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Iu I Sedletskiĭ

Publications and source records attributed to Iu I Sedletskiĭ.

At least 19 recordsLinked to original sources

[Surgical treatment of severe forms of metabolic syndrome].

The authors analyze the components of the metabolic syndrome in patients with morbid obesity treated at the surgical department. The effects of a modified operation of jejunal-ileal shunt on the components of the metabolic syndrome were shown in 220 patients operated upon at the clinic of Faculty surgery of the Pavlov Medical Academy in St. Petersburg. The indications to the operative treatment of the metabolic syndrome were substantiated on the basis of etiopathogenesis. The estimation of long-term results of the operation of jejunal-ileal shunt in patients with the metabolic syndrome is given.

Body Mass Index↗

[The dynamics of the coronary bed state in patients with ischemic heart disease after surgical correction of dyslipoproteidemia].

The investigation included 85 ischemic heart disease patients with the coexistent dyslipoproteidemia. In 39 of the patients the operation of partial shunting was performed for correction of the impaired lipid metabolism. It was found that the partial ileoshunting was an effective method of correction of dyslipoproteidemia. The effect of the operation was due to lowering the total cholesterol level in blood (at an average by 25.6%) and elevation of the HDL level (at an average by 19.6%). The results of the following angiographic examinations have shown a clear effect of the inhibition of progressing coronary atherosclerosis in patients who underwent surgical correction of dyslipoproteidemia that allows the partial ileoshunting to be considered as an effective method of the secondary prophylactics of atherosclerosis. The HDL level is the main marker of the dynamics of the atherosclerotic process in the coronary arteries.

Adult↗

[Long-term results of the use of different modifications of the partial ileal shunt operation in the treatment of patients with atherogenic dyslipoproteinemias].

The article presents long-term (up to 20 years) results of performing the classical H. Buchwald operations and its various modifications in 145 patients. Creation of ileoileoanastomoses 5 cm from the ileocecal valve and a standard shunt of 250 cm of the ileum allowed to obtain a necessary and considerable (27% at an average) hypocholesterolemic effect and to eliminate diarrhea at the postoperative period.

Adult↗

[Dyslipoproteinemia and prognosis of the course of ischemic heart disease after coronary bypass].

The article deals with the observation of 88 patients with ischemic heart disease, 62 of them had coexistent dyslipoproteidemia. More pronounced atherosclerotic lesions of the coronary artery were found to develop in patients with dyslipoproteidemia influencing the degree of ischemic heart disease before coronary bypass. Within the period of 10 years after operation dyslipoproteidemia patients have 3.5 times higher risk of the development of myocardial infarction, more than 2 times higher risk of reappearance of stenocardia and death from cardiovascular diseases. Patients with dyslipoproteidemia have 2 times higher probability of generalization of the atherosclerotic process in patients with is chemic heart disease at later terms after coronary bypass.

Angina Pectoris↗

[20 years' experience of treating patients with extreme forms of obesity].

During 20 years 356 patients with morbid obesity of the III-IV degrees were operated on, 339 of them being subjected to jejunoileal shunting in the authors' modification. The developed measures for the selection of patients, preoperative preparation, anesthesia and operation technique allowed the amount of postoperative complications to be reduced from 15 to 5%. Long-term results were followed-up in 220 patients during 3-17 years. Stable loss of the body mass, regression of the diseases resulting from obesity were noted in 187 of these patients (85%). Electrolytic disorders were found in 16.8% of the patients. The reconstruction of the small intestine because of progressing hepatic insufficiency was performed in 16 patients. Less than 20% loss of the body mass was noted in 18 patients.

Adult↗

[Surgical treatment of recurrent goiter].

The authors have analyzed and generalized their 20-years experience with surgical treatment of 247 patients with recurrent goiter. Among them 48 patients had recurrent toxic goiter and 199 patients had nontoxic goiter. Postoperative complications developed in 8.3% of the patients with recurrent toxic goiter and in 6% of the patients with nontoxic goiter. The overall postoperative lethality was 1.2%. Operative treatment is recommended by the authors for recurrent toxic and nontoxic goiter, conservative treatment with radioactive iodine is thought to be expedient for a repeated recurrence. For preventing recurrences of toxic and nontoxic goiter after the first operation the administration of small does of the thyroid hormones is considered to be expedient during 1.5-2 months.

Adolescent↗

[Combined operations in extreme forms of obesity].

The authors make an analysis of their experiences with combined operations for extreme forms of obesity in 93 patients. Indications to such operations were considered to be only the diseases which could cause complications of the early and late postoperative period. In spite of more pronounced signs of aggression the combined operations do not enhance frequency and severity of postoperative complications. Recommendations are given for the selection of anesthesia, the access and sequence of operation steps. Measures are proposed which allow the frequency of postoperative complications to be decreased from 59.8 to 29.8%.

Adult↗

[Jejunoileal bypass in the prevention and treatment of clinical manifestations of atherosclerosis in patients with morbid obesity].

Jejunoileostomy effects on blood lipids and cardiovascular system were investigated in obese patients. They were found to lose 30% of their body mass within 6 postoperative months with parallel reduction in concentrations of total cholesterol, triglycerides, LDL and VLDL cholesterol and apoprotein B. These changes persisted for 4.5 years of the follow-up. The surgery in males has a more pronounced effect on blood lipids than in females. Significant changes were not registered in post- and preoperative levels of HDL cholesterol and apolipoprotein A-1. Jejunoileostomy promoted a fall in blood pressure, a rise in exercise tolerance, alleviation of atherosclerosis symptoms.

Adolescent↗

[Effects of jejunoileal shunting operation on the blood circulation system in patients with morbid obesity].

With the use of radiocardiography, the indices of central hemodynamics were studied in 22 patients with III-IV degree morbid obesity who underwent the operation of jejunoileal shunting. A special attention should be paid to the state of the patients within the first 18 months after the operation, because at this period, reformation of the cardiovascular system is most pronounced. The formulas for prediction of the state of the central hemodynamics at the late postoperative period are suggested.

Adult↗

[The dynamic electrocardiogram in the late period after the surgical treatment of obesity patients].

An analysis is presented of ECG of 68 patients with obesity (grade III-IV) before the operation of jejunoileal shunting and 1-2, 3-5 and 6-10 years after surgery. It was found that the main changes in the cardiovascular system occur during the first 2 years, i.e. during the period of body mass reduction. The importance of ECG in the diagnosis of hypertrophy of different compartments of the heart in obesity of grade III-IV.

Adult↗

[Surgical treatment of ischemic heart disease using internal thoracic artery and partial ileal bypass].

The authors recommend complex two-stage treatment of ischemic heart disease, including a reconstructive operation on the coronary arteries and an operation for correcting the disturbed plasma lipid spectrum (partial ileal bypass). The results of operative treatment of 150 patients with the use of the internal thoracic artery were studied. The authors emphasize the advantages of this operation over one using an autovein graft. Complex operative treatment was conducted in the clinic in 60 patients with a good clinical effect. The authors also recommend operation for partial ileal bypass as an independent intervention in dyslipoproteinemia and diffuse affection of the coronary arteries.

Adult↗