Optimization of the technique for removal of benign tumors and wound suturing in a general surgical hospital

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  • Authors: Izmaylov AG1, Dobrokvashin SV1, Izmaylov SG2, Leontev AE2, Lukoyanychev EE2, Bodrov AA2, Kapustin KV3, Vorontsov AY.3, Volkov DE1
  • Affiliations:
    1. Kazan State Medical University
    2. City clinical hospital №7 of the Leninskiy region of Nizhny Novgorod n.a. E.L. Berezov
    3. Nizhny Novgorod Regional Clinical Oncology Center
  • Issue: Vol 101, No 4 (2020)
  • Pages: 579-585
  • Section: Clinical experiences
  • URL: https://kazanmedjournal.ru/kazanmedj/article/view/34071
  • DOI: https://doi.org/10.17816/KMJ2020-579
  • Cite item
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Abstract


Aim. To improve the results of surgical treatment in patients with large lipomas by using the device for closing the edges of wounds, allowing local preventive hemostasis in the surgical wound area, to create optimal conditions for atraumatic suturing and thereby reduce the amount of intraoperative bleeding and subsequently reduce the amount of postoperative wound complications.

Methods. The results of treatment of 105 patients with different localization of large lipomas were analyzed. Lipomas ranged from 8.0 to 20 cm in diameter. All patients were divided into 2 groups: the control group consisted of 53 (50.5%) patients for which used the traditional technique of tumor excision with closing surgical wounds, and the study group with 52 (49.5%) patients, for which to reduce tissue damage during tumor removal and the edges of wound suturing, one of the device variants developed by us was used, approximation-distraction device. Fisher's exact test was used for the comparison of the outcomes rate, a p-value <0.05 was considered statistically significant.

Results. Surgical wound complications occurred in 7 (6.7%) of 105 patients. In the study group, surgical wound complications occurred in 1.9% (1 observation), in the control group 11.3% (6 observations). Surgical wound complications were severity grade I and grade IIIa. Complications of the first grade did not require a debridement and will regress on its own; in grade IIIa complications, an opening, excision and drainage surgical wounds were performed without general anesthesia.

Conclusion. Moderate local selective near-tumor tissue compression that occurs when the device branches come closer to each other accelerates spontaneous thrombus formation in damaged small vessels. This creates favorable conditions for the surgeon to work in a “dry” wound.


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About the authors

A G Izmaylov

Kazan State Medical University

Author for correspondence.
Email: izmailov_alex@mail.ru

Russian Federation, Kazan, Russia

S V Dobrokvashin

Kazan State Medical University

Email: izmailov_alex@mail.ru

Russian Federation, Kazan, Russia

S G Izmaylov

City clinical hospital №7 of the Leninskiy region of Nizhny Novgorod n.a. E.L. Berezov

Email: izmailov_alex@mail.ru

Russian Federation, Nizhny Novgorod, Russia

A E Leontev

City clinical hospital №7 of the Leninskiy region of Nizhny Novgorod n.a. E.L. Berezov

Email: izmailov_alex@mail.ru

Russian Federation, Nizhny Novgorod, Russia

E E Lukoyanychev

City clinical hospital №7 of the Leninskiy region of Nizhny Novgorod n.a. E.L. Berezov

Email: izmailov_alex@mail.ru

Russian Federation, Nizhny Novgorod, Russia

A A Bodrov

City clinical hospital №7 of the Leninskiy region of Nizhny Novgorod n.a. E.L. Berezov

Email: izmailov_alex@mail.ru

Russian Federation, Nizhny Novgorod, Russia

K V Kapustin

Nizhny Novgorod Regional Clinical Oncology Center

Email: izmailov_alex@mail.ru

Russian Federation, Nizhny Novgorod, Russia

A Yu Vorontsov

Nizhny Novgorod Regional Clinical Oncology Center

Email: izmailov_alex@mail.ru

Russian Federation, Nizhny Novgorod, Russia

D E Volkov

Kazan State Medical University

Email: izmailov_alex@mail.ru

Russian Federation, Kazan, Russia

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Supplementary files

Supplementary Files Action
1.
Рис. 1. Общий вид одного из вариантов аппарата для сопоставления краёв операционной раны: 1 — бранши; 2 — винтовой механизм; 3 — направляющие спицы. Пояснение в тексте

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2.
Рис. 2. Схематичное изображение последовательности этапов удаления опухоли поверхностных тканей: а — дозированное сдавление; б — радикальное иссечение; в — сближение краёв раны; г — наложение швов. Пояснение в тексте

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3.
Рис. 3. Общий вид устройства для сближения краёв раны при удалении липомы мягких тканей спины

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4.
Рис. 4. Вид операционной раны без признаков наружного кровотечения. Этап ушивания операционной раны

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© 2020 Izmaylov A.G., Dobrokvashin S.V., Izmaylov S.G., Leontev A.E., Lukoyanychev E.E., Bodrov A.A., Kapustin K.V., Vorontsov A.Y., Volkov D.E.

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