[Use of nickel-titanium alloys in plasty of the anterior abdominal wall]. / Primenenie nikelid-titanovykh splavov pri plastike perednei briushnoi stenki.

The work presents results of the surgical treatment of postoperative hernias of the abdominal wall using explants of titanium nickelide in 48 patients. Data of biopsy of the anterior abdominal wall muscles in these patients are given. The anatomo-morphological and functional incompetence is shown. A method of preparing the patients with giant hernias to operation with the help of dynamic pneumocompression is described. The indications to using the explants in hernioplasty are determined by the methods of somatometry and intraoperative dynamometry. The data of three methods of combined hernioplasty are presented: with the use of a superelastic network from a nickelide-titanium alloy; explant with tractional properties, effect of the "shape memory"; method of extracorporeal extension of the abdominal wall at the postoperative period. The nearest and long-term results followed-up during 3 years are shown.

[Treatment of complete pancreatic ruptures and their complications]. / Lechenie polnykh razryvov podzheludochnoi zhelezy i ikh oslozhnenii.

24 victims with complete ruptures of the pancreas underwent operations of the occlusion of pancreatic ducts, distally to the site of injury. There were no lethal outcomes in these cases. 16 patients were examined in follow-up period from 2 to 10 years, no signs of endocrine insufficiency were revealed in any case; moderate exocrine insufficiency was detected in 2 patients. There were no signs of chronic posttraumatic pancreatitis in any of the examined patients.

[Occlusion of pancreatic ducts in pancreonecrosis]. / Okkliuziia protokov podzheludochnoi zhelezy pri pankreonekroze.

The article deals with the results of treatment of acute experimental necrosis of the pancreas by occlusion of its duct system with Adgenol. This led to authentic reduction of the level of trypsin, amylase, and middle mass molecules and improvement of the microhemocirculation parameters. The microscopic organization in the regional lymph nodes was normalized 3 hours after occlusion of the pancreatic ducts. The ultramicroscopic anatomy of the endothelial cells of the microvessels in the lymphatic sinuses was stabilized, leading to restoration of effective transendothelial transport. The method was used in 11 patients in the clinic. A good clinical effect was produced in 10 patients. There were no fatal outcomes.

[Acute pancreatitis after gastric surgery]. / Ostryi pankreatit posle operatsii na zheludke.

After operation on the stomach in 1,602 patients (3.9% mortality) acute postoperative pancreatitis (APP) developed in 60 of them. Twenty patients died from APP. The impulsive pain symptom and diastasuria were characteristic of the clinical picture in 35 patients. According to the severity of the impulsive pain, the diastasis level in the urine, and the complex of therapeutic measures needed to arrest the developing APP, three degrees of ductal hypertension were distinguished. There were no deaths among patients with APP of the first degree. In 23 patients APP was marked by manifest intoxication from the first postoperative day and subsequent development of many complications which called for reoperations. In this group 18 patients died. In 2 cases APP was distinguished by a rapid course and fulgurant development. Attention was drawn from the very beginning to the extreme severity of the patients' condition. Symptoms of shock prevailed in the clinical picture. Both patients died. The authors suggest a scheme of APP prevention with the use of aldehydes, antioxidants, inhibitors of proteolytic enzymes, a complex of vitamins.

[The surgical treatment of malignant tumors of the head of the pancreas and of the periampullary area]. / Khirurgicheskoe lechenie zlokachestvennykh opukholei golovki podzheludochnoi zhelezy i periampuliarnoi oblasti.

Under analysis are results of pancreatoduodenal resections in 71 patients. In patients with mechanical jaundice lymph drainage with sorption and return of lymph into the vascular bed was used during the preoperative preparation. Occlusion of the duct system of the pancreas stump with glue KL-3 was performed on 62 patients, in 9 patients choledochocholecysto-anastomosis was used in order to improve the quality of the biliodigestive opening. A cryoprocedure on the nonremoved portion of the tumor was performed in 3 cases on the posterolateral surface of the portal vein. These measures allowed the postoperative lethality to be reduced up to 11.2%.

[Deep hernioplasty through preperitoneal approach]. / Glubokaia gernioplastika iz predbriushinnogo dostupa.

A total of 1,390 herniotomies for the repair of inguinal hernias were carried out in 1980-1987. In 257 operations the anterior wall of the inguinal canal was reinforced. Recurrences occurred in 11.8% of cases. In 473 patients the posterior wall of the inguinal canal was reinforced by the methods suggested by Yu. A. Nesterenko and Yu. B. Salov. Recurrences developed in 6.8% of cases. Sixty-two operations were performed through a preperitoneal access after L. Nyhus and R. Condon; recurrences occurred in 6 patients. The authors' modification of herniotomy after L. Nyhus and R. Condon was carried out in 498 cases. Recurrences were found in 1.9% of 152 examined patients. In 70 patients herniotomy was performed by other methods.

[Increasing the effectiveness of lymphosorption in patients with mechanical jaundice]. / Povyshenie éffektivnosti limfosorbtsii u bo'lnykh s mekhani- cheskoi zheltukhoi.

Drainage of the thoracic lymph duct and lymphosorption used in 120 patients with mechanical jaundice has reduced the degree of hepatic insufficiency in the preoperative period and improved results of operative interventions. This was especially appreciable in a group of patients with a benign mechanical jaundice. Elimination of toxic substances from the lymph during lymphosorption was greater when using a vibration column, sorbent impregnation by sodium caffeine+-benzoate and ethanol treatment of the lymph.

[Surgical tactics in acute cholecystitis]. / Khirurgicheskaia taktika pri ostrom kholetsistie.

More active surgical tactics is recommended in acute cholecystitis, which consists in a tendency to solve the question of an emergency operative intervention in the first 24 hours after admittance to the clinic and the performance of postponed operations on the 3rd-5th day. This leads to increase of surgical activity, decrease of the frequency of complicated forms of acute cholecystitis and total and postoperative mortality and postoperative complications, and a shorter period of hospital stay.