Optimization of the Cardiosurgical Services of the Voronezh Region, Providing an Example of High-Tech Medical Care to the Patients of Older Age Group

Abstract


Relevance Enteroparesis and perifocal edema in the zone of anastomosis lead to the rise of pressure in the intestinal lumen, the enlargement of its diameter, the stretching of its wall, the proportional increase of the distance among sutures, which may contribute to the rupture of the sutures and interfere with the reparative process in the zone of anastomosis. The purpose of the study The objective is to develop the pathogenetically justified method of a single-row continuous Z-shaped suture by using microsurgical techniques. Materials and methods Experimental research was performed on 70 adult albino rats of the line «Vistar» in two stages. At the first stage, distinctive features of the healing of intestinal wounds were compared. The anastomosis was performed using a single-row penetrating interrupted suture in the 1st series and a single-row continuous locking serous-muscular-submucous stitch in the 2d series. At the second stage, we focused on the development of the pathogenetically justified method of the single-row continuous serous-muscular-submucosal Z-shaped suture, practiced the application of this suture on 100 fresh gastrointestinal conglomerates of pigs and 10 adult albino rats of the line «Vistar». Results and their discussion In the early postoperative period, we observed the tendency towards the development of more durable sutures of the anastomosis in the second series than in the first one. The new single-row continuous Z-shaped suture has a higher strength, hermeticity and large fixing area of serous membranes. Conclusion Within the proposed use of the technique of the single-row continuous serous-muscular-submucosal Z-shaped suture, there is the distribution of the multi-vector tensile force that can prevent hyperextension of tissues and anastomotic leak.

Voronezh Regional Clinical Hospital №1, 151 Moskovskii Ave., Voronezh, 394066, Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com
 MD, Professor, Deputy Director of the Scientific Centre of cardiovascular surgery named after A.N. Bakulev scientific-organizational work

Voronezh Regional Clinical Hospital №1, 151 Moskovskii Ave., Voronezh, 394066, Russian Federation

Email: author@vestnik-surgery.com
MD, Professor, head. CTD. surgery for coronary heart disease and cardiac rhythm Voronezh regional clinical hospital №1

Voronezh Regional Clinical Hospital №1, 151 Moskovskii Ave., Voronezh, 394066, Russian Federation

Email: Nazarov8481@mail.ru
cardiovascular surgeon of the Voronezh regional clinical hospital №1

  1. Bokeriia L.A., Olofinskaia I.E, Skopin I.I. Analiz
  2. gospital'naya letal'nost' u pozhilyh bol'nyh, perenesshih operacii na serdce
  3. s iskusstvennym krovoobrashcheniem.[Analysis of
  4. hospital mortality in elderly patients after cardiac surgery
  5. with cardiopulmonary bypass.]
  6. Grudnaia i serdechnososudistaia
  7. khirurgiia. 2007; 5: 8-10.
  8. Bokeriia L.A., Stupakov I.N., Samorodskaia I.V. Dolgosrochnye
  9. rezul'taty operacii na otkrytom serdce u pacientov starshe 65 let. [Long-term
  10. results of open heart surgery in patients older than 65 years.]
  11. Grudnaia i serdechno-sosudistaia khirurgiia.2008; 6: 4-7
  12. Vertkin A.L., Zairat'iants O.V., Khovasova N.O.Komorbidnost' v kardiologii: razgovor za stolom
  13. razdel.
  14. [Comorbidity in cardiology: a conversation at the table of
  15. section.] Novosti kardiologii. 2012; 1: 18-19. - (in Russ.).
  16. Gendlin G.E., Vavilov P.A., Storozhakov G.I.Protezirovanie
  17. klapanov serdca u lyudej starshe 60 let. [Prosthetics of
  18. heart valves in people older than 60 years.]
  19. Klinicheskaia
  20. gerontologiia. 1997; 2: 19-24.
  21. Ivanov V.A., Domnin V.V., Rudakov A.S., Evseev E.P.,
  22. Podchasov D.AKratkosrochnye rezul'taty hirurgicheskogo lecheniya
  23. priobretennyh klapanov serdca serdca i rakovyh bol'nyh pozhilogo vozrasta. [Short-term results of surgical treatment
  24. of acquired valvular heart and cancer patients elderly.]
  25. Grudnaia i serdechno–sosudistaia khirurgiia. 2010; 4: 22-
  26. Amerikanskaya Associaciya Serdca. Serdce i insul't statisticheskoe
  27. Obnovlenie.[American Heart Association. Heart and Stroke Statistical
  28. Update.] Dallas, Tex: American Heart Association, 2006.
  29. Oganov R.G., Maslennikova G.Ya. Neinfekcionnye
  30. bolezni v Rossijskoj Federacii i rol' faktorov riska.
  31. V oblasti ukrepleniya zdorov'ya i profilaktiki neinfekcionnyh
  32. bolezni v Rossii i Kanade (red. O.S. Glazunova i S.
  33. Stachenko).[Noncommunicable
  34. disease in the Russian Federation and the role of risk factors.
  35. In Health Promotion and Prevention of Noncommunicable
  36. disease in Russia and Canada (Eds. I.S. Glasunov and S.
  37. Stachenko).]
  38. July 2006. 150p.HP5-16/2006E ISBN: 0-062-
  39. Lung B., Cachier A., Baron G. et al. Eur. Heart J. //2005; 26:
  40. -2720.
  41. Tseng E., Chieh A Lee, Cameron D.E. et al. Ann. Surg.
  42. ; 225: 6: 793-804.
  43. VOZ. Starenie i zdorov'e. 1999. Global'noe dvizhenie za
  44. aktivnoe starenie.[WHO. Ageing and Health. 1999. Global movement for
  45. active ageing.]

Views

Abstract - 69

PDF (Russian) - 30

PlumX

Dimensions


Copyright (c) 2014 ., ., .

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies