PubMed Health⌕ Search

Biomedical subjects

Iu G Starkov

Publications and source records attributed to Iu G Starkov.

At least 19 recordsLinked to original sources
PubMed2006

[Laparoscopic procedures in focal lesions of the liver].

Seventy-three laparoscopic procedures were performed for the treatment of focal lesions of the liver. Fifty-four patients had operations for non-parasitic cysts of the liver and cystic disease. Polycystic disease of the liver was in 8 patients. Multiple cysts were in 19 patients, solitary - in 27. A total of 139 cysts were treated. Surgery was performed with the standard technique. Atypical marginal resection of the liver was performed in 16 patients for hemangioma (n=8), nodular hyperplasia (n=2), hepatic metastases (n=5), hamartoma (n=1). Atypical marginal resection by type of peritumor resection was conducted in 5 cases, and it was similar to segmentectomy in 11 cases. Laparoscopic cryodestruction of benign tumors and hepatic metastases was performed in 3 patients including in combination with atypical marginal resection in 2 cases. There were no intrasurgical complications which required laparotomies. There were no hemotransfusions. Long-term results were followed-up from 1 to 3 years in 25 patients with hepatic cysts and from 3 months to 3 years in 7 patients after marginal resection for hemangiomas and fibronodular hyperplasia. Ultrasonic examination revealed no recurrences of the disease.

Hepatectomy↗
PubMed2005

[Endoscopic subfascial dissection of venous perforants in treatment of venous trophic ulcers of the legs].

Endoscopic subfascial dissection was performed in patients with chronic venous insufficiency of CEAP class 4-6. 76 surgeries were performed in 68 patients. Mean age of the patients was 56 years. The causes of chronic venous insufficiency were varicose (37) and postthrombotic diseases. Trophic ulcers were in 46 patients. Thirty patients underwent earlier various phlebectomies, including Linton's surgery (6 patients). In 33 patients endoscopic subfascial dissection of venous perforants was combined with various phlebectomy, in 37 patients -- with excision of ulcer with following autodermoplasty few days after surgery. Endoscopic subfascial dissection was carried out with special surgical R.Wolf endoscope with 6 mm instrumental canal, and also standard laparoscopic optical devices "Olympus". Complications during surgery were seen in 2 patients: bleeding in subfascial space (1.3%) and perforation of tissues in ulcer zone (1.3%). In postoperative period long (up to 14 days) lymphorrhea and suppuration of surgical wound were in 2 (2.6%) patients. It is concluded that endoscopic approach is optimal for elimination of pathological reflux through venous perforants in complicated forms of chronic venous insufficiency of the lower extremities, including trophic ulcers resistant to treatment.

Adult↗
PubMed2004

[Prophylaxis of thromboembolic complications in laparoscopic cholecystectomy].

A complex system of prophylaxis of thromboembolic complications (TEC) in laparoscopic surgeries based on study of hemodynamic disorders in cava vein bed and specific risk factors is discussed. System of TEC prophylaxis and prognosis of TEC risk degree was developed. Problems of prophylaxis of venous thrombosis in laparoscopic cholecystectomy in patients with chronic diseases of lower extremities veins are regarded in detail. This system permitted us to completely avoid TEC from 1996 in surgical treatment more than 2500 patients.

Adult↗
PubMed2003

[Antegrade papillosphincterotomy in laparoscopic cholecystectomy].

Stenotic lesions of the distal part of the common bile duct are often revealed in laparoscopic cholecystectomy. From 1997 intraoperative antegrade papillosphincterotomy (APST) has been introduced in clinical practice of the endoscopic department of the A.V. Vishnevsky Institute of Surgery as the method able both to treat choledocholithiasis and restore adequate bile outflow. Indications to APST were stenosis of Vater's papilla (13 patients), stricture of a terminal part of the common bile duct (6 patients), choledocholithiasis in combination with distal bile duct stenosis (20 patients), isolated choledocholithiasis (4 patients). APST was successful in 36 patients and in 35 ones it was a final procedure for correction of ducts lesions. There were no complications of APST. It is an effective method in the treatment of intraoperatively defected stenotic lesions of the biliary tracts and choledocholithiasis. It makes the base of one-stage surgical policy in line with cholangioscope-assisted lithoextraction, intraoperative retrograde papillosphincterotomy and balloon dilatation of Vater's papilla. Antegrade papilloshincterotomy in patients with cholelithiasis and lesions of the ducts revealed during surgery permits one to reduce number of complications, time of hospital stay and increase comfort of surgical care.

Ampulla of Vater↗
PubMed2001

[Ultrasonic diagnosis of focal damages in thoracoscopic operations].

5-year experience of developed in PAMS A.V. Vishnevsky Institute of Surgery RAMS ultrasonic examination (USE) of the lung in thoracoscopic operations for focal lung lesions (FLL) is presented. Pilot experience of ultrasonic topical and differential diagnosis of FII opens a new page in diagnosis of respiratory diseases. Over 5 years 74 USE of FLL were performed. FLL were found in 91% cases. Detailed topical diagnosis of allows to design the lung resection with the best functional result. In postoperative X-ray examination neither atelectases nor zones of stable hypoventilation were detected. Normal echographic picture of lung tissue and echosemiotics of different focal lesions are descubed. The experience of diagnosis by echographic signs of FLL shows teasibility of differentiation of hamartomas from tuberculomas and focal metastatic lesions. The payential of differential diagnosis is illustrated. Differential diagnosis supported enucleation in superficial hamartomas and resection in suspected malignant tumor or tuberculosis. Use of intraoperative USE in the majority of cases of focal lesions located both in depth of lung tissue and subpleurally warrants the success of operation in thoracoscopic variant.

Diagnosis, Differential↗
PubMed2000

[Diverticuli of duodenal papillar region and their role in development of choledocholithiasis and strictures of bile and pancreatic ducts].

Up to present time there is no common view on the role of diverticuli of the papillar region of the duodenum (DPRD) in development of the strictures of terminal parts of the common bile duct and major pancreatic duct. The main method for the diagnosis of DPRD is fibroduodenoscopy (FDS). Relaxational FDS is the most informative method for detailed examination of diverticulum and for assessment of its interrelations with longitudinal crease and the major duodenal papilla (MDP). During the last 2 years all patients with DPRD underwent ERCPG, which helped to obtain more complete information of the presence and the character of the strictures of terminal parts of the common bile duct and the pancreatic duct. DPR has been revealed in 5% of patients with calculous cholecystitis and in 9.5% of patients with choledocholithiasis. Of the patients, admitted to the Institute for postcholecystectomy syndrome from 1994 to 1999, DPRD were revealed in 30% of cases. The patients with DPR and chronic pancreatitis of nonalcoholic and nonlithogenic etiology, made up 9% of all patients with DPR and chronic pancreatitis. In 87 patients with DPR, suffering from various surgical diseases, following changes of bile and pancreatic ducts were revealed: choledocholithiasis (47%), stenosis of the large bile duct (15%), strictures of terminal parts of the large bile duct and major pancreatic duct (10%). There is evidence, that para- and peripapillary diverticuli deteriorate evacuatory function of the bile and pancreatic tracts due to compression of terminal parts of the choledochus and the pancreatic ducts with strictures formation, which promote disturbances of the bile and pancreatic juice passage. Biliary stasis and pancreatic juice passage disturbances create favorable conditions for lithogenesis and promote development of cholangitis, mechanical jaundice and chronic pancreatitis. Patients with choledochal and major pancreatic duct strictures and stenoses of the papilla in DPR underwent EPST with favorable initial and long-term results. The authors suggest, that DPR are an important etiopathogenetic link in the development of many diseases of the organs of hepatobiliary region, associated with biliary and pancreatic hypertension.

Aged↗
PubMed2000

[Videothoracoscopy in diagnosis and treatment of small peripheral pulmonary masses].

This study was devoted to examination of efficacy of modern methods of diagnosis and surgical treatment of patients with small peripheral pulmonary masses (SPPM) with the use of videothoracoscopy. The results of examination and treatment of 126 patients with SPPM (80 patients underwent videothoracoscopy) were analysed. This study demonstrated high-quality of modern complex of clinicoradiological investigations for diagnosis of SPPM. The reliability of the complex is 91%. The necessity of immediate elective operation of the patients with SPPM is shown for verification of the process and adequate surgery. Videothoracoscopic surgery is effective method of treatment in patients with SPPM.

Diagnosis, Differential↗
PubMed2000

[Laparoscopic cholecystectomy in choledocholithiasis and stricture of the terminal part of the common bile duct].

The authors offer the treatment and diagnostic algorithm in choledocholithiasis, stricture of a terminal portion of the common hepatic duct and papilla stenosis revealed in laparoscopic cholecystectomy (LCE). With the purpose of intraoperative assessment of bile ducts states during LCE, the diagnostic system including laparoscopic and ultrasonic examinations, cholangiography and choledochoscopy was developed and applied. In intraoperative revealing of choledocholithiasis without bile outflow disorders and wide cystic duct the authors prefer to remove the concrements during choledochoscopy through cystic duct without intervention on Vater's papilla (VP). In combination of choledocholithiasis with bile outflow disorders and also in isolated papilla stenosis and stricture of a terminal portion of the common hepatic duct, one-stage laparoscopic cholecystectomy, intraoperative antegrade papillosphincterotomy and retrograde calculus extraction is optimal. In cases when complete endoscopic calculus extraction is impossible, the drainage of the common hepatic duct by Cholsted's with subsequent delayed endoscopic papillosphincterotomy (EPST) is acceptable. During intraoperative examination in 49 patients (57.6%) the concrements in choledochus, not diagnosed earlier, were revealed, in 21--stricture of terminal choledochus portion and in 19 patients--papilla stenosis. In 12 cases the concrements were removed during choledochoscopy through the cystic duct stump, 4 patients with big concrements required laparoscopic choledocholithotomy. In 16 cases LCE with various variants of choledochus drainage was performed as the first stage, as the second stage--EPST and lithoextraction. Antegrade papillosphincterotomy was performed in 15 patients during LCE. In 12 cases intraoperatively revealed choledocholithiasis combined with papilla stenosis (7) and choledochus stricture (5) was the indications to intraoperative papillosphincterotomy. Papilla stenosis was the indication to antegrade papillosphincterotomy in 3 patients.

Adult↗
PubMed2000

[Differential diagnosis of pancreatic head cancer].

The results of clinical, instrumental and laboratory examinations were analyzed for 99 patients. 59 of them had pancreatic head cancer, 40--chronic pseudotumorous pancreatitis. The importance of complex ultrasonic diagnosis in detection of pancreatic diseases (98%), in true diagnosis of unresectable tumors (96.7%), and also in determination of bile ducts lesion level in obstructive jaundice is shown. It was revealed that spiral computed tomography (SCT) had an advantage over computed tomography in diagnosis of pancreatic tumors and in assessment of their resectability. Sensitivity of combined use of US, SCT and tumor marker CA 19-9 in pancreatic cancer diagnosis increases to 95.2%. High diagnostic value of laparoscopy with laparoscopic ultrasonic examination as a method of final assessment of tumor resectability is shown.

Biomarkers, Tumor↗