All articles - Surgery
Number of articles: 716
-
Delivery device for the application of hemostatic implant geprocel in minimum-invasive surgeryDespite the achievement of modern surgery in nowadays, there is no special delivery device for laparo-scopic surgery in the minimally invasive surgery. This kind of device must meet the following characteristics: the ability to dispense a certain amount of powder in the target zone, safety and efficiency at the high pressure in the abdominal cavity. A new delivery device for the use of hemostatic powder Heprocel in minimally invasive surgery was developed by the developers of SI “RSSPMCS named after acad. V.Vakhidov”. The effectiveness of the delivery device was evaluated experimentally on 8 mongrel dogs weighing up to 7.5 kg. The developed de-livery device ensures an uniform distribution of the hemostatic implant Heprocel over the wound surface of the liver. The proposed device is an effective delivery system capable of transport a dosed amount of hemostatic powder to the target bleeding area during manipulations in laparoscopic surgery
Journal problems of biology and medicine -
Introduction. Trauma is a global health problem, being the 4th cause of death after cardiovascular diseases, malignant neoplasms and chronic lung diseases, and is also the main cause of death under the age of 45 [17]. Every year around the world, about 200,000 people die from injuries, or 1 person every 3 minutes [4]. According to WHO estimates, by 2020, trauma will be the first or second cause of the loss of years of productive life for the entire world population [1]. Abdominal trauma accounts for 10-12% of all polytrauma, does not tend to decrease and remains an urgent problem of urgent surgery, while spleen and liver injury is most common [5]. Of particular socio-economic importance in the problem of damage to parenchymal organs is the fact that more than half of the victims are persons of the most able-bodied age. -
Determination of clinical-economical efficiency of simultaneous operation of femaleThe presence in 30-40% [1,5,9,12,35,37,42] of patients of combined surgical and gynecological diseases puts before surgeons and gynecologists a solution to the problem of simultaneous correction of such a pathology, i.e. conducting simultaneous operations [6,7,11,21,25,29,36, 38, 40]. The production of minimally invasive and simultaneous operations emphasizes their undoubted advantages over several consecutive surgical interventions, both in therapeutic and economic aspects, both for the state and for patients in general. [2, 6,8,10,13,14,16,18,19,20,22,23]
Journal problems of biology and medicine -
Burning shock: pathogenesis, clinic, principles of treatmentBurn shock is the first stage of burn disease and develops when the surface of the body is affected by an area of 10-15% with superficial and 5-10% with deep burns [6,11,14].
Journal problems of biology and medicine -
Evaluation of results reconstructive surgery on the arteries infrainguinal zone in the immediate postoperative periodOperated on for chronic obliterating diseases of arteries in infrainguinal zone of 147 patients divided into 2 groups: op- erated by the method of reversed autovein (n=79) and operated by the method of using autovein in situ(n=68). In the imme-diate postoperative period thrombosis of grafts was 9.2% in group 1, 7.6% in the 2nd group. Each group performed one amputation at the hip level. Deaths cases are absent. Thus, during the femoro-distal bypasses by autovein excellent results are achieved with a method in situ, and in reversed autovein
Journal problems of biology and medicine -
Analysis of options preoperative preperation and anesthesia in the treatment of thyroid diseasesThe results of surgical treatment, preoperative preparation and anesthesia of 72 patients operated on goiter are presented in the article. A new approach to stress-protective preoperative therapy is suggested. The efficacy of anesthesia with of ketamine and advantages of this approach in comparison with standard general anesthesia are shown.
Journal problems of biology and medicine -
The results of the application of compressesive-distractive osteosynthesis at refract tibia diaphysisThere results of osteosynthesis of tibia by Ilizarov in 540 patients are mentioned in the article. Patients were examined by dividing them into 2 groups. In 486 patients who were in the first group, it was tried to insert broken bones were at once, they were attached to the Ilizarov installation consisting of 4 rings. The part of bones that was impossible to insert at once, were inserteded gradually with the help of the installation. In 80% of patients the bones grew together in time. In 20% there was a slow fusion not fusion and false joints. In 54 patients who were in the second group, the bones were inserted at the same time with the help of IIT, and are attached to the installation of the Ilizarov. In all Patients who were in the second group but one (he had con- comitant diseases, obesity -III degree, diabetes) bones have grown together during. The reason of the fact that the bones were inserted at the same time and were strongly attached to the seam.
Journal problems of biology and medicine -
First experience of unilateral spinal anesthesia in patients of senior and senior age at operations in the bottom section of the abdominal caveA comparative clinical evaluation of two types of neuraxial blockade: symmetrical unilateral spinal anesthesia and spinal anesthesia during operations on the ground floor of the abdominal cavity in elder-ly patients. After obtaining informed consent were included 30 patients (17 men and 13zhenschin), which are divided into two groups of 15 people, depending on the variant carried out neuraxial blockade. Comparative evaluation of clinical neuraxial blockade was carried out on the basis of the definition of motor and sensory block. Unilateral spinal anesthesia with hyperbaric bupivacaine is an effective method of anesthesia-sided sur-gical interventions on the ground floor of the abdominal cavity and adequate postoperative analgesia positive
Journal problems of biology and medicine -
Regional lymphatic antibioticothtrapeutics at the children’s surgeryThe effectivity of the regional lymphatic antibioticothtrapeutics in the complex treatments of the children with the pus-inflamaties was learned at 276 patients. The patients are divided into 2 groups. In the main group is used the complex treatments with the regional lymphatic antibioticothtrapeutics, which held for taking into consideration the regional lymphacurrent, the collector particularity of the structure lymphatic system in given sphere and in the anatomo-physiological particularites of the children’s organism. The control were 101 patients, who were treated with the traditional methods of putting the antibiotics (under skin, inside muscle, inside vein). Using the individual lymphatic antibioticothtrapeutics at the children’s surgery lead to the improvement the results of cure, to shortening the dates stauing children at the hospital and giving considerable economical effect.
Journal problems of biology and medicine -
Complications of valvulotomy at femorо-popliteal autovenous bypass grafting according to the method in situAnalyzed the results of 68 operations of femorо-popliteal and femorо-tibial autovenous bypass grafting according to the method in situ. In the immediate postoperative period in 6 (8,8%) cases there was a throm-bosis of the shunt, and in 2 (2,3%) cases perforation of the shunt due to intimal separation. Causes of throm-bosis in 4 cases there was a partial destruction of venous valves due to the imperfection of the existing types of valvulotomes. Cause of the shunt perforations were incorrect technique of valvulotomy
Journal problems of biology and medicine -
In the Samarkand branch of the scientific center of emergency medical care, the results of treatment of 136 patients with various forms of pancreatonecrosis, which were on inpatient treatment for the period 2006-2016, were analyzed. Based on the criteria of the APACHE-II scale, 86 patients (63.2%) had an unfavorable prognosis of pancreatic necrosis (with an integral index of more than 8 points), and favorable in pancreone-crosis (50.8%). It should be emphasized that the components of the success of management of patients with acute pancreatitis, and especially sterile and infected pancreatic necrosis, should include modern ideas about the inseparable pathogenetic nature of these conditions, determining the strategy of topical diagnosis and the tactics of complex treatment in emergency pancreatology -
Results of modified surgical access to regional lymph nodes in the treatment of renal cancerPurpose: To study the long-term results of a new method of surgical access to the main vessels and regional renal cancer lymphocollectors. Materials and methods: In the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology, as well as in its Tashkent City Branch from 2010-2015, 96 patients were treated. The distribution of patients by sex and age intervals is shown in the figure. There male predominance 51 (53.1%) versus 45 (46.9%) women, the ratio was 1.1: 1. The age range is from 21 to 75 years, the average age of patients was 56.0 ± 1.3 years. From 96 patients participating in the study, a tumor process was established in 51 (53.1%) men and 45 (46.9%) women. The number of patients with metastatic lesion of regional lymph nodes were followings: N1 - 10 (10.5%), N2-6 (6.2%). In the remaining 80 (83.3%) patients, regional lymph nodes were intact. All patients underwent radical-extended nephrectomy. After laparotomy, the ascending and transversely dividing colon of the large intestine is mobilized, the loops of the intestines are pulled back with a moist towel up and to the left. After this, the back of the peritoneum is opened over the projection of the aorta from the level of the aortic bifurcation, the top with the dissection of the triceal ligament is opened beyond the peritoneal space. Results: The character of the histological form of the kidney tumors established after the operation by morphological examination were followings: the clear cell cancer in 77 (80.2%), papillary cancer in 8 (8.3%), unclassifiablc cancer in 4 (4.2% ), chromophobic cancer - in 7 (7.3%). At stage 1, no metastasis was detected. In stage 2 metastasis was noted in 4.2% of cases. In stage 3, 18.0% metastasis was detected. In 27.3% of patients metastasis took place in the 4th stage. All 13 patients (13.5%) had postoperative progression of the disease revealed. Conclusion: In renal tumors with Ti, we recommend performing selective lymphodisection, that is removing of first-order lymph nodes for precise staging. For T2.4N0.2M0 tumors, it is recommended to perform an extended lymph dissection from the level of the diaphragm legs to the aortic bifurcation. The development of surgical access with a cut of the triceal ligament with extended lymph node dissection of the renal cancer and a small number of postoperative complications make it possible to apply it in all patients with renal cancer.
Doctor's Herald -
Clinicoanamnestic picture of children with natal trauma of cervical spineThe article presents the results of the main causative factors and medical history data in neonates un-dergoing natal trauma of the cervical spine. Birth injury to the cervical spine was diagnosed in 103 infants the main group and observed under the age of life. As a control group examined 30 healthy newborns. Based on these data, concluded that the lesions of the central nervous system with natal cervical trauma associated with a direct effect on the cervical spine and a violation of cerebral circulation in vertebrobasilar vascular bed
Journal problems of biology and medicine -
In recent years, the number of cases of damage to the urinary tract with the formation of a fistula after repeated obstetric operations (2 or 3 scars on the uterus) has increased. In a broader concept, a fistula is an artificial passage formed between two adjacent hollow organs or between hollow organs and the outer skin. -
Disadvantages and ways of improvement in diagnostics and surgical treatment of the diabetic foot syndromePatients with diabetes mellitus, often, there are changes in the vessels in the form of calcification of the middle shell of arteries and arterioles (arteriolosclerosis of Menkeberg, mediacalcinosis). The determination of the x-ray stage of calcification of the arteries, gives additional information on the state of the vessels of the foot. Destructive changes in blood vessels, soft tissues and bones, conducted surgical interventions are naturally related. The study of these patterns is possible with a timely, critical study of anamnestic, diagnostic data and therapeutic measures. In this regard, to date remain relevant issues related to the development of differentiated treatment, taking into account all possible diagnostic data and improving surgical methods for treating the diabetic foot syndrome.
Doctor's Herald -
Efficiency of laparoscopic hose rescue of the stomach and intra-cellular cylinder in reducing diseases, according with obesityThe main goal of bariatric interventions is to achieve sustained weight loss in obese individuals, which reduces the risk of overall morbidity and mortality. Based on the experience of treatment of 20 obese patients, was established that 6 months after laparoscopic sleeve resection of the stomach (LSRS), which was performed by 16 patients, the body mass index (BMI) decreased from 47,7 ± 2,0 to 38,2 ± 1,4 kg/m2. The installation of intragastric balloon (IGB), carried out by 6 patients with extremely high body weight for the purpose of preoperative preparation before LSRS, helped to reduce the BMI from 71.5 ± 3.0 to 61.3 ± 1.4 kg / m2. The use of IGB and LSRS led to a positive dynamics of the conditions associated with obesity: the number of people with dyslipidemia decreased by 53%; remission ofdiabetes mellitus is achieved in 50%; normalization of blood pressure indicators - in 67%; regression of non-alcoholic fatty liver disease was achieved - in 43% of cases, depression was eliminated in 80%, and mobility disorders - in 65% of cases. IGB and LSRS allowed to improve the Cardiometabolic Disease Staging score, achieving zero cardiometa-bolic risk in 35% of patients, and in the remaining patients - transition to an easier stage.
Doctor's Herald -
The risk of venous thromboembolism in patients with renal cell carcinoma With intraluminar invasion of the inferior vena cava after surgery with a fragmented a tumor thrombusThe aim of this work was to determine the long-term risks of venous thromboembolism (VTE) in patients with subsequent extraction of residual tumor thrombus and the effect of residual tumor thrombus on overall survival. The first aim was to determine the risk of VTE during a 2-year follow-up period. The second aim was the determination of the overall survival within 2 years. In patients with residual tumor thrombus, the overall survival rate was lower than in patients with a fully resected tumor thrombus, or in those who did not have a tumor thrombus. Conclusions: the presence of residual tumor thrombus is an important risk factor for the development of VTE amid patients with renal cell carcinoma.
Doctor's Herald -
Surgical tactics in cholelithiasis complications of obstructive jaundiceAnalysis results was performed in 116 patients with cholelithiasis complicated by mechanical jaundice who were on the treatment in the city medical association between 2014 on 2016. As a supporters of the two-stage approach to the treatment of mechanical jaundice, the first stage we carried out decompression and sani-tation biliary tract. Preference gave endoscopic retrograde intervention. Endoscopic papillosphincterotomy carried out in 68 patients (58,6%) combined with choledocholithoextraction in 39 patients (57,3%). We consid-er, that at mechanical jaundice the best is two-stage approach with the using of minimally invasive treatments. Operation of choice is endoscopic retrograde intervention with the subsequent cholecystectomy with mini ac-cess. In the impossibility of the decompression is carried out drainage of biliary with the restoration of contin-uous passage of bile in the intestines with laparotomy after stabilization of the state of the patient
Journal problems of biology and medicine -
Efficacy and safety of spinal anesthesia in operations of hernias of intervertebral discsObjective: comprehensive evaluation of the effectiveness and safety of spinal anesthesia (SA) in the rapid elimination of discogenic hernia. Material and methods: The basis of the clinical trial data are laid 65 patients with spinal disorders and spinal cord in the lumbar and sacral levels. Depending on the type of anesthesia used (CA or total intravenous anesthesia (TIA) with mechanical ventilation (MV) endotracheal way + О2), the patients were divided into two groups. Results: The research revealed that just before surgery in all patients s-BP, d-BP, m-BP, HR, SpО2 was within the normal range. These results suggest that the TIA with ventilator endotracheal way + О2 does not fully ensure the full protection of the body from operating aggression. CA isobaric with 0.5% solution of bupi- vacaine in a dose of 15 mg 20 provides anesthesia beginning 5-8 min lasts 2-3 hours. Patients were observed clinically significant disorders of respiratory function and hemodynamics. Conclusion: The described technique allows to carry out surgery safely and effectively
Journal problems of biology and medicine -
Results of diagnostics and surgical treatment of intrabelly bleedingsThe research basis included results of diagnostics and treatment of 42 patients with traumas and diseas-es of bodies of a belly cavity, for diagnostics and which treatment under indications have been used modern endovideosurgical hemostasis methods. During the spent researches it has been established that the basicmeth- ods of diagnostics of severity level of intrabelly bleedings and a choice of methods of their treatment are ultra- sonic, КТ and a videolaparoscopy. As a whole, application endovideosurgical for diagnostics and treatment of intrabelly bleedings allows to avoid technologies unjustified laparotomy, to lower death rates, to reduce quan- tity of complications, and also to reduce time of stay of patients in a hospital in comparison of medical tech- niques by means of open operative access
Journal problems of biology and medicine -
Peculiarities of the acute of acute surgical pathology in hiv infected / aids patientsWith acute diseases of the abdominal cavity, 10 patients were hospitalized, 4 of them for acute appendi-citis, 3 for perforated ulcers, 1 for acute cholecystitis, 1 for gastrointestinal bleeding and 1 for infiltrates and phlegmon retroperitoneal space. Studies were conducted to analyze the immune status of patients taking into account the phagocytic activity of neutrophils, humoral and cellular immunity. HIV infection is not an excuse for refusing surgery in patients with acute surgical pathology. Observations showed that the HIV-associated infection burdens the course of the postoperative period. In patients, there is a prolonged phenomenon of intox-ication, pain, prolonged course of suppuration of the wound, as well as a difficult cleansing of the wound
Journal problems of biology and medicine -
Our experience in recovery support at congenital dislocation of the hip in older children and adolescentsCreate a canopy above the head of the femur is distribute method of surgical treatment aimed at the res-toration of supporting ability and the dysplastic hip joint pathology. This article describes a method developed by the authors of surgery 11 older children and adolescents with congenital hip dislocation. This option of sur-gery is an effective treatment for children aged 7 to 18 years in violation of the relations hip dysplastic genesis
Journal problems of biology and medicine -
Microbiological assessment of the effectiveness of phytotherapy in phlegmons of maxillofacial area in children42 children aged from 7 to 16 years old with phlegmons maxillofacial area have been included to inves-tigation. After lancing of the purulent focus we locally used gauze turunda impregnated in 1% solution essen-tial oil of Anise on the apricot oil. Qualitative and quantitative bacteriologic examinations have been carried out on 1, 3, 5 and 7 days after surgical operation. Bacterized of the wound in the basic group of treatment has dramatically reduced especially regarding anaerobe flora by decreased number of bacteria more than 3 times. Local use of essential oil of Anise is shortened duration of hospital treatment in 3±1 days
Journal problems of biology and medicine -
Surgery engrained anteromedial dislocation of the radial head in childrenPresented results of surgical treatment of old dislocations of caput of radii. Findings of searching were based on results of surgical treatment 37 patients with dislocations of caput radii on different reasons. Patients were done open reduction of caput of radii with repair of ligament annular. For modernization methods of re-pair of ligament annular we used its capsule of the joint and pats of ligament annular which has more anato-my-physiologically for elbow joint. By this method we have good and satisfactory functional results on 97,4% cases and anatomical on 95,7% cases
Journal problems of biology and medicine -
The arthroplasty of the hip at fracture of a neck of a femurConcerning a fracture of a neck of a femur 65 patients in particular have been operated total endopros-thesis replacement of a joint is carried out. Under our observation there were 65 patients who have executed primary endoprosthesis replacement of a coxofemoral joint concerning femur neck fractures. Among treated 28 - 60 years (43%) are more senior. The most elderly patient was 84 years old. – 22 (33.8%), 80 years – 2 pa-tients – 3% are also more senior than patients from 40 to 50 years. Feature of the early postoperative period was the fact that the patients operated after 3 days from the moment of receipt, much more difficult also are longer the patients operated within the first 3 days adapted to walking on crutches and to service of, than. Good results are received at 86% of the operated patients. The endoprosthesis replacement of a coxofemoral joint executed in early terms (it is optimum within the first week after a change), allows to make active victims, to reduce quantity of postoperative complications, a lethality and to adapt patients to independent and active life for rather long period.
Journal problems of biology and medicine
