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Biomedical subjects

B K Komiakov

Publications and source records attributed to B K Komiakov.

At least 19 recordsLinked to original sources
PubMed2006

[Surgical treatment of patients with micro-cystitis of tuberculous and other etiology].

The urinary bladder was reconstructed by using different segments of the gastrointestinal tract in 45 patients aged 21 to 72 years. The indication for surgery was microcystis of tuberculous and other etiology in 28 (62.2%) and 17 (37.8%) patients, respectively. The overall post-operative mortality was 2.2% (1 patient). Early and late complications were observed in 17.8 and 30.4% patients, respectively. Analysis of the causes of complications has indicated that they are associated with the urine diversion method and with the scope of urinary bladder resection. Seven repeated operations were performed. Augmentation cystoplasty should follow subtotal microcystectomy. For correction of azotemia and for prevention of stricture in the early postoperative period, the neocystis should be continuously irrigated with antiseptic solutions in order to eliminate urine, mucus, and blood clots.

Adult↗
PubMed2005

[Replacement of the urinary bladder by the stomach body].

In the period from 2001 through 2004 plasty of the urinary bladder was performed in 24 patients using a. et v. gastroepyploici dexter. Mean age of the patients (18 men and 6 women) was 58.2 years. Gastrocystoplasty in 18 patients was performed after radical cystectomy for urinary bladder cancer, in 6 patients for neurogenic and small urinary bladder. The authors' original modification with a complete transversal resection of the stomach body taken together with the lesser curvature was used in operations on 10 patients. Early postoperative complications developed in one patient, late ones--in two patients, there were no lethal outcomes. Positive functional results were noted in all patients within the terms of observations from 2 through 22 months. Good quality of life was noted in all of them.

Adult↗
PubMed2005

[Substitution of a lengthy defect of the ureter for the vermiform appendix].

The authors share their experiences with the substitution of the ureter for the appendix in three patients. In two of them the lengthy constriction of the pelvic portion of the ureter resulted from postirradiation alterations, in the other--from a gunshot wound of the lumbar area. The sufficient length and diameter of their appendix on a mobile mesentery allowed its being used for the substitution of the ureter. The results of operations were successful and without postoperative complications in all cases.

Adult↗
PubMed2005

[Changes in the expression of receptors of steroid hormones in the development of partial androgen deficiency of aging men (PADAM)].

This work is devoted to the vital topic of the influence of partial androgen deficiency of aging men (PADAM) on the development of cells with androgen receptors. The results obtained in this study suggest a conclusion that the production of testosterone by some tumors and tissues of the peritumorous zone, which is accompanied by increased proliferative activity and disturbance of the regulation of the cell cycle, is caused by PADAM. The given changes are directed at compensating for testicular deficiency (in particular at overcoming the androgen-dependent stage of development of androgen-sensitive cells). These changes are a partial manifestation of metabolic syndrome (X-syndrome). The atypical cells, which unavoidably develop during metabolic syndrome, are dealt with by means of the immune system, whose capabilities become less and less adequate in the given circumstances.

Aged↗
PubMed1998

[Supravesical urinary diversion--a palliative treatment method for patients with inoperable bladder cancer].

In patients with inoperable cancer of the urinary bladder complicated by uretherohydronephrosis, chronic pyelonephritis, chronic renal failure, profuse bleedings from the tumor and pronounced dysuria, the supravesical derivation of urine is thought to be vitally indicated in spite of the unfavourable prognosis of the basic disease. First, it is necessary to provide the adequate drainage of the upper urinary ducts and kidneys followed by making favourable conditions for their longer and good functioning.

Aged↗
PubMed1985

[Emergency transvesical adenomectomy].

Based upon the present-day theories and their personal clinical experiences (236 patients with urgent adenomectomies) the authors show the expediency of the urgent radical operative treatment of patients with adenoma of the prostate complicated by ischuria.

Aged↗
PubMedDate not supplied

[Short-term outcomes of radical surgery for bladder cancer].

A total of 102 radical cystectomies have been conducted for 1996-2001 (94 males, 8 females, age 37-78 years, mean age 57.5 years). Most of the patients (81.4%) were diagnosed to have transitional cell carcinoma. Supravesical urine derivation was made by means of ureterocutaneostomy and transureteroureteronephrostomy in 7(6.9) patients, ureterosigmoanastomosis--in 41(40.2%), Sigma-rectumpouch--in 1(0.9%) patients, ileocystoplasty, largely by Hautmann and Studer was carried out in 52(51%) patients. Postoperative complications developed in 25(24.5%) patients who often had adhesive ileus. Four patients died: 2 of pulmonary artery thromboembolism, 1 of acute cardiac failure and 1 of sepsis. Methods of continence urine derivation were preferred, such as ureterosigmoanastomosis by Mainz-Pouch II and creation of orthotopic bladder of the ileum.

Adult↗
PubMedDate not supplied

[Short-term results of radical cystectomy].

The paper presents the results of 114 radical cystectomies made in 1996-2002. The age of 114 patients (103 males, 11 females) ranged from 37 to 78 years (mean age 57.5 years). Transient cell carcinoma was diagnosed in 81.5% patients. Supravesical urine derivation was conducted by means of ureterocutaneostomy and transureteroureteronephrostomy in 9 (7.9%) patients, ureterosygmoanastomosis--in 43 (37.7%) patients, artificial orthotopic urinary bladder was created in 7 (6.1%) patients of a gastric segment and in 55 (48.2%) patients of the ileum. Postoperative complications were observed in 28 (24.6%) patients, intestinal obstruction being a prevailing complication. Five patients died: 2 of pulmonary artery thromboembolism, 1 of acute cardiac failure, 1 of sepsis and 1 of gastric bleeding. Continent methods of urine derivation were preferred, such as ureterosygmoanastomosis by Mainz-Pouch II and creation of orthotopic urinary bladder of the stomach or of the ileum.

Adult↗
PubMedDate not supplied

[The surgical treatment of closed injuries and strictures of the urethra].

Under analysis were results of operative treatment of 291 patients aged from 7 to 76 years with traumas and strictures of the urethra at the period from 1970 to 1990. Totally 325 operations have been performed. The primary suture of the urethra was successfully used in 8 of 36 patients with trauma of the urethra. Tunneling of the urethra for its strictures which was widely used in the clinic up to 1980 gave 46.2% of recurrences during the first 3 months after operation. It required the surgical methods to be changed. During the recent 11 years 161 operative interventions have been performed: 103 (64.0%) resections of the urethra, 45 (28.0%) internal optical urethrotomies and transurethral resections (TUR) of scarry tissues, 7 (4.3%) epidermoplasties of the urethra and 6 (3.7%) tunnelings of the urethra. The amount of recurrences dropped up to 13.7%. The primary suture of the urethra is necessary for penetrating ruptures of the urethra if the patient's state allowed. Resection of the urethra must be the operation of choice in patients with strictures and obliteration of the urethra. The endoscopic methods of treatment (urethrotomy and TUR) are indicated for short strictures and scarry deformity of the posterior urethra after operations on the prostate. The epidermoplasty is expedient for lengthy strictures.

Adolescent↗
PubMedDate not supplied

[Surgical treatment of long ureteral strictures].

The paper reviews experience, specific features and outcomes of surgical treatment of 115 patients (60 males, 55 females) with long strictures and defects of the ureter. Renal and ureteral malformations, acquired strictures were detected in 14 (12.2%) and 101 (87.8%), respectively. The following reconstructive operations were made in 102 patients: ureterocalicoanastomosis by Neuvert (n = 3), specially designed original plastic repair of the lumbar ureter (n = 3), ureterolysis (n = 7), indirect ureterocystoanastomosis (n = 39), appendicoureteroplasty (n = 2), intestinal plastic reconstruction of the ureters and urinary bladder (n = 43), autotransplantation of the kidney (n = 3). Postoperative complications developed in 13 (11.3%) patients. No lethal outcomes occurred. Urinary tracts improved hemodynamics in all the patients. Recovery of ureteral passage in its long strictures necessitates atypical surgery. These were listed above. The proposed method of lumbar ureter replacement by mobilization and raising urinary bladder wall together with relevant ostium and pelvic ureter is perspective.

Adolescent↗
PubMedDate not supplied

[Orthopic plastic repair of the urinary bladder with a gastric segment].

Urinary bladder plastic repair with a gastric segment on a. et v. gastroepyploici dex was made in 22 patients (18 males, 4 females, mean age 58.2 years) from November 2001 to June 2003. Gastrocystoplasty was made in 17 patients after radical cystectomy for urinary bladder cancer, and in 5 patients with neurogenic and small urinary bladder. Three patients have undergone surgery in our modification with a complete cross resection of the gastric body with the lesser curvature. Lethal outcomes were absent. Follow-up for 2-22 months demonstrated that all the patients achieved positive functional results and good quality of life.

Adult↗
PubMedDate not supplied

[Treatment of epithelial tumors of the upper urinary tracts].

The authors present the results of different operative treatments of tumors of the upper urinary tracts (UUT). A total of 116 patients with UUT tumors were examined and treated from 1990 to 2002 (age 19-80 years, mean age 61.3+/- 1.3 years; males 82, females 34). Tumors of the renal pelvis and the ureter were detected in 76 (65.5%) and 40 (34.5%) patients, respectively (8.0 and 4.3% of a total number of patients with tumors of the kidneys and UUT). 107 (92.2%) patients were operated. Nephroureterectomy and ureterectomy with resection of the urinary bladder were performed in 73 (68.2%) patients, TUR of the urinary bladder wall, ureteral ostium with pelvic part of the ureter and nephroureterectomy (including endovideosurgery) in 22 (20.6%), nephroureterocystectomy in 4 (3.7%), resection of the pelvic ureter with Boari's operation in 5 (4.7%), nephroscopy, ureteroscopy with removal of urothelial tumor in 3 (2.8%) patients. Postoperative complications (most of them infectious-inflammatory) developed in 10 (9.3%) patients. Lethality was 0.9%. Tumor recurrences occurred in 27 (25.2%) patients within 5-year follow-up. 15 (14.0%) patients were reoperated. 5-year survival reached 67.0%. Conventional and radical method of treating patients with tumors of the renal pelvis and ureter is nephroureterectomy with urinary bladder resection and its modification. In invasion of the tumor in the muscular layer of the bladder wall surgery should be extended and supplemented with cystectomy. Conservative surgical interventions are indicated in tumors of the sole kidney, bilateral process, benign or surface tumor of the urothelium.

Adult↗