RESUMEN
There were examined 46 patients, in whom operative treatment of perforative duodenal ulcer was conducted. Organ-preserving operations were performed in conjunction with selective proxymal or truncal vagotomy. In far-remote terms after the operation in 12 patients gastrooesophageal reflux have occurred, DeMeester index have constituted 17.5-38.5. Impact of operative trauma on antireflux power of gastro-oesophageal junction was noted.
Asunto(s)
Úlcera Duodenal/cirugía , Reflujo Gastroesofágico/patología , Úlcera Péptica Perforada/cirugía , Adulto , Úlcera Duodenal/complicaciones , Úlcera Duodenal/patología , Reflujo Gastroesofágico/etiología , Humanos , Persona de Mediana Edad , Úlcera Péptica Perforada/complicaciones , Úlcera Péptica Perforada/patología , Periodo Posoperatorio , Vagotomía/métodosRESUMEN
The standard transvenous electrocardiostimulation (ECS) is currently used in many specialized hospitals. The authors offered and launched systematic application of simple but available technique of epymiocardiac ECS using pericardoscopy since middle of 80th. According to this principle, the authors developed some diversities of manipulation which are distinctive due to their availability, reliability and supersafety. The method could be recommended for wide-spread usage in practice because of high efficacy, few complications and absence of fatal outcomes in correct intervention. Described methods used in treatment of considerable quantity of patients and adapted to real work conditions of public health hospitals.
Asunto(s)
Arritmias Cardíacas/terapia , Técnicas Electrofisiológicas Cardíacas , Complicaciones Posoperatorias , Toracoscopía , Arritmias Cardíacas/diagnóstico , Investigación sobre la Eficacia Comparativa , Técnicas Electrofisiológicas Cardíacas/efectos adversos , Técnicas Electrofisiológicas Cardíacas/instrumentación , Técnicas Electrofisiológicas Cardíacas/métodos , Humanos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Reproducibilidad de los Resultados , Toracoscopía/efectos adversos , Toracoscopía/métodosRESUMEN
The results of prosthetic hernioplasty, performed in 61 patients for a small- and middle-size abdominal wall hernia (AWH) were analyzed. In a control group in 18 (29.5%) patients the IPOM-procedure was applied and in the main group in 43 (70.5%)--the combined plasty. Complications, which have had occurred in 2 (11.1%) patients of a control group and in 4 (9.3%)--of the main, were cured using conservative methods. While five-year followup the AWH recurrence was not noted. The introduction of the elaborated tactic of treatment, named the combined reconstructive hernioplasty, have permitted to improve the late functional and cosmetic results due to restoration of abdominal linea alba integrity.
Asunto(s)
Técnicas de Cierre de Herida Abdominal , Hernia Abdominal/cirugía , Herniorrafia/métodos , Laparoscopía/métodos , Mallas Quirúrgicas , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Dolor Postoperatorio/tratamiento farmacológico , Resultado del Tratamiento , Adulto JovenRESUMEN
After performance of organ preserving operations the cytotoxic stamms of H. pylori were revealed in 47 (94%) patients with recurrent ulcer. after gastric resection--in 27 (58.6%). The conduction of antihelicobacteric therapy is indicated to all the patients, in whom recurrent ulcer had occurred after organ preserving operations performance, its indication after gastric resection performance must be individual, after the patient examination succession. Application of a combined preparation, consisting of 20 mg of omeprazol, 500 mg of clarithromycin, 1000 mg amoxicillin, in a standard dosage of 3 tablets twice a day during 7 days have permitted to achieve the H. pylori cytotoxic stamms eradication in 94.2% of the patients. The preparation is well endured by the patients, the adverse reactions are minimal, temporary, their occurrence does not necessitate the preparation abolition.
Asunto(s)
Antibacterianos/uso terapéutico , Antiulcerosos/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/efectos de los fármacos , Úlcera Péptica/cirugía , Amoxicilina/administración & dosificación , Amoxicilina/efectos adversos , Amoxicilina/uso terapéutico , Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Antiulcerosos/administración & dosificación , Antiulcerosos/efectos adversos , Claritromicina/administración & dosificación , Claritromicina/efectos adversos , Claritromicina/uso terapéutico , Esquema de Medicación , Combinación de Medicamentos , Infecciones por Helicobacter/microbiología , Helicobacter pylori/aislamiento & purificación , Humanos , Omeprazol/administración & dosificación , Omeprazol/efectos adversos , Omeprazol/uso terapéutico , Úlcera Péptica/complicaciones , Úlcera Péptica/tratamiento farmacológico , Úlcera Péptica/microbiología , Recurrencia , Resultado del TratamientoRESUMEN
The results of application of constant vacuum extraction, a new method of the lower extremities trophic ulcers treatment, are adduced. There was shown the method efficacy in the treatment of the varicose disease complications, there were noted the reduction of the wound healing terms in comparison with such using conventional methods of treatment, the advantages and peculiarities of the method as well.
Asunto(s)
Úlcera Varicosa/terapia , Cicatrización de Heridas , Adulto , Anciano , Humanos , Pierna/irrigación sanguínea , Persona de Mediana Edad , Vacio , Úlcera Varicosa/etiología , Insuficiencia Venosa/complicacionesRESUMEN
The state of the gastric mucosa regional blood flow and microcirculation in 148 patients with duodenal ulcer disease, complicated by sub-compensated or decompensated stenosis of gastric outlet, was studied. The lowering of indexes in various parts of stomach, along curvature minor especially, was revealed. These date substantiate the necessity of application of the organ-preserving operation with the ulcer excision and the dilating pyloroduodenoplasty performance in late stage of stenosis. If is recommended application of preparations, promoting normalization of the blood rheologic properties and mucosal microcirculation, for prophylaxis and the regional blood flow restoration in the early postoperative period.
Asunto(s)
Úlcera Duodenal/complicaciones , Estenosis Pilórica/complicaciones , Estenosis Pilórica/cirugía , Estómago/irrigación sanguínea , Vaciamiento Gástrico/fisiología , Humanos , Pletismografía de Impedancia/métodos , Terapia RecuperativaRESUMEN
The results of operative treatment of 126 patients with esophageal cancer, localized on different level, were analysed. In 73 of them the thoracic esophagus affection was revealed. Radical operations were performed in 46 and the palliative--in 27 patients. As a rule, one-staged esophagoplasty was done, using stomach and colon. The original method of the gastric transplant lengthening was proposed, permitting to perform one-staged retrosternal esophagoplasty with construction of cervical esophagogastroanastomosis. Complications have occurred in 6 patients.
Asunto(s)
Neoplasias Esofágicas/complicaciones , Neoplasias Esofágicas/cirugía , Estenosis Esofágica/etiología , Estenosis Esofágica/cirugía , Esofagoplastia/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Torácicos/métodosRESUMEN
Method of gastric wall tone determination before the operation in patients with gastroduodenal ulcer disease, complicated by pyloroduodenal stenosis (PDS) was elaborated. There were examined 86 patients with sub- and 62 with decompensated PDS using method of electrogastrography and of the intragastric pressure registration--using method of the opened catheter. Three degrees of the gastric motor function disorder were delineated. Tactics of treatment of such patients was elaborated.
Asunto(s)
Úlcera Duodenal/fisiopatología , Tono Muscular , Estenosis Pilórica/fisiopatología , Estómago/fisiopatología , Atropina , Úlcera Duodenal/complicaciones , Vaciamiento Gástrico/efectos de los fármacos , Humanos , Tono Muscular/efectos de los fármacos , Neostigmina , Parasimpatolíticos , Parasimpaticomiméticos , Cuidados Preoperatorios , Estenosis Pilórica/etiología , Estómago/efectos de los fármacosRESUMEN
The results of treatment of 259 patients with perforative duodenal ulcer, complicated by penetration and stenosis, were analysed. The original methods of ulcer excision are proposed. Excellent and good late follow-up result was noted in 159 (84.6%) patients, fair--in 15 (8.2%), bad (ulcer recurrence)--in 8 (4.4%).
Asunto(s)
Obstrucción Duodenal/etiología , Hemorragia/etiología , Úlcera Péptica Perforada/complicaciones , Úlcera Péptica Perforada/cirugía , Obstrucción Duodenal/cirugía , Estudios de Seguimiento , Hemorragia/cirugía , Humanos , Índice de Severidad de la EnfermedadRESUMEN
The method of operative treatment of complicated duodenal ulcer disease consisting gastroduodenostomy, translocated by 3-4 cm medially and lower from the ulcer crater and strengthened by a spur on a small curvature side.
Asunto(s)
Úlcera Duodenal/cirugía , Duodeno/cirugía , Estómago/cirugía , Adulto , Anastomosis Quirúrgica , Humanos , Persona de Mediana EdadRESUMEN
The strict acceptance of the radicalism principles while the purulent inflammation origin eliminate, an accurate sanation and early placement of suture on the operation wound, its adequate and active drainage in combination with expedient local with the help of foamy aerosol "Dioxizol" and stable compensation of hyperglycemia, correction of the homeostasis disorders are necessary in the treatment of diabetes mellitus patients with local purulent-necrotic disease of the soft tissues.
Asunto(s)
Complicaciones de la Diabetes , Procedimientos Quirúrgicos Operativos/métodos , Infección de la Herida Quirúrgica/prevención & control , Aerosoles , Anciano , Anciano de 80 o más Años , Antiinfecciosos Locales/uso terapéutico , Biopsia , Terapia Combinada , Combinación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Poloxaleno/uso terapéutico , Polímeros/uso terapéutico , Glicoles de Propileno/uso terapéutico , Quinoxalinas/uso terapéutico , Infecciones de los Tejidos Blandos/complicaciones , Infecciones de los Tejidos Blandos/patología , Infecciones de los Tejidos Blandos/cirugíaAsunto(s)
Abdomen/cirugía , Infección de la Herida Quirúrgica/prevención & control , Abdomen Agudo/complicaciones , Abdomen Agudo/microbiología , Abdomen Agudo/cirugía , Adolescente , Adulto , Aerosoles , Anciano , Anciano de 80 o más Años , Antiinfecciosos/administración & dosificación , Evaluación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Peritonitis/etiología , Peritonitis/microbiología , Peritonitis/cirugía , Quinoxalinas/administración & dosificación , Infección de la Herida Quirúrgica/microbiologíaRESUMEN
The surgical treatment results of the hepatopancreatoduodenal zone cancer in the clinic from 1987 till 1992 are adduced. Of 91 operated patients in 31 of them the radical or conditionally radical operations were done. The modifications of their own of conventional methods were applied. Further improvement of the diagnosis methods is needed as well as the search of possibilities to augment the frequency of the radical operations accomplishment.
Asunto(s)
Neoplasias Duodenales/cirugía , Neoplasias Pancreáticas/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Colangiopancreatografia Retrógrada Endoscópica , Colestasis/diagnóstico , Colestasis/etiología , Diagnóstico Diferencial , Neoplasias Duodenales/diagnóstico , Neoplasias Duodenales/diagnóstico por imagen , Estudios de Evaluación como Asunto , Humanos , Persona de Mediana Edad , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/diagnóstico por imagen , UltrasonografíaRESUMEN
The experience with the use of the different methods of quantum hemotherapy in the treatment of elderly and senile patients with purulent-inflammatory diseases of the soft tissues has been summarized. Comparative characteristic of their effectiveness is presented. The authors consider the most expedient the use of intravascular quantum hemotherapy and combined methods.
Asunto(s)
Sangre/efectos de la radiación , Terapia por Láser , Terapia Ultravioleta , Heridas y Lesiones/terapia , Anciano , Anciano de 80 o más Años , Estudios de Evaluación como Asunto , Humanos , Persona de Mediana Edad , Supuración , Factores de Tiempo , Heridas y Lesiones/sangreAsunto(s)
Ácidos Aminosalicílicos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Colitis Ulcerosa/terapia , Esclerodermia Localizada/complicaciones , Abdomen Agudo/diagnóstico , Abdomen Agudo/etiología , Traumatismos Abdominales/complicaciones , Adolescente , Traumatismos en Atletas/complicaciones , Colitis Ulcerosa/tratamiento farmacológico , Colitis Ulcerosa/cirugía , Terapia Combinada , Fútbol Americano , Humanos , Masculino , MesalaminaRESUMEN
Preservation of adequate blood supply to a gastric wall and resistance of mucosa of the gastroduodenal region with simultaneous full-value parasympathetic denervation of its acid-producing zone in performance of selective proximal vagotomy contributes to decrease in incidence and pronouncement of ischemic disorders in motor-evacuatory function of the stomach at the early postoperative period, effective and stable reduction in acid production, shortening of duration of the postoperative treatment and rehabilitation of the patients, prophylaxis of ulcer recurrences.
Asunto(s)
Úlcera Duodenal/cirugía , Vagotomía Gástrica Proximal/métodos , Animales , Úlcera Duodenal/fisiopatología , Motilidad Gastrointestinal , Humanos , Isquemia/etiología , Isquemia/prevención & control , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Recurrencia , Estómago/irrigación sanguínea , Estómago/fisiopatologíaRESUMEN
The complex study of the indices of local immune and natural resistance in the parietal mucus of the gastroduodenal zone and general immunity in 174 patients with duodenal ulcer disease before and after surgical treatment was performed. Pronounced suppression of local immunity, presence of autoimmune processes having influence on its indices were noted. After the organ-preserving operations with an ulcer excision, the immune indices restored more rapidly than after gastric resection and vagotomy without an ulcer excision.