[Role of selective decontamination in combined treatment of chronic anal fissure].

Effectiveness of selective decontamination in combined treatment of patients with chronic anal fissure and concomitant proctitis was studied in clinical randomized investigation including 103 patients. The etiologically significant flora colonizing the chronic defect of the anoderma does not coincide with the composition of feces microflora and is presented by anaerobic microorganisms or a combination of aerobes and anaerobes. It was established that topical etiotropic antibacterial therapy in combination with medicamentous sphincterotomy in the outpatient treatment resulted in quicker arrest of the pain syndrome, accelerated epithelization of the fissure and made the period of treatment 2 times shorter as compared with control.

[Application of new technologies in resection of the liver].

Against the background of operations using expensive equipment, the results of liver resection by the apparatus-plastic method produce favorable impression. Positive results are obtained due to the simplicity of performing resections and reliable sealing of the wound surface by the laser "welding". Favorable course of the postoperative period depended on the minimal volume of the intraoperative blood loss, the absence of exude complications in the postoperative period.

[The prognostic role of interleukin-6 in peritoneal exudate of patients with diffuse peritonitis].

A prospective longitudinal controlled investigation of 189 patients with secondary diffuse peritonitis was performed. A correlation between the levelof interleuikin-6 of peritoneal exudate, the severity of the patients' state, the number of complications and outcome of the course of the disease was established. The maximal number of complications and unfavorable outcomes falls on the peak value ofinterleuikin-6.

[Effects of short-term immunosuppression on the engraftment of skin transplants at syndrome of the diabetic foot].

Effects of a single administration of small doses of 5-fluorouracil on results of skin plasty for syndrome of the diabetic foot were studied in 61 patients who had undergone local operations for pyo-necrotic diseases of the foot against the background of diabetes mellitus. The completion phase of their treatment was free dermal plasty with a split skin graft. Administration of 5-fluorouracil during the plasty operation was found to be accompanied by less marked inflammatory reaction in the transplant bed and in the graft. The frequency and square surface of lysis in the transplanted dermal skin graft were considerably lowered.

[Dysfunction of the endocrine system in patients with abdominal sepsis].

The article presents results of a prospective investigation of 270 patients with abdominal sepsis. Three variants of endocrine impairments were established which correlated with the intensity of syndrome of inflammatory response and severity of the patients' state. In addition, possible transition of one variant of the endocrine dysfunction into another was proved in case of increased number of programmed sanitation relaparotomies.

[Method for improving results of local operations for pyo-necrotic disease of the foot associated with diabetes mellitus]. / Sposob uluchsheniia rezul'tatov lokal'nykh operatsii po povodu gnoino-nekroticheskikh zabolevanii stopy pri sakharnom diabete.

Under study was the influence of antimetabolite 5-fluoracil with the preferential influence on the lymphocytic link upon the outcomes of local operations in patients with diabetic foot syndrome. The investigation was performed in 95 diabetes mellitus patients who had undergone local operations for pyo-necrotic diseases of the foot. The group of investigation included 55 patients additionally given 5-fluoracil (5 mg/kg) during local operation. The injection of the drug was followed by moderate lympho- and thrombopenia arrested by the 7th day after a single injection, reduced content of the acute phase reactants and a dramatic drop of the content of circulating immune complexes. Clinically it was followed by a rapid disappearance of the inflammation signs in the wound. In the group of patients given 5-fluoracil there were reliably less reamputations, greater number of wounds healing by primary intention after the first local operation and of those successfully closed with the help of plastic operations. No general toxic effects of the used doses of the drug were noted.

[Conservative surgery in injuries and focal formations of the spleen]. / Sberegatel'naia khirurgiia pri povrezhdeniiakh i ochagovykh obrazovaniiakh selezenki.

Clinical records of 128 operations on the spleen including 102 organ-saving procedures are surveyed [correction of servieved]. Basing on his rich experience of organ-saving operations the author suggests classification of injuries of the spleen resting on the criteria dictating certain surgical policy. Diagnostic algorithm is proposed which provides early and correct diagnosis. The techniques are described including original approach which save the spleen or its part in lesions of various locations and sizes. Saving policy is based on peculiarities of intraorganic circulation and is justified by functional importance of the spleen in the body.

[Diagnosis and therapy of malignant primary and metastatic liver neoplasms]. / Diagnostika i lechenie pervichnykh i metastaticheskikh zlokachestvennykh opukholei pecheni.

Ultrasonic examination of liver and laparoscopy have been carried out to diagnose hepatic tumors. An original procedure of laparoscope-controlled needle biopsy of liver has been suggested. Any required extent of liver resection can be obtained by an apparatus-reconstruction method developed at the Clinic. The procedure employs preserved peritoneal transplants.

[Diagnostic difficulties in closed injuries of the liver and spleen]. / Trudnosti diagnostiki zakrytykh povrezhdenii pecheni i selezenki.

Based on an analysis of 327 case histories of patients with injuries of the abdominal cavity organs and literature data the author calls attention to shortcomings in the examination of patients with injuries of the liver and spleen. The author proposes to pay attention to the importance of objective and special methods of examination and diagnostics of injuries of organs of the abdominal cavity when training surgeons of emergency departments.

[Plastic surgery of splenic wounds with heterogenic preserved peritoneum]. / Plastika ran selezenki geterogennoi konservirovannoi briushinoi

Heteroperitoneum was employed with hemostatic purposes for splenic injuries, Experiments were conducted on 80 dogs. The results of studies have evidenced the development of aseptic inflammation at the site of a contact between the spleen and a graft. The proper splenic capsule and omentum are the source of development of new connective tissues. Gradually, heteroperitoneum is subject to fibrillolysis, fragmentation and fusion. Six-seven months following the operation heteroperitoneum is completely substituted by newly-formed connective tissues. A newly-formed capsule is considerably thicker than the proper splenic capsule, and its structure differs but little from the latter. One case of clinical application of the heterogenous preserved peritoneum with hemostatic purposes in splenic trauma is described.