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Biomedical subjects

Iu A Shelygin

Publications and source records attributed to Iu A Shelygin.

15 recordsLinked to original sources
PubMed2001

[Laparoscopic rectum repair].

A reliable and simple method of allograft fixation in laparoscopic posterior-loop rectopexy (LPR) was developed. The study was carried out on 40 cadavers, peak effort of separation of the net fixed to the sacrum by various methods was evaluated. Effort of separation in fixation of the net by sutures was 10.1 +/- 2.12 kg, in fixation by hernial stapler--1.13 +/- 0.36 kg, stapler "Pro-Tack"--6.38 +/- 1.85 kg, in fixation of the net by the new device--8.9 +/- 0.75 kg. From 1995 till 1999 LPR was performed with the new device in 15 patients, the open posterior-loop rectopexy (OPR) with fixation of the net by non-absorbable sutures--in 16 patients. In LPR intraoperative blood flow was twice as small (146.0 +/- 79.2 ml) as in OPR (275.6 +/- 76.9 ml). Mean time of LPR was 183.1 +/- 69.8 min, OPR--211.3 +/- 57.9 min. Relief of pain after LPR enabled with reduction of narcotic analgetics requirement (58.3 +/- 1.5 mg). Mean dose of narcotic analgetics after OPR was 93.2 +/- 1.4 mg. The proposed method of allograft fixation and device for it realization are effective and meet all requirements.

Analgesics, Opioid↗
PubMed2000

[Long-term result of hemicorporectomy].

A 12-year follow up result of hemicorporectomy in a patient is represented. The patient was operated several times since 1983 for massive perianal condylomas. In 1985 the ulcer with hard edges was revealed in the perianal region, spreading to the perineum and root of the scrotum. Biopsy data evidenced for epidermoid carcinoma Abdominoperineal extirpation of the rectum was carried out with broad dissection of the skin of the perineum and with resection of the seminal follicle. Postoperative period was complicated by prolonged pyogenous infection of the perineal wound which prevented from radiation treatment. 9 months later the relapse of the tumor was detected in the perineum with deep pyogenic fistulas formation. 6 courses of chemotherapy by 5-fluorouracyl were carried out. During the process of examination in September 1987 in the perineal area a large massive tumor occupying the whole pelvic cavity and growing into the posterior wall of the urine bladder and left ishial bone, spreading to the scrotal root and surrounded by the net of fistulous tracts was revealed. Hemicorporectomy was carried out with previously layed one-stem sygmostomy keeping intact, and retroperitoneal Y-shaped uretero-ureter anastomosis being formed and right ureter being fixed at the skin of the right abdominal wall. A special prosthesis--"a glass"--was made for the patient, in which he could move from the bed to the chair or the wheeled chair, to move at home or in the street and to drive his own car. Later, evacuation of the uroliths through the uretherocutaneous stoma was observed. Gradually urolithiasis progressed, mainly in the right kidney, and in 1995 the development of purulent rightsided paranephritis was detected which demanded right-sided nephrectomy. Thus, in spite of a number of complications we can state, that hemicorporectomy has cured the patient of advanced, cancer and he feels satisfied with this treatment and saving 12 years of life.

Adult↗
PubMed1998

[Up-to-date approach to the treatment of rectal cancer].

During the last 15 years 2404 radical operations of various types were carried out for cancer of the rectum. The rate of postoperative complications made up 28.3% and mortality--2.9%. The tendency to increase of locally spread forms of cancer up to 96.2% with metastases to regional lymph nodes up to--52.3% was detected. The use of adequate chemotherapy, updated suturing devices and new variants of radical operations, combined and extended ones in particular havw much contributed to carrying out radical interventions with complete restoration of bowel continuity in 70% of patients. 5 year survival rate of patients after sphincter saving plastics and restorative procedures made up 60.2-65.3%, after extirpations with colostomy--54.2%. Promising results of improvement the indices of 5 year survival were obtained when preoperative irradiation in regime of multifractioning SOD 45-55 Gy was used together with administration of 5-fluorouracil (5-7.5 g).

Combined Modality Therapy↗
PubMed1995

[Differential diagnosis of non-epithelial rectal neoplasms].

Experience in the treatment of 118 patients with nonepithelial new growths of the rectum has been accumulated at the Scientific Research Institute of Proctology in the period from 1970 to 1991. They accounted for 1.5% of all benign and malignant tumors of this organ. Leiomyoma was diagnosed in 44, leiomyosarcoma in 18, lipoma in 30, fibroma in 17, neurinoma in 7 and rhabdomyoma in 2 of these patients. A differential diagnosis was made between benign and malignant tumors, as well as with other nonepithelial new growth of the rectum. On the basis of the clinical picture and the results of digital and instrumental (radiological, endoscopic, and ultrasonic) examination of the rectum the correct preoperative diagnosis may be established with certain probability. This influences directly the choice of the volume of the operative intervention in various types of nonepithelial rectal tumors. Morphological verification of the tumor is the principal method of examination in establishing the differential diagnosis in the preoperative and postoperative periods.

Adult↗
PubMed1994

[Transanal resection of the rectum].

A new method of an organ-preserving operation for the management of the initial forms of rectal carcinoma and benign tumors of the distal parts of the rectum has been elaborated and successfully used at the Scientific Research Institute of Proctology. It consists in transanal resection of the rectum with creation of a recto-anal anastomosis. Transanal resection of the rectum was performed on 34 patients. Sixteen patients had giant or recurrent villous tumours of the distal part of the rectum 6 of which had undergone malignant degeneration. In a group of 34 patients 14 had the initial forms of carcinoma of the inferoampular part of the rectum, 2 had a deep cystic colitis, and the other 2 patients were operated on for neurilemoma and teratoma. Recurrences were not revealed in patients with benign diseases in follow-up periods of 2 to 8 years. Recurrent carcinoma of the rectum in the region of the anastomosis was found in 2 patients in follow-up periods of 25 to 37 months. They underwent extirpation of the rectum. The new method enables stable recovery to be achieved and saves the patients from crippling abdomino-anal resections and extirpation of the rectum in the management of benign new growths and initial forms of carcinoma of the distal parts of this organ.

Adenoma, Villous↗
PubMed1992

[The surgical treatment of benign smooth-muscle tumors of the rectum].

From analysis of the surgical treatment of 36 patients with rectal leiomyoma the authors suggest and substantiate the indications for various types of operative interventions according to the size and location of the tumor. The late-term results of the treatment were studied in all patients who underwent surgery and a brief review of literature on the methods of diagnosis and surgical management of benign smooth-muscle tumors of the rectum is given.

Adult↗
PubMed1990

[Combined surgery of the large intestine and biliary tract].

The article deals with the experience in the treatment of 204 patients with diseases of the biliary tract who underwent operation for various diseases of the colon. In 147 of them intervention on the colon was carried out simultaneously with cholecystectomy and other operations on the biliary tract. In 57 patients the gallbladder was not removed and in 7 (12.2%) of them the immediate postoperative period was marked by the development of complications connected with a disease of the gallbladder. As a result 3 out of the 57 patients were operated on for a second time. The frequency of postoperative complications among patients who were subjected to combined operations was 46.9%, the death rate--4.8%. It is important to point out that these indices hardly differed from those in the general group of patients (4.2% and 4.8%, respectively). Thus, cholecystectomy combined with intervention on the colon is admissible and, undoubtedly, expedient because it prevents the development of complications of cholelithiasis in the early postoperative period and saves the patient from undergoing a second operation on the biliary tract later.

Cholecystectomy↗
PubMed1990

[Simultaneous radical surgery in patients with cancer of the rectum with metastases to the liver].

From 1972 to 1987, a total of 3.033 operations were carried out for carcinoma of the rectum at the Research Institute of Proctology. Various types of resection of the liver were conducted in one stage in 51 cases. The postoperative mortality in the group of patients who underwent operation in association with resection of the liver was 5.9%, which was only slightly higher than that in the general group of patients with rectal carcinoma (4.9%) operated on in the same period of time. Among 35 patients dismissed from the clinic after removal of verified metastases of the liver 15 had been operated on more than 5 years ago. Four of them have a survival period of more than 5 years and 2 have a survival period of over 10 years. On basis of their experience, the authors claim that the performance of one-stage radical operations for rectal carcinoma with removal of solitary metastases from the liver is admissible and, most probably, expedient.

Adult↗
PubMedDate not supplied

[Analgesia and intensive therapy in single-step, combined and complex operations].

300 single-step, combined and complex operations have been performed to patients aged 16 to 82 years in the Institute of Proctology, USSR Ministry of Public Health, over the last 10-year period. Surgery was performed under various types of endotracheal combined analgesia: NLA, NLA in combination with halothane or calypsol. Arterial hypotension (short-term BP decrease by more than 40% baseline) was found in 29 patients (9.6%), no intraoperative lethal outcomes have been observed. The volume of the infusion-transfusion therapy depended on intraoperative blood loss, duration of surgery and the extension of surgical interventions (8.4-12.4 ml/kg.h). An overall mortality rate was 3.6%, which does not exceed the mortality rate observed during conventional operations on the colon.

Adolescent↗