ABSTRACT
The authors analyse the causes of 170 (38.3%) complications which occurred after 435 interventions for selective proximal vagotomy (SPV) with or without a stomach-draining operation. Specific complications were encountered in 31.9% and unspecific complications in 7.0% of cases. Intraoperative complications happened in 6 (3.6%) patients who had complications after vagotomy, early complications--in 54 (31.5%), and late complications--in 79 (46.8%) patients. The main causes of the specific complications were technical faults in performing SPV, disorder of gastric secretory, motor-evacuation, and barrier activity due to incomplete, inadequate vagotomy. Inadequate drainage and disorders of the immune system and dietary regimen, gastroduodenal reflux are conducive to the development of complications after SPV. Reconstructive-restorative operations and resection of the stomach are the operations of choice in organic complications after SPV and produce good late-term results.
Subject(s)
Intraoperative Complications , Vagotomy, Proximal Gastric/adverse effects , Duodenogastric Reflux/complications , Humans , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/surgery , Reoperation , Stomach Diseases/complications , Time FactorsABSTRACT
The article discusses experience in the diagnosis and methods of treatment of thromboembolism of the pulmonary arteries at the Department of Surgery of the Vessels of the Scientific Research Institute of Experimental Surgery. There were 238 patients under observation. A complex of modern diagnostic methods were applied, including, besides the routine methods of examination, angiopulmonography with measurement of blood pressure in the pulmonary trunk and right heart chamber and scanning of the lungs. Thus, comparison of the modern antipulmonological and isotope examinations allow a correct intravital diagnosis of thromboembolism of the pulmonary artery to be established. Administration of thrombolytics into the focus of affection by catheterization of the pulmonary artery is the most effective method of nonoperative treatment.
Subject(s)
Pulmonary Embolism/diagnosis , Diagnosis, Differential , Electrocardiography , Embolectomy , Humans , Pulmonary Artery/diagnostic imaging , Pulmonary Embolism/mortality , Pulmonary Embolism/therapy , Radiography , Thrombectomy , Thrombolytic TherapyABSTRACT
The results of treatment have been analyzed for 45 patients with nonspecific spontaneous hemopneumothorax. Therapeutic policy was decided upon individually basing on the patient's condition and clinical appearance of the disease. Urgent surgery was performed in 68.0% of patients for continuous intrapleural bleeding and tense pneumothorax. The rest cases underwent pleural puncture. Pleural drainage failed to eliminate spontaneous hemopneumothorax in all the patients. The causes of SHP were established mostly intraoperatively. In 81.8% of the cases it resulted from a rupture of a bullous lung. Long-term follow-up (1-18 years) of 28 patients treated surgically and conservatively recorded no recurrences.
Subject(s)
Hemopneumothorax/surgery , Adolescent , Adult , Aged , Child , Hemopneumothorax/diagnosis , Humans , Male , Middle Aged , Pleura/surgery , Pneumonectomy/methods , Suction/methods , Suture TechniquesSubject(s)
Cholecystitis/surgery , Peritonitis/etiology , Subphrenic Abscess/etiology , Surgical Wound Dehiscence/complications , Drainage/methods , Humans , Intraoperative Care , Peritoneal Lavage , Peritonitis/prevention & control , Peritonitis/surgery , Reoperation , Subphrenic Abscess/prevention & control , Subphrenic Abscess/surgeryABSTRACT
The efficacy of prolonged epidural blockade and hyperbaric oxygenation in the complex treatment of varicose ulcers of the lower limbs was studied in 112 patients. When applied separately and in combination, prolonged epidural blockade and hyperbaric oxygenation facilitate the improvement of the immediate and late-term results of treatment and reduce the period of hospitalization of the patients.
Subject(s)
Analgesia, Epidural , Hyperbaric Oxygenation , Varicose Ulcer/therapy , Adult , Evaluation Studies as Topic , Humans , Length of Stay , Middle Aged , Varicose Ulcer/diagnosis , Varicose Ulcer/surgeryABSTRACT
Selective proximal vagotomy (SPV) was performed in 435 patients whose age ranged from 16 to 80. The isolated variant of SPV was applied in 130 and SPV with a stomach draining operation was conducted in 305 patients; 320 patients were examined after the operation in follow-up periods of 7 years and more. Postoperative lethality was 0.6%. A recurrent ulcer was revealed in 4.3% of patients. The causes of the recurrence are indicated. The results were found to be excellent and good in 76%, satisfactory in 16.9%, and poor in 7.1% of the examined patients.
Subject(s)
Peptic Ulcer/surgery , Pylorus , Vagotomy, Proximal Gastric , Adolescent , Adult , Aged , Duodenum/surgery , Female , Follow-Up Studies , Gastroenterostomy , Humans , Male , Middle Aged , Pylorus/surgery , Time FactorsABSTRACT
Current methods used for the prevention of vein thrombosis were evaluated with the help of radioisotopic investigation in 175 patients, aged 40 to 74 years, after extensive abdominal surgery. Deep vein thrombosis of the lower limbs was detected by radioisotopic investigation in 6% of the patients after preventive treatment with low-dose heparin, in 14% after treatment with rheopolyglucin, and in 16% after sequential external intermittent pneumatic compression of the lower extremities, versus 26% in the group of patients who had received no special preventive treatment. As shown by the clinical pattern, most cases of thrombosis were asymptomatic. Hemorrhagic complications are extremely rare where preventive medication is used properly.
Subject(s)
Blood Coagulation/drug effects , Dextrans/administration & dosage , Heparin/administration & dosage , Postoperative Complications/prevention & control , Thrombophlebitis/prevention & control , Adult , Aged , Cholecystitis/surgery , Clinical Trials as Topic , Female , Humans , Infusions, Intravenous , Injections, Subcutaneous , Male , Middle Aged , Peptic Ulcer/surgery , Postoperative Care , Postoperative Complications/blood , Preoperative Care , Thrombophlebitis/bloodSubject(s)
Arteriosclerosis Obliterans/physiopathology , Conjunctiva/blood supply , Leg/blood supply , Adult , Aged , Humans , Microcirculation , Middle AgedSubject(s)
Kallikreins/blood , Kinins/blood , Microcirculation , Peptic Ulcer/blood , Peptic Ulcer/surgery , Adolescent , Adult , Aged , Conjunctiva/blood supply , Female , Gastrectomy , Humans , Male , Middle Aged , Peptic Ulcer/physiopathology , Time Factors , VagotomySubject(s)
Aortic Diseases/surgery , Arteriosclerosis/surgery , Blood Vessel Prosthesis , Diabetic Angiopathies/surgery , Adult , Aged , Animals , Aorta, Abdominal , Dogs , Humans , Male , Middle AgedSubject(s)
Leg/blood supply , Thrombophlebitis/diagnosis , Chronic Disease , Female , Humans , Male , Syndrome , Thrombophlebitis/bloodSubject(s)
Echinococcosis, Pulmonary/surgery , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Methods , Middle Aged , Postoperative ComplicationsABSTRACT
The authors analyze the treatment of 74 patients with non-specific spontaneous pneumothorax. Relapses were observed in 6.7% of cases. The authors have shown that a partial pneumothorax should be treated actively and conservatively. By this method in 61 of 74 patients (82,6%) the lungs were expanded. Operations were performed in 13 patients. The surgical treatment is indicated in complete pneumothorax complicated by stable collapse of the lung, continuous intrapleural hemorrhage and suppuration of the pleural cavity.
Subject(s)
Pneumothorax/surgery , Adolescent , Adult , Aged , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Pleura/surgery , Pneumonectomy/methods , Pneumothorax/diagnosis , PuncturesABSTRACT
Experiments were conducted on 39 mongrel pubertal dogs. The course of pressor and depressor reactions under conditions of normal vital activity and after partial corporocaudal resection of the pancreas was studied. The principal indices characterizing the changes of pressor reaction to noradrenaline, and of the depressor one -- to bradykinin and kallikrein before and 10 to 12 days after the corporocaudal resection of the pancreas were determined. Resection of the corporo-caudal part of the pancreas intensified the pressor reactions to noradrenaline, and depressor ones to bradykinin and kallikrein; it increased the initial negative chronotropic effect of catecholamines on the heart, and also enhanced the positive chronotropic effect of noradrenaline, kallikrein and bradykinin on the heart.
Subject(s)
Blood Pressure , Cardiovascular Physiological Phenomena , Islets of Langerhans/physiology , Animals , Arrhythmias, Cardiac/etiology , Bradykinin/pharmacology , Dogs , Heart Conduction System/physiology , Heart Rate , Kallikreins/pharmacology , Norepinephrine/pharmacology , Pancreatectomy/adverse effects , Venous PressureABSTRACT
Data concerning 175 cases operated upon for gastroduodenal ulcer are set forth in the article. Much importance is attached to a thorough mobilization of the duodenum, treatment of its stump, gastroenterostomy on the shortest afferent loop and to a broad use of suturing apparatuses and of caprone as a suture material, as well. Mortality constituted 1.1%.