ИЗМЕНЕНИЯ УЛЬТРАСТРУКТУРНОЙ ОРГАНИЗАЦИИ ПОЧКИ В УСЛОВИЯХ ЭКСПЕРИМЕНТАЛЬНО СМОДЕЛИРОВАННОЙ ТЕПЛОВОЙ ИШЕМИИ ПРИ ОПЕРАТИВНОМ ВМЕШАТЕЛЬСТВЕ

Сергей Валерьевич Попов; Руслан Гусейнович Гусейнов; Андрей Николаевич Горшенин; Константин Владимирович Сивак; Петр Казимирович Яблонский; Олег Николаевич Скрябин; Татьяна Ивановна Виноградова

Authors

Сергей Валерьевич Попов St. Luka Clinical Hospital, 46, Chugunnaya ul., St. Petersburg, 194044, Russian Federation
Руслан Гусейнович Гусейнов St. Luka Clinical Hospital, 46, Chugunnaya ul., St. Petersburg, 194044, Russian Federation
Андрей Николаевич Горшенин St. Luka Clinical Hospital, 46, Chugunnaya ul., St. Petersburg, 194044, Russian Federation
Константин Владимирович Сивак St. Luka Clinical Hospital, 46, Chugunnaya ul., St. Petersburg, 194044, Russian Federation
Петр Казимирович Яблонский St. Luka Clinical Hospital, 46, Chugunnaya ul., St. Petersburg, 194044, Russian Federation
Олег Николаевич Скрябин St. Luka Clinical Hospital, 46, Chugunnaya ul., St. Petersburg, 194044, Russian Federation
Татьяна Ивановна Виноградова St. Luka Clinical Hospital, 46, Chugunnaya ul., St. Petersburg, 194044, Russian Federation

Abstract

Nowadays the laparoscopic kidney resection is a “gold standard” for treatment of tumor stages T1–2a.
One of the most important factors is kidney thermal ischemia leading to ischemic and reperfusion damage. It’s of current importance to elaborate a nephron-sparing complex end create an eff ective algorithm for preoperative, operative and post-operative periods. Th e key problem is a choice of time interval for renal artery clamping during operation, which will not cause irreversible structural and functional kidney changes. Th e purpose of this experimental study is a detection of maximum safe time of ischemia with morphologic verifi cation via electronic microscopy. Study results show that kidney epithelium keeps vitality in 30 minutes and 60 minutes of ischemia. In 90 minutes it has irreversible cells damage (necrosis). Th erefore “the point of no return” for kidney epithelium is beyond one hour interval of thermal ischemia. In combination with eff ective pharmacologic protection this fact expands the opportunities of modern laparoscopic surgery. Refs17. Figs 8.

Keywords:

kidney thermal ischemia, electronic microscopy, malpighian tuft, ischemia reperfusion syndrome

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References

Литература

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References

Nix, S., Smith M., Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. Journal of Foot and Ankle Research, 2010, no. 3, 21 p.

Roddy, E. Zhang W., Doherty M. Prevalence and associations of hallux valgus in a primary care population. Arthritis & Rheumatism (Arthritis Care & Research), 2008, vol. 59, no. 6, pp. 857–862.

Gallentine, J. W. Deorio J. K., Deorio M. J. Bunion surgery using locking-plate fi xation of proximal metatarsal chevron osteotomies. Foot Ankle International, 2007, no. 28 (3), pp. 361–368.

Fakoor M., Sarafan N., Mohammadhoseini P., Khorami M., Arti H., Mosavi S., Aghaeeaghdam A. Comparison of Clinical Outcomes of Scarf and Chevron Osteotomies and the McBride Procedure in the Treatment of Hallux Valgus Deformity. Archives of Bone and Joint Surgery, 2014, Mart, no. 2 (1),pp. 31–36.

Vopat B. G., Lareau C. R., Johnson J., Reinert S. E., DiGiovanni C. W. Comparative study of scarf and extended chevron osteotomies for correction of hallux valgus. Foot and Ankle Specialist, 2013, no. 6 (6),pp. 409–416.

Smith, S. E., Landorf K. B., Butterworth P. A., Menz H. B. Scarf versus chevron osteotomy for the correction of 1–2 intermetatarsal angle in hallux valgus: a systematic review and meta-analysis.The Journal

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Vega M. R., Jackson-Smith J. L. A variable fi rst metatarsal distal “L” osteotomy with adductor tendon transfer. The Journal of Foot and Ankle Surgery, 1995, no. 34 (4), pp. 384–388.

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Havlícek V., Kovanda M., Kunovský R. Surgical management of hallux valgus by techniques preserving the first metatarsophalangeal joint: long-term results [Article in Czech]. Acta chirurgiae orthopaedicaeet traumatologiae Cechoslovaca, 2007, no. 74 (2), pp. 105–110.

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