[Postoperative complications after inguinal PHS hernioplasty using PHS and lichtenstein hernioplasty].

Immediate and delayed results of inguinal hernioplasty with the use of PHS and Lichtenstein hernioplasty in 228 patients are reported. It is concluded that inguinal hernioplasty with PHS and Lichtenstein hernioplasty do not significantly different in terms of the frequency of postoperative complications and relapses. Seroma occurred less frequently after PHS hernioplasty (a = 0.022). Although the frequency of a chronic postoperative pain was lower after PHS hernioplasty its severity was not significantly different in the two groups.

[Effectiveness of duspatalin therapy in the treatment and prevention of post-cholecystectomy syndrome].

Results of evaluation of the efficiency of myotropic spasmolytic Duspatalin during long-term therapy and preventive treatment of functional post-cholecystectomy syndrome are presented. The influence of the treatment on manifestations of clinical symptoms, quality of a life estimated based on a visual-analog scale, and intestinal microbiocenosis (changes in the activity of short-chain fatty acids) are discussed.

[Open alloplasty of postoperative ventral hernias].

Early and long-term results of the open ventral postoperative hernia alloplasty in 118 patients have been analyzed. The onlay and sublay techniques of the hernioplasty have been employed. The frequency of complications, local status and quality of life were studied a year after the operation. The overall postoperative morbidity and recurrence rates were reliably less after the sublay mesh implantation. The method has also provided better quality of life and local status characteristics.

[The role of biliary decompression and correction of dysbiosis in the treatment of obstructive jaundice].

The article providing in-depth analysis of pathogenesis of obstructive jaundice shows that this disease is manifest not only as changes at the hepatic level (cholestasis, cholehemia, cholangitis, cholangio- and lymphovenous shunts, hepatic encephalopathy) but also as marked dysbiotic disturbances due to anacholia and toxic metabolites that cause bacterial translocation and endotoxemia complicating liver insufficiency. Based on the literary data and original observations, a new scheme for the treatment of obstructive jaundice is proposed including simultaneous correction of both components of hepatoenteric turnover, also, it permits to improve the outcome of the postoperative period.

[Efficiency of combined endoscopic hemostasis in patients with peptic ulcer complicated by hemorrhage].

Results of endoscopic application of collagenous preparation thrombocol to the ulcer are presented. It is maintained that combined treatment of patients with peptic ulcer complicated by hemorrhage including endoscopic hemostasis (EH) and eradication therapy improves its outcome. Specifically, combined EH (adrenalin injection and subsequent application of thrombocol to the ulcer) reduces the frequency of recurrent hemorrhage and the need in urgent surgical intervention in patients with active hemorrhage (F Ia, Ib). Preventive EH with thrombocol in patients with active hemorrhage and high probability of its relapse (F IIa, IIb) reduces the frequency of recurrent hemorrhage and the necessity of emergency surgical treatment. In patients with active hemorrhage (F IIa, IIb, IIc) thrombocol promotes healing of the ulcer and decreases duration of hospitalization.

[Endovenous laser photocoagulation for the treatment of varicose vein disease of the lower extremities].

Varicose vein disease of the lower extremities is a challenging socio-medical problem because it is responsible for high disability rate and requires substantial expenditures. According to different authors, the disease occurs in 10.4-23.0% of men and 29.5-39.0% of women. Numerous methods for its treatment have been proposed, each having advantages and drawbacks. The main criteria for the efficiency of treatment are the injury rate, aesthetic outcome, and frequency of relapses. These criteria can be met if new methods are developed allowing for good cosmetic results without detriment to clinical efficiency of radical operation. This paper presents results of analysis of original and published data on the practical application of endovenous laser photocoagulation for the treatment of varicose vein disease A total of 74 patients (79 legs) were operated by this method between 2006 and 2008. Ecchymosis occurred in 85.1% of the patients, induration in 18.9%, skin hyperpygmentation in 24.3%, paresthesia in 14.8%, greater saphenous vein thrombophlebitis and thigh hematoma in 2.7%, skin burn in 1.3%. Complete occlusion was achieved in all patients. No relapses were documented during a 18 month follow-up period. Quality of life (SF-36 questionnaire) improved on weeks and 12 after surgery. It decreased week after surgery (AVVQ) but improved thereafter. A similar trend was observed when quality of life was evaluated (VCSS) on week 12 postoperatively. It is concluded that endovenous laser photocoagulation is an efficacious method for the treatment of varicose vein disease but further randomized studies are needed to better assess its reliability and safety.

[Endoscopic subfascial dissection of perforating veins of lower legs in patients with venous ulcers].

Prospective analysis of the results of endoscopic subfascial dissection of perforating veins of lower legs in 68 patients with venous ulcers is presented. Four patients developed postoperative wound infection. Mean duration of hospitalization was 4.5 days. The patients were able to resume routine daily activity within 8 days after surgery. Mean length of ulcer healing was 7.0 months. Complete healing required 3 months in 22.1% of the patients, 6 months in 38.2%, 9 months in 66.2%, and 1 year in 97.1%. Ulcers recurred in 2 patients. Mean clinical and disability scores 8 months after surgery were on an average very low. It is concluded that subfascial dissection of perforating veins of lower legs in patients with venous ulcers improves clinical symptoms, promotes healing of ulcers, produces minimal postoperative complications, and plays an important role in correction of concomitant pathology.

[Helicobacter pylori in patients with bleeding ulcer].

The diagnostic sensitivity of the polymerase chain reaction (PCR) and urease respiratory test (URT) in H. pylori infection are compared. The efficacy of H. pylori eradication in patients with a bleeding peptic ulcer using three-component scheme (De-nol, Clarythromycin, Furazolidon) and a complex medication Pylobact is also compared. Thus, URT, performed within 24 hours after the admission is more effective in patients with bleeding ulcer, then PCR. H. pylori eradication is more successful with Pylobact (93,8%) and has less side-effects in such patients, then the used three-component eradication scheme.

[Rhythmic pneumocompression for treatment of patients with chronic obliterating diseases of the lower-limb arteries].

A total of 68 patients suffering from chronic obliterating diseases of the lower-limb arteries (CODLLA) under-went treatment with rhythmic pneumocompression (RPC) in the descending <> mode with a simultaneous relief of pressure in the sections of the cuffs. The values of the pneumatic action exceeded the APS determined on the shoulder by 10-20 mm Hg. The therapeutic course consisted of 10-15 sessions. Clinical improvement commenced to be observed as soon as after the first session of RPC: the patients were found to have decreased pain, and increased distance of pain-free walking. Based upon the parameters of the dynamics of the cutaneous temperature on the feet, transcutaneous determination of pO2, dynamic pulse oximetry, acid-base balance, and the indices of the blood gaseous composition, the authors have hereby arrived at the conclusion that the therapeutic impact of the RPC in the mode of the descending <> with the values of the pneumatic impact exceeding the APS was related to the opening of the capillary bed and stimulation of the metabolic processes. The method may therefore be safely recommended to be used in patients presenting with CODLLA, especially in the presence of distal lesions to the arteries of the lower extremities, as a preoperative preparation of the vascular bed.

[Prevention of lithogenesis in cholecystitis]. / Profilaktika kamneobrazovaniia pri kholetsistite.

To treat and prevent cholelithiasis is one of the pressing problems facing modern medicine. A Vega MPT-705 apparatus was used to treat 52 patients with different forms of cholecystitis. Matrix regenerating therapy that had effects at cellular and subcellular levels was found to arrest an acute inflammation in the gallbladder wall, to normalize the physicochemical parameters of bile. It was concluded that the Vega MPT-705 apparatus could treat acute cholecystitis and hence prevent cholelithiasis.

[Diagnosis and treatment of Helicobacter infections in patients with stomach ulcer associated with hemorrhage]. / Diagnostika i lechenie khelikobakterial'noi infektsii u bol'nykh iazvennoi bolezn'iu, oslozhnennoi krovotecheniem.

Diagnosis and treatment of stomach ulcer associated with helicoid-bacterial infection and with hemorrhage are discussed in the paper. The many-year observations show that the risk of relapsing hemorrhage is high in patients with the above diagnosis. Eradication of the causative agent by using the modern therapeutic schemes cuts significantly the rate of such relapses. The most effective method of monitoring the infection and eradication results is suggested, i.e. urease test combined with microbiological diagnosis involving the method of polymerase chain reaction.

[An analysis of the strain homogeneity of parietal biotopes of the gastrointestinal tract]. / Analiz shtammovoi obshchnosti pristenochnykh biotopov zheludochno-kishechnogo trakta.

The lumen and parietal biotopes of the human gastrointestinal tract were investigated, i.e. the antibiotic sensitivity of strains E. coli and Enterococcus faecalis residing in them were comparatively analyzed. Certain isolation degrees not only of the parietal and fecal biotopes but also of certain micro-regions in the intestine wall were detected. The obtained data confirm a previously made assumption on the cluster distribution of microorganisms in the parietal mucin. The distinct strain differences between the parietal and fecal biotopes are not enough to completely extrapolate the available characteristics of the lumen microflora on the parietal microbiocenose. The above stated underlines the necessity in purpose-oriented research of parietal microbe populations of "internal" biotopes.

[Prevention of breast cancer]. / Profilaktika raka molochnoi zhelezy.

Analysis of 60 Russian and foreign publications demonstrated that the incidence of breast cancer and socio-biological characteristics of this disease necessitate improvement of methods for its prevention and treatment. Factors significantly increasing the probability of breast cancer are analyzed. Risk groups in need of thorough prophylactic examinations and treatment can be formed on the basis of these data. Some dyshormonal hyperplasias are considered as precancer. Active prophylactic measures, including surgery, are recommended for patients with such forms of mastopathy. There is a group of patients with 100% risk of breast cancer. Cancer can be prevented in them by prophylactic interventions, from resection of the mammary gland to subcutaneous mastectomy with plasty. Such strategy will have a positive impact on the incidence of breast cancer and the results of its treatment.

[Descending rhythmic pneumocompression as a medical treatment of atherosclerosis obliterans]. / Niskhodiashchaia ritmicheskaia pnevmokompressiia kak novyi metod konservativnogo lecheniia obliteriruiushchego ateroskleroza arterii nizhnikh konechnostei.

About 2 percent of the population of the world suffers from atherosclerotic lesion of the lower extremity arteries. However, the treatment of this pathology is an unsolved problem so far. The authors used a method of rhythmic pneumocompression for medical treatment of patients with chronic arterial insufficiency due to lower extremity vascular atherosclerosis obliterans. A total of 56 patients with stages II-III atherosclerotic lesion were examined. The findings indicated that the method noticeably reduced the intensity of the pain syndrome and tissue ischemia. The procedure exerted a reflex action on the cardiovascular system: the patients had slower heart rate and lowered blood pressure.

[A study of the human parietal gastrointestinal tract microflora in health and disease]. / Issledovanie pristenochnoi mikroflory zheludochno-kishechnogo trakta u cheloveka v norme i pri patologii.

An original technique was used to investigate the human colon mucin in different pathologies of gastrointestinal tract. The microbial pattern of the biotope in question was found to be dependable on a morphological-and-functional condition of the intestinal wall. It is noteworthy, that not only its quantitative and qualitative composition but also the nature of the inter-microbe relations and the "specific content" of microbes are subject to changes. A correlation was established between the studied characteristics of the human parietal gastrointestinal biotope and the biochemical blood parameters. The results revealed a new chain in the pathogenesis of disbiotic processes occurring in the colon mucous tunic. The diagnostic value of microbiological parameters of the human colon mucous tunic is under discussion.

[The parietal mucin microbial population in different sections of the human gastrointestinal tract]. / Mikrobnye soobshchestvo pristenochnogo mutsina razlichnykh otdelov zheludochno-kishechnogo trakta cheloveka.

Microbiological examinations of the human-colon parietal mucin were made in different sections of the human gastrointestinal tract (GIT). Biopsy samples of the human colon mucus tunic were used as the research material. Convincing data were found by research on the importance of the anatomic-and-morphological factor in shaping-up of microbiocenosis of the colon-wall parietal mucin. It was established that, depending on a GIT section, not only the quantitative and qualitative composition of normal microflora but also the nature of inter-microbe interactions are subject to changes. In particular, biopsy materials of the small-intestine parietal mucin are much different from that of the colon. The colon section from the ascending colon to the sigmoid colon has, with some exceptions, an identical microbial composition. At the same time, the rectum is significantly different from other colon sections. The results are suggestive of the below cluster-type pattern of parietal biological material: microorganisms are clustered as small domains with certain specific and quantitative compositions. It was established that, although feces and parietal mucin have a similar species composition of microorganisms, still, there is a number of essential differences between them in as far as the frequency ratio and the microorganism concentration are concerned, which signifies a certain degree of isolation of the above biopsy materials. Finally, a certain isolation degree of the feces biopsy materials and of the parietal ones was established.

[Parital microflora of human intestine]. / Issledovanie pristenochnoi mikroflory kishechnika cheloveka.

The modified method of the microbiological study of parietal mucin has been developed. The proposed method makes it possible to evaluate the parietal microflora of the intestine. The advantages of using physiological saline and Hanks' solution as medium ensuring the storage and self-thinning of mucin have been proved. The optimum time of making the microbiological study of intestinal mucin has also been determined.

[Prolonged normovolemic hemodilution in therapy of patients with obliterating endarteritis of lower limb vessels]. / Prolongirovannaia normovolemicheskaia gemodiliutsiia v terapii bol'nykh s obliteriruiushchim endarteriitom sosudov nizhnikh konechnostei.

The response to prolonged normovolemic hemodilution in 101 patients with obliterating endarteritis of the legs manifested as pain relief in 84.2%, complete or partial healing of trophic ulcers in 82.9 and 17% of cases, respectively, remission from stage III to stage II, from stage II to stage I in 47% and 37.3% of patients, respectively. There was also less frequent occurrence of postoperative specific and nonspecific complications, of high-traumatic amputations.

[Surgical treatment of varicose veins of the lower extremities in a polyclinic]. / Operativnoe lechenie varikoznogo rasshireniia ven nizhnikh konechnostei v poliklinike.

The authors discuss the results of 40 operations carried out in the outpatient clinic for varicosity of the lower limb veins. The number of complications did not exceed that in operations performed in the inpatient clinic. The home conditions, the absence of a possible intrahospital infection, and the increased motor activity help in rapid rehabilitation of the patients. The period of working disability is significantly reduced.

[Pre- and postoperative treatment of trophic ulcers in a controlled germ-free environment]. / Pred- i posleoperatsionnoe lechenie troficheskikh iazv v usloviiakh upravliaemoi abakterial'noi sredy.

Pre- and postoperative treatment was conducted in 140 patients with trophic ulcers in a controlled abacterial medium in the period from 1985 to 1988. The etiological factor of the development of the trophic ulcer was primary varicosity in 86 (61.4%) and the post-thrombophlebitic syndrome in 54 (38.5%) patients. Venous hemodynamics improved both on the healthy and on the affected extremity. Besides, there was a tendency towards a decrease of the blood proteolytic activity near the focus of affection and an increase of that in the peripheral blood.