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Biomedical subjects

Iu A Nesterenko

Publications and source records attributed to Iu A Nesterenko.

At least 19 recordsLinked to original sources
PubMed2005

[Results of Shuldays' surgery in elective and urgent surgery].

Results of treatment of inguinal hernias with multilayer plastic reconstruction (PR) according to Shuldays in elective and urgent surgery are analyzed. Advantages of multilayer PR are evaluated. In long-term period (up to 3 years) recurrences were seen in 0.5 to 1.0%. This is 10 times less than in plastic surgeries of anterior wall. Multilayer PR is particularly indicated for patients over 40 years with long anamnesis, weak tendinous structures, severe destruction of the posterior wall. This surgery is universal, can be performed in elective and urgent situations.

Abdominal Muscles↗
PubMed2003

[Treatment of calculous cholecystitis and its complications].

Results of treatment of 10,724 patients with different forms of acute and chronic cholecystitis are analyzed. Surgical treatment was performed in 7819 (72.9%) patients. Variants of treatment of acute and chronic cholecystitis are presented. Typical cholecystectomy is the basic surgery in patients with acute calculous cholecystitis (63% procedures). Laparoscopic cholecystectomy (LCE) was performed in 37% patients. Two-stage surgeries with previous microcholecystostomy (MCS) and endoscopic papilloshincterotomy (EPST) are indicated in late hospitalization of patients with intoxication and severe concomitant diseases. They permit to prepare patients for cholecystectomy and to decrease scope of surgery. In cholelithiasis and jaundice EPST and MCS are indicated for almost all patients as a preliminary procedure before surgery on the biliary tract and cholecystectomy. This two-stage variant permitted to reduce postoperative lethality from 9.7 to 1.6%. In chronic cholecystitis LCE is the main type of surgery with minimal postoperative lethality. For patients with recurrent calculous cholecystitis, frequent exacerbations, severe concomitant diseases EPST in choledocholithiasis and sanation of gall bladder through fistula are indicated.

Cholecystectomy↗
PubMed1994

[Ultrasound diagnosis of acute appendicitis].

The possibilities of ultrasonic examination in the diagnosis of acute appendicitis are analysed. The ultrasonic parameters are systematized on the basis of examination of 76 patients with various forms of acute inflammation of the vermiform process and of 16 healthy individuals. Exosemeiotics of acute appendicitis is presented. The high significance of USE in complex examination of patients with suspected acute inflammation of the vermiform process difficult for diagnosis is shown. This was confirmed by the results of complex examination of 151 patients with various urgent pathological conditions whose clinical symptomatology was similar to that of acute appendicitis. It was found that USE improves the diagnostics in difficult clinical cases and lessens the number of diagnostic and tactical errors. The wide use of ultrasonic examination in the daily practice of surgical clinics is recommended.

Acute Disease↗
PubMed1994

[Laparoscopy in the differential diagnosis of acute abdomen].

The work analyses the results of emergency laparoscopy in 4,730 patients with acute surgical pathology of the abdominal organs. There were 26.3% of males and 73.7% of females; 26.5% of patients were of an elderly age. Laparoscopy was undertaken in all cases in which the diagnosis was questionable but the clinical picture was that of "acute abdomen" and in patients with an established diagnosis for conducting therapeutic manipulations: microcholecystostomy, drainage of the abdominal cavity. The authors show differential endoscopic signs of some acute surgical diseases of the abdominal organs. Laparoscopy confirmed the clinical diagnosis in 45.5% of cases and revealed indications for an emergency operation in 896 patients (33.8%). Laparoscopic microcholecystostomy was performed 137 times and drainage of the abdominal cavity 398 times. The diagnostic value of laparoscopy came to 97.1% on the average.

Abdomen, Acute↗
PubMed1994

[Basic principles of treatment for patients with acute pancreatitis].

The results of treatment of 1,320 patients with acute pancreatitis were analysed, 460 of them had the destructive form of the disease. The high significance of multicomponent etiopathogenetic treatment is demonstrated. The importance of etiotropic treatment with the application of endoscopic interventions, as well as treatment with cytostatics is emphasized. Timely combined use of these methods prevents a progressive uncontrolled course, and reduces the volume of treatment and its duration. The authors also discuss the first experience in nontraditional management of patients with postnecrotic cavitary complications of pancreonecrosis by the aspiration "closed" method with the use of ultrasound.

Acute Disease↗
PubMed1993

[Pathologic changes of major duodenal papilla in biliopancreatic diseases].

The condition of the major duodenal papilla and the periampullary region was studied in 1,113 patients with diseases of the biliary tract and pancreas. In 88.6% of cases complex examination revealed various pathological changes which were considered to be important etiological factors of the development of the diseases. These changes were found to be particularly significant in patients with the postcholecystectomy syndrome. The authors present the modern methods for correction of pathology of the major duodenal papilla, among which endoscopic interventions are most valuable.

Acute Disease↗
PubMed1993

[Outcome of treatment of incarcerated hernia].

Experience in surgical treatment of 632 patients for incarcerated hernias of different localization is analysed. The patients' ages ranged from 39 to 91, 448 (70.9%) patients were over 60 years of age. Inguinal and umbilical hernias were encountered most frequently--62.5%. The intestine was resected in 93 patients, 80 of them were over 60 years of age (86%). Among these patients 63 were admitted to the clinic 1 to 4 days after the incarceration had occurred. The causes of late hospitalization: through the patient's fault in 80 (24.8%) cases, due to the doctor's errors in the prehospital stage in 39 (12.1%) cases. Kerte's method for determining the viability of the incarcerated intestine is subjective to a certain measure--the surgeons made errors in 14% of cases (confirmed histologically). The mortality was 13.4%, in 85% death occurred at an age over 70 and in 74% of cases the patients were admitted 24 hours to 4 days after the incarceration. Incompetence of the sutures of the anastomosis (41%) was the main cause of death. Late hospitalization, elderly and old age, severe concomitant complications, and unwarrantably extended volume of the interventions were the main causes of unfavorable outcomes of the management of this category of patients.

Adult↗
PubMed1993

[Morphofunctional aspects in surgery of chronic pancreatitis].

On the basis of 15-year experience in the treatment of patients with chronic pancreatitis, among which 236 patients underwent operation, the authors describe the examination scheme and discuss the indications and various methods for treatment of the disease. Particular attention is bestowed upon morphological changes of the pancreas, including ultrastructural analysis, as well as on the study of the functional condition by evaluation of the pure pancreatic secretions. The importance of the extrasecretory function of the pancreas in choosing the method of direct intervention on the organ is shown. The indications for nonoperative, endoscopic, and surgical treatment of chronic pancreatitis are determined according to the morphofunctional changes.

Adult↗
PubMed1993

[The ultrasonic diagnosis of choledocholithiasis].

The results of examination and treatment of 162 patients with clinically suspected choledocholithiasis were analysed. The high significance of ultrasonic examination in the diagnosis of a calculous nature of the affection of the biliary tree with a record of its echosemeiotics is shown. The wide use of ultrasonic examination yields better information. Study of the results of complex examination of 110 patients with verified choledocholithiasis confirmed the high rarefying capacity of the ultrasonic method in the detection of stones in the extrahepatic biliary tree (85.8% accuracy of the examination) both when it is applied for the first time and when it is used during the treatment. Obligatory performance of ultrasonic examination in diseases of the extrahepatic biliary ducts is suggested.

Adult↗
PubMed1990

[Surgical tactics in mechanical jaundice].

On the basis of complex examination and treatment of 167 patients with obstructive jaundice of various etiology, the authors suggest a differentiated approach to the choice of the volume, method, and duration of detoxification therapy as well as the time and volume of an operative intervention. The necessity of preoperative correction of cholestasis by nonoperative measures and instrumental methods of decompression of the biliary tract is substantiated. It is shown that intraarterial regional infusion therapy must be applied in patients whose condition is most serious.

Choledochostomy↗
PubMed1990

[Surgical tactics in peptic ulcer hemorrhage].

The article discusses the results of treatment of 256 patients with gastroduodenal hemorrhages. The routine actively temporizing strategy was employed in the treatment of the first group of patients. The total mortality in the group was 13%, postoperative one, 33%. In the second group active surgical strategy was based on the results of recurrent hemorrhage prognosis. The total mortality was 6%, postoperative one, 6.5%. It is concluded that active surgical strategy which is based on prediction of recurrent hemorrhage yields better results of management of patients with ulcerative hemorrhages.

Adult↗
PubMed1989

[Nonorganic retroperitoneal tumors].

The possibilities of various methods of examination in 22 patients with nonorganic retroperitoneal tumors were evaluated on the basis of complex diagnosis. The importance of ultrasonic examination for determining the tactics of the management of patients is shown. The method improves the results of examination of patients with nonorganic retroperitoneal tumors and allows the volume of radio-endoscopic studies to be reduced.

Diagnosis, Differential↗