[Combination of giant mucocele of the appendix and adenocarcinoma of the rectum].
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Biomedical subjects
Publications and source records attributed to Iu P Savchenko.
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An analysis of results of surgical treatment of 158 adult patients with the syndrome of chronic colostasis (SCC) has shown that the rectal form of Hirschsprung's disease (RFH) was diagnosed in 57 patients while idiopathic megadolichocolon (IMC)--in 101 patients. There were two types of SCC: proctogenic and cologenic. The proctogenic type appears in patients with RFH due to hypogangliosis and agangliosis, and in patients with IMC--as a result of dystrophy of ganglionic neurons of the Meissner plexus of the rectum. The computed morphometry and histochemical investigations have shown that hypogangliosis and agangliosis in RFH were of congenital origin while dystrophy of the rectal ganglia in many patients with IMC was an acquired pathology. The marginal variant of the second type of the colon structure can be considered as a cause of SCC. A new operation--endofascial resection of the rectum--is proposed for treatment of proctogenic SCC. The differential surgical strategy with pathomorphogenesis of SCC taken into account allowed to get satisfactory results in 73% of cases.
Since 1994 in addition to standard operations for chronic and acute hemorrhoids in Krasnodar military hospital the device for suturing in removal of internal hemorrhoids has been applied. From 1994 to 2000 examination and treatment of 240 patients with hemorrhoids were carried out. In the study group (128 patients) hemorrhoidectomy was performed by the developed method, in control (112 patients)--by standard techniques. In early postoperative period significantly smaller quantity of complications were seen in the study group (8.4%) compared with control group (29.8%). Decrease of hospital stay and out-patient treatment was also seen. Relapses of the disease were not revealed in terms from one to six years after surgery. The device may be employed in simultaneous operations when concomitant anorectal diseases are present. The above results justify one-stage operations in combination of chronic hemorrhoids with anorectal diseases. The proposed device makes this surgery easier.
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458 patients with postcholecystectomy syndrome have been examined. In 289 (63.1%) of them the reason of complication and location of the lesion in biliopancreatic-duodenal zone have been specified. In 212 (73.4%) patients the endoscopic treatment was used, including papillosphincterotomy with removal of concrements; suprapapillary choledochoduodenostomy; nasobiliary draining, endoprosthesis. In 181 (85.4%) of cases these methods appeared to be efficient and final; in 31 (14.6%) they promoted stabilization of clinical status of patients and performing surgery in more favorable conditions. Complications have been registered in 4 (1.9%) patients, 1 patient (0,47%) died. The authors advocate endoscopic methods as methods of choice in postcholecystectomy syndrome.
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