Khirurgiia
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Based on literature and own original clinical data authors conclude that Ogilvie's syndrome is the form of dynamic obstruction of colon due to lesion of retroperitoneal neural nodes, heart failure and intoxication. Ogilvie's syndrome complicates therapeutic and surgical diseases. ⋯ Ogilvie's syndrome is successfully treated with evacuation of intestinal contents, but the risk of recurrence after this treatment is high. Ethiotropic therapy, correction of water-electrolytic balance and tissues oxygenation, administration of acetylcholinesterase inhibitors are the more effective treatment of this syndrome.
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Multicenter Study Comparative Study
[Treatment of bile ducts injuries after laparoscopic cholecystectomy].
Features of bile ducts injuries after laparoscopic cholecystectomy were analyzed at 54 patients. High level of lesions (H. Bismuth III-IV type) was revealed at 80% cases. ⋯ Biliodigestive anastomosis with Roux techniques and transhepatic drainages was the main surgical method (76% cases). Peritonitis and other severe complications required two-stage treatment. Overall 40 (74.1%) patients followed-up more 3 years; there were no cases of stricture recurrence.
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Overall 1218 patients with lung injuries were treated during 11 years. The rate of deep wounds and injuries of central zone and root of lung was 24.9%. Endoscopic and x-ray methods (especially computed tomography) were used for diagnosis. ⋯ Resection of lung and pneumonectomy were performed at 10.2% patients, closure of lung wound--at 41.3%. Surgical treatment of lung wound with dissection and revision of wound canal was performed at 42.6% patients with deep injuries. Classified surgical tactics permits to reduce the rate of postoperative pulmonary complications from 62 to 11.6%, and lethality--from 11.2 to 3.1%.
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Results of surgical treatment of 782 patients with perforated gastric and duodenal ulcers are analyzed. Gastric ulcers of I type were diagnosed at 86 (10.9%) patients, prepyloric and pyloric ulcers - at 441 (56.4%), duodenal ulcers - at 255 (32.6%) patients. Perforation was combined with bleeding and stenosis at 24 (3.1%). ⋯ Early postoperative complications after vagotomy with ulcer excision and pyloroplasty were diagnosed at 8.3%, after stomach resection - at 18.2% patients (p<0.01). The quality of patients life was higher after organ-saving operations. Proximal gastric vagotomy with excision of ulcer and pyloro- or duodenoplasty should be regarded as operation of choice at perforated duodenal ulcers.
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Results of surgical treatment of 154 patients with thorax injuries are analyzed. Most of the patients (93 ps, 60.4%) had penetrating wounds. X-ray examination remains the open most method of diagnosis. ⋯ There were no postoperative lethal outcomes. The rate of postoperative complications was 22.7%. Videothoracoscopy and video-assisted mini-thoracotomy are effective methods for diagnosis and treatment, reduce the rate of postoperative complications and lethal outcomes, limit the indications to wide thoracotomy.