RESUMEN
Prospective investigation of the traumatic disease course was conducted in 71 injured persons, suffering a combined cranioabdominal trauma with the objective to determine the main functional systems and dynamics of their state severity. The occurrence rate and the severity degree of cardiovascular insufficiency were determined--in accordance to indices of the integrative body rheography and integrative dual frequency impedansometry, respiratory insufficiency (PaO2/FiO2 ratio), the organ insufficiency severity (in accordance to SOFA scale). There was established, that changes in respiratory and cardiovascular systems are corresponding to the staged pathogenetic characteristics of the traumatic disease periods. So on, it is expedient to perform the urgent and postponed operative interventions in a period of their relative stabilization. The presence of severe craniocerebral trauma, as a part of a combined cranioabdominal trauma causes significant and durable impairment of the functional systems activity.
Asunto(s)
Traumatismos Abdominales/diagnóstico , Traumatismos Craneocerebrales/diagnóstico , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Respiratoria/diagnóstico , Traumatismos Abdominales/patología , Traumatismos Abdominales/fisiopatología , Traumatismos Abdominales/cirugía , Traumatismos Craneocerebrales/patología , Traumatismos Craneocerebrales/fisiopatología , Traumatismos Craneocerebrales/cirugía , Manejo de la Enfermedad , Progresión de la Enfermedad , Insuficiencia Cardíaca/patología , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/cirugía , Humanos , Selección de Paciente , Pletismografía de Impedancia , Estudios Prospectivos , Insuficiencia Respiratoria/patología , Insuficiencia Respiratoria/fisiopatología , Insuficiencia Respiratoria/cirugía , Índices de Gravedad del TraumaRESUMEN
The results of surgical treatment of 281 injured persons for combined cranio-abdominal trauma in acute period of traumatic disease, were analyzed. Depending on the trauma and internal organs injuries severity, there were applied: conservative therapy, mini-invasive interventions, laparotomy for abdominal element of the trauma, also there were determined the operation volume (complete, reduced, minimal) and expediency of the "damage control" tactics application. It made possible to perform conservative therapy in the main group in 12.6% injured persons, laparoscopic operations--in 35%, and to reduce laparotomy operations duration trustworthy. Indications for craniotomy in acute period of trauma were established in 9 injured persons of a control group and in 15--of the main group. While indications for craniotomy and laparotomy presence, the operation on abdominal organs was performed primarily or both interventions were done simultaneously with minimal or reduced volume.
Asunto(s)
Traumatismos Abdominales/cirugía , Traumatismos Craneocerebrales/cirugía , Traumatismo Múltiple/cirugía , Heridas Penetrantes/cirugía , Traumatismos Abdominales/patología , Enfermedad Aguda , Traumatismos Craneocerebrales/patología , Craneotomía/métodos , Humanos , Laparoscopía/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Traumatismo Múltiple/patología , Heridas Penetrantes/patologíaRESUMEN
The peculiar features of the clinical course and treatment of primary gastric MALT-lymphoma in 7 patients are discussed. Diagnosis was established by morphological examination of resected material. Six patients had low-grade tumor while one showed signs of blast-transformation. Stage IEB disease was identified in 4 cases, IIEB--3. Complete remission duration after combined surgical and chemoradiation treatment ranged 3.5-80 months (mean duration--35.1 months), survival--5-84 months (mean duration--43.1 months). Relapse was registered in one case 3.5 months after operation.
Asunto(s)
Linfoma de Células B de la Zona Marginal/patología , Linfoma de Células B de la Zona Marginal/terapia , Neoplasias Gástricas/patología , Neoplasias Gástricas/terapia , Adulto , Quimioterapia Adyuvante , Supervivencia sin Enfermedad , Femenino , Mucosa Gástrica/patología , Humanos , Linfoma de Células B de la Zona Marginal/tratamiento farmacológico , Linfoma de Células B de la Zona Marginal/radioterapia , Linfoma de Células B de la Zona Marginal/cirugía , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Radioterapia Adyuvante , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/radioterapia , Neoplasias Gástricas/cirugía , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
The results of the application of argon coagulator "Forse-40-GSU-System" in reconstruction of abdominal wall for ventral hernias are presented. The use of this coagulator provides decrease of intraoperative blood loss volume, an achievement of good results during the preparation of a skin flap for autodermoplasty.