[Prevention of colorectal anastomotic leakage in patients with rectal cancer]. / Profilaktika nesostoiatel'nosti shvov kolorektal'nogo anastomoza u bol'nykh rakom priamoi kishki.

OBJECTIVE: To develop a technique of anastomosis sutures protection using the Foley catheter in rectal cancer surgery. MATERIAL AND METHODS: There were 42 patients with rectal cancer T1-3N0-2M0 (the 7th TNM edition) who underwent radical sphincter-sparing surgery with neoadjuvant chemoradiotherapy for the period from November 2016 to June 2018. All procedures were performed at the Regional Clinical Oncology Center. All operations were completed with formation of colorectal anastomosis in 'end-to-side' fashion. Patients were divided into 2 groups (main and control) depending on used technique. In the main group (n=20), Foley catheter #30 in accordance with original method was used to protect the anastomosis. Preventive colostomy was applied in 15 patients. The control group consisted of 22 patients. None of these patients underwent prevention of anastomosis leakage. Preventive colostomy was performed in 14 patients. RESULTS: There were no early postoperative complications in the main group. The catheter was removed after 7-9 days. In the control group, 5 patients had symptoms of anastomotic leakage (22.5%; p<0.05). Medication was effective in 4 cases. Re-laparotomy were required in 1 patient. CONCLUSION: Thus, anastomosis sutures protection using the Foley catheter is quite reliable and technically simple procedure with favorable outcomes.

[Comparative long-term results of surgical treatment of patients with diffuse toxic goiter]. / Sravnitel'nye otdalennye rezul'taty khirurgicheskogo lecheniia bol'nykh diffuznym toksicheskim zobom.

AIM: To analyze long-term outcomes of Graves' disease management. MATERIAL AND METHODS: There were 428 patients for the periods 2000-2004 and 2005-2010. Patients were called for examination and thyroid status control. 2 groups were compared: group 1 of 203 patients and group 2 of 225 patients. RESULTS: It was found that after subtotal resection by original technique (patent 1802309 of the Russian Federation, MPK 5 G01N1, 1/28) in group 1 euthyroid state was observed in more than half (59.4%) of patients, hypothyroidism - 30.3% and recurrence - in 10.3% 10 years postoperatively. At the same time most of patients of group 2 (71.6%) after predominant thyroidectomy had hypothyroidism, euthyroid state was only in 24%. Postoperative recurrent diffuse toxic goiter incidence was 4.7%. CONCLUSION: The dynamics of postoperative thyroid status depending on type of surgery and follow-up was presented.

[Functional changes and structural features of the testis in patients after acute parotid orchitis]. / Funktsional'nye izmeneniia i strukturnye osobennosti polovykh zhelez u patsientov, perenesshikh ostryi parotitnyi orkhit.

Structural changes and functional features of the testes were studied in 20 patients who had had parotid orchitis (PO) 6 months to 1.5 years before the study. The examination including ultrasonography of the testes, investigation of ejaculate, radioimmunoassay for serum testosterone, FSH, LH brought out a significant reduction of the mean volume and echogenicity of the affected testicles by 44.7 and 50%, respectively, in 15 patients; a 58.2% decrease in the number of spermatozoa in ml; a 71.2% rise in FSH level in 6 patients. Morphometry of biopsy specimen of the testicles on the affected side has shown that mean sectional area of the tubules has diminished by 40%, the spermatogenesis index--by 77.1% while the volume of the intertubular connective tissue increased by 47.7%. Thus, after acute PO, the patients develop atrophic changes in the testes and a decline in spermatogenic function up to secretory infertility.

[Prevention of postoperative hypothyroidism in surgical treatment of diffuse toxic goiter]. / Profilaktika posleoperatsionnogo gipotireoza pri khirurgicheskom lechenii diffuznogo toksicheskogo zoba.

Experience of treatment of more than 1000 patients with diffuse toxic goiter (DTG) is presented. Complex of measures performed before and after operation for reduction of hypothyroidism rate is developed. Histology examination during operation permits to determine volume of residual thyroid tissue. Local laserotherapy improves long-term results of surgical treatment. Rate of postoperative hypothyroidism in patients with DTG has decreased from 43.6 to 3.3%.

[Surgical treatment for autoimmune thyroiditis]. / Khirurgicheskoe lechenie autoimmunnogo tiroidita.

The authors present the experience in the treatment of 1379 patients with autoimmune thyroiditis (AIT). 285 from them underwent surgery (20.6%). Conservative treatment with the use of laser therapy is a base in management of AIT (79.4%). Indications for surgical treatment and its scope were determined intraoperatively according to the results of an urgent biopsy of thyroid gland. They are: cancer of thyroid in combination with AIT, high degree of the risk of malignization, large size of the goitre with the symptoms of constringency of surrounding tissues, presence of pseudonodes and ineffectiveness of the conservative treatment and laser therapy. Follow-up data of the patients after surgical treatment for AIT showed that for several years their mode of life was quite favourable.

[The dynamic observation of patients with diffuse toxic goiter in the postoperative period by means of echography]. / Dinamicheskoe nabliudenie za bol'nymi s diffuznym toksicheskim zobom v posleoperatsionnom periode metodom ékhografii.

The authors used vernier calipers for measurement of the thyroid remnant during operation with special reference to data of an emergency histological analysis which determined the state of toxicosis, lymphoid infiltration, the presence of the extrafollicular epithelium. In addition, the patient's age, duration of the disease and taking thyreostatics was considered. It determined an individual approach to solution of the question of size of the gland to be left. The fate of the remnant thyroid was followed-up with the help of echography. In the majority of patients with diffuse toxic goiter a 90% increase of the remnant as compared with the initial data was noted in a month after operation, six months later it was 126%, a year later 186%. Close functional correlation was found between the data of histological investigations, age of the patients, duration of the disease and taking thyreostatics.

[A rapid morphometric method for determining thyroid gland function]. / Uskorennyi morfometricheskii metod opredeleniia funktsional'noi shchitovidnoi zhelezy.

The incidence of postoperative hypothyrosis after subtotal resection of the thyroid for diffuse toxic goiter is rather high, 40-50% according to many authors. A method is suggested permitting assessment of the share of "active zones" during surgery. A certain amount of thyroid tissue is left with due consideration for this share, this amount being sufficient to attain an euthyroid state in the postoperative period.

[Ways to decrease postoperative hypothyroidism in patients with diffuse toxic goiter]. / Puti snizheniia posleoperatsionnogo gipotireoza u bol'nykh diffuznym toksicheskim zobom.

The authors note that postoperative hypothyrosis is observed much more often than recurrences of thyrotoxicosis in patients with diffuse toxic goiter. The incidence of hypothyrosis is associated with the amount of the remnants of tissue, its functional abilities, regeneration, state of the hormonal and immune systems of the organism. The authors describe their method of determining the mass of the thyroid residue. The incidence of hypothyrosis was reduced from 43 up to 18%.

[Prognosis in the surgical treatment of diffuse toxic goiter]. / Prognozirovanie rezultatov khirurgicheskogo lecheniia diffuznogo toksicheskogo zoba.

Reduction of the incidence of postoperative hyperthyroidism (POH) is one of the urgent problems of DTG surgery. According to Soviet authors, it reaches 48%. The authors take into account a complex consisting of the patient's age, the degree of thyrotoxicosis, and the results of emergency (intraoperative) histological study. A program was elaborated with due consideration for adequate preoperative examination, preparation of the patients for the operation, a standardized method with reliable determination of the mass of the thyroid residue, morphometric examination of the removed part of the thyroid, study of the late-term results and their comparison with the preoperative clinical picture. Intraoperative determination of the percentage of active zones and the presence of intrafollicular epithelium and lymphoid infiltration made it possible for the authors to reduce POH incidence from 43.5% to 2.8%.

[Diagnosis and treatment of acute pancreatitis]. / Diagnostika i lechenie ostrogo pankreatita.

From study of 549 patients with various forms of acute pancreatitis (AP) the authors conclude that membrane disorders occur in these patients, in which case membrane modulators, products of lipid peroxidation (PLO) among others, play an inducing role. In addition to the routine clinical data, of great significance for the diagnosis of AP are laboratory findings on lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, endogenous enzymes, transamidinase, concentrations of free kinins, blood coagulative system, study of free radical oxidation of lipids, beta-lipoprotein levels, etc. The authors recommend a wider use of fatty emulsions with heparin and intraarterial infusion of agents in the generally accepted complex of therapeutic measures. Operative treatment is usually indicated in approximately 20% of cases.

[Extracorporeal methods in the treatment of surgical endotoxicosis]. / Ekstrakorporal'nye metody lecheniia khirurgicheskogo éndotoksikoza.

The effectiveness of the use of extracorporeal methods of treatment of endotoxicosis in 54 surgical patients has been analysed. The authors consider as the most effective the early use of the efferent methods with mandatory inclusion of hemodialysis.

[Surgical treatment of 286 patients with goiter in the Algerian People's Democratic Republic]. / O khirurgicheskom lechenii 286 bol'nykh zobom v Alzhirskoi narodnoi demokraticheskoi respublike.

The paper is concerned with the results of the investigation of 286 patients with different types of thyroid pathology, operated upon by the authors over a 2-year period in the Algerian People's Democratic Republic. Of them 61.5% were patients with diffuse euthyroid goiter. The results obtained indicate that the mountainous areas of this country are goiter endemic.

[Arterial hypertension in renal venous hypertension]. / Arterial'naia gipertoniia pri venoznoi gipertenzii pochek.

The authors have conducted an experimental study in dogs and shown that a considerable disturbance of blood flow in renal veins can cause stable arterial hypertension.

[Kidney functional dynamics in eliminating vasorenal hypertension by a kidney autograft]. / Dinamika funktsii pochki pri likvidatsii vazorenal'noi gipertonii metodom autotranspnatatsii pochki.

In acute and chronic experiments on 45 dogs the authors obtained vasorenal hypertension, the elimination of which was fulfilled by means of autotransplantation of the kidney without transection of the ureter. The dynamical study of renal function was carried out through an analysis of arterial blood pressure, erythropoietic activity, blood serum, reticulocytic count, creatinine, residual nitrogen, diuresis, radioisotopic investigation, chromocystoscopy at open bladder, excretory urography, aortograhy, phlebography and morphometric studies of the renal glomeruli.