RESUMEN
It was evaluated the frequency of focal nodular liver hyperplasia and treatment resultsin 1425 patients for the last 17 years in 2 time period. The own experience and literature data were used. First this disease was considered as very rare liver tumor because of underdeveloped diagnostics. Tumor detection was the indication for laparotomy. In some patients removal of the tumor was not performed if intraoperativebiopsy has shown tumor benign. The indication for dynamic observation and surgical treatment were identified with increasing number of patients, diagnostics improvement, and analysis of immediate and long-term results. The operation provides persistentcure.
Asunto(s)
Hiperplasia Nodular Focal , Laparotomía , Neoplasias Hepáticas , Hígado , Espera Vigilante , Adulto , Anciano , Niño , Femenino , Hiperplasia Nodular Focal/diagnóstico , Hiperplasia Nodular Focal/fisiopatología , Hiperplasia Nodular Focal/cirugía , Estudios de Seguimiento , Humanos , Laparotomía/métodos , Laparotomía/tendencias , Hígado/diagnóstico por imagen , Hígado/patología , Hígado/cirugía , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/fisiopatología , Neoplasias Hepáticas/cirugía , Masculino , Evaluación de Resultado en la Atención de Salud , Estudios Retrospectivos , Federación de Rusia , Tiempo de Tratamiento , Ultrasonografía , Espera Vigilante/métodos , Espera Vigilante/tendenciasRESUMEN
Experience in treatment of leiomyosarcoma of the retrohepatic segment of the inferior vena cava at any separately taken clinic is scarce. Given a rare nature of the pathology involved, whose diagnosis and management require joint participation of various-specialty physicians, we have considered it wise to present our own clinical case report.
Asunto(s)
Implantación de Prótesis Vascular/métodos , Leiomiosarcoma , Neoplasias Vasculares , Vena Cava Inferior , Adulto , Diagnóstico Diferencial , Disección/métodos , Femenino , Humanos , Leiomiosarcoma/diagnóstico , Leiomiosarcoma/fisiopatología , Leiomiosarcoma/cirugía , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Neoplasias Vasculares/diagnóstico , Neoplasias Vasculares/fisiopatología , Neoplasias Vasculares/cirugía , Vena Cava Inferior/patología , Vena Cava Inferior/cirugíaRESUMEN
The aim of the report is to demonstrate an algorithm of diagnostics and treatment of patients with nonparasitic hepatic cysts and to show how deviation from proposed tactics can lead to serious complications, making the treatment more difficult, long and expensive.
Asunto(s)
Quistes/diagnóstico , Hepatopatías/diagnóstico , Biopsia , Quistes/cirugía , Diagnóstico Diferencial , Drenaje/métodos , Femenino , Estudios de Seguimiento , Humanos , Hepatopatías/cirugía , Masculino , Persona de Mediana EdadRESUMEN
Results of treatment of 378 patients with non-complicated non-parasitic hepatic cysts during the last 15 years are presented. Diagnostics was based on the developed algorithm of diagnostics and treatment of space-occupying lesions of liver. Therapeutic approach to non-parasitic hepatic cysts was defined on the basis of their sizes. At case of small cysts monitoring was carried out. During the period of supervision the authors didn't observe any complications. Increasing of the cyst sices was signed only in 7.94% of cases. Puncture and sclerotherapy under ultrasound control were carried out in medium cysts with 96.70% of efficacy. If the authors didn't deny the parasitic or tumorous nature of liver lesions carry out the surgical treatment, which was also considered to be indicated at case of sizcable enlargement of the non-parasitic hepatic cysts and inefficiency of mini-invasive treatment.
Asunto(s)
Quistes/terapia , Hepatopatías/terapia , Punciones/métodos , Escleroterapia/métodos , Quistes/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Hepatopatías/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , UltrasonografíaAsunto(s)
Equinococosis Hepática/complicaciones , Equinococosis Pulmonar/complicaciones , Adolescente , Diagnóstico Diferencial , Equinococosis Hepática/diagnóstico , Equinococosis Hepática/cirugía , Equinococosis Pulmonar/diagnóstico , Equinococosis Pulmonar/cirugía , Femenino , Estudios de Seguimiento , Humanos , Laparotomía , Succión/métodos , Tomografía Computarizada por Rayos XRESUMEN
The experience in treatment of 14 patients with focal cirrhosis of the liver is summarized. Clinical and morphological data is presented. It is noted that clinical picture is poor and non-specific. Ultrasonic examination is the main diagnostic tool. It is demonstrated that histological examination of removed specimen is often necessary for final diagnosis. Method of choice in the treatment of patients is surgical one. The scope of surgery depends on intraoperative features, extended hepatic resection is not usually indicated.
Asunto(s)
Hepatectomía/métodos , Cirrosis Hepática , Adolescente , Adulto , Anciano , Biopsia , Niño , Diagnóstico Diferencial , Resultado Fatal , Femenino , Estudios de Seguimiento , Humanos , Cirrosis Hepática/patología , Cirrosis Hepática/cirugía , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Problems of diagnostic and treatment policy in hepatic lesions are considered. Based on analysis of 511 cases, the authors demonstrate that among hepatic lesions as well as widespread diseases (hemangioma, cancers, parasitic and non-parasitic cysts) rare diseases can be also found. Diseases of different organs may simulate hepatic lesions.
Asunto(s)
Hepatopatías/diagnóstico , Neoplasias Hepáticas/diagnóstico , Actinomicosis/diagnóstico , Adenoma/diagnóstico , Adolescente , Adulto , Anciano , Algoritmos , Quistes/diagnóstico , Diagnóstico Diferencial , Equinococosis/diagnóstico , Equinococosis Hepática/diagnóstico , Hígado Graso/diagnóstico , Femenino , Cuerpos Extraños/diagnóstico , Hemangioma/diagnóstico , Humanos , Enfermedades Renales/diagnóstico , Absceso Hepático/diagnóstico , Cirrosis Hepática/diagnóstico , Parasitosis Hepáticas/diagnóstico , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Opistorquiasis/diagnóstico , Seudoquiste Pancreático/diagnóstico , Embarazo , Embarazo Ectópico/diagnósticoAsunto(s)
Adenocarcinoma/etiología , Arterias/trasplante , Puente de Arteria Coronaria/métodos , Epiplón/irrigación sanguínea , Antro Pilórico , Neoplasias Gástricas/etiología , Estómago/irrigación sanguínea , Adenocarcinoma/cirugía , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Gástricas/cirugía , Factores de TiempoRESUMEN
Reparative regeneration after fetal tissue transplantation and after surgical stimulation was studied in rats with experimental cirrhosis of the liver. Fetal tissue restored the morphology and function of cirrhotic liver and modified functional activity of peritoneal macrophages.
Asunto(s)
Trasplante de Tejido Fetal , Cirrosis Hepática Experimental/cirugía , Alanina Transaminasa/sangre , Animales , Aspartato Aminotransferasas/sangre , Bilirrubina/sangre , Tetracloruro de Carbono/toxicidad , Cirrosis Hepática Experimental/inducido químicamente , Cirrosis Hepática Experimental/patología , Cirrosis Hepática Experimental/fisiopatología , Regeneración Hepática , Macrófagos Peritoneales/fisiología , Masculino , Ratas , Trasplante HomólogoAsunto(s)
Antiinfecciosos/administración & dosificación , Aspirina/análogos & derivados , Glicina/administración & dosificación , Lisina/análogos & derivados , Necrosis/cirugía , Cicatrización de Heridas , Heridas y Lesiones/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Aspirina/administración & dosificación , Niño , Preescolar , Combinación de Medicamentos , Femenino , Humanos , Lisina/administración & dosificación , Masculino , Persona de Mediana Edad , Necrosis/tratamiento farmacológico , Supuración , Infección de Heridas/tratamiento farmacológico , Infección de Heridas/patología , Infección de Heridas/cirugía , Heridas y Lesiones/tratamiento farmacológico , Heridas y Lesiones/patologíaRESUMEN
The experience of treatment of 36 patients with peptic postoperative ulcer, admitted to clinic in urgency, was analyzed: 29--with bleeding, 6--with the pronounced pain syndrome, 1--with perforation of ulcer. The conservative therapy conduction permitted to stop the bleeding and to abolish the pain syndrome, but the stable epithelialization of ulcers couldn't be achieved. Transthoracic supradiaphragmatic truncal vagotomy is the operation of choice for the treatment of peptic ulcer caused by inadequate stomach resection extent. All the patients recovered.
Asunto(s)
Úlcera Péptica/cirugía , Complicaciones Posoperatorias , Adolescente , Adulto , Niño , Urgencias Médicas , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Úlcera Péptica Hemorrágica/cirugía , Úlcera Péptica Perforada/cirugía , Complicaciones Posoperatorias/cirugía , Factores de TiempoAsunto(s)
Úlcera Duodenal/diagnóstico , Duodenitis/diagnóstico , Gastritis/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adulto , Diagnóstico Diferencial , Úlcera Duodenal/cirugía , Duodenitis/cirugía , Gastritis/cirugía , Humanos , Masculino , Invasividad Neoplásica , Neoplasias Pancreáticas/cirugía , Pancreaticoduodenectomía , Tomografía Computarizada por Rayos XAsunto(s)
Colelitiasis/rehabilitación , Úlcera Duodenal/rehabilitación , Colonias de Salud , Úlcera Gástrica/rehabilitación , Colecistectomía/rehabilitación , Colelitiasis/cirugía , Terapia Combinada , Úlcera Duodenal/cirugía , Gastrectomía/rehabilitación , Infecciones por Helicobacter/rehabilitación , Infecciones por Helicobacter/cirugía , Helicobacter pylori , Humanos , Úlcera Gástrica/cirugía , Factores de Tiempo , Ucrania , Vagotomía/rehabilitaciónRESUMEN
In the experiment on 80 rats, the intraoperative lavage of the colon (IL) in its perforation and acute obstructive ileus was performed. Lavage was performed before wound closure and placing the anastomosis. In using IL with hyperoxigenated solution, the favourable course of the postoperative period, increase in number of the animals survived, decrease in incidence of complications were noted. The wound and intestinal anastomosis healed by first intention. The method is recommended for the use in clinical practice.
Asunto(s)
Enterostomía/métodos , Intestino Grueso/cirugía , Oxígeno/administración & dosificación , Animales , Intestino Grueso/efectos de los fármacos , Intestino Grueso/fisiopatología , Cuidados Intraoperatorios , Ratas , Ratas Wistar , Irrigación Terapéutica/métodos , Resultado del Tratamiento , Cicatrización de Heridas/efectos de los fármacosRESUMEN
In 186 patients with obstructive jaundice admitted to the clinic for diagnosis of its cause, the ultrasound scanning with duodenoscopy was employed. This permitted to establish the cause of jaundice in 84.9% of the patients and to choose proper therapeutic tactics at the shortest time after hospitalization. In 80% of the patients, an obstacle for bile outflow was liquidated by means of endoscopy. When it was not possible to established the cause of jaundice by the findings of ultrasound scanning and duodenoscopy, percutaneous transhepatic cholangiography was performed, which has proved to be successful in 5.9% of cases. Use of the given methods for diagnosis permitted to define the optimal therapeutic tactics in patients with obstructive jaundice, to reduce the lethality.
Asunto(s)
Sistema Biliar/diagnóstico por imagen , Colestasis/diagnóstico , Duodenoscopía , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Colecistitis/complicaciones , Colecistitis/diagnóstico , Colecistitis/cirugía , Colelitiasis/complicaciones , Colelitiasis/diagnóstico , Colelitiasis/cirugía , Colestasis/etiología , Colestasis/cirugía , Femenino , Cálculos Biliares/complicaciones , Cálculos Biliares/diagnóstico , Cálculos Biliares/cirugía , Humanos , Masculino , Persona de Mediana Edad , Pancreatitis/complicaciones , Pancreatitis/diagnóstico , Pancreatitis/cirugía , Esfinterotomía Endoscópica , UltrasonografíaRESUMEN
The authors have successfully used for local treatment of purulent wounds a new preparation acelysin. In animals with the induced abscesses, under the influence of acelysin, more rapid recovery than in the control group of animals treated with hypertonic sodium chloride solution, dioxidine solution was achieved. The effectiveness of treatment was judged by duration of the course of a wound process, findings of morphologic, cytologic and bacteriologic studies. Use of acelysin solution in 24 patients with suppuration of an operative wound has confirmed its effectiveness.
Asunto(s)
Antiinfecciosos/uso terapéutico , Aspirina/análogos & derivados , Glicina , Lisina/análogos & derivados , Infección de la Herida Quirúrgica/tratamiento farmacológico , Adolescente , Adulto , Anciano , Animales , Niño , Combinación de Medicamentos , Femenino , Humanos , Inflamación/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Ratas , Infección de la Herida Quirúrgica/fisiopatología , Cicatrización de Heridas/efectos de los fármacosRESUMEN
The lethality for 2 years in two general surgical departments is analysed. In total, 7417 patients underwent 4254 operations, including 1181 (27.7%)--elective, 3073 (72.2%)--emergency ones. After elective operations, 12 (1%) patients died, after the emergency operation--189 (6.1%). There were the following causes of lethality after elective operations: different concomitant diseases present before the operation, or developed after it (0.68% of cases); diagnostic, tactical and technical errors (0.32%). Causes of lethality after emergency operations: related to age and irreversible changes in the organism (2.6% of cases); different concomitant diseases (0.8%); late referral to a physician (1.49%); diagnostic, tactical and technical errors (1.3%).