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Biomedical subjects

N Damianov

Publications and source records attributed to N Damianov.

At least 19 recordsLinked to original sources
PubMed2004

[Two cases of multifocal colorectal cancer--polypoid tumor of the colon and small flat carcinoma of the rectum].

The two cases of multifocal colorectal cancer are described and the proximal tumors are located at right and left colon. The distal tumors are small flat rectal carcinomas, rear with bad prognosis and the first scientific reports for this kind of lesions are dated from less than 20 years. The authors prefer colonoscopy instead of irigography for the diagnosis of the small flat colorectal carcinoma because of the limited possibilities of irigography for lesions less than 2 cm. It is necessary to perform intraoperative endoscopy for the exact localization of the small lesion of the rectum that define the level of resection. Different surgery tactics are applied determinably of the site of the polypoid tumor. In the case when the large tumor was localized in the right colon the operation is finished with temporary ileostomy. In the other case left-colectomy with Dixon's operation are done. The study is interesting because of the rare cases of the small flat carcinoma of the colon.

Aged↗
PubMed2004

[A case of metachronous carcinoma of the colon diagnosed and radical operated with restorative anastomosis after more than 5 years from the first left hemicolectomy].

The authors described their observation about the female patient with an advanced carcinoma (T4) of the descendent colon where left hemicolectomy was done in the beginning of 1998. The patient is operated again after more than 5 years because of the cancer in the site of the anastomosis. Radical reresection with restorative anasomosis is performed and for this reason the colon is putting via mesenteric radix. The case is analyzed and there are suggestion about is this a local recurrence or "de novo" carcinoma It is important to follow up the patients during lifetime for early uncovering of local recurrence. Endocoloscopy and scener are preferable for this aim.

Adenocarcinoma↗
PubMed2004

[A case of two simultaneous carcinoma lesions of the colon and rectum with different differentiation and stage of neoplastic process].

It considers a patient with simuitant colorectal carcinoma. Both tumor lesions are from different stage and different histological type. The grade of invasion of tumor process does not correspond to the histological type of neoplasma and nider to the size of the primer tumor. The different evolution of those simuitants lesions does not correspond with criteria for histological type and with the stage of primer tumor as a prognostic factors.

Adenocarcinoma↗
PubMed2003

[Continence of anorectal sphincter complex in the early postoperative period after direct colo-anal anastomoses with colo-colic J pouch].

UNLABELLED: According to up-to-date concepts for local spread of a rectal cancer it is possible to perform a radical rectal resection with a restorative anastomosis inspite of the fact that the tumor is located in the middle or the distal third of the rectum. Usually a total resection of the rectum and coloanal anstomosis have to be performed. There are two ways to restore the continuity of the gut: a straight coloanal anstomosis or J pouch anastomosis. 22 patients with rectal cancer localized between 4 and 9 cm from the anal verge, were operated and restorative anastomoses were performed. The first 18 patients were with a straight coloanal anastomosis. In the last 4 cases coloanal anastomoses were done between the anus and colocolic 7 cm J pouch. During the first month there were 6 patients with total and 9 with partial incontinence in the group with straight coloanal anastomosis. Transrectal sonography confirmed contractility of the puborectal muscle and sphinctermanometry showed lower resting tone and squeeze pressure in cases with incotinence. No incontinence was observed in the group with J pouch and the shinctermanometry data were the same as these of healthy controls. CONCLUSION: The rectal ampula has reservoir function and its loss after total resection of the rectum is the reason for frequent bowel movements, urgency and leakage. Reconstruction with a colonic J pouch is associated with better bowel function compared to the straight coloanal anastomosis.

Anal Canal↗
PubMed2003

[Total mesorectal excision in the surgical treatment of rectal cancer of middle and distal third of the rectum--precondition for local recurrences].

The author presents his own results of surgical treatment of 54 patients with rectal carcinoma. The point of view is total mesorectal excision as a condition for reducing of local recurrence. The anatomic preconditions and the surgical technics for total mesorectal excision are described. The observing of the rules of an ablastic surgical intervention with exact total mesorectal excision follow to an increase of the treated patients with restorative anastomoses (70%), in spite of the the fact that 75% of the patients are with tumor located at the distal third of the rectum. The postoperative mortality is 3.7% and the local recurrencies are 7.4%.

Anastomosis, Surgical↗
PubMed2003

[Endoluminal echography in rectal cancer--preoperative staging and postoperative control].

The aim of this study is to determine the diagnostic potential of endoluminal echography and the pitfalls sources in the preoperative staging and postoperative follow-up in patients with rectal cancer. 245 patients with rectal carcinoma are evaluated during 10 years period (Jan. 1993-Jan. 2002 years). 96 patients are monitored in the early and late postoperative periods for the early detection of local recurrence as well as for the anorectal physiology assessment after low anterior rectal resection or coloanal anastomosis. Lineal transducer UST-657-5MHz (Aloka 620) and 10MHz miniprobe are applied. The accuracy for T-staging is 84% and for N-staging is 82%. The local recurrence is detected in 21 patients, on average 12.6 months after curative surgery. The local recurrence is more often in cases of lymph node involvement as well as if some specific echographic features for extramural vascular invasion are present. Endoluminal echography provides individual therapeutic management and postoperative control in patients with rectal cancer.

Adult↗
PubMed2000

[Iatrogenic lesions of hepatocholedocus in cholecystectomy].

This is a report on nine patients presenting different intraoperative lesions to hepatocholedochus, some of them diagnosed in the course of operation, and others- after the intervention. A variety of plastic repairs of the hepatocholedochus, including simple suture, Saple's operation or hepatodigestive anastomosis after Longmayre are performed. The probability of inflicting lesions, the underlying causes and the therapeutic approach to concrete cases are analyzed. Abiding to the principles of surgery is strongly recommended, such as: sufficient and appropriate operative access, atraumatic manipulations, drainage of the gallbladder bed and the like, with a view to perclude serious and sometimes fatal complications' occurrence, as well as making early diagnosis and accordingly taking the most opportune surgical solution to the problem faced.

Bile Ducts, Extrahepatic↗
PubMed2000

[Local recurrence after radical surgery for rectal carcinoma].

The incidence rate of local recurrences after radical operative treatment of rectal carcinoma and the risk factors involved, methods of early diagnosis and surgical therapeutic approach are comprehensively analyzed. Reference is also made to 86 scientific publications on the issue. During the 20-year follow-up period, no tendency of the incidence of local rectal carcinoma relapses to decrease is noted. The risk factors contributing to their occurrence are distributed in two groups depending on the primary tumor characteristics (location, stage of development, locoregional spreading, differentiation degree, genetic features), and operative intervention used (type, distal resection line, application of total mesorectal excision, extensive minor-pelvis lymph dissection etc.). The early diagnosis is based on mandatorily performed procedures, such as rectoscopy (coloscopy), endo-ultrasonography with purposeful thin-needle biopsy, assessment of tumor markers and immunoscintigraphy. The surgical tactics in coping with a local recurrence of rectal carcinoma becomes increasingly aggressive and radical by resorting to re-resection, abdomino-perineal extirpation, en-bloc resections and even minor pelvic exenteration. Postoperative 5-year survivorship amounts to 54.5 per cent.

Digestive System Surgical Procedures↗
PubMed1999

[Francke's operation--a resolution for deep small echinococcal cysts of the liver].

The operation of Francke in hydatid disease treatment is described--puncture, aspiration, sterilization--with emphasis laid on the technical details. The indications for its practical implementation are specified--small echinococcus cysts, deeply located within the parenchyma of the organ, or diffuse abdominal echinococcosis. In diagnosing such cysts intraoperative ultrasonography is considered as absolutely necessary and mandatory. The operation is practicable in handling first-stage cysts according to Volynkin, containing thin echinococcus liquid only, whereas in the presence of daughter vesicles it is not indicated. Postoperatively, dispensary outpatient observation and chemotherapy of the hydatid disease are recommended with a view to promote radical cure.

Echinococcosis, Hepatic↗
PubMed1998

[Sphincter-preserving operations in the treatment of carcinoma of the middle and lower third of the rectum].

The prerequisites for sphincter-salvaging interventions in the operative management of carcinoma of the middle and lower third of rectum are analyzed. Reference is made to 96 scientific publications of the issue, with due consideration given to the anatomical and physiological prerequisites for coloanal anastomoses. Updated knowledge of intramural diffusion of the neoplastic process in distal direction promotes the performing of ablastic surgical intervention with resection line 2 cm beneath the tumor. The practical implications of total mesorectal excision for reducing local recurrences are underscored. Analysis of the summed up literature data warrant the assumption that in the event of differentiated carcinoma of the rectum, located 1.5-2 cm above linea dentata, sphincter-salvaging operation should be undertaken with a priority given to direct manual coloanal, transanal anastomosis. This type of surgical interventions are attractive on account of the likelihood to preserve the anal sphincter complex--a fact having an essential practical bearing on the lifestyle of patients. Eventual local relapses lend themselves readily to diagnosis and treatment by abdominoperineal extirpation. Thus the latter may be deferred in time, and in most patients it may prove unnecessary altogether.

Anal Canal↗
PubMed1997

[Perforations of hepatic hydatid cysts].

Out of a total of 753 patients operated for liver echinococcosis, in 43 (5.71 per cent) various perforations are observed, namely: in the biliary apparatus, chest, abdominal cavity, gastrointestinal tract, subphrenic and subcutaneous tissue. Their incidence in bile ducts is the highest. The lethality is rather elevated with two patients dying on the operating table. In conclusion, proceeding from the severity of the complication emphasis is laid on the necessity of early diagnosis of the disease, before development of serious complications, successfully achieved in the last few years.

Aged↗
PubMed1996

[Endocavitary echography following abdominoperineal extirpation of the rectum].

Transrectal echography using a high-frequency transducer is a well established method for preoperative rectal carcinoma assessment, and for postoperative follow-up of patients with anterior resection for rectal carcinoma. Having in mind the impossibility for follow-up study of patients with abdominal perineal extirpation of the rectum by transrectal echography, a new pattern of application of the transducer employed for endorectal examination is suggested. In five patients (4 women and 1 man) endocavitary echography through the anal canal is done. In women the examination is supplemented by transvaginal echography. A local recurrence in the course, of transvaginal study is recorded in one patient. The technique of examination and the superiorities of the procedure are discussed.

Abdomen↗