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Biomedical subjects

V D Fedorov

Publications and source records attributed to V D Fedorov.

At least 19 recordsLinked to original sources
PubMed1991

[Catheterized balloon mitral valvuloplasty in pregnancy].

Catheterized balloon mitral valvuloplasty was carried out in two females with rheumatic mitral stenosis on the 28th and 24th weeks of pregnancy. The operation on the first patient was performed at the beginning of the development of pulmonary edema. Treatment produced good results in both cases. The surface of the mitral orifice increased from 1.5 and 1.6 to 3.2 and 3.5 cm2, the pressure gradient between the left atrium and left ventricle reduced from 40 and 30 to 6 and 4 mm Hg. There was attended by disappearance of the diastolic murmur and the clinical manifestations of congestion in pulmonary circulation in both patients. Mitral regurgitation did not occur after the operation. Radioscopy lasted 20 and 33 minutes. Protective screens were used to protect the fetus from direct exposure to X-ray. Pregnancy terminated at full term by spontaneous delivery in both patients. The babies, both girls, are healthy. Catheterized balloon mitral valvuloplasty does not yield to closed mitral commissurotomy in efficacy. The mild character of injury inflicted during the operation and no need for general anesthesia make this intervention most preferable in female patients with mitral stenosis during pregnancy.

Adult↗
PubMed1991

[Extracorporeal ultrasonic lithotripsy of biliary calculi].

The article analyses the efficacy of extracorporeal lithotripsy by a LT-01 piezoelectric lithotriptor (EDAP, France). A total of 72 lithotripsy sessions were performed on 37 patients, in 2 of them who suffered from chronic calculous cholecystitis the procedure was conducted on the day before the operation. As a method for treatment, extracorporeal lithotripsy was applied in 35 patients for the following indications: solitary and multiple stones measuring in sum no more than 3 cm in the satisfactory functioning of the gallbladder and patency of the bile ducts. In 35 patients the stones were crushed to fragments of various size. In 29 patients extracorporeal lithotripsy produced a marked effect and was the final method of treatment. Six patients were operated on (cholecystectomy) due to exacerbation of chronic cholecystitis in 4 patients, pancreatitis in one patient; total destruction of calcinated large stone fragments could not be achieved after 6 sessions in one patient.

Adolescent↗
PubMed1991

[Principles of surgical treatment of inguinal hernia].

The work is based on the analysis of the results of surgical treatment of inguinal hernias in 198 patients in the period from 1983 to 1988. Most of the patients were over 60 years of age, a lesser number were under 35 (11.1%). Hernias of a complicated and transitional form were found in 174 patients and mild forms only in 24 patients. The hernias were recurrent in 45 and sliding in 59 patients. Proceeding from the specific features of the surgical anatomy of the inguinal space, all patients, irrespective of their age and the form and type of the hernia, were treated by operation with plastics of the opening of the hernial sac to the back of the elements of the spermatic cord. The only exception were patients under 35 years of age with a mild form of oblique inguinal hernia, in which case variants of operations with enforcement of the anterior wall of the inguinal canal were carried out. The Schouldies and McVay methods were preferred, in recurrent and all complicated forms of inguinal hernias they were combined with operations of the Endrews and Postempsky types; the last named was mostly used in individuals over 60 years of age and in repeatedly recurring hernias. The late-term results were studied in follow-up periods of 2 to 7 years in 176 patients in the group of 198 individuals who were operated on. In 77.7% of them 3-6 years have passed since the operation. Almost all patients of mature age have resumed their occupation, there are complaints neither of pain at the site of the operation nor of changes in sexual potency. Recurrent hernias were not detected.

Abdominal Muscles↗
PubMed1990

[Characteristics of wound infection in long-term crush syndrome].

Clinicobacteriological examination was carried out in 31 patients with the crush syndrome (CS) and extensive damage to the soft tissues in combination with bone fractures complicated by wound infection. Inadequate surgical treatment in the early periods after the trauma (complete closure of the wound, making small incisions of the involved skin and subcutaneous fat) is particularly hazardous in such cases because it leads to the development of severe wound infection. This disease is marked by a complex polymicrobial structure of the causative agents, massive dissemination of aerobic and opportunistic anaerobic bacteria in the purulent focus (10(7)-10(9) microbial bodies), and a high proportion (48.4%) of obligate anaerobic microflora. Wound infection in the CS takes a grave clinical course, but without profound microbiological study it is difficult to differentiate it into aerobic and anaerobic (clostridial and ++non-clostridial) forms. This is evidence of the need for emergency extended bacteriological diagnosis at all the stages of treatment. "Pure" aerobic infection was identified in half of the patients and mixed aerobic-anaerobic infection in the other half. The possibility of the involvement of asporogenic anaerobes is shown (35.5% of cases). The high risk of the development of gas gangrene is detected (9.7%) and its is concluded that early prevention is necessary by adequate surgical intervention, adequate intensive antibacterial and detoxification therapy, including hyperbaric therapy. The efficacy of current antigangrene immunization agents must be evaluated.

Armenia↗
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↗
PubMed1990

[The organization of care for burn victims in catastrophes].

The experience in medical care and treatment of burned patients showed that adequate anti-shock infusion therapy can be established only 4-6 hours after the sustained trauma. However, even despite such a delay, many burned patients (75-80%) get well, due to the later adequate complex treatment controlled by experienced burn specialists [correction of combustiologists] in hospital units specially organized and equipped for this category of patients. Within the first 2-4 days after the trauma, it is recommended to distribute major accident victims between different specialized burn units, using specially equipped air and motor transportation vehicles.

Burn Units↗
PubMed1989

Combined treatment of colonic cancer.

One hundred seventy-eight patients with cancer of different segments of the colon were treated with preoperative radiation and surgery. Preoperative radiation with 25 MeV betatron was employed according to the method developed by the authors. Radiation treatment was tolerated by patients in the absence of manifest general and local reactions. No decrease below 3000 in the rate of leukocytes was observed after a total dose of up to 40 Gy. After radiotherapy, improvement in the general state was achieved in 72 percent and positive roentgenologic findings were seen in 70.8 percent of patients. The preoperative irradiation therapy was followed by 153 radical and 28 palliative operations. There was no increase in postoperative morbidity or mortality. The morphologic study of surgical specimens showed that considerable changes in the tumoral tissue, including disappearance of cancer cells, were seen in 75 percent of cases. The five-year survival rate of 112 patients after radical surgery indicates that it is worthwhile to use the combined treatment approach for tumors located in the right colon and in cases of suspected or existing infiltration into adjacent organs and tissues.

Adult↗
PubMed1979

[Use of 25-MeV brehmsstrahlung in the combined treatment of cancer of the large intestine].

Preoperatively, 105 patients with cancer of the colon were subjected to radiation therapy with a braking beam from 25 MeV Betatron. The colon was examined roentgeno-endoscopically in all these cases. As a result of the radiation treatment a marked clinical effect was noted in 94 patients, while in 12 cases locally-unresectable tumors were rendered resectable. 77 patients were radically operated upon, and a morphological assay of the operation specimens indicated significant changes arising in the tumor tissue due to the effect of ionizing radiation. The results of the combined therapy of colonic cancer patients prove the rationale of employing high-energy radiation therapy preoperatively.

Evaluation Studies as Topic↗