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Registration Number

0213U001326, 0112U003080 , R & D reports

Title

Studing the features and optimisation of spleenectomy at hematological patients treatment

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Head

Khvopostov E.D.,

Registration Date

28-01-2013

Organization

Kharkov National University named after V.N. Karazin

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Object of research - pathology of the blood system, requiring splenectomy. Methods - clinical, instrumental (ultrasonic method and fibergastroduodenoscopy, CT, MRI), laboratory, immunological, pathomorphological and immunohistochemical methods. Since September 2004 inClinic of Surgical Diseases of V.N. KarazinKharkiv National University based Railways Clinical Hospital ultrasonography (USG) of the abdomen is providedby devices Sonoace 4800 firms "Medison", Toshiba Nemio and ultrasonic imaging system expert class Philips HDI 4000 Convex probe with a frequency of 2 to 5 MHz, in real time, complete for videolaparoscopic surgery - "Endomedium", Russia; Karl Storz, Germany, certified clinical, biochemical and bacteriological laboratory (Certificate of MH hospital № 007 103, the highest category of 26 December 2007 to 26 December 2010, rehistratsiynyy number 4246). The aim - to improve the results of surgical treatment of patients with disorders of the blood system based on a comprehensive study of the characteristics of electrosurgical and ultrasonic effects on tissue when performing splenectomy for dissection and coagulation. The study consists of experimental and clinical parts. Experimental work included acute and chronic experiments on 168 laboratory mature rats - males Wistar weighing 200-250 g.The first (main) group consisted of animals that splenectomy and spleen resection performed by ultrasonic scalpel (USS), II - (control) group, with animals in which as intraoperative dissector used electrocoagulation (EC). In acute experiments evaluated the quality of the dissection, the presence of hemostasis by-line dissection, coagulating ability of devices, the length of the zone of destruction. In chronic experiments studied the dynamics of reparative processes.The clinical part of the work performed on the basis of complex clinical laboratory and instrumental examination of 97 patients with various diseases of the blood system, which required splenectomy. Depending on the intraoperative dissector to mobilize the spleen with splenectomy, patients were divided into 2 groups with the same principle as in the experiment. Zoneof lateral necrosis after ultrasonic dissection in 2.5 - 4 times less than after the application of high-frequency alternators. Dissection and coagulation using ultrasonic energy is characterized by a purely local effect and reliable hemostasis.Comparing the duration of surgery while performing splenectomy was found the reducing of spent time for 30-40 minutes in patients where used USS.It marked decrease of intraoperative blood loss in patients where used USS for 100-120ml and reduce of postoperative complications from 8.8% to 2.5%. Splenectomy helps restore normal immunoreactivity, which is most pronounced after laparoscopic splenectomy (LSE)

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Гриньов Р.
Душик Л.
Цівенко О.

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2020-04-02