[An analysis of postoperative mortality in patients with large-intestine occlusive ileus due to tumor origin]. / Analiz na sledoperativnata smurtnost pri patsienti s obturatsionen debelochreven ileus ot tumoren proizkhod.

A total of 232 patients presenting occlusive ileus caused by colorectal carcinoma undergo operative treatment in the period 1979 through 1990. In 160 of them the tumor is located in the colon, and in seventy-two--in the rectum. One-hundred twenty-two radical and 110 palliative operations are performed (52.58 and 47.42 per cent, respectively). Postoperative lethality amounts to 24.57 per cent, with underlying causes peritonitis (35.08%) and severe ileus intoxication (21.05%). The causes of postoperative lethality are analyzed with a special reference to tumor location, extensiveness of the surgical intervention, clinical course of the disease, concurrent complications and concomitant diseases. The lowest is the mortality rate following radical two-stage operations with removal of the neoplasm in the first stage.

[The factors determining survivorship in patients with colorectal carcinoma complicated by obstructive ileus of the large intestine]. / Faktori, opredeliashti prezhiviaemostta pri bolni s kolo-rektalen kartsinom, uslozhnen s obturatsionna debelochrevna neprokhodimost.

A total of 232 patients with obturation ileus, caused by locally advanced colorectal carcinoma, are operated over a 12-year period (1979-1990). In 160 patients (68.97 per cent) the tumor is located in the colon, and in 72 (31.03 per cent)-in the rectum. The operative interventions performed are distributed as follows: 122 (52.58 per cent) radical, and 110 (47.42 per cent) palliative. There are 84 patients (36.03 per cent) in IV clinical stage. Postoperative lethality among those subjected to radical operation amounts to 25.41 per cent, with leading underlying causes-peritonitis (35.08 per cent) and serious ileus intoxication (21.05 per cent). The survival over 1, 3 and 5-year periods among those radically operated is 74.59, 48.37 and 34.06 per cent, respectively. Histologically differentiated adenocarcinoma is demonstrated in 69.38 per cent, undifferentiated-in 17.50 per cent, and mucinous adenocarcinoma-in 13.12 per cent. The factors with a high prognostic value include: stage of primary tumor development, lymph involvement, type of operative intervention and histological variant of the neoplasm.

[Anaerobic surgical infection]. / Vurkhu anaerobnata khirurgichna infektsiia.

The study covers 125 patients with anaerobic surgical infection, aged 7 to 82 years. Of the total 27 cases are operated for acute cholecystitis, four--diffuse acute peritonitis, seventeen--acute appendicitis, and three--acute hematogenous osteomyelitis. In acute cholecystitis and acute appendicitis microbiological study is carried out of the content, organic wall and periorganic space. In acute cholecystitis patients anaerobic flora is found in 39.01 per cent, and gram-negative--in 44.9 per cent, and in those presenting acute appendicitis--in 28.3 per cent and 58 per cent, respectively. The clinical analysis results point to a severer clinical course in the patients presenting anaerobic flora. The letter becomes manifest as mono infection in 37.2 per cent. It is pointed out that in the presence of two or more signs, characteristic of anaerobic infection, namely: destructive early process, offensive odor and intoxication, anaerobic bacterial flora should be invariably considered. At each microbiological examination the results of staining according to Gram should be also demanded from the laboratory.