# Vol 5, No 1 (2012)

## Original articles

### Treatment of patients with chronic pancreatitis complicated with false aneurysm of celiac trunk artery basin and superior mesenteric artery

Kubyshkin V.A., Kriger A.G., Cygankov V.N., Varava A.B.

#### Abstract

Pseudoaneurysms of visceral arteries in patients with acute destructive pancreatitis, is not such a rare complication can
lead to fatal complications, and requires timely diagnosis and highly qualified surgical treatment. This article presents the
tactics and results of treatment of 33 patients with this pathology, it is proposed classification of pseudoaneurysms because
of their their relation to the pancreatic duct. Also, the article describes the treatment in these patients, including both open
and endovascular intervention.

Journal of Experimental and Clinical Surgery. 2012;5(1):12-21
12-21

### Method fistuloenterostomy with chronic pancreatitis complicated by pancreatic fistula

Korobka V.L., Chistyakov O.I., SHapovalov A.M., Glushkova O.I., Korobka R.V.

#### Abstract

The aim of the study was to develop a new method of organ-preserving surgical treatment of pancreatic fistula, which allows
efficient and reliable to eliminate external pancreatic fistulas by internal drainage of the pancreatic duct into the lumen of
the jejunum, does not interfere with normal passage of pancreatic secretion in the digestive tract. With the application of the
developed techniques operated on 8 patients. Results of surgical treatment of patients with chronic pancreatitis with external
pancreatic fistulas, operated by the developed technique confirmed the efficiency of the method to eliminate the fistula while
preserving the physiological passage of pancreatic secretion in the digestive tract, and the way to reduce the risk of failure of
fistula and disseminated septic complications of the abdominal cavity.

Journal of Experimental and Clinical Surgery. 2012;5(1):22-25
22-25

### Diagnosis and surgical treatment of cystic pancreatic tumors

Kriger A.G., Karmazanovskij G.G., Gorin D.S., Kochatkov A.V., Vetshev N.N., Berelavichus S.V.

#### Abstract

During the period from 2006 till 2011 105 patients with cystic tumors of the pancreas were observed. 30 patients had serous
cystadenoma, 36 – mucinous cystic tumors (30 – benign, 6 – malignant), 23 - intraductal papillary-mucinous tumors (15 –
benign, 8 – malignant), 16 - solid-pseudopapillary tumors (15 – benign, 1- malignant). Clinical presentation of cystic tumors
was found only in cases, where pancreatic hypertension or compression of adjacent structures by lesion was observed.
Methods of instrumental visualization allowed to find cystic tumors even in case of small size. However differential diagnostic
may be difficult not only among different types of cystic lesions, but between cystic tumors and pseudocysts of pancreas.
Surgical treatment was carried out in 100 patients. According to localization of tumor and signs of malignancy different
procedures were done: Whipples procedure – 22, distal pancreatectomy – 53, total pancreatectomy – 3, central resection
of pancreas – 9, duodenum-preserving pancreatic head resection – 9, enucleation of tumor – 4. Postoperative morbidity was
generally caused by pancreatitis. In 7 cases patients had postoperative pancreatic fistulas, which were cured conservatively.
There was no postoperative mortality.

Journal of Experimental and Clinical Surgery. 2012;5(1):26-32
26-32

### To the question of surgical tactics for patients with a chronic pancreatitis

Anosenko S.A.

#### Abstract

The article represents the analysis of treatment of 238 patients with a chronic pancreatitis. Among them 174 (73,1 %) patients
have undergone to various kinds of operations. The long-term results (after 5 and more years) have been followed in a
medical group of 91 (52,3%) patients, quality of life – in a group of 53 (30,4%) patients. It is established that in the nearest
as well as in the remote period at chronic pancreatitis resectional operations are more effective. Compared with draining
operations their performance is accompanied with a mortality decrease and improved quality of life of patients. To improve
the passableness of pankreatodigestive anastomoses at their narrowing in a remote period it is expedient to use an endoscopic
balloon dilatation of the anastomosis zone through the lumen of the isolated nestis. This improves the state of patients, their
physical and psychological status.

Journal of Experimental and Clinical Surgery. 2012;5(1):33-37
33-37

### Immunotropic influence of ronkoleukin at different ways of administration at experimental widespread purulent peritonitis

Gostishchev V.K., Kosinec V.A.

#### Abstract

migratory activity under action of mitogen-induced immunocompetent blood cells, Peyer's patches, spleen and inguinal lymph
nodes was studied at various ways of its introduction at an experimental widespread purulent peritonitis. It is established that
usage of «Ronkoleukin» in the postoperative period at a widespread purulent peritonitis corrects action of immunocompetent
cells, changing their properties of regulation of neutrophil granulocytes’ migratory activity. The given effect was observed in
all investigated bodies, however was most expressed for immunocompetent cages of peripheral blood and Peyer's patches.
It is shown that expressiveness of «Ronkoleukin»'s immunotropic action depends on a way of its introduction. For the
first time the way of intracutaneous introduction of «Ronkoleukin» which in a dose of 3 000 ME/KG renders so expressed
immunotropic effect, as well as at intravenous and hypodermic introduction in standard dosages is offered.

Journal of Experimental and Clinical Surgery. 2012;5(1):38-46
38-46

### Clinical and morphological features of widespread purulent peritonitis current during long programmed sanitization of the abdominal cavity

Makushkin R.Z., Murav'ev K.A., Bajramukov R.R., Haciev B.B., Petizhev E.B., Oganesyan A.V.

#### Abstract

The  treatment  analysis  of  56 patients, suffering  from  generalized  purulent  peritonitis , was  held  at the  department  of  purulent  surgery  SISRCCSTМA  of  Stavropol  from  2007 to 2010.The principal cause of  GPP  development  was  peritonitis  at  the  background  of  pancreonecrosis - 42,8 %. The majority of patients (44,6 %) at  the moment of  laparostomy  application were  in  grave  condition (20-30 points on MPI  scale).All  patients  with  GPP  were  forcedly  treated  with  longterm  programmed  sanations  of  abdominal  cavity  with  number  of sanations  which is more  than  4. At  the occurrence of  polyorganic dysfunction  with  the part of patients, the  conduction  of extracorporal  methods  of detoxication  even after  the  first  session  considerably  reduced  the  signs of  RDSA, renal  and  hepatic  insufficiency. At  the background  of  multiple sanations,  the current  of  pyoinflammatory  process  in  abdominal  cavity acquired  positive  dynamics  at  stable  hemodynamic  indicators. In  the  course of  treatment  11 patients died (19,6 %),  45 patients  were  discharged   from  hospital (80,4 %).  The  main  reasons  of lethal  outcome  were  sepsis (46 %), polyorganic  insufficiency (27,3 %), cardiovascular  insufficiency(18%)  and  RDSA (9 %).

Journal of Experimental and Clinical Surgery. 2012;5(1):47-50
47-50

### Acute perforated ulcers of the small intestine in patients with total purulent peritonitis

Gol'brajh V.A., Maskin S.S., Bobyrin A.V., Karsanov A.M., Derbenceva T.V., Lopastejskij D.S., Tadzhieva A.R.

#### Abstract

Modern views on etiology, pathogenesis of acute ulcers of the small intestine (AUSI) complicated by perforation were
presented. Purulent total peritonitis (PTP) is one of the reasons of acute stress-ulcers beginning. Perforation of AUSI in this
group was diagnosed in 16 (3,2%) patients. By the example of patients with PTP, the risk-factors of AUSI formation were
determined: high level of the Mannheim peritonitis index (more 15), long-term nose-intestinal intubation, prolonged artificial
lung ventilation and enteroparesis in postoperative period. For prophylaxis of AUSI elimination of circulatory hypoxia,
enteroparesis, endotoxicosis are demanded.

Journal of Experimental and Clinical Surgery. 2012;5(1):51-53
51-53

### Estimation of electrophysiological indicators of the motility of the gastrointestinal tract at patients with the duodenum ruptured ulcer

Kosenko P.M., Vavrinchuk S.A.

#### Abstract

This paper is a detailed study of electrophysiological indicators of electrogastrointestinography at 64 patients with a
perforated ulcer of a duodenum after isolated (without a vagotomy) operations. For an estimation of electrophysiological
indicators we used the multifactorial statistical analysis that has allowed to frame mathematical electrophysiological model
of postoperative disturbances of motility and evacuation. The multifactorial statistical analysis also allowed us to carry out
the comparative analysis of results of the executed operative measures. We establish the dependence of electrophysiological
indicators of a motility of a gastroenteric tract from character and volume of the executed operative measures.

Journal of Experimental and Clinical Surgery. 2012;5(1):54-59
54-59

### The syndrome of enteric insufficiency as the vector of early diagnostics of polyorganic dysfunction in urgent surgery

Fedoseev A.V., Murav'ev S.Y., Budarev V.N., Abuvarda F.H., Borisenko R.S., Panina N.Y., Golyakova N.A.

#### Abstract

One of the most actual problems in urgent surgery now is diagnostics and treatment of abdominal sepsis. For it's decision the
deep knowledge of the syndrome of enteric insufficiency is necessary. As the result of our research the presence of statisticaly
reliable connection between the polyorganic dysfunction and the expression of this syndrome was found in patients with
urgent surgical pathology.

Journal of Experimental and Clinical Surgery. 2012;5(1):60-64
60-64

### The predictions and prophylaxis of intraabdominal adhesion in patients with acute intesninal non-tumor obstruction

Lavreshin P.M., Gobedzhishvili V.K., Gobedzhishvili V.V., Kelasov I.G.

#### Abstract

Clinical trials on 119 patients after operative treatment of the acute intestinal non-tumor obstruction. Designed the diagnostic
algorithm for prognosis of pathologic adhesion, included the dynamic of auto-antibodies formation index, type of acetylation,
external signs of dysplasia of connective tissue, pathological scars, ets. Antiadhesion therapy is appropriate to use in patients
with high risk of pathologic adhesion formation. We developed and introduced into practice the aspects of by-step applying of
medicines and different physical factors in complex of prophylaxis the intraabdominal adhesion in patients with predisposing
to it. By using the rating test method it was established the reliable decreasing (in 3 times) of the adhesion formation risk in
patients with predisposing to its formation to whom was applied the complex antiadhesion treatment. Dynamics of changes
the serum titer in patients' blood to adhesion antigen complex during treatment letting to evaluate the effectiveness of
providing anti-adhesion treatment.

Journal of Experimental and Clinical Surgery. 2012;5(1):65-70
65-70

### Bile investigation for diagnosis liver and kidney failure in early postoperative period after surgical intervention on the biliary tract

Sosnin D.Y., Zubareva N.A.

#### Abstract

We examined 98 patients with surgical diseases of bile ducts and pancreas. In the early postoperative period in the bile, swollen
to drain out, studied the concentration of cholesterol and urea. In blood serum defined urea, total protein, albumin, and
cholesterol and prothrombin index. In postoperative period uncurtained the regularities of the dynamics of bile composition,
which reflects the development of functional insufficiency of the liver and kidneys. By research of urea, determined a cl
ose correlation between its content in blood serum and bile, which served as the basis for developing way of using this
fluid for monitoring of nitrogen excretory renal function. By research of bile cholesterol revealed the growth of its concentration
if it is a favorable postoperative period. With the development of liver failure this dynamic was absent, and the cholesterol
level was below 16 mg / dl. The observed differences in the dynamics of cholesterol level served as the basis for developing
a method for diagnosis of liver failure in patients in the early postoperative period. By comparing the operative charact
eristics of the proposed method is set its greater diagnostic specificity in comparison with traditional serum markers of
hepatodepression.

Journal of Experimental and Clinical Surgery. 2012;5(1):71-75
71-75

### IPOM with glue

Parshikov V.V., Izmajlov S.G., Orlinskaya N.Y., Rotkov A.I., Dudel'zon V.A.

#### Abstract

The tension-free repair of abdominal wall is standard procedure in surgery of hernias. However, experience of glue using in
Russia is small. In work are studied results of IPOM with glue and ximedon local using. Four groups of rats were operated by
IPOM technique. Macroscopic and morphological changes were observed in 14, 21, 28, 90 days after implantation. Is noted,
the mesh fixation using cyanoacrylate glue and ximedon has best results of reliability and toughness, low level of adhesions
in comparison to sutures.
The new technique of tension-free plasty is a perspective way in surgery of abdominal wall reconstruction.

Journal of Experimental and Clinical Surgery. 2012;5(1):76-79
76-79

### Efficiencys comparison of various ways of surgical treatment of postoperative ventral herniae

Shcherbatyh A.V., Sokolova S.V., Shevchenko K.V.

#### Abstract

Treatments results of 617 patients with postoperative ventral herniae have been given. 492 (79,7%) patients to whom hernioplasty
with polypropylene endoprosthesis has been applied, have come in the basic group, 461 (74,7%) patients from them
have been operated with a method « on lay », 31 (5%) patients with a method « sub lay ». The group of clinical comparison
has been made by 125 (20,3%) patients who underwent hernioplasty by local tissue. It has been revealed, that application of
endoprosthesis in hernioplasty allows to reduce quantity of herniae relapses and to raise quality of life of patients, but quantity
of wound complications after alloplasty remains high. Thus, the choice of a way of plasty in postoperative ventral herniae
remains not to be solved and consequently this problem in modern herniology remains to be an actual one.

Journal of Experimental and Clinical Surgery. 2012;5(1):80-82
80-82

### Portal vein thrombosis: etiology, diagnosis, and treatment characteristics

SHercinger A.G., Kicenko E.A., Lyubivyj E.D., Fandeev E.E., Sysoeva E.P.

#### Abstract

Portal vein thrombosis (PVT) is the main cause of extrahepatic portal hypertension. Risk factors for PVT are divided into
systemic (inherited and acquired thrombophilia) and local (abdominal inflammation, injury of the portal system). Acute
PVT is usually asymptomatic or oligosymptomatic and thereby often misdiagnosed. Most frequent first manifestation of
chronic PVT is the life threatening complication of portal hypertension – gastroesophageal variceal bleeding. Doppler
ultrasonography, oesophagogastroduodenoscopy, and also computed or magnetic-resonance angiography should be included
in clinical investigation for these patients. Early anticoagulation is the main point in the treatment of acute PVT. Selective
portocaval shunt surgery is the most radical procedure for deliverance from portal hypertension and it’s complications
in case of chronic PVT. Endoscopic treatment in combination with nonselective β-blockers are effective for primary and
secondary prophylaxis of variceal bleeding. Despite severity of the PVT complications, prognosis is good in these patients:
5-years survival is 85-95% if adequate treatment and prophylaxis performed.

Journal of Experimental and Clinical Surgery. 2012;5(1):83-91
83-91

### Prevention of bleeding complications in operations for congenital deformation of aortic arch

Arakelyan V.S., Ivanov A.A., Gamzaev N.R., Chshieva I.V., Papitashvili V.G., Gidaspov N.A.

#### Abstract

Paper is devoted to modern aspects of the prevention of hemorrhagic complications - one of the most common and dangerous
complications during operations on the aorta. Extensive surgical trauma, prolonged contact of blood with foreign surface
infrared device, large doses of heparin, hypothermia, and especially weakness of the vascular wall of the aorta is altered
causes bleeding in the intra-and postoperative period. The article reflects modern methods of combating and prevention of
bleeding complications in operations for congenital deformation of aortic arch.

Journal of Experimental and Clinical Surgery. 2012;5(1):92-97
92-97

### The study of blood supply to the left half of the colon to prevent ischemic complications in resection of infrarenal abdominal aortic aneurysm

Dyusupov A.А., Karpenko A.A., Adil'hanov G.O., Bulanov B.S.

#### Abstract

With the purpose to study the blood supply to the left half of colon the experimental study on 18 human cadavers and clinical
study of two groups of patients who underwent resection of infrarenal abdominal aortic aneurysm with and without the use
of prophylactic measures to prevent ischemic complications of the left half of the colon were realized. Experimental study on
human cadavers showed that by the value in the blood supply to the distal descending colon, sigmoid colon and rectum the
2nd place in percentage internal iliac arteries have occupied. Among operated on for infrarenal abdominal aortic aneurysm
without the use of objective methods for the prevention of ischemia of the left half of colon chronic ischemia developed in 12
(30%) cases. The proposed package of measures of preoperative examination and intraoperative method of measurement of
the retrograde pressure in inferior mesenteric artery with clamping the internal iliac arteries can determine the indications
for reimplantation of the involved arteries into the vascular prosthesis branches at resection of abdominal aortic aneurysm
and get encouraging results.

Journal of Experimental and Clinical Surgery. 2012;5(1):98-103
98-103

### The quality of life of the patients ,which have had surgery of minimal access to the aorta and the main arteries

Krasavin V.A., Smirnov G.V., Fomin A.A., Krotova E.N., Krasavin G.V., Mihajlenko E.V.

#### Abstract

This research is devoted to the quality of life of the 183 patients with occlusion of the main arteries of the lower extremities of
the segment, which have had reconstructive vascular surgery. Quality of life was assessed using a questionnaire MOS SF -36
before surgery among patients which have had various limp ischemia and after surgery that was performed out of normal
access and also minimal access to the aorta at different times. Assessmet subject to the same quality of life of patients with
different outcomes of surgery-recovery of blood circulation in the limps and thrombosis of the shunt. It is shown, that quality
of life worsens with deepening of an ischemia of extremities. Indicators become better at restoration of blood circulation after
the reconstructive surgery. The quality of life is better after surgery that was performed out of minimal access.

Journal of Experimental and Clinical Surgery. 2012;5(1):104-109
104-109

### Distant results and complications of cardiodilatation in patients with achalasia

Nizamkhodzhaev Z.M., Ligay R.E., Bekchanov H.N., Mirzakulov A., Otavanov D.

#### Abstract

Experience of treatment of 413 patients with achalasia is represented in article. General method of treatment is cardiodilatation
was performed in 377 patients (91,3%): wth Stark apparatus – in 35, pneumatic method – in 312 and hydrobaloon
method – in 30. Complications rate (bleeding, esophagitis escalation, perforation et c.) after different methods of cardiodilatations
was investigated. The less complications rate occurs by using of pneumatic and hydrobaloon models of dilatators.
Examination of distant results shown direct dependence between increasing of dysphagia recurrence and stage of disease
independenly from cardiodilatation method.

Journal of Experimental and Clinical Surgery. 2012;5(1):110-113
110-113

### The algorithm of ultrasound combined with varicose veins and osteoarthritis of the knee

Shcheglov E.A., Vezikova N.N., Kartsova I.V., Rybakov V.I., Kheyfets I.V.

#### Abstract

The paper is devoted to the actual problem of the diagnostic algorithm in conjunction varicose veins of the lower extremities and knee osteoarthritis development. The proposed algorithm includes Triplex ultrasound of lower extremity veins and knee artrosonografy. Studies were conducted both before treatment and during it. The application of this algorithm allows to estimate the dynamics of the articular process in the course of treatment, identify the state of the main veins of the lower limbs, to determine the cause of recurrent varicose veins.

Journal of Experimental and Clinical Surgery. 2012;5(1):114-119
114-119

### To early diagnosis of necrotizing fasciitis

Shaginyan G.G., Efremov A.V., Chekanov M.N., Shtofin S.G.

#### Abstract

Necrotizing fasciitis (NF) is a rare but still life-threatening soft-tissue infection characterized by rapidly spreading necrosis
of the muscle fascia and of the surrounding tissues. The aim of the study was to develop the early methods of diagnosis of
NF, analyze the clinical and laboratory findings of 17 patients and identificate the major characteristics that could help to
diagnose NF in the early stages of infection. Our data suggest that NF may exert particular tropism and/or toxicity for muscle,
responsible for early muscle necrosis, as a primary cause of CPK level elevation. At the average the exceedence of a normal
level was about 77,4 U/L. In 10 days after appropriate treatment (surgical debridement with antibiotic therapy) the CPK
level didn’t exceed the bounds of normal value (195 U/L). Early diagnosis and treatment, consisting of surgical debridement
along with appropriate antibiotic therapy, are required to reduce morbidity and mortality rates.

Journal of Experimental and Clinical Surgery. 2012;5(1):120-125
120-125

### Application of plasma flows in the complex treatment of bone whitlow

Khasanov A.G., Nigmatzyanov S.S., Nurtdinov M.A., Shamsiev R.E., Sakaev R.S., Nigmatullin N.R.

#### Abstract

The authors analyze 118 cases of surgical treatment of bone whitlow. In the study group 67 (56,7%) used a plasma stream
in complex treatment of patients. In comparison group 51 (43,3%) carried out traditional treatment. In the study group the
quantity of unsatisfactory results was essential less, than in comparison one. The authors conclude that the use of plasma
flow in the ”coagulation” in bone whitlow can significantly improve surgical treatment by reducing the exudative phase and
acceleration of reparative processes.

Journal of Experimental and Clinical Surgery. 2012;5(1):126-130
126-130

### An experimental justification of using jet sanitization and platelet concentrate in the treatment of chronic osteomyelitis of cortical bones

Glukhov A.A., Alekseeva N.T., Mikulich E.V.

#### Abstract

The results of complex treatment of chronic osteomyelitis of cortical bones. The experiment was carried out on 56 outbred rats.
To study the dynamics of structural and functional changes produced in the bone histological and radiological investigation
were hold. The data obtained indicate that the use of jet reorganization and platelet concentrate is an effective guide for
achieving the desired results in the treatment of chronic osteomyelitis.

Journal of Experimental and Clinical Surgery. 2012;5(1):131-136
131-136

### Influence of antiandrogen therapy on bone metabolism in patients with prostate cancer

Idrisov S.N., Batko A.B., Komyakov B.K., Khvedynich A.S.

#### Abstract

In the complex treatment of prostate cancer is widely used hormonal therapy, which may develop due to osteoporosis.
Patients’ skeleton condition before start of antiandrogen treatment should be examined to assess indications for substation
therapy with calcium and biphosphonates.

Journal of Experimental and Clinical Surgery. 2012;5(1):137-140
137-140

### Diagnostics of microcirculatory bed condition at patients with electrotrauma

Lubin A.V., Shapovalov K.G.

#### Abstract

The comparative estimation of a microcirculatory bed condition and components of a vascular tonus regulation was done by the laser Doppler fluometry method at 14 patients with electric current lesion of top extremities. All surveyed showed the
decreased microcirculation indicator, the increased myogenetic vessels tonus, the decreased highest possible amplitudes in myogenetic, sphygmic and endothelial ranges. The reactance of a vascular wall at a electrocurrent lesion of top extremities weakened in reply to the occlusion, the reserve of a capillary blood flow decreased in 1,5-2 times. Thus, electric current influence led to proof changes of a microcirculatory bed condition.

Journal of Experimental and Clinical Surgery. 2012;5(1):141-144
141-144

### Mechanical circulatory support – a report from Europe’s largest single-center experience

Stepanenko A.V., Romantschenko O.A., Dubaev A.A., Dranishnikov N.V., Schweiger M., Viereke J., Potapov E.V., Pasic M., Weng Y., Huebler M., Hetzer R., Krabatsch T.

#### Abstract

The implantation of ventricular assist devices (VADs) is a valuable option in patients with end-stage heart failure. The number of VAD implantations is growing worldwide. Between 7/1987 and 7/2010 we implanted 1598 VADs in 1455 patients. The majority were male (81.0 %), and their mean age was 49.4 years (range 0.3 days to 82). Indications for implantation were: cardiomyopathy (n=1074), postcardiotomy heart failure (n=282), acute myocardial infarction (n=83), graft failure after heart transplantation (n=64), and others (n=61). In 55.5% the VAD implanted was left ventricular, in 39.5% biventricular and in 4.8% right ventricular. Until 1995 the implanted pumps were mostly pulsatile. Today, however, more than 95% of the implanted VADs are continuous-flow rotary pumps. The average support time was 148.6 (range 0 to 1836) days. The percentage of biventricular VADs has dropped over the years to 20% in 2009. 347 patients could be successfully bridged to heart transplantation. In 122 patients (8.3%) the device could be explanted after myocardial recovery. In 2009 31.4% of the patients were implanted for permanent support. During the study period 521 patients could be discharged home or to a rehabilitation center. Implantation of ventricular assist devices is now an established treatment for patients with both acute and chronic end-stage heart failure. Small implantable left ventricular assist devices of the second and third generation are now broadly employed worldwide with growing acceptance and decreasing complications. The percentage of biventricular support has dropped over the years to 20%.

Journal of Experimental and Clinical Surgery. 2012;5(1):145-153
145-153

### The use of early enteral nutrition and selective decontamination of the intestine in the treatment of acute destructive pancreatitis

Mylnikov A.G., Korolev S.V.

#### Abstract

The problems of diagnosis and treatment of acute pan-
Creatine (OP) is traditionally considered one of the most
Complicated in surgical practice. This is
On the one hand, a significant increase in the frequency
Its occurrence. So, if at the beginning of the twentieth century, the OP was
He was seen as casuistry, but now
Acute surgical diseases of the abdominal organs
Cavity, it is second only to acute appendicitis and
Acute cholecystitis [1, 3, 4, 5, 16, 26]; Moreover, the co-
The socio-economic significance of the problem lies in the
That the OP is mainly affected by persons working
Of the same age (30-50 years) [10, 11, 16, 26]. On the other hand,
Although the overall lethality in OP varies from 1
Up to 7% [3, 4, 10, 16], then under destructive forms it
Remains at an extremely high level (from 12 to 87%), not
With a clear downward trend in recent years
20 years [1, 3, 7, 10, 26].

Journal of Experimental and Clinical Surgery. 2012;5(1):154-159
154-159

### Diagnosis and correction of dysbiosis in patients with postcholecystectomy syndrome

Vinnik Y.S., Serova E.V., Pahomova R.A., Per'yanova O.V., Rukosueva T.V.

#### Abstract

Gallstone disease (GSD) is considered one of the most common diseases and gives way only to atherosclerosis, leaving ulcerous disease of stomach and duodenum (KDP) [4, 5, 8, 9]. In the world annually is about 3 million operations on the biliary tract, mainly cholecystectomies [3]. However, cholecystectomy about cholelithiasis does not always solve the problems of the patient. In some patients the pain persists and dyspepsia, are similar to those before surgery, and the combined term postcholecystectomy syndrome (PHES) [2, 6].
In the pathogenesis of cholelithiasis and PHES a significant role belongs to the microflora of the intestine and the hepatobiliary zone. However, the results of bacteriological research of bile in this pathology are not always comparable. Conflicting results the sensitivity bioculture to antimicrobial chemotherapy, as well as data on development of disbacteriosis in different periods after cholecystectomy [1, 7].
The purpose of the study: improving results of treating patients with disbacteriosis after cholecystectomy.

Journal of Experimental and Clinical Surgery. 2012;5(1):160-163
160-163

### Analysis of the effectiveness of mini-access in cases of hernias of the anterior abdominal wall in the conditions of the central regional hospital

Alimov I.A., Mashkin A.M., Preferansov A.B.

#### Abstract

The use of mini-access and video-laparoscopic technologies - the main directions of reducing the traumatism of operations, reducing the patient's stay in the hospital and speeding up the rehabilitation period. As a rule, laparoscopic technologies are introduced in large hospitals - regional and urban. At the same time, in different regions, up to 40% of operated patients are residents of rural areas and small towns, and they are assisted in the conditions of the central regional hospitals (CRH). The relative disadvantages of laparoscopic operations are the high cost of equipment and supplies, the high incidence of complications at the stage of development of the operation. Therefore, it is difficult to provide hospitals with enough qualified personnel who are able to perform laparoscopic operations around the clock in CRH conditions, where surgeons often have 1-2 doctors. In this regard, mini-access seems more pragmatic and affordable solution. The hernia operation remains one of the most frequent
And in the urgent, and in routine practice of the surgeon.
Laparoscopic hernioplasty has not yet received unequivocal recognition and wide spread even in large surgical
Hospitals. Therefore, the idea of reducing the traumatism of surgery for abdominal hernia due to the use of mini-access, especially in the practice of the regional surgeon, seems to us very relevant and promising.

The purpose of the work: to assess the possibility and effectiveness of the use of mini-access in hernia under conditions of CRH.

Journal of Experimental and Clinical Surgery. 2012;5(1):164-167
164-167

### PH-meters daily rates for different types of fundoplication

Volchkova I.S.

#### Abstract

In the last ten years, The problem of increasing incidence of gastroesophathic- Geral reflux disease (GERD). Despite
Introduction of the newest anti Creations and prokinetics, the amount of With GERD is growing every year. The main method of House diagnosis and control of treatment effectiveness Non-erosive forms of GERD is the pH-metry [1]. Paw- The luxury technology of treatment of GERD gave a push To the emergence of a new stage in antireflux surgery [2]. Currently known and applied Various methods of antireflux operations. The
A great recognition of surgeons is the operation Nissen [3,4,5]. Surgery consists of In mobilizing the distal part of the esophagus, creating Folds of the stomach bottom around (360 °) of the esophagus and Stomach to the anterior abdominal wall. We have developed a new method of fundoplication, Which maximizes the use of anatomical-physiological- The esophagus and gastrointestinal Course (PWP).

Objective: to study the antireflux effect Developed method of fundoplication in GERD, Using as a criterion of effectiveness the indicators of su- Accurate pH - metry.

Journal of Experimental and Clinical Surgery. 2012;5(1):168-170
168-170

### Comparative evaluation of the effectiveness of surgical treatment of patients with metabolic syndrome

Kiryenkova E.V., Litvinova L.S., Aksenova N.N., Sededtsov V.I., Seledtsova I.A., Mironyuk N.I., Zatolokin P.A.

#### Abstract

In the last decade, an increasing spread the question of acquiring surgical corobesity of the reaction, one of which is pawroscopically gastro-bypass surgery (LGS). The at least, the main method of treating metabolic syndrome (MS) and weight loss remains therapeutic treatment [6, 8]. Due to the fact that co the number of patients with MS is growing, a critical question is you boron species correction. Bearing in attention insufficient experience with the use bariatriical operations in Russia, we compared the effecness of surgical treatment of MS efficacy conservative treatment of this dislevania.

Journal of Experimental and Clinical Surgery. 2012;5(1):171-173
171-173

### Analysis of the characteristics of postoperative pain syndrome in resection of the thyroid gland within the framework of the concept of antistress anesthetic protection

Nemakhova E.A., Lavrentiev A.A., Grigorovich R.I., Scriabin I.V., Biryukova T.A., Popov P.A.

#### Abstract

The expressed pain syndrome in the postoperative period takes place in 30-75% of cases. In Russia, according to a survey of patients of different
Clinics, it was revealed that not less than 40.7% of patients who underwent scheduled and emergency surgeries, noted dissatisfaction with the quality of postoperative analgesia. In this case, thyroid disease
The glands (thyroid gland), subject to compulsory surgical treatment, occupy the most important place in the structure of modern surgical pathology. Existing operative interventions are typical
Factors of operational and anesthetic stress (including postoperative pain syndrome) are the underlying causes of neurovegetative imbalance of the body and potential mechanisms of tanatogenesis. Consequences of expression
Postoperative pain is psychoemotional stress, the likelihood of chronic pain syndrome, vegetative disorders, lengthening the post-operative period, and a decrease in the quality of life of patients.
The problem of antistress anesthesia at the level of postoperative analgesia during thyroid resection operations remains incompletely solved. It should be assumed that the traditional
Methods of postoperative analgesia require serious methodological optimization. However, for effective development of optimized programs for postoperative analgesia and stress-limiting protection of the body during thyroidectomy resection at the preparatory stage, it is necessary to obtain a detailed characterization of the pain syndrome and to estimate the actual level of effectiveness of the traditional method of anesthesia after this type of surgical intervention. The above-mentioned circumstances determine the high relevance
Of this study.
The aim is to analyze the effectiveness of complex anti-stress protection of the body during thyroid resection based on evaluation of the characteristics of postoperative pain syndrome and neurovegetative status of patients.

Journal of Experimental and Clinical Surgery. 2012;5(1):174-177
174-177

### Surgical correction of brittle bones using titanium nickelide materials in children

Slizovsky G.V., Titov M.V., Kuzhelivsky I.I., Lukyanov A.I., Shikunova Y.V., Stepanov M.Y., Oorzhak M.D.

#### Abstract

Imperfect osteogenesis (HO), or fragility Bones, is a congenital malformation of the Tion. This pathology of the whole organism with predominant Damage to bone tissue, related to
A large group of diseases - osteogenezis imperfekta. More common in males [1, 4]. The clinical picture of the NO is characterized in Mainly multiple fractures of long Tubular bones, which subsequently lead to Curvature of the limbs and the progression of weShear atrophy. It should be noted that such Patients there is a clinical feature - the presence Blue sclera and "amber teeth", and with the age of for Mirated triangular shaped face. After birth Child fractures of the bones arise from different
Chin - swaddling or shifting the child, with Try to sit, stand on legs, at runtime Massage. Fractures in patients with DU are accompanied Classic signs: soreness, swelling, Lost, crepitation of fragments; Consolidation of Walks in normal terms, according to the age of reBenches. It should be noted that with the growth of the child and with Change in the static-dynamic conditions of the origin of the Formation of deformation of the lower extremities, Which further determines their shape. Most Frequent deformation of the thigh is a curvature At an angle, open to the inside and back like a riding breeches. The bones of the lower leg are curved in the sagittal planeIn the form of a saber-like shape. In the future, with A noticeable discrepancy Between the shortened limbs and normally Twisted body [3]. Treatment of patients with ND is to provide Proper care, prevention of fractures, preDeflection of deformations, strengthening of muscular The skeleton and the elimination of deformed
Tions. For surgical correction of deformities The lower extremities are developed and applied in Orthopedics quite a lot of methods: osteoclasis, Osteotomy, segmental osteotomy, for fixation Fragments are used metal rods with n- Tearing, decortication, segmental osteotomy And plastic by allografts by type "Fagots". The use of distraction apIlizarov for correcting deformations in the Soil is difficult because of osteoporosis and
Of the spoke [2, 5]. All this leads the patient to a deep invalid.
That determines the relevance of this pathology As in the choice of surgical strategy, and in tactics Restorative treatment.
Objective. Assess the effectiveness of the Of titanium nickelide materials during surgical Correction of clinical manifestations of BUT in children

Journal of Experimental and Clinical Surgery. 2012;5(1):178-180
178-180

### Modern views on diagnostic and reconstructive management of patients with posttraumatic defects and deformities of the facial bones

Vladimirovna I.K., Dubina L.K., Drobyshev A.Y., Davydov D.V., Yakimenko I.I.

#### Abstract

According to the WHO for 2010, a person's injuries account for about 40% of all types of injuries. In 60% of cases the age of the victims does not exceed 40 years. At present, the frequency of traumatic injuries of the bones of the facial skeleton does not tend to decrease. The growth of injuries, which is currently observed, is also reflected in the increase in the frequency of combined craniocerebral injuries, primarily craniofacial injuries [1]. Fractures of the bones of the middle face are often combined with damage to the brain and other parts of the body that determine the severity of the condition of the patients and the location of their treatment.
In connection with the anatomical features of the structure of the middle zone of the face, the diagnosis and treatment of injuries in this area are quite a challenge. The middle zone of the face consists of thin bone plates with a large number of air-bearing cavities. This zone is strengthened by buttresses, thanks to which the strength of the facial part of the skull is created and the force applied to the bones of the facial skeleton is redistributed. The complexity of the anatomical and physiological connections of the middle zone makes it difficult to diagnose traumatic injuries: the variety of variants of displacement of fragments of the bones of this part of the skull, their fusion even at significant displacements and, as a consequence, the occurrence of posttraumatic deformations, are the causes of gross aesthetic disturbances [10]. The complexity increases in the case of destruction of the walls of the orbit and the displacement of the eyeball.

Journal of Experimental and Clinical Surgery. 2012;5(1):181-185
181-185

### Experience in using of spinal anesthesia in operations on the anorectal region in ambulatory clinic

Dubrov V.E., Veredchenko V.A., Kuktenko A.V., Cohan A.M.

#### Abstract

In recent years, priority directions for the development of health care in the Russian Federation, stationary substitution of low-invasive technologies, are becoming increasingly widespread. In the outpatient proctology, minimally invasive methods of treating various diseases of the anorectal area have developed, with particular attention to the choice of anesthesia, which can be applied in outpatient settings.
Journal of Experimental and Clinical Surgery. 2012;5(1):186-188
186-188

## New in surgery

### A new method of immersed interintestinal anastomosis

Tarasenko S.V., Aftaev V.B., Prus S.Y.

#### Abstract

The number of patients with diseases of the colon, in need of surgical treatment is growing steadily. In Russia, 40,000 - 45,000 cases of colon cancer are registered each year, in the United States - 140,000, i.е. In 1 out of 20 residents, colon cancer is detected. There are always recommendations on the use of surgical treatment in one stage with the restoration of intestinal continuity in diseases of both the right and left half of the colon. The problem of the formation of joints of the organs of the gastrointestinal tract remains one of the central problems in surgical gastroenterology. Despite the improvement of the methods of anastomosing, the results of their use can not fully satisfy clinicians. One of the serious complications in the postoperative period is the inconsistency of the anastomosis sutures.
Journal of Experimental and Clinical Surgery. 2012;5(1):189-192
189-192

### The method of surgical correction of funnel chest deformation in children

Slizovsky G.V., Maslikov V.M., Kuzhelivsky I.I., Stepanov M.Y.

#### Abstract

The anatomical and clinical description of the funnel-shaped deformity of the chest (DVGK), the bootmaker's chest, pectus excavatum, was made in
Late 16th century and published as an essay by the famous anatomist and physician Bauhinus in 1594 in Frankfurt.
The first operation in the area of HDCE was performed in 1911 by Ludwig Meyer, who resected the rib cartilage. DVGK, according to a number of authors, occurs in 0.6-2.3% of cases, which is 91% of congenital deformations of the chest (Willital et al., 1981). DVGK - the most frequent pathology of the chest wall in children. Most deformations of this kind are accompanied by impaired breathing and hemodynamics. Even a slight cosmetic defect causes significant changes in the child's psyche, leads to a closed way of life, neurosis-like conditions and, ultimately, social maladjustment. The only way to change the configuration of the chest is surgical correction. To correct the funnel-like deformity of the chest, more than 50 different surgical procedures have been proposed (L. Ombredan, R. Gross, GA Bairov, F. Rebein, A. Brunner, V. Paltia, I. Krause, M. Ravich, F. Robichek , AI Kondrashin, I. Vada, VI Geraskin, YA Brodko).

Journal of Experimental and Clinical Surgery. 2012;5(1):193-197
193-197

### Management of patient with strangulated paraesophageal hernia

Dergal S.V., Korytsev V.K.

#### Abstract

One of the terrible complications of parasophageal hernias is their infringement [1]. In practice, this complication is not common, and clinical manifestations can be very diverse in this case
And simulate other acute diseases of the thoracic and abdominal cavities. According to various authors, the shortest time interval from the moment
The patient's admission to the diagnosed diagnosis is observed in hospitals that have experience in the treatment of such patients [2]. We give a clinical observation.
Journal of Experimental and Clinical Surgery. 2012;5(1):198-199
198-199

## Review of literature

### The problem questions of diagnostic and prognosis in severe acute pancreatitis

Firsova V.G., Parshikov V.V.

#### Abstract

Abroad, there is some experience with the use of synthetic and biogenic adhesives in the surgical treatment of hernias. In Russia, such interventions are carried out only in some clinics. The development and application of glue compositions are in the center of attention of the leading Germanic schools.
In the experimental work, the features of intraperitoneal plasticity of the abdominal wall were studied using a grid using glue and xymedon. It is shown that their use has certain advantages in comparison with the traditional use of surgical sutures. Glutinous fixation of the mesh is much stronger than implantation of the endoprosthesis with a surgical suture, and the adhesion process is less pronounced. Local application of xymedon corresponds to the maximum strong fixation of the mesh and does not increase the formation of adhesions in the abdominal cavity.

Journal of Experimental and Clinical Surgery. 2012;5(1):200-206
200-206

### Modern methods of minimally invasive surgical treatment of stomach perforations

Tsatsaev H.M., Alipov V.V.

#### Abstract

Perforation of the stomach - life-threatening osFalsification of a number of diseases, primarily gastric ulcers, Complication, in which lethality reaches 17% [11, 38]. If treatment of ulcer bleeding is good, In 90% of cases of minimally invasive
Endoscopic technologies has undergone significant Changes, the methods of closing the perforatedTh hole remain fundamentally unchanged [15]. The operation of choice in urgent surgery is perforatinUp to now, suturing remains Perforation hole [26]. However, with laparoIntensive intervention takes most of the time Not on the main stage of the operation, but on access and suturing Wound, and the severity of the course of the postoperative period In many respects depends not on the amount of operative intervention Of the size of the operating wound [21].

Journal of Experimental and Clinical Surgery. 2012;5(1):207-212
207-212

### Sublay retromuscular technique in tension-free repair of abdominal wall hernias

Parshikov V.V., Hodak V.A., Petrov V.V., Romanov R.V.

#### Abstract

The tissue joining technique is one of the Most controversial issues in surgery, Which can not be overestimated [19, 20, 23]. Importantly, The topic was once again underlined by the At the All-Russian Conference of Surgeons in 2010. This problem is closely related to the treatment of one Of the most numerous categories of patients  Of patients with hernias [13]. Methods hernias on Are in the focus of attention of surgeons for many Years [65,76]. The most complex sections of the herniolo- The issues of postoperative care Ventral hernias [5,35,61]. First of all, this is Associated with a large number of recurrences of this
Pathology (up to 50%), despite the accumulated ten- Experience and perfection of technology Of operations [2]. In addition, the contingent of patients With large and gigantic hernias represents
A problematic group of patients, both for Ha, and for an anesthesiologist, and the problem is operational - anesthesia risk is far from being resolved [38,85]. In recent years, plastic local tissue- I finally lost my position to the modern Technologies based on the use of synthetic Endoprostheses for the closure of abdominal defects Walls [1]. Using the grid allowed us to solve a number of Problems, perform plastic surgery without stretching the tissues and Increase intra-abdominal pressure, warn Certain local and systemic complications [10,20]. Application of non-stretch plastic is active Is implanted in emergency surgery [15,27,12,31].

Journal of Experimental and Clinical Surgery. 2012;5(1):213-218
213-218

### The choice of suture material in surgical practice at the present stage

Bychkov I.V., Bychkov I.

#### Abstract

In recent years, most surgeons are giving increasing importance to the issue of the choice of suture material. Close attention to this issue due to the fact that the outcomes of any operation depend largely on the quality and structure of the suture material and its interactions with surrounding tissues [7, 11, 13, 18].
Suture material – General name for a variety of materials (threads, needles) used for connecting tissues or ligation of vessels. The need to use threads for the needs of surgery originated in the very early stages of development of medicine. In ancient times for sutures used tendinous fibers of mammals, amphibians leather, fiber, rubber tree, coconut. Later, surgical practice has found its application thread from flax and silk. However, each of these materials had a number of limitations, such as the ability to provoke inflammation and infection of the tissue, low mechanical reliability of the formed seams, and other negative qualities that led to many postoperative complications and, consequently, limit their applicability. In the last 10-15 years thanks to the development of the chemical industry and the introduction of nanotechnology in the Arsenal of the surgeon appeared in a wide range of modern suture material, which can be classified according to the following characteristics [3, 10, 32].

Journal of Experimental and Clinical Surgery. 2012;5(1):219-223
219-223

## Memorials

### Nikolai Ivanovich Pirogov: sickness, death, embalming and preservation of the body

Mnikhovich M.V., Kaktursky L.V., Huminski Y.I., Fomina L.V., Vernygorodsky S.V., Kaminskaya N.A., Miglyas V.G.

#### Abstract

In 2011, December 5 marked 130 years from the day Death of a great citizen and patriot of Russia, A surgeon, a morphologist, a pathologist, an exPerimentator, scientist, educator, public de-
A humanist, and a philosopher NI Pirogov. Hardly There is a history of Russian, and world medicine Another name, surrounded by such a halo of national Glory, with such love and veneration as the name of genius - Nikolai Ivanovich Pirogov!

Journal of Experimental and Clinical Surgery. 2012;5(1):224-232
224-232

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