Veidlapa Nr. M-3 (8)

Course Description Status: Approved

Course Description Version: 25/26.R.4.00

Description Period: 2025./26 academic year rudens semestris

Study Course Accepted: -

Study Course Description

Surgical Diseases II (Urology, General, Cardiac, Vascular and Thoracic Surgery)

Main Study Course Information

Course Code
KK_046
Branch of Science
Clinical medicine; Surgery
ECTS
9.00
Target Audience
Medicine
LQF
Level 7
Study Type And Form
Full-Time

Study Course Implementer

Course Supervisor
Haralds Plaudis
Structure Unit Manager
Jānis Gardovskis
Structural Unit
Department of Surgery
Contacts

Riga, 13 Pilsonu Street, VSIA P.Stradiņa KUS, Block No 24, kk@rsu.lv, +371 67069745

About Study Course

Objective

Students will acquire knowledge of emergency and elective surgery of abdominal, thoracic, cardiac and vascular, as well as urology diseases, their nature and aetiology, pathogenesis, clinical picture, diagnostics, principles of treatment and prevention, and organ transplantation.

Preliminary Knowledge

Human anatomy, basics of propaedeutics, physiology and pathology, basics of propaedeutics and surgery.

Learning Outcomes

Knowledge

1.After successfully completing the course, the student will have acquired knowledge and will be able to: • Describe the nature, etiology, and pathogenesis of urological, general, thoracic, cardiac, and vascular surgical diseases; • Characterize the clinical presentation, diagnostics, treatment principles, and prevention of these conditions; • Recognize the clinical manifestations and potential complications of these diseases, list modern clinical, laboratory, and instrumental diagnostic methods, as well as surgical treatment options and their indications.

Skills

1.Upon successful completion of the course, the student will be able to: • Examine surgical patients using palpation, percussion, auscultation, and related methods; • Assess patient complaints and medical history; • Interpret endoscopic examination results of the digestive tract; • Analyze diagnostic findings and treatment options for abdominal cavity, thoracic, cardiac, and vascular conditions; • Perform stoma patient care; • Examine urological patients; • Assess complaints and medical history of urological patients; • Conduct a physical examination of urological patients using palpation, percussion, auscultation, and related methods; • Perform male and female bladder catheterization (on a mannequin); • Perform a rectal examination (on a mannequin).

Competences

1.Upon completion of the course, students will be able to: • Analyze data obtained from diagnostic examinations; • Develop a laboratory and instrumental examination plan for patients; • Assess specific surgical cases and interpret laboratory and instrumental diagnostic findings; • Formulate and logically justify a comprehensive surgical diagnosis; • Develop a management plan for specific surgical clinical cases; • Determine indications for conservative and surgical treatment; • Analyze diagnostic data obtained from urological patients; • Develop a laboratory and instrumental examination plan for urological patients; • Assess specific urological cases and interpret laboratory and instrumental diagnostic findings; • Formulate and logically justify a comprehensive urological diagnosis; • Develop a management plan for specific urological clinical cases; • Determine indications for conservative and surgical urological treatment.

Assessment

Individual work

Title
% from total grade
Grade
1.

Self-assessment tests
-
-

Examination

Title
% from total grade
Grade
1.

Evaluation in the study course
-
10 points

1. Attendance: 100% required.

2. Self-assessment tests: If multiple-choice self-tests are available in E-studies, they must be completed before each class.

3. Evaluation in course sections:

  • General Surgery and Urology – in each class, the student completes a multiple-choice test. In the final class of General Surgery and Urology, the student completes a clinical case task.
  • Vascular Surgery – in the last class (of three), the student presents an independent assignment – a clinical case, in accordance with previously announced requirements.
  • Cardiac and Thoracic Surgery – in the final class, the student completes a final test.

4. Final course grade is composed of two equally weighted parts:

50% – Tests during classes:

  • Urology (10% of the final grade)
  • General Surgery (10% of the final grade)
  • Cardiac Surgery (10% of the final grade)
  • Thoracic Surgery (10% of the final grade)
  • Vascular Surgery (10% of the final grade)

50% – Written clinical case assignments:

  • Urology – in the final Urology class (25% of the final grade)
  • General Surgery – in the final General Surgery class (25% of the final grade)

Course evaluation survey: To assess the overall quality of the study course, students must complete the course evaluation survey in the Student Portal.

Study Course Theme Plan

FULL-TIME
Surgical Diseases II. Urology

  1. Video Lecture

Modality
Location
Contact hours
Off site
Video
2

Topics

Traumatic injuries of abdominal organs (liver, spleen, pancreas, intestinal ruptures etc.).
Description

general surgery lecture

  1. Video Lecture

Modality
Location
Contact hours
Off site
Video
2

Topics

Chronic pancreatitis, pancreatic tumors. Clinic, diagnostics, treatment.
Description

general surgery lecture

  1. Video Lecture

Modality
Location
Contact hours
Off site
Video
2

Topics

Acute and chronic disorders of mesenteric circulation.
Description

general surgery lecture

  1. Video Lecture

Modality
Location
Contact hours
Off site
Video
2

Topics

Peripheral arterial disease (PAD). Algorithm for diagnosis of PAD. Basic concepts in vascular surgery. Treatment of PAD Management of intermittent claudication. Management of chronic limb-threatening ischaemia. Acute limb ischaemia. Management of acute limb ischaemia. Surgical risk analysis. Assessment of the viability of the limb. Contraindications to surgical revascularisation. Assessing the amputation risk (WlFl classification).
Description

vascular surgery lecture

  1. Video Lecture

Modality
Location
Contact hours
Off site
Video
2

Topics

Carotid and vertebral artery diseases. Arterial aneurysms. Abdominal aortic aneurysm. Acute aortic syndrome. Aortic dissection. Chronic venous disease. Acute and chronic deep vein thrombosis. Diseases of mesenteric arteries and veins.
Description

vascular surgery lecture

  1. Video Lecture

Modality
Location
Contact hours
Off site
Video
2

Topics

Prostate cancer. Malignant tumours of kidney, urinary bladder, testis and penis.
Description

urology lecture

  1. Video Lecture

Modality
Location
Contact hours
Off site
Video
2

Topics

Benign prostatic hyperplasia. Non-neurogenic male lower urinary tract symptoms.
Description

urology lecture

  1. Video Lecture

Modality
Location
Contact hours
Off site
Video
2

Topics

Symptoms and syndroms of disorders of urinary tract. Principles of investigation. Infection of urinary tract.
Description

urology lecture

  1. Video Lecture

Modality
Location
Contact hours
Off site
Video
2

Topics

Urolythiasis. Aethiology, pathogenesis, methods and principles of investigation, treatment.
Description

urology lecture

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Colorectal cancer and premalignant diseases. Clinical picture and surgical approach deppending on localization of the tumor. Radical and palliative operated patient discussion.
Description

general surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Peritoneal adhaesions. Intestinal fistulas. Stoma care. Clinical presentation, diagnosis and treatment.
Description

general surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Polytrauma – its concept and definition. Principles of prehospital and intrahospital care of a polytrauma patient – primary, secondary and tertiary evaluation. Trauma team. Principle of "Damage control surgery".
Description

general surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Gastrointestinal bleeding. Zollinger – Ellison syndrome.
Description

general surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Chronic pancreatitis. Tumours of the pancreas. Clinical picture, diagnostics, treatment.
Description

general surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Gastric cancer and pre-malignant lesions. Diagnosis and differential diagnosis. Importance of early diagnosis. Surgery principles: radical and palliative treatment.
Description

general surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Spotlights in the diagnosis and treatment of brachiocephalic arteries, abdominal aortic aneurysms, venous disease and diseases of mesenteric vessels. Analysis of current international vascular surgical guidelines, using ESVS Guidelines on Management of Atherosclerotic Carotid and Vertebral Artery; ESVS Guidelines on Management of Abdominal Aortic Aneurysms; ESVS Guidelines on Management of Chronic Venous Disease; ESVS Guidelines on Management of the Diseases of Mesenteric Arteries and Veins.
Description

vascular class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Spotlights in the diagnosis and treatment of peripheral arterial diseases. Analysis of current international vascular surgical guidelines, using Trans-Atlantic Inter-Society Consensus (TASC) Guidelines; ESVS Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases.
Description

vascular class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Diseases of veins and lymphatic vessels in extremities. Clinical presentation, diagnosis and treatment. Thrombosis and thrombophlebitis, deep vein insufficiency. Tropical ulcers. Gangrene. Diagnostics and treatment.
Description

vascular class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Basics and principles of organ transplantation.
Description

transplantology class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Malignant diseases of prostate – prostate cancer. Symptoms, pathogenesic theories, diagnostic methods. Principles of treatment. Conservative and surgical treatment.
Description

urology class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Kidney and urinary bladder cancers.
Description

urology class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Symptoms of diseases of lower urinary tract. Benign prostatic hyperplasy.
Description

urology class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Symptoms and syndroms of disorders of urinary tract. Principles of investigation. Urological emergencies.
Description

urology class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Penile and testicular cancers.
Description

urology class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Urolithiasis. Etiology, symptoms, classification, theories of stone formation. Diagnostic techniques. Elimination of complications.
Description

urology class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Infections of the urinary tract. Acute secundary pyelonephritis. Forms of the pyelonephritis. Specific infection diseases of the urinary tract, tbc. Cystitis, orchitis, prostatitis.
Description

urology class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Functional urology. Urine incontinence, overactive bladder. Diagnostics and treatment.
Description

urology class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Purulent diseases of lungs and pleural cavity.
Description

thoracic class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Oesophageal diseases (achalasia, strictures, cancer, diverticula). Diseases of diaphragm (hernia, lesions).
Description

thoracic class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Lung cancer, pathology of the mediastinum.
Description

thoracic surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Thoracic trauma (rib fractures, pneumothorax, haemothorax – manipulations).
Description

thoracic surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Surgical treatment of acute and chronic heart failure. Short-term and long-term mechanical circulatory assist devices. Heart transplantation. Acute and chronic pathology of the thoracic aorta.
Description

cardiac surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Epidemiology, methods of treatment and prevention of cardiovascular diseases. A brief history of cardiac surgery. Cardiopulmonary bypass - the most important technology in modern heart surgery.
Description

cardiac surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Heart valve diseases, causes, diagnosis and indications for surgery. Types of heart valve surgery. Anticoagulation after heart valve surgery.
Description

cardiac surgery class

  1. Class/Seminar

Modality
Location
Contact hours
On site
Study room
3

Topics

Diagnosis of coronary heart disease, indications for invasive diagnostic methods and surgical operations. Variants of myocardial revascularization operations. Importance of guidelines. Management of the postoperative period. Long-term results of revascularization.
Description

cardiac surgery class
Total ECTS (Creditpoints):
9.00
Contact hours:
96 Academic Hours
Final Examination:
Exam (Written)

Bibliography

Required Reading

1.

Lekciju materiāli e-vidē/Lecture materialsSuitable for English stream

2.

Bergan J. J., Bunke-Paquette N. 2014. The Vein Book. Oxford University Press. 555 pp. (jaunāka izdevuma nav)Suitable for English stream

3.

Townsend, C.M. 2021. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 21st ed. Elsevier.Suitable for English stream

4.

Braunwald, E., Bonow, R.O. 2022. Braunwald's heart disease: a textbook of cardiovascular medicine. 9th ed. Saunders.Suitable for English stream

5.

Kirklin, J., Blackstone, E. 2013. Kirklin/Barratt-Boyes Cardiac Surgery. 4th ed. Elsevier. (jaunāka izdevuma nav)Suitable for English stream

6.

Dienemann, H.C., Hoffmann, H., Detterbeck, F.C. 2015. Chest Surgery. Springer.Suitable for English stream

7.

LoCicero, J. 2018. Shields' General Thoracic Surgery. Wolters Kluwer.Suitable for English stream

8.

Hoffmeister et.al. 2015. English language version of the S3-consensus guidelines on chronic pancreatitis: Definition, aetiology, diagnostic examinations, medical, endoscopic and surgical management of chronic pancreatitis.Suitable for English stream

9.

Potapov, E. V., et al. 2019. 2019 EACTS Expert Consensus on long-term mechanical circulatory support. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 56(2), 230–270.Suitable for English stream

10.

Otto, C. M., et al. 2021. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 143(5), e35–e71.Suitable for English stream

11.

Reynard, J., Brewster, S.F., Biers, S., Neal, N.L. 2019. Oxford Handbook of Urology. 4th ed. OUP Oxford.Suitable for English stream

12.

Chapple, C., Hillary, C., Patel, A., MacDiarmid, 2018. Urodynamics Made Easy. 4th ed. Elsevier.Suitable for English stream

13.

Partin, A.W. et al. 2021. Campbell-Walsh-Wein Urology. 12th ed. Elsevier.Suitable for English stream

14.

Čerņevskis, H., Strazdiņš, V., Lietuvietis, V., Bozotova, N. 2015. Urīnceļu infekcijas pieaugušajiem un bērniem. Rīga: SIA izdevniecība «PILATUS»

15.

Dahm, P., Dmochowski, R. 2018. Evidence-based Urology. 2nd ed. Wiley.Suitable for English stream

Additional Reading

1.

Williams, N.S., O'Connell, P.R., McCaskie, A. 2018. Bailey & Love’s Short Practice of Surgery. 27th ed. London: Champan & Hall MedicalSuitable for English stream

2.

Brunicardi, F., et al. 2019. Schwartz's Principles of Surgery, 11th ed. McGraw-Hill.Suitable for English stream

3.

Cameron, J.L., Cameron, A.M. 2020. Current Surgical Therapy. 13th ed. Elsevier.Suitable for English stream

4.

G Rocco et al. 2017. Uniportal Video-Assisted Thoracic Surgery. In: Operative Thoracic Surgery. 6th ed. CRC Press.Suitable for English stream

5.

Rami-Porta, R., 2016. IASLC Staging Handbook in Thoracic Oncology. 2nd ed.Suitable for English stream

6.

Dang, C.V. 2020. Acute Mesenteric IschemiaSuitable for English stream

7.

Hajjar, L.A., Teboul, JL. 2019. Mechanical Circulatory Support Devices for Cardiogenic Shock: State of the Art. Crit Care 23, 76 (2019).Suitable for English stream

8.

Sen, A., Larson, J.S., Kashani, K.B. et al. 2016. Mechanical circulatory assist devices: a primer for critical care and emergency physicians. Crit Care 20, 153 (2016).Suitable for English stream

9.

Moorjani, N., Viola, N., Walker, W.S. 2016. Key Questions in Thoracic Surgery. TFM Publishing.Suitable for English stream

10.

Gardovskis, J. 2013. Ķirurģija. 2.izd. Rīga: Rīgas Stradiņa universitāte.

11.

Zollinger, R.M., Ellison, E.C. 2011. Zollinger's Atlas of Surgical Operations. 11th ed. New York: Mc Graw Hill. (akceptējams izdevums)Suitable for English stream

12.

European Association of Urology guidelinesSuitable for English stream

Other Information Sources

1.

Clinical Practice Guidelines of the European Society for Vascular Surgery and European Journal of Vascular and Endovascular surgerySuitable for English stream

2.

Conwell, D.L., et.al. 2014. American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: Evidence-Based Report on Diagnostic Guidelines:Suitable for English stream

3.

Bray, F., Ferlay, J., Soerjomataram, I., et al. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 countries. CA Cancer J Clin 2018 Nov;68(6):394-424Suitable for English stream

4.

NICE guidelines for upper GI bleeding. 2016. Acute upper gastrointestinal bleeding in over 16s: management.Suitable for English stream

5.

European Respiratory Society (ERS) guidelinesSuitable for English stream

6.

ESMO Clinical Practice Guidelines: Gastrointestinal CancersSuitable for English stream

7.

ESMO Clinical Practice Guidelines: Lung and Chest TumoursSuitable for English stream

8.

Otto, C. M., et al. 2021. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 143(5), e72–e227.Suitable for English stream

9.

Vahanian, A., et al. 2021. 2021 ESC/EACTS Guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS), European Heart Journal, Volume 43, Issue 7, 14 February 2022, Pages 561–632Suitable for English stream

10.

McDonagh, T.A. et al. 2021. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal, Volume 42, Issue 36, 21 September 2021, Pages 3599–3726Suitable for English stream

11.

Neumann, F. et al. 2018. ESC/EACTS Guidelines on Myocardial Revascularization: ESC Clinical Practice Guidelines. European Heart Journal, Volume 40, Issue 2, 07 January 2019, Pages 87–165Suitable for English stream

12.

Gloviczki P., ed. 2017. Handbook of Venous and Lymphatic Disorders: Guidelines of the American Venous Forum, Fourth Edition. CRC Press Taylor&Francis Group. 815 pp.Suitable for English stream

13.

European Society of Thoracic Surgeons (ESTS) guidelinesSuitable for English stream

14.

Acute Heart Failure and Mechanical Circulatory SupportSuitable for English stream

15.

Hajjar, L.A., Teboul, JL. 2019. Mechanical Circulatory Support Devices for Cardiogenic Shock: State of the Art. Crit Care 23, 76 (2019).Suitable for English stream

16.

Sen, A., Larson, J.S., Kashani, K.B. et al. 2016. Mechanical circulatory assist devices: a primer for critical care and emergency physicians. Crit Care 20, 153 (2016).Suitable for English stream