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2.
Khirurgiia (Mosk) ; (10): 4-11, 2013.
Artículo en Ruso | MEDLINE | ID: mdl-24300571

RESUMEN

The article summarizes the experience of surgical treatment of 47 patients (1964-2012 yy) with lung arteriovenous malformations (LAVM). Men were 29, women - 18. Age varied from 6 to 49 years. 20 patients had solitary lung arteriovenous malformations, the rest 27 had multiple malformations. Before 1983 the main diagnostic means was the angiopulmonography, since that the multyspiral computed tomography has been used. Before 1980 all patients received major surgical treatment, i.e., lobectomy (n=29), pneumonectomy (n=1) and 1 explorative thoracotomy. After 1980 the endovascular embolisation under the X-ray control took the leading place among the treatment options for these patients. 11 patients had 17 embolisations; the lung resection was performed only in 3 cases. All negative outcomes (4 lethal and 8 complications) were registered before the 1980. The were no lethal outcomes after the endovascular embolisation; only 3 patients had complications. All patients demonstrated satisfactory and good outcomes, considering objective parameters and quality of life early and long after the endovascular embolisation.


Asunto(s)
Malformaciones Arteriovenosas/cirugía , Procedimientos Endovasculares/métodos , Pulmón/irrigación sanguínea , Neumonectomía/métodos , Arteria Pulmonar/anomalías , Venas Pulmonares/anomalías , Toracotomía/métodos , Adolescente , Adulto , Angiografía , Malformaciones Arteriovenosas/diagnóstico por imagen , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Arteria Pulmonar/cirugía , Venas Pulmonares/cirugía , Estudios Retrospectivos , Tomografía Computarizada Espiral , Resultado del Tratamiento , Adulto Joven
3.
Khirurgiia (Mosk) ; (5): 4-9, 2012.
Artículo en Ruso | MEDLINE | ID: mdl-22810528

RESUMEN

Technical progress of recent years allowed thoracic surgery to become a safer procedure. Experience of thoracic operations in our institution counts up to 14 962 cases (1963-2009 yy). Of them 223 (1.5%) patients had rethoracotomies on the reason of various operative complications. 112 patients had the intrapleural bleeding, 56 patients were reoperated on the reason of coagulated hemothorax, 57 patients demonstrated the bronchial stump insufficiency, and 11 were reoperated on other reasons. The frequency of rethoracotomy had decreased from 2.5 to 0.2%. The on-time rethoracotomy allows to save the patients' life and do not aggravate the overall result of the treatment.


Asunto(s)
Hemotórax , Hemorragia Posoperatoria , Reoperación/estadística & datos numéricos , Toracotomía , Femenino , Hemotórax/etiología , Hemotórax/cirugía , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Seguridad del Paciente , Selección de Paciente , Hemorragia Posoperatoria/etiología , Hemorragia Posoperatoria/cirugía , Reoperación/métodos , Toracotomía/efectos adversos , Toracotomía/métodos , Toracotomía/estadística & datos numéricos
4.
Med Parazitol (Mosk) ; (3): 23-6, 2010.
Artículo en Ruso | MEDLINE | ID: mdl-20873181

RESUMEN

Thirty-six piglets (15 days old) were inoculated with Echinococcus according to the authors' procedure. Hepatic hydatid cyst growth in the piglets was ultrasonographically monitored 3 months after inoculation. In 15 piglets, the size of hepatic hydatid cysts was as high as 6.5 x 8.5 cm 5 months after infection. The cavity of larvocystic fibrous capsule was eliminated, by inverting the resection margins inward with interrupted catgut sutures. For content aspiration, the cystic bed was occasionally drained by a polyvinyl chloride tube with two side holes, which was brought outward through an individual incision. Thesubhepatic area was also drained by a "cigar" tampon through an individual incision. The wound healed in layers, tightly. Marginal resection of the liver was performed to stimulate regenerative processes in the resected area.


Asunto(s)
Equinococosis Hepática/tratamiento farmacológico , Echinococcus , Juglans , Hígado/parasitología , Extractos Vegetales/uso terapéutico , Administración Oral , Animales , Modelos Animales de Enfermedad , Equinococosis Hepática/cirugía , Humanos , Paecilomyces/aislamiento & purificación , Cuidados Posoperatorios/métodos , Porcinos , Factores de Tiempo
5.
Khirurgiia (Mosk) ; (9): 25-32, 2008.
Artículo en Ruso | MEDLINE | ID: mdl-18833180

RESUMEN

4023 operations on account of primary bronchopulmonary cancer were performed in the period of 1963--2006 years. Rare malignant tumors (carcinoid, adenocystic cancer, sarcoma, large cell carcinoma etc.) were diagnosed in 379 (9,1%) cases. 275 patients of those had bronchpulmonary carcinoid; adenocystic cancer was diagnosed in 26 patients; 67 had various types of non-epithelial malignant tumors and 11 had a large cell carcinoma. All patients were operated on, morphological verification was obtained in all cases. The surgical tactics in patients with rare malignant tumours should be the same as for non-small cell lung--lobectomy of pneumonectomy with lyphadenectomy. The long term follow-up results witness the advisability of surgical treatment.


Asunto(s)
Neoplasias Pulmonares/cirugía , Neumonectomía/métodos , Adolescente , Adulto , Anciano , Niño , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/diagnóstico , Escisión del Ganglio Linfático/métodos , Masculino , Persona de Mediana Edad , Enfermedades Raras , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
6.
Khirurgiia (Mosk) ; (5): 26-31, 2007.
Artículo en Ruso | MEDLINE | ID: mdl-17690676

RESUMEN

Among 4005 patients with lung cancer 26 (0.65%) of them had adenocystic bronchial cancer, including 13 male and 13 female patients aged 13 to 60 years. Overall 33 operations have been performed at 26 patients, 5 of them were operated twice, and 1 patient underwent 3 surgical procedures. The plastic operations on bronchi (10) were the main surgical procedures. Four patients underwent pneumonectomy with resection of tracheal bifurcation, and 2 patients - circular resection of primary bronchus with resection of carine and tracheobronchial angle. One patient died after surgery, postoperative complications were seen at 4 patients including hemothorax (1), bleeding (1) and empyema (2). Twenty-five patients have been discharged, 21 of them were followed-up. Three patients survived more 3 years, 6 patients - more 5 years, 8 - more 10 years, 2 - more 15 years, and 2 - more 20 years. Long-term results of radical surgical treatment argue the efficacy of these surgeries at adenocystic bronchial cancer.


Asunto(s)
Neoplasias de los Bronquios/cirugía , Cistoadenoma/cirugía , Neumonectomía/métodos , Adolescente , Adulto , Biopsia/métodos , Neoplasias de los Bronquios/diagnóstico , Broncoscopía , Cistoadenoma/diagnóstico , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Radiografía Torácica , Estudios Retrospectivos
8.
Khirurgiia (Mosk) ; (10): 50-3, 2004.
Artículo en Ruso | MEDLINE | ID: mdl-15477828

RESUMEN

Experience in treatment of 164 patients with combined trauma of abdomen and pelvis is analyzed. Mean age of the patients was 40.1+/-17 years, 94 patients were male, 70 -- female. ISS was 28.6+/-11 points. Lethality was 44.5%, during first day -- 61.6%. High lethality may be associated with mistakes in surgical and traumatological policy. Abdominal surgery was performed in 64 (39%) patients, only in 24 (14.6%) of them laparotomy was curative, the rest 40 (85.4%) patients underwent diagnostic laparotomy. It is demonstrated that diagnostic laparotomy has negative influence on prognosis of combined trauma of the abdomen and pelvis. Adequate traumatological policy has also great influence on lethality, particularly during the first day. Overall lethality of patients with rotary-vertical instability of the pelvis was lower in the group with fixation of the pelvis than in conservatively treated patients (41.7 and 56.6%). Lethality during day 1 in patients with fixed pelvis was 0, without fixation of the pelvis -- 82%. It is concluded that verified indications for laparotomy and active traumatological policy improve treatment results in patients with combined trauma of abdomen and pelvis.


Asunto(s)
Traumatismos Abdominales/cirugía , Pelvis/lesiones , Adulto , Femenino , Humanos , Laparotomía/métodos , Masculino
9.
Khirurgiia (Mosk) ; (7): 23-5, 2004.
Artículo en Ruso | MEDLINE | ID: mdl-15340324

RESUMEN

Importance of laparoscopy (LS) in diagnosis of intraabdominal catastrophe in patients with combined trauma (CT) is determined. Based on analysis of treatment results in 1,118 patients with CT it was revealed that real LS requirement does not exceed 10%, and it may influence negatively trauma outcome. Low diagnostic value of this method was revealed: sensitivity 98.4%, specificity 51%, accuracy 69.2%. It is concluded that LS is not a method of choice in diagnosis of intraabdominal injuries in patients with CT.


Asunto(s)
Traumatismos Abdominales/diagnóstico , Laparoscopía , Traumatismo Múltiple/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Sensibilidad y Especificidad
11.
Khirurgiia (Mosk) ; (9): 22-6, 2002.
Artículo en Ruso | MEDLINE | ID: mdl-12380181

RESUMEN

Diagnostic value of verification methods for abdominal injuries in patients with combined trauma (CT) was analyzed, severity of injuries by Injuries Severity Scale (ISS) was specified. From 503 patients with CT (ISS = 17.6 +/- 9) diagnostic laparocentesis (DLC) was used in 224 (44.6%), USI--in 204 (40.4%), diagnostic laparoscopy (DLS)--in 49 (9.8%). Diagnostic value of each method is not optimal as they do not confirm or exclude injuries of abdominal organs requiring emergency surgery. Absence of clear criteria of diagnosis of intraabdominal catastrophe leads to significant number of unnecessary laparotomies (DLC--39%, USI--43%, DLS--48.6%) that makes graver state of patients with CT and prognosis.


Asunto(s)
Traumatismos Abdominales/complicaciones , Traumatismos Abdominales/diagnóstico , Traumatismos Abdominales/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Laparoscopía/métodos , Masculino , Persona de Mediana Edad , Traumatismo Múltiple/complicaciones , Traumatismo Múltiple/diagnóstico , Valor Predictivo de las Pruebas , Ultrasonografía
12.
Khirurgiia (Mosk) ; (1): 32-3, 2002.
Artículo en Ruso | MEDLINE | ID: mdl-11875945

RESUMEN

Among 29,875 autopsies 59 cases of mediastinal echinococcosis were revealed. Among 4178 patients with thoracic echinococcosis 55 patients had mediastinal echinococcosis. All the patients were operated, most of them underwent ideal ecinococcectomy. Intraoperative prophylaxis of echinococcosis was performed: plearal cavity was treated by low-frequency ultrasound and glycerin. 7 examined patients demonstrated reduction of immune and phagocytosis indices in blood (DC3+, CD4+, CD8+, CD16+, CD21+). Increase of immunoglobulines A, M, G and circulating immune complexes was revealed. Reactions of scolexprecipitation and lymphocytes antigen-fixing were positive.


Asunto(s)
Equinococosis/epidemiología , Enfermedades del Mediastino/epidemiología , Antígenos CD/inmunología , Equinococosis/inmunología , Equinococosis/patología , Femenino , Humanos , Masculino , Enfermedades del Mediastino/patología , Uzbekistán
13.
Eksp Klin Farmakol ; 64(5): 43-5, 2001.
Artículo en Ruso | MEDLINE | ID: mdl-11764500

RESUMEN

The echinococcal immunosuppression induced in experimental mice by a human parasite strain is accompanied by immunosuppression, whereby the administration of immunomodulants favors normalization of the cell and humoral immunity chains. Among a series of preparations studied, the best results were obtained for polyoxidonium: in the case of immunosuppression induced by cyclophosphan, polyoxidonium administration led normalization of the cell and humoral immunity and the phagocytosis of neutrophils and macrophages.


Asunto(s)
Adyuvantes Inmunológicos/farmacología , Equinococosis/inmunología , Animales , Formación de Anticuerpos , Ciclofosfamida/toxicidad , Humanos , Tolerancia Inmunológica , Inmunidad Celular , Masculino , Ratones , Fagocitosis/efectos de los fármacos
14.
Med Parazitol (Mosk) ; (3): 40-3, 2000.
Artículo en Ruso | MEDLINE | ID: mdl-10981412

RESUMEN

Parasitic cysts were intraoperatively treated with glycerol in 179 patients with echinococcosis at various sites and 3% hydrogen peroxide in 165 patients with hepatic echinococcosis. Experiments on 60 cotton rats experimentally infected with Echinococcus alveolaris and 156 albino mice with E. granulosus provided evidence for the surgical use of 80-100% glycerol or 3% hydrogen peroxide to treat the cysts. Intraoperative glycerol treatment of cysts in patients with complicated hepatic echinococcosis fails to normalize amino acid metabolism, as well as immunity even a year postoperatively. The glycerol method has no contraindications for pulmonary and hepatic echinococcosis. Hydrogen peroxide has a damaging effect on all germinal elements of both E. alveolaris and E. granulosus. The authors recommend that 3% hydrogen peroxide should be intraoperatively used for treatment of cysts. After surgery, there is a tendency for amino acid metabolism to become normal in such patients.


Asunto(s)
Equinococosis Hepática/cirugía , Aminoácidos/análisis , Aminoácidos/efectos de los fármacos , Animales , Anticestodos/uso terapéutico , Terapia Combinada , Evaluación Preclínica de Medicamentos , Equinococosis Hepática/complicaciones , Equinococosis Hepática/tratamiento farmacológico , Equinococosis Hepática/inmunología , Equinococosis Hepática/metabolismo , Femenino , Glicerol/uso terapéutico , Humanos , Peróxido de Hidrógeno/uso terapéutico , Inmunidad/efectos de los fármacos , Cuidados Intraoperatorios , Masculino , Ratones , Sigmodontinae
15.
Khirurgiia (Mosk) ; (7): 41-3, 2000.
Artículo en Ruso | MEDLINE | ID: mdl-10958068

RESUMEN

The analysis of treatment results in 112 patients with foreign bodies in the rectum, aged from 16 to 80 years, was carried out. 99.1% of the patients were men. All the patients were examined and treated in proctology department of the Moscow municipal clinical hospital N 67 from 1969 to 1998. The examination was made by standard scheme, including rectal touch, rectoromanoscopy, X-ray and ultrasonic examinations. In 107 patients the foreign body was removed without surgery, 5 patients required laparotomy. When possible it was removed by fingers and also with use of forceps. When small foreign bodies could not be reached by finger, they were removed through rectoscope. Foreign bodies of big sizes, proximal end of which was in the sigmoid colon, were removed under anasthesia with the help of the assistant who fixed the foreign body through the abdominal wall in the left ileac region. In impossibility of the subject removal by these methods and presence of complications (perforation, peritonitis), laparotomy with subsequent transanal subject removal without colon section was performed, in case of perforation--with wound suturing or colostomy.


Asunto(s)
Cuerpos Extraños/terapia , Laparoscopía , Proctoscopía , Recto/lesiones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Cuerpos Extraños/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
16.
Khirurgiia (Mosk) ; (6): 37-9; discussion 40, 2000.
Artículo en Ruso | MEDLINE | ID: mdl-10900842

RESUMEN

The aim of this study was to analyse the results of the treatment of extraperitoneal rectal and perineal injuries for 153 patients. All the patients were examined according to the scheme. Therapeutic-diagnostic algorithm was developed for perineal, anal, rectal injuries. Wide opening and drainage of the wound was used. The method allows to avoid colostomy and its subsequent operative closing in extraperitoneal injury of the rectum. The method of surgical treatment is recommended in extraperitoneal rectal and perineal injuries.


Asunto(s)
Traumatismos Abdominales/cirugía , Colostomía , Perineo/lesiones , Recto/lesiones , Succión , Heridas Penetrantes/cirugía , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Perineo/cirugía , Recto/cirugía , Estudios Retrospectivos
17.
Khirurgiia (Mosk) ; (5): 27-9, 2000.
Artículo en Ruso | MEDLINE | ID: mdl-10842962

RESUMEN

Experimental series of 60 cotton rats and 150 white mice infected with echinococcus showed that 80-100% glycerin and 3% peroxide solution were effective scolicidal solutions for inactivation of the parasite. 344 patients have been operated on for hydatid disease with inactivation of the parasite by means of these scolicidal solutions. Glycerin during the surgical management of the hydatid cysts is effective and harmless in uncomplicated hydatid liver disease and any hydatid pulmonary cysts. Glycerin is contraindicated in complicated hydatid liver disease because of immunity disturbance. In complicated hydatid liver disease management of the hydatid cysts by 3% peroxide is effective and harmless. It is necessary to correct the hydatid liver disease patients' immunity in the preoperative and postoperative periods. Tactivin and antiechinococcus drug SK-1 are effective immunomodulators in hydatid liver disease.


Asunto(s)
Adyuvantes Inmunológicos/uso terapéutico , Anticestodos/uso terapéutico , Equinococosis Hepática/tratamiento farmacológico , Equinococosis Pulmonar/tratamiento farmacológico , Animales , Contraindicaciones , Quimioterapia Combinada , Equinococosis Hepática/inmunología , Equinococosis Hepática/cirugía , Equinococosis Pulmonar/inmunología , Equinococosis Pulmonar/cirugía , Echinococcus/efectos de los fármacos , Echinococcus/aislamiento & purificación , Glicerol/uso terapéutico , Humanos , Peróxido de Hidrógeno/uso terapéutico , Inmunidad Celular/efectos de los fármacos , Periodo Intraoperatorio , Ratones , Péptidos/uso terapéutico , Ratas , Sigmodontinae , Extractos del Timo/uso terapéutico , Resultado del Tratamiento
20.
Khirurgiia (Mosk) ; (3): 7-11, 1999.
Artículo en Ruso | MEDLINE | ID: mdl-10216348

RESUMEN

The study is based on the results of conservative and operative surgical treatment of 184 victims with open and closed, isolated and combined injuries of the liver. The patients' age was from 15 to 80 years. All patients were examined and treated in 1991 to 1996 in Moscow clinical hospital No 67. Conservative treatment for superficial injuries of the liver were carried out in 72 patients. 112 patients underwent urgent operations. Conservative treatment included: examination, control diagnostic laparoscopy and introduction of control drainage followed by dynamic laparoscopy. Operative treatment included: laparotomy, revision of the abdominal cavity, sutures or resection of the liver, surgical treatment of the other abdominal organs. Comparative analysis of two methods of treatment demonstrated possibility and necessity of the use of conservative treatment for superficial injuries of the liver, especially in combined traumas.


Asunto(s)
Traumatismos Abdominales/terapia , Antibacterianos/uso terapéutico , Transfusión Sanguínea , Drenaje/métodos , Hígado/lesiones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Infección de Heridas/prevención & control , Heridas no Penetrantes/terapia , Heridas Penetrantes/terapia
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