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Biomedical subjects

B K Shurkalin

Publications and source records attributed to B K Shurkalin.

At least 19 recordsLinked to original sources
PubMed2003

[Postoperative complications in patients with peritonitis].

One thousand three hundred and ten patients with peritonitis have undergone surgery: local limited peritonitis was in 230 patients, local unlimited--in 342, general--in 738 patients. After surgery suppuration of the wound was seen in 92 (7.1%) patients, phlegmons of the abdominal wall--in 16 (1.3%), progressive peritonitis--in 40 (3.1%), abscesses of abdominal cavity--in 13 (1.0%), eventration--in 19 (1.5%), adhesive intestinal obstruction--in 17 (1.3%). Laparoscopy was used for diagnosis of intraabdominal complications in 47 patients. This allowed to avoid unjustified laparotomies in 20 patients. Application of laparoscopy is limited by degree of bacterial contamination of peritoneal exudates. Early adhesive intestinal obstruction in 7 patients was treated with endoscopic procedure. Sonography is effective in diagnosis of intraabdominal complications, detection of site of safe puncture before postoperative laparoscopy and drainage of abscesses.

Abdominal Abscess↗
PubMed2003

[Diagnosis and treatment of postoperative intraabdominal complications].

Postoperative complications after 8168 reoperations were seen in 143 (1.8%) patients. Clinical symptoms, laboratory tests, results of x-ray and ultrasound examinations were taken into account in diagnosis of the complications. Differential diagnosis of postoperative peritonitis, stable paralytic intestinal obstruction, early adhesive obstruction and intraabdominal bleeding based only on clinical data is difficult in many cases. Ultrasonic examination and laparoscopy permitted to reduce number of unjustified relaparotomies. In the majority of cases relaparotomy was considered as a method of choice in treatment of these complications. Mini-invasive surgeries may be performed only in mild complications. Lethality in the treatment of postoperative complications after relaparotomy was 39.4%, after laparoscopic surgeries--8.8%, after US-assisted drainage--0. General lethality was 29.4%.

Abdomen↗
PubMed2001

[Can perforated ulcer be not sutured?].

Experiments in 5 pigs and 18 mongrel dogs have shown the possibility to close perforating ulcers with plates of biopolymer "Tachocomb". The method is proposed as an alternative to suturing perforations in the zone of pylorus in order to prevent stenosis of the pyloric part of the stomach. The experimental data obtained have confirmed good adhesive and stimulating properties of the fibrin-collagen substance. Successful results of using the method were demonstrated in 2 patients with perforating ulcers.

Adult↗
PubMed2001

[Results and prospects of treatment of general forms of peritonitis].

956 patients with general peritonitis were operated: 596 patients--for diffuse peritonitis, 360--for general peritonitis. The causes of peritonitis were: perforating gastroduodenal ulcers (454), acute destructive appendicitis (190), acute destructive cholecystitis (82), perforation of small intestine and colon (96), postoperative peritonitis (80), other diseases (54). In low degree of bacterial contamination of abdominal cavity (not more Ig 5 CFU/g) operations were completed without abdominal drainage, laparoscopic variant of the operation being optimal. In postoperative period, out of 691 patients with low degree of bacterial contamination wound infection was in 7.9%, intraabdominal infection--in 2.5%, polyorganic insufficiency--in 1.0%; lethality was 5.9%. In high degree of bacterial contamination (more Ig 5 CFU/g) and massive unremovable fibrinous patch on the peritoneum the programmed revisions and sanations of abdominal cavity were performed, sometimes--control laparoscopic revisions. In postoperative period of 256 patients with high degree of bacterial contamination wound infection arose in 6.0%, intraabdominal infection--in 4.2%, polyorganic insufficiency [symbol: see text] in 42.6%; lethality was 18.1%.

Adult↗
PubMed2001

[Intraabdominal cholerrhea after cholecystectomy].

Cholecystectomy (CE) was performed in 2303 patients with cholelithiasis and its complications. Cholerrhea (CR) after operation was in 31 (1.34%) patients: after laparoscopic CE (1425 patients)--in 18 (1.26%), after open CE (878 patients)--in 13 (1.48%). Source of CR was not found in 21 patients, CR from gall bladder bed was revealed in 7, from cystic duct stump--in 2, from hepaticojejunoanastomosis--in 1 patient. Ultrasonic examination, endoscopic retrograde pancreatocholangiography, laparoscopy were used for diagnosis of this complication. CR stopped spontaneously in 19, after endoscopic papillosphincterotomy--in 4 patients. Spread of bile in abdominal cavity was revealed in 6 patients, 4 of them underwent laparoscopic operations, 2--open operations. Infrahepatic encapsulated bile clumps were in 2 patients, they underwent ultrasonic-assisted drainage.

Cholecystectomy↗
PubMed2001

[Complications of laparascopic cholecystectomy].

1389 laparoscopic operations were fulfilled for chronic and acute cholecystitis. In 41 patients (3%) it was necessary to pass on to laparotomy. Injury of hepaticocholedochus was made in 6 patients (0.5%), bleedings appeared in 9 (0.7%), bile leakage at the postoperative period--in 9 (0.5%). Subhepatic abscess was formed in 2 patients. Wound complication sat at the postoperative period developed in 33 patients (2.5%), pulmonary complications--in 7 patients. One patients died of myocardial infarction. The most frequent causes of intraoperative injuries of the vascular and duct structures of the hepatoduodenal ligament and the bile bladder bed were found to be cicatricial and inflammatory alterations of the areas mentioned and non-typical variants of the anatomical situs of the vessels and bile ducts. The detailed examination of the patients at the preoperative period, knowledge of the anatomical variants of the disposition of bile and vascular structures in the operation zone allow to prevent their intraoperative injury.

Cholecystectomy, Laparoscopic↗
PubMed2000

[Mode of surgery completion in peritonitis].

1310 patients with various forms of peritonitis were operated during 1989-1998. The tactics of the treatment was determined depending on bacterial contamination of the abdominal cavity. In abscesses of the abdominal cavity with massive bacterial contamination (6-7 CFU/g) drainage procedure was used. Mortality rate made up 4.8%. In local extended and diffuse peritonitis with a slight bacterial contamination of the abdominal cavity (3-5 CFU/g) and in absence of fibrinous deposition fixed on peritoneum, the drainage of the abdominal cavity was not used, and laparoscopy was performed in postoperative period for the control of the course of infectious process. Mortality rate was 0.6%. In extended peritonitis with massive bacterial contamination (6-8 CFU/g) the method of repeated explorations and sanitations of the abdominal cavity was used, mortality rate being 17.8%. The overall lethality made up 7.8%. Postoperative wound infection occurred in 6.7%, intraabdominal infection as abscesses or progressing peritonitis--in 2.1% of cases.

Humans↗
PubMed2000

[Laparoscopy in the diagnosis of acute appendicitis].

The results of diagnosis of acute appendicitis (AA) were retrospectively analyzed in 2403 patients, in 336 of them diagnostic laparoscopy (DLS) was performed. Acute appendicitis was diagnosed in 132 (39.3%) patients, other surgical diseases were found in 102 (20.35%) and acute surgical abdominal diseases of were excluded in 102 (20.35%) patients. AA was also diagnosed in 17 patients suspected for other surgical diseases of the abdomen. This is DLS showed AA in 149 (42.2%) patients and its absence in 204 (57.8%) cases DLS revealed cathartic AA was in 3 (2%) patients, in of 2 of them there was a diagnostic error during morphologic control (no inflammation). The diagnostic error rate was 96% in the group of 163 patients undergone appendectomy for cathartic AA without previous DLS. At DLS destructive AA forms were diagnosed in 111 patients, diagnostic errors were made in 0.9%. In the group of patients undergone appendectomy for destructive AA without previous DLS, the diagnostic errors rate was 1.1%. In 35 cases (23.4%) when the appendix could not be visualized at DLS (including patients with appendiceal infiltrate), the diagnosis was based on indirect criteria, errors being made in 3 cases. There were neither direct nor indirect data on the appendiceal status in 3 (0.9%) DLS. In these cases, the policy was based on clinical manifestations.

Acute Disease↗
PubMed1999

[Technical aspects of nasointestinal intubation].

According to the authors' opinion nasointestinal intubation have some advantages over "open" methods of decompression of the small bowel in paralytic intestinal obstruction resulted from peritonitis and mechanical obstruction of the small bowel. The authors' experience with more than 500 their own cases indicates, that application of nasointestinal intubation is not only necessary, but safe as well if keeping strictly to the established technique. Technical aspects of the method, possible errors which could occur during the performance of nasointestinal intubation and introduction of the probe are described. Complications which made up 2.6% are analysed.

Gastrointestinal Diseases↗
PubMed1999

[Laparoscopic operations in emergency surgery].

582 laparoscopic operations for various urgent diseases of the organs of abdominal cavity were made. 190 of them were performed for acute appendicitis, 266--for acute cholecystitis and its complications, 33--for pancreonecrosis, 39--for perforated gastro-duodenal ulcers, 32--for acute bowel obstruction and 22--for other pathological conditions. The necessity of conversion to conventional open surgery has arose in 41 (7.0%) patients. Intraoperative complications were detected in 7 (1.3%) patients. Postoperative complications developed in 18 (3.3%) patients. 2 patients (0.4%) died. The obtained results of treatment made it possible to recommend laparoscopic operations in acute abdominal diseases.

Abdomen↗
PubMed1998

[Laparoscopy in perforated gastroduodenal ulcers].

The authors have performed operations on 32 patients with perforated ulcers of the duodenum and 7 patients with perforated ulcers of the stomach. The diameter of the perforations was 2-8 mm. In 10 of the 39 patients the perforation defects could not be sutured by the laparoscopic method. The authors consider that of great significance for the decision to make laparoscopic operations was the diagnosis of peritonitis, size and localization of the perforation, the surgeon's experience with endoscopic operating. The technique of laparoscopic suturing the perforations is described. Special attention is paid to the special disposition of the surgeon and his assistant at the operating table.

Duodenal Ulcer↗
PubMed1993

[Chemical mucolysis and obliteration of the gallbladder lumen in high surgical risk patients (experimental study)].

A method for obliteration of the gallbladder, based on its mucoclasis with phenol preparations, was developed in experiments on unbred dogs. The safety of using preparations based on phenol for chemical demucosation of the gallbladder is demonstrated. The suggested method may serve as a prototype for the development of similar interventions in clinical practice in acute cholecystitis and cholelithiasis after endoscopic cholecystostomy and cholecystolithoextraction. The method was used in clinical practice in 3 patients with acute calculous cholecystitis and severe concomitant pathology and a high operative-anesthesiological risk.

Acute Disease↗
PubMed1992

[Ciprofloxacin and other antimicrobial drugs in the treatment of disseminated peritonitis].

Forty two patients with general peritonitis were treated with ciprofloxacin and combinations of various antimicrobial drugs. Ciprofloxacin had the highest effect on aerobic and anaerobic microbes in the peritoneal cavity which defined the favourable clinical results in all the patients. Moreover, there were observed no disorders in the composition of the normal intestinal microflora which in the end promoted a decrease in the number of the patients with suppuration of the surgical wound.

Adolescent↗
PubMed1990

[Treatment of peritonitis of appendicular etiology].

The authors had 475 patients with appendicular peritonitis under observation. All of them underwent emergency operation and were given antibacterial therapy with metronidazole and agents of the aminoglycoside series. Among 223 patients, the operation on whom was completed by traditional drainage of the abdominal cavity and complete closure of the operative wound, 148 patients developed postoperative complications. Five patients died. In 252 patients, primarily delayed sutures were applied to the wound and drainage of the abdominal cavity was limited. The abdominal cavity was inspected repeatedly in 24 patients with generalized peritonitis and clinical signs of anaerobic nonclostridial infection. Postoperative complications occurred in 87 patients and were limited to suppuration of the wound. One patient died.

Adolescent↗
PubMed1989

[Characteristics of the course of peritonitis in relation to the degree of perforation of the gastrointestinal tract].

An examination and treatment of 80 patients with general forms of peritonitis has shown that the course of the disease is greatly dependent on the character of the bacterial dissemination of the abdominal cavity. A microbiological examination has shown that in all the levels of perforation of the gastro-intestinal tract there are associations of various microorganisms. The most severe course of peritonitis is observed when caused by infection by colonic contents with prevailing anaerobic ++non-clostridial microflora in the exudate. The method of repeated revisions of the abdominal cavity should be used for these forms of peritonitis.

Abscess↗