Biomedical subjects
Publications and source records attributed to A E Lagoda.
In 90 patients with an acute sepsis application of cryopreserved hepatocytes and splenic sections had promoted detoxication and immunocorrection, improved the rehabilitational indexes significantly.
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Results of examination and treatment of 143 patients with duodenal ulcer disease associated with cardia insufficiency were analyzed. The cardia valve function was investigated with the help of elaborated diagnostic complex. According to the data obtained, 3 grades of cardia insufficiency were suggested. Individualized surgical tactics based on the functional state of gastroesophageal junction was applied for the treatment of patients. The cardia dysfunction were not revealed 3 years after the operation, the treatment result was good or fair in 95.8% of patients.
The experience to use in the treatment of duodenal ulcer disease the new methods of vagotomy: selective distal antral cellular vagotomy (SDAV) and selective distal vagotomy with pyloroplasty (SDV) is substantiated. By means of these operations, the suppression of phase II of gastric secretion is achieved due to denervation of gastrin-producing antral portion of the stomach. The results of experimental studies in 15 dogs, and the results of treatment of 37 patients with duodenal ulcer disease caused by the increased production at phase II of alimentation are presented. SDAV was performed in 20 patients, SDV--in 17. A result of treatment was studied in 34 patients at the period of up to 3 years. A pronounced acid inhibiting effect of the new methods of vagotomy was noted. No ulcer recurrence was revealed.
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On the basis of analysis of the results of surgical treatment of 488 patients with a perforative ulcer, 314--with a bleeding one, and 118--with penetrating pyloroduodenal ulcer, impairment in motor-evacuatory duodenal function was established in 12.8% of cases. A conclusion was made about the necessity to correct this disorders, indications for the operation for duodenostasis in complicated ulcer disease were substantiated.
The technique for performance of gastrectomy under conditions of emergency surgery permitting to shorten the duration of intervention and increase its effectiveness is presented. Gastrectomy was performed in 7 patients with gastric cancer complicated by profuse bleeding. All the patients are alive, no anastomotic suture failure occurred.
An analysis of results of organ saving operations in combination with selective proximal vagotomy in 234 patients with duodenal ulcer revealed that one of the causes of unfavourable treatment outcomes is the development of erosive-ulcerative lesions of the stomach. The leading etiological factors for distal gastritis in duodenogastric reflux, for proximal gastritis-ischemia of the gastric wall in the devascularization zone. Individualized treatment with consideration of the etiopathogenesis of postoperative gastritis allows to reduce the frequency of development of postvagotomy disorders by 19.8%.
The authors examined 527 patients who underwent organ-preserving operations with vagotomy for bleeding duodenal ulcers. Motor-evacuation disorders were encountered in 23.3% of patients in the form of gastrostasis. A classification of gastrostasis was formulated on the basis of the obtained data. The possibility of establishing the differential diagnosis of the causes of gastrostasis is shown. The aspects of individualization of the therapeutic tactics according to the etiology and severity of gastrostasis are discussed.
The effectiveness of surgical treatment of 193 patients with generalized purulent peritonitis was analysed. The complex of bacteriologic and immunologic investigations contributed to optimization of antibacterial and immunocorrective therapy. Rational antibacterial therapy should be based on the principle of the use of broad and super-broad spectrum antibiotics with mandatory inclusion into the programme for treatment of metronidazole, administration of antibacterial agents before, at the time and after the operative intervention before identification of microflora and determination of its sensitivity to antibiotics. The therapeutic and tactical approach developed permitted to reduce lethality in generalized purulent peritonitis from 39.5 to 24.9%.
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The results of the histodyl test used in studies of gastric acid production in patients with peptic ulcer evidence that this test helps obtain additional information on the mechanisms of hyperacid acid production and on the ratio of the digestion nervous reflex and humoral phases. The test objectivises pH metry data, is reliable, and may be useful in practical gastroenterology.
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From study of the results of treatment of 157 patients with gastric and duodenal ulcer by an individual approach to the choice of the operative methods according to the results of prognostic tests, the authors revealed a high practical significance of using cholinolytics for diagnostic purposes. The choice of the method of surgical treatment with due regard for the prognostic evaluation of the effect of vagotomy on the gastric motor and acid-producing functions determined a 8.4% reduction of the frequency of postoperative motor-and emptying complications of gastric activity, and a 6.8% reduction of the incidence of recurrent ulcer.
Our experience with treatment of 758 patients with bleeding pyloroduodenal ulcers evidence in favour of expediency to perform diagnostic ++pyloro-duodenotomy. ++Pyloro-duodenotomy is a mandatory stage of excision of bleeding pyloroduodenal ulcers. Improvement and differential choice of its methods permits to enlarge the store of surgical interventions on the pyloroduodenal zone.