Klinichna khirurgiia最新文献

The usage experience of the electric welding technologies for biological tissues in 158 patients, while applying Ukrainian high—frequency generator ЕК 300 М1, was presented. Laparoscopic appendectomy, laparoscopic plasty of inguinal hernia, laparoscopic cholecystectomy, open resection of small and large bowel, during which the method of electric welding of biological tissues was applied, had constituted the main surgical interventions. The electric welding usage have permitted to reduce the operation time and the blood volume loss, and also the clipses quantity needed, which are applied for the hemostasis completion and hermetization of anatomic structures after their transsection. Аnalysis of the data obtained witnesses high efficacy of the procedure application for the biological tissues conjunction as well as for acceleration of their reparation processes, occurring after disconnection.

Endovascular endoprosthesis infrarenal aorta constitutes a miniinvasive highly technological method of treatment of a life-thretening pathology. Experience of transcutaneous endoprosthesis of infrarenal aorta in 6 patients was presented. Possibility of a common femoral artery (CFA) suturing, using Prostar XL apparatus, was estimated on a stage of the endoprosthesis dimensions calculation in accordance to a CT and duplex US scanning data and recommendations of manufacturer. In transcutaneous CFA suturing the complications were absent. Absence of a sectional access to CFA have permitted to avoid such complications, as neuralgia, paresthesia, seroma, suppuration of operative wound. In bilateral suturing of CFA a duration of the patients stationary state have reduced.

The comparative analysis data were presented, concerning the results of complex treatment of 28 patients, suffering ischemic-gangrenous form of the diabetic foot syndrome, developing on background of chronic ischemia of the lower extremities stage IV. In 14 patients (main group) a routine complex of the treatment measures was added by application of an active pressure (negative pressure wound therapy - NPWT) and a capicor preparation; 14 patients (the comparison group) were treated in accordance to routine scheme. In accordance to the comparative analysis data, in patients of the main group the wound surface sarea have kept reducing in twice more rapid, than in a comparison group, the wounds healing was achieved in 94% patients, duration of the patients’ stationary stay have reduced by (5.2 ± 1.4) days.

The experience of treatment of 37 patients, suffering diffuse peritonitis, in 18 of them in complex with vacuum-therapy, is adduced. In a comparison group a sanation relaparotomy was applied only. International classifications SOFA, APACHE II, Manheim’s Index of the Peritonitis Severity were used for estimation of the patients’ state severity. The vacuum-therapy application have promoted significant reduction of the abdominal cavity microbial soiling, permitted to escape the compartment syndrome occurrence, and to reduce the sanation relaparotomy performance rate.

The results of surgical treatment of 54 patients, suffering the brain cystic meningiomas of various localization, were analyzed. The patients were operated on in universal conditions by neurosurgeons of one operative team, of them 24 – using new technologies. Wide application of new technologies in surgery of the brain cystic meningiomas have permitted to reduce the surgical intervention invasiveness essentially, and, as a consequence, to reduce trustworthily the operation time essentially, as well as the intraoperative blood loss severity.

Own experience of the patients treatment for the mammary gland cysts (MGC) in its benign dysplasia was analyzed. Comparative analysis of efficacy of a laser-induced sclerotherapy for the MGC and chemical sclerosing (96% еthanol) was conducted. There was established, that the cyst recurrency rate depends upon volume of the cavity and it is reducing while application of a laser-induced sclerotherapy.

Impact of a durable action of myorelaxant pipecuronium bromide on intraabdominal pressure (IAP) in rats in experimentally simulated acute peritonitis was studied. In the rats in purulent pancreatitis, іnduced by L-аrginin, IAP was in 4,5 times high (p < 0.001), than in intact laboratory animals. Pipecuronium bromide have lowered IAP by 33.4%, witnessing efficacy of application of myorelaxants in treatment of intraabdominal hypertension in purulent pancreatitis.

Experience of treatment of chronic wounds in 11 patients in 2014 – 2016 yrs was analyzed. The impact of negative pressure, using domestically manufactured apparatus «АGАТ- Dnepr», in complex of treatment as a local therapy, was applied. Vacuum-therapy was conducted preoperatively and postoperatively together with autodermoplasty. The injection material for the skin regeneration “lacerta” was applied subcutaneously intraoperatively. The Ialuset-cream bandages were used in 10 - 12 days postoperatively during 2-3 weeks. Еfficacy of vacuum-therapy was estimated, basing on analysis of the wound process course dynamics, clinic-laboratory criteria, terms of the wound defect complete closure. The patients’ stationary treatment duration have constituted 38.3 days at average. Complex treatment of chronic wounds have had guaranteed complete healing of the wound defect in 7 (63%) patients in terms up to 1 - 5 weeks, and in 3 (26%) - 6 weeks.