[Surgical treatment of mesenteric cyst of small bowel]. / Khirurgicheskoe lechenie kisty bryzheiki tonkoi kishki.

A rare case of surgical treatment of mesenteric cyst of the small bowel is described. The diagnosis was confirmed by irrigography and contrast-enhanced computed tomography of the abdomen. The patient underwent small bowel and mesentery resection with subsequent entero-enteroanastomosis. Postoperative period was uneventful. This case confirms advisability of total en-bloc excision of the cyst via resection of intact mesentery and small bowel segment. Literature data indicate that the only treatment method for mesenteric cysts is surgery.

[Lymphotropic therapy in patients after surgical revascularization of lower-limb vessels]. / Limfotropnaia terapiia u bol'nykh posle khirurgicheskoi revaskuliarizatsii sosudov nizhnikh konechnostei.

Occlusive and stenotic lesions of lower-limb arteries appear to be amongst the most common manifestations of the pathology of the cardiovascular system and are characterized by various degree of chronic arterial insufficiency. Revascularization is the main stage of treatment for chronic arterial insufficiency of the lower extremities. Performing a reconstructive operation aimed at restoring the arterial blood flow in the ischaemized extremity is accompanied and followed by the development of reperfusion syndrome. The purpose of this study was to assess efficacy of using regional lymphotropic therapy for treatment of reperfusion syndrome in patients with chronic ischaemia of lower limbs in the postoperative period. The study included two groups of patients: the comparison group with standard postoperative treatment and the study group where the standard therapy was supplemented with regional lymphotropic therapy. In the postoperative period, the patients in both groups developed reperfusion oedema of the operated lower limb on day 3 after arterial reconstruction, however, on POD 7 after revascularization, the severity of oedema was apparently less in the study group. Lymphorrhoea after operative treatment in the study group was encountered significantly less often as compared with the control group. According to the findings of ultrasonographic examination of soft tissues in the postoperative period, patients of both groups on POD 3 were found to have pronounced oedema of soft tissues. However, on POD 7 the study group patients demonstrated a dramatic decrease in the thickness of oedema of the subcutaneous fat versus the comparison group patients. Regional lymphotropic therapy after reconstructive operations on arteries of lower limbs promoted a decrease in the severity of reperfusion syndrome on the operated lower limb.

[Evaluation of local treatment of donor sites wounds in patients with deep burns]. / Otsenka mestnogo lecheniia ran donorskikh mest u patsientov s glubokimi ozhogami.

AIM: To assess the impact of local treatment of donor sites wounds in patients with deep burns on the frequency of complications and to identify the main risk factors of complications of donor sites wounds. MATERIAL AND METHODS: There were 486 patients with deep burns who underwent split-thickness skin grafting. Treatment of donor sites wounds was carried by using of moisture-controlled dressings DDB-M in the main group (n=56). Conventional approach including once imposed wet-to-dry gauze bandages was applied in the control group. RESULTS: We identified the structure of complications of the donor sites wounds and the main risk factors of suppuration.

[Total revascularization of the lower limb in a patient with multifocal atherosclerosis and critical ischaemia]. / Total'naia revaskuliarizatsiia nizhnei konechnosti u bol'nogo s mul'tifokal'nym aterosklerozom i kriticheskoi ishemiei.

Described in the article is a clinical case report regarding revascularization of the entire arterial bed of the lower extremity in a male patient presenting with multifocal atherosclerosis, stenoses of the arteries of the iliofemoral segment, occlusions of the superficial femoral artery, popliteal artery and arteries of the crus. Clinically, the patient was diagnosed as having critical ischaemia of the lower limb with wet necrosis of the toes. The patient simultaneously underwent semiclosed loop endarterectomy from the arteries of the femoropopliteal segment with the help of the Vollmar rings, autovenous popliteal-tibial prosthetic repair, as well as exarticulation of the toes.

[Microbiological profile of postoperative infection in current oncology surgery]. / Mikrobiologicheskii profil' posleoperatsionnoi infektsii v sovremennoi onkokhirurgii.

AIM: To analyze in-hospital infection in oncology center within 2012-2016. MATERIAL AND METHODS: There were 98 patients with nosocomial infection who underwent surgery for malignancies. Microbiological examination of biological materials was carried out by appropriate laboratories according to generally accepted methods. RESULTS: Mono- and polymicrobial infection was observed in 58 and 42% of cases. Staphylococcus aureus was the most common agent in patients with microbial infection. Minimal inhibitory concentration of vancomycin (MIC) ≥1.0 µg/ml was revealed in 60% of microbes. Microbial agents isolated were resistant to antibacterial drugs used to prevent postoperative infectious complications. CONCLUSION: In-hospital infection was accompanied by staphylococci as a rule. Causative agents of nosocomial infections are usually resistant to conventional antibacterial drugs. Moreover, 60.1% of microbes had minimal inhibitory concentration of vancomycin ≥1.0 µg/ml that indicated the need for alternative therapeutic agents.

[Experimental investigation of self-soluble cava-filter].

Pulmonary embolism accounts for sudden death of a third of patients. Endovascular catheter interventions including cava-filter implantation have the great promises for the prevention of pulmonary embolism and treatment of phlebothrombosis in inferior vena cava system. The aim of our research is creation of self-soluble cava-filter for prevention of pulmonary embolism and evaluation of opportunity of one-stage filter implantation. We conducted the series of experiments. We used 18 rabbits as experimental animals. The essence of experiment was to prove the possibility for application and to evaluate the extent of absorption of developed cava-filter in lumen of vena cava. It was revealed that copolymer rods implanted among gluteal muscles fibres and near ear vena completely dissolved after 40-50 days. Health of animals didn't change. The cava-filter dissolved partially. There were not toxic effects. The results suggest that there is need to continue research for developing of cava-filter of soluble copolymer.

[Method of cholecystectomy for large Hartman pocket inosculated with biliary tracts].

The patients were divided into 2 groups according to the method of cholecystectomy. The 1st group included 36 patients operated on by a traditional method. The 2nd group consisted of 34 patients operated on by the proposed method of cholecystectomy (invention application N 2008103639) developed at the department of hospital surgery of the Ulianovsk state university. Complications were noted more often in the first group of patients: injury to the common bile duct (5.6%), bleeding from the gallbladder bed (11.1%), bile excretion (8.3%). Complications in the second group: bleeding from the gallbladder bed (2.8%). The proposed method of cholecystectomy for large Hartman pocket inosculated with biliary tracts allows a decrease of such complication as bleeding, bile excretion, excludes injuries of the common bile duct.

[Decision on the operative treatment of gastroduodenal ulcers in patients with large perforated openings and with associated ulcerogenic complications].

Optimal kinds of surgical treatment were developed for perforated gastroduodeal ulcers and associated complications (stenosis, bleeding), with large perforated openings in patients with high risk of radical operative treatment. The method was used in operations on 30 patients. The second group consisted of 30 patients after suturing perforated gastroduodenal ulcers. Healing of ulcer defects after plasty of the perforated gastroduodenal ulcers by tunneling was noted 9 days earlier on average as compared with suturing.

[A multipurpose frame retractor for treatment of perforated gastroduodenal ulcers].

The article describes a method for minilaparotomic suturing of perforated ulcers in the pylorobulbar zone. The method was successfully used in surgical treatment of 6 patients with perforated ulcers without complications.