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Biomedical subjects

A Merdzhanov

Publications and source records attributed to A Merdzhanov.

At least 19 recordsLinked to original sources
PubMed1991

[The diagnostic and surgical problems in chronic pancreatitis due to biliary calculosis].

Proceeding from personal clinical experience gained during many years of studies, the authors discuss the diagnostic and surgical problems of biliopancreatitis. In recent years biliary calculosis has been basic etiologic factor in 70 per cent of the cases; 76.8 per cent of the patients had complaints of long standing, while in the rest the history was shorter. The duration did not correspond to the morphologic findings. Only 43 per cent of the patients had clinical symptoms suggestive of accompanying pancreatitis, and echographic examination helped to establish the diagnosis in only 21 per cent of the cases. Two thirds (64 per cent) were patients in advanced and senile age, 5.8 per cent had severe preoperative complications and 52 per cent had systemic diseases affecting organs other than the liver and pancreas. The operations were primary in 169 patients (82 per cent) and repeat in 38 (18 per cent). The remote results were very good in 82 per cent, good in 9 per cent and satisfactory in 9 per cent. It is considered that treatment of chronic biliopancreatitis keeps on being surgical; endoscopic manipulations rather seldom produce ultimate therapeutic effect.

Adult↗
PubMed1990

[Sphincter-sparing operations in rectal cancer].

Data on 564 patients who underwent operation for cancer of the rectum are analysed. Amputation of the rectum was resorted to most frequently because of the low localization of the neoplastic process in the majority of patients. Mortality was higher in amputation than in anterior resection of the rectum. Criteria for sphincter-preserving operations are determined. Preference is given to anterior resection of the rectum as a more physiological operation which was also performed on elderly patients.

Adult↗
PubMed1990

[Hemorrhage from esophageal varices].

Bleeding from varicose veins (VV) of the esophagus remains a serious therapeutic problem to date. From experience in operative treatment of 164 and nonoperative management of 33 patients the authors discuss the modern trends of the treatment of this disease. New drugs are applied to reduce pressure in the portal system, on the one hand, and new operative techniques are studied, on the other. Endoscopic sclerotherapy of VV is resorted to more and more extensively. The authors applied it in 48 patients with a satisfactory effect. The authors claim that planned surgical treatment produces the best effect.

Adult↗
PubMed1989

[The surgical treatment of rectal cancer].

Analysis was made of the case records of 1307 patients operated for rectal cancer--788 (60.3 per cent) men and 519 (39.7 per cent) women. Most common was the disease in the age group 50 to 75 years. The operations performed were: radical--879 (67.3 per cent) and palliative--428 (32.7 per cent). Of all radically operated patients, in 532 (60.5 per cent) the rectum was extirpated. Mortality in this group was 10.9 per cent. Abdominal resection was performed in 235 patients (26.7 per cent) with 8.9 per cent mortality. In 70 patients (8 per cent) sphincter-preserving type Babcock or Toupet operations were performed with case fatality rate about 14 per cent. Of all 1307 patients in the near postoperative period 112 died (8.5 per cent). The authors give preference to low anterior resection to other type of sphincter-preserving operations.

Aged↗
PubMed1989

[Sugiura's operation in portal hypertension].

The opportunities for surgical treatment of gastro-esophageal varices in patients with portal hypertension are discussed. The results of portal systemic shunts and ablative (devascularizing) operations are compared. The operative technique of Sugiura is described in detail and the modifications aimed at reducing the operative risk and the duration of the intervention are reviewed. Personal experience is recorded with two cases and the positive impressions of this operation. Proceeding from the good postoperative results, especially in patients with nonalcoholic cirrhosis, prevailing in this country, the authors suggest this surgical intervention an alternative method for planned and emergency treatment of part of the patients with hemorrhage from esophageal varices.

Esophageal and Gastric Varices↗
PubMed1989

[Minkowski-Chauffard disease as a surgical problem].

Minkowski-Chauffard's disease keeps on being primarily a subject for hematologists, but surgeons play a definite role in its treatment, if we take into consideration the encouraging effect of splenectomy. Experience is recorded gained at the Department of Abdominal Surgery of the Research Institute of Gastroenterology and Hematology with 34 patients for a period of 35 years, 13 of them during the last 18 years. A patient is presented with a characteristic clinical pattern, associated with calculosis of the common bile duct, a very rare observation in this disease. A review is made on the current knowledge on the etiology, pathogenesis clinical manifestations and treatment of the disease. The need of splenectomy, with simultaneous search for accessory spleen and for biliary pathology, prompting revision of the biliary system as well, is emphasized.

Abnormalities, Multiple↗
PubMed1989

[Surgical procedures in duodenal ulcer hemorrhage].

Analysis was made of 893 patients operated for duodenal ulcer. Of these, 872 (97.6 per cent) were operated as nonemergency planned patients; the outcome was fatal in 5 (0.57 per cent). Emergency operative intervention at the acme of the bleeding was performed in 21 patients (2.4 per cent) because of failure to control the bleeding by conservative means. Six of these patients died (24.0 per cent) during the early postoperative period. Highest was the percentage of patients in whom extended gastric resection was made; there were no lethal cases among patients subjected to antrumectomy and truncus resection. Preference is given to truncus vagotomy with sparing resection of the stomach; this is considered a reliable and safe method for stopping the bleeding and curing the patients from the ulcer.

Aged↗
PubMed1987

[Echinococcosis of the pancreas].

A rare clinical observation of echinococcus cyst in the body and tail of pancreas is described, penetrating retroperitoneally to the hilus of the spleen and to the left lateral duct, confirmed and successfully treated by surgical operation. The disease caused considerable diagnostic difficulties during the preoperative period.

Adult↗
PubMed1986

Pharmacokinetics and quantitative characterization of cefotiam excretion after intravenous administration to patients after cholecystectomy.

Six patients, aged 52 to 71 years, with T-tube drainage of the common bile duct and a urinary catheter after cholecystectomy, were studied in order to evaluate the urinary and biliary excretion and pharmacokinetics of cefotiam in the early postoperative period. Each patient received cefotiam 1 g i.v. as a bolus injection. Cefotiam in plasma, urine, and bile were determined by HPLC. A 2-compartment open model with elimination from the central compartment satisfactorily fitted the plasma levels of the drug. The renal clearance of cefotiam (CLR = 133 ml/min) was an order of magnitude greater than its biliary clearance (CLB = 11.8 ml/min). Glomerular filtration was the main mechanism for elimination of cefotiam. The values of CLR and CLB in relation to the total plasma clearance (CL = 138. ml/min) demonstrated the negligible role of metabolism in elimination of cefotiam in these patients.

Aged↗
PubMed1985

[Pyogenic liver abscesses--diagnostic and surgical problems].

The authors discuss the clinical-diagnostic and surgical problems in the treatment of the pyogenic hepatic abscesses. Eight patients, undergone the operation during the second period after 1971, were out of 18 patients operated (1951--1983) were analyzed in details. An inexplicable predomination of males and affection of all age groups is reported. The abscesses are cryptogenic in 2 of the patients, after operation of the hepaticbiliary system--in 2, after gastric operation--in 3, after abdominal trauma--in 1. The possible way of penetration of the infection is discussed. In was established that it parallel with the characteristic clinical picture and biochemical deviations, typical for the septic process, a definite diagnosis is made via echography and computer tomography, supported by scintigraphy, angiography, punching of the abscess, inspection graphy of the hepatic region. The treatment is difficult and complex: Antibiotic, generally tonizising and surgical. The choice of the operative approach denends on the localization, number of the abscesses and character (pyogenic, amebic, etc). The therapeutic tasks are discussed as well as the operation methods applied, punch-aspiration including. The risk of complications and lethality remain high, three patients were discharged healthy, with improvement--2, deceased--3 (sepsis, stress-ulcer, pulmonary embolism).

Adult↗