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Biomedical subjects

V S Dovganiuk

Publications and source records attributed to V S Dovganiuk.

5 recordsLinked to original sources

["Silent" pheochromocytomas].

The results of surgical treatment of 126 patients with "hormonally inactive" and catecholamine secreting tumors of the adrenals were studied. Among them 2 cases (1.6%) of "dumb" pheochromocytoma were diagnosed. The clinical observations have shown the difficulties in the diagnosis of "dumb" pheochromocytoma before operation, risk of performing adrenalectomy and necessity to correct hemodynamic disorders during anesthesia in connection with latent catecholamine activity. The laboratory and instrumental means of examination of patients with suspected "hormonally inactive" tumor of the medullary substance of the adrenal are proposed. The variants of prevention and arrest of hemodynamic disorders during ablation of the "dumb" pheochromocytoma were considered. When the "dumb" pheochromocytoma had the diameter less than 5 cm and the adequate preparation was conducted the authors propose a laparoscopic access for adrenalectomy on the right, and retroperitoneoscopic access on the left. The detection of the catecholamine secreting tumor of more than 5 cm diameter, when problems with the clipping of the central vein of the adrenal take place, open accesses should be preferred--mainly thoracophrenotomy in the X intercostal space. If it was not possible to prove "dumb" pheochromocytoma before operation and it was started with endovideosurgical intervention during which it was not possible to first clip the central vein of the adrenal and the risk of hemodynamic disorders was high, the early transition to open operative intervention is thought to be expedient.

Adrenal Gland Neoplasms↗

[Clinico-anatomic rationale for the access and technique in video-endoscopic adrenalectomy].

The results of surgical treatment of 60 patients with tumors of the adrenals with the help of endovideosurgical techniques were analyzed and described. The article also presents the data of experimental investigations performed in 31 corpses of subjects of different constitution and topography of the adrenals in the retroperitoneal space and different accesses to them with the help of endovideosurgical technique. The most effective and safe accesses and the method of endovideosurgical adrenalectomy have been developed, substantiated and approbated in clinical practical work. In most cases the right laparoscopic and left retroperitoneoscopic adrenalectomies should be considered the operations of choice in treatment of patients with tumors of the adrenals. It was proved that the decision for the optimal endovideosurgical access and the corresponding adrenalectomy should be made individually for each patient with special reference to the clinicoanatomical criteria found. The endovideosurgical adrenalectomy should not be opposed to open methods of surgery which are expedient in patients with large size of the tumor, signs of malignancy and possible intraoperative complications.

Adrenal Gland Neoplasms↗

[Contemporary trends in surgery of adrenal glands].

There have been analysed the records of suprarenectomy in 459 patients with Conn' syndrome, syndrome of Icenko-Cushing as well as with androsteroma, pheochromocytoma and other tumors, who were operated in the clinic of abdominal surgery of S.P. Fedorov Russian Military Medical Academy. On the base of retrospective analysis the most actual aspects in surgery of the adrenal glands and the ways of the development of this branch of medicine have been determined. High effectiveness and perspectiveness of endovideosurgical removal of the adrenal glands is shown. Original and tested methods of choice of surgical approach, prophylaxis and treatment for some complications of suprarenectomy (adrenal insufficiency, Nelson' syndrome, etc.) are proposed. Substantiated policy in so-called hormono-inactive tumors of the adrenal glands is proposed.

Academies and Institutes↗

[The diagnosis and treatment of hormonally inactive adrenal formations].

Under analysis are results of an examination of 56 patients with hormonally non-active tumors of the adrenals, 48 of them were operated upon. In 20 patients (35%) they had clinical manifestations, 16 patients (28%) had an elevated level of the 17-HCS and 17-CS excretion in the 24-hours urine. Morphological investigations of the tumors in 20 patients have revealed clear cell adenomas of the cortical layer of the adrenal, in 19 patients--tumoral cysts, in 3 patients--true cysts, in 1 case-myelolipoma, in 1 case--ganglioneuromyelolipoma, in 4 cases--hormonally non-active carcinomas of the adrenal cortex. The authors propose to designate the new formations described as hormonally non-active tumors of the adrenals. In view of the absence of absolute methods for the identification of malignancy of the tumors the operative treatment of them is proposed.

17-Hydroxycorticosteroids↗