[Four years of experience in plastic surgery of anterior abdominal wall hernias with mesh implants made of titanium thread]. / Chetyrekhletnii opyt plastiki gryzh perednei bryushnoi stenki setchatymi implantatami iz titanovoi niti.

OBJECTIVE: To evaluate the results of using titanium thread mesh implants in the treatment of anterior abdominal wall hernias. MATERIAL AND METHODS: This article evaluates the titanium thread mesh implant used by us in the treatment of 240 patients with anterior abdominal wall hernias; describes the features of this type of implants and the technical features of various types of operations using them. RESULTS: The overall rate of postoperative complications was 2.9%. Hernia recurrence was observed in 2.4% of patients after laparoscopic transabdominal preperitoneal hernioplasty. CONCLUSIONS: The use of a mesh implant made of titanium thread did not reveal any specific complications for this implant. At the stage of gaining experience with a mesh implant made of titanium thread, technical difficulties may occur when placing and fixing it, which increases the duration of surgery.

[Surgical treatment of colon cancer in advanced age patients with severe comorbidities]. / Vliyanie komorbidnogo fona na vozmozhnost' khirurgicheskogo lecheniya bol'nykh rakom obodochnoi kishki pozhilogo i starcheskogo vozrasta.

OBJECTIVE: To analyze surgical (including minimally invasive) treatment of advanced age patients with colon cancer and severe comorbidities. MATERIAL AND METHODS: Advanced age patients with colon cancer (≥60 years) were compared with younger ones. Concomitant diseases were detected in 94,4% of older patients and in 45,9% of patients in the control group (χ2=51,747; p<0,001). RESULTS: Surgery time, intraoperative blood loss, length of hospital-stay, postoperative morbidity and mortality were similar. CONCLUSION: Severe comorbidities did not significantly affect surgical outcomes in these patients and did not increase postoperative morbidity and mortality.

[Early and long-term outcomes of minimally invasive interventions in urgent colon surgery]. / Blizhaishie i otdalennye rezul'taty mini-invazivnykh vmeshatel'stv v urgentnoi khirurgii tolstoi kishki.

OBJECTIVE: To analyze the results of minimally invasive surgical treatment of patients with urgent colon diseases. MATERIAL AND METHODS: There were 89 patients with urgent colon diseases. All patients were divided into 2 groups: the main group - 31 patients who underwent laparoscopic surgeries, the control group - 58 patients operated via open access. Both groups were comparable by age and underlying disease. However, significant differences in gender, severity of comorbidities and complications of the underlying disease were observed. RESULTS: Surgery time, postoperative morbidity (9.7% vs. 6.9%) and postoperative hospital-stay were similar in both groups. Quality of life was significantly better in the main group compared with the control group if colostomy was absent. In case of stoma, there were no between-group differences. CONCLUSION: Laparoscopic surgery is associated with reduced need for analgesics, similar duration of intervention and postoperative morbidity. Complete restoration of quality of life in these patients is observed in 6 months after surgery. Colostomy results similar quality of life after laparoscopic and open surgery.

Influence of dust particles on ionization equilibrium in partially ionized plasmas.

A chemical model is proposed for a dusty plasma consisting of electrons, ions, neutrals, and positively charged dust particles all being at thermodynamic equilibrium. An expression is derived for the Helmholtz free energy, which comprises the ideal part, taking into account the charge of dust particles, and the excess part, evaluated in the framework of the self-consistent chemical model [Phys. Rev. E 83, 016405 (2011)PLEEE81539-375510.1103/PhysRevE.83.016405]. The ionization potential depression for a dust-free partially ionized hydrogen is analytically evaluated for weakly and strongly ionized states to consistently account for the presence of charged and neutral components. An ad hoc interpolation of the ionization potential depression, valid across the whole ionization region, is put forward and subsequent solution of the generalized Saha equation is found to be in a perfect agreement with exact calculations. Minimization of the Helmholtz free energy of dusty plasmas provides the number densities of free electrons, free ions, neutrals, and the dust electric charge as well. Based on consideration of weakly and strongly ionized states, a straightforward comparison is made of the ionization equilibrium in a partially ionized plasma with and without dust particles to demonstrate that at thermal equilibrium positively charged dusts are responsible for an increase in the number density of free electrons and a decrease in the number density of free ions. It is analytically proved that nonideality effects result in a growth of the number densities of free electrons and ions by obtaining the so-called electron and proton ionization potential depressions. Electric charge of dust particles is systematically studied as a full plasma component rather than considering a detailed balance of the electron and ion fluxes on the surface of a solitary dust grain.

[Treatment of postoperative ventral hernias with the use of mesh implants made of titanium thread]. / Lechenie posleoperatsionnykh ventral'nykh gryzh s ispol'zovaniem setchatykh implantov iz titanovoi niti.

AIM: Study of the results of the use of titanium thread mesh implants in the treatment of postoperative ventral hernias. METHODS: The study included 84 patients with postoperative ventral hernias. All performed open-access prosthetic hernioplasty. 2 groups were formed: the main group consisted of 32 patients who used a mesh implant made of titanium thread as an implant, the comparison group consisted of 52 patients whose hernioplasty was performed using a polypropylene mesh implant. There were no statistically significant differences between groups of patients by age, gender, average body mass index, risk class of anesthesia (ASA), size and location of hernias. RESULTS: The frequency of postoperative complications in the main group was 6.2%, in the comparison group - 3.8%. There were no statistically significant differences in this indicator between the groups. At the time of discharge from the hospital, the level of plasma C-reactive protein in patients of the main group was significantly lower than in patients of the comparison group. CONCLUSION: The use of titanium thread mesh implants in the treatment of postoperative ventral hernias is accompanied by a less inflammatory response of the body to the implant and does not lead to an increase in the frequency of postoperative complications.

[Surgical treatment of acute calculous cholecystitis followed by one-day discharge of patients]. / Khirurgicheskoe lechenie ostrogo kal'kuleznogo kholetsistita s dosutochnoi vypiskoi bol'nykh.

AIM: To develop rational tactics of surgical treatment of patients with acute calculous cholecystitis with their subsequent discharge within 1 day since admission. MATERIAL AND METHODS: There were 283 patients with acute cholecystitis and 58 patients with chronic cholecystitis. All patients underwent laparoscopic cholecystectomy. Patients with acute cholecystitis were divided into 2 groups: main group - 136 patients were discharged within 1 day since admission, control group - 147 patients who were discharged later. Age, gender, duration of attack and ASA score were similar in both groups. RESULTS: Incidence of intraoperative complications was significantly higher in the control group compared with the main group (6.1% vs. 0.7%). There were no postoperative complications in the main group; postoperative morbidity in the control group was 6.1%. Criteria preventing discharge within 1 day since admission were developed. Uneventful early postoperative period after laparoscopic cholecystectomy allows us to discharge 48% of patients with uncomplicated acute calculous cholecystitis within 1 day since hospitalization. The developed algorithm of treatment is followed by reduced hospital-stay by 4 days. CONCLUSION: The developed algorithm of treatment of patients with acute calculous cholecystitis can reduce hospital-stay up to 1 day. Favorable early postoperative period and follow-up of patients after discharge are essential for safe treatment.

[Minimally invasive surgery for colorectal cancer in advanced age patients]. / Miniinvazivnaia khirurgiia kolorektal'nogo raka u bol'nykh pozhilogo i starcheskogo vozrasta.

AIM: To evaluate the role of laparoscopic surgery for colorectal cancer in advanced age patients. MATERIAL AND METHODS: 290 patients with colorectal cancer were enrolled including 121 patients with rectal cancer and 169 patients with colon cancer. Main group consisted of 171 patients over 60 years old, control group - 119 patients younger 60 years old. RESULTS: Radical advanced procedures on different parts of colon including laparoscopic approach were performed in the majority of advanced age patients. Outcomes were considered as good, we did not notice serious complications (5.4% after rectal surgery, 3.9% after colon surgery). Differences were not significant compared with younger patients including laparoscopic interventions for emergency indications. Nevertheless, surgical treatment of advanced age patients with colorectal cancer makes special demands for equipping of the clinic and physicians' qualification. CONCLUSION: Advanced age is not a serious limitation in choice of laparoscopic access in both elective and emergency surgery in patients with colorectal cancer.

[Efficacy of video-assisted procedures in advanced age patients with colorectal cancer]. / Éffektivnost' videoéndoskopicheskikh vmeshatel'stv u bol'nykh kolorektal'nym rakom starshikh vozrastnykh kategorii.

AIM: To assess advisability of video-assisted surgery in advanced age patients with colorectal cancer. MATERIAL AND METHODS: The study involved 44 patients with large intestine tumors. There were 30 patients with colon cancer aged 78.0±1.1 years and 14 patients with rectal neoplasms aged 75.0±1.8 years. All of them underwent elective video-assisted resections without conversion of the approach. RESULTS: Good and satisfactory results were achieved in 95.5% of patients. Postoperative complications occurred in 5 (11.4%) cases followed by redo surgery in 2 (4.5%) patients. Mortality was absent. CONCLUSION: Video-assisted procedures are preferable in elective surgery of colorectal cancer in advanced age patients regardless stage and localization of the process.

[Emergency endoscopic surgery of colon cancer]. / Vozmozhnosti ékstrennoi videoéndoskopicheskoi khirurgii raka obodochnoi kishki.

AIM: To assess the role of endoscopic technologies in treatment of complicated forms of colorectal cancer. MATERIAL AND METHODS: Our trial included patients after endoscopic intervention (n=18) and open surgery (n=11). RESULTS: Mean time of surgery in this group was 158.8±10.7 minutes. In elective surgery group this value was 161.3 minutes (p>0.05). Mean blood loss was not great (near 122.5±17.9 ml). Overall and postoperative hospital-stay was 23.1±2.4 and 8.6±0.5 days, respectively. There were no intraoperative and postoperative complications. CONCLUSION: Endoscopic interventions may be performed for colon cancer for emergency indications including patients with severe complications.

[Endoscopic interventions in patients with colorectal cancer: the effect of comorbidities]. / Videoéndoskopicheskie vmeshatel'stva u bol'nykh kolorektal'nym rakom.

AIM: To evaluate endoscopic technologies in treatment of patients with colorectal cancer and severe comorbidities. MATERIAL AND METHODS: Two groups of patients after endoscopic (group 1, n = 58) and open (group 2, n = 40) surgery were assessed. RESULTS: Comorbidities were observed in 90.7% patients in group 1 and 83.3% patients in group 2 (p > 0.05). Mean comorbidity index was 6.9±0.3 (2-14) and 7.1±0.7 (2-18) in both groups respectively. Comorbidities ASA grade 3-4 were observed in 88.2% patients of group 1 had and in 71.4% patients of group 2 (p > 0.05). One patient of group 1 with intra-abdominal bleeding required conversion of surgical approach. In another case the conversion was due to technical difficulties during intestinal resection. Postoperative complications were noted in 2 patients (3.4%). There were no intraoperative complications in group 2. Postoperative complications were observed in two cases (5.0%). CONCLUSION: Severe comorbidities do not impose serious restrictions on the choice of endoscopic approach in colorectal cancer patients.

[Laparoscopic surgery for colon cancer]. / Laparoskopicheskaia khirurgiia raka obodochnoi kishki.

AIM: To assess laparoscopic surgery in treatment of colon cancer patients. MATERIAL AND METHODS: The results of laparoscopic treatment of patients with colorectal cancer are presented in the article. It was estimated the influence of various clinical parameters including age, gender, comorbidities, tumor localization and stage and complications on laparoscopic management of these patients. CONCLUSION: It was revealed that efficiency of laparoscopic surgery in patients with colon cancer is affected by tumor stage and presence of complications.

[Laparoscopic cholecystectomy in short-stay hospital]. / Laparoskopicheskaya kholetsistektomiya v usloviyakh statsionara odnogo dnya.

AIM: To develop the protocol of surgical management of cholelithiasis in short-stay hospital. MATERIAL AND METHODS: Surgical treatment of 161 patients with cholelithiasis was analyzed. All of them underwent elective cholecystectomy. Short-stay hospital group included 41 patients. 120 patients were operated in surgical department (group 2). RESULTS: Incidence of intraoperative complications was 2.4% and 3.4% in both groups respectively (p>0.05). Postoperative complications were more frequent in group 2 (8.3% vs. 2.4%, p<0.05). Mean hospital-stay was 1 and 4.4 days in both groups respectively. CONCLUSION: Treatment of chronic calculous cholecystitis is advisable in short-stay hospital. Indications for this approach and its safety in certain patients were determined. The protocol of surgical management of chronic cholecystitis in short-stay hospital was develped.

[Results of surgical treatment of cholelithiasis by laparotomic and minimally invasive accesses].

The article presents the results of surgical treatment of 1038 patients with cholelithiasis, acute and chronic calculous cholecystitis and complicated forms of the disease. Operations were performed with traditional laparotomic and minimally invasive approaches. Indications for choosing access, as well as the advantages and disadvantages of various options of surgery in patients with cholelithiasis are discussed.

[Laparoscopic cholecystectomy in case of acute cholecystitis].

The article describes the results of laparoscopic cholecystectomy in patients with acute cholecystitis. 97 patients including 13 men and 84 women aged from 20 to 74 years were included in the study. There was not the conversion to laparotomy and intraoperative complications in all cases. 83 patients, which amounted to 85.7% of the patients, were discharged on the next day after operation. The last 14 patients had the variation of postoperative hospitalization period from 2 to 4 days. Laparoscopic cholecystectomy is a safe and effective procedure in patients with acute cholecystitis.

[Minilaparotomy cholecystectomy in patients with acute calculous cholecystitis].

It was done the analysis of surgical treatment results of 383 patients with the exacerbation of chronic calculous cholecystitis and acute obstructive calculous cholecystitis. All patients were operated from traditional and minilaparotomy approaches. Positive results were obtained in 93.2% of patients operated from minilaparotomy approach with a low rate of intraoperative and postoperative complications. Minilaparotomy cholecystectomy can be considered as a reliable mini invasive method of surgical treatment of patients with cholelithiasis, including purulent destructive forms of cholecystitis.

[Results of the laparoscopic cholecystectomy in elderly patients].

The results of 165 laparoscopic cholecystectomies were analyzed. All patients were divided into two groups according their age: the 1st group embrased patients from 60 years and older and the 2nd group included younger patients. The mean operative time was 89.5 min among the patients of the 1st group and 94.8 min among the patients of the 2nd group. For the 1st and 2nd groups, respectively, the overall hospital stay was 13.1±0.6 and 9.4±0.3 days; and the postoperative treatment lasted for 6.7±0.5 and 7.5±0.3 days, respectively. Complications were registered in 1.3 and 2.2% of patients, respectively. Thus, the results and outcomes of the laparoscopic cholecystectomy in elderly patients are comparable with those in younger contingent.

[The minilaparotomy cholecystectomy in patients with calculous cholecystitis].

The article presents the results of surgical treatment of 596 patients with cholelithiasis, operated with minilaparotomy access. Good results were obtained in 93% of patients with chronic calculous cholecystitis, as well as acute inflammation. This access is provided a low number of intraoperative and postoperative complications. In addition, the minimal access allows to extend, if necessary, the intervention and control the complications.

[The laparoscopic cholecystectomy in elderly patients].

The laparoscopic cholecystectomy in elderly patients. The treatment results of 142 patients with the cholelithiasis aged 23-84 years are represented. The operated patients were divided in two groups: those, younger 60 years; and the older patients, who were operated on laparoscopically. The authors proved, the the majority of the senile patients can be operated on laparoscopically.