Vol 4, No 1 (2011)

Original articles

Peculiarities of surgical tactics in postoperative ventral hernias in elderly patients

Evseev M.A., Golovin R.A., Sotnikov D.N., Lazarieva N.M.

Abstract

The questions of surgical tactics in large and giant postoperative hernia in patients of older age groups. An analysis of the causes of recurrent hernias and postoperative complications identified the need to use algorithmic approach to the selection method of plasty of abdominal wall, defined the criteria for the possibility of operational benefits in patients with severe concomitant diseases, as well as a preoperative preparation program.

Journal of Experimental and Clinical Surgery. 2011;4(1):10-16
pages 10-16 views

Special features of early postoperative period in herniaplasty with different position of the prosthetic mesh

Kuznetsov A.V., Kuznetsov Y.V., Dobryakov B.S., Alexeev B.V., Shestakov V.V., Borodach A.V., Fedin E.N.

Abstract

In clinic they are studing peculiarities of  early postoperative period in patients with ventral hernia repair using different polypropylene   prosthetic mesh placement were studied. Observations were made with regards to complications analysis, surgical trauma course, duration of operation and mesh consumption. Effectivety of  “sublay” and “underlay” prosthetic mesh placement was proven.

Journal of Experimental and Clinical Surgery. 2011;4(1):17-20
pages 17-20 views

The long-term results of radical organpreserving operations compared with resection of the stomach and suturing in elderly patients with complicated gastroduodenal ulcer

Vinnik Y.S., Chaikin N.A., Aksyutenko A.N., Parsley S.I., Kolesnytsky O.A., Teplyakova O.V.

Abstract

Long-term results show a significant superiority of radical organpreserving  operations compared with suturing and stomach resection in elderly patients with perforated gastroduodenal ulcer. Quality of life after radical operations in patients older 60 years is remaining high. The long-term syndromes specific to the patients condition after resection or suturing present in minimal percents of cases.

Journal of Experimental and Clinical Surgery. 2011;4(1):21-28
pages 21-28 views

Perforated ulcer in the elderly – is there a generic operation?

Tarasenko S.V., Zaitsev O.V.

Abstract

Comment on the article J. S. winnik et al.: "Long-term results of radical breast conserving surgery in treatment of perforated gastroduodenal ulcers in patients of elderly and senile age"

Journal of Experimental and Clinical Surgery. 2011;4(1):29-30
pages 29-30 views

Standardization of complex dynamic diagnosing and tactics of treatment of postoperative peritonitis

Nazyrov F.G., Devyatov A.V., Hodjiev D.S., Babadjanov A.H., Sadykov R.Y.

Abstract

Structural issues of primary interventions, development frequency, mortality and treatment tactics of postoperative peritonitis after emergency and selective abdominal operations were analyzed on huge clinical material.  The assessment and opportunity of prognostic integral scale application, summery of results, which let to standardize protocols of treatment of patients with postoperative peritonitis, adequately estimate  risk and selection of optimal tactics of reoperation.

Journal of Experimental and Clinical Surgery. 2011;4(1):31-39
pages 31-39 views

Dynamics of the system inflammation in staged abdominal repair of general purulent peritonitis

Vinnik Y.S., Zdzitowiecki D.E.

Abstract

This paper is devoted to the influence of constant transmembrane peritoneal dialysis during the systemic inflammatory response syndrome in patients with general purulent peritonitis (GPP). On the basis of comparative analysis of the results of staged surgical treatment of 67 patients with GPP the clinical efficacy of this method of the abdominal cavity was proved. As a result of constant transmembrane peritoneal dialysis has reduced the absolute risk of postoperative complications in the half-open run by BP at 23,0% and a relative – on 27,1%

Journal of Experimental and Clinical Surgery. 2011;4(1):40-44
pages 40-44 views

Severity condition assessment in patients with intra-abdominal surgical infection

Gvozdik T.P., Kononov V.S., Nurtelecom M.A.

Abstract

The therapy outcome of 258 patients with intra-abdominal surgical site infection has been evaluated, 205 (79,5%) of which developed abdominal sepsis of different severity degrees. In order to assess risk factors of lethal outcome, the severity of illness and related organ dysfunction scores have been calculated by means of APACHE II, SAPS, MODS и SOFA, as well as the procalcitonin levels test laboratory findings (PCT). In the present study, procalcitonin levels evaluation has shown to be a high sensitivity test that provides objective information for an infectious process assessment, correlating to APACHE II scores (R2=0,86). The concomitant liver dysfunction has been revealed be the most unfavorable factor for intra-abdominal infection prognosis, being the direct cause of death in 28,3% cases. The most sensitive values are total bilirubin, alkaline phosphatase, triglyceride levels, with the highest correlation ratio R2=0,92, R2=0,89, R2=0,93, respectively, which allows their application as an early diagnostic procedure for liver dysfunction detection in this group of patients with the perspectives of its correction.

Journal of Experimental and Clinical Surgery. 2011;4(1):45-50
pages 45-50 views

The role of organo-tissue barriers in the formation of a systemic inflammatory reaction and neutralize toxins in pancreatic necrosis, the choice of rational tactics surgical treatment

Lubyanka V.G., Chernenko V.F., Aliev A.H., Zharikov A.N., Yelchaninova S.A., Mishchenko A.N.

Abstract

Despite the intensive development of the diagnosis and surgical treatment of pancreatic necrosis (PN), mortality remains
high, reaching 30-50% or more. This is due, on the one hand, with insufficient study of the mechanisms pancreatogenic
toxemia, generalized infection, manifestations of the Systemic Inflammatory Response (SIR) and the role of organ-tissue
barriers in the neutralization of toxins (the liver, lungs, muscles and cellulate array), on the other hand, the ineffectiveness
of drugs in their system application as a result of blocking organ microcirculation and limiting their availability. As a result,
research has found evidence of the complexity of the SIR and the mechanisms of toxemia in the PN (enzymatic, metabolic
and bacterial), which showed a high level of leukocytosis, the study of enzymes, especially when infected Mon, reflecting the
morphological and functional liver damage, as the primary detoxification barrier pancreatogenic aggression. These humoral
indicators can serve when they raise specific markers of the severity of toxemia and SIR. Application regional arterial drug
therapy provider medicinal effect is in the region of defeat, can achieve better results in reducing mortality in Mon, compared
with traditional methods of treatment.

Journal of Experimental and Clinical Surgery. 2011;4(1):51-56
pages 51-56 views

Esophagoplasty in patients with burn strictures of the esophagus

Cikini Y.V., Drobyazgin E.A., Kutepov A.V., Berkasova I.V.

Abstract

Esophagoplasty in cicatricial narrowing of the esophagus is made postburns 116 patients. Disease duration - from 1 month
to 31 years. Subtotal shunt esophagocolonoplastik left half of the colon made 68, extirpation of the esophagus with a plastic
colon 9, extirpation of the esophagus with a plastic stomach tube in 38 patients. Long-term results of surgical intervention
were studied in all patients during the period from 1 month to 13 years. Study of long-term results and quality of life after
esophagoplasty showed significant benefits extirpation of the esophagus with esophagogastroplasty before esophagocolonoplastik.

Journal of Experimental and Clinical Surgery. 2011;4(1):57-62
pages 57-62 views

Ways to improve the integrity of lung injuries during video-assisted thoracoscopic surgery

Tepikin A.A., Korymasov E.A., Pismennyy A.K.

Abstract

The aim of the work was to improve the results of pulmonary resection by developing and implementing ways of sealing the
wounds of biological adhesives, and drugs. Were analyzed the results of applying additional methods sealing line of manual
and mechanical suture after atypical resection of the lung. Methods of aerial and hemostasis are particularly necessary for
emphysematous changes in pulmonary tissue. Application of differential approach to the choice of sealing the seam line to
reduce the number of complications in the postoperative period.

Journal of Experimental and Clinical Surgery. 2011;4(1):63-66
pages 63-66 views

Distant result prognostication in illeofemoral reconstructive surgery in patients with obliterating atherosclerosis using morphometria of vascular wall

Polyantsev A.A., Mozgovoy P.V., Frolov D.V., Polikarpov I.A., Naumov V.V., Spilchuk A.M., Schelokov R.V., Schelokova Y.V.

Abstract

Scientific prognostication of distant results in reconstructive surgery in illeofemoral area for patients with obliterating
atherosclerosis using morphometria of the vascular wall. The study investigates 49 patients operated on aortoilliac arterial
segment. Observation period took 5 years. Late thrombotic reocclusions were presented in 16 patients (32,6%). Morphological investigations with morphometria of vascular walls were carried out. During the early and late postoperative period
permeability of reconstructed zones, as well as main artery permeability further than anaestamosis zone were estimated.
Prognostically unfavorable signs in respect of high possibility of thrombotic reocclusions in late postoperative period are as
follows:presence of macrophages in the arteries, intimae hyperplasia with degenerative elements etc. According to this data  a prognostic model for determination of late postoperative thrombotic reocclusions for patients with aortoilliac arterial
surgery was created

Journal of Experimental and Clinical Surgery. 2011;4(1):67-70
pages 67-70 views

Prognosis and surgical tactics in obliterating atherosclerosis of lower extremities

Kazantsev A.V., Korymasov E.A.

Abstract

We studied the prognostic significant clinical, hemodynamic, hemostasiological, immunological characteristics, markers of endothelial dysfunction, changes in lipid profile in patients with atherosclerosis obliterans of the femoral-femoralpopliteal-tibial localization. As a result, multivariate analysis the pathogenetically substantiated prediction system with the
calculation of the index of the disease. When the index of less than 13 points for obliterative atherosclerosis assessed as non
progressive, at index 13 points, and more-progressive.

Journal of Experimental and Clinical Surgery. 2011;4(1):71-78
pages 71-78 views

Neovasculogenesis stimulation is a new trend in the treatment of chronic arterial occlusive diseases of lower extremities

Sukovatykh B.S., Orlova A.Y.

Abstract

An analysis of experimental investigation of 70 male Vistar rates and results of examination and treatment of 30 patients suffered by chronic low limbs ischemia caused by atherosclerosis has been completed. All experimental animals
were divided into three groups: healthy, control, and investigated respectively. A chronic limb ischemia was achieved
by excision of the main vessel such as femoral, popliteal, and upper part of calf vessels. Having achieved an ischemia
a treatment was not done in the control group. Whereas animals of the control group received injection of platelet enriched autoplasm into the calf and thigh muscles. It was discovered that intramascular injection of platelet enriched
autoplasm into the animal’s ischemic limb increases microcirculation level 2,4 times and dicreases area of muscular
necrosis by 2,4 times to 28 experimental day. In patients 500 ml of blood were derived, from which a platelet enriched
plasma was made. 100 ml of the plasma were injected under ultrasound guidance along the deep femoral and popliteal arteries of the more 2nd “b” degree ischemic limb. A contralateral limb was used as a control group. After the treatment a blood flow volume was increased 1,4 times, main 885,08– in 1,3 times, and microcirculation level – in 1,2 times.

Journal of Experimental and Clinical Surgery. 2011;4(1):79-84
pages 79-84 views

Immunotherapy at the diabetes 2 types, complicated by the syndrome of diabetic foot, by the complex of natural cytokines and antimicrobial peptides

Kovalchuk L.V., Potemkin V.V., Baldina T.N., Barbin P.B.

Abstract

In research results of inspection and treatment of 75 patients with DFS are analysed. Patients are divided into 2 investigated groups depending on character of disease and treatment schemes. The first group have made 25 (33,3 %) patients
by whom treatment under the traditional scheme (antibacterial therapy, disaggregants, angioprotectors, antioxidants,
correction level of hyperglycemia, surgical treatment, bandagings with ointment of Levomekol was spent). In the second
group are included 50 (66,7 %) patients with purulent-necrotic defeats of foot, in which treatment, along with the standard
methods, it was used immunecorrection by a preparation "Superlimf". The control group of 25 persons is presented by
healthy people. It is established that application immunotherapy by complex natural cytokines and antimicrobial peptides
at a diabetes 2 types, complicated by the diabetic foot syndrome, pathogenetic is proved. Оbserved decrease of activity of
processes lipid peroxidation was, stabilization in antioxidant blood protection, decrease endogenous intoxication, normalisation of phagocytic a component of immune system, level of circulating immunoglobulin in blood. At patients about a
syndrome of diabetic foot immunecorrection a preparation "Superlimf" is a choice method immunomodelling therapies

Journal of Experimental and Clinical Surgery. 2011;4(1):85-89
pages 85-89 views

The effectiveness of local application of perfluorocarbon in the treatment of pyogenic infections of skin and soft tissue

Mokhov E.M., Armasov A.R., Amrullayev H.A.

Abstract

The article contains dates of the research of efficiency perfluorocarbon emulsions in treatment of pyogenic infections of skin
and soft tissues on the group of 78 patients. After incision of abscesses of soft tissues, dressings of the septic wounds were
made using application of a perftoran. The study revealed the influence of perfluorocarbon at first stage wound healing. It
was revealed a rapid decrease in inflammation, an increase of wound’s healing rate, the reduction of treatment time. As a
result of the study it can be recommended to apply perftoran in treatment of purulent wounds after incision of abscesses in
treatment of pyogenic infections of skin and soft tissues

Journal of Experimental and Clinical Surgery. 2011;4(1):90-93
pages 90-93 views

Biomechanical analysis of indicators of movements in the joints of the lower extremity in patients with coxarthrosis as a method of functional diagnosis

Guriev V.V., Zorya V.I., Biryukova E.V., Prokopenko R.A., Frolov A.A.

Abstract

Biomechanical parameters of the movements of patients with different stages of idiopathic, posttraumatic coxarthrosis and
with avascular necrosis were studied. Low limb movements were recorded with electromagnetic system. Angular amplitudes,
angular velocities and parameters of joint stiffness and joint flexibility were calculated using movement recordings and
previously developed biomechanical model. It was shown that these parameters adequately describe the stage of hip joint
injury. As for patients with early stages of coxarthrosis, these parameters describe the differences between the limb under
suspicion and the intact limb. The proposed biomechanical parameters can be used as the numerical assessments of a
functional state of the low limb under coxarthrosis: for a diagnostics, including early one, for an assessment of the results of  operative interventions, for an assessment of the effectiveness of rehabilitation procedures

Journal of Experimental and Clinical Surgery. 2011;4(1):94-100
pages 94-100 views

Value of parameters of a microblood flow in diagnostics of the slowed down consolidation of fractures of long tubular bones

Miromanov A.M., Uskov S.A., Mironova O.B., Shapovalov K.G., Namokonov E.V.

Abstract

The method laser Doppler-flowmetria (LDF) carries out research of indicators of a microcirculatory bed at 66 patients with
fractures of long tubular bones the early postoperative period. It was established, that at patients as with an uncomplicated
current, and development of the slowed down consolidation of fractures in the first days of a trauma the microcirculation
indicator, the maximum amplitude of fluctuations of components of a vascular tonus decreases, the neurogenic, myogenetic
tonus raises, the given parametres remain invariable for the second days of the postoperative period. At the slowed down
consolidation reduction of an indicator of microcirculation and augmentation of indicators of components of a vascular
tonus at the tenth days of a postoperative intervention becomes perceptible. Application of method LDF at fractures of long
bones of extremities allows to supervise a current reparation process in the postoperative period and to expect possibility of
development of disturbance of an osseous tissue at the stage of preclinical manifestations

Journal of Experimental and Clinical Surgery. 2011;4(1):101-106
pages 101-106 views

The reasons of the most frequent formation of impression of external surface of tibia’s distal plateau

Fedorov V.G., Solovyov V.M., Shapranov O.N., Ezhov E.S.

Abstract

Ankle fractures are more often intrasynovial and lead to impression changes. The research includes the studying of mechanical properties of distal epimetaphis and spongy bone’s density according to spiral computed tomography data. The
research brought out that external and back surfaces of tibia are less dense. It explains the reasons of impression deformation of lateral surface of tibia’s distal plateau in cases of Dupuitren-typed fracture. This information is necessary to make
the right choice of treatment’s tactic

Journal of Experimental and Clinical Surgery. 2011;4(1):107-110
pages 107-110 views

Topographo-anatomic aspects of a comparative estimation of posterolateral and anterolateral operative approaches to bodies of lumbar vertebras

Efimov A.N.

Abstract

For operation performance on bodies of lumbar vertebras it is possible to use both posterolateral and anterolateral operative
approaches. Accurate criteria of a choice of approache are not present. There are criteria of a quantitative estimation of the
operative approaches, offered by Sozon-Jaroshevich. This article is devoted a comparative estimation of operative approaches
to lumbar vertebras on the basis of values of quantitative criteria of three widespread accesses – on Kornev, on Southwick
and Robinson, on Chaklin. Modelling of this accesses on 18 corpses of various type of a constitution was spent. Topographoanatomic distinctions of the specified approaches are as a result revealed, quantitative distinctions of right- and left-sided  approaches and distinction of criteria for each type of a constitution are proved

Journal of Experimental and Clinical Surgery. 2011;4(1):111-117
pages 111-117 views

Morphofunctional state estimation of the thyroid remainder after thyroid gland resection

Petrova T.N., Krasnorutsky O.N., Bugrimov D.Y.

Abstract

The morphofunctional dynamics of the thyroid remainder after the thyroid gland resection on occasion the colloid goiter are
considered and analysed. The technique of the patients rehabilitation in early postoperation term including the complexes
therapy of multivitaminous complex “Vitrum” with combination of correction the hormonal status is proposed. The
application of rehabilitation scheme in comparison with traditional observation after operating term permits to prevent the
development of postoperation complication to reduce the term of temporal invalidity and to improve the quality life of the
patients

Journal of Experimental and Clinical Surgery. 2011;4(1):118-121
pages 118-121 views

Correction of the immunity infringements in use antiadhesive polymeric implants in experiment

Lazarenko V.A., Konoply A.I., Bezhin A.I., Lipatov V.A., Gomon M.S., Loktionov A.L., Zhukovskiy V.A.

Abstract

Deficiency of immunity after every surgical intervention? Which is accompanied with a serious illness, anesthesia, many
drugs (antibiotics), develop deficiency of immunity. And adhesive disease of peritoneum is the most frequent complication
of surgical operations. In accordance with some scientist, - implantation of the most effective antiadhesive polymeric agents,
can be the cause of development deficiency of immunity too. In experiments in white rats were studies indexes of immunity
in experimental abdominal adhesive process with implantation of prophylactic agent Mesogel. Were proved by experiments,
that immunomodulators. Derinat and Longidasa can correct the disorders of immunity in postoperative period

Journal of Experimental and Clinical Surgery. 2011;4(1):122-129
pages 122-129 views

Reparative processes at the site of intestinal anastomosis created in experimental

Novozhilov V.A., Goldberg O.A., Lepihova S.A., Semenyuta A.A., Rasputin A.A., Nazarov Y.M.

Abstract

The results about treatment of 45white rats presents since the intestinal anastomosis had been performed. The optimal types
of intestinal anastomosis formation were investigated in reconstructive operations on the intestine in experimental animals.
The morphological analysis of reparative process taking place in anastomosis area was carried out during applying of the
different types of intestinal sutures. This experimental study confirms the evidence of two series continuous suture and
reliability of its use during operations in experimental models. It also proves the priority of its applying in clinical practice
of newborns

Journal of Experimental and Clinical Surgery. 2011;4(1):130-134
pages 130-134 views

Pathomorphological analysis pancreas in different forms pancreatic necrosis

Viskunov V.G., Asatryan A.H., Protsenko S.I.

Abstract

An experimental study was performed on 120 white Wistar "rats" Animals were divided into 4 groups, each group of 30
animals. When creating models of the CES, flowing mainly on the type of fat pancreatic necrosis was carried out with two
pathogenic FACT (ductal hypertension and activation of phospholipases). The dynamics of development of progressive fatty
pancreatic necrosis with marked cellular infiltration, formation of infiltration, the inflammatory reaction. In the second
series of experiments using crystalline trypsin shows the evolution of hemorrhagic pancreatic necrosis with involvement of
visceral organs, hemodynamic shock, DIC, as a result of uncontrolled proteolysis. Our studies allow us to consider the fat and
hemorrhagic pancreatic necrosis as different morphological units that must be considered in clinical practice

Journal of Experimental and Clinical Surgery. 2011;4(1):135-139
pages 135-139 views

Short-term outcomes of carotid endarterectomies using different types of patch materials

Fokin A.A., Kuvatov A.V., Rodnyansky D.V., Degtyarev M.S.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):140-142
pages 140-142 views

Prevention of wound pyo–inflammatory complications in urgent abdominal surgery

Dobrokvashina S.V., Izmailov A.G., Volkov D.E.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):143-144
pages 143-144 views

Determination of the viabilities of the intestine during experimental acute intestinal obstruction

Rodin A.V., Pleshkov V.G., Leonov S.D.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):145-147
pages 145-147 views

The syndrome of abdominal hypertension of the patients with diffused peritonitis

Savchenko Y.P., Kuevda E.V., Golikov I.V.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):148-150
pages 148-150 views

The role of esophageal blood supply in case of some esophageal operatios

Chepurnoy M.G.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):151-152
pages 151-152 views

Surgical treatment patients with multimodal euthyroid goiter

Turcan A.Y.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):153-155
pages 153-155 views

Physical rehabilitation of patients after coronary artery bypass surgery shuntings at a sanatorium stage of regenerative treatment

Borisov V.A., Korotkova S.B., Zelenina M.T., Kelina N.V., Knyazeva T.I.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):156-158
pages 156-158 views

Features of hi-tech ophthalmology surgical help at combination splinter explosive trauma with damages of eyes

Dzhioeva A.V., Stepanov A.V.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):159-161
pages 159-161 views

Experience

Combined endovascular and surgical management of low ampular rectal cancer

Vorobyev G.I., Kuzminov A.M., Korotkih N.N., Popov R.V., Olshansky M.S.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):162-167
pages 162-167 views

The first experience of simultaneous RF ablation and mastectomy for breast cancer with liver metastases

Novomlinsky V.V., Glukhov A.A., Redkin A.N., Sokolov A.P., Chvikalov E.S., Ostroushko A.P.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):168-169
pages 168-169 views

New in surgery

The way of the single-step surgical treatment of the pyogenic-fistulous forms of the epithelial-coccygeal path

Koreyba K.A., Tresurokov I.V., Demyanov S.L.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):170-172
pages 170-172 views

Review of literature

Evolution of carotid surgery

Zatevahin I.I., Matyushkin A.V., Mustafin A.H.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):173-178
pages 173-178 views

Kursk school of phlebology

Sukovatykh B.S., Sukovatykh M.B.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):179-189
pages 179-189 views

The organization and management indeperent work student on pulpit of the surgical profile of the high educational institution

Shagivaleev N.A., Samoday V.G.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):190-192
pages 190-192 views

Memorials

Nikolai Ivanovich Pirogov. Study in Germany

Dubayev A.A.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):193-194
pages 193-194 views

Pokrovsky Anatoly Vladimirovich. To the 80 anniversary since the birth

Andreev A.A., Ostroushko A.P.

Abstract

-

Journal of Experimental and Clinical Surgery. 2011;4(1):195
pages 195 views

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