Surgery

The research goal is to state possibility of virtual colonoscopy and to determine the localization and nature of neoplasms in the large intestine. Materials and methods: 38 patients have been examined by the method of virtual colonoscopy. The preceding stage of diagnosis by total fibrocolonoscopy has not been a success. Results: Virtual colonoscopy has been performed in 94.7% of patients. The same tumors have been identified in the proximal colon, direct examination of which has not been possible. Conclusion: Virtual colonoscopy is the method of choice for topical diagnosis of tumors of the colon

The article discusses the surgical treatment of ingrown nail in patients with recurrent disease. The advantages of a new method of operation have been explained in the article. It gives a detailed description of the operation. The clinical and additional methods of research have confirmed the fact that a new operation reduces the wound healing period and the number of ingrown nail recurrences

The research goal is to develop a new objective diagnostic method of prerecurrence syndrome that will prognose bleeding recurrence from gastroduodenal ulcers. Materials and methods. Method of laser Doppler flowmetry (LDF) of the regional perfusion of tissue has been used. The experimental part has been done on 30 white laboratory rats. Characteristics of regional tissue perfusion in the simulation and laser hemostasis of bleeding have been studied. Gastroduodenal endoscopy has been performed with laser Doppler flowmetry (ELDF) in clinical conditions to predict the recurrence of ulcerative bleeding. The prognostic method of gastroduodenal ulcerative bleeding was used in 58 patients hospitalized with such pathology and activity of bleeding Forrest II. Results. The study of microcirculation parameters and experimental hemostasis has showed the possibility of using LDF to measure its performance. Effective hemostasis has been accompanied by a significant decrease in perfusion. On the basis of microcirculation parameters in ulcerative bleeding, medical adrenaline test has been proposed for an objective verification pre-recurrence syndrome. To evaluate the effectiveness of endoscopic hemostasis perfusion has been measured before and after its implementation. Conclusion. ELDF has objectified the prognosis of ulcerative bleeding recurrence, verified pre-recurrence syndrome and evaluated the efficacy of endoscopic hemostasis

The research goal is to develop a universal method of monitoring of intragastric medium dynamics. It allows diagnosing of bleeding recurrences and monitoring the effectiveness of gastric secretion suppression. In Saratov clinic of General Surgery use of probe-detector, dynamic endoscopy, laser Doppler flowmetry and methods of endoscopic hemostasis has reduced mortality: postoperative mortality has been decreased from 7,4 to 1,6%, while the general mortality — from 3,5 to 1,5%. The proposed devices can be used separately, and do not allow parallel assessment of pH of gastric juice, the microcirculation in the stomach wall and bleeding recurrences. 47 patients have been under the study. The changes in electroconductivity of intragastric medium have been proved in the suppression of intragastric secretion and the appearance of blood in gastric lumen. The received data have considered impedancemetry as the method of monitoring of intragastric medium in gastroduodenal bleedings

Objective of the research is to improve the results of surgical treatment in patients with postoperative acute bleeding erosions and ulcers of stomach and duodenum by their prediction and validation of methods for prevention and treatment. Materials and methods. A retrospective analysis of 3746 case histories of patients has been made. Acute erosive and ulcerative lesions, complicated by gastroduodenal bleeding, have been diagnosed in 220 cases (5, 9%) in the postoperative period. Older patients have been accounted 62, 8%. Results. Acute erosive and ulcerative lesions have been developed in 5.6% of all operated patients of older age, and 0,3% in patients of middle age. Mortality rate in older patients with bleeding acute erosive and ulcerative lesions has accounted 35,8. Conclusion. The development of gastroduodenal acute erosive and ulcerative lesions is considered to be a risk factor degenerating condition of older patients in the postoperative period. The main areas of acute erosive and ulcerative lesions treatment are antisecretory therapy and endoscopic hemostasis. Endoscopic hemostasis should be accompanied by good antisecretory treatment with antacid effect in the stomach. The use of injections of H2-blockers does not prevent bleeding recurrences

Aim of investigation — to analyze the results of treatment of patients with atherosclerotic gangrene of a limb, to identify the causes of adverse outcomes amputation. Materials and methods: We analyzed the results of examination and treatment of 218 patients with atherosclerotic gangrene of the limb. Good outcome of amputation was considered the primary surgical wound healing of the stump. Suppuration, secondary healing, re-amputation and death we attributed to the adverse results of amputation. Results: The adverse outcomes of amputation due to technical errors in surgery, properly chosen level, inadequate drainage of the wound stump, an unsuccessful operation on the arteries of a limb, inadequate empirical antibiotic therapy, patient's age, functional capabilities of myocardium, the duration of critical ischemia, as well as the lack of psychological adaptation of patients before amputation. Conclusion: To decide the need for amputation in patients with atherosclerotic gangrene follows the assessment of possible vascular reconstructive surgery. In determining the level of amputation is necessary to objectively assess the degree of disruption of regional blood flow using multilevel manometry and laser Dopplerflowmetry. In preparation for amputation should be paid special attention to the correction of rheological and coagulation properties of blood, normalization of the functional state of the myocardium, as well as specialized psychotherapeutic training for timely and adequate psychological adaptation of the patient

The effectiveness of different surgical techniques in patients with cystic lesions of spleen is considered in the article. The results of treatment of 9 children aged from 9 to 16 years old during the period from 1998 till 2009 have been analyzed. The examination included ultrasound computerized tomography and MRT Differential diagnosis was made between lymphangiomas, hemangiomas and true cystic growths of spleen. The proper diagnosis was made after his-tological examination. The invasive procedures preserving spleen were preferred. But despite the surgical technique the possibility of cystic recurrence was remained. Percutaneus puncture with draining and long term sclerotherapy performed by laparoscopy control was considered to be a safe procedure

The research objective was to study the dynamics of the bacterial contamination and the healing rate of the experimental purulent wound when applying the suspension of copper, iron, zinc nanoparticles locally. Iron, copper and zinc nanoparticles received by a plasmochemical method were used under the influence of a plasmic stream with the temperature 5000-6000°K. 40 white rats — males with purulent wounds were used in the investigation. Planimetric and bacteriological methods of study helped evaluate the traumatic process. They were carried out on the 3rd, 5th, 7th, 10th and 14th days. Application of the suspension of copper nanoparticles ensured the elimination of the causative agent which had contaminated the wound in a short period of time in comparison with the groups in which iron and zinc nanoparticles had been applied and the control group. The shortest term of wound healing was detected when using the suspension of copper nanoparticles; a rather less healing rate was observed when using the suspension of zinc nanoparticles. Regenerating action of iron nanoparticles was less evident considerably, but significantly differed from the control group. In conclusion it was stated that the use of the suspensions of metal nanoparticles in the isotonic solution was proved to be effective in the local treatment of purulent wounds. Suppression of microbial flora and regenerative action were detected to various degrees. The most evident antiseptic and regenerative action was determined in copper nanoparticles

Methods: to optimize treatment of patients with complicated forms of chronic venous insufficiency of our method was applied systems analysis, proposed by Th. Saaty (1993), and was called the «method of analysis of hierarchies». Results: the results indicate a direct relationship to the choice of methods for the treatment of patients with complicated forms of chronic venous insufficiency of the influence of individual actors and the goals of each. Conclusion: applying the analytic hierarchy process in selecting a method of treatment in patients with complicated forms of chronic venous insufficiency of the lower extremities can improve the quality of life of patients and reduce the frequency of disability, reduce the rate of loss of ability to self-service, as well as reduce the costs of treating both the patient and medical institution

The article presents the modern innovation technologies in diagnostics and surgery treatment of liver focal formations