ABSTRACT
The authors proposed the new methods of forming of microsurgical biliary-enteric anastomoses with sphincteric and antireflux properties. Development and anatomico-experimental substantiation of the new methods were performed on 68 experimental animals (dogs) and 20 organocomplexes of human cadavers. An experimental approbation of microsurgical biliary-enteric anastomoses showed the possibility, safety and high function of anastomoses. Microsurgical technique and developed methods of biliary-enteric anastomoses were applied on 65 patients with good results.
Subject(s)
Bile Ducts, Extrahepatic/surgery , Biliary Tract Surgical Procedures/methods , Intestine, Small/surgery , Jaundice, Obstructive/surgery , Microsurgery/methods , Plastic Surgery Procedures/methods , Aged , Anastomosis, Surgical/methods , Animals , Dogs , Female , Humans , Middle Aged , Models, Anatomic , Treatment OutcomeABSTRACT
Aim: To study and compare the results of reconstructive and restoretive operations for strictures and bile duct injuries in patients operated by traditional methods and with the use of microsurgical techniques. Materials and methods: analysis of 181 and reconstructive restore operations reconstruction works produced on the occasion of strictures (111) and intraoperational damage (16) of the bile ducts, strictures choledocho-duodenal anastomosis and choledochocele (20), congenital cysts of the bile ducts (10), chronic indurative pancreatitis (15), the Fatherof papilla stenosis (5), syndrome Mirizzi 4 types (4). In the formation biliodigestive anastomoses traditional technique applied in 116 patients, microsurgical by 65. Results: a comparative evaluation of results of surgical treatment of patients operated on traditional way and with the use of microsurgery technique showed a reduction in the number of postoperative complications in patients undergoing microsurgical operations, such as the insolvency of the seams biliodigestive anastomosis, hepatic failure, acute cholangitis, stricture of the biliodigestive anastomosis. Conclusion: to improve the results of reconstructive operations on the extrahepatic bile ducts contributes microsurgical techniks, which provides minimal trauma to the tissues, histologically accurate adaptation of homogeneous layers sew bodies, contributes healing of biliodigestive anastomosis primary tension. In the absence of conditions for the imposition of microsurgical bilitigating anastomosis without frame drainage should prima adopt changeable transhepatic drainage as in reconstructive and restorative operations.
Subject(s)
Bile Ducts, Extrahepatic , Cicatrix , Digestive System Surgical Procedures/adverse effects , Postoperative Complications , Adult , Aged , Bile Ducts, Extrahepatic/pathology , Bile Ducts, Extrahepatic/surgery , Cicatrix/etiology , Cicatrix/pathology , Cicatrix/surgery , Female , Humans , Male , Middle Aged , Postoperative Complications/pathology , Postoperative Complications/surgeryABSTRACT
THE AIM: to present some information-about the rare primary hypertrophy of the pylorus in adults and a clinical case of a patient with this disease. MATERIALS AND METHODS: the patient A., 52 years of age, after which clinical-instrumental and laboratory research was diagnosed with infiltrative form of cancer of the pylorus with decompensated stenosis. The used: videothoracoscopy, fluoroscopy, peripheral computer electrogastrogram, local fluorescence spectroscopy. The General blood and urine tests, biochemical blood tests, PCR for the determination of tumor markers. RESULTS: The resection of 2/3 of the stomach Billroth I. histological examination of the pylorus diagnosed with hypertrophy of circular muscle fibers, to a lesser extent, hypertro- phy of the longitudinal fibers with inflammatory changes. CONCLUSION: in cases of suspected infiltrative form of cancer of the pylorus in adults differential diagnosis it is advisable to include the primary hypertrophy of his.
Subject(s)
Pyloric Stenosis, Hypertrophic , Stomach Neoplasms , Female , Humans , Middle Aged , Pyloric Stenosis, Hypertrophic/diagnosis , Pyloric Stenosis, Hypertrophic/pathology , Pyloric Stenosis, Hypertrophic/physiopathology , Pyloric Stenosis, Hypertrophic/surgery , Stomach Neoplasms/diagnosis , Stomach Neoplasms/pathology , Stomach Neoplasms/physiopathology , Stomach Neoplasms/surgeryABSTRACT
AIM: An improvement of the stomach through the development of reconstructive operations results of anatomical - the experimentally study and clinical testing of a series of new microsurgical areflux gastrointestinal anastomosis with sphincter properties. MATERIALS AND METHODS: The study was performed on 60 animals (dogs) and 52 organocomplexes people dead. 4 A series of experiments, developed new ways to 4 gastro-intestinal anastomosis with sphincter properties gastroduodenostomii way to "end to end" (patent number 2,197,903); pilorosohranyayuschey gastrectomy method (patent number 2,201,714); gastronesteostomy way to "end to side" (patent number 2,201,716); gastroduodenostomii way to the formation of artificial pyloric sphincter (patent number 2,212,195). RESULTS: Anatomical studies on cadaveric organocomplexes installed, but that the use of the formation of the gastro-intestinal anastomosis of microsurgical techniques and a separate cross-linking methods of internal and external casings of hollow organs without entrainment into the joint mucosa anastomosis gives high.impermeability and durability, retains histotopography linkable tissues. Gastric resection methods developed to form microsurgical gastrojejunal anastomosis and gastro used in clinical practice in 20 patients. Operated patients were examined after 1-6 years after surgery. When gastroscopia they celebrated, good function Form-balanced, the sphincter, the absence of duodenal reflux. CONCLUSION: The use of microsurgical techniques with gastric resection with the formation of functionally active gastroduodenal and gastrojejunal anastomosis can create gastrointes.inal anastomosis with anti-reflux properties and save the porter, without violating its contractile function, ensures minimum trauma to the tissues, the exact adaptation of the histologic homogeneous layers of the walls of bound bodies.
Subject(s)
Duodenum , Gastroesophageal Reflux , Microsurgery/methods , Stomach , Anastomosis, Surgical , Animals , Dogs , Duodenum/physiopathology , Duodenum/surgery , Female , Gastroesophageal Reflux/physiopathology , Gastroesophageal Reflux/surgery , Humans , Male , Stomach/physiopathology , Stomach/surgeryABSTRACT
OBJECTIVE: To reveal the peculiarities of manifestations and treatment of gastroesophageal reflux disease (GERD) in patients with peptic ulcer disease of the stomach and duodenum, hiatal hernia (HH) and after stomach resection. MATERIALS AND METHODS: 387 patients with GERD, peptic ulcer disease of the stomach and duodenum (200 patients), after resection of the stomach Billroth II (150 patients), 37 patients with HH. Videoendoscopic equipment company OLYMPUS (Japan) was used. Biopsies of the mucous membranes of the pylorus, body, angle of the stomach and esophagus were studied to identify preneoplastic changes. HP was determined histologically, cytologically, urease tests. RESULTS: The patients with GERD and peptic ulcer disease of the stomach and duodenum were complained on the heartburn, the patients after resection of the stomach--on feeling bitterness in the mouth, with HH--on the pain behind the breastbone. More severe degree of GERD (C and D) was endoscopic feature in patients with HH and A degree or endoscopic negative form--after resection of the stomach. Preneoplastic changes of the esophageal mucosa with columnar epithelium were found in cases of less severe degrees of inflammation. The degree of esophagitis, presence of preneoplastic changes were determined depending on the presence of Helicobacter pylori. Antireflux surgery was performed under strict indications. CONCLUSION: Clinical features, endoscopic, morphological manifestations of GERD in patients with pectic ulcer disease of the stomach and duodenum, with resection of the stomach and patients with HH were determined. This is dictated the individual differentiated approach to the choice of the treatment.
Subject(s)
Duodenal Ulcer , Esophagoscopy , Gastroesophageal Reflux , Stomach Ulcer , Adult , Duodenal Ulcer/complications , Duodenal Ulcer/pathology , Duodenal Ulcer/surgery , Female , Gastroesophageal Reflux/etiology , Gastroesophageal Reflux/pathology , Humans , Male , Middle Aged , Stomach Ulcer/complications , Stomach Ulcer/pathology , Stomach Ulcer/surgeryABSTRACT
The authors describe the results of 6-years' application of compositions based on liquid silicone rubber SKTN for cosmetic correction of pectus excavatum in 24 patients. The results of investigation of physico-mechanical properties of original allomaterials based on SKTN compared with the properties of soft tissues of living organism are shown. The effects of ageing of these allomaterials in the environment of the living tissues are presented.
