[EXPERIENCE OF APPLICATION OF THE ELECTRIC WELDING METHOD FOR BIOLOGICAL TISSUES IN URGENT AND ELECTIVE SURGERY].

The usage experience of the electric welding technologies for biological tissues in 158 patients, while applying Ukrainian high­frequency generator ЕК 300 М1, was presented. Laparoscopic appendectomy, laparoscopic plasty of inguinal hernia, laparoscopic cholecystectomy, open resection of small and large bowel, during which the method of electric welding of biological tissues was applied, had constituted the main surgical interventions. The electric welding usage have permitted to reduce the operation time and the blood volume loss, and also the clipses quantity needed, which are applied for the hemostasis completion and hermetization of anatomic structures after their transsection. Аnalysis of the data obtained witnesses high efficacy of the procedure application for the biological tissues conjunction as well as for acceleration of their reparation processes, occurring after disconnection.

[DETERMINATION OF A FATTY ACIDS CONTENT IN BILIARY LIPIDS AS A PROGNOSTIC FACTOR FOR THE COMPLICATIONS OCCURRENCE IN PATIENTS AFTER OPERATIONS FOR AN ACUTE CHOLECYSTITIS IN A HIGH OPERATIVE­ANESTHESIOLOGICAL RISK].

Investigation was conducted with objective to establish a prognostic significance of the fatty acids content in biliary lipids for the complications occurrence in patients, operated on for an acute cholecystitis, while presence of high operative­anesthesiological risk. A fatty acids content in biliary lipids was analyzed in 64 patients in presence of moderate (grade ІІ) and severe (grade ІІІ) course of the disease. Coefficients К1 and К2 for prognostication of postoperative purulent­inflammatory complications occurrence were elaborated, their threshold level (К1=0.59, К2=1.8) was established. There was established, that excess of the threshold meaning of К1 and К2 in a bile of patients, suffering an acute cholecystitis while presence of high operative­anesthesiological risk, constitutes a prognostic criterion for the postoperative purulent­inflammatory complications occurrence

[Surgical treatment of duodenal fistulae].

The experience of surgical treatment of 10 patients with external intestinal fistulae was analyzed. The plot of the operation was to exlude the duodenum from the digestion by performing the retrocolic gastroenteroanastomosis after Roux or on the ultrashort loop. Early operation prevent septic complications and electrolyte disbalance. Duodenal fistulae, developed on the background of pancreonecrosis or after endoscopic retrograde cholangiopancreaticography, necessitate the external choledochial drainage.

[Application of antiseptic decasan in purulent infections of pararectal region].

The results of studying of antiseptic preparation Decasan for the treatment of patients, suffering purulent infections of pararectal region, are adduced. Efficacy of Decasan was analyzed in 102 patients. The results of investigation obtained are trusting hig antiseptic efficacy of preparation, witnessing possibility of its application as a preparation of choice for the treatment of patients, suffering purulent infections of pararectal region.

[Method of gastric drainage in connection with vagotomy in treatment of complicated posbulbar ulcers].

New surgical technique for treatment of "low" duodenal ulcers--transversal posterior retrocolic gastroenteroanastomosis with selective proximal vagotomy--was worked out and introduced by the authors. 78 patients (61 men and 17 women at the age of 14-76 years) with "low" duodenal ulcers were operated using this technique during 1982-2007 years. Short-term and long-term results of treatment were studied. Advantages of this technique and indications for the operations were determined. Obtained results indicate that this surgical approach is reliable and effective and can be applied in clinical practice.

[Surgical tactics in the ulcer pyloroduodenal stenosis in decompensation stage].

In the ulcer pyloroduodenal stenosis the stages of complete and noncomplete decompensation are suggested. In 73% of observations, while performing an adequate preoperative preparation it was possible to convert pyloroduodenal stenosis from the stage of complete decompensation into the stage of noncomplete decompensation, in which the performance of organpreserving operation is possible. In the patients, suffering pyloroduodenal stenosis in the stage of noncomlete decompensation, resection of 2/3 of stomach is performed.

[Method of postcolectomy syndrome prophylaxis].

Method of prophylaxis of postcolectomy syndrome after colectomy and rectum anterior resection at two-stage surgical treatment of severe forms of nonspecific ulcerative colitis and colon diffuse polyposis has been developed and used at 9 patients. Postoperative complications were seen at 2 (22.2%) of them. This method permits to reduce the symptoms of postcolectomy syndrome after radical stage of surgery (colectomy and anterior resection of rectum) and to improve the clinical course of postoperative period after reconstructive stage of surgery.

[Quality of life in patients after restorative operations].

The analysis of the results of the surgical treatment of colon cancer, ulcerative colitis, Crohn's disease, polyposis of colon, diverticular disease of colon on the bases of quality of life scale indexes, questionnaire SF-36 was carried out. The authors have compared the quality of life of patients who underwent surgical treatment using restorative operations after removing functional parts of the colon. The quality of life indexes in 11-12 days after the operation were higher in the first group compared with the second one. Positive influence of laparascopic intervention on quality of life considerably differs from that in the second group in 3 and 6 months and in one and three years after the operation was done.

[Erysipelas].

The literature review presents statistical data, etiology, pathogenesis, clinical course and complications of erysipelas. Principles and treatment approaches of the disease, its prophylaxis and management of the complications are discussed in the article.

[Surgical policy in reconstructive surgery on the colon].

Thirty-year experience with 1685 reconstructive operations on the colon is analyzed. Novel surgical policy has increased the rate of primary-reconstructive operations for the last 5 years from 78.8 to 87.9%, decreased the number of postoperative complications from 33 to 21.8%, intestinal anastomosis-dependent complications -- from 22.6 to 8.4%, postoperative lethality -- from 6.9 to 2.4%, raised the rate of good functional results from 64 to 88.2%.

[Nonspecific ulcerative colitis and Crohn's disease--the main problem of modern coloproctology].

There is adduced modern strategy of treatment of nonspeciphic ulcerative colitis and Crohn's disease, which owe medical and social significance due to their strictly progressive course, severe complications origin threat, invalidisation of patients. Conduction of conservative pathogenetically substantiated therapy of uncomplicated nonspeciphic ulcerative colitis and Crohn's disease in conditions of specialized gastroenterologic or proctologic stationary assists essential limitations of indications for surgical treatment of the patients. Conduction of an adequate operative intervention according to strict indications permits to improve results of the patients' treatment essentially.

[Use of sodium hypochlorite in surgery].

This literature review contains the theoretical reasoning of sodium hypochlorite use, physical and chemical characteristics and features, effects of sodium hypochlorite on biological substrates having given grounds for clinical use of sodium hypochlorite. Indications and contraindications for infusion of sodium hypochlorite solutions as well as associated complications and their prophylaxis are covered.

[Abdomino-anal resection in the treatment of low-ampullar cancer of the rectum].

Surgical policy was developed for improvement of functional results and quality of life in patients operated on for low rectal cancer. This policy includes choice of the method of sphincter-saving operation depending on the stage of the tumor, grade of malignancy, distance from a low edge of the tumor to dentate line. Methods of prevention of ischemia and necrosis of brought down colonic transplant and anal incontinence were used. This increased the number of sphincter-saving operations in low location of rectal cancer by 35%, reduced the rate of necrosis of intestinal transplant from 7 to 4.4%, saved continent function and improved significantly quality of life in 89.8% operated patients.

[Use of ozonotherapy in clinical practice].

The review presents theoretical substantiation of the use of ozone, its physico-chemical propeties, influence of ozone on biological substrates that made it practical in clinics. Indications and contrindication of ozonotherapy are presented in the article as well as adverse reactions of the method and its prophylaxis.

[Application of preparations relief ultra and relief advance in practice of coloproctological department].

Efficacy of application of preparations Relief Ultra and Relief Advance as pathogenetically directed medicines was established, basing on analysis of the examination and treatment results in 133 patients with anal region diseases (acute and chronic hemorrhoids, nonspeciphic ulcerative colitis, the Crohn's disease, acute paraproctitis, rectal polyp). For local conservative treatment it is expedient to apply preparations in various pharmacological forms in complex. Application of preparation Relief Ultra endorectally in conjunction with preparation Relief Advance endorectally and locally on the wound surface is indicated after performance of elective and urgent operative interventions for rectal and anal zone diseases.

[Ultrasonic diagnosis of an acute appendicitis and its complications]. / Ul'trazvukova diahnostyka hostroho apendytsytu ta ioho uskladnen'.

Retrospective analysis of the examination results in 292 patients with an acute appendicitis (AA) was conducted. There were 184 (63%) of patients operated on, for AA--168 (57.5%). Possibilities of ultrasonic investigation in the AA diagnosis were estimated. Due to introduction of this method it become possible to escape the operation performance in 58 (13.7%) of patients and to reduce the frequency of idle appendectomy for simple AA as twice. Broad application of ultrasonic investigation in urgent surgery would permit to establish the AA diagnosis correctly and substantially and to determine the tactic of patients treatment.