[Early complications after surgery for middle- and lower-ampullar cancer: total mesorectumectomy or "blind" preparation of rectum?].

It was performed a comparative analysis of parameters of early postoperative period in 318 patients with middle- and lower-ampullar cancer of rectum who underwent total mesorectumectomy and "blind" preparation of rectum. All patients were divided into 2 groups. The main group included 202 patients after total mesorectumectomy. The control group included 116 patients after "blind" preparation of rectum. Statistically significant differences in frequency of laparotomy wounds suppuration, urinary tract dysfunction and postoperative mortality were revealed. These complications were diagnosed more frequent in case of "blind" preparation of rectum. In the main group laparotomy wounds suppuration depended on sex (p<0.001, r=0.65), in the control group - on surgeon's experience (p=0.006, r=0.58), localization of tumor (p<0.001, r= -0.87) and type of surgery (p<0.001, r= -0.76). Urinary tract dysfunction after total mesorectumectomy depended on patient's sex (p<0.001, r=-0.77), after "blind" preparation of rectum - sex (p=0.002, r= -0.39) and performing of preoperative radiation therapy (p<0.001, r=0.46). In the main group none of the analyzed variables effected on the postoperative mortality. In the control group age (p=0.006, r=0.48), intraoperative blood loss (p=0.002, r=0.55), anastomosis failure (p=0.01, r=0.61), postoperative bleeding (p<0.001, r=0.88), early adhesive intestinal obstruction (p=0.006, r=0.77) effected on the mortality. It is considered that total mesorectumectomy in comparison with "blind" preparation of rectum decreases frequency of postoperative complications and mortality.

[Pathogenetical aspects of complicated abnormal renal mobility].

The present article is devoted to the search for topographic and anatomical factors of abnormal renal mobility that affects renal hemodynamics and determines complicated course of nephroptosis. Comparative evaluation of hemodynamics in patients with chronic pyelonephritis and symptomatic hypertension in abnormal renal mobility depending on the distribution on the degree of rotation and skeletotopic omission of kidney was performed. According to the data of frequency analysis and correspondence analysis of Statistics 6.0 program, it was determined that kidney rotated in three dimensions, and mainly in II degree descent kidney in study group. It was found that consistent multiple view scanning of patients with abnormal renal mobility allows to accurately assess the violations of tissue blood flow, which determine severity of complications of the disease, and to choose an adequate conservative and surgical treatment in each case.

[Features of hydrodinamics in drainage of the upper urinary tract (experimental study)].

The present article is devoted to the search for the physical factors affecting the intrapelvic pressure in patients with kidney catheters. Based on mathematical prediction and experiment, value of air bubbles, hampering urine outflow and contributing to the development of purulent postoperative complications in urology, was demonstrated. A certain number of air bubbles in catheters leads to the formation of air-urinary impaction, causing a sharp increase of intrapelvic pressure. Correlation analysis showed a direct relationship between the amount of air bubbles in the drainages and resistance force to urinary flow. The study showed that the presence of air bubbles in the catheter and drainage tubes is unacceptable. Compliance with certain rules and standards of work allows to prevent their formation, which in turn reduces the risk of urinary infection and the development of septic complications. This approach will help to predict the possible postoperative complications, accelerate the introduction of modern technologies, and improve the quality of urological care.

[Pathogenetic criteria of nephroptosis]. / Patogeneticheskie kriterii podvizhnoi pochki.

The aim of the study was to specify treatment policy in nephroptosis on the basis of characteristics of the onset, development and course of the disease. A total of 83 patients with nephroptosis were examined. The rotation angles of the kidney were summed using standard excretory urograms in clino- and orthostasis. Radionuclide nephroscintigraphy, rheorenography were made in 72 patients. Statistical processing employed correlation, cluster, discriminant analysis of the program Statistica. The method of estimation of the angles of rotation of the movable kidney in three planes was introduced. Grouping of patients by the sum of the rotation angles appeared more precise in reflecting disorders of intraorganic circulation in the kidney than skeletotopic distribution by the nephroptosis degree. Standard excretory urograms allow determination of the sum of the angle of rotation of the movable kidney and, finally, adequate conservative or surgical treatment method. Surgery can correct disorders of intraorganic blood flow by creating physiological position for the kidney raising to the due level and eliminating rotation.