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Biomedical subjects

N A Grishin

Publications and source records attributed to N A Grishin.

6 recordsLinked to original sources

[Thoracoscopic splanchnic sympathectomy in pancreatic diseases].

Thoracoscopic splanchnicsympathectomy (TSSE) was performed in 8 patients with inoperable tumors of the corpus and tail of the pancreas and in 3 patients with painful syndrome of chronic pancreatitis. Severe painful syndrome in the upper abdominal region was the main indication for ISSE. Thoracoscopic resection of the lower thoracic sympathetic ganglia and splanchnic nerves was performed. Postoperative complications were detected in 3 patients: in one case it was pneumothorax, in two--pains in the thorax due to the injury of intercostal nerve by thoracoport. There were no lethal outcomes accounted for surgical procedure. The effectiveness of the operation was evaluated by the use of descriptive and visual analogue scales of pain sensitiveness and changes of the amplitude of somatosensor provoked potentials of the brain. Favourable and satisfactory results were obtained in 9 cases.

Abdominal Pain↗

[Ultrasonic study in thoracoscopic operations].

Intraoperative ultrasound diagnosis (IOUSD) was made in several thoracoscopic interventions in 15 patients: diagnostic thoracoscopies (3) in patients with lymphogranulomatosis, carcinoid and peripheral lung cancer, enucleation and atypical resection of the lung (4) in patients with hamartochondromas, in excision of lung cyst (1), in removal of foreign body of the lung (1), in removal of celomic cysts (2) and in ablation of neurofibroma of the mediastinum (1), in atypical resection of the lung and enucleation of tuberculomas (2). Video thoracoscopy in combination with intraoperative ultrasound examination provides possibility for precisional diagnosis of focal disease of the lung and mediastinal organs, including local masses of small sizes, and is rather informative method of diagnosis. IOUSD allows to define the diagnosis more exactly and to determine the extent of pathological process, to prevent complications and locate intraparenchymal masses and foreign bodies in lung tissues, and thus enables to complete operation without thoracotomy.

Cysts↗

[Choice of surgical approach in laparoscopic cholecystectomy].

A definition of a surgical access in laparoscopic interventions is formulated. The importance of use of various surgical accesses is stressed. The results of treatment of 410 patients with calculous cholecystitis are analysed. 72 of the patients have been previously operated on abdominal cavity. The cause of technical mistakes and failures are analysed. The original method of ultrasound evaluation of abdominal cavity adhesions in patients, who had been operated on previously is proposed. The method was used in 45 patients, and in 95% of the cases the evaluation was perfectly accurate. Indications for use of a particular surgical access, depending on a site of a previous operation, are formulated. The method of an open laparoscopy is described. It is indicated in case of previously performed low-middle laparotomy and ultrasonic picture of adhesions in the umbilical region; in umbilical hernias; in big and multiple choleliths (more than 30 cubic cm of total volume).

Adolescent↗

[Results of laparoscopic cholecystectomy].

Laparoscopic cholecystectomy (LCE) was performed in 410 patients with calculous cholecystitis. Acute phlegmonous cholecystitis was in 14 patients. The indications for the LCE were similar to the indications for "open" cholecystectomy. The specific features of LCE are analysed. The long-term follow up period was from 3 to 16 months. Good functional results were achieved in 98% of the patients.

Adolescent↗

[Results of laparoscopic cholecystectomy].

The paper provides the results of two-year use of laparoscopic cholecystectomy as a treatment of calculous cholecystitis in patients with various clinical and morphological types of calculous cholecystitis. Less intraoperative trauma, a mild postoperative period, and early activization of patients, good cosmetic effect are indisputable advantages of this therapeutical method which is an alternative to an open operation for calculous cholecystitis.

Acute Disease↗

[Results of various treatment modalities in the calculous cholecystitis].

Two alternative methods for the treatment of calculous cholecystitis are evaluated: extracorporeal lithotripsy was performed in 284 patients, laparoscopic cholecystectomy--in 130 patients. Even in strict selection of patients, lithotripsy was ineffective in 32 of them and they were subjected to an operation; in another group of patients elimination of the fragments from the gallbladder was incomplete. Therefore, extracorporeal lithotripsy may be used in no more than 10% of patients with cholelithiasis. Laparoscopic cholecystectomy was conducted in 130 patients. In 6 (4.5%) of them the operation had to be completed by laparotomy because complications occurred during the laparoscopic intervention. Laparoscopic cholecystectomy has some obvious advantages over open cholecystectomy: easier postoperative period, early activation of the patients, a good cosmetic effect. However, to determine the boundaries and possibilities of this method accumulation of experience is needed.

Adolescent↗