[Laparocentesis and laparoscopy in closed abdominal trauma].
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Biomedical subjects
Publications and source records attributed to B M Bratash.
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An experience with treatment of 50 patients having closed hepatic injuries is analysed. The use of instrumental methods of exploration (laparoscopy and laparocentesis) facilitates to establish the diagnosis and shortens considerably the time of preoperative examination of patients. Suturing of the hepatic wound with its pedicled omentum tamponade is the principal type surgery. The postoperative mortality was 29.6 per cent.
Based on the study of the immediate results of therapy in 172 patients and late results in 123 patients with open diaphyseal fractures of long tubular bones, the number of poor immediate and late results were found to be directly related with the degree of damaging soft tissues at the fracture site. An analysis of the results also indicated their reliable dependence on the choice of the therapeutic method employed. A predominant immobilization of the fracture in a plaster dressing after primary surgical treatment of the wound and open or closed reposition of the fracture is largely recommended. In some kinds of fractures when securing of fragments in a plaster dressing was unfeasible, then the use of delayed metallic osteosynthesis is indicated. Primary osteosynthesis in open fractures may be used only if specially indicated.