DOI 10.15372/SSMJ20180412
PRIMARY HIP REPLACEMENT FOR THE RIGHT FEMORAL NECK FRACTURE IN A PATIENT ON CHRONIC HEMODIALYSIS PROGRAM AND REPEATED SURGICAL TREATMENT FOR NEUROENDOCRINE TUMOR
Author Affiliations11 Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan of Minzdrav of Russia 630091, Novosibirsk, Frunze str., 17
2Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan of Minzdrav of Russia 630091, Novosibirsk, Frunze str., 17
3Autonomous non-profit organization «Сlinic of Traumatology, Orthopedics and Neurosurgery of NRITO» (ANO «Сlinic NRITO») 630091, Novosibirsk, Frunze str., 19a
41 Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan of Minzdrav of Russia 630091, Novosibirsk, Frunze str., 17
5Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan of Minzdrav of Russia 630091, Novosibirsk, Frunze str., 17
6Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan of Minzdrav of Russia 630091, Novosibirsk, Frunze str., 17
7Autonomous non-profit organization «Сlinic of Traumatology, Orthopedics and Neurosurgery of NRITO» (ANO «Сlinic NRITO») 630091, Novosibirsk, Frunze str., 19a
Abstract
The clinical case is fairly rare combination of severe somatic pathology (neuroendocrine cancer, terminal chronic kidney disease, program hemodialysis, etc.) and orthopedic and traumatologic pathology (right femoral neck pseudarthrosis) requiring surgical intervention with high risks for patient’s life. The patient has been suffering from polyneuroendocrine cancer since 2001. The history of multiple surgical interventions for polyneuroendocrine cancer is presented. Neuroendocrine cancer is considered as the least often oncologic disease. It is very dangerous, because neuroendocrine cells are spread throughout the body and can affect almost any organ. The treatment prognosis is unknown. At present, this type of cancer is poorly researched, which precludes the introduction of new treatment options and preventive activities. In the setting of comorbid pathology that arose from neuroendocrine cancer treatment (comorbidity index 12, according to ASA IV), the patient received the right femoral neck fracture. Surgical treatment for femoral neck fracture in patients burdened with comorbid pathology is a challenge for surgeons, anesthesiologists-resuscitators, therapists, nutritiologists, and doctors of other specialties. An abandonment of surgical intervention worsens the quality of life, aggravates disability, leads to the development of trophic, thrombo-embolic and infectious complications, and increases the likelihood of adverse outcome. Surgical treatment in the setting of specialized hospital is the most expedient. Therefore, due to comorbidity of such patients, a niche-targeted approach to treatment by specialists is needed at all stages of treatment with a seamless transfer of care and consistency of treatment activities.
Key words
References1. Bikbov B.T., Tomilina N.A. Renal replacement therapy for ESRD patients in Russian Federation, 1998-2011 (Report of Russian RRT Registry. Part 1). Nefrologiya i dializ = Nephrology and Dialysis. 2014. 16. (1). 11–127. [In Russian].
2. Karyakin N.N., Donchenko E.V., Mukhin P.V. Quantitative assessment of dependense of several mortality and morbidity rates from healthcare sources. Meditsinskiy almanakh = Medical Almanac. 2014. (3). 16–20. [In Russian].
3. Pomazkov A.A., Cherkasov M.F., Khindikaynen A.Yu., Kushnareva O.E., Fedorova K.Yu. The retrospective analysis of the frequency of occurrence of tumors of the gastrointestinal tract neuroendocrine component in 10 years in the city of Rostov-on-Don. Sovremennyye problemy nauki i obrazovaniya = Modern problems of science and education. 2016. (6). URL: http://science-education.ru/ru/article/view?id=25490. [In Russian].
4. Guide to hip surgery. Eds. R.M. Tikhilov, I.I. Shubnyakov. Saint-Petersburg, 2014. 1. 368 p. [In Russian].
5. Simonenko V.B., Dulin P.A., Mananin M.A. Guide: Neuroendocrine tumors. Moscow: GEOTAR-Media, 2010. 240 p. [In Russian].
6. McCullough P.A., Kellum J.A., Haase M., Muller C., Damman K., Murray P.T., Cruz D., House A.A., Schmidt-Ott K.M., Vescovo G., Bagshaw S.M., Hoste E.A., Briguori C., Braam B., Chawla L.S., Costanzo M.R., Tumlin J.A., Herzog C.A., Mehta R.L., Rabb H., Shaw A.D., Singbartl K., Ronco C. Pathophysiology of the cardiorenal syndromes: executive summary from the eleventh consensus conference of the Acute Dialysis Quality Initiative (ADQI) // Contrib Nephrol. 2013. 182. 82-98.
About Authors (Correspondence):
Kirilina S.I. – doctor of medical sciences, chief researcher, anesthesiologist-resuscitator, e-mail: ksi-kln@ngs.ru
Full Text
Received: 30/08/2018
Accepted: 30/08/2018