Biomedical subjects
Publications and source records attributed to K D Toskin.
The experience of external drainage application of biliary ducts via lig. teres hepatis was summarized. The lowering of complications rate by 7.8%, lethality--by 4.1% was promoted by the above mentioned method application.
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An analysis of the 20-years experience with treatment of inguinal hernias is presented. Patients with "light" forms of inguinal hernias and with a good condition of the posterior wall, inconsiderable widening of the deep opening of the inguinal canal can be successfully treated by Martynov's and Girard's methods. In complicated forms of the inguinal hernia it is necessary to strengthen the posterior wall of the inguinal canal, in cases with big recurrent and repeatedly recurring hernias it must be completely reconstructed, often with the help of alloplasty. A method of alloplasty of the inguinal canal is proposed for complicated forms of inguinal hernias. Operations were made on 62 patients, recurrent hernias were noted in 2 patients (3.4%). Another method of operations is proposed used in men of young and middle age excluding traumas of elements of the spermatic cord. Operations were performed on 111 patients, recurrences were noted in 2 of them (2%).
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A method for plasty of the complex forms of postoperative and umbilical hernias is described. The muscular-aponeurotic edges of the hernial ring are sutured in such a way to make the peritoneal leaflet adjoin each other. Use of the method mentioned permits approximation of the similar tissues, reduction in their tension when suturing and maximum preservation of the volume of the abdominal cavity. Decrease in incidence of the disease recurrences from 40 to 16% was noted.
304 operations with simultaneous herniotomy were performed on 282 patients for different associated diseases. Most frequent combinations of the diseases coexistent with ventral hernias, specific features and immediate results of the operations are described. The opinions of different scientists on the name, definition and essence of simultaneous operations are analyzed. The authors propose their personal definition of the simultaneous operations.
The immune status in 68 patients with diffuse and generalized peritonitis was studied. It was established, that a degree of the impairment in immune response depended on peritonitis spreading. Endolymphatic antibiotic therapy had immunostimulating effect in patients with diffuse peritonitis, in generalized peritonitis, this was not observed. In patients with generalized peritonitis, it is necessary to include into the complex of treatment the other methods of immunologic correction.
The authors' views of the problem of reconstructive and restorative surgery of the biliary tract are set forth and original methods are suggested for external and through drainage after formation of hepatohepatic- and hepaticojejunal-anastomosis (via the inferior surface of the right lobe of the liver in the region of the gallbladder bed and through the round ligament of the liver). Some problems of operative techniques in establishment of the anastomoses are discussed. A total of 39 operations were carried out: 25 reconstructive and 14 restorative. The postoperative mortality was 28.2% (11 patients). Preference is given to restorative operations because they are technically simpler.
The article deals with the author's views on certain aspects of the problem of reconstructive and restorative surgery of the biliary tract. Original methods are suggested for external drainage (through the inferior surface of the right hepatic lobe in the region of the gallbladder seat and through the round ligament of the liver) in formation of ++hepato-hepatico- and hepaticojejunoanastomoses. Problems of operative techniques in formation of the anastomoses are discussed. Thirty-nine operations have been carried out in the clinic in the recent decade in high strictures and traumas of the biliary tract, 25 were reconstructive and 14 restorative. Postoperative mortality was 28.2% (11 patients). Intoxication and hepatargia associated with cholangiolytic abscesses of the liver were the main causes of death.
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