[Tuberculous lesion of the spleen].
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Adult↗
Biomedical subjects
V I Bondarev
Publications and source records attributed to V I Bondarev.
[Immediate and remote results of pylorus-preserving and pylorus-reducing operations in complex surgical treatment of perforated pyloric-duodenal ulcers].
The results of surgical treatment of 224 patients with perforated pyloroduodenal ulcers were analyzed. 110 patients were operated using pyloruspreserving and pylorusreducing methods. The new method of pyloroduodenoplasty is suggested. Duodenogastral reflux after pyloruspreserving operations is arised in 4.5% of observations, after pylorusdestructive--in 46.7%.
Duodenal Ulcer↗
[Prophylaxis of purulent-septic complications after amputation of lower extremity for atherosclerotic gangrene].
Results of treatment of 78 patients, in whom atherosclerotic gangrene of lower extremity had occurred, were analyzed. There was proposed the method of the extremity amputation on level of femur, using two flaps, and apparatus for formation of cutaneomuscular flap as well, introduction of which have allowed to reduce frequency of purulent-septic complications to 7.1%. Lethality had lowered from 13.1 down to 5.3%.
Abscess↗
[Endoscopic choledochoduodenostomy].
Method of endoscopic choledochoduodenostomy was elaborated and introduced in clinical practice. Results of formation of endoscopic biliodigestive anastomosis in 12 patients for 1990-2000 yrs period were analyzed. In 7 (5.8%) patients complications occurred, 1 (0.8%) patient died.
Adenoma↗
[Fundamentals of complex treatment of acute destructive pancreatitis].
Results of treatment of 240 patients with an acute pancreatitis were analyzed. There were assigned two groups taking into account stage of severity of pancreonecrosis and stage of polyorganic insufficiency. In 147 patients with mild stage and moderate stage conservative treatment was undertaken, in 93 patients with severe course different operative interventions were performed in urgent and emergent order and in period of postnecrotic complications occurrence. Application of such an approach have permitted to lower the postoperative complications frequency in 1.9 the value. Mortality had constituted 22.6%.
Acute Disease↗
[The role of anatomical factors in predicting the probability of the development of an abdominal ischemic syndrome].
Anatomo-topographical studies, performed in 100 human corpses established that predispositions to development of the extravasal compressions (EC) of the coeliac trunk (CT) may be observed at high location of the aortal canal mouth, which is usually observed in case of dolichomorphic constitutional type. Complications of not diagnosed coeliac trunk extravasal compressions were the possible reason in 3% of sections. Acute substernal angle (< or = 70 degrees) is an easily determined and significant indicator of dolichomorphic type. This should be taken into account by clinicians in cases of unclear abdominal syndrome.
Abdomen↗
[Intra-abdominal lavage in the multimodal treatment of patients with acute diffuse peritonitis].
Study showed that the suggested method for appraising the severity of the inflammatory process makes it possible to decide whether peritoneal lavage is necessary in each concrete case. The authors examined 217 patients with acute generalized peritonitis (AGP). Four degrees of the risk of a severe course of AGP were distinguished conditionally. Patients with the first degree of risk do not need intraabdominal lavage. To remove the noted inflammatory changes in the peritoneum it was sufficient to cleanse thoroughly and drain the abdominal cavity and introduce antibiotics into it during complex treatment. Intraabdominal lavage is indicated for patients with the second degree of risk and with marked inflammatory changes in moderate circulatory changes. Abdominal lavage with peritoneostomy is indicated for patients with pronounced inflammatory (N = 3.8 cond. units) and microcirculatory disorders (Y = 0.2 cond. units). Peritoneal lavage is not indicated in patients (third and fourth degrees of risk) with considerable inflammatory (N = 4.04 cond. units) and microcirculatory disorders (Y = 0.4 cond. units).
Acute Disease↗
[Surgical treatment of diseases of operated stomach].
Surgical treatment of 293 patients with diseases of an operated on stomach is analysed. Relapse of peptic ulcer after closure of a perforation was encountered in 170 patients, the dumping syndrome in 54, peptic ulcer of the anastomosis in 60, the afferent loop syndrome in 6, and a rare type of diseases of an operated on stomach in 3 patients. Classification of diseases of an operated on stomach according to the syndromes and differential diagnosis of functional syndromes are presented. Indications for surgical correction depending on the type and severity of the pathological condition were developed. The late-term results were studied in 266 patients. The results were good in 72%, satisfactory in 21%, and poor in 7% of cases. The late-term results in surgical correction of functional syndromes were good in 29%, satisfactory in 51.6%, and poor in 13.5% of patients. Mortality after all repeated operation was 1.3%.
Afferent Loop Syndrome↗
[Differentiated approach to repeated practicable cleansing of the abdominal cavity in patients with acute diffuse peritonitis].
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Abdomen↗
[Surgical treatment of diseases of the operated stomach].
Clinical follow-up results of 876 patients with operated stomach malady, 342 of whom were operated on, were analyzed. In 58% of patients after the perforation closure the ulcer recurrence occurred, in 26% after gastric resection--peptic ulcer, in 26%--functional pathological syndrome. Surgical tactics depended on character of previously conducted procedure, general condition and age of the patient, secretory function of stomach and operative situation. Complications occurred in 6.1% of patients. Mortality was 1.2%.
Aged↗
[Extravasal compression of the popliteal artery].
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Constriction, Pathologic↗
[Extravascular compression of visceral arteries in the diaphragmatic segment of the aorta].
There were 140 patients operated for the celiac trunk (CT) and renal arteries extravascular compression (FC) in diaphragmatic aorta segment. The clinical syndromes of chronic abdominal ischemia and vasorenal hypertension were depicted. The predisposing factors of CT EC is the patients' dolichomorphic constitution with epigastric angle of < or = 70 degrees. The effectiveness of differentiated tactic choice of operative intervention magnitude according to the disease stage was shown. The late follow-up results witnesses the necessity of timely and adequate treatment.
Abdomen↗
[Disorders of immune status in duodenal ulcer complicated by perforation and peritonitis].
The chemotaxic activity of neutrophil granulocytes was studied in 112 patients with duodenal ulcer disease complicated by perforation and peritonitis with a different degree of spreading. Sharp decrease in spontaneous migration of leukocytes (SML) was revealed in generalized peritonitis. In diffuse peritonitis, the index didn't differ from that in normal subjects. In patients with the complicated course of the postoperative period, SML stimulation under the influence of the own serum was noted. At day 3-9 after the operation, the stimulating activity of the humoral factors of immunity was gradually decreasing. Use of the stimulators of migrative activity of phagocytes contributes to normalization of their function. In patients who had the immunocorrigative agents been prescribed, aggravation of peritonitis and purulent-septic complications were noted 1.4-fold less often than in absence of such treatment.
Adult↗
[The therapeutic measures in acute diffuse peritonitis].
Analysis of the observations of 431 patient with acute diffuse peritonitis is presented. Use of intraabdominal flowing lavage is recommended in patients with inflammatory phenomena against the background of moderately pronounced changes in microcirculation in the parietal peritoneum. The maximum clinical effect of hemosorption and lymphosorption was noted at the first 3 days after the operation in cathepsin-D activity in the blood equal to 14-17 activity units/(min.mg) and lymphorrhea over 700 ml/day. Lethality was 18.8%.
Acute Disease↗
[The use of cholesorption in the treatment of patients with acute cholecystitis complicated by cholangitis].
The results of treatment of 137 patients with acute cholecystitis complicated by cholangitis are presented. The causes and clinical signs, and tactics for operative treatment of the disease are described. Progressive hepatic failure is one of the causes of lethality. Use of the developed method of cholesorption permitted to reduce the incidence of hepatic failure development, decrease postoperative lethality to 9.5%.
Acute Disease↗
[New approaches in diagnosis and therapy of the thoracic outlet syndrome].
The results of diagnosis and treatment of the thoracic outlet syndrome (TOS) in 35 patients have been analysed. Compression of the subclavicular neurovascular bundle at the site of its outlet from the thoracic cavity was most frequent cause of TOS development. A degree of compression was assessed quantitatively by the data of a modified functional dynamic test. The modified operation, including resection of the I rib (and of a cervical one in its presence), scalene muscle, musculus pectoralis minor, periarterial sympathectomy of the subclavicular artery, was performed. In narrow (less than 1.5 cm) costoclavicular space, the II rib was additionally resected. An excellent long-term result is indicative of the effectiveness of the method.
Adolescent↗
[Prevention of early inflammatory complications after transthoracic interventions and estimation of the degree of immunologic deficiency].
An analysis of the results of the examination and treatment of 379 patients undergoing transthoracic interventions showed that the use of the target-aimed selective immunomodulation, short-term antibacterial prophylaxis, inhibitors of arachidonic acid metabolites, active elimination of the circulating immune complexes and medium-weight molecular peptides and adequate local analgesia after the interventions providing normalization of the laryngeal reflex and early activation of the patients permitted the incidence of the pulmonary complications to be decreased by 2.5 times, pleural complications by 1.7 times, suppuration of the postoperative wound by 1.8 times and the total expenses by 25.6 per cent.
Adjuvants, Immunologic↗
[Combined antibacterial therapy in acute lactation mastitis].
The results of treatment of 129 patients with acute suppurative lactic mastitis are presented. In severe forms of the disease, the use of combined antibiotic therapy+ permits to shorten the duration of in-patient treatment from 13.5 to 10.3 days, prevent the disease recurrence.
Acute Disease↗