ABSTRACT
Clinical observations confirming the presence of critical zones in blood supply of the intestine are presented. It was shown that exclusion of the vessels of the right half of the colon is responsible for the disturbance of blood supply in the terminal part of the small intestine. Suture bands should be displaced to the level at which the intramural pressure ensures the viability of the intestine in the anastomosis zone. This should be taken into account in resections of the transverse colon, left-side hemicolectomy, abdominal resection and frontal resection of the rectum.
Subject(s)
Intestines/blood supply , Intestines/surgery , Surgical Wound Dehiscence/prevention & control , Anastomosis, Surgical/methods , Colectomy , Colonic Neoplasms/physiopathology , Colonic Neoplasms/surgery , Female , Gastrectomy , Humans , Ischemia/complications , Male , Middle Aged , Regional Blood Flow , Stomach Neoplasms/physiopathology , Stomach Neoplasms/surgery , Surgical Wound Dehiscence/etiologyABSTRACT
The method of pancreatogastrectomy for carcinoma of the stomach is discussed on the basis of clinical experience (115 operations) and anatomical (192 anatomical specimens) and experimental (36 dogs) studies. The authors describe the techniques of the surgical approach reversible mobilization of organs, choice of the optimal level of pancreas resection with maintenance of adequate blood circulation in the stump, treatment of the stump by means of the round ligament of the liver, and drainage of the abdominal cavity. With the use of these techniques the mortality after this operation reduced from 20% to 8%.
Subject(s)
Gastrectomy , Pancreatectomy , Splenectomy , Animals , Dogs , Drainage , Humans , Pancreatic Neoplasms/surgery , Postoperative Complications , Splenic Neoplasms/surgery , Stomach Neoplasms/surgeryABSTRACT
Staining of cytologic preparations with a new stain, heretofore not employed for this purpose, results in differentiated panchromatic high-quality staining of the preparations, achieved in few seconds. This method is used in emergency and planned cytologic investigations and in mass prophylactic check-ups.
Subject(s)
Staining and Labeling/methods , Cytological Techniques , Humans , Time FactorsSubject(s)
Esophageal Neoplasms/surgery , Esophagoplasty/methods , Stomach/surgery , Surgical Flaps , Adult , Aged , Female , Humans , Male , Middle Aged , PeristalsisSubject(s)
Gastrectomy , Gastroscopy/methods , Stomach Neoplasms/surgery , Transillumination , Humans , Intraoperative PeriodABSTRACT
The examination of lymph nodes of 64 preparations removed in resections of the stomach and gastrectomies associated with extensive lymphadenectomy has shown that for invasive forms of gastric cancer extensive lymphadenectomy should be fulfilled with ablation of lymph nodes adjacent to major parietal vessels: hepatic, splenic, superior mesenterial arteries, celiac trunk, aorta, inferior vena cava and portal vein.
Subject(s)
Lymph Node Excision/methods , Stomach Neoplasms/surgery , Evaluation Studies as Topic , Gastrectomy , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Neoplasm Invasiveness , Neoplasm Staging , Stomach Neoplasms/pathologyABSTRACT
When using routine methods of lymphadenectomy the excisable parietal groups of lymph nodes are left intact. This is considered to be an unjustified ground for refusal of a curative operation for gastric cancer Metastases to lymph nodes of these groups are frequently found in gastric cancer. The authors recommend to use extensive lymphadenectomy when the removed preparation includes the lymph nodes of parietal groups. It was shown that the degree of the operative risk did not increase in this case. Five year survival was achieved in certain patients having metastases to lymph nodes of parietal groups.
Subject(s)
Gastrectomy/methods , Lymph Node Excision/methods , Stomach Neoplasms/surgery , Esophageal Neoplasms/surgery , Follow-Up Studies , Humans , Lymphatic Metastasis , Pancreatic Neoplasms/surgery , Splenic Neoplasms/surgery , Time FactorsABSTRACT
A combination procedure of surgical fibrogastroscopy was employed for diagnosis of incipient gastric carcinoma. It involved a routine examination of the mucosa, transillumination (examination in transmitted light) and endoscopy of the illuminated surgically-exposed stomach, with the endoscope's ligh being switched off. The study conducted in 24 patients with incipient carcinoma showed the effectiveness of the said diagnostic procedure in identifying foci of such lesions, their anatomic pattern as well as the extent of involvement of different layers of the stomach wall, submucosal and serous muscular layer.
Subject(s)
Precancerous Conditions/diagnosis , Stomach Neoplasms/diagnosis , Biopsy , Gastroscopy , Humans , Intraoperative Care , Male , Middle Aged , Precancerous Conditions/surgery , Stomach/pathology , Stomach Neoplasms/surgery , TransilluminationABSTRACT
An experience with 115 splenopancreatogastrectomies is described. The general mortality was 20%. In the last series two patients died out of 24. To prevent necrosis of the pancreatic stump certain levels of amputation of the organ are recommended.
Subject(s)
Gastrectomy/methods , Pancreatectomy/methods , Splenectomy/methods , Stomach Neoplasms/surgery , Animals , Arteries/surgery , Dogs , Follow-Up Studies , Humans , Pancreas/blood supply , Pancreatic Neoplasms/secondary , Pancreatic Neoplasms/surgery , Splenic Artery/surgery , Splenic Neoplasms/secondary , Splenic Neoplasms/surgeryABSTRACT
The investigations were performed during 139 operations. A conclusion was made that the arterial pressure level in the intramural vessels of the intestine was a reliable criterion of its viability. Repeated measures after the liquidation of the intestine strangulation can show the reestablishment of the disturbed blood circulation. The angiotensometry indices can serve as a guide for surgical tactics.
