[Multidisciplinary approach to surgical treatment of patients with superficial abdominal obesity]. / Mul'tidistsiplinarnyi podkhod k khirurgicheskomu lecheniyu patsientov s poverkhnostnym abdominal'nym ozhireniem.

OBJECTIVE: To analyze an effectiveness of laparoscopic surgery with simultaneous abdominoplasty in patients with superficial abdominal obesity. MATERIAL AND METHODS: Laparoscopic abdominal, retroperitoneal and pelvic surgery with simultaneous abdominoplasty was performed in 25 patients with body mass index >40 kg/m2. RESULTS: Surgery time and intraoperative blood loss were significantly higher after simultaneous surgery (p<0.05). However, these differences did not influence postoperative period. Duration of analgesic therapy, activation of patients and length of hospital-stay, as well as overall postoperative morbidity were similar in both groups (p>0.05). Simultaneous abdominoplasty resulted significantly better quality of life according to almost all parameters (p<0.05). CONCLUSION: According to certain indications, abdominoplasty is advisable as the first stage of simultaneous surgery in patients with large subcutaneous fat apron after bariatric surgery or in those with primary superficial abdominal obesity. The positive aspects of abdominoplasty are simplification of laparoscopic stage, reduced intra-abdominal pressure in postoperative period, excellent and good aesthetic effect and improved quality of life.

[Complex use of ultrasound tomography in the algorithm of diagnostics for patients with acute destructive pancreatitis].

The article describes the experience of puncture aspiration biopsy in 136 patients (110 males and 26 females at the age of 19-74) with suspected destructive pancreatitis in one-day inpatient conditions, followed by microscopic and microbiological tests. In order to increase the diagnostic accuracy when detecting necrotic zones, 49 patients were examined by ultrasonic tomography using the color Doppler mapping and the method of energetic Doppler with subsequent spot puncture. The results of microbiological and cytological tests of the smear materials taken by fine-needle aspiration under ultrasonic control enable the authors to use the most efficient antibacterial therapy as well as to support the strategy of surgical treatment of destructive pancreatitis in its various forms in the conditions when clinical differential diagnosis is complicated. These methods increase the efficacy of medical treatment for this category of patients.