[THE PROGNOSTIC FACTORS ANALYSIS FOR THE REPEATED DEVELOPMENT OF GASTRIC POLYPS AFTER ENDOSCOPIC POLYPECTOMY].

There were analyzed the results of treatment of 1450 patients, to whom in surgical departments of Lugansk Regional Clinical Hospital the elective endoscopic polypectomy for solitary and multiple gastric polyps, premalignant changes, was conducted. The unfavorable prognosis signs, trustworthily impacting the gastric polyps reoccurring, were considered: quantity of gastric polyps, their dimensions, localization and presence of mucosal erosions. Reoccurrence of majority of the polyps in gastric antrum may be due to microcirculatory disorders, present in their mucosa.

[MORPHOLOGICAL CRITERIA OF THE ENTERAL INSUFFICIENCE SEVERITY IN A DIFFUSE PERITONITIS FOR DETERMINATION OF A SUBSEQUENT TACTICS OF THE PATIENTS TREATMENT].

The results of treatment of 87 patients for diffuse peritonitis (DP) were analyzed, in whom the enteral insufficiency (El) was estimated. The small intestine biopsies for morphological investigations were taken during its resection performance on the border between the pathologically changed and intact wall. Comparative morphometric analysis of destructive and inflammatory processes in a small intestine was conducted for establishment of morphological criteria for the EI prognosis in a DP. Morphological criteria of the EI severity were established for determination of a subsequent tactics for the patients' treatment and prognosis.

[CORRECTION OF ENTERAL INSUFFICIENCY SYNDROME IN PATIENTS, SUFFERING DIFFUSE PERITONITIS].

The results of treatment of 65 patients, suffering diffuse peritonitis, were analyzed. For the abdominal cavity sanation and intestinal decontamination the adopted selective bacteriophages (polyvalent pyobacteriophage, intesti-bacteriophage, and the coliproteus one) were applied. The abdominal cavity state was estimated while doing a programmed relaparotomy. Bacteriologic investigation of exudate, excreted along nasointestinal probe, and of peritoneal exudate was conducted. The intestinal motor-evacuation function restoration was estimated in accordance to data of ultrasonographic investigation. Application of the procedure proposed have promoted earlier restoration of intestinal motor and the barrier functions, and elimination of enteral insufficiency syndrome.

[Efficacy of application of radiofrequency scalpel and ozono-ultrasound method in dynamics of planimetric indices of the wound course process in the patients, suffering an acute purulent lactation mastitis].

The results of planimetric investigation, conducted in 82 patients, suffering an acute purulent lactation mastitis (APLM), were analyzed. Of them 42 patients (the main group) were operated on, using radiofrequency scalpel, for the postoperative wounds processing the low-frequency ultrasound and ozonated isotonic solution of sodium chloride were used. In 40 patients (group of comparison) the conventional methods of treatment of APLM were applied.

[Efficacy of surgical treatment of patients for an acute lactational mastitis using radiofrequency scalpel and ozono-ultrasonic method].

According to microbial investigation data, conducted preoperatively, intraoperatively, in 7 days postoperatively for an acute purulent lactational mastitis, there was noted significant reduction of the wound microbial soiling while application of radiofrequency scalpel and ozono-ultrasonic method in comparison with such while application of conventional methods of treatment.

[A complex method for prophylaxis of laparoscopic cholecystectomy complications].

The clinical examination and treatment results were analyzed in 1282 patients, in whom laparoscopic cholecystectomy, using complex method of the complications prophylaxis, was performed for calculous cholecystitis. The complications have had occurred in 21 (1.64%) patients, the conversion necessity--in 10 (0.78%), 3 (0.23%) patients died.

[The choice of optimal operative intervention in patients, suffering an acute tumoral impassability of large intestine].

The results of treatment of 101 patients, suffering an acute ileus (AI), caused by colonic cancer, were presented. The operation was performed in 88 patients for AI in subcompensated and decompensated stages. Right-sided hemicolectomy with ileotransversoanastomosis formation was done for right-sided localization of the tumor in a subcompensated stage. The outloading end colostomy was done after tumoral excision and ileotransversoanastomosis formation accomplishment in patients, suffering AI in a decompensated stage with purulent peritonitis. Obstructive large-bowel resection was performed for left-sided colonic cancer with AI in a decompensated stage, and for subcompensated stage--a left-sided hemicolectomy with Y-type anastomosis was done. Postoperative complications rate have constituted 27.3% and lethality--12.5%.

[Gastric secretory function in patients with chronic renal insufficiency and gastroduodenal hemorrhage].

Gastric hypersecretion occurrence in patients, suffering chronic renal insufficiency (CHRI), creates conditions for acido-peptic gastroduodenal zone affection with possible formation of erosive-ulcerative defects, complicated by hemorrhage. In 116 patients, suffering CHRI, the state of gastric mucosa secretory function was studied up. In patients with an acute gastrointestinal hemorrhage and CHRI in conservative and terminal stages the analysis of acidity was conducted.

[Dynamics of changes of the blood biochemical indices in patients with obturation jaundice caused by choledocholithiasis, effect of plasmapheresis].

In choledocholithiasis the obturation jaundice and its complication hepatic insufficiency are accompanied by accumulation of significant quantity of water-soluble and protein-associated toxins in the blood. Application of plasmapheresis promotes the patients state improvement and intoxication severity reduction. The levels in the blood lowering of bilirubin, the average-mass peptides concentration, activity of transaminases, alkaline phosphatase were noted.

[Autoimmune changes in patients with multiple gastroduodenal ulcers and their pathogenetic significance in the complex surgical treatment].

There were examined 73 patients, suffering for multiple gastroduodenal ulcers and included in the main group, and 56 patients with solitary gastroduodenal ulcer, included in the comparison group. The lymphocytes migration impeding reaction (LMIR) was applied to characterize the autoimmune changes in both groups of patients. It was established, that in the patients with multiple gastroduodenal ulcers and with ulcers of small sizes the LMIR was essentially lowered in relation to all the autoantigenes investigated. The data obtained trust the important significance of the immunological investigation conduction in substantiation of the pathologic process pathogenesis, what must be taken into account during performance of surgical treatment and while applying the treatment-rehabilitation measures after the operation.

[The state of antioxidant defense system in patients with multiple gastroduodenal peptic ulcers]. / Stan systemy antyoksydantnoho zakhystu u khvorykh z chyslennymy pentychnymy vyrazkamy shlunka ta dvanadtsiatypaloï kyshky.

There were examined 32 patients with multiple gastroduodenal ulcers ageing 24-65 yrs (basic group) and 30 patients with gastroduodenal ulcers of conventional size (group of compare). The antioxidant defense system (ADS) state was studied, using analysis of its enzymes (catalase and superoxydismutase) activity, integrating index F was calculated as well. Prominent disorders of the ADS (the catalase activity increase and the superoxydismutase activity decrease) were revealed in patients with multiple gastroduodenal ulcers. Also the reduction of index F, which characterizes the ratio of prooxidant and antioxidant properties of the blood, was noted.

[Lipid peroxidation in patients with multiple peptic ulcers in the stomach and duodenum]. / Pokaznyky perekysnoho okysnennia lipidiv u khvorykh z chyslennymy peptychnymy vyrazkamy shlunka ta dvanadtsiatypaloï kyshky.

Under the observation there were 62 patients with multiple ulcers of a stomach and duodenum from 23 till 65 years old, randomized under the sex, age and character of pathological process (sizes and localization of peptical ulcers). In all patients the parameters of lipids peroxidation were studied. The increase of intensity the peroxidation of lipids were revealed, at the expense of augmentation in a peripheric blood of the patients of concentration of a final metabolite peroxidation of lipids--malon's dialdehyde and intermediate products--dien's conjugates. The rising of a parameter hemolysis peroxidation of erythrocytes is marked also.

[Change of the cell immunity indexes in patients with multiple gastroduodenal ulcers under the influence of surgical treatment]. / Izmenenie pokazatelei kletochnogo immuniteta u bol'nykh s mnozhestvennymi iazvami zheludka i dvenadtsatiperstnoi kishki pod vliianiem khirurgicheskogo lecheniia.

There were followed up 62 patients with multiple gastroduodenal ulcers. Before the operation in them distinct changes of the cell chain of immunity were established: T-lymphopenia, the T-lymphocytes subpopulations dysbalance, predominantly with reduction of the circulating T-helpers/inductors (CD4+) quantity with preservation on nearly normal and moderately subnormal level of T-suppressors/killers (CD8+), the immunoregulatory index (CD4/CD8) lowering. The quantity of B-lymphocytes (CD22+) was in normal limits or moderately reduced. Essential lowering of index of the lymphocytes blasttransformation reaction was noted, witnessing inhibition of the T-lymphocytes functional activity occurrence. Overall the data obtained have had witnessed the secondary immunodeficiency state presence, which deepened after operative intervention performance and was not removed as a result of the conventional treatment conduction.

[Efficacy of cycloferon and erbisol in the complex surgical treatment of multiple gastroduodenal ulcers]. / Effektivnost' tsikloferona i érbisola v komplekse khirurgicheskogo lecheniia mnozhestvennykh iazv zheludka i dvenadtsatiperstnoi kishki.

There were examined 65 patients with multiple gastroduodenal ulcers. The formation of secondary immune deficiency state on background of endogenic "methabolic" intoxication syndrome was noted in them. The blood immune indexes normalization was promoted by cycloferon and erbisol incorporation in complex of surgical treatment of multiple gastroduodenal ulcers. While conduction of the dispensary follow-up observation in 80% of patients the laboratory indexes have had persisted normal. In 20% of patients the conduction of repeated course of treatment, using erbisol and cycloferon, is indicated in 6-8 months after surgical treatment.

[Content and molecular composition of circulating immune complexes in patients with multiple gastroduodenal ulcers]. / Soderzhanie i molekuliarnyi sostav tsirkuliruiushchikh immunnykh kompleksov u bol'nykh s mnozhestvennymi iazvami zheludka i dvenadtsatiperstnoi kishki.

In 45 patients with multiple gastroduodenal ulcers the humoral immunity indexes were studied up. Formation of secondary immune deficiency with simultaneous raising of the circulating immune complexes level on account of accumulation in the blood of their most pathogenic middle and small molecular fractions and reduction of large molecular fractions was established in patients with multiple gastroduodenal ulcers.

[Application of octreotide in patients with acute pancreatitis]. / Primenenie oktreotida u bol'nykh s ostrym pankreotidom.

In 1986-2002 yrs period 515 patients were treated in the clinic for an acute pancreatitis. The severity of the disease was assessed according to clinical and laboratory data, basing on Ranson scale. Severe acute pancreatitis was diagnosed in 45 (8.7%) of patients. In 16 patients together with conventional treatment octreotide was applied in 100-300 mkg/day dosage during 5 days. Fast improvement of the patients state and elimination of acute pancreatitis symptoms was noted. All the patients are alive.