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1.
Khirurgiia (Mosk) ; (2): 97-103, 2024.
Article Ru | MEDLINE | ID: mdl-38344966

Gallstone disease remains an important medical and socially significant problem due to the increase in the proportion of patients of young and working age. At the same time, along with the increase in incidence, the number of complicated forms, such as choledocholithiasis in combination with stenosing duodenal papillitis (SDP) and obstructive jaundice, is increasing, which increases the importance of surgical approaches in the complex treatment of the disease and expands the range of conservative methods of therapy. In the given clinical observation of a young patient with severe cholelithiasis, accompanied by early and late complications, including the formation of postoperative scars and ventral hernias. At the last of the described stages of treatment during allohernioplasty, a complication developed in the form of a seroma followed by phlegmon of the anterior abdominal wall in the area of the implant, which served as the basis for including both local (NPWT therapy) and general (a course of infusions of a succinate-containing drug) methods in the treatment regimen, which contributed to more pronounced positive dynamics of the patient's condition.


Choledocholithiasis , Jaundice, Obstructive , Meglumine/analogs & derivatives , Humans , Succinates
2.
Khirurgiia (Mosk) ; (10): 150-154, 2023.
Article Ru | MEDLINE | ID: mdl-37916570

The incidence of intestinal fistulas after laparotomy for various reasons (peritonitis, acute pancreatitis or trauma) is 1.5%. Fistula formation in patients with chronic gastrointestinal diseases has a rapid onset, severe course, and poor prognosis. Against the background of a long course of the disease and depletion of the body, there is a decrease in the activity of reparative processes, which leads to the manifestation of postoperative complications: the formation of fistulas, insolvency of intestinal anastomoses, peritonitis. Vacuum drainage is a treatment method aimed at eliminating exudate, reducing the area of the wound and its epithelization. The inclusion of a succinate-containing solution in the treatment regimen improves metabolic processes and improves the prognosis of the disease. As an illustration, a description of the clinical observation of patients with similar pathology and different treatment regimens is given.


Intestinal Fistula , Negative-Pressure Wound Therapy , Pancreatitis , Peritonitis , Humans , Negative-Pressure Wound Therapy/adverse effects , Acute Disease , Pancreatitis/complications , Intestinal Fistula/diagnosis , Intestinal Fistula/etiology , Intestinal Fistula/surgery , Peritonitis/etiology , Succinates
3.
Khirurgiia (Mosk) ; (3): 28-32, 2023.
Article Ru | MEDLINE | ID: mdl-36800866

An example of the use of 3D-modeling of 3D-printing in the diagnosis and choice of a surgical approach for the treatment of hepaticocholedochal stricture is given. The inclusion of meglumine sodium succinate (intravenous drip, once a day, 500 ml, course of 10 days) into the therapy regimen was substantiated, which contributed to the reduction of intoxication syndrome due to its antihypoxic mechanism of action and, as a result, to a reduction in the duration of hospitalization and an increase in the quality of life of the patient.


Cholestasis , Quality of Life , Humans , Constriction, Pathologic , Printing, Three-Dimensional , Common Bile Duct
4.
Khirurgiia (Mosk) ; (6): 76-81, 2020.
Article Ru | MEDLINE | ID: mdl-32573536

OBJECTIVE: To evaluate the effectiveness of preparing a wound for plastic closure of autoskin using a negative pressure apparatus and Reamberin. MATERIAL AND METHODS: . The results of preoperative preparation of 24 patients with chronic wounds of various etiologies were analyzed. Depending on the treatment regimen, the patients were divided into groups: the main one (n=18), the patients of which were divided into subgroups: in IA (n=9) they used NPWT therapy for 5 days, in IB (n=9) it was combined with Reamberin infusions (1.5% intravenously at a rate of 40-60 drops/min, 500 ml, once a day for 5 days). Patients of the comparison group (II, n=6) received standard preparation. In the dynamics of therapy, a morpho-histological study of wound biopsies was carried out with the determination of the area of fibroblasts, the area of the nucleus of fibroblasts, the number of vessels and the determination of their diameter. After autodermoplasty, the survival of the skin flap was determined. RESULTS: It was found that the combined use of NPWT therapy and Reamberin significantly increases the effectiveness of therapy: the greatest effect on fibroblastogenesis was exerted by the inclusion of NPWT therapy in the regimen - an increase of 1.5 times compared with the results of the traditional regimen. The vascularization of the wound surface (increase in the area and diameter of blood vessels) was best influenced by the combined preparation (NPWT-therapy and Reamberin) preparations - an increase of 3.4 times in comparison with the comparison group, which affected the dynamics of the survival of the skin flap: it was 1.3 times higher than in the comparison group (p<0.01). CONCLUSIONS: The results obtained, along with good tolerability of the drug, allows us to recommend the inclusion of Reamberin in the scheme of preoperative preparation of patients with this pathology.


Antioxidants/administration & dosage , Meglumine/analogs & derivatives , Negative-Pressure Wound Therapy , Skin Transplantation , Succinates/administration & dosage , Wounds and Injuries/drug therapy , Wounds and Injuries/surgery , Chronic Disease , Humans , Infusions, Intravenous , Meglumine/administration & dosage , Preoperative Care , Transplantation, Autologous , Wound Healing , Wounds and Injuries/etiology , Wounds and Injuries/therapy
5.
Khirurgiia (Mosk) ; (8): 91-94, 2019.
Article Ru | MEDLINE | ID: mdl-31464282

A successful administration of NPWT-therapy combined with Reamberin infusion for gastroenterostomy failure after stomach resection is reported in the article. It was noted that antioxidant/antihypoxic drug Reamberin combined with NPWT-therapy has a positive metabolic effect and results more active and rapid healing of the wounds. The absence of adverse effects of the drug allows us to recommend its inclusion into complex treatment of patients with this pathology.


Antioxidants/therapeutic use , Gastrectomy/methods , Gastroenterostomy/adverse effects , Gastrointestinal Agents/therapeutic use , Meglumine/analogs & derivatives , Negative-Pressure Wound Therapy , Stomach/surgery , Succinates/therapeutic use , Gastrectomy/adverse effects , Humans , Meglumine/therapeutic use , Wound Healing/drug effects
6.
Khirurgiia (Mosk) ; (1): 101-104, 2019.
Article Ru | MEDLINE | ID: mdl-30789617

A clinical case of successful combined use of NPWT-therapy and Reamberin infusion in the treatment of a non-healing (over 5 months) trophic ulcer of the lower limb in an elderly patient is presented. It was manifested that introduction of antioxidant/antihypoxant drug reamberin on the background of NPWT-therapy in patient with slow healing wounds has a positive effect on metabolic processes, resulting in more active and rapid cleansing of wound surface from opportunistic microflora by the 5th day of therapy. Absence of adverse effects to drug application allows to recommend its inclusion in the complex treatment scheme in patients with this pathology.


Antioxidants/administration & dosage , Leg Ulcer/therapy , Meglumine/analogs & derivatives , Negative-Pressure Wound Therapy , Succinates/administration & dosage , Aged , Combined Modality Therapy , Humans , Infusions, Intravenous , Leg Ulcer/microbiology , Leg Ulcer/physiopathology , Meglumine/administration & dosage , Opportunistic Infections/microbiology , Opportunistic Infections/physiopathology , Opportunistic Infections/therapy
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