RESUMEN
In 83.7% of patients with nephrolithiasis the morpho-functional disorders of urinary ways were disclosed. The complex of pathogenetically substantiated treatment of such patients was proposed. Together with performing of sparing removing of calculi the operative correction of hemo- and urodynamics with disorders local homeostasis restoration is performed using application of specific inhibitors of urolithogenesis, basing on hyperbaric oxygenation.
Asunto(s)
Nefrocalcinosis/cirugía , Humanos , Nefrocalcinosis/etiología , Resultado del Tratamiento , Urodinámica/fisiologíaAsunto(s)
Cateterismo , Cálculos Renales/terapia , Obstrucción Ureteral/terapia , Cateterismo Urinario , Adulto , Anciano , Cateterismo/métodos , Femenino , Humanos , Cálculos Renales/complicaciones , Cálculos Renales/diagnóstico por imagen , Pelvis Renal/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Radiografía , Retratamiento , Uréter/diagnóstico por imagen , Obstrucción Ureteral/diagnóstico por imagen , Obstrucción Ureteral/etiología , Cateterismo Urinario/métodosRESUMEN
Rheorenographic findings, activities of 4 major glycolytic enzymes and 3 Krebs cycle ones in serum and blood, urinary fibrinolytic activity were analyzed in 117 patients with coral nephrolithiasis (the pelvis was drained after calculus removal) in 114 patients with non-coral calculi (the pelvis was sutured) before and 7, 14 days after surgery. Rheography revealed a significant decrease in arterial vascular tone and blood filling and an impairment in venous return in the diseased kidney. In the patients with nephrolithiasis, the enzymatic activity showed 3.5-10.5- and 4.5-11.5-fold increase (p less than 0.001) in the Krebs cycle and glycolysis, respectively, suggesting activation of not only oxidative phosphorylation, but anaerobic glycolysis. Tubular metabolic acidosis occurred, which made the enzymes enter blood and urine from the epithelial cells. On days 7-14 of postoperation, rheographic parameters, enzymatic and fibrinolytic activities of the urine remained virtually unchanged as compared to the values observed in the preoperative period. Moreover, the patients with a sutured pelvis showed highly accelerated glycolysis during the surgery against prior to the procedure. Urinary mitochondrial enzyme release increased, which reflected an enhancement of degenerative changes in nephron cells. Urinary fibrinolytic activity remained lower. In the patients with a drained pelvis, all the parameters in question became better.
Asunto(s)
Homeostasis/fisiología , Cálculos Renales/fisiopatología , Adulto , Enfermedad Crónica , Femenino , Humanos , Riñón/fisiopatología , Riñón/cirugía , Cálculos Renales/cirugía , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Pielonefritis/fisiopatología , Pielonefritis/cirugía , Urodinámica/fisiologíaRESUMEN
In 90 youths at the age of from 14 to 16 years suffering from left-sided varicocele, the authors have used a retroperitoneoscope for high ligation and transection of the testicular vein. There were no complications at the time of operation and after it. In control examination 1.5-2 years later, no varicocele recurrences were revealed. In 15 patients with profuse bleeding from carcinomatous tumor of the urinary bladder, the authors performed ligation of the internal iliac arteries by means of a retroperitoneoscope.
Asunto(s)
Endoscopía , Arteria Ilíaca/cirugía , Espacio Retroperitoneal , Cordón Espermático/irrigación sanguínea , Varicocele/cirugía , Venas/cirugía , Adolescente , Humanos , Ligadura , Masculino , Instrumentos QuirúrgicosRESUMEN
Operative interventions on the kidneys and ureters were performed in 85 patients. In revision of the upper pole of a kidney and its median segment, the authors have used the original technique of retroperitoneoscopy (paranephroscopy) in the 11-th intercostal space. The techniques of decapsulation of a kidney, pyelo-, nephrostomy by means of the retroperitoneoscope, operative approaches to the different parts of the ureter, technique for removal of its stones are presented.
Asunto(s)
Riñón/cirugía , Uréter/cirugía , Adulto , Femenino , Tecnología de Fibra Óptica/instrumentación , Humanos , Laparoscopios , Masculino , Persona de Mediana EdadRESUMEN
Computerized dynamic gamma scintigraphy with indirect radionuclide angiography was carried out in 29 patients with a single kidney. It was found that patients with a single kidney show already at the stage of "intact" organ persistent disorders of intrarenal hemodynamic processes as well as chronic urostasis. This variant of radionuclide examination may be used in the prophylactic management of this category of patients.
Asunto(s)
Cálculos Renales/diagnóstico por imagen , Riñón/diagnóstico por imagen , Nefrectomía , Humanos , Ácido Yodohipúrico , Riñón/irrigación sanguínea , Cálculos Renales/cirugía , Microcirculación/diagnóstico por imagen , Compuestos de Organotecnecio , Ácido Pentético , Periodo Posoperatorio , Angiografía por Radionúclidos , Pentetato de Tecnecio Tc 99m , Tomografía Computarizada de EmisiónRESUMEN
On the basis of the follow up of 141 patients after radical operations for gastric cancer, special diet variants have been developed with due regard for postoperative terms and the character of complications after gastric resection. Positive results of dietotherapy were recorded in 71.5% of the patients, that was evidenced by their clinical picture and laboratory data: coprological, biochemical and immunological. The condition was not changed in 15.6% of the patients, negative shifts were noted in 18 patients (12.7%), in 12 of them relapses or metastases of the tumor were recorded.