Search

Results of surgical treatment of 310 patients with inguinal hernias were analyzed depending on hernioplasty method. Advantages of hernioplasty methods without tissues tension over traditional ones were demonstrated. Indications and contraindications of each method were determined. Algorithm of individual choice of surgery method for inguinal hernias has been developed.

The results of differential diagnosis of hemorrhage fever with renal syndrome and acute surgical diseases of abdominal organs in 1250 patients were analyzed. It was revealed that the course of the disease was similar to acute abdomen in 13.2% of them. The combination of fibrogastroduodenoscopy and diagnostic laparoscopy is optimal for differential diagnosis and permits to reveal typical symptoms of hemorrhage fever with renal syndrome.

Minimally invasive technologies were used in treatment of 89 patients with cholelithiasis complicated by mechanical jaundice and purulent cholangitis. Advantages of the two-stage operative treatment of such patients were shown. The first stage is decompression of the bile duct, the second stage is a radical operation either by laparoscopic or minilaparotomic methods. It allows to avoid extensive and traumatic operations and secures better immediate and long-term results of treatment.

Results of treatment of 89 patients with cholelithiasis complicated by obstructive jaundice and purulent cholangitis using the minimally invasive technologies are analyzed. The advantages of two-stages surgical treatment of these patients are demonstrated. The decompression of biliary tract are performed as the first stage, radical operations by laparoscopy or minilaparotomy--as the second stage. This method permits to refuse the large and traumatic operations and to improve significantly the nearest and long-term results of treatment.

Of the 526 patients with colonic diverticulosis, severe bleeding was observed in 80 (15.2%) people, mainly in the elderly. Emergency surgical interventions were required in 13.8% of patients. Surgical tactics are described depending on the prevalence of diverticulosis and the intensity of bleeding.

Results of mammoplasty with the allotransplant "Bioplant" performed in 41 patients with purulent mastitis were assessed on the basis of studying the dynamics of the echographic, electrothermometric, thermo- and rheographic picture of the mammary gland. Using the methods of echo-, thermo-, rheography at different terms of the postoperative period allowed prognosis to be made of the local pyo-inflammatory complications, activity and completeness of regenerative processes in the allotransplantation area, recovery of the parenchyma and functions of the mammary gland operated upon.

An experience with treatment of 210 patients with hiatal hernias is summarized, 162 (77.1%) of them having a concomitant pathology of the abdominal cavity. Most frequently the hiatal hernias were associated with gastroduodenal ulcers (48.6%), chronic cholecystitis (18.1%), ventral hernias (5.7%). A new method of correction of hiatal hernias is described which prevents the development of complications resulting from an extreme narrowing of the hiatus. Good long-term results were obtained in 55.9% of the patients, satisfactory--in 34.3% unsatisfactory in 9.8% of the patients, results of the isolated correction of the hiatus being worse that those obtained after the combined operations. A conclusion is made that well-grounded simultaneous operations for hiatal hernias are followed by perfect medico-social and economic effects.

The authors have made an analysis of the frequency of appearance of duodenogastral reflux after resection of the stomach in ulcer disease in 487 patients at remote terms depending on the method of restoration of the gastrointestinal continuity. The results obtained suggest high frequency of the duodenogastral reflux after Billroth-II gastric resection. The method of gastric resection proposed by the authors allowed the frequency of the appearance of duodenogastral reflux to be considerably reduced.

The article presents results of 25 restorative operations performed on patients who had endured resection of the rectum. Causes of the complications were established. A new method of restoration of the intestinal continuity after the Hartman operation has been developed in the clinic. The method developed was used in 25 operations. It had a positive effect not peculiar to other operations. It excluded incompetence of sutures of anastomosis with a short rectal stump and preserved the initial force of the constrictor of the rectum due to using the new principle of extra-sphincter descending of the mobilized intestine.

An investigation was performed on 52 corpses of humans in order to study possibilities of anterior extransphincteral descending of the colon in performing restorative operations after Hartman resection of the rectum. Advantages of the new method of operation along the tunnel for the descending and necessary length of the colotransplant for excessive descending were established. The technique developed proved to have advantages over the well-known methods. The advantages were confirmed in 25 restorative operations in the clinic.

Currently, ultrasound (ultrasound) is given great attention in the recognition of acute surgical diseases of the abdominal cavity. This is due to its safety, non-invasiveness, short and easy for the patient period of study, and most importantly, high information content and the possibility of dynamic control with its help without significant adjustments to the patient's condition.

The results of 267 relaparotomies performed in 242 patients with various emergency conditions in the postoperative period (2.1% of the number of initially operated patients) were analyzed. The most frequent indications for reoperations were peritonitis, intestinal obstruction, and bleeding. Mortality after relaparotomies averaged 33.8% and depended on the type of complications and the timing of repeated surgeries. The value of reasonable and timely indications for relaparotomy was determined by comprehensive dynamic observation and the use of additional research methods.

Currently, there is a growing incidence of colorectal tumors everywhere. In colorectal cancer complications the number of postoperative complications and mortality remain rather high - from 27 to 58.8%. Therefore, the issues of surgical treatment of cancer of this localization are of particular relevance.

Prolonged retroperitoneal blockades were performed in 20 patients with acute pancreatitis. Positive effects were obtained in 17 patients. The use of prolonged retroperitoneal novocain blockade with the help of a catheter during operation and in the postoperative period facilitated early liquidation of postoperative paresis of the intestine and arrest of acute manifestations of pancreatitis.

Results of a dynamic endoscopic examination of 213 patients after operations of suturing perforating gastric and duodenal ulcers are described. Stable healing of the ulcer was obtained in 20.2% of the patients. In 79.8% of the patients the ulcer failed to heal or recidivated. A comparison of roentgen findings and results of endoscopic examinations has shown that roentgen analysis gave the correct diagnosis but in 44.7% of the patients examined.

The article generalizes experience in the treatment of concurrent diseases of the abdominal organs in 567 patients; 1,214 operations were performed. Concurrent gynecological diseases are encountered most frequently during emergency surgery, affections of the stomach, bile ducts, and postoperative ventral hernias--in planned operations. On the basis of study of the clinical material and the results of operations it was established that concurrent operations should be performed in specialized departments in a planned order.

Results of the treatment of 3253 patients with acute paraproctitis are analysed. The treatment must be complex, with a radical operative intervention as a decisive measure directed to a radical dissection of the abscess and liquidation of the internal opening of the abscess in the rectum. Positive results were obtained in 88,3% of the patients.

Novokain retroperitoneal blockades were used in 150 patients with non-specific ulcerative colitis, diverticulosis and functional disturbances of the colon. The blockades allowed improving results of the treatment, normalizing the motor function, cupping off the inflammatory process, shortening the time of staying at the hospital.

In examination of 100 patients after operations on the abdominal organs, a high incidence of disorders in function of the esophagogastric junction was noted. Their timely diagnosis and rational correction are the urgent problem in the abdominal surgery.

Results of the surgical treatment of perforations of asymptomatic ulcers of the stomach and duodenum in 63 patients are analyzed. Closure of the perforation opening is thought by the authors to be operation of choice in the treatment of such ulcers. Good and satisfactory results were obtained in 83% of the observations.