[One-row continuous suture in abdominal surgery]. / Odnoriadnyi nepreryvnyi shov v abdominal'noi khirurgii.

One-row continuous suture (OCS) was used in 3605 patients while placing anastomoses in different parts of the digestive tract, extrahepatic bile ducts and pancreas as well as suturing after gastrostomy and choledochotomy. Two techniques of OCS were used. In 526 patients OCS was used for biliary tract surgery with complications rate 1.3%. In surgery of the stomach and small intestine OCS was used in 2606 patients; the insufficiency rate of stomach and small intestine anastomoses was equal (0.04%). In surgery of colon and rectum OCS was used in 405 patients; insufficiency rate was 1.5%. In surgery of the pancreas this suture was used in 70 patients without complications after surgery. Analysis of the data shows high reliability of OCS for anastomoses in abdominal surgery and allows to recommend its wider use in clinical practice.

[The arteriolymphatic administration of antibiotics in treating patients with suppurative-inflammatory diseases of the abdominal cavity organs]. / Arteriolimfaticheskoe vvedenie antibiotikov pri lechenii bol'nykh s gnoino-vospalitel'nymi zabolevaniiami organov briushnoi polosti.

Experimental study of pharmacokinetics of Gentamicin was carried out in 23 dogs. Three different modes of its intralymphatic administration were used: intranodular inguinal, lymphotropic retroperineal and arterio-lymphatic. It has been established, that arterio-lymphatic mode of introduction of antibiotics (as well as regional endolymphatic and lymphotropic) warrants high concentration of antibiotics in venous blood and lymph. The peculiarity of arteriolymphatic administration is regional effect of accumulation of the antibiotic in organs and tissues of abdominal cavity of corresponding arterial region. Arteriolymphatic infusions of antibiotics have been introduced into complex of drug treatment of patients with pyogenic and inflammatory disorders of abdominal organs. The clinical testing has revealed high curative effect of this made of antibiotics administration.

[Determination of antioxidative potential of biological fluids by using semiconductor chemical sensors]. / Opredelenie antioksidatnogo potentsiala biologicheskikh zhidkostei s pomoshch'iu poluprovodnikovykh khimicheskikh sensorov.

A procedure has been developed for determining the concentrations of superoxide anion radical (SOAR) in aprotonic fluids by using semiconductor chemical sensors. SOAR life in pure solutions is 6.3 hours. Supplements of biological fluids (blood, urine, plasma) increase the rate of SOAR death. There is a great difference in the reaction rate of SOAR with biological fluids in apparently healthy and ill individuals. It is suggested that the above procedure opens vistas both for studies of vital activity and for diagnosis of abnormalities.

[Ultrasound findings in the zone of cholecystectomy and their role in prognosis of paralytic ileus development]. / Rezultaty ultrazvukovogo issledovaniia zony kholetsistéktomii i ikh rol v prognozirovanii razvitiia dinamicheskoi kishechnoi neprokhodimosti.

A comparative analysis of 112 patients' case histories with calculous cholecystitis has revealed that morphological alterations of the gallbladder wall and in the perevesicular area as well as the operative techniques are essential for the wound healing and ultrasound picture in cholecystectomy zone. Ultrasound investigation within postoperative 24 hours enables a significant prognosis of the onset of intestinal paresis, its severity and duration. This is important for conducting early prophylactic measures.

[Combined treatment of generalized acute peritonitis]. / Kompleznoe lechenie ostrogo razlitogo peritonita.

The results of examination and treatment of 166 patients were studied. The patients were divided into 3 groups: in the 1st (80 patients) acute generalized peritonitis was treated according to the conventional surgical canons, in the 2nd (54 patients) interchangeable plasmapheresis was added to the conventional treatment, in the 3d (32 patients) the whole complex of treatment was used--the routine method together with extracorporeal detoxication and staged sanatations of the abdominal cavity. Including plasmapheresis and staged sanatations in complex of treatment of acute generalized peritonitis intensifies the effect of treatment. The intervals between the staged sanatations and sessions of plasmapheresis depend on the stage and course of peritonitis. In the conventional method of treatment of acute generalized peritonitis according to the authors' observations the mortality rate made up 39%, when plasmapheresis was included it lowered to 30%, and when combined treatment was used mortality rate dropped to 22%. The data of this study demonstrates the potential and efficacy of combined treatment of acute generalized peritonitis with the use of interchangeable plasmapheresis and staged sanatations of the abdominal cavity.

[An experimental model of acute purulent peritonitis]. / Eksperimental'naia model' ostrogo gnoinogo peritonita.

There are important shortcomings in all the existing models of acute peritonitis. The original model, most close to clinical conditions, has been proposed. The grey rabbits of 1.5-2.0 kg were used in experimental trials. The 5 cm laparotomy has been performed in all the rabbits under thiopental anesthesia. In rabbits of the control group the wound was closed without any manipulations in abdominal cavity. In the other animals the terminal part of the small intestine (15-18 cm) was isolated with two intestinal forceps and saline solution was injected inside. The intestine content was aspirated and mixed with the rabbits blood. The punctate without blood was injected in rabbits of the 2d group; in the 3d group-the mixture of punctate and blood (5 ml of blood per kg of body weight); 10 ml per kg were injected in rabbits of the 4th group; 15 ml per body weight-in the 5th group. In rabbits of the 1st, 2d and 3d groups there were no signs of peritonitis 7 days after the injection. In animals of the 4th and 5th groups clinical, morphological and bacteriological sings of acute peritonitis were detected. The severity of its course depended on the amount of blood in the mixture that was used for irritation of peritoneum. All animals of the 5th group died by the end of the 4th day. Thus, the use of 10 ml of autopunctuate of terminal part of small intestine in combination with the animals blood (10 ml per kg), is the most proper model of peritonitis, that is most close to clinical situations and enables to study its phases and test various methods of treatment.

[Method of pancreatoduodenal resection and intraoperative prevention of acute pancreatitis]. / Tekhnika pankreatoduodenal'noi rezektsii i intraoperatsionnoi profilaktiki ostrogo pankreatita.

In the period from 1988 to 1991 the authors carried out 27 pancreatoduodenal resections with 11.1% mortality. From analysis of the results they formulated the main technical principles of this operation and suggested a complex of intraoperative measures for prevention of acute postoperative pancreatitis. The complex included application of a 5-fluorouracil-containing covering of the pancreas at the stage of exposure of the complex which will be removed; individualization of the methods for treatment of the pancreatic stump depending on the diameter of the pancreatic duct; the use of prolene in forming the pancreaticoenteroanastomosis; intraoperative administration of cephalosporins and dioxidine followed by antibacterial therapy; application of microsphere with cytostatics to the pancreas at the operation end for prolongation of pancreatic secretion suppression.

[Pharmacokinetic validation of intra-arterial lymphotropic antibiotic therapy of pyo-inflammatory diseases of organs of the peritoneal cavity]. / Farmakokineticheskoe obosnovanie vnutriarterial'noi limfotropnoi antibiotikoterapii gnoino-vospalitel'nykh zabolevanii organov briushnoi polosti.

Intraarterial infusion of antibiotics provided a 1.39-2.84-fold regional increase in the antibiotic concentration as compared to that after the intravenous infusion in the organs and tissues of the abdominal cavity affected by an inflammatory process. Regional intraarterial lymphostimulation provided a 1.31-1.64-fold increase in the antibiotic resorption from the affected organs and tissues of the abdominal cavity to the relevant regional lymph nodes. Combined intraarterial administration of the antibiotic and lymphostimulant made it possible to provide high antibiotic concentrations in both the affected organs and tissues of the abdominal cavity and the respective portions of the regional lymphatic system.

[Structural changes of blood vessels and bile ducts in pathology]. / Izmeneniia arkhitektoniki krovenosnykh sosudov i zhelchnykh protokov pri patologicheskikh protsessakh.

Examination of 305 liver specimens of human cadavers of various age and study of the findings of intravital contrast examination of the duct and vascular system in 130 patients aged from 22 to 84 years revealed changes in the architectonics of the vessels and bile ducts in pathological processes. In healthy individuals the enlargement of the length and diameter of the vessels and ducts and increase in the depth of distribution of their intrahepatic branches from the surface of the liver ware regular in character and depended on the size of the liver and the age; they were marked by a straight linear course without sharp bends and dilatations. The length, diameter, the angles at the junction, and the direction of the course of the vessels and ducts changed sharply in inflammatory processes in the liver and bile ducts, focal lesions, and cirrhosis. Irregular enlargement of the diameter of the vessels and ducts and their marked tortousness were noted. The changes in the duct system were in direct dependence on the pressure in the biliary tract, the higher the pressure, the greater was the dilatation of the ducts at all levels.

[The effect of absorbent materials with drugs on wound healing]. / Vliianie absorbiruiushchikh materialov s lekarstvennymi preparatami na ranevoi protsess.

Absorptive hydrophilic materials (MAH) containing dioxydin and terrilytin as drug components were studied in experiments on guinea pigs infected with K-11 strain of E. coli. The results showed that the wounds in animals who did not receive treatment were cleaned by the 14th day, while the wounds in animals treated by applications of MAH with dioxydin and terrilytin became clean on the 3rd day, i. e. 5 times quicker. Absorptive hydrophilic materials containing dioxydin and teriilytin were easily handled, easily applied and removed, they did not injure the granulation tissue, and intensified growth of peripheral epithelialization. Thus, experimental study showed absorptive hydrophilic materials containing dioxydin and terrilytin to be highly effective in the treatment of purulent wounds, which allows them to be recommended for clinical use.

[Catheter dilatation in combined and generalized arterial occlusion and stenosis of pelvic and lower limb arteries]. / Kateternaia angiodilatatsiia pri sochetannykh i rasprostranennykh okkliuzionno-stenoticheskikh porazheniiakh arterii taza i nizhnikh konechnostei.

The article discusses the possibilities and tactics of radiologically-guided intravascular angioplasty in extended and combined occlusive-stenotic lesions of the lower limb arteries from experience gained in 116 intravascular dilatations in 78 patients. The authors show that it is really possible to perform catheter angioplasty in patients with extended and combined occlusive-stenotic lesions of arteries of the pelvis and lower limbs with compulsory use of spasmolytic and anticoagulant therapy during the operation and, in addition, also disaggregate therapy in the postoperative period. Extended occlusions of the femoral artery, beginning from the opening of the deep femoral artery, should be managed by a retrograde popliteal approach.

[Diagnostic value of cholinolytics in the surgical treatment of peptic ulcer]. / Diagnosticheskoe znachenie kholinolitikov v khirurgii iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki.

From study of the results of treatment of 157 patients with gastric and duodenal ulcer by an individual approach to the choice of the operative methods according to the results of prognostic tests, the authors revealed a high practical significance of using cholinolytics for diagnostic purposes. The choice of the method of surgical treatment with due regard for the prognostic evaluation of the effect of vagotomy on the gastric motor and acid-producing functions determined a 8.4% reduction of the frequency of postoperative motor-and emptying complications of gastric activity, and a 6.8% reduction of the incidence of recurrent ulcer.

[Intralymphatic antibacterial therapy of acute cholecystitis]. / Endolimfaticheskaia antibakterial'naia terapiia ostrogo kholetsistita.

Clinical examination of 34 patients showed that lymphotropic administration of antibiotics creates concentrations in organs and tissues involved in the inflammatory process in acute cholecystitis which are 1.63-14.95 times higher than those produced by intramuscular injection. Study of the course of the clinical picture of the disease in 122 patients with acute destructive cholecystitis revealed the high efficacy of this method of antibiotic therapy: the laboratory indices of the inflammation became normal within a shorter period of time, the inflammatory process in the gallbladder was arrested more rapidly, the number of postoperative complications fell 2.6 times, and the terms of hospital-stay of the patients reduced by 1.3 times. Lymphotropic antibiotic therapy is more pathogenetic in the management of acute destructive cholecystitis.

[The prevention of suppuration of postoperative wounds]. / Problema profilaktiki nagnoenii posleoperatsionnykh ran.

A method to prevent operative wound suppuration is offered. An experimental animal model of operative wound suppuration was elaborated to specify rational antibiotic-antiseptic prophylaxis and adequate wound drainage. This yielded a complex of measures to prevent purulent complications on the part of the operative wound. In addition, an original turbidimetric technique to assess the resistance of the biological fluid microflora to antisepsis was elaborated. The complex prophylaxis against suppuration of infected wounds was clinically tested on 124 patients operated on for different acute surgical conditions of abdominal organs. The wound process was controlled by means of an original endoscopic-bacteriologic technique. The postoperative period was complicated by the wound suppuration in two of the 124 patients (1.6 per cent). The postoperative hospital stay in most cases lasted 5-7 days.

[Ultrasound monitoring during healing process in drained postoperative wound]. / Ul'trazvukovoi kontrol' za ranevym protsessom v drenirovannoi posleoperatsionnoi rane.

The diagnosis of subclinical suppuration in operative wounds after removal of drainage tubes can be established after ultrasonic investigation of the wound. The ultrasound findings permit control of postoperative purulent complications by taking therapeutic measures to evacuate suppurative wound contents.