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Surgical Diseases II
Study Course Description
Course Description Statuss:Approved
Course Description Version:5.00
Study Course Accepted:21.06.2024 08:32:35
| Study Course Information | |||||||||
| Course Code: | KK_036 | LQF level: | Level 7 | ||||||
| Credit Points: | 4.00 | ECTS: | 6.00 | ||||||
| Branch of Science: | Clinical Medicine; Surgery | Target Audience: | Medicine | ||||||
| Study Course Supervisor | |||||||||
| Course Supervisor: | Kaspars Zeiza | ||||||||
| Study Course Implementer | |||||||||
| Structural Unit: | Department of Surgery | ||||||||
| The Head of Structural Unit: | |||||||||
| Contacts: | Riga, 13 Pilsoņu Street, VSIA P.Stradiņa KUS, corpus No 24., kk rsu[pnkts]lv, +371 67069745 | ||||||||
| Study Course Planning | |||||||||
| Full-Time - Semester No.1 | |||||||||
| Lectures (count) | 11 | Lecture Length (academic hours) | 2 | Total Contact Hours of Lectures | 22 | ||||
| Classes (count) | 14 | Class Length (academic hours) | 3 | Total Contact Hours of Classes | 42 | ||||
| Total Contact Hours | 64 | ||||||||
| Study course description | |||||||||
| Preliminary Knowledge: | Human anatomy, physiology and pathology, basics of propaedeutics and surgery. | ||||||||
| Objective: | Students will acquire knowledge of emergency and elective surgery of abdominal, thoracic, cardiac and vascular diseases, their nature and aetiology, pathogenesis, clinical picture, diagnostics, principles of treatment and prevention as well as organ transplantation. | ||||||||
| Topic Layout (Full-Time) | |||||||||
| No. | Topic | Type of Implementation | Number | Venue | |||||
| 1 | Traumatic injuries of abdominal organs (liver, spleen, pancreas, intestinal ruptures etc.). | Lectures | 1.00 | other | |||||
| 2 | Acute and chronic disorders of mesenteric circulation. | Lectures | 1.00 | auditorium | |||||
| 3 | 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). | Lectures | 1.00 | other | |||||
| 4 | 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. | Lectures | 1.00 | other | |||||
| 5 | Chronic pancreatitis, pancreatic tumors. Clinical signs, diagnostics, treatment. | Lectures | 1.00 | clinical base | |||||
| 6 | Valvular heart disease, causes, diagnostics, indications for surgical treatment. Surgical options in valvular heart disease. Anticoagulation options after heart valve operations. | Lectures | 1.00 | other | |||||
| 7 | Pathophysiological mechanism of heart failure, classification. Surgical options in heart failure. Analysis of the methods of mechanical assist devices. Heart transplantation. Congenital heart disease, classification, surgical options. | Lectures | 1.00 | other | |||||
| 8 | Purulent diseases of lungs and pleural cavity. | Lectures | 1.00 | other | |||||
| 9 | Oesophageal diseases (achalasia, strictures, cancer, diverticula). Diseases of diaphragm (hernia, lesions). | Lectures | 1.00 | other | |||||
| 10 | Chronic pancreatitis, pancreatic tumors. Clinic, diagnostics, treatment. | Lectures | 1.00 | other | |||||
| 11 | Bariatric surgery | Lectures | 1.00 | other | |||||
| 12 | 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. | Classes | 1.00 | clinical base | |||||
| 13 | 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. | Classes | 1.00 | clinical base | |||||
| 14 | 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. | Classes | 1.00 | clinical base | |||||
| 15 | Colorectal cancer and premalignant diseases. Clinical picture and surgical approach deppending on localization of the tumor. Radical and palliative operated patient discussion. | Classes | 1.00 | clinical base | |||||
| 16 | Chronic pancreatitis. Tumours of the pancreas. Clinical picture, diagnostics, treatment. | Classes | 1.00 | clinical base | |||||
| 17 | Peritoneal adhaesions. Intestinal fistulas. Stoma care. Clinical presentation, diagnosis and treatment. | Classes | 1.00 | clinical base | |||||
| 18 | Gastric cancer and pre-malignant lesions. Diagnosis and differential diagnosis. Importance of early diagnosis. Surgery principles: radical and palliative treatment. | Classes | 1.00 | clinical base | |||||
| 19 | Gastrointestinal bleeding. Zollinger – Ellison syndrome. | Classes | 1.00 | clinical base | |||||
| 20 | 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". | Classes | 1.00 | clinical base | |||||
| 21 | Epidemiology of cardiovascular disease. Prevention, treatment and financial resources. | Classes | 1.00 | clinical base | |||||
| 22 | Diagnostics of coronary heart disease, indications for invasive diagnostic methods and surgical treatment. Types of surgical myocardial revascularization. Role of Guidelines. Postoperative management. | Classes | 1.00 | clinical base | |||||
| 23 | Thoracic trauma (rib fractures, pneumothorax, haemothorax – manipulations). | Classes | 1.00 | clinical base | |||||
| 24 | Lung cancer, pathology of the mediastinum. | Classes | 1.00 | clinical base | |||||
| 25 | Basics and principles of organ transplantation. | Classes | 1.00 | clinical base | |||||
| Assessment | |||||||||
| Unaided Work: | 1) MCQ self-control and clinical case task must be completed before every class in E-studies about topics in general, thoracic, cardiac surgery and transplantology. 2) Student writes a clinical case report (if available due to restrictions in hospitals). 3) General, thoracic and cardiac surgery: after the surgery cycle student completes a clinical case report task in E-studies. 4) Vascular surgery: during the third class of vascular surgery student presents an independently completed task, described, and given by the teacher during the classes. In order to evaluate the quality of the study course as a whole, the student must fill out the study course evaluation questionnaire on the Student Portal. | ||||||||
| Assessment Criteria: | Students’ knowledge of aetiology, pathogenesis, clinical picture, diagnostics, treatment principles and prevention of surgical diseases is assessed during the practical classes, as well as during discussions of clinical cases. Final evaluation (grade) in this study course is calculated from two marks of equal importance: 1) Assessment of student’s activity during the course – 50%. This mark includes assessment of the clinical case report (10%), results from case report tasks completed after general surgery (10%), cardiac surgery (10%), thoracic surgery cycles (10%) and evaluation of student’s activity during the vascular surgery classes (10%). 2) Exam mark – 50%. Exam is computer-based test which consists of two parts and is organized for all student groups at once. 1st part: MCQ test with 100 questions (25% of the final grade), 2nd part: 2 clinical case report tasks (25% of the final grade). (Exam can be subject to a change, in which case detailed information will be available in E-studies) | ||||||||
| Final Examination (Full-Time): | Exam | ||||||||
| Final Examination (Part-Time): | |||||||||
| Learning Outcomes | |||||||||
| Knowledge: | On successful completion of the course, the students will be able to: • describe diseases of general, thoracic, cardiac and vascular surgeries, their aetiology and pathogenesis; • explain the clinical picture, diagnostics, principles of treatment and prevention of urgent and elective abdominal and vascular surgical diseases; • describe up-to-date methods of clinical, laboratory and instrumental investigation; • discuss surgical treatment methods and their indications. | ||||||||
| Skills: | As a result of successful completion of the course, the students will be able to: • perform physical examination of a patient using palpation, percussion and auscultation; • explain the results of upper GI tract endoscopy; • evaluate investigation results of the abdominal, chest, endocrine organs, cardiovascular system and explain treatment possibilities; • perform medical care of the stoma patient. | ||||||||
| Competencies: | On successful completion of the course, the students will be able to: • analyse data of 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; • formulate and justify a full clinical diagnosis; • plan tactics for a surgical clinical case; • formulate indications for surgical and conservative treatment. | ||||||||
| Clinical Skills: | |||||||||
| No. | Skill | Level | |||||||
| 1 | Thoracocentesis (pleural effusion) | B1 - Basic level | |||||||
| Bibliography | |||||||||
| No. | Reference | ||||||||
| Required Reading | |||||||||
| 1 | Lekciju materiāli e-vidē/Lecture materials | ||||||||
| 2 | Gardovskis, J. 2013. Ķirurģija. 2.izd. Rīga: Rīgas Stradiņa universitāte. | ||||||||
| 3 | Bergan J. J., Bunke-Paquette N. 2014. The Vein Book. Oxford University Press. 555 pp. | ||||||||
| 4 | Townsend, C.M. 2021. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 21st ed. Elsevier. | ||||||||
| 5 | Zollinger, R.M., Ellison, E.C. 2011. Zollinger's Atlas of Surgical Operations. 11th ed. New York: Mc Graw Hill. (akceptējams izdevums) | ||||||||
| 6 | Braunwald, E., Bonow, R.O. 2022. Braunwald's heart disease: a textbook of cardiovascular medicine. 9th ed. Saunders. | ||||||||
| 7 | Kirklin, J., Blackstone, E. 2013. Kirklin/Barratt-Boyes Cardiac Surgery. 4th ed. Elsevier. | ||||||||
| 8 | Dienemann, H.C., Hoffmann, H., Detterbeck, F.C. 2015. Chest Surgery. Springer. | ||||||||
| 9 | LoCicero, J. 2018. Shields' General Thoracic Surgery. Wolters Kluwer. | ||||||||
| 10 | Ārvalstu studentiem/For international students: | ||||||||
| 11 | Bergan J. J., Bunke-Paquette N. 2014. The Vein Book. Oxford University Press. 555 pp. | ||||||||
| 12 | Zollinger, R.M., Ellison, E.C. 2011. Zollinger's Atlas of Surgical Operations. 11th ed. New York: Mc Graw Hill. (akceptējams izdevums) | ||||||||
| 13 | Kirklin, J., Blackstone, E. 2013. Kirklin/Barratt-Boyes Cardiac Surgery. 4th ed. Elsevier. | ||||||||
| 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 Medical | ||||||||
| 2 | Brunicardi, F., et al. 2019. Schwartz's Principles of Surgery, 11th ed. McGraw-Hill. | ||||||||
| 3 | Cameron, J.L., Cameron, A.M. 2020. Current Surgical Therapy. 13th ed. Elsevier. | ||||||||
| 4 | G Rocco et al. 2017. Uniportal Video-Assisted Thoracic Surgery. In: Operative Thoracic Surgery. 6th ed. CRC Press. | ||||||||
| 5 | Rami-Porta, R., 2016. IASLC Staging Handbook in Thoracic Oncology. 2nd ed. | ||||||||
| 6 | Dang, C.V. 2020. Acute Mesenteric Ischemia | ||||||||
| 7 | 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. | ||||||||
| 8 | 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. | ||||||||
| 9 | Hajjar, L.A., Teboul, JL. 2019. Mechanical Circulatory Support Devices for Cardiogenic Shock: State of the Art. Crit Care 23, 76 (2019). | ||||||||
| 10 | 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). | ||||||||
| 11 | Moorjani, N., Viola, N., Walker, W.S. 2016. Key Questions in Thoracic Surgery. TFM Publishing. | ||||||||
| Other Information Sources | |||||||||
| 1 | Clinical Practice Guidelines of the European Society for Vascular Surgery and European Journal of Vascular and Endovascular surgery | ||||||||
| 2 | Conwell, D.L., et.al. 2014. American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: Evidence-Based Report on Diagnostic Guidelines: | ||||||||
| 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):394-424 | ||||||||
| 4 | NICE guidelines for upper GI bleeding. 2016. Acute upper gastrointestinal bleeding in over 16s: management. | ||||||||
| 5 | European Respiratory Society (ERS) guidelines | ||||||||
| 6 | ESMO Clinical Practice Guidelines: Gastrointestinal Cancers | ||||||||
| 7 | ESMO Clinical Practice Guidelines: Lung and Chest Tumours | ||||||||
| 8 | 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. | ||||||||
| 9 | 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. | ||||||||
| 10 | 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 561–632 | ||||||||
| 11 | 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 3599–3726 | ||||||||
| 12 | 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 87–165 | ||||||||
| 13 | 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. | ||||||||
| 14 | European Society of Thoracic Surgeons (ESTS) guidelines | ||||||||
| 15 | Acute Heart Failure and Mechanical Circulatory Support | ||||||||
| 16 | Hajjar, L.A., Teboul, JL. 2019. Mechanical Circulatory Support Devices for Cardiogenic Shock: State of the Art. Crit Care 23, 76 (2019). | ||||||||
| 17 | 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). | ||||||||
