ABSTRACT
Resection of kidney is an organ-sparing operation finding an increasingly wider application. It is designed to preserve the maximum amount of functionally competent renal parenchyma. However, surgery produces multiple effects on the kidney resulting in ischemic lesions and dysfunction which has serious consequences for the clinical course of the early post-operative period and long-term outcome of the treatment. The causes and after-effects of ischemia are considered, much attention is given to its pathogenetic mechanisms and the process of healing of renal parenchyma depending on the surgical modality and method of hemostasis.
Subject(s)
Ischemia , Kidney , Nephrectomy/adverse effects , Organ Sparing Treatments/adverse effects , Postoperative Complications , Hemostasis, Surgical/methods , Humans , Ischemia/etiology , Ischemia/physiopathology , Ischemia/prevention & control , Kidney/blood supply , Kidney/physiopathology , Kidney/surgery , Kidney Function Tests , Nephrectomy/methods , Organ Sparing Treatments/methods , Postoperative Complications/physiopathology , Postoperative Complications/prevention & control , Wound HealingABSTRACT
Treatment results of 986 patients with perforative gastroduodenal ulcers were analyzed. The sequence of surgeon's acts was diagnostically effective in 99.5%. 776 (78.7%) of patients presented with duodenal ulcer; 210 (21.3%) had gastric ulcer. Ulcer closure was performed in 934 (94.7%) cases; gastric resection was made in 52 (5.3%) cases. Postoperative lethality rate was 4.3%. Tissue destruction proved to be partly connected with the level of the connective tissue metabolites in blood. The balance of factors of aggression and defense (Helicobacter invasion, level of mucus formation, mucosal leucocytal infiltration, acid level in stomach and level of necrosis factor in blood) was registered in long-term follow-up in dependence of the operation performed. Ulcer perforation recurrence was registered in 18.8% of simple closure cases and in 3.8% of patients after gastric resection.
Subject(s)
Digestive System Surgical Procedures , Duodenal Ulcer , Gastroscopy/methods , Peptic Ulcer Perforation , Postoperative Complications/prevention & control , Stomach Ulcer , Adult , Digestive System Surgical Procedures/adverse effects , Digestive System Surgical Procedures/methods , Duodenal Ulcer/complications , Duodenal Ulcer/immunology , Duodenal Ulcer/microbiology , Female , Helicobacter pylori/isolation & purification , Humans , Male , Middle Aged , Monitoring, Immunologic/methods , Monitoring, Physiologic , Peptic Ulcer Perforation/etiology , Peptic Ulcer Perforation/immunology , Peptic Ulcer Perforation/surgery , Prognosis , Secondary Prevention , Stomach Ulcer/complications , Stomach Ulcer/immunology , Stomach Ulcer/microbiology , Time-to-Treatment , Treatment OutcomeABSTRACT
The current rise in the incidence of cholelithiasis is accompanied by an increased frequency of its complicated forms. Mechanical jaundice is a common unfavourable complication of cholelithiasis and choledocholithiasis, its consequence. Epidemiology, etiology, and clinical features of this disease are discussed Classification of mechanical jaundice is proposed Much attention is given to its pathogenetic mechanisms. Methods of laboratory and instrumental diagnostics as well as approaches to the surgical treatment of mechanical jaundice are described
Subject(s)
Choledocholithiasis/complications , Jaundice, Obstructive , Humans , Jaundice, Obstructive/etiology , Jaundice, Obstructive/physiopathology , Jaundice, Obstructive/surgeryABSTRACT
The results of the treatment of 2384 patients with gastric and duodenal ulcers are analyzed. It is demonstrated that over last years the number of complications has increased: perforations -- 2.6 fold, and bleedings -- 7 fold. Markers of a destructive injury of gastric and duodenal mucosa (helicobacter contamination, immunological disorders, level of tumor necrotic factor alpha, indices of catabolism of connective tissue) were studied. It is revealed that such disorders have direct influence on destruction of gastric and duodenal wall manifesting as life-threatening complications.
Subject(s)
Helicobacter Infections/complications , Peptic Ulcer Perforation/etiology , Peptic Ulcer/complications , Peptic Ulcer/physiopathology , Antigens, CD/immunology , Helicobacter pylori , Humans , Neutrophils/immunology , Peptic Ulcer/immunology , Peptic Ulcer/surgery , Peptic Ulcer Perforation/immunology , Peptic Ulcer Perforation/surgeryABSTRACT
Traumas and cicatricial strictures of the lobar and sectorial hepatic ducts in 9 patients are analysed. The method of operative transillumination vasoscopy was used to exclude devascularization of an isolated intestinal loop. The authors describe the operative techniques and the methods of using bilateral replaceable transhepatic drainage in injuries to the lobar and sectorial hepatic ducts with their bifurcation and trifurcation.
