[Open and laparoscopic surgery via minimally invasive approach in the treatment of perforated ulcer: a systematic review and metaanalysis]. / Laparotomnye i laparoskopicheski assistirovannye operatsii iz minidostupa v lechenii probodnoi yazvy. Sistematicheskii obzor i metaanaliz.

OBJECTIVE: Systematic review and metaanalysis of the effectiveness of open and minimally invasive laparoscopic suturing of perforated peptic ulcer. MATERIAL AND METHODS: Searching for Russian and English language reports included Scientific Electronic Library, Cochrane Collaboration Library and PubMed databases. We have analyzed contents of specialized journals, reviews and their references. Unpublished data were obtained via communication with chiefs of national surgical hospitals. RevMan 5.3 software was used for metaanalysis. RESULTS: We found no international randomized trials in available literature. Metaanalysis was based on national non-randomized studies. Total sample was 1177 cases. Laparoscopic minimally invasive surgery was performed in 43% of cases (n=503), open suturing - in 57% (n=674) of patients. Choice of these procedures is not currently not standardized. Minimally invasive procedures are shorter in time (mean difference -8.02, 95% CI -11.26 - -4.77, p<0.00001) and ensure less hospital-stay (mean difference -1.93, 95% CI -2.97 - -0.88, p=0.0003). Complications were less common (OR 0.14, 95% CI 0.07-0.27, p<0.00001) after minimally invasive operations (2.4%, 12/503) compared to laparotomy (11.4%, 77/674). Incidence of suture failure was similar (OR 0.4, 95% CI 0.1-1.6, p=0.2) (0.4% (2/503) vs. 0.7% (5/674)). Postoperative mortality was higher (OR 0.14, 95% CI 0.05-0.37, p<0.0001) after laparotomy (8%, 54/674) compared to laparoscopy (0.8%, 4/503). CONCLUSION: A metaanalysis indicates the advantage of laparoscopy-assisted suturing of perforated ulcer via minimally invasive approach over laparotomy. The absence of a standardized approach in choosing of minimally invasive laparotomy and conventional approach is a limitation of these results.

[Plasmapheresis in combined treatment of patients with acute intestinal obstruction]. / Plazmaferez v kompleksnom lechenii ostroi kishechnoi neprokhodimosti.

Comparative analysis of the results of treatment of patients with acute intestinal obstruction was carried out. Plasmapheresis was used in postoperative period in 38 patients. 32 operated patients were treated with conventional methods of detoxication. It was established that after the earliest performance of plasmapheresis in postoperative period, manifestations of toxemia revived more rapidly and significantly and intestinal motility restored more rapidly.

[Role of endoscopy in diagnosing rare sources of small intestinal bleedings due to vascular disorders]. / Znachenie éndoskopii v diagnostike redkikh istochnikov tonkokishechnykh krovotechenii, obuslovlennykh sosudistymi porazheniiami.

The authors describe two cases of intraoperative endoscopic diagnosis of hemangioma and vasculitis of the small intestine. The examination was conducted during laparotomy by colonoileoscopy and enterotomy. The authors believe this method to be most effective in emergency surgery when the operation cannot be postponed because of the patient's severe condition caused by hemorrhagic shock.

[Criteria for determining the degree of body intoxication in patients with acute intestinal obstruction]. / Kriterii opredeleniia stepeni intoksikatsii organizma u bol'nykh s ostroi neprokhodimost'iu kishechnika.

The analysis of their own observations, criteria of determination of organism intoxication degree, methods of an acute ileus treatment are adduced. The effectiveness of an active organism detoxication method plasmapheresis was noted.

[Plasmapheresis in the combined treatment of patients with obstructive jaundice]. / Plazmaferez v kompleksnom lechenii bol'nykh s obturatsionnoi zheltukhoi.

An experience with treatment of 129 patients has shown that plasmapheresis can be effectively used for detoxication. The method of plasmapheresis and dynamics of changes in clinical and biochemical indicators are described.

[The use of enteral tube feeding in patients with gastric and duodenal peptic ulcer]. / Primenenie énteral'nogo zondovogo pitaniia u bol'nykh s iazvennoi bolezn'iu zheludka i dvenadtsatiperstnoi kishki.

The authors used enteral tube feeding with a multicomponent balanced mixture "Ovolakt" in complex treatment of gastric and duodenal ulcer in 69 patients among which 42 had complicated forms (stenosis, penetration, bleeding) and 27 had no complications. In establishing the diagnosis laboratory tests and radiological and endoscopic examination were conducted. The gastric secretory function was studied by intragastric pH-metry and pH-chromoscopy conducted during enteral feeding and in dynamics after it was ended. In most cases of cicatrization of the gastric and duodenal defects, hypo- and hyperchlorhydria respectively, persisted. Among 42 patients with complicated course of peptic disease, 21 were treated by operation and 19 received nonoperative treatment. The postulcer cicatrix formed 2-3 weeks after enteral feeding was ended in 27 cases of uncomplicated peptic ulcer and in 19 patients with complicated ulcers who were given nonoperative treatment. Complications after operative treatment were not encountered. Patients not treated by operation spent 20-30 days in the hospital.

[Experience in using preserved xenogeneic hepatocytes in the combined treatment of jaundice patients]. / Opyt primeneniia konservirovannykh ksenogepatotsitov v kompleksnom lechenii bol'nykh zheltukhami.

The authors give brief characteristics of the apparatus "subsidiary liver" and describe the mechanism of its work. The method of taking the liver of piglets and isolation of hepatocytes are described. The characteristics of patients are given in who the apparatus "subsidiary liver" was used. Certain parameters of blood were shown to be reduced after using the apparatus "subsidiary liver".

[The use of gravitational plasmapheresis in hepatology]. / Primenenie gravitatsionnogo plazmafereza v gepatologii.

The experience with the use of gravitation plasmapheresis in treatment of patients with jaundice of different genesis is summarized. A technique for performance of plasmapheresis in patients with parenchymatous and obstructive jaundice, number of the manipulations performed, volume of plasma removed, dynamics of normalization of the biochemical indices of the blood of the patients are presented.

[Plasmapheresis with extracorporeal membrane oxygenation of the blood in the treatment of peritonitis]. / Plazmaferez s ékstrakorpora'lnoi membrannoi oksigenatsiei krovi v lechenii peritonita.

Plasmapheresis with extracorporeal low-flow membrane oxygenation of the blood was used in 18 patients with peritonitis. The superiority of plasmapheresis over the other methods of extracorporeal organism detoxication is shown.