[A new method of aponevrosis suturing after laparotomy in urgent abdominal surgery].

Objective: To improve the results of treatment of patients undergoing laparotomy by using of a new method of aponeurosis suturing after laparotomy.

Material And Methods: Training process for a new method of aponeurosis suturing after laparotomy was organized on the patented medical simulator for learning the technique of laparotomy closure. The method was introduced into surgical practice later.

[Preventive abdominal wall repair in high-risk groups of postoperative ventral hernia].

Aim: To identify the most important predictors of postoperative hernia and to determine the indications for preventive surgical repair of abdominal wall.

Material And Methods: Prospective analysis included 398 medical records of patients who underwent median laparotomy. Experimental tensiometry was applied to determine strength of intact fascia.

[The consequences of cholecystectomy].

Aim: to analyze the consequences of cholecystectomy.

Material And Methods: 348 patients were under observation within 10  years after cholecystectomy. Surgery for destructive and chronic cholecystitis was performed in 115 and 233 patients respectively.

[Evaluation of long-term results of surgical treatment of thyroid's diseases].

It was analyzed the surgical treatment results of thyroid's diseases in 462 patients in terms 1-15 years. Relapse of the disease was defined in 39.4% of cases after organ-preserving operations.

[Perforative gastroduodenal ulcers].

Treatment results of 986 patients with perforative gastroduodenal ulcers were analyzed. The sequence of surgeon's acts was diagnostically effective in 99.5%.

[The surgical treatment of the incarcerated hernia].

The treatment results of 1540 patients with the incarcerated hernias of various localization were analyzed. It was revealed, that treatment results depend not only of the patient's age and concomitant diseases and operating time but the choice of surgical access and the type of intestinal anastomosis. The main postoperative negative factor proved to be the increase of the intraabdominal pressure, which severely impairs the lung ventilation.

[Neurohumoral changes in acute intestinal obstruction].

Neurohumoral changes were studied in 431 patients with acute intestinal obstruction and in experiments in 165 small laboratory animals with the model of small intestine ileus. The results were obtained on the basis of estimation of the concentration of catecholamines, acetylcholine-like substances, serotonine, histamine, their metabolism products in blood plasma and of the cardiointervalography data. The neurohumoral changes were shown to appear as early as the initial stage of the disease and to be progressing when the disease period became longer.

[Principles of determination of surgical policy in general peritonitis].

Based on clinical examination and analysis of treatment results of 575 patients with general peritonitis, the most informative factors were determined which predict lethal outcome, progression of peritonitis and help choose the most effective surgical policy. It is demonstrated that conventional treatment is preferable in the interval of perioperative score of APACHE II from 0 to 10, and programmed sanation relaparotomies -- from 11 to 15. Data about efficacy of total intestinal decompression and peritoneal-enteral lavage, and also methods of mathematical prediction of postoperative complications and outcomes are presented.

[Complicated gastroduodenal ulcers].

The results of the treatment of 2384 patients with gastric and duodenal ulcers are analyzed. It is demonstrated that over last years the number of complications has increased: perforations -- 2.6 fold, and bleedings -- 7 fold.

[The application wound sorption in complex treatment of destructive forms of erysipelas inflammation].

The method of application wound sorption with sorbent Vaulen was used in treatment of erysipelatous inflammation in 49 patients. The first signs of healing appeared 1.5-2 times quicker, the rate of lessening the area of the wound surface was 21-35% greater.

[Directed therapy in complex treatment of lower limb diabetic angiopathy].

Clinical efficiency of directed therapy was assessed for 312 patients with distal type of lower limb diabetic angiopathy. Methods of directed therapy included indirect electrochemical detoxication, hemosorption and their combination. It was shown that while successful rate of conventional conservative therapy does not exceed 50%, hemosorption and indirect electrochemical detoxication can increase this rate by 5-35%, depending on the initial severity of lower limb ischemia.

[Mechanism of action of paravasal infiltration].

In order to study the mechanisms of action of paravasal infiltration the content of middle mass molecules and general thiol groups in the central and regional blood flow were studied in 65 patients with obliterating atherosclerosis. The relationship between the stage of extremity ischemia and concentration of general thiol groups was shown.

[The prognosis of the course of endogenous intoxication in emergency surgery].

On the basis of an analysis of 256 patients with diffuse peritonitis, destructive pancreatitis, mechanical jaundice and purulent cholangitis and complex investigations it was established that the degree of clinical manifestations of endointoxication corresponded to a definite degree of disorders of the central nervous system. The most adequate indices of the course and prognosing the toxic process are thought to be the level of the leukocytic index of intoxication, the prothrombin index, the degree of monocytopenia and proteinuria. Their dynamics reflects changes of the concentration of toxic intermediary metabolites and main characteristics of electron paramagnetic resonance of blood plasma.

[The structure of endotoxemia in peritonitis and means of eliminating it].

An examination of 43 patients has revealed 11 toxic compounds of intermediary metabolism (aldehydes, methylizocyanide, ethanol, aceton etc.) whose concentration in blood became several tens times higher. Their accumulation was most considerable at the decompensation phase.

[Endogenous toxicity in acute hepatic failure and ways of eliminating it].

The structure of causes of the endogenous intoxication in 39 patients with acute hepatic insufficiency is studied. Eleven toxic compounds of an organic nature were found responsible for genesis fo the disorders and outcomes of acute hepatic insufficiency. Possible use of hemosorption and hyperbaric oxygenation for the elimination of toxic products is analysed.

[Blood plasma kinin system status in mechanical jaundice and means for its correction].

The state of the kinin system in mechanical jaundice and possible ways for its normalization were analysed on the basis of clinico-experimental observations. In 32 patients with postoperative hepatic insufficiency developed against the background of mechanical jaundice a considerable activation of the kinin system was detected which was found to have a direct correlation with the severity of the disease. In experiments on 185 albino rats with model of mechanical jaundice during 40 days a comparative analysis of the state of the kinin system in the initial state, under conditions of hyperbaric oxygenation (HBO) and when using kontrikal and sodium salicylate against the background of HBO was made.