DIAGNOSTICS AND TREATMENT OF PERFORATED PYLORODUODENUM ULCERS IN WOMEN.

The results of treatment of 75 women with perforated ulcers have been studied. There were prevailed women of middle and elderly age groups among patients who underwent surgery. A wound closure of perforated opening and abdominal sanation were performed by laparoscopic means in 30,7% of patients and using midline laparotomy in 29,3% cases. There were carried out the laparoscopic sanation of the abdominal cavity and the wound closure of perforated ulcer from mini-access using the set of mini-assistant in 10,7% patients. Radical operations were applied in 16% cases. The early postoperative complications took place in 8,1% of the patients, the rate of lethality was 4,0%. The long-term results were evaluated and considered as good in 55,5% women, satisfactory ­ in 30,1% and unsatisfactory ­ in 14,2% cases.

[OBTURATIVE BOWEL OBSTRUCTION CAUSED BY GALLSTONES].

The article discussed the results of surgical treatment of obturative bowel obstruction caused by gallstones. An analysis of results was made in two groups of patients. Ultrasonic tomography and laparoscopic diagnostics were used in the main group. An application of modem methods of diagnostics allowed reducing of lethality rate.

[The use of plasma stream for the treatment of chronic osteomyelitis].

80 patients with chronic osteomyelitis were treated. Plasma stream was used in complex treatment in 53,75%, which gave the notably less amount of unsatisfactory results of treatment, then in those patients, who were treated without the use of plasma stream. Therefore, authors declare, that a plasma stream allows the intensification of surgical treatment of osteomyelitis.

[Results of 20 year puncture treatment of cystic disease].

An analysis of results of using the puncture method of treatment of solitary cysts of the liver, kidneys and spleen in 1343 patients has shown that the staged method of treatment makes surgical resection of the cysts considerably less necessary.

[Use of plasma technology in treatment of patients with pyo-inflammatory diseases of soft tissues].

The authors substantiated the method of treatment of pyo-inflammatory diseases based on experiments in white rats, using plasma flow at different stages of the process. The plasma technology was used in the clinic in 130 patients that allowed shortening the period of preparing the wounds to operative treatment and reducing the period of hospital stay from 15.3 to 9.2 days, improving results of treatment by 20% and saving on expensive bandaging materials and medicines.

[Results of mini-invasive surgical procedures at abdominal reoperations].

Results of abdominal reoperations in two groups of patients are analyzed. In group 1 (n=86) the repeated surgeries were performed with laparoscopic technologies through a mini-approach, in group 2 (n=87)--with conventional long laparotomy. It is demonstrated that mini-invasive surgical procedures are associated with shorter hospital stay, reduced rate of complications and lethal outcomes.

[Associated laparoscopic interventions for gallstones]. / Sochetannye laparoskopicheskie vmeshatel'stva pri zhelchnokamennoi bolezni.

Since 1994 till 2000 the authors have performed 1152 laparoscopic cholecystectomies. Coexistent diseases of the organs of the abdominal cavity were diagnosed in 13.02% of the patients operated on by using laparoscopic techniques. In parallel the simultaneous interventions were performed for hiatal hernias, ulcer of the duodenum, commissural disease of the peritoneum, chronic duodenal obstruction, ventral hernias, diseases of the genital organs, liver and chronic appendicitis. The greater volume of the operations when performing the associated operations by the laparoscopic method does not make the course of the postoperative period more severe and gives good results in 89.3% of the patients.

[Choice of surgical method in patients with inguinal hernias]. / Vybor metoda operativnogo lecheniia bol'nykh s pakhovymi gryzhami.

Results of surgical treatment of 310 patients with inguinal hernias were analyzed depending on hernioplasty method. Advantages of hernioplasty methods without tissues tension over traditional ones were demonstrated. Indications and contraindications of each method were determined. Algorithm of individual choice of surgery method for inguinal hernias has been developed.

[Differential diagnosis of hemorrhagic fever with renal syndrome and acute surgical diseases of abdominal organs]. / Differentsial'naia diagnostika gemorragicheskoi likhoradki s pochechnym sindromom i ostrykh khirurgicheskikh zabolevanii organov briushnoi polosti.

The results of differential diagnosis of hemorrhage fever with renal syndrome and acute surgical diseases of abdominal organs in 1250 patients were analyzed. It was revealed that the course of the disease was similar to acute abdomen in 13.2% of them. The combination of fibrogastroduodenoscopy and diagnostic laparoscopy is optimal for differential diagnosis and permits to reveal typical symptoms of hemorrhage fever with renal syndrome.

[Clinical and morphological aspects of Helicobacter pylori invasion in reflux esophagitis]. / Kliniko-morfologicheskie aspekty invazii Helicobacter pylori pri refliuks ezofagite.

The mucosal biopsies morphological investigation of the lower third of esophagus were conducted for Helicobacter pylori detection in 43 patients with reflux-esophagitis. Helicobacter pylori were detected in 66.7%, gastric metaplasia-in 83.3% of patients. Helicobacter pylori plays an important role in reflux-esophagitis pathogenesis. Surgical treatment is indicated if the combined antireflux and antibacterial therapy is ineffective.