[Problems of metals biocompatibility].

Bone tissues of human skull, jaws and dental hard tissues are formed under mastication loads acting as functional irritants and thus maintaining their physical qualities. Knowledge of tensions and deformations in bony structures allows creating favorable conditions for dental implant placement and function.

[The replacement of postresectional defects of the thorax with the use of tissue implant of nanostructural nickelid-titan thread].

The original method of the replacement of postresectional defects of the pericardium, diaphragm and the thoracic wall with the use of tissue implant of nanostructural nickelid-titan thread was tested in vivo on 30 outbred dogs. The efficacy of the plasty was assessed radiologically and pathomorphologically. The nickelid-titan thread implant proved to be a good plastic substance, allowing the replacement of major postresectional defects of various thoracic structures. The newly formed tissue intergrows the implant mass, thus forming the entity of regenerative tissue, which completely provides anatomic and physiologic reconstruction of the injured area.

[Mandible bone grafting by intraoral access].

The efficiency of intraoral approach to reconstruction defects of the mandibula was analyzed. Received results testified to high efficiency of intraoral approach to bone plastic of mandibula as the way allowing to achieve decrease of number of postoperative complications, terms of rehabilitation of patients and to ensure optimum anatomofunctional and aesthetic results.

[Method of reconstruction of posterior wall of inguinal canal with special nikelid-titanium device at the patients with non-strangulated hernia].

Original device from nikelid-titanium for reconstruction of posterior wall of inguinal canal was created. Clinical application of this device permitted to prevent the hernia recurrences in long-term period after surgery and reduce the number of complications associated with compression of spermatic cord. Doppler examination of testicular vessels demonstrates that this device improves blood flow compared with other methods of hernioplasty.

[Temporary and permanent NiTi stents in percutaneous surgery for ureteropelvic segment stricture].

A total of 18 roentgenoendoscopic percutaneous interventions for strictures of the ureteropelvic segment (UPS) have been made by the authors from the beginning of 2004: in 15 (83.3%) females and 3 (16.7%) males aged 16-48 years. Recurrent strictures developed in 11 (61.1%) patients after operations by Kuchere, Pristlay, Andersen-Hines, in 7 (38.9%) patients the strictures were primary. UPS bougieurage and endotomy were made in 3 and 15 patients, respectively. UPS intubation with a PVC tube was made in 2 cases, with a permanent NiTi stent-crown--in 5 cases, temporary stent--in 9 cases, in 2 cases intubation was not made. Complete recovery of UPS passability and significant reduction of hydronephrosis were seen in 15 (83.3%) patients, insignificant effect was registered in 3 patients (one case of PVC tube intubation, one case of NiTi temporary stent, one case of no intubation). Efficacy in patients with permanent stent was 100%, in patients with temporary stent--88.9%, in patients with a PVC tube and without intubation--in 50%. Novel techniques of intubation with permanent and temporary stents with shape memory after percutaneous correction of UPS stricture are promising in the treatment of patients with this pathology of the upper urinary tract and may become an operation of choice.

[Surgical treatment of gastroesophageal reflux disease combined with duodenal ulcer].

Operations for ulcer disease of the duodenum were performed on 696 patients. In 112 (16.1%) patients there were symptoms of insufficient obturating function of the cardia, which was considered to be an indication to antireflux simultaneous operation on the cardia. The indications were worked out for the decision on operative methods in patients with ulcer disease of the duodenum in combination with gastroesophageal reflux disease. Methods of resection were used in 88 (78.5%) patients, videolaparoscopic selective proximal vagotomy with an original means of fundoplication--in 24 (21.5%) patients. Good and excellent long-term results after operation were noted in 95.5% of the patients.

[A new method for microdrainage using a porous titanium nickelide endoprosthesis in resurgery of uncompensated glaucoma].

Experimental (23 rabbits) and clinical (42 patients with operated glaucoma) studies were conducted to evaluate the effect of a titanium nickelide implant on ocular tissue in modified deep sclerectomy in order to normalize intraocular pressure. Scleral morphological studies in the area of implant placement revealed the formation of a capsule with "fissures" and vessels. Clinically, there was intraocular pressure compensation in 92.8% of the patients operated on.

[Nephropexy with superelastic porous titanium nikelide].

The authors propose a novel method of operative treatment of nephroptosis based on application of superpermeable porous titanium nikelide. The method provides a complete recovery of blood flow and urodynamics in the low kidney in strict fixation of the kidney in its physiological state due to formed functional scar (invasion of the vessels and collagen by porous tissue). The technique of the operation consists in lumbotomy in the tenth intercostal place with reaching the top of the kidney with placement of the plate of porous titanium nikelide. The kidney takes the right place when pressed to the diaphragm. Rapid adhesion of the kidney and tissues in the diaphragm region is provided by unique characteristics of the porous implant. Addition fixation of the kidney is not necessary, the scar at the place of implantation is rather elastic.

[Method of forming of compressive terminal colon anastomosis].

The method of creation of compressive terminal colon anastomosis with implants of TN-10 titanium nikelid was developed. Experimental studies carried out on 60 mongrel dogs demonstrated higher physical strength and biological containment of these anastomoses compared with manual and mechanical ones. Regeneration completed earlier after surgery and was accompanied by less inflammation. Clinical study was carried out in 54 patients. There were no lethal outcomes, insufficiency of anastomosis was seen in 1 (1.9%) case.

[Urgent resection of the colon with compressive anastomosis and afferent colostoma].

Thirty patients with colon disease in need of urgent surgery have undergone resection of the colon with formation of terminal afferent colostomy and compressive colon-colon anastomosis using oval and linear nikelid-titanium implants. Complications were seen in 6 (20%) patients, lethality was 6,7% due to multiorgan failure in the presence of generalized peritonitis. There were no complications due to colon-colon anastomosis. The above method permits one to reduce surgical trauma of future reconstructive surgeries.

[Experimental grounds for the formation of an increased pressure zone in the area of "impaired" lower esophageal sphincter].

A method of the formation of an artificial lower esophageal sphincter (LES) with the help of superelastic threads made of a nickelide-titan alloy was developed in the experiment. An experimental model of an artificial LES was tested on cadaver organic combinations of the esophagus and stomach in ten watchdogs and ten rabbits. Tests of the esophageal passage and antireflux features of the artificial lower esophageal sphincter (LES) and assessment of morphological changes in esophageal wall layers with the emphasis on changes of the esophageal wall structure and gastroesophageal passage near the thread were made. This experiment proved that the passage in the artificial lower esophageal sphincter (LES) area is not disturbed and a zone of increased pressure is created.

[Surgical treatment of gastroesophageal reflux]. / Khirurgicheskoe lechenie refliuks-ezofagita.

One hundred and seventy-five patients with gastroesophageal reflux disease (GERD) were treated, 144 (82.2%) of them underwent surgery. In 106 (73.6%) patients laparotomy was used, in 38 (26.4%) -- laparoscopic surgeries. Transabdominal USE of the esophagus, stomach and duodenum, endoscopic ultrasonoraphy (EUS) of the esophagus were used for diagnosis of GERD in addition to standard tests. Based on EUS data, classification of severity of reflux-esophagitis was proposed. New method of laparoscopic creation of artificial lower esophageal sphincter (LES) with super thin (95, 45 mm) and super elastic filaments made of nikelid-titan alloy was developed in experiment and introduced into clinical practice. Thirty-four laparoscopic surgeries were performed, 26 (76.4%) of them -- with creation of artificial LES. In this group 94.4% of patients demonstrated excellent and good results in long-term period. Pressure in the area of LES in these patients increased by 70%, on the average, after surgery.

[The treatment of patients with traumatic osteomyelitis of the mandible by using porous permeable titanium nickelide implants]. / Lechenie bol'nykh s travmatichesim osteomielitom nizhnei cheliusti s ispol'zovaniem poristykh pronitsaemykh implantatov iz nikelida titana.

Use of titanium nickelide based porous permeable implants for repair of postosteomyelitis mandibular defects is discussed. Five patients with mandibular defects of different location and extent were operated on. Surgical methods are described. A clinical example of using a porous permeable implant is offered. The implant designed as a mandible was used for repair of an extensive mandibular defect. Good immediate and remote results of operations indicate good prospects of using such implants.

[Self-contained cryoapplicators made of porous titanium nickelide in the treatment of precancer of the lip and oral mucosa]. / Avtonomnye krioapplikatory iz poristogo nikelida titana v lechenii predraka guby i slizistoi obolochki polosti rta.

A set of autonomic cryoapplicators of porous titanium nickelide is designed, their physical parameters described, and cryogenic properties studied on gelatin model. Ninety-eight patients with precancer diseases of the red lips and buccal mucosa were treated using these applicators. The applicators are easy to use and meet the requirements to cryoinstruments. Cryoexposure is to be performed during the first minute after coolant charging, when the temperature of the applicators is close to the nitrogen one. The larger is the diameter of the working piece of the applicator and the larger is the device, the more ice is formed. The depth of freezing is 2 to 6 mm. The choice of an applicator, duration of cryoexposure, number of cryocontacts, and cycles of freezing and thawing depend on the form of precancer disease, size of lesions, and degree of the pathological changes. Good results were attained in 96.9 +/- 1.6% of patients.

[Initial experiences in creation of anastomoses in abdominal surgery using implants with shape "memory"]. / Pervyi opyt formirovaniia anastomozov v briushnoi khirurgii implantatami s "pamiat'iu" formy.

The article analyses the first experience in 230 operations for creation of compression anastomoses in abdominal surgery of the esophagus, stomach, gallbladder, and common bile duct by means of implants with shape "memory". Complications occurred in 10% of cases, the mortality rate was 3.04%. The suggested method simplifies the operative technique, shortens the duration of the operation, and reduces the incidence of postoperative complications (anastomositis, incompetence of sutures, reflux gastritis, dumping syndrome).

[Inter-intestinal compression anastomosis in children]. / Mezhkishechnyi kompressionnyi anastomoz u detei.

Enterostomy of the afferent intestine with preliminary formation of an intestinal anastomosis with the efferent loop was carried out in 11 children. The anastomosis was created by means of a compression device of an alloy "with shape memory". Among the children who underwent operation 7 were newborns with intestinal atresia and 4 were children of an older age with peritonitis and perforation of the intestine. No operative complications were encountered. An intestinal anastomosis with a fistula-bearing intestine allows multiple complications of routine enterostomy to be avoided.