Biomedical subjects
Publications and source records attributed to L U Nazarov.
Cleansing of the abdominal cavity by the open method-laparostomy and the use of polymer materials-was conducted in 85 patients with generalized peritonitis (mainly due to perforation of a malignant tumor of the colon). With the use of this method the incidence of purulent complications reduced from 50% to 35.2% and mortality from 42% to 25.8%.
In the clinic, at preoperative preparation of the patients with cancer of the colon complicated by perifocal inflammation, the irrigation of a tumour area, using antibacterial preparations, is employed. After laparoscopy, a drainage tube with microirrigator for perfusion of the antibacterial solution is introduced to the region of tumour location. Using the method described, 25 patients were prepared for the operation. Their state improved after 7-8 days. One-stage radical operation was performed in 20 patients. Of them in 17, primary intestinal anastomosis was created.
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At the clinic of Scientific Research Institute of Proctology, Ministry of Public Health of Armenia, in 97 patients with complicated cancer of the colon and rectum, a two-barrel loop colostomy was created for the recent 10 years. Use of intraperitoneal method contributed to 3-fold decrease in incidence of postoperative purulent complications. Irrigation of a tumour site with antibacterial preparations in perifocal inflammation of colonic cancer together with carrying out the complex antibacterial therapy permits to perform the radical operations.
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Different methods of treatment of wounds after opening the abscess were used in 165 patients with extended abscesses because of acute form of the epithelial coccygeal passage at the stage of preparing to operation. At the stage of opening the abscess and during radical operation tissue of the purulent wall of the abscess was dissected and subjected to histomorphometric analysis in order to establish the degree of inflammatory infiltration of the tissues. Terms of the radical operation were substantiated as well as the methods of treatment of the wounds at the stage of opening the abscess and radical operation.
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The results of treatment of 316 patients with chronic pustular lesions of the perineum and sacrococcygeal region are discussed. It is shown that the only radical measure in this category of patients is total excision of the involved tissues and, in combined variants, simultaneous performance of typical operations for rectal fistula or coccygeal pilonidal fistula. In localized and mostly in regional forms of the disease one-stage surgical interventions are expedient. Many-stage operations are indicated in extensive and, less frequently, in regional forms. Postoperative complications occurred in 5.3% of cases and were associated with wound suppuration. The late-term results were studied in 71.7% of patients who underwent operation: recurrences developed in 3.7% of cases.
The suggested methods for the treatment of chronic non-tumorous diseases of the rectum contributed to reduction in the incidence of postoperative complications and shortening of the duration of treatment. Hemorrhoidectomy was performed without leaving the node stumps with the use of sphincterotomy. Anal fissures were treated differentially. In long intra-sphincter and trans-sphincter fistulas, a wound of the anal region was sutured tightly, for the treatment of complex fistulas, the modified ligature method was employed. The glue and polymeric compositions were used.
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Polyps and villous tumors were found in 1525 of 10624 patients (14.3%) aged from 40 to 60. In 82% of the cases they were in combination with ulcer disease of the stomach and duodenum, with inflammatory diseases of the gastro-intestinal tract, diverticulitis, tumors of the colon. 1519 polypectomies and dissection of villous tumors both via the fibroscope, rectoscope and by transanal access were made. Complications were obtained in 5 patients, recurrent disease was noted in 3 patients (0.9%).
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