Klinichna khirurgiia最新文献

There were analyzed the results of treatment of 1450 patients, to whom in surgical departments of Lugansk Regional Clinical Hospital the elective endoscopic polypectomy for solitary and multiple gastric polyps, premalignant changes, was conducted. The unfavorable prognosis signs, trustworthily impacting the gastric polyps reoccurring, were considered: quantity of gastric polyps, their dimensions, localization and presence of mucosal erosions. Reoccurrence of majority of the polyps in gastric antrum may be due to microcirculatory disorders, present in their mucosa.

The analysis of 82 patients medical records with venous trophic ulcers (VTU) of the lower limbs were presenting. pH in patients with VTU determined in three locations: the surface of ulcers, venous modified and unmodified skin and ulcers. Cytological examination of secretions from wounds conducted in 32 (39.1%) patients using smears. In 19 (23.2%) patients prevailed exudation stage, in 37 (45.1%) – granulation, in 26 (31.7%) - epithelialization. At all stages of wound healing at a distance from the ulcers observed values change skin pH to the acid side. Typical sings of first phase of wound healing were degenerative–inflammatory and inflammatory type of cytogram, and for the granulation phase – inflammatory–regenerative and regenerative one.

Technical peculiarities of the aortal valve prosthesis, using miniinvasive access, were presented. Оperative interventions were conducted in 48 patients, using upper partial J-like ministernotomy. The access is effective and enough secure, has advantages, comparing with classic longitudinal median sternotomy, because it permits to minimize a surgical trauma, to preserve the thoracic cage framework, and to achieve better cosmetic effect.

Results of the hemostasis conduction in conditions of revascularization in 106 patients, оperated on for atherosclerotic affection of aorta and the main arteries of the lower extremities, were adduced. Syndrome of hypercoagulation of traumatic stage of surgical intervention in early postoperative period is developing due to thrombinemia on background of a fibrinolytic system depression. There was proved a necessity to impact on thrombin-fibrinous factor (factor ІІа) of hemocoagulant cascade by application of nonfractionized heparins immediately after conclusion of operative intervention with thromboprophylaxis prolongation, using low-molecular heparins (impact on Ха factor) in accordance to the branch standards.

The results of training in Odessa National Medical University 36 students on the virtual endoscopy simulator "Basic laparoscopic skills" were generalized. We determined self-learner ratio of the questionnaires, practical skills coefficient estimated check-lists, the resulting ratio of practical skills for each group. These coefficients were effective for the overall assessment and reliable calculations of long-term survival skills.

Efficacy of combined and potentiated methods of anesthesiological support of operative interventions on the organs of pancreatoduodenal zone was estimated. In 43 consequently treated patients operative interventions was performed for malignant tumors and fibrous-degenerative changes of pancreatic gland. Efficacy and interchangeability of various methods of anesthesiological support for reduction of the operative risk stage and the risk of intraoperative iatrogenic injury was studied.

Hepatico-jejunoanastomosis (HJA) was formed in accordance to the high-frequency electric welding method: in 14 patients – for the main bile outflow disorders, in 8 of them – as a consequence of the periampullar zone malignances, in 6 – stricture of a common hepatic duct, HJA earlier formatted, purulent cholangitis, iatrogenic damage of biliary ducts. In all the patients the welded averting one-layered termino-lateral or latero-lateral HJA were formatted. The welded anastomoses have appeared hermetic, sufficiently hard, immediately after the formation and further.

Comparative estimation of the local treatment results for purulent-inflammatory diseases of soft tissues, using standard methods and composition, owing sorption and antimicrobial properties and basing on a nanodispersedsilica, was conducted. The composition application in complex of treatment have promoted more rapid clearance from necrotized tissues and microorganisms, rapid appearance of granulations, the intoxication severity reduction, the phase I of the wound process duration shortening, what have permitted to put secondary sutures on the wound on the 6 – 7th postoperative day, and total duration of the patients’ stationary treatment have reduced by 3.7 days.

Impact of the allogenic tissue transplantation of the fetal cerebral large hemispheres and the оlfactory bulb tissue (OBT) on the healing processes after the brain contusion was studied in experiment. The investigation was performed on mongrel male rats: in laboratory animals of the first group in the first day after open penetrating local cerebral trauma (OPLCT) the allogenic fetal nervous tissue fragment was transplanted into the formatted tissue defect; for the second group – in the first day after cerebral trauma the allogenic OBT fragment was transplanted into the formatted tissue defect; and for the third group (control) - the OPLCT was done without further transplantation of tissues. The impact of the allogenic fetal nervous tissue transplantation was demonstrated by more active participation of glial cells during the healing process course, and the OBT transplantation was followed by activation of neoangiogenesis processes , mainly in the injured brain. The experimental simulation choosed permits to study the possibilities of application of neurogenic tissues in the brain contusion treatment, and to determine the therapy tactics.