Publications by authors named "S G Shapovalyants"

5 Publications

  • Page 1 of 1

[New approaches in conservative treatment of acute adhesive small bowel obstruction].

Khirurgiia (Mosk) 2021 (6):45-53

City Clinical Hospital No. 17, Moscow, Russia.

Objective: To improve the outcomes of therapy of acute adhesive small bowel obstruction via development of a comprehensive management including CT, deep endoscopy-assisted nasointestinal drainage of small bowel with injection of a water-soluble contrast.

Material And Methods: There were 128 patients with acute adhesive small bowel obstruction for the period from 2015 to 2018. The study included 2 groups of patients depending on therapeutic approach and duration of treatment. In the first group, conventional approach for acute adhesive small bowel obstruction was applied. Upon admission, all patients with confirmed acute adhesive small bowel obstruction underwent gastric intubation for decompression of the upper gastrointestinal tract. Barium sulfate injection followed by X-ray examination was performed to assess an effectiveness of therapy. In the second group, computed tomography was performed in addition to X-ray examination and ultrasound. Moreover, conservative treatment included deep endoscopy-assisted nasointestinal drainage and subsequent administration of a water-soluble contrast in addition to traditional approaches.

Results: Therapy was effective in 99 (71.2%) patients; 39 (28.8%) ones required surgery. Deep endoscopy-assisted nasointestinal drainage with injection of a water-soluble contrast was effective in 45 (78.9%) patients. Overall mortality in traditional approach was 1.4%, postoperative mortality - 3.7%. There were no lethal outcomes in case of a new approach.

Conclusion: Deep endoscopy-assisted nasointestinal drainage with injection of a water-soluble contrast is the most effective therapeutic method for acute adhesive small bowel obstruction (78.9%). These findings can significantly improve treatment outcomes in these patients.
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http://dx.doi.org/10.17116/hirurgia202106145DOI Listing
May 2021

[Russian consensus on current issues in the diagnosis and treatment of obstructive jaundice syndrome].

Khirurgiia (Mosk) 2020 (6):5-17

Pirogov Russian National Research Medical University, Moscow, Russia.

The Russian consensus document on topical issues of the diagnosis and treatment of obstructive jaundice syndrome was prepared by a group of experts in various fields of surgery, endoscopy, interventional radiology, radiological diagnosis and intensive care. The goal of this document is to clarify and consolidate the opinions of national experts on the following issues: timing of diagnosis of obstructive jaundice, features of diagnostic measures, the need and possibility of conservative measures for obstructive jaundice, and strategy of biliary decompression depending on the cause and level of biliary block.
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http://dx.doi.org/10.17116/hirurgia20200615DOI Listing
July 2020

Instrumental Mechanoreceptoric Palpation in Gastrointestinal Surgery.

Minim Invasive Surg 2017 31;2017:6481856. Epub 2017 Dec 31.

Faculty of Mechanics and Mathematics, Lomonosov Moscow State University, Moscow, Russia.

Background And Aims: Small gastric or colorectal tumours can be visually undetectable during laparoscopic surgeries, and available methods still do not provide a 100% localisation rate. Thus, new methods for further improvements in tumour localisation are highly desirable. In this study, we evaluated the usage of the Medical Tactile Endosurgical Complex (MTEC) in gastrointestinal surgery for localisation of tumours. The MTEC provides the possibility of instrumental mechanoreceptoric palpation, which serves as an analogue of conventional manual palpation.

Methods: Ninety-six elective surgeries were performed, including 48 open surgeries, 43 laparoscopies, and 5 robot-assisted surgeries. The 20 mm version of the MTEC tactile mechanoreceptor was used in open surgeries, and the 10 mm version in laparoscopic and robot-assisted surgeries.

Results: The mean time of instrumental mechanoreceptoric palpation was 3 minutes 12 seconds for open surgeries, which constituted the early stage of the learning curve, and 3 minutes 34 seconds for laparoscopic surgeries. No side effects or postoperative complications related to instrumental mechanoreceptoric palpation were observed, and this procedure provided data sufficient for tumour localisation in more than 95% of cases.

Conclusion: Instrumental mechanoreceptoric palpation performed using MTEC is a simple, safe, and reliable method for tumour localisation in gastrointestinal laparoscopic surgery.
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http://dx.doi.org/10.1155/2017/6481856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804355PMC
December 2017

[RADICAL ENDOSCOPIC REMOVAL OF ADENOMA OF THE MAJOR DUODENAL PAPILLA WITH SUCCESSFUL INTRAOPERATIVE CORRECTION OF COMPLICATIONS].

Eksp Klin Gastroenterol 2015 (10):44-5

We introduce one of the successful clinical observations of a radical endoscopic removal of adenoma of the major duodenal papilla with severe dysplasia, as well as intraoperative correction of complications, jet bleeding and retroduodenal perforation, which occurred during this operation.
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June 2016
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