Abstract:

Introduction: surgical treatment of an area of accumulation of breast microcalcifications requires the surgeon to choose the optimal method of surgery. For a long time, the gold standard of surgery was the placement of a wire needle under X-ray control and subsequent removal. In our study, we want to demonstrate one of new methods, which is based on the placement of ultrasound marks in the area of accumulation of calcifications at the preoperative stage and further removal under the control of ultrasound device.

Aim: was to make comparative analysis and estimate the effectiveness of preoperative marking with ultrasound-positive (US-positive) marks in patients with non-palpable breast neoplasms.

Material and methods: the study included 165 patients (age 32 - 71 years). Patients were divided into three groups depending on the preoperative marking. The first group: installed ultrasound-positive Gel Mark UltraCor Bard marks in the region of microcalcifications at the outpatient stage.

The second group: marking with a wire needle «DuaLok» Bard immediately before the operation.

The third group: according to results of a repeated preoperative examination, which included: unilateral mammography in two projections with marker, a skin mark was established in the projection of a non-palpable formation.

Results: study showed that when choosing a surgical treatment using ultrasound-positive marks, the risk of detecting tumor cells at edges of the resection decreases, the time of surgery is shortened, and the volume of resection of healthy breast tissue is minimized.

Study proved that marking using ultrasound-positive marks has an advantage over other methods of preoperative marking and can be implemented in medical organizations that are not equipped with x-ray equipment for marking non-palpable breast formations immediately before surgery.

References

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Abstract:

Aim: was to investigate the application of decompression interventions conducted under ultrasound control in patients with acute cholecystitis in elderly including methods of obliteration of gallbladder with «MM-ge».

Materials and methods. For the period from July 2008 to September 2011 in City Hospital №68 mini-invasive methods have been appliec in 173 elderly and senile age patients with clinical and echographic picture of acute destructive cholecystitis. There were performed 219 minimally invasive procedures. In this study we performed obliteration of the gall bladder through the implantation of a porous crosslinked polyvinyl alcohol («MM-gel»), intended for use in medicine.

Results. On the base of experience we developed tactics of treatment of elderly and senile patients with acute cholecystitis with the use of mini-invasive ultrasound-guided interventions. Study showed that it is optimum to make gallbladder puncture under ultrasound guidance for sanitation and decompression. In case of failure percutaneous ultrasound-cholecystostomies were performed. Obliteration of gallbladder cavity with implantation of «MM-gel» were successfully performed in 5 cases.

Conclusions. During the research, efficiency and safety of minimally invasive treatment of acute cholecystitis in elderly and senile patients were proved, there was no negative impact on quality of life. Obliteration of the gallbladder cavity with plastic «MM-gel» can be the method of choice for surgical treatment of these patients and requires further development and study of long-term results.

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