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Biomedical subjects

G K Zherlov

Publications and source records attributed to G K Zherlov.

At least 37 records · Page 2Linked to original sources
PubMed2003

[Contribution to the methods of formation of pancreatojejunal anastomosis during pancreatoduodenal resection].

A method preventing a contact of the intestinal content and bile with the wound surface of the stump and pancreatic juice in the pancreatic ducts was proposed in order to prevent reflux of the infected intestinal content in the ducts of the pancreas. The work was fulfilled in experiment and in clinic. The article is well illustrated and recommended for publication as having a scientific and practical value.

Adult↗
PubMed2003

[Colostoma with reflex evacuation--a new approach in rehabilitation of stoma patients].

Involuntary evacuation of the stoma is the problem of social rehabilitation of stomed patients. In 17 patients during formation of colostoma reservoir-holding mechanism was created. Strain of parietal peritoneum led to subjective feelings predicting colostoma evacuation that were seen 10-20 min before defecation and presented as heaviness in projection of external end of stoma in 15 (88.2%) or elements of intestinal colic in 2 (11.8%) patients. This permitted 9 patients to control colostoma evacuation. Five (29.4%) patients demonstrated ability to control defecation for 10-15 min with tension of the muscles of the anterior abdominal wall.

Colorectal Neoplasms↗
PubMed2002

[Complex treatment of patients with pylorobulbar ulcers in combination with duodenogastric reflux].

The complex approach to therapy of pylorobulbar ulcers combined with duodenogastral reflux was developed and introduced into the clinical practice. The treatment stipulates the elements of functional surgery and eradicative antiinflammatory and antisecretory therapy. The use of this complex method permits to obtain the good results providing the food passage close to physiologic one, to prevent the ulcer recurrence, development of gastric mucosa pathology caused by duodenogastral reflux and persistence of Helicobacter pylori infection. As the result the patients' life quality significantly improves.

Adult↗
PubMed2002

[Prophylaxis and treatment of reflux cholangitis].

A method of creation of choledochojejunoanastomosis (CJA) was developed experimentally on 12 dogs. The method lies in creation of valvular CJA using walls of the common bile duct and submucosous-mucosous membrane of the small intestine mobilized by Roux. According to this method 103 patients with obstructive jaundice due to lesion of distal part of common bile duct were operated. Postoperative complications were seen in 6 (5.8%) patients, 3 (2.9%) patients died. In the period from 3 months to 10 years after operation 63 patients were examined, there were no cases of reflux-esophangitis.

Anastomosis, Roux-en-Y↗
PubMed2002

[Surgical creation of a reservoir-colostomy with reflex evacuation].

The authors consider that the problem of social rehabilitation of "colostomized" patients consists in an involuntary and sudden character of evacuation from the ostomy due to the absence of normal imperative urge to defecation. For this purpose a method of reservoir-retaining colostomy modulating the appearance of urge to defecation was worked out in experiments and used in clinic in 17 patients. Preconditions for the appearance of the urge were regular sensations due to mediated distention of the parietal peritoneum after filling the reservoir-retaining volume. The subjective sensations preceding the evacuation from the colostomy appeared 10-20 minutes before defecation and were felt as discomfort and abdominal cramping towards of the external end of the colostomy in 15 (88.2%) and as elements of intestinal colic in 2 (11.8%) patients. So, 9 (53%) patients managed to sufficiently control the evacuation from the ostomy and not to use the pouch. Five patients (29.4%) demonstrated the ability to restrain defecation for 10-15 minutes by straining the anterior abdominal wall muscles when the urge appeared. Evacuation from the ostomy was reiterative (2-4 times), once or twice a day, rarely 3-4 times a day and lasted from 15 till 60 minutes.

Colostomy↗
PubMed2002

[Function of the liver and gallbladder after subtotal gastric resection and gastrectomy with the creation of an artificial stomach].

A comparative ultrasound and radiological investigation of gallbladder and hepatic tree function was made in patients after operation with creation of artificial stomach, Billroth I and Roux operations. The control group consisted of 30 unoperated patients. Scintigraphy discovered gallbladder dyskinesia in 12 (18.7%) patients of the study group and in 6 (20%) controls. Ultrasonography--in 15 (33.3%) patients of the study group, 5 (25%) patients after distal resection of the stomach with pyloriform gastroduodenoanastomosis, 18 (51.47%) patients operated by Roux and 5 (16.6%) controls, respectively. It is shown that normal transduodenal passage of food has a positive effect on gallbladder and liver functions.

Biliary Dyskinesia↗
PubMed2001

[Gastric, duodenal ulcer, Helicobacter pylori and secretory immunoglobulin A before and after the surgery].

The analysis of Helicobacter pylori (HP) and secretory IgA (SIgA) effects on the course and recurrence of gastroduodenal ulcer provides grounds to suggest that a pathogenic role of HP in secretory hypofunction of the gastric stump, unchanged mucosa and normal SIgA production is not leading. Elimination of the pathological process may bring functional restoration of the stump mucosa which adapts to HP invasion. Therefore, expansion of indications to eradication therapy in late postoperative period needs further study.

Adult↗
PubMed2001

[Diagnosis and surgical treatment of postbulbar ulcers of the duodenum].

The method of surgical treatment of postbulbar ulcers of the duodenum based on the data of their localization, complications, functional state of the stomach and duodenum, technical skills of the surgeon includes radical ablation of the ulcer, reestablishment of the gastroduodenal continuity with the formation of the functionally active anastomosis or selective proximal vagotomy. The method allows to considerably lessen the amount of complications at the early postoperative period and to obtain good functional results at late terms of observations.

Adolescent↗
PubMed2001

[Proximal resection of the cardiac portion of the stomach].

From 1989 to 1999 75 proximal resections of the stomach were performed. There were two variants of operation. In the first variant, invaginative valve from submucous-mucous membrane of the esophagus and the stomach was formed in the zone of gastroesophageal anastomosis. In the second variant, for prevention of anastomotic sutures eruption late after surgery and prophylaxis of valve expanding, duplication of muscular membrane on esophagus was formed. 58 patients were operated by the first variant, 17--by second variant. Postoperative lethality was 2.7% (1 patient died after operation of the first variant, 1 patient--after the second variant). In early postoperative period the complications were revealed in 8 (10.7%) patients. There was no insufficiency of anastomotic sutures. Mean hospital stay after operation was 14.7 +/- 3.5 bed days. Reflux-esophagitis of severe degree in remote period after operation was seen in 1 (1.3%) patient, catarral--in 4 (5.3%), all the patients were operated by the first variant.

Adult↗
PubMed2001

[Choice of surgical strategy in gastroduodenal ulcer hemorrhage].

An analysis of 567 patients aged from 15 to 89 years with gastroduodenal bleedings was made. Ulcer disease of the stomach was diagnosed in 173 (30.5%) patients, ulcer disease of the duodenum--in 354 (62.4%) patients, 26 patients (4.6%) had combined gastroduodenal ulcers, 14 patients (2.5%) had ulcers of the gastroenteroanastomosis (after Billroth-II operations). Operations were fulfilled in 250 (44.1%) of all the patients. The operation of choice at the high state of bleeding is considered by the authors to be resection of 1/2 of the stomach by the method modified in the clinic. Postoperative lethality was 4%, complications were noted in 12% of the patients. All the complications were nonspecific, i.e. characteristic of any operations on organs of the abdominal cavity. Incompetence of the anastomosis sutures was not noted which in our opinion can be accounted for by a specific method of forming the anastomosis. The average amount of bed-days after the operations was 19.5 +/- 3.3.

Adolescent↗
PubMed2001

[A variant of functionally active esophagogastric anastomosis in the surgery of stenosing lesions of the esophagus].

A method of forming a cervical are flux esophgeal-gastric anastomosis has been developed allowing to exclude or considerably decrease the effect of esophago-gastro-pharingeal reflux on the esophageal stump mucosa after subtotal resection of the esophagus and performing one-moment esophagogastroplasty. A muscular constrictor and a circular invagination valve formed in the area of the esophagogastroanastomosis represent a single mechanism having the functional properties approximating the natural esophagocardial passage which prevents the reflux of the stomach contents into the esophagus stump and is a guarantee of prophylactics of reflux-esophagitis and stenosis of the created anastomosis.

Adenocarcinoma↗
PubMed2001

[Reservoir ileorectal anastomosis].

It was established in experimental and clinical studies that creation of reservoir ileorectal anastomosis by standard methods is accompanied by hypotonia, lining deformation and transformation of mucosa: of terminal part of the ileum under the influence of "aggressive" rectal contents. Development of a great number of secretory elements and loss of basic part of resorption structures of small intestine mucosa are accompanied by chronic postcolectomic diarrhea. Method of creation of reservoir ileorectal anastomosis with areflux mechanism was developed for correction of these disorders. Results of experimental studies on 33 dogs and 5 clinical cases demonstrate that the areflux mechanism coordinates motor-evacuatory intestinal function after colectomy and impedes development of specific pathomorphologic changes of mucosa of reservoir ileorectal anastomosis. This is the main condition for repair of fecoformation in patients in remote period after colectomy.

Adult↗
PubMed2001

[On the problem of assessing quality of life of stomach cancer patients after surgical treatment].

375 patients, aged 31-71, received surgery for stomach cancer stage I-III (1984-1999) (gastroectomy--266, subtotal resection--109; operation after Roux (group I)--313, jejunoplasty (group II)--62). Our findings on the end results based on general clinical examinations data and a modified EORTC questionnaire pointed to advantages offered by jejunoplasty since it was for lower better quality of life.

Adult↗
PubMed2001

[Functional results of an operation for forming an "artificial stomach" after gastrectomy and subtotal distal resection of the stomach].

The operations of plastic substitution of the resected stomach with a transplant of the jejunum were fulfilled in 81 patients. The aim of the operations was to establish the natural passage through the duodenum. Of 55 able-bodied patients 31 returned to their regular work, 14 patients changed their work to easier. An investigation of the main parameters of metabolism and of the questionnaires distributed among the patients have shown a high level of the "quality of life" of the patients operated upon at later terms after operations. The involvement of the duodenum in digestion due to the jejunal plasty of the resected stomach made the disorders of digestion rarer, improved the quality of life of the patients at later terms after operation, thus promoting their social and labor rehabilitation.

Adult↗
PubMed2000

[Reconstructive jejunogastroplasty].

A method of reduodenization providing the formation of the invagination-valvular jejunoduodenal and sphinctero-valvular esophagojejunoanastomoses has been developed for treatment of patients with postgastroresectional disorders. The method allows the duodenum to be included in the process of digestion by means of creation of the small intestine transplant from the efferent intestinal loop. For prevention of regurgitation at the remote postoperative period the invagination-valvular jejunoduodenal anastomosis was formed by the authors method. Observation of the patients during 5 years following the operation showed good functional results of the operation proposed.

Adult↗