ABSTRACT
Total colectomy with a one-stage ileorectostomy was fulfilled in 72 patients (67 children and 5 adult patients) with severe nonspecific ulcerative colitis by the method developed by the author. In 8 of the patients there was constriction of the rectum which required transanal finger bougieurage during the operation. None of the 72 patients had incompetence of the anastomosis. Follow-up observations during many years showed a rather high effect of the operation including the patients who had constriction of the rectum.
Subject(s)
Colectomy/methods , Colitis, Ulcerative/surgery , Ileostomy/methods , Adult , Anastomosis, Surgical , Child , Colitis, Ulcerative/complications , Constriction, Pathologic/complications , Female , Humans , Ileum/surgery , Male , Rectal Diseases/complications , Rectum/surgeryABSTRACT
New suture compression device (SCD) is developed and used in 119 patients for formation of esophageal-intestinal (10), esophageal-gastric (4), gastro-intestinal (10), intestinal-intestinal (19), intestinal-colon (18) and colon-colon (58) anastomosis. Insufficiency of sutures was seen in 2 (1.68%) patients after left-sided hemicolectomy (1) and resection of the sygmoid colon. One patient died, lethality was 0.84%.
Subject(s)
Esophagus/surgery , Intestines/surgery , Stomach/surgery , Suture Techniques/instrumentation , Anastomosis, Surgical/instrumentation , Animals , Dogs , Equipment Design , Humans , Pressure , Treatment OutcomeABSTRACT
Description of developed by N. N. Kanshin method of creation of ileorectoanastomosis during simultaneous total colectomy due to severe nonspecific ulcerous colitis is presented. The method was used in 72 surgeries (in 67 children and 5 adults). There were no cases of sutures insufficiency. Long-term results confirm high efficacy of total colectomy in severe nonspecific ulcerous colitis both in children and adults.
Subject(s)
Colectomy/methods , Colitis, Ulcerative/surgery , Ileostomy , Ileum/surgery , Rectum/surgery , Adolescent , Adult , Age Factors , Anastomosis, Surgical , Child , Child, Preschool , Female , Humans , Male , Treatment OutcomeABSTRACT
For treatment of two consecutively opened into abdominal cavity perforating fistulas of small bowel in conditions of purulent peritonitis the author successfully used funnel-shaped obturators by Kolchenogov. In the same patients in later adhesive intestinal obstruction, which could not be eliminated by common surgical mode, continuous introduction of semifluid food and intestinal chyme collected from enterostoma (located above the obstruction) were carried out through enterostoma located above the obstruction. After resorption of inflammatory infiltrate bowel continuity was restored. Based on favourable results of treatment for perforation fistulas opening into free abdominal cavity, the author more than once in conditions of purulent peritonitis successfully applied sutureless suspending enterostomies on the catheter of Petzer, which principally is an analogue of the obturator by Kolchenogov, using the same method as in perforation fistulas. Inflamed bowel wall thus is well accreted with abdominal wall, and after withdrawal of catheter by Petzer the developed tubular bowel fistula is rapidly healing spontaneously.
Subject(s)
Enterostomy/methods , Intestinal Fistula/surgery , Intestine, Small , Peritonitis/complications , Adult , Follow-Up Studies , Humans , Intestinal Fistula/complications , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Male , Peritonitis/surgery , Suppuration/complications , Suppuration/surgery , Wound HealingABSTRACT
Phlegmon of retroperitoneal cellular tissue as a complication of endoscopic papillosphincterotomy (PST) was observed in 9 patients. All these patients in the first several hours after PST complained of pains in epigastrium and right hypochondrium. 2 days later the signs of pyogenous intoxication appeared. For diagnosis of complications after PST roentgenological and radionuclide methods as well as US examination and computer tomography were used. For exploration of retroperitoneal phlegmon extraperitoneal approach was employed. The phlegmon cavity was drained by number of tubes TMMK and aspiration-lavage treatment 3 patients died.
Subject(s)
Cellulitis/etiology , Sphincterotomy, Endoscopic/adverse effects , Surgical Wound Infection/etiology , Adult , Aged , Cellulitis/diagnosis , Cellulitis/therapy , Fatal Outcome , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retroperitoneal Space , Retrospective Studies , Suction , Surgical Wound Infection/diagnosis , Surgical Wound Infection/therapyABSTRACT
New method for performance of compression esophago-intestinal lasso-anastomosis is proposed. Th main point of the anastomosis consists in pressing of bowel walls to esophageal walls at small cuff by latex ring fixed by special apparatus LPK-25 introduced into the lumen of the bowel through additional incision which is anastomosed with the esophagus. Stretched latex ring creates elastic squeesing of tissues on caval cuff and stops blood flow. Cranially to the zone of compression accretion of esophageal walls with the bowel occurs, and caudally to this zone necrosis has appeared, which resulted in rejection of all compressing construction. These experimental and clinical examinations (31 gastrectomies, 1 proximal resection of the stomach) have demonstrated perspective of compressive lasso-anastomosis and its advantages in comparison with mechanical stapling and conventional hand-made intestinal suture with threads.
Subject(s)
Anastomosis, Surgical/instrumentation , Esophagus/surgery , Gastrectomy , Intestine, Small/surgery , Suture Techniques/instrumentation , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Aged , Animals , Equipment Design , Female , Gastrectomy/methods , Humans , Stomach Neoplasms/pathology , Stomach Neoplasms/surgeryABSTRACT
The many-layers hernioplasty by N. N. Kanshin's method was performed in 533 patients for direct inguinal hernia. In 240 patients no opening and dissection of the hernial sac was performed. These patients had 1.9% of recurrences of hernias. The authors note the absence of negative consequences resulting from this peculiar intervention.
Subject(s)
Hernia, Inguinal/surgery , Female , Hernia, Inguinal/pathology , Humans , Inguinal Canal/pathology , Inguinal Canal/surgery , Male , Methods , Middle Aged , Recurrence , Surgical Flaps/methodsABSTRACT
An analysis of results of 26 patients has been made who had incompetent sutures of anastomoses and stump of the duodenum at the nearest postoperative period after gastric resection. In 14 patients (main group) aspiration-lavage method of drainage was used, in 12 patients (control group) other methods of treatment of incompetent sutures were employed. The advantage of the aspiration-lavage method of treatment over other methods is shown.
Subject(s)
Duodenum/surgery , Gastrectomy , Surgical Wound Dehiscence/surgery , Adult , Aged , Anastomosis, Surgical , Emergencies , Female , Humans , Male , Middle Aged , Peritonitis/etiology , Peritonitis/mortality , Peritonitis/surgery , Reoperation , Suction/methods , Surgical Wound Dehiscence/complications , Surgical Wound Dehiscence/mortality , Therapeutic Irrigation/methodsABSTRACT
The incidence of hospital and posthospital wound complications was studied in 236 patients, residents of Zelonograd, who underwent operation for acute appendicitis. The material was collected at City Hospital No. 3 and four out-patient clinics of Zelenograd. The incidence of suppuration of the surgical wound in the hospital period was 13.1%, that of nonpurulent complications was 9.3%, and the total incidence of the wound complications was 22.4%. In the posthospital period additional suppuration of wounds was encountered in 23.3% of patients, nonsuppurative wound complications in 17.1%, and the total incidence of posthospital wound complications was 40.3%. The frequency of rehospitalization was 5.5%, the incidence of postoperative hernias was 0.9%. The economical loss due to the development of wound complications in 236 patients operated on for acute appendicitis came up to 56,120 roubles.
Subject(s)
Appendectomy , Surgical Wound Infection/etiology , Acute Disease , Adult , Appendectomy/adverse effects , Appendectomy/economics , Appendicitis/surgery , Costs and Cost Analysis , Female , Humans , Male , Patient Readmission/economics , Postoperative Complications , Suppuration , Surgical Wound Infection/economicsABSTRACT
A goal-oriented local approach to the prevention of postoperative purulent complications includes the use of compression suture devices to establish intestinal anastomoses and a complex of measures aimed at preventing surgical wound suppurations. To form compression anastomoses, use was made of the original AKA-2, AKA-4, IZhKA and SPTU devices fitted with compression clamps and of magnet facilities. The complex of measures to prevent postoperative wound suppurations includes optimal methods of laparotomy wound suture and the use of antibacterial suture materials, bathing of the wound by pulsed douche under pressure, local antibacterial prophylaxis by new dosage forms, preventive aspiration lavage and drainage of the wounds. Comparative clinical investigations carried out in more than 3,000 patients have demonstrated the effectiveness of the preventive methods under consideration and a decrease of the rate of postoperative wound suppurations from 11.7 to 2.3%. The rate of anastomosis failure amounted to 2.7%.
Subject(s)
Surgical Wound Infection/prevention & control , Anastomosis, Surgical/methods , Anti-Bacterial Agents/therapeutic use , Digestive System Surgical Procedures , Drainage , Humans , Suppuration , Suture Techniques , Therapeutic IrrigationABSTRACT
Treatment of 124 patients with abdominal abscesses is analysed. Sixty-four patients (a test group) were treated by air-tight drainage of the abscess cavity with double-tube silicone drains and automatic fraction irrigation of the purulent cavity in the postoperative period. Other methods of intraabdominal abscess drainage were used in 60 patients (a control group). The advantages of closed programmed aspiration-irrigation treatment are shown.
Subject(s)
Abdomen , Abscess/surgery , Drainage/methods , Adolescent , Adult , Aged , Aged, 80 and over , Child , Drainage/instrumentation , Female , Humans , Male , Middle Aged , Therapeutic IrrigationABSTRACT
Autogenous dermal implants were used for plastic purposes in 359 patients who underwent operations for inguinal, postoperative, and diaphragmatic hernias, closure of laparotomy wounds and fixation of sutures on the esophagus. Suppuration of wounds occurred in 2% of cases. Recurrences were noted in 1.8% in treatment of inguinal hernias and in 2.9% of patients treated for postoperative hernias. There were no eventrations. Morphological examination showed autogenous dermal tissues to possess good properties as plastic material.
Subject(s)
Skin Transplantation , Esophagus/surgery , Evaluation Studies as Topic , Hernia, Diaphragmatic/surgery , Hernia, Inguinal/surgery , Humans , Laparotomy/adverse effects , Postoperative Complications/surgeryABSTRACT
The authors examined appendix tissues taken from 16 children and adolescents who had undergone colectomy for severe chronic ulcerative colitis. Fourteen patients had the mucosa and submucous layer involved in the chronic inflammatory process that is typical of ulcerative colitis, 5 patients showed inflammation in the muscular and subserous layers. The clinical symptomatology of appendicitis was absent.
