Klinichna khirurgiia最新文献

The impact of implantation of synthetic matrix NeuroGelTM together with neurogenic stem cells (NSC) on the course of posttraumatic spasticity syndrome was studied. Тhe laboratory animals were white mongrel male rats (5 mo, 250 g); the trauma simulation – transsection of the left half of spinal cord (SC) on the ТХІ level. Experimental group 1 consisted of a SC trauma, homotopic implantation of NeuroGelTM together with NSC of fetal (Е17) mice hippocampus (n=20); while group 2 – a SC trauma, homotopic implantation of NeuroGelTM (n=20); and group 3 – a SC trauma (n=16). Investigation of the function index and the spasticity index of posterior ipsilateral extremity was done in accordance to Basso-Beattie-Bresnahan and Ashworth scales. Association of the function index and the spasticity index of posterior ipsilateral extremity in all groups in various variants of the samples formation is ambiguous, witnessing possibility of additional correlation between these characteristics of a movement system. The NSC xenotransplantation in conjunction with NeuroGelTM changes the spasticity syndrome course, creates conditions for its facilitation in remote period after a SC trauma.

The clinic-morphological investigation on the efficacy results while application of the аrgon–plasm coagulation (АPC) in combination with laparoscopy in the treatment of hepatic hemangioma, are presented. The conduction of laparoscopic intervention, using the APC, have promoted the improvement of postoperative rehabilitation in the patients in aspects of subjective (the pain intensity) and clinic-laboratory indices of hepatic function. In accordance to the morphological investigation data, based on hepatic biopsies, more organ-preserving impact of the APC was noted on hepatic parenchyma.

Own experience of the endoscopic methods usage in diagnosis and treatment of chronic pleural diseases in 343 patients, оperated, using videothoracoscopy and video-assisted thoracoscopy, was presented. Postoperative lethality have constituted 0.29%. Application of endoscopic methods in treatment of chronic pleural diseases was highly effective and miniinvasive.

Analysis of clinical and functional results of microsurgical restoration of eyeball in remote terms after primary surgical processing for traumatic injury of eyes, using combined one-stage operative intervention on anterior and posterior segments, was presented. Satisfactory result was achieved in 56.4% injured persons, in 43.6% - functional outcome after the operation, concerning perspectives of further restoration of optic functions, have appeared unsatisfactory.

Results of treatment of 124 patients, suffering locally-advanced oral and oropharyngeal cancer were analyzed. In these patients after wide excision of tissues the defect has occurred, which would be impossible to close using simple suturing. To these patients a primary plasty, using musculo-cutaneous or adiposo-cutaneous flap, was performed. The defect, occurring after resection of the oral cavity floor together with the mandibular anterior fragment, constitutes the most complex one for the plasty performance. The main principles of the defects plasty were determined. The plastic material choice depends on peculiar clinical situation, the surgical intervention volume, the defect localization and its size.

The covered perforation of gastroduodenal ulcer constitutes certain difficulties in diag'nosis, causing distortion of clinical symptoms. The diagnosis is usually established withdelay. In the clinic during 7 years in 24 patients the covered perforative aperture of gas'troduodenal ulcer was revealed, constituting 6.8% оf total number of perforative ulcers.Pneumoperitoneum was not established. After pneumogastroscopy in 3 patients with afree gas revealed, they were operated on. After analyzing of dynamics in rest of patientstheir state degradation and the peritoneal symptoms occurrence was noted, what havehad demanded performance of operative intervention. Lethality was 4.1%.

Results of examination and treatment in 256 patients, suffering an acute ileus (AI), wereanalyzed. Differentiation—diagnostic program was elaborated, what have permitted toestablish a correct diagnosis in 98.4% patients. Higher informativity of ultrasonograph'ic investigation, permitting to verify the diagnosis on early stage of the disease and toestimate conservative treatment efficacy, accordingly, in 94.4 and 87.8% patients, wasestablished while doing comparative analysis of ultrasonographic and radiological diag'nostic methods.