Veidlapa Nr. M-3 (8)
Study Course Description
Diagnostics and Treatment of Surgical Diseases (General, Cardiac and Thoracic Surgery)
Course Code
KK_017
Branch of Science
Clinical medicine; Surgery
ECTS
4.50
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 about aetiology, pathogenesis, clinical presentation, main diagnostic steps and principles of prevention and treatment of different surgical pathologies including thoracic, cardiac, vascular and abdominal diseases; will acquire knowledge how to differentiate urgent and elective conditions; will learn to define correct indication for surgical intervention; preoperative risk assessment and management of the postoperative period.
Preliminary Knowledge
Knowledge of the normal anatomy, normal and pathological physiology of the human body as a whole and of each of its major organ systems. Knowledge of the mechanisms important in maintaining the body's homeostasis. Knowledge of the clinical propaedeutics. Basics in radiology and clinical laboratory testing. Knowledge of the general surgery.
Learning Outcomes
Knowledge
1.On successful completion of the course, the students will be able to: • describe urgent and elective thoracic, cardiac, vascular and abdominal surgical diseases, their epidemiology, pathogenesis and clinical picture; • understand and describe the diagnostics, principles of treatment and prevention of said diseases; • define the criteria according to which the type of surgical treatment is chosen; • define the main risk factors of surgical treatment; • list the main complications of surgical treatment; • describe the appropriate preparation of the patient for surgery and the management of the postoperative period; • describe heart disease epidemiology, symptoms and signs during the preoperative period as well as the most important diagnostic methods; • indicate surgical procedures for surgical heart disease (myocardial revascularization, heart valve procedures, pacemaker implantation); • describe basic principles of cardiopulmonary bypass and assisted circulation; • choose appropriate treatment in heart pathology and timely refer the patient for surgical treatment.
Skills
1.On successful completion of the course, the students will be able to: • examine a surgical patient with thoracic, cardiac, vascular and abdominal pathology; • analyse the obtained data and define the clinical diagnosis; • define the indications that justify the choice of surgical treatment and the type of operation; • explain how to do thoracentesis in case of hydrothorax and pneumothorax; • describe indications for minimally invasive diagnostic manipulations and treatment principles of oncological diseases; • prepare a patient for cardiac surgery and evaluate the preparation of the patient; • manage postoperative rehabilitation and evaluate the patient status.
Competences
1.On successful completion of the course, the students will be able to: • analyse the results of the patient examination; • prepare necessary laboratory and instrumental investigation plan for the patient; • analyse a surgical case and interpret data acquired from laboratory and instrumental investigation methods; • evaluate the patient risk factors before surgery; • formulate and justify a full clinical diagnosis; • plan tactics for the surgical clinical case; • define indications for surgical and conservative treatment; • give first aid to patients with acute surgical diseases; • state indications for timely surgical treatment in different groups of cardiac pathology; • be competent in ethical praxis including the role and limitations of performing different procedures themselves or referring patients properly.
Assessment
Individual work
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Title
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% from total grade
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Grade
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|---|---|---|
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1.
Individual work |
-
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-
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Students prepare PowerPoint presentation which highlights epidemiology, clinical presentation, main diagnostic steps, criteria for the formulation of the diagnosis and the treatment options of the surgical pathology. There could be changes in Independent work during remote or semi-semote study.
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Examination
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Title
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% from total grade
|
Grade
|
|---|---|---|
|
1.
Examination |
-
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-
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Active participation in practical classes, qualitatively and timely written home works, qualitative oral answers in all classes.
In some classes there will be required presentations that highlights epidemiology, clinical presentation, main diagnostic steps, criteria for the formulation of the diagnosis and the treatment options of the surgical pathology.
Theoretical knowledge will be tested by discussions during practical classes and discussion of case reports. Clinical skills will be evaluated at the patient's bed.
Pass can be received by 100% fulfilling these conditions: full attendance of practical classes and all tests submitted on E-studies.
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Study Course Theme Plan
FULL-TIME
Part 1
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Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
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On site
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Specialized room
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4
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Topics
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Acute abdominal pain, definition and concept, main causes, type of the abdominal pain depending on the localisation of the pain receptors. Acute abdomen – diagnostics and differential diagnostics, the most common diagnostic errors. Indications for urgent surgical intervention in case of symptomatology of acute abdomen. Presentation of acute surgical diseases in geriatric patients.
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-
Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
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On site
|
Specialized room
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4
|
Topics
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Minimally invasive surgery – benefits, risk factors and methods in general surgery practice (endoscopic, laparoscopic, NOTES and SILS). Hybrid operations.
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-
Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
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On site
|
Specialized room
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4
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Topics
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Pre- and postoperative period. Risk factors in surgery. Disturbances of coagulation. Preparation of the patient for elective and urgent operations. Peculiarities of surgical diseases in oncology patients. Surgical treatment principles of oncological diseases. (Principles of the nutritional support, enteral and parenteral nutrition. Diabetes and surgery.)
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-
Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
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On site
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Other
|
4
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Topics
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Basics and principles of organ transplantation.
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-
Class/Seminar
|
Modality
|
Location
|
Contact hours
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|---|---|---|
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On site
|
Specialized room
|
4
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Topics
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Thoracic trauma (rib fractures, pneumothorax, haemothorax, injury of chest cavity organs and diaphragm, – manipulations).
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-
Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
|
On site
|
Specialized room
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4
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Topics
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Lung cancer, solitary pulmonary nodules.
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-
Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
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On site
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Specialized room
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4
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Topics
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Purulent diseases of the lungs and pleural cavity. Empyema, lung abscess, bronchopleural fistula, mediastinitis, bronchiectasis.
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-
Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
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On site
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Specialized room
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4
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Topics
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Surgically treated esophageal diseases (cancer, perforation, diverticula). Diseases of mediastinum.
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-
Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
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On site
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Specialized room
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4
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Topics
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Epidemiology of vascular heart disease. Prevention, treatment options, financial resources.
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Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
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On site
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Specialized room
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4
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Topics
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Valvular heart disease, causes, diagnostics, indications for surgical treatment. Surgical options in valvular heart disease. Anticoagulation options after heart valve operations.
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-
Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
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On site
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Specialized room
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4
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Topics
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Diagnostics of coronary heart disease, indications for invasive diagnostic methods and surgical treatment. Types of surgical myocardial revascularisation. Guideline meaning. Postoperative management.
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-
Class/Seminar
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Modality
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Location
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Contact hours
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|---|---|---|
|
On site
|
Specialized room
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4
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Topics
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Pathophysiological mechanism of heart failure, classification. Surgical options in heart failure. Analysis of mechanical assist. device methods. Heart transplantation. Congenital heart disease, classification, surgical options.
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Total ECTS (Creditpoints):
4.50
Contact hours:
48 Academic Hours
Final Examination:
Test (Semester)
Bibliography
Required Reading
1.
Mācību grāmata “Ķirurģija”, prof. J.Gardovska redakcijā, Rīga: RSU, 2013.
2.
Townsend, C. M., Beauchamp, R. D., Evers, B. M., Mattox, K. L. (2017) Sabiston Textbook of Surgery (20th ed.). Elsevier.
3.
Cardiac Surgery in the Adult and ed by H.Edmunds, New York, Mc Graw – Hill comp.
4.
Cardiac Syrgery 3rd ed. J.W.Kirklin. Ed Churchill Livingstone Comp.
5.
Atlas of minimally invasive surgical techniques. Ashley H. Vernon, Stanley W. Ashley. Izdevniecība: Elsevier Saunders, 2012.
6.
Cohn, L., & Adams, D. (2018). Cardiac Surgery in the Adult (5th ed.). Mc Graw-Hill Education.
7.
Kouchoukos, N., Blackstone, E., Hanley, F., & Kirklin, J. (2012). Kirklin/Barratt Boyes Cardiac Surgery: Expert Consult (4th ed.). Elsevier.
8.
Ellison, E.C., Zollinger, R.M. (2016) Zollinger`s Atlas of Surgical Operations. (10th ed.). McGraw-Hill Companies. ISBN 978-0-07-179755-9
Additional Reading
1.
Schwartz's Principles of Surgery: Single Volume 11th Revised edition Mc. Graw-Hill Medical, 2019.
2.
Cameron, J., & Cameron, A. (2020). Current Surgical Therapy (13th ed.). Elsevier.
3.
Acute Care Surgery: Principles and Practice. Ed. by L.D.Britt. – Springer, 2007.
4.
Laparoscopic Surgical Oncology. Ed. by Theodore T.Pappas, Emmanouel Leandros. - McGraw-Hill, 2005.
5.
Laparoscopic Colorectal Surgery. Ed. by Jeffrey W.Milsom, Bartholomaus Bohm, Kiyokazu Nakajama – 2nd ed. - Springer, 2006.
6.
Laparoscopic Surgery. Key Points, Operating Room Setup and Equipment Editors: Pignata, Giusto, Bracale, Umberto, Lazzara, Fabrizio (Eds.), Springer 2016.
7.
Chest Medicine: Essentials of Pulmonary and Critical Care Medicine 5th Revised edition by Michael A. Matthay, Richard W. Light, R.A. Matthay, Ronald B. George; ISBN-13: 9780781752732; ISBN-10: 0781752736; 2005; Lippincott Williams and Wilkins.
8.
Richter, J., & Castell, D. (2012). The Esophagus (6th ed.). Wiley-Blackwell
9.
General thoracic surgery. Fifth edition. Volume 1.Edited by Thomas W. Shields, Joseph LoCicero III, Ronald B. Form, Lippincott Williams & Wilkins. 2000.
10.
Pleural Diseases 5th Revised edition by Richard W. Light; ISBN-13: 9780781769570; ISBN-10: 0781769574; 2007; Lippincott Williams and Wilkins.
11.
Autoru kolektīvs. „Rekomendācijas nieru transplantācijā”, Rīga, SIA Medicīnas apgāds, 2015.
12.
Handbook of Kidney Transplantation. Sixth Edition. Danovitch, G. M. (Editor) Wolters Kluwar, 2017, 606pp. ISBN: 9781496326157.
13.
Donald Hricik (Editor), American Society of Transplantation. Primer on Transplantation, 3rd Edition. Wiley-Blackwell, 2011.
14.
Abhinav Humar, Arthur J. Matas, William D. Payne. Atlas of Organ Transplantation. Springer, 2015.
15.
Kirk AD, Knechtle SJ, Larsen CP, Madsen JC, Pearson TC, Webber SA (Editors). Textbook of organ transplantation. Wiley-Blackwell, 2014.
16.
C.E.H. Scott-Conner. Essential operative techniques and anatomy. 4th ed. LWW, 2014.
17.
Р.Розенталь. „Получение органов, тканей и клеток для трансплантации”, ред. П.Апинис. Rīga, SIA „Nacionālais apgāds”, 2005.
18.
Clinical Atlas of Airway Disease: Bronchoscopy, Radiology and Pathology James H. Harrell, David R. Duhamel Saunders. 2004
19.
Thymic epithelial tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Girard, N. et al. Annals of Oncology, Volume 26, v40 - v55 (2015) https://doi.org/10.1093/annonc/mdv277
20.
Baumgartner, H., Falk, V., Bax, J., De Bonis, M., Hamm, C., Holm, P., . . . Brecker, S. (2017, 9 21). 2017 ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal, 38(36), 2739-2791
21.
Economic burden of cardiovascular diseases in the enlarged European Union. J.Leal. European Heart Journal, v 27, issue 13, p. 1610 – 1619 (2006).
22.
2020 AHA/ACC Key Data Elements and Definitions for Coronary Revascularization: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Coronary Revascularization.
23.
2018 ESC/EACTS Guidelines on myocardial revascularization.
24.
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, ahajournals.org
25.
2017 ESC/EACTS Guidelines for the management of valvular heart disease. Academic.oup.com
26.
Antithrombotic therapy in patients with prosthetic heart valves. Ed.P.Auriyemma (2011.)
27.
2019 EACTS Expert Consensus on long-term mechanical circulatory support. Academic.oup.com
28.
Recommendations for the Use of Mechanical Circulatory Support: Ambulatory and Community Patient Care: A Scientific Statement From the American Heart Association. Ahajournals.org
29.
Heart Failure Guideline Updates 2019 Acoi.org
Other Information Sources
1.
Postmus, P. E., Kerr, K. M., Oudkerk, M., Senan, S., Waller, D. A., Vansteenkiste, J., Escriu, C., Peters, S., & ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org (2017). Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of oncology : official journal of the European Society for Medical Oncology, 28 Suppl 4, iv1–iv21. https://doi.org/10.1093/annonc/mdx222
2.
Juanpere, S., Cañete, N., Ortuño, P., Martínez, S., Sanchez, G., & Bernado, L. (2013). A diagnostic approach to the mediastinal masses. Insights into imaging, 4(1), 29–52. https://doi.org/10.1007/s13244-012-0201-0
3.
ESC/EACTS Guidlines on myocardial revascularization 2010. (http://www.escardio.org)
4.
Wilkins, E., Wilson, L., Wickramasinghe, K., Bhatnagar, P., Leal, J., Luengo-Fernandez, R., … Townsend, N. (2017). European Cardiovascular Disease Statistics 2017 edition. European Heart Network, Brussels.