[The indices dynamics of platelet pool and the level of TGF-beta1 in different forms of acute pancreatitis].

The results of study of quantitative functional characteristics of platelets are shown in patients with acute pancreatitis. The patients (57 people) with acute pancreatitis were examined: 40 patients had a mild clinical course of acute pancreatitis and 40 patients had a severe clinical course of acute pancreatitis. The circular functional mass of platelets and the level of TGF-beta1 were determined in dynamics in patients with acute destructive pancreatitis. A correlated analysis was made among the results obtained by means of laboratory and instrumental examinations and clinical course of acute pancreatitis. It was found, that the increase of TGF-beta1 and circular functional mass of platelets in the course of several days was really a good prognostic factor of clinical course of acute pancreatitis. The data obtained showed that the changes of indices of quantitative and functional characteristics of platelets are the important pathogenetic criterion of prognosis for severity of clinical course of acute pancreatitis.

[Decision on the strategy of treatment of acute cholecystitis in high operative risk patients].

Based on their personal experience with treatment of 118 patients the authors consider that sanitation-decompression percutaneous-transhepatic punctures of the gallbladder under US control can be used for arresting the inflammation process. The integral scales SAPS-II and POSSUM allow identification of groups of patients with high operative risk. The strategy of treatment depends on both the state of the patient and results of USI. The detection of an obturating concrement in the gallbladder neck requires punctures for decompression of the gallbladder and attempts to reestablish normal bile passage in addition to conservative therapy at early terms.

[Direct results of endovideosurgical transabdominal adrenalectomy]. / Neposredstvennye rezul'taty énovideokhirurgicheskoi transabdominal'noi adrenaléktomii.

Results of transabdominal adrenalectomy performed in 29 patients with different tumors of the adrenals were estimated. The lower traumaticity of the access due to using a new technology as well as taking prophylactic measures for lower aggressive influence of the pneumoperitoneum allowed performing combined operative interventions in 30% of cases and avoiding serious intra- and postoperative complications.

[The comparative hemodynamic characteristics in the lower extremities during laparoscopic and traditional interventions on the abdominal cavity organs]. / Sravnitel'naia kharakteristika gemodinamiki v nizhnikh konechnostiakh pri laparoskopicheskikh i traditsionnykh vmeshatel'stvakh na organakh briushnoi polosti.

The plethysmographic methods were used for studying the influence of pneumoperitoneum in hemodynamics in lower extremities. It was proved to cause venous stasis in them and constriction of precapillaries in the venous area predominantly. The degree of such influence depends on the strain of the pneumoperitoneum and its duration. This factor should be taken into consideration for prophylaxis of postoperative complications.

[Use of laparoscopic methods in combined surgery]. / Ispol'zovanie laparoskopicheskikh metodov pri sochetannykh operatsiiakh.

The authors have made a comparative analysis of the effectiveness of isolated and combined laparoscopic cholecystectomies. The control group consisted of 246 patients subjected to isolated cholecystectomies. The group under study included 22 patients in whom combined cholecystectomies were performed. The comparative analysis included the following clinical data: duration of the operation, number of postoperative days in the hospital, amount of postoperative complications. It was concluded that the little-invasive laparoscopic technique used in one of the steps of the combined operation allowed traumatism of the surgery to be decreased which in its turn allowed wider indications to combined operations.

[Endolymphatic therapy and current detoxication methods in the treatment of peritonitis]. / Endolimfaticheskaia terapiia i sovremennye metody detoksikatsii v lechenii peritonita.

An original method of endolymphatic therapy with the stimulation of the lymph outflow was developed and used in 108 patients with peritonitis. The dynamics of intoxication parameters was studied during the endolymphatic therapy, indirect electrochemical oxidation of blood, photochemotherapy and traditional treatment. The method proposed has been found to be most efficient. The method of endolymphatic therapy with the lymph stimulation allowed lethality from peritonitis to be decreased to 7.4%.

[Methods for estimating the severity of the status of resuscitated surgical patients]. / O sposobakh otsenki tiazhesti sostoianiia reanimatsionnykh bol'nykh khirurgicheskogo profilia.

The skin electric resistance in the representative points was measured by the Nakatani technique in 86 surgical patients during resuscitation. Two most informative indices were established: the average electric resistance of the skin and the renal index. A significant correlation (r = 0.78) was obtained between the average electric resistance of the skin and score sum SAPS. Changes of the renal index allow the dynamics of the patient's state to be estimated, and along with the electric resistance of the skin--the degree of traumatic consequences of the operative intervention. The method is simple and not dangerous for the patients.