Biomedical subjects

G K Zherlov

Publications and source records attributed to G K Zherlov.

At least 19 recordsLinked to original sources

PubMed2006

[Reconstructive jejuno-gastroplasty in the treatment of operated stomach disease].

The results of treatment of 205 patients with operated stomach disease were analyzed. Conservative therapy was effective in 71.7% patients. Surgical treatment was used in 58 (28.3%) patients. Reoperation was performed less than a year after primary surgery in 5.2% patients, 1 to 3 years later -- in 41.4%, 3 to 5 years -- in 36.2%, more than 5 years later - in 17.2% patients. Early after operation complications were observed in 24.1% patients. Clinical and device examinations demonstrate that surgical reconstruction significantly reduces intensity of pathological symptoms in all the patients.

Adult↗

PubMed2006

[Optimization of prognosis and surgical prophylaxis of bleedings from esophageal varicose veins].

New methods of prediction of bleeding from the esophageal varicose veins improve treatment outcomes. These methods consist of endoscopic assessment of varicose vein and mucous membrane with determination of thickness of the vein wall and mucosa, and also assessment of reflux-esophagitis with endoscopic ultrasonography. Original operation of azigoportal disconnection was performed in 13 patients followed-up after surgery from 1 to 4 years. The results obtained demonstrate high efficacy of this surgery for prophylaxis of repeated bleedings from esophageal varicose veins.

Aged↗

PubMed2006

[Modeling of rectal ampulla and rectosigmoid sphincter mechanism in anterior resections of various level].

Original technologies of modeling of rectal ampulla and rectosigmoid sphincter mechanism have been developed for improvement of short- and long-term results after anterior resection of the rectum. The study group consisted of patients after upper resection (n=54) where rectosigmoid mechanism was formed as valve flap on 4-5 cm distally to anastomosis with recovery of pelvic peritoneum at this level, and of the patients after lower resection (n=47) where modeling of rectal ampulla and rectosigmoid mechanism was performed with serosomyotomy of intestinal portion between sphincter and anastomosis. The control group consisted of patients with direct anastomoses at the distance of 6-12 cm (n=12) and 5-1 cm from the anus. 4-6 months later the ampulla-shaped dilatation of intestinal portion after serosomyotomy and formation of functionally active sphincter mechanism were detected in patients of the study group. Developed technologies reduced the number of patients with multi-moment evacuation and incapable to hold the stool for 15 min.

Aged↗

PubMed2006

[The potential for endoscopic dissection of the leg perforating veins].

This paper describes the results of endoscopic dissection of the leg perforating veins in patients suffering from different forms of chronic venous insufficiency of the lower limbs. Varicosity was present in 54 (88.4%) and postthrombophlebitis in 7 (11.6%) patients. Before operation the patients were provided ultrasound Doppler and duplex scanning. Microcirculation was examined by laser Doppler flowmetry. The study evidences decreased perfusion of the superficial skin layers during the growth of arteriolo-venular blood shunting that occurs because of phlebohypertension. For endoscopic dissection of the leg perforating veins an original titanium nickelide clips was employed, which allowed ligation of the veins measuring over 5 mm via a standard endoscopic canal. The use of the given technique made it possible to minimize the time of operation, to decrease traumatic injury of intervention due to the exclusion of incisions in the area of trophic disorders. The mean time required for ulcerous defect healing accounted for 32.3+/-1.7 days. Regulation of lower limb microcirculation was restored 3 months after surgical treatment.

Adult↗

PubMed2006

[Functional results of the surgery of esophageal opening hernia].

The article presents an original method of laparoscopic anti-reflux surgery, immediate and long-term results of the treatment of 132 patients with esophageal opening hernia. It also describes the analysis of the life quality of patients with the gastroesophageal reflux disease before and after the surgery.

Adult↗

PubMed2005

[Choice of radical surgical method in patients with sutured perforated gastroduodenal ulcers].

Long-term results of suturing of perforated gastroduodenal ulcer in 364 patients were analyzed. Within 16 years after surgery recurrence of ulcer was seen in 215 (62.9%) patients. Radical elective surgeries were performed in 197 (54.1%) from 2 mos to 16 years after perforation of ulcer. Indications for radical surgery were determined on the basis of the disease duration, presence and nature of complications, level of acid-production, etc., and also data of endoscopic ultrasonography. In early postoperative period 1 (0.5%) patient died. Long-term results were followed from 2 mos to 11 years in 168 (85.3%) patients. Recovery of reservoir and motor-evacuation function of the operated stomach was demonstrated with special examinations. The mean gastrointestinal index (GIQLI) in long-term period was 124.6 after resection surgeries and 120 after organ-retaining surgeries.

Adolescent↗

PubMed2005

[Modification of rehabilitation stage after inter-sphincter resection of the rectum].

Endoscopic ultrasonic examination for diagnosis of malignant tumors of a lower-ampullar part of the rectum determined indications to inter-sphincter resection consisting in total mesorectumectomy, resection of the rectum and internal sphincter. The method of creation of a globe-shape reservoir with artificial muscular sphincter was developed. Fourteen patients underwent surgery, the follow-up was up to 3,5 years. It is demonstrated that a globe-shape extensible reservoir and autonomic bloching function of muscular sphincter are the main conditions of repair of defecation functions in long-term period after inter-sphincter resection.

Anal Canal↗

PubMed2005

[Clinical, endoscopic and morphological criteria for assessing function of esophageal anastomosis].

UNLABELLED: Clinical and endoscopic data on 115 patients after surgery with creation of esophageal anastomosis was analyzed. Functional status of esophageal anastomosis was studied with x-ray, endoscopic, morphological, and US-assisted endoscopic METHODS: The findings provided information for development of functionally effective esophageal anastomosis criteria. Potential of US-assisted endoscopy was demonstrated. Objective and early diagnosis of the depth and intensity of inflammatory infiltration in early postoperative period allowed conduction of adequate treatment. The study of tissue structure in the zone of esophageal anastomosis in a late postoperative period discovers the cause of functional insufficiency of esophageal anastomosis.

Adult↗

PubMed2005

[Correction of the motor-evacuation function of the postoperative stomach in the early postoperative period].

We conducted the analysis of the results of surgical treatment of 255 patients with duodenal ulcers. In the early postoperative period the evacuation and motility function of the postoperative stomach was corrected with the use of the autonomous electrostimulator of the gastrointestinal tract (EAS GT) in all patients - in the main group (n = 125) and drug stimulation (cerucal 2.0 intramuscularly twice a day) and in the control group (n = 130). The use of EAS GT-3 certainly reduces symptoms of dyscoordination of the motor function of the gastrointestinal tract.

Clinical Protocols↗

PubMed2005

[Surgical treatment of stage IV cardial achalasia].

An original method of surgical treatment of patients with stage IV cardial achalasia was developed. Seven patients aged 42 to 59 years underwent surgery according this method. Objective methods of examination and life quality study with GIQLI carried out 3 months to 5 years after surgery demonstrate satisfactory anatomic and functional results.

Adult↗

PubMed2005

[Experimental grounds for the formation of an increased pressure zone in the area of "impaired" lower esophageal sphincter].

A method of the formation of an artificial lower esophageal sphincter (LES) with the help of superelastic threads made of a nickelide-titan alloy was developed in the experiment. An experimental model of an artificial LES was tested on cadaver organic combinations of the esophagus and stomach in ten watchdogs and ten rabbits. Tests of the esophageal passage and antireflux features of the artificial lower esophageal sphincter (LES) and assessment of morphological changes in esophageal wall layers with the emphasis on changes of the esophageal wall structure and gastroesophageal passage near the thread were made. This experiment proved that the passage in the artificial lower esophageal sphincter (LES) area is not disturbed and a zone of increased pressure is created.

Animals↗

PubMed2005

[Method of treatment of reflux-esophagitis after gastrectomy].

A new method of treatment of reflux-esophagitis developed for patients after gastrectomy has a distinctive moment: the formation of a restraining mechanism in the field of esophago-gastric anastomosis, without opening the intestinal tube lumen. The carried on trials of clinical application of the method have shown its high effectiveness for prophylactics ofjejuno-esophageal reflux both in the early and distant terms after operation. The method of operating was given a patent of the Russian Federation.

Adult↗

PubMed2004

[Surgical treatment of gastroesophageal reflux].

One hundred and seventy-five patients with gastroesophageal reflux disease (GERD) were treated, 144 (82.2%) of them underwent surgery. In 106 (73.6%) patients laparotomy was used, in 38 (26.4%) -- laparoscopic surgeries. Transabdominal USE of the esophagus, stomach and duodenum, endoscopic ultrasonoraphy (EUS) of the esophagus were used for diagnosis of GERD in addition to standard tests. Based on EUS data, classification of severity of reflux-esophagitis was proposed. New method of laparoscopic creation of artificial lower esophageal sphincter (LES) with super thin (95, 45 mm) and super elastic filaments made of nikelid-titan alloy was developed in experiment and introduced into clinical practice. Thirty-four laparoscopic surgeries were performed, 26 (76.4%) of them -- with creation of artificial LES. In this group 94.4% of patients demonstrated excellent and good results in long-term period. Pressure in the area of LES in these patients increased by 70%, on the average, after surgery.

Adult↗

PubMed2004

[Prophylaxis and treatment of complications after resection of the stomach with Roux anastomosis].

One hundred and seventy-eight subtotal distal resections of the stomach with creation of the valve in an outflowing part of the small intestine were analyzed. There was no postoperative lethality due to the method of surgery. One (0.6%) patient died on day 18 after surgery for acute cardiac insufficiency. General surgery complications were seen in 3 (1.7%) cases. In 2 (1.1%) patients Roux syndrome developed, it was treated conservatively on day 12 - 18. Repair of tonisity, peristalsis of the gastric stump and diverting intestinal loop was registered late after surgery. Mild forms of damping-syndrome were diagnosed in 2.8% cases, superficial gastritis of the gastric stump -- in 33.3%, atrophic gastritis -- in 11.1%. The intestinal valve provided physiological evacuation and impeded reflux into the gastric stump.

Adult↗

PubMed2004

[Restoration of nutritional status in patients with complicated course of ulcer during preoperative period].

The comparative analysis of the efficiency of the enteral tube feeding and parenteral feeding in 52 patients with the subcompensated stenosis of the pylorus was carried out. Satisfactory results were received in all groups of patients taking enteral and parenteral feeding. Consequently, the differences in the parameters of the catabolic index and general protein in the patients taking balanced food mixes rich in calories and 'usual feeding' were statistically significant. Complications caused by enteral tube feeding were observed in 23.3%. None of the patients having such complications required food suspension. The frequency and significance of such complications were higher (54.5%) in the group of the patients taking parenteral feeding. This study has shown that the enteral tube feeding is just as efficient as the parenteral feeding. Besides, the enteral tube feeding is characterized by less significant side effects and is more cost-efficient.

Body Mass Index↗

PubMed2004

[Enteral tube feeding at the early postoperative period (stomach surgery)].

The article describes a comparative analysis of the efficacy of various variants of nutritive support in 115 patients with complicated gastroduodenal ulcers at the early postoperative period. 95 patients received enteral tube feeding, 50 of them receiving balanced isocaloric formulas and 45 of them receiving broths and decoctions as a nutritious substrate. The control group comprised 20 patients who received full parenteral feeding. The results were assessed on Day 5 after the beginning of feeding. Satisfactory results were received in all of the groups. The main advantages of balanced formulas are their easy dosage, smaller number of complications and lower price (as compared to parenteral feeding) as well as better (as compared to "ordinary" products) indexes of the nutritious status recovery.

Adult↗

PubMed2003

[Surgical treatment of gastric and duodenal ulcer disease with chronic duodenal obstruction].

One hundred and twenty-nine surgeries were performed from 1990 to 2001 for gastric (50) or duodenal (79) ulcers with chronic duodenal obstruction. Resection of 1/2 of the stomach by Bilrot-I was performed in 118 patients, pylorus-saving resection with creation of areflux valve in duodenal bulb--in 5, selective proximal vagotomy with duodenoplasty--in 6 patients. In early postoperative period complications were seen in 10 (10.9%) patients, postoperative lethality was 0.8% (one patient died). There was no insufficiency of anastomotic sutures. Postoperative stay was 11.3 +/- 1.5 days. In remote period after surgery symptoms of chronic pancreatitis was in 2.3% patients, but there were no symptoms of duodenostasis. Roentgenological symptoms of compensated duodenal obstruction were seen in 2 patients operative on for decompensated duodenostasis. These patients had no complaints.

Adult↗

PubMed2003

[Method of selective proximal vagotomy].

A method of selective proximal vagotomy has been developed experimentally. It provides additional parasympathetic denervation of an acid-producing zone of the stomach by means of circular transsection of gastric and esophageal muscular membranes above and below cardial sphincter with forming of are flux esophageal-gastric valve. Clinical use of this method in 75 patients confirmed experimental data about a good function of the created valve and adequate decrease of acid production. This improved short and long-term results and reduced the time of temporary disability.

Denervation↗