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Biomedical subjects

M D Khanevich

Publications and source records attributed to M D Khanevich.

At least 19 recordsLinked to original sources

[Treatment of tumoral colonic obstruction].

The work was devoted to problems of treatment of patients with cancer of the colon complicated by tumoral colonic obstruction. The authors propose an improved clinical classification of disturbances of colonic obstruction with colorectal cancer. The questions discussed are: decision on the strategy of treatment of acute colonic obstruction patients, the possible differential approach to choosing methods of treatment depending on localization of tumor and duration of the period of the development of intestinal obstruction. The results of treatment of 148 patients with colorectal cancer complicated by acute colonic obstruction are analyzed. It was shown that in 20% of patients with the initial stage of obstruction with the tumor localized in the left half of the colon it was possible to resolve the obstruction by conservative measures followed by the preparation of the patients to planned operation.

Acute Disease↗

[Frontal resection as a means of decision for surgical treatment of rectum cancer].

The work has been devoted to the improvement of methods of surgical treatment of cancer of the rectum. The possibilities to perform organ-saving operations in treatment of cancer of the rectum are discussed. An analysis of treatment of 351 patients with cancer of the rectum has shown that frontal resection of the rectum is possible in more than 40% of such patients since such interventions save the function of the rectum more completely. New methods of preoperative preparation of the patients are described as well as the application of the improved methods of surgical interventions.

Adult↗

[Immune correction in patients with colostomas and fistulas].

Symptoms of secondary immune deficiency were revealed in 37 out of 84 wounded with colonic fistulas and colostomas. During the preparation of the patients to restorative operations for the improvement of the immune system functions the patients were given transfusions of donor leuko-suspension taken from subjects with high titer of antibody in blood serum to colon bacillus and intravenous infusions of immunoglobulin. Such immunocorrection allowed restoration of immune potential of organism during a short time and improvement of the operation results.

Abdominal Injuries↗

[Treatment of acute venous thromboses in patients with varicose disease of lower extremity veins].

The work was devoted to surgical methods of treatment of acute venous thromboses of main lower extremity veins for prevention of thromboembolic complications in patients with varicose disease of lower extremities. Possibilities of surgical correction of the venous blood flow are discussed at different variants of the course of acute venous thrombosis. An analysis of treatment of 92 patients with thrombotic lesions of the main lower extremity veins and high danger of thromboembolic complications has shown that more than 40% of patients with venous thromboembolism need treatment with surgical and medicodiagnostic endovascular interventions. Surgical and endovascular methods of prophylactics of thromboembolism of the lesser circle of blood circulation for complicated forms of chronic venous insufficiency are described.

Female↗

[Minimally-invasive combined radiosurgical interventions in diagnosis and treatment of pulmonary artery thromboembolism].

Basing on the analysis of results obtained during the investigation and treatment of 38 patients suspected of pulmonary artery thromboembolism (PAT) the algorithm of measures applied in our hospital was developed. Its purpose was to put the PAT diagnosis and treatment in order. In our investigations the leading treatment method was the regional infusion therapy conducted through the transformation of diagnostic catheterization of pulmonary artery trunk into the treatment intervention. With the purpose of embolus hydrodynamic destruction the regional thrombolysis was conducted under conditions of fast high-pressure perfusion. It was preceded by the mechanical recanalization of thrombosis zone by the distal part of probe in order to create more favorable perfusion conditions. To prevent the repeated PAT when the source of thromboembolism was revealed the cava-filter implantation in the infra-renal part of inferior cava was performed.

Combined Modality Therapy↗

[Enteral therapy of the syndrome of intestinal insufficiency in patients with peritonitis].

Sixty five patients with peritonitis were examined and divided into two groups. The operative intervention in all the patients included transnasal intubation of the small intestine. The basic enteral therapy used in the first group of patients was made with the glucose-saline solution and transition to a balanced polysubstrate mixture "nutrient standard" with the increasing concentration. For the patients of the second group a special program was developed for enteral therapy in which glutamine and pectine were included in the glucose-saline solution as well as nutrient mixtures containing middle chain triglycerides. Active decompression of the small intestine followed by the enteral administration of the nutrient mixtures facilitated quicker correction of the intestinal insufficiency in patients with severe forms of peritonitis.

Adult↗

[Restorative operations in colostomy patients with short stump of the rectum].

An analysis of restorative operations on 113 patients with a story of obstructive resection of the colon after Gartman has shown that of special technical difficulty were operations on patients with a short (less than 10 cm) stump of the rectum. In 26 patients an apparatus stitch "to the pitch" with the help of suturing apparatuses AKA-2 and AKA-4 of the firm "Ethicon" was used. In 9 patients a combined hand sewing was used. In the patients in whom the continuity of the colon was restored with the help of a mechanical suture "to the pitch" or by the hand combined sewing there were no incompetent anastomoses. Results of the operations were followed-up during the period from 6 months to 3 years. In 2 patients (5.4%) stricture of the anastomosis was diagnosed following its formation with the help of the apparatus AKA-4.

Colon↗

[The treatment in ulcerative hemorrhages in patients with liver cirrhosis and portal hypertension].

Treatment of 34 patients with bleedings from chronic gastroduodenal ulcers associated with cirrhosis of the liver and portal hypertension was analysed. Overall lethality was 41.2%, postoperative lethality was 41.7%. Temporary hemostasis due to a solution of Caprofen used during fibrogastroduodenoscopy allows the operation to be delayed and complex intensive therapy can be performed in patients with hepatic insufficiency. Control medical endoscopic investigations should be performed 4 and 12 hours after admission to the hospital of patients with sub- and decompensated cirrhosis of the liver with portal hypertension and symptoms of unstable hemostasis. The emergency and delayed operative treatment of patients with subcompensated hepatic insufficiency should include organ-saving operations such as vagotomy with pyloroplasty and/or dissection of the ulcer. Operation is indicated to patients with cirrhosis of the liver at the stage of decompensation but if they have evident reappearance of bleeding and in minimal volume. The attainment of final endoscopic hemostasis will allow to avoid surgical interventions intolerable for this category of patients.

Adult↗

[Use of leukocytic suspension in the treatment of diffuse peritonitis].

Immunocorrection by means of transfusions of donor leukocytes was performed in 64 patients. Transfusions of the leukocytic suspensions in short courses (2-3 transfusions to one patient or 300-500 ml per a course) during the first three days after operation allowed the immune status of organism to be improved and increased the effectiveness of the antibacterial and infusion-detoxication therapy. The greatest medical effect was obtained when using the leukosuspension from donors with natural high (from 1:160 and higher) titers of antibodies to E. coli.

Adolescent↗

[Use of an artificial carrier of oxygen on the base of modified hemoglobin in patients with gastroduodenal hemorrhage].

Infusions of Helenpole used in 23 patients allowed for a short time to stabilize hemodynamics and to considerably improve the gas-transporting function of blood. The best curative effect in patients with hemorrhagic shock was obtained by means of intravenous jet infusions of the medicine, after stabilization of the hemodynamic indices with the help of an intravenous dropper (80-90 drops/min). The dose of the 1% solution of the medicine was 25-30 ml/kg of the patient's body weight.

Adult↗

[An erythrocyte suspension in Modegel in the treatment of acute gastrointestinal hemorrhages].

The effectiveness of a suspension of erythrocytes in the new colloid preservative "Modegel" (in 1:1 ratio) was studied in the complex treatment of 31 patients with severe gastroduodenal bleedings. It was established that the hemodynamic, antianemic action of the suspension was not inferior (and even excels) to the action of the whole preserved blood and the erythrocytic mass. The suspension transfusion has a favorable effect upon functions of the liver and kidneys, corrects the acidic-alkaline state of the recipients' blood, decreases the lipid peroxidation and has detoxicating properties. During transfusion of the suspension hypocoagulation of blood doesn't take place. The temperature reactions following the suspension transfusion are rare. The suspension of erythrocytes "Modegel" deserves wide introduction to clinical practice.

Acute Disease↗

[Acute intestinal obstruction as a problem in emergency surgery].

An experience with treatment of acute ileus is presented. Operations were performed on 499 patients. Postoperative lethality from small intestine obstruction was 12.5%, from the colon obstruction--32.4%. The methods of treatment of different forms of intestinal ileus are described.

Acute Disease↗

[New possibilities of prevention of acute gastric and intestinal ulcers in peritonitis with drugs of anti-hypoxic and antioxidant action].

A retrospective analysis has been made of 96 cases of acute erosions and peptic ulcer emerging in diffuse purulent peritonitis. The examination and treatment of 124 patients suggested that toxic peritonitis runs with excessive accumulation of lipid peroxidation products in the serum. Administration of antihypoxic drugs and antioxidants promoted stabilization of peroxidation thus preventing gastroduodenal erosions and ulcer.

Acute Disease↗