Surgical Diseases I (Emergency and Planned Abdominal, Breast and Endocrine Surgery)

Study Course Description

Course Description Statuss:Approved

Course Description Version:11.00

Study Course Accepted:18.08.2022 12:19:22

Study Course Information
Course Code:		KK_013			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:		Genadijs Trofimovičs
Study Course Implementer
Structural Unit:		Department of Surgery
The Head of Structural Unit:
Contacts:		Riga, 13 Pilsonu Street, VSIA P.Stradiņa KUS, Block No 24, kkrsu[pnkts]lv, +371 67069745
Study Course Planning
Full-Time - Semester No.1
Lectures (count)		17	Lecture Length (academic hours)			2	Total Contact Hours of Lectures		34
Classes (count)		6	Class Length (academic hours)			5	Total Contact Hours of Classes		30
Total Contact Hours									64
Study course description
Preliminary Knowledge:
Anatomy, physiology and pathology of the corresponding anatomic region, basics of propaedeutics.
Objective:
Students will acquire knowledge of urgent and elective abdominal, breast and endocrine surgical diseases, their aetiology, pathogenesis, clinical picture, diagnostics, principles of treatment and prevention.
Topic Layout (Full-Time)
No.	Topic				Type of Implementation		Number	Venue
1	Breast diseases. Clinical signs, diagnostics, treatment.				Lectures		1.00	other
2	Breast cancer. Clinical signs, diagnostics, principles of complex treatment.				Lectures		1.00	other
3	Rectal diseases: haemorrhoids, fissures, paraproctitis. Pathogenesis, clinical signs and diagnostics, principles of surgical treatment.				Lectures		1.00	other
4	Acute and chronic appendicitis. Clinical signs, differential diagnostics and diagnostics. Complications and treatment tactics.				Lectures		1.00	other
5	Large bowel diseases. Crohn’s disease, nonspecific ulcerative colitis, diverticulosis, polyposis. Clinical signs, diagnostics, principles of surgical treatment.				Lectures		1.00	other
6	Primary abdominal wall hernias. Clinical signs, differential diagnostics and diagnostics. Complications of hernias. Different options of surgical treatment methods.				Lectures		1.00	other
7	Acute pancreatitis. Classification. Pathogenetic peculiarities in different types of patients. Basics of conservative treatment. Indications for surgical treatment, treatment tactics for different clinical forms of acute pancreatitis.				Lectures		1.00	other
8	Peritonitis. Etiology, pathogenesis, classification, clinical signs, diagnostics, principles of complex treatment.				Lectures		1.00	other
9	Liver disease (tumors, echinococcus, alveococcus). Liver cirrhosis. Portal hypertension. Clinical signs, diagnostics, treatment.				Lectures		1.00	other
10	Gallstone disease. Acute and chronic cholecystitis. Pathogenesis, clinical signs and diagnostics. Complications of gallstone disease. Treatment tactics in case of gallstone disease and different clinical forms of cholecystitis.				Lectures		1.00	other
11	Complications of ulcer disease (perforation, bleeding, stenosis, penetration, malignisation); clinical signs, diagnostics, differential diagnostics. Surgical treatment tactics and methods.				Lectures		1.00	other
12	Surgical diseases of thyroid and parathyroid glands.				Lectures		1.00	other
13	Ileus. Classification. Differential diagnosis. Principles of conservative and surgical treatment.				Lectures		1.00	other
14	Incision and uncommon localisation hernias.				Lectures		1.00	other
15	Mechanical jaundice. Cholangitis. Postcholecystectomy syndrome. Gallbladder and bile duct tumors. Clinical signs, diagnostics, treatment algorithm.				Lectures		1.00	other
16	Bariatric surgery.				Lectures		1.00	other
17	Minimally invasive surgery.				Lectures		1.00	other
18	The gallstone disease. Acute and chronic cholecystitis. Pathogenesis. Clinical picture and diagnostics. The surgical tactics in case of different forms of the disease. Complications of the gallstone disease. Liver disease (tumors, echinococcus, alveococcus). Liver cirrhosis. Portal hypertension. Clinical signs, diagnostics, treatment. Surgical diseases of spleen. Mechanical jaundice. Cholangitis. Postcholecystectomy syndrome. Gallbladder and bile duct tumors.				Classes		1.00	clinical base
19	Acute pancreatitis. Classification. Peculiarities of pathogenesis in different types of patients. Basics of conservative treatment. Indications for surgery, treatment tactics for different clinical forms of acute pancreatitis.				Classes		1.00	clinical base
20	Complications of ulcer disease (perforation, bleeding, stenosis, penetration, malignization), diagnostics, differential diagnostics. Large bowel diseases. Crohn’s disease, nonspecific ulcerative colitis, diverticulosis, polyposis. Rectal diseases: haemorrhoids, fissures, paraproctitis. Pathogenesis, clinical signs and diagnostics; surgical treatment tactics and methods.				Classes		1.00	clinical base
21	Primary external abdominal wall hernias. Clinical signs, differential diagnostics and diagnostics. Complications of hernias. Different options of surgical treatment methods. Acute and chronic appendicitis. Diagnostics, differential diagnostics. Surgical treatment.				Classes		1.00	clinical base
22	Breast diseases: cancer. Diagnostics, principles of complex treatment. Precancerous diseases.				Classes		1.00	clinical base
23	Surgical diseases of thyroid, parathyroid and adrenal glands.				Classes		1.00	clinical base
Assessment
Unaided Work:
1) During the surgical cycle the students hand-in description of one surgical patient (if available due to the epidemiological situation in Hospitals; information will be given during the surgery cycle). 2) Students write an academic case history (if available due to the epidemiological situation in Hospitals; information will be given during the surgery cycle).
Assessment Criteria:
Knowledge will be tested during practical classes by multiple choice tests on E-studies, generated by "Schoolhouse test" program and by discussion of clinical cases besides the patient’s bed or in online classes. Student can pass the study course by fulfilling 100% these 3 conditions: all the lectures are watched, all classes are attended,all the tests/ other tasks mentioned on E-studies are handed-in. One of the additional tasks (if available due to the epidemiological situation in Hospitals; details will be given during the surgery cycle): during the surgical cycle students perform duty in Emergency department with description of one surgical patient and write an academic case history.
Final Examination (Full-Time):		Test (Semester)
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		Upon successful completion of the course, the students will have knowledge that will allow to: • list and describe urgent and elective abdominal, breast and endocrine surgical diseases, their aetiology and pathogenesis; • explain the clinical picture, diagnostics, principles of treatment and prevention of urgent and elective abdominal, breast and endocrine surgical diseases; • describe aetiology, pathogenesis, and prevention of the above mentioned diseases; recognise clinical picture and possible complications of these diseases; • describe up-to-date methods of clinical, laboratory and instrumental investigation; • discuss surgical treatment methods and their indications.
Skills:		Upon successful completion of the course, the students will be able to: • do manual palpation of the breast glands; • collect patient's complaints and anamnesis; • do physical examination of the patient using palpation, percussion and auscultation; • explain the results of upper G-I.
Competencies:		Upon successful completion of the course, the students will be able to: • analyse data acquired during the surgical 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; • formulate indications for surgical and conservative treatment; • plan tactics dealing with the current clinical situation.
Clinical Skills:
No.	Skill						Level
1	Breast physical examination						B1 - Basic level
Bibliography
No.	Reference
Required Reading
1	Lekciju materiāli e-vidē/ Lectures in E-study
2	Mācību grāmata “Ķirurģija”, prof. J.Gardovska redakcijā, 2013.
3	Townsend, C. M., Beauchamp, R. D., Evers, B. M., Mattox, K. L. (2017) Sabiston Textbook of Surgery (20th ed.). Elsevier
4	Ellison, E.C., Zollinger, R.M. (2016). Zollinger’s Atlas of Surgical Operations, Tenth Edition. McGraw-Hill Education.
Additional Reading
1	Raftery, A. T., Delbridge, M. S., Wagstaff, M. J. D. (2017). Churchill's Pocketbook of Surgery (5th ed.). Churchill Livingstone , Elsevier
2	Henry, M., Thompson, J. (2012). Clinical Surgery (3rd ed.). Saunders, Elsevier
3	Paterson-Brown, S. (2018). Core Topics in General & Emergency Surgery. (6th ed.). Elsevier
4	Lennard, T., Lennard, T. (2013). Endocrine Surgery (5th ed.). Saunders Ltd, Elsevier
5	Phillips, R., Clark, S. (2018). Colorectal Surgery (6th ed.). Elsevier
6	Dixon, J. M., Garden, O. J., Paterson-Brown, S. (2018). Breast Surgery (6th ed.). Elsevier
7	Garden, O. J. (2018). Hepatobiliary and Pancreatic Surgery (6th ed.). Elsevier
8	Garden, O. J., Bradbury, A.W., Forsythe, J. L. R., Parks, R.W. (2017) Principles and Practice of Surgery (7th ed.). Elsevier
9	Forsythe, J. (2013). Transplantation (5th ed.). Saunders Ltd., Elsevier
10	Brunicardi F, & Andersen D.K., & Billiar T.R., & Dunn D.L., & Kao L.S., & Hunter J.G., & Matthews J.B., & Pollock R.E.(Eds.), (2019). Schwartz's Principles of Surgery, 11e. McGraw-Hill.
11	Laparo-endoscopic Hernia Surgery, Evidence Based Clinical Practice Editors: Bittner, R., Köckerling, F., Fitzgibbons, Jr., R.J., LeBlanc, K.A., Mittal, S.K., Chowbey, P. (Eds.) , 2018.
12	The Art of Hernia Surgery, A Step-by-Step Guide.Editors: Campanelli, Giampiero (Ed.), 2018.
13	Inguinal Hernia Surgery Editors: Campanelli, Giampiero (Ed.), 2017.
14	The SAGES Manual of Hernia Surgery Editors: Davis, Jr., S. Scott, Dakin, Gregory, Bates, Andrew (Eds.) 2019
15	Surgery of the Breast. Principles and Art. Ed. by Scott L. Spear. - 2nd ed. Lippincott Williams & Wilkins. 2006.
16	Diseases of the Breast. Ed. by Jay R. Harris, Marc E. Lippman, Monica Morrow, C. Kent Osborne. - 3rd ed. Lippincott Williams & Wilkins. 2006.
17	Laparoscopic Surgical Oncology. Ed. by Theodore T.Pappas, Emmanouel Leandros. - McGraw-Hill, 2005
18	Oxford Handbook of Clinical Surgery. Ed. by Greg McLatchie, Neil Borley, Joanna Chikwe – 3rd ed. – Oxford University Press. 2007.
19	Greenfield's Surgery: Scientific Principles & Practice. Ed. by Michael W. Mulholland, Keith D. Lillemoe, Gerard M. Doherty, Ronald V. Maier, Gilbert R. Upchurch – 6th ed. - Lippincott Williams & Wilkins. 2016.
20	Cameron: Current Surgical Therapy. Ed. by John L. Cameron – 8th ed. - Mosby, Inc. 2004.
21	Docherty, G.M. (2020) Current Diagnosis & Treatment: Surgery, 15e., McGraw-Hill Education,
22	Hernia Surgery, Current Principles Editors: Novitsky, Yuri W. (Ed.), 2016
Other Information Sources
1	2016 WSES guidelines on acute calculous cholecystitis: https://wjes.biomedcentral.com/articles/10.1186/s13017-016-…
2	2017 WSES and SICG guidelines on acute calculous cholecystitis in an elderly population: https://wjes.biomedcentral.com/articles/10.1186/s13017-019-…
3	Leppäniemi, A., Tolonen, M., Tarasconi, A. et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg 14, 27 (2019). https://wjes.biomedcentral.com/articles/10.1186/s13017-019-…
4	Hope, W.W., Cobb, W.S., Adrales, G. L. (2017). Textbook of Hernia. Springer.