Publications by authors named "Sht Donev"

Purpose Or Objective: The aim of this study was to explore the potential relationship between the time estimation and psychological distress in patients with solid tumors prior to starting radiotherapy.

Materials And Methods: In this multicenter study were included a total of 344 patients with solid tumors (197 with and 147 without metastatic disease). The time estimation was assessed by evaluating each subjects prospective estimation of how fast 1 min passed compared to the actual time.

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Personal experience with the operative management of 28 patients presenting acute purulent peritonitis with ensuing ileus using a complex approach, based on total "internal" splinting of the small intestine, is shared. The 4-channel sound, designed and constructed in the clinic for intubation and simultaneous lavage of the small intestine, promotes effective staged evacuation of the toxic content from the disconnected bowel segments. What is more, a possibility is created for the formation of controlled adhesions between the intestinal loops.

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The authors examined critically no big one series of 41 patients undergone surgical procedures about liver hydatid cyst after so called "covered method". The simplicity of the method is signified and the lower risk, mortality and morbidity makes it convenient for surgeons with different degree and ability. The post operative application of 30% NaCl solution remove the risk of protoscolices into the fibrous capsule.

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Problems relating to suture of the urinary bladder wall are discussed against the background of experimental and clinical studies on ten laboratory animals (pigs) and a series of urological patients subjected to bladder operation. The somewhat different technique of the bladder-wall suture employed is characterized by features such as being anatomically justified, atraumatic and antibacterially reasonable. The simple and readily performed suture of the bladder wall, and the positive experimental and clinical results attained are a prerequisite for practical implementation in the routine clinical practice of this type of bladder suture.

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Operative treatment of stress incontinence using Goebell-Stoeckel's procedure is undertaken in a rather limited number of patients. As shown by the analysis of the postoperative results, the scope of intervention is by no means warranted from anatomical viewpoint. The comparatively similar postoperative results in the contingent being examined point to the necessity of performing mandatory and more detailed functional examinations prior to operation, as well as broadening the scope of intervention under urologic, gynecologic and surgical aspects.

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The results of palliative endoscopic treatment by bougienage using Eder-Puestow instrumentation, performed in a limited contingent of patients presenting benign esophageal strictures, are analyzed. It is underscored that the method is readily carried out and effective, and seldom leads to noteworthy complications, such as esophageal perforations--one patient alone presenting cicatricial stricture out of the total of 42 cases given treatment with bougienage over a 10-year period. The commonest cause of benign strictures of the esophagus in the series being examined is reflux (peptic) esophagitis against the background of hiatus hernia.

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In a clinical series including 32 patients with achalasia an assessment is done of the possibilities afforded by palliative management using the method of pneumatic balloon dilatation with Rigiflex dilatator. Emphasis is laid on the simplicity and efficacy of this endoscopic procedure, seldom giving rise to serious complications--one esophageal perforation only (3.1 per cent) out of the total of 32 patients treated over a 10-year period.

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The palliative treatment results in 41 patients presenting intractable malignant stenosis of the esophagus--carcinomas among which one carcinoid and three branchial carcinomas--following endoscopic implantation of a plastic prosthesis (tubus) are analyzed. It is stressed that it is a matter of a palliative method, promptly eliminating the nutritional passage impairment; in case of tracheoesophageal fistula is a method of choice, but leads to a comparatively high incidence of serious complications-perforations of the esophagus (7.3 per cent) all with lethal outcome.

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Personal ten-year-long surgical and clinical experience with the application of truncal vagotomy in 51 patients with complicated duodenal ulcers-23 with hemorrhage, 19 with perforation and nine with stenosis, is shared. Emphasis is laid on the superiorities and comparatively low lethality (5.8 per cent) of the application of this type of vagotomy during the surgical management of complicated duodenal ulcers, as well as on the great diagnostic relevance of fiber gastroscopy applied on the apex of hemorrhage in case of bleeding duodenal ulcers.

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This is a report on an exclusively rarely met with anomaly, consisting in interposition of the gallbladder within the extrahepatic bile ducts where ducti hepatici open into the gallbladder. Ductus cysticus assumes the role of ductus choledochus, and terminates in papilla duodeni major. Ductus hepaticus communis is completely lacking.

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The results of the operative management of 37 patients with acute necrotic pancreatitis, covering a ten-year period (1984-1993), are discussed. It is stressed that regardless of the complex conservative and subsequent precisely indicated operative management, acute necrotic pancreatitis remains an exclusively serious and problem disease, accounting for a still very high overall lethality--35.1 per cent according to the case material analyzed.

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