Biomedical subjects
Publications and source records attributed to G V Kopysov.
An analysis of 120 patients with multiple trauma is given. The authors believe that the question of diagnostics of the injuries, the succession of using diagnostic methods should be solved collectively. A conclusion has been made that urgent surgery in complex with resuscitation measures must be performed in patients with internal hemorrhage, increasing intracranial hematoma, tamponade of the pericardium, increasing hemopneumothorax.
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An analysis of the observation of 107 patients has shown the etiological factors of the appearance of postoperative ventral hernias to be varied: lowered resistance of the patient's organism to infection, choice of an irrational operative access, insufficient hemostasis, carelessness in handling with tissues during operation, severe concomitant diseases, erroneously chosen method of anesthesia. Peridural anesthesia is recommended for the operative treatment of ventral hernias.
High incidence of diagnostic errors in thoracoabdominal wounds is due to the critical state of the patients, insufficient clinical examination and underestimation of localization of the wound hole. Errors in diagnosis result in the incorrect sequence of surgical procedures, time loss during the arrest of bleeding, use of traumatic operative accesses.
The surgeon's tactics in appendicular infiltrate should be chosen following a complete examination of the patient and careful observation. Appendectomy is indicated in loose appendicular infiltrate. Conservative therapy is a method of choice for the treatment of a dense appendicular infiltrate. Periappendicular abscess should be opened and drained.
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Literature data on 294 patients with injuries of the duodenum and 24 personal observations were analyzed in order to reveal the localization and character of the injuries, surgical interventions, complications and outcomes of damages of this organ. Injuries of the duodenum, especially of its retroperitoneal portions, were found to be more frequent. Reserves for improving results of the treatment were shown to be in better diagnosing and performing operations with minimum amount of anastomoses, careful drainage of the retroperitoneal space, aspiration of the gastro-intestinal content.
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The control fibrogastroscopy of the resected stomach in patients showing the clinical picture of postoperative anastomositis has proved that the application of an unresolving suture material (caprone) for a marginal suture of gastroenteroanastomosis causes post-resection inflammation of anastomosis in about 50% of cases. For improvement of surgical results the authors suggest to substitute marginal caprone sutures with catgut or tantal agraffes.
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