[Long-term results of closure of perforated pyloro-duodenal ulcers].

Long-term results of closure of perforated ulcers were analyzed in 91 patients. Excellent and good results were obtained in 70% of the patients, in 12.1% the results were satisfactory. In 18.6% of the cases the results were considered unsatisfactory. Bad long-term results were due to the absence of dispensary follow-up, the absence of repeated courses of anti-ulcer therapy, and not following the recommendations on the treatment. Excellent and good long-term results observed in 70% of the patients allow recommendation of suturing the perforated opening and anti-ulcer therapy in patients with perforated pyloroduodenal ulcers.

Surgical treatment of chronic ischemia of the digestive organs caused by compressive stenosis of the celiac trunk.

Compressive stenosis of the celiac trunk is a common cause of chronic ischemia of the digestive organs with consequent morphological and functional changes in these organs. Decompression of the celiac trunk is an effective operation which normalizes the central and visceral circulation and results in resolution of ischemic lesions of the digestive organs and cicatrization of ischemic gastroduodenal ulcers, in particular. In some cases it is necessary to combine decompression of the celiac trunk with other surgical procedures to eliminate complications of ischemic lesions of the stomach and duodenum or other associated lesions.

[Pathogenetic basis of the diagnosis and treatment of lymphedema of the lower extremities]. / Patogeneticheskie osnovy diagnostiki i lecheniia limfedemy nizhnikh konechnostei.

A combined clinico-morpho-physiologic investigation was conducted in 98 patients with primary and secondary lymphatic edema. All patients underwent lymphography by means of electron and light microscopy; biopsy specimens obtained from a lymphatic vessel at lymphography were investigated histologically, and contractility records were made. Pronounced disorders were demonstrated in the lymphatic vessels and their myocytes. New rational schedules of pathogenetic treatment for lymphedema of the lower limbs are outlined on the basis of the reported findings.

[Compression stenosis of the celiac trunk as 1 of the causes of ischemic disease of the digestive organs]. / Kompressionnyi stenoz chrevnogo stvola kak odna iz prichin ishemicheskoi bolezni organov pishchevareniia.

Experience in the treatment of 218 patients with compression stenosis of the celiac trunk is generalized. The clinical symptoms and the angiographic semiotics of the disease are described in detail. Active surgical tactics is substantiated and the results of operations are studied.

[The diagnosis of Helicobacter infections in patients with gastric and duodenal peptic ulcers]. / Diagnostika khelikobakternoi infektsii u bol'nykh iazvennoi bolezn'iu zheludka i dvenadtsatiperstnoi kishki.

The results of the study of 33 patients having gastroduodenal peptic ulcer, with 9 of them subjected to surgical treatment, are presented. The diagnostics of Helicobacter infection was made with the use of bacteriological and biochemical assays. The study revealed that in the overwhelming majority of cases peptic ulcer was associated with the presence of H.pylori, and the most informative method for the diagnostics of H.pylori infection was the bacteriological study of biopsies from the pyloric antrum characterized by the highest degree of massive contamination. The determination of ammonia concentration by biochemical assay with the use of Aerotest was most suitable for the diagnostics of H.pylori infection in patients with a short history of peptic ulcer.

[Treatment tactics and prognosis in gallbladder cancer in relation to the degree of spread of the tumor]. / Lechebnaia taktika i prognoz pri rake zhelchnogo puzyria v zavisimosti ot rasprostranennosti opukholi.

The experience of treatment of 88 cases of gallbladder cancer was used in developing a TNM staging classification of the lesion. The extent and procedure of radical surgery versus tumor stage as well as long-term results of treatment are discussed.

[Renal artery embolization in treating tumorous diseases of the kidneys]. / Embolizatsiia pochechnykh arterii v lechenii opukholevykh zabolevanii pochek.

Indications, complications, advantages and limitations of different procedures for renal artery embolisation used in treatment of kidney tumors are discussed. Four case reports on renal tissue embolisation by means of administration of barium sulfate suspension are presented. The procedure is not complicated, reliable and the results of its application are irreversible. Use of barium sulfate suspension for embolisation of inoperable tumors of kidney is substantiated.

[Diagnostic and prognostic value of kidney function tests in cadaveric kidney transplantation]. / Diagnosticheskoe i prognosticheskoe znachenie nekotorykh pokazatelei funktsii pochek pri transplantatsii trupnoi pochki.

Within the first 6 weeks after kidney transplantation the diagnostic and prognostic importance of some characteristics of partial renal function was studied in 48 patients with postoperative acute renal failure (ARF), precrisis, acute rejection of the transplant, and a crisis-free course of the postoperative period. It was established that the numerical data and the diagnostic importance of the characteristics under study are determined by the degree of the preceding ischemic lesion of the kidney. Some functional criteria of the crisis irreversibility and the effect on its temporary parameters of postoperative ARF were defined.

[Diagnostic value of determining endogenous proteinase inhibitors in cancer patients]. / Diagnosticheskaia tsennost' opredeleniia éndogennykh ingibitorov proteinaz u onkologicheskikh bol'nykh.

Patients with stage III and IV cancers of different sites revealed a 47-76% increase in serum total antitrypsinic activity. A mean 40% increase was observed in cases of inflammatory pathology. Both study groups demonstrated raised alpha 1-antitrypsin levels, while that of alpha 2-macroglobulin did not show any significant changes. The level of alpha 1-antitrypsin accounted for 89 and 83% of total antitrypsinic activity in cases of inflammation and controls, respectively, while in cancer patients this index was significantly lower (70%). The diagnostic value of total antitrypsinic activity appeared to be higher than that of alpha 1-antitrypsin level determination. It is inferred that, apart from alpha 1-antitrypsin, malignant growth is associated with raised levels of more specific endogenous proteinase inhibitors, except alpha 2-macroglobulin.

[Detection of Helicobacter pylori in stomach cancer]. / Vyiavlenie Helicobacter pylori pri rake zheludka.

Helicobacter pylori (HP) infection was detected in different segments of the gastric mucosa in 13 patients with stomach tumors. Twenty five patients suffering from stomach ulcers were used as controls. HP infection was diagnosed by means of urease and microbiological testing. HP was identified in all cases of stomach cancer, the rates of dissemination in the mucosa in such patients being higher than in those with stomach ulcers.

[Surgical tactics in non-toxic nodular goiter]. / Khirurgicheskaia taktika pri uzlovom netoksicheskom zobe.

Surgical policy in 246 cases of nodular euthyroid goiter was reviewed. Urgent histological examination of operative biopsy specimens of the removed thyroid tissue has disclosed subclinical thyroid cancer in 6.6% of the patients. The authors hold that surgical intervention is an effective measure in prophylaxis and early detection of thyroid cancer in clinical cases of nodular nontoxic goiter.

[Cholelithiasis in young people]. / Zhelchnokamennaia bolezn u lits molodogo vozrasta.

The results of the treatment for cholelithiasis from 1979 to 1989 were considered. The percentage correlation between young and older patients was established. The time--course of the disease incidence was demonstrated. In the age group studied (16-35 years) clinical signs of the disease were characterized, anthropometric values presented, sex-related incidence and general duration of the diseases considered. Diagnostic techniques for the main disease and some concurrent conditions of the alimentary tract were discussed. The frequency of complicated cholelithiasis in young persons and the specificity of complications were established. Problems of cholelithiasis treatment in young persons were discussed.

[Blood flow and free radical oxidation of lipids in gastric and duodenal mucosa in complicated duodenal ulcers]. / Krovotok i svobodno-radikal'noe okislenie lipidov v slizistoi zheludka i dvenadtsatiperstnoi kishki pri oslozhnennom techenii duodenal'noi iazvy.

38 patients with complicated duodenal ulcer were examined with polarographic method. The significant decrease of tissue blood flow was revealed in all segments of gastroduodenal zone. The increased level of free-radical oxidation of lipids was determined in duodenal mucosa and ulcer edges. Disorders of blood supply and activation of free-radical lipid oxidation play an important role in the mechanism of ulcer formation. The drugs improving blood supply and antioxidants should be used in combined therapy and preoperative preparation.

[Repeated operations on the extrahepatic bile ducts]. / Povtornye operatsii na vnepechenochnykh zhelchnykh putiakh.

Experience in repeated operations on the biliary tract in 51 patients is analysed. Endoscopic retrograde cholangiopancreatography is one of the informative methods. The choice of the method of operative treatment must be individualized according to the nature of the pathological process in the biliary system. An endoscopic intervention may be an alternative to surgical operations in many cases.

[Bone marrow reaction to surgical intervention in gastroduodenal hemorrhage]. / Reaktsiia kostnogo mozga na khirurgicheskoe vmeshatel'stvo pri gastroduodenal'nom krovotechenii

Experimentally and clinically, the authors have studied the effect of massive blood loss and various operative procedures (Billroth I and Hofmeister-Finsterer gastrectomies, pyloroplasty with vagotomy) on the hemopietic system. It has been found that the bone marrow response was mainly dependent on blood loss. A surgical intervention renders but insignificant effect on hemopoiesis, similar to that of a moderate hemorrhage, the character of an operative procedure being of no improtance.

[Evaluation of the hazard of surgical intervention at the height of gastroduodenal hemorrhage]. / Otsenka opasnosti operativnogo vmeshatel'stva na vysote gastroduodenal'nogo krovotecheniia

Based on the experimental data obtained, it was concluded that the danger of surgery at the height of the primary hemorrhage, although massive it may be, is somewhat exaggerated by surgical specialists. Recurrent in a short period of time hemorrhages are believed to be more inherent in danger than an operation in primary bleeding. The results of the experiments are supported by observations over 70 patients, operated upon for ulcerous bleeding, and in 11 patients who were subjected to surgery for profuse hemorrhage from cancerous gastric ulcers.

[Reinfusion of the patient's own irradiated blood in surgical patients]. / Reinfuziia obluchennoi sobstvennoi krovi khirurgicheskikh bol'nykh.

The experimental work on the autotransfusion of the blood irradiated wit UV rays has shown this method to increase the oxygenating capacity of the blood. The clinical experience with more than 240 reinfusions of the UV irradiated own blood to 65 patients with different surgical diseases showed a pronounced curative effect. The method was used in 45 patients with purulent diseases, in 15 patients in the pre- and postoperative periods.

[Extracorporeal shockwave lithotripsy in cholelithiasis]. / Ekstrakorporal'naia udarno-volnovaia litotripsiia pri zhelchnokamennoi bolezni.

The authors describe their experiences with using stroke-wave lithotripsy in 102 patients with cholelithiasis. Positive results were obtained in 68% of the patients. Indications to lithotripsy are formulated. A description of specific features of the method is given.

[Combined surgical procedures and their role in current surgery]. / Sochetannye operativnye vmeshatel'stva i ikh rol'v sovremennoi khirurgii.

An analysis of results of simultaneous operations in 103 patients with different surgical diseases has shown advantages of such operations saving the patient from several diseases.

[Method of surgical intervention for compression stenosis of the celiac trunk]. / Metodika khirurgicheskogo vmeshatel'stva pri kompressionom stenoze chrevnogo stvola.

Experience with the surgical treatment of 265 patients with a compressive stenosis of the celiac trunk has been analyzed. Stenosis of the celiac trunk is known to be a cause of ischemic abnormalities of the stomach, duodenum, pancreas. Decompression of the celiac trunk is an effective method of treatment of the ischemic disease of digestion organs resulting in better organic blood circulation and involution of the appearing pathologic processes. In a number of patients there appeared symptoms for associated interventions due to complications of ischemic gastroduodenal ulcers or concomitant diseases. Excellent and good remote results were noted in 79,6%, satisfactory--in 16,7%, unsatisfactory--in 3,7%.