[Postcholecystectomy syndrome].
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Biomedical subjects
Publications and source records attributed to G G Pirtskhalaishvili.
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Quality of life was assessed in 60 cystectomized patients with bladder cancer versus method of urine derivation. Surgery had been ended with formation of "wet" stoma in 39 cases (ureterocutaneostomy--in 30 patients and operation after Bricker--in 9) whereas in 21 cases "dry" stoma had been formed with derivation of the urine into large bowel reservoir assuring controlled voiding. Only as few as 9 (23.1%) "wet" stoma patients retained the pretreatment activity as compared to 100% of those in the other treatment group. One-third of the "wet" stoma patients were unsatisfied with functional results of surgery and preferred formation of the reservoir which assured controlled voiding and allowed freedom from urinal.
Five hundred and sixty-two males, aged 15-50 years, were questionnaired to assess their knowledge about testicular cancer, its early symptoms, treatment and role of self-examination in early diagnosis of tumor. Only 25 (4.5%) respondents answered all 9 questions correctly whereas 93 (16.6i%) failed completely. On the average, each respondent gave a correct answer to four questions out of nine. The study pointed to very poor knowledge about testicular cancer among young males. This calls for making educational effort to improve the situation.
Long-term results were assessed in 173 bladder cancer patients subjected to cystectomy. Twenty-eight (16.2%) patients died postoperatively. End results were evaluated in 142 patients. The patients were followed up for 1-17 years. Within that period, 50 patients (35.2%) died of tumor progression whereas 20--from renal failure (14.1%). Overall three- and five-year survival was 54.8 +/- 5.1 and 50.0 +/- 5.6%, respectively. Treatment results were studied versus stage, histologic pattern, type of treatment, tumor growth pattern and age. A significant correlation was established for stage and effectiveness of cystectomy only.
Cystectomy with derivation of urine into large bowel reservoir was performed in 35 cases of bladder cancer including five females. Four patients (11.4%) died postoperatively. In patients with partial or complete ileocecal valve failure, the best functional results were obtained with formation of intussusceptum in the area of the ileum stoma. The reservoir volume increased with time, reaching 750 +/- 57.9 ml by the end of the second year. Within the same period, pressure in the totally filled reservoir decreased from 32 +/- 1.7 to 18 +/- 4.3 un. Postoperative monitoring of anatomic structure of the kidneys showed improvement in urine passage. Wide integration of the procedure discussed with practice will improve results of bladder cancer treatment.
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Dissemination to regional lymph nodes was verified in 49 (18.8%) out of 260 cases of penile carcinoma. The frequency of metastasis in poorly differentiated squamous cell carcinoma was 2.2 times that in well-differentiated tumor. Similarly, in endophytic growth patients, it was 2.7 times that of exophytic tumors. Also, a significant correlation was established between the frequency of dissemination to lymph nodes and primary tumor size: 4.6% for T1, 19.3%--T2 and 30.9%--T3, respectively, and T4 was identified in 3 out of 5 patients.
A total of 231 patients undergoing transurethral resection combined with intravesical chemotherapy were examined for incidence of vesical tumor relapses. Some patients were subjected only to transurethral resection (Group I), those had the resection followed by intravesical adriamycin (Group II), those underwent the resection followed by thiophosphamide chemical prevention (Group III), and those had surgeries after intravesical chemotherapy (Group IV). The incidence of the relapses was 44, 43.1, 29.6, and 52.9%, respectively. The incidence of relapses was examined in relation to the type, malignancy, and multiple foci of the tumor.
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The analysis of the treatment results is given for 183 patients with bladder cancer following cystectomy under various methods of urine derivation. Ureterocutaneostomy, Brickers operation, ureteral implantation into an isolated segment of the sigmoid, ureteral implantation into the colonic reservoir with controlled evacuation, radical cystectomy with ureteral implantation into an isolated rectal bladder with formation of sigmostoma, ureterosigmoanastomosis were performed in 94, 15, 10, 35, 12 and 17 patients, respectively. As shown by the follow-up available for 151 patients, 55 patients died of the tumor progression, 22 of renal complications, 11 of other causes. Within 2 postoperative years the disease progression and renal failure caused death in 65 (73.9%) out of 88 patients. The least lethality due to renal failure (3.2%) was recorded in patients with colonic reservoir.