recurrences (16.5%), and only two recurrences in group II. In patients of group II having no pathological changes there were no recurrences while in group I there were two (3.3%). The recurrence rate in patients with pathological changes (II, III and IV stages of Vanderschuren classification) was 3% after VATS and as high as 31.5% after the chest tube treatment. The diagnostic thoracoscopy should be performed in all patients with the first episode of PSP for the assessment of the lung and pleura condition. The presence of any pathological changes points to a high risk of recurrences and should be considered as an indication for antirelapse measures (VATS). Surgery is not necessary when no morphological alterations are revealed at DT.

Adult↗