[Effect of antihypoxant infusion on microbial endotoxin circulation in obstructive jaundice patients].

The dynamics of microbial endotoxemia in group of 149 patients with cholelithiasis complicated by obstructive jaundice has been studied as dependent on the perioperative tactics of infusion therapy. The perioperative period in obstructive jaundice patients is complicated by a significant increase in lipopolysaccharidemia caused by translocation mechanisms and disorders of the liver detoxification function. In Group 1, 47 patients received infusion therapy including Ringer's solution and 10% glucose solution at a 1:1 ratio. In group 2, 55 patients received infusion therapy with only Sterofundin G-5 solution. In Group 3, 47 patients received the infusion therapy with remaxol in a dose of 800 ml/day. It is established that the infusion of Sterofundin G-5, and to a greater extent the infusion of remaxol, reduces the early postoperative degree of decompensation and accelerates recovery of the detoxifying function of Kupffer cells with respect to microbial endotoxin.

[Surgical treatment of colorectal cancer liver metastases with microwave thermoablation].

Domestic device for destruction of tumors by microwave power was designed. Initial series of laboratory experiments were performed with microwave liver ablation. Primary series of patients with colorectal cancer metastases to the liver demonstrate positive results. Short-term exposure, programmable shapes and sizes of ablative zones are the distinctive advantages of microwave thermoablation (MTA). 329 patients underwent liver resections during 2005-2010 years.108 patients had colorectal cancer metastases to the liver. 52 (48,14%) patients had bilobar liver lesions. Among them 11 patients underwent liver resection combined with MTA of contralateral liver lesions. Reliable differences in survival rates among patients with monolobar and bilobar metastatic lesions were not observed. Median of survival rate amounted 22.8 months in patients operated for metastatic colorectal cancer. Variants of surgical treatment are proposed.

[Tactics of preoperative infusion therapy in obturation jaundice].

The influence of the infusion therapy content on a hepatic function of bile outflow (HFBO), a bilirubin content and the enzymes activity in obturation jaundice in 139 patients was studied up. In 54 patients (the first group) a Ringer solution and 10% solution of glucose in 1:1 ratio were applied; in 37 patients (the second group) - a sterofundin-G-5 solution; in 48 patients (the third group) - remaxol in a dose of 800 ml/day. Application of sterofundin-G-5 and remaxol as a component of infusion therapy have promoted a bile outflow intensity enhancement in early postoperative period in comparison with such while Ringer solution and 10% solution of glucose application. Remaxol more effectively have eliminated a hyperbilirubinemia, enzymemia and a HFBO disorder, than sterofundin-G-5.

[Infusion correction of bile outflow and endotoxicosis in patients with mechanical jaundice].

The investigations were performed in 139 patients divided into 3 groups and who were given similar volume of infusion therapy (1600 ml/day). In the first group consisting of 54 patients the solution of infusion therapy included the Ringer solution and 10% of glucose solution in the ratio 1:1. In the second group (37 patients) the infusion therapy was performed with a solution of sterofundin-G-5. In the third group (48 patients) remaksol in dose 800 ml/day was included in infusion therapy. The inclusion of sterofundin-G-5 and remaksol in the infusion therapy increased the rate of bile outflow at the early postoperative period as compared with the solutions of Ringer and 10% of glucose. Remaksol is better for arresting endotoxicosis and bile excreting function of the liver as compared with infusion of sterofundin-G-5.