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Biomedical subjects

E A Vagner

Publications and source records attributed to E A Vagner.

At least 19 recordsLinked to original sources
PubMed1998

[The results of prostatic adenomectomy in patients with severe concomitant diseases].

Immediate and long-term results of prostate adenomectomy were studied in 1549 patients, 322 of whom being of old age. In 1499 (96.8%) patients concomitant diseases were revealed: ischemic heart disease (934 patients), cardiosclerosis after 1-3 myocardial infarction (185), hemiparesis after acute cerebrovascular disturbances (74), diabetes mellitus (88), chronic lymphoid leukemia (5), cirrhosis of the liver (15), cancer (22) and true diverticula (15) of the urine bladder, drug-related polyallergy (16). 628 patients were radically operated in conditions of circulatory insufficiency of stage I-II. In 631 (40.7%) patients surgical intervention was carried out as urgent because of acute dysuria (hampering of urination) or to bleeding from tumor. Transvesical adenomectomy was carried out with hemostasis by 2 semipouch string removable sutures. In 89.5% of patients uncomplicated course of postoperative period was observed. Postoperative lethality in patients with concomitant diseases made up 3.2%. Causes of death were postinfarction cardiosclerosis (6.5%), after-effect of cerebrovascular stroke (5.4%), diabetes mellitus (5.7%), cirrhosis of the liver (6.7%). 6 months to 11 years after the operation 91.2% of the patients achieved good follow-up functional results of surgical treatment, in majority of the patients medical and social rehabilitation was observed.

Aged↗
PubMed1998

[Blood reinfusion during nephrectomy in patients with kidney neoplasm'].

Reinfusion of autologous blood in 22 patients with cancer of the kidney was used during nephrectomy. Intraoperative blood loss made up 1000-4000 ml (20-80% VCB). 800-3600 ml of blood was collected from the operation wound and reinfused. In spite of massive blood loss, 20 patients recovered. Lethal outcomes (2 patients) were not caused by blood reinfusion. In 19 patients of control group with renal cancer massive blood loss was compensated by preserved donor blood transfusion. It is shown that reinfusion of autologous blood promotes more stable hemodynamics during the operation, reduces the quantity of postoperative complications and lethal outcomes, provides qucker restoration of morphologic structure of the blood and results in less substantial changes in filtration of a single kidney. There were no statistically significant differences in 5-year survival rate of patients in the study (40.9%) and control (42.1%) groups, nor in the frequency of hematogenous metastasizing of cancer. Because blood reinfusion does not increase the risk of hematogenous metastases of cancer, it is not contraindicated in massive blood loss during nephrectomy in patients with renal cancer.

Adenocarcinoma↗
PubMed1998

[Postoperative complications in proximal stomach resection].

During 20 years (1972-1994) the authors carried out proximal resections of the stomach in 106 patients for cancer of proximal part of the stomach extended to the esophagus. Morphological verification data are presented. Total lethality rate made up 20.8%. It decreased with gaining of experience and improvement in selection of patients (1972-1982--29.6%, 1983-1994--17.7%). The most common complication in postoperative period was exudative pleuritis: in 16% of operated patients insufficiency of sutures of the esophagogastric anastomosis was observed. For prophylaxis of suture insufficiency pyloroplasty by Heineke-Mikulich and continuous (to 4-5 days) naso-gastral drainage were of principal significance. Great importance was attached to establishment of the anastomosis by the method developed by the authors. The results of the operations depend also on the operative approach: two-stage combined approach (laparotomy, thoracotomy) brings the least lethality.

Adenocarcinoma↗
PubMed1997

[Antioxidants in the treatment of cholelithiasis patients].

Results of examination and treatment of 157 patients with cholelithiasis against the background of a liver pathology were summed up. The antioxidant system in such patients was studied. The degree of a decrease of catalase activity in the liver and blood serum as well as the ascorbic acid content were found to depend on the liver state of patients with cholelithiasis. Greatest changes were found in patients with cirrhosis of the liver and chronic active hepatitis. The method of complex treatment of cholelithiasis patients with non-enzymatic antioxidants alpha-tocopherol and ascorbic acid is proposed. Activity of organ specific liver enzymes urokaninase and histidase was used for the estimation of treatment efficiency. Complex administration of ascorbic acid and alpha-tocopherol was shown to improve the liver function in patients operated upon for cholelithiasis.

Antioxidants↗
PubMed1996

[The humeral immunity indices of pleural exudate in the diagnosis and prognosis of the pleural complications after lung operations and chest trauma].

Examination of humoral immunity factors in the pleural exudate was carried out in 49 patients: 15 patients had clotted postoperative hemothorax, 10 patients had bronchial fistulas after pulmonectomy, 24 patients were included in a control group. In patients with clotted postoperative hemothorax a decreased circulating immune complex (CIC) level in the pleural exudate was observed on the 10th-14th days followed by the elevation of the CIC level with a simultaneous increase in the IgA concentration and a decrease in the IgC and IgM concentration. Characteristic of the patients with bronchial fistulas and pleural empyemas was the two-fold increase of the IgA, IgM and IgG level in the pleural exudate as compared with the normal postoperative course.

Antibody Formation↗
PubMed1993

[Treatment of patients with ureteral calculi].

Various methods of treatment were introduced to improve the results of management of patients with stones in the ureters and early restoration of their working capacity. Emergency ureterolithotomy (197 patients) reduced the incidence of postoperative complications by 2.4 times and the duration of in-patient treatment by 1.8 times. Hermetic sealing of the ureteral suture with glue in ureterolithotomy (43 patients) led to airtightness of the suture in 93.0% of cases. Needle reflexotherapy relieved an attack of renal colics in 94% of patients. After general multicomponent vibration (71 patients) and sonic stimulation (216 patients) the stones were discharged in 80.3 and 93.1% of patients, respectively. The application of organizational measures (creation of a city center of emergency urological service) and introduction of new methods for treatment of ureteral stones reduced the terms of rehabilitation of patients by 1.8 times, the economical effect in this case came to 392,3 rubles per each patient.

Colic↗
PubMed1992

[Rethoracotomies and repeat operations on the lungs].

The article generalizes materials of 148 rethoracotomies. Main complications are described. Grounds are given for the use of perfusion through the xenospleen at the early postoperative period in order to liquidate the coagulated haemothorax mainly after pulmonectomy. An original method of determination of the coefficient of relative viscosity of the exudate on the absorbing base is described. The method allows the objective control of infectivity of the pleural exudate to be performed. The clinical use of different methods of detoxication in the preoperative period is substantiated: UVI of blood, hemocarbosorption and xenohemosorption, which allowed to reduce lethality after rethoracotomies and reoperations on the lungs.

Contraindications↗
PubMed1991

[Blood reinfusion in stab-incision heart injuries].

The authors had 110 patients with heart injuries (HI) under observation. The blood loss was, 1,092 +/- 120 ml in isolated HI and 2,410 +/- 246 ml in combined HI. Blood reinfusion (BR) was performed during 91 operations, the average volume was 1,233 +/- 215 ml. The peculiarities of reinfusion techniques are analysed and its advantages and shortcomings are critically appraised. The causes of fatal outcomes are shown according to the character of the heart damage and the volumes of blood loss and reinfusion. Mortality in HI with the use of BR was 16.5%.

Adolescent↗
PubMed1991

[Surgical interventions in tuberculosis of the lungs without prior antibacterial therapy].

Operations were performed on 102 patients (93 with tuberculomas, 2 with fibrocavernous tuberculosis, and 7 with infiltrative tuberculosis of the type of caseous pneumonia) without preoperative chemotherapy. Certain difficulties in identification of the nature of the disease in tuberculomas are pointed out. It is shown that only emergency histological study helps to avoid errors. Postoperative complications occurred in 5.9% of patients. Exacerbation of tuberculosis after economical resections in tuberculomas occurred in 2.1% of patients due to a nonradical intervention. The expediency of early interventions which allow the term of treatment to be shortened is shown.

Adolescent↗
PubMed1991

[Principles of the correction of central hemodynamic disorders in severe combined thoracic trauma].

Successive treatment of syndromes of circulatory disorders on the basis of complex evaluation of central hemodynamics was conducted in 73 patients with severe closed chest trauma. Reinfusion reduced the requirements for donor blood by 28%. The volume of the infusion-transfusion therapy was regulated according to the ventricular filling pressure and the Frank-Starling curves. The optimal level of pulmonary capillary pressure blocking was 12-20 mm Hg in patients with cardiac insufficiency and 8-12 mm Hg in the other patients. Spasmolytics, saluretics, and droperidol were prescribed and fluid intake was limited in pulmonary circulation hypertension. Cardiac glycosides, calcium preparations, antiarrhythmic agents, and diuretics were given in cardiac insufficiency.

Adult↗
PubMed1990

[Heart injuries in isolated and multiple trauma].

Under investigation were specific features of the clinical picture in 34 patients with associated wounds of the heart and pericardium. Four dissimilar clinical groups were established. A comparative analysis of associated and isolated injuries (38 patients) has been made from the viewpoint of frequency of diagnostic errors, volume of the intraoperative blood loss and character of postoperative complications.

Abdominal Injuries↗
PubMed1990

[Methods of regional analgesia in closed trauma of the chest].

The literature data has been analysed to evaluate the efficacy of the methods of regional analgesia (RA) in closed chest trauma. Various types of blocks are described. Epidural analgesia with local anaesthetics and narcotics is detailed. Epidural electrostimulation and introduction of drugs affecting the endogenous systems are shown to show good promises.

Anesthesia, Conduction↗
PubMed1990

[Endoscopic occlusion of the bronchial stump in bronchial insufficiency].

The results of endoscopic occlusion of the stump of the main bronchus in its insufficiency were studied in follow-up periods of up to 3 years in 27 patients. The indications for the method were developed and the techniques of the occlusion described. Endoscopic occlusion is most expedient and sparing in early insufficiency of the bronchial stump under conditions of acute pyothorax and the presence of complications in a solitary lung. Its application is not opposed to the other commonly used methods of treating bronchial fistulas after pulmonectomy.

Adult↗