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Biomedical subjects

P Panchev

Publications and source records attributed to P Panchev.

At least 19 recordsLinked to original sources
PubMed2004

[Early and late complications following 388 nephrectomies in different diseases of the kidney and the ureter].

Early and late complications of nephrectomy include: chronic renal failure (CRF), haemorrhagic events, lumbar fistulas and other complications of different origin. This study covers 388 nephrectomies due to different diseases of the kidneys and the urethra. Clinical diagnosis and treatment of the patients are held at the Chair of Urology of the Alexandrovska Hospital for the period 1990-1995. There are established the following early and late complications: renal failure--in 37 patients (9.53%), haemorrhagic events--in 2 patients (0.51%), lumbar fistulas--in 4 patients (1.03%). Other complications are calculous anuria in 1 patient (0.25%), nephrectomy following plastic surgery of a kidney calyx--in 1 patient (0.25%), nephrectomy in a case with one functionally preserved kidney--1 patient (0.25%), nephrectomy in a case following kidney transplantation--1 patient (0.25%), and fatal outcome through the early postoperative period--in 2 patients (0.51%). Authors conclude that: 1) nephrectomy is followed by complications through the early and the late postoperative period; 2) complications following nephrectomy are rare but they are one of the most serious and important sequella in urologic surgery.

Humans↗
PubMed2004

[A case of penis self-injection of liquid paraffin--operative treatment and results].

The authors describe a rare clinical case named penis "paraffinoma" or "lipogranuloma". This problem has been discussed in only 6 scientific reports and articles during the period 1996-2002 [1, 2, 4, 5, 6]. Jh. Jeong et al. (1996) operated 13 patients with penis paraffinoma and concluded that the plastic and reconstructive procedures are safe and without any complications.

Adult↗
PubMed2004

[Uroinfections and the possibilities of therapy with levofloxacin].

UNLABELLED: The common occurrence, of inflammatory diseases in the urinary tract and the genitals in men, is quite a reason for identification of the agents and looking for some new chances of therapeutic treatment. MATERIALS AND METHODS: For a period of two years (2002-2003) we accomplished 4810 microbiological tests of urine and prostate secretion on patients with uroinfections. The cultures are completed on standard nutrition medium, as the biochemical identification of the strains is accomplished by the systems mini API and "bio Merieux" BBL Crystal, "Becton Dickinson". Meanwhile for a period of one year, 113 patients with different uroinfections are treated and studied. In 16 (14.1%) Levofloxacin (Tavanic-R) is applied i.v. 500mg/daily as in the rest cases 97 (85.9%) Tavanic are applied per oral in different therapeutic doses. RESULTS AND DISCUSSIONS: The most common agent in our study was the E. Coli, as for the year 2003 we read an increase of the infections caused by E.Coli with 3.4% comparing to the previous one (38.5% to 35.1%). The differentiation of patients treated with Levofloxacin in groups is completed as follows: with acute uncomplicated cystitis--pyelonephritis after ESWL--15.9%; with postoperative uroinfections--20.3%; with chronic post-tuberculosis pyelonephritis--4.4%; and with inflammatory diseases of the male genitals--37.2%.

Anti-Infective Agents, Urinary↗
PubMed2004

[Surgical treatment in complications of renal transplantation].

The increasing number of renal transplantations in Bulgaria and the increased survival rate of renal transplantation patients lead to an increase of the number of complications (vascular, urological, liquid collections) requiring surgical intervention. One hundred and ninety renal transplantation patients have been treated in the Department of Renal Transplantation for the period 1997-2003. Of these 12 were admitted to the Clinic of Vascular Surgery. We observed 36 surgical complications: arterial thrombosis--7, venous thrombosis--1, arterial stenosis--7, lymphocoele--4, hematoma--4, ureteral fistula--6, ureteral stricture--6, ureterolithiasis--1. We undertook following surgical interventions: vascular reconstruction, thrombectomy, lymphocoele punction, fenestration towards peritoneal cavity, reimplantation techniques (a modo Gregoari, Boeminghausi, Boari), termino-terminal anastomosis with native ureter, uretero-enteric anastomosis, ESWL of ureteral stone. Renal transplantation complications requiring surgical interventions are serious urological problem. The severity, the type (vascular, liquid collection, urological), and the diagnosis of these complications determine patients' prognosis. Urgent surgical interventions lead to rapid recovery of graft function, eradication of the infection, amelioration of blood flow, and improved graft survival.

Constriction, Pathologic↗
PubMed2004

[Intraoperative effect of preoperative embolization of the renal artery in patients with kidney carcinoma].

Aim of the embolization of the renal artery is to provoke ischemia or shut out from blood supply of the kidney tissue including pathologically changed area. As a result of this procedure the affected kidney becomes suitable for surgical removal without significant loss of blood. In this study there are included 116 nephrectomies due to kidney carcinoma. Clinical diagnosis and treatment of the patients are held at the Clinic of Urology of the Alexandrovska Hospital for the period 1990-1995. Embolization of the renal artery is accomplished in 52 subjects (63.41%). The procedure was contraindicated in 10 subjects (8.62%). It was established intraoperatively that the affected kidney had good embolization in 46 subjects (88.46%), in 4 subjects (3.44%) it had excellent embolization, and in 2 subjects (1.72%) there was just peripheral embolization. Authors conclude that: 1) Nevertheless this method is invasive it still has a place in urologists' practice. 2) Preoperative embolization of the renal artery is a devise for surgical removal of the kidney as well as achieving maximum effect.

Blood Loss, Surgical↗
PubMed2004

[Treatment with cefrom (cefpirom) in severe urological infections].

Severe uro-genital infections frequently complicate a wide range of urological conditions. The favorable outcome of these infections depends mainly on the choice of appropriate antimicrobial treatment. Cefrom is bactericidal beta-lactamase-resistant IV generation cephalosporine antibiotic. In 2003 we treated 20 patients with severe urinary tract infections with Cefrom. We achieved excellent therapeutic results--urinary tract infections were eradicated in all patients, as shown by the microbiological investigations of urine specimen after the antibacterial course of treatment. The wide antimicrobial spectrum, the good tissue permeability in the organs of the genito-urinary tract and the good tolerability of Cefrom make this antibiotic a drug of choice in patients with acute and complicated urological infections.

Adolescent↗
PubMed2004

[The role of polyclonal anti-T-lymphocyte antibodies (ATG) in the kidney transplantation].

UNLABELLED: The successes in the kidney transplantation are closely connected with the successes of the immunology and the advance of the immunosuppressive therapy. The main task of the modern immunosuppressive therapy is the insurance of medicines with a minimum nephro-toxicity, and the optimum protection regarding the adoptive body against an early reaction of rejection. The polycomponent anti-T-limphocitic antibodies (ATG) give us the opportunity of that. The polycomponent anti-T-limphocitic antibodies or the antilimphocitic serum (ALS) are xenogenetic polycomponent antibodies, that are directed to the human T-limphocites, i.e. antitimocitic globuline (ATG). They are received by immunization of rabbits or horses with human thymus limphoid cells. They are received for the first time by horses, and later on by rabbits. The last patent medicines have more powerful effect. In spite of the side effects of the polycomponent ATG, the patent medicine is used for inductive treatment after transplantation of organs and for a treatment of acutely rejection of the graft. We have treated 15 patients after kidney transplantation with ATG for a period of an year in the ward of kidney transplantation in The Clinic of Urology. The patients with transplantation are at the age of 21 to 50 years old, and by sex--11 male and 4 female patients. 9 of them are transplanted from alive donor and 6--from a dead body. We have applied the patent medicine of ATG Timoglobuline in a phial of 5 mg\ml intravenally in a bank of 500 ml physiological solution according to the weight and the blood test of the patients. We have applied a fourfold immunosuppressive therapy: Urbazon, Imuran, CyA(Neoral) +ATG. CONCLUSIONS: ATG is a mixture of monocomponent polyspecific antibodies, which, in spite of its side effects, has been applied successfully in transplantation for more than 30 years. In the course of many years anti-CD3 patent medicine OKT3 has been the only one monocomponent antibody for the treatment of an acute rejection of the graft for inductive therapy in transplanted patients.A chimerical (baziliksimab) and humanized (daklizumab) monocomponent antibodies of the alpha-chain of the receptor for IL-2 (CD25) are used for the prophylaxis of the episodes of acutely rejection of the transplanted kidney during the last 10 years. ATG does not consists of anti-CD25 antibodies. That is why the simultaneously application of ATG with baziliksimab or daklizumab is expected to have an additional effect with a complementary mechanism of efficacy.

Adult↗
PubMed2004

[Surgical treatment of hydrocele--modern aspects].

Basically no one has ever introduced into practice any better procedure in cases of hydrocele than those of Winkelmann and Bergman. We recommend always a resection of the covering sheets of the testis as a profilactic measure against recurrency. Our study included 192 patients with hydrocele who were operated during the period 2000-2001 in the Clinic of Urology, Medical University of Sofia. The surgical procedures included: Winkelmann's procedure--in 118 cases (61,45%); Bergman's procedure--in 63 cases (32,81%);Orchiectomy--in 3 cases (1.56%) of total testicular atrophy; Combination of hydrocele and co-existing groin hernia was found in 4 cases (2,08%); Orchiectomy--in 1 case (0.52%) of bleeding which lead to hematoma on the 4th postoperative day; Reoperation--in 1 case (0.52%) of compression of the testicular blood vessels (after Winkelmann's procedure); Suppuration of the operative wound-- in 2 cases (1.02%) after Winkelmann's procedures. The authors consider that: 1. Winkelmann's and Bergman's procedures prooved to be quite satifactory as surgical treatment of patients with hydrocele. 2. Diagnosis and surgical treatment are easy to be performed. Postoperative complications are possible in cases of poor surgical technics, damaged local status and shortened time for hemostasis. 3. The well-known method of Lord was not used in our practice, but we do not deny it.

Adolescent↗
PubMed2003

[Single stage reconstructive operations of the male urethra].

UNLABELLED: The male urethra with its anatomic and tissue characteristics demands a differential approach in its reconstruction. The single stage operations, with using of a different plastic material as a treatment of some diseases of the male urethra (hypospadias, strictures), are already quite common to the urological practice. The authors are offering a retrospective analysis to the reconstructive operations of the male urethra with using a plastic material from the preputium and the skin of the penis. MATERIALS AND METHODS: For a period of 10 years 94 patients were followed ont: hypospadias--51 (53.9%); strictures--27 (28.7%); fistulas--16 (18%). Were described different operative techniques, but in all patients were used a one stage act. In patients with hypospadias we used five different techniques according to the sort of hypospadias. In patients with strictures we used three methods: with preputial flap; with circular flap from the dorsum of the penis and with a parallel longitudinal to the urethra flap from the ventral surface of the penis. RESULTS: From the first group of patients we had 17 (33.3%) with anterior hypospadias, 28 (54.9%) with middle, and 6 (11.8%) with posterior hypospadias. We achieved a full correction of the penis in 96.1% of the cases. We marked postoperative fistulas in 7 (13.7%) patients. In the second group of patients we marked 4 (14.8%) cases with postoperative Fistulas; restrictures in 2 (7.4%) cases and diverticul of the urethra in 1 (3.8%) case. In the third group fistulas were formed after urethroplasty in 11 (68.7%) cases and traumas and uroflegmons in 5 (31.3%) cases. We marked refistulisation in 5 cases. CONCLUSIONS: The urethroplasty with pedicular skin flaps from the preputium and the skin of the penis is a method of choice in patients with anterior strictures of the urethra. The single stage reconstructive operations of the male urethra are quite effective and promising.

Adolescent↗
PubMed2001

[Endoscopic treatment of complete obliteration of posterior urethra].

The authors shared their experience in regard of treatment of complete urethral obliteration. In a 14-year they diagnosed and treated 37 patients (aged 22-74 years) with obstruction of the lower urinary tract as a result of complete urethral obliteration. The etiology include 14 patients after perineal urethral trauma, in 10 patients the main cause was urethral inflammation of posterior urethra, in 8--as a consequence of transurethral surgery and in 5--after suprapubic prostatectomy. Main diagnostic methods they used were retrograde urethrography and urethroscopy with 0 degree fiberoptic. In all patients an endoscopic incision of fibrotic tissue was carried out thus the entering the bladder cavity was successful. In some patients operative technique with a Benique through cystostomy cannel and bladder neck just opposite to the urethrotome knife was used. In three patients (8.2%) the procedure failed due to the massive urethral hemorrhage. They report recurrent urethral strictures in 24 patients (64.8%), treated with visual urethrotomy. The continence was compromised in 6 patients (16.2%).

Adult↗
PubMed2000

[Some etiologic factors in condom-induced allergic contact balanitis].

Clinical cases presenting allergic contact balanitis from condoms are studied using a combination of patch testing and chemical analysis by gas chromatography and high-resolving liquid chromatography to identify the causative agents involved. It has been previously established that zinc ethylphenyl dithiocarbamate (ZEPC)--a dithiocarbamate-type accelerant (DTC)--is an etiological factor in the event of contact allergy to condoms. Later it is confirmed that DTCs, such as zinc dimethyl dithiocarbamate (ZDMC), zinc diethyl dithiocarbamate (ZDEC) and zinc dibutyl dithiocarbamate and amines, such as dimethylamine (DMA), diethylamine (DEA) and piperidine (PIP) are likewise implicated in condom-induced contact balanitis. As shown by the investigation along this line, although thiurams are believed to be more allergenic, as compared to the corresponding DTCs and amines, both DTCs (ZDMC, ZDEC, ZDBC, ZEPC) and amines (DMA, DEA and PIP) are noteworthy etiological factors of allergic contact balanitis from condoms.

Adult↗
PubMed2000

[A modification of Freyer's typical prostatectomy].

Adenomectomy in its present-day modality has a millennium-long history. Chronologically, its development, justly or not, is marked by a great number of names among which it is worth noting Sir Peter Freyer (London) and his paper published in 1901, dealing with the radical treatment of the hypertrophied prostate by urinary bladder exposure. E. Fuller (USA) claims that the first practical implementation of the method six years previously is credited to him. Since then, there are no different opinions on the need of total gland enucleation, with some differences remaining in terms of operative access and hemostasis. Over the period 1998-1999, thirty-two adenotomies are performed according to Freyer's original method in the Department of Urology--University Hospital "Alexandrovska". An indwelling catheter with inflated balloon is inserted into the prostate bed for hemostasis without using packs or placing sutures. The obtained results are estimated as good.

Adult↗
PubMed2000

["Fossa" carcinoma - a relapse or "rest" carcinoma of the kidney?].

The local relapse represents a unique variant of the advanced stage of a disease (A Esrig et 1992). Presumably, "fossa" carcinoma may result from incomplete resection or persisting tumor in the regional contiguous lymph nodes (JB D Kernion 1978). The average time interval for a relapse to occur is 31 months after nephrectomy, and in most patients it becomes manifest with symptoms, such as losing weight, fatigability and lumbar discomfort (D Esrig et al 1992). In cases with local recurrence a long-term survivorship may be attained by resorting to aggressive surgical intervention (S Tanguag et al 1996). This is a report on twenty-three patients with "fossa" carcinoma covering the period 1994 through 1999, with a total of 425 patients with renal carcinoma operated during the same period of time. All patients undergo operation--lumbar access is used in 22 cases, and transperitoneal--in one. In one patients resection of colon is necessitated, whereas in five the neoplastic mass hardly lends itself to complete excision, with enucleation alone being done. At follow-up study the survival terms are as follows: up to 1 year--18 patients, up to 3 year--16 patients, up to 5 year--12 patients.

Adult↗
PubMed2000

[Endoscopic treatment of complete obliteration of posterior urethra].

The authors shared their experience in regard of treatment of complete urethral obliteration. In a 14-year they diagnosed and treated 37 patients (aged 22-74 years) with obstruction of the lower urinary tract as a result of complete urethral obliteration. The etiology include 14 patients after perineal urethral trauma, in 10 patients the main cause was urethral inflammation of posterior urethra, in 8--as a consequence of transurethal surgery and in 5--after suprapubic prostatectomy. Main diagnostic methods they used were retrograde urethrography and urethroscopy with 0. fiberoptic. In all patients an endoscopic incision of fibrotic tissue was carried out thus the entering the bladder cavity was successful. In some patients operative technique with a Benique through cystostomy cannel and bladder neck just opposite to the urethrotome knife was used. In three patients (8.2%) the procedure failed due to the massive urethral hemorrhage. They report recurrent urethral strictures in 24 patients (64.8%), treated with visual urethrotomy. The continence was compromised in 6 patients (16.2%).

Adult↗
PubMed1999

[Live-donor kidney transplantations. The problems of vascular reconstructions].

The aim of the study was to evaluate the vascular surgery problems in 59 kidney transplantations from live donor, performed by the team for kidney transplantations (vascular surgeons and urologists) of Medical University--Sofia, for the period from April 1996 to May 1999. Nephrectomy was performed on 59 relatives (44 female and 15 males)--54.33 years average age. Donor kidneys were transplanted to 37 males (55.71 years average age) and 22 females (36.85 years average age). The average duration of hemodialysis prior to transplantation was 60.18 months (5.015 years). Most of donor kidneys were right--38, while only 21 were left. In six kidneys duplex renal veins were presented (10.16%), while in other 7 cases (11.76%) there were duplex renal arteries. We preferred termino-terminal anastomoses of donor renal artery to the hypogastric artery of the recipient, which provides not only better regional hemodynamics guaranteeing long term patency of the anastomoses, but presents optimal positioning of new kidney to the retroperitoneal space of recipient avoiding external compression of renal vessels. The standard performance of venous anastomoses was termino-lateral to the iliac vein of the recipient. In 7 cases, saphenous vein graft was used to replace or prolong the donor arteries or veins. Postoperative results of live donor kidney transplantation were successful in all cases, except one case (1.74% of 71 venous anastomoses) with late deep venous thrombosis of recipient's iliac vein resulting in kidney rupture and unavoidable nephrectomy. There were also 5 cases of haemorrhage (8.47%): in 3 of them from the renal hilus and in 2--profuse bleeding from the operative approach, all successfully treated after reoperation. Our satisfactory results in live donor kidney transplantation prove this method as a method of choice in certain cases of chronic renal insufficiency, especially in lack of cadaver kidneys. Contemporary vascular surgery disposes of various techniques that makes possible transplantation even in cases with serious anomalies of renal vessels. The atraumatic nephrectomy of donor kidney remains one of the main factors contributing to the successful outcome of kidney transplantation.

Adolescent↗
PubMed1999

[The most common complications associated with nephrectomy].

Access to the kidney and technical performance of nephrectomy should be related to the stage of the disease and degree of pathological process development (I. Viktorov 1983, S. Lambrev and T. Andreev 1961, T. Patrashkov 1982, F. S. Judy et al 1995). Advanced pathoanatomical changes in the kidney and pararenal space greatly interfere with the operation, especially in the event of adhesions to peritoneum and contiguous tissues (N. A. Lopatkina et al 1986, N. Minkov 1987, T. Patrashkov and H. Kumanov 1988). In the authors' reports presented are analyzed 388 patients nephrectomized in the University Hospital "Alexandrovska", covering the period 1990 through 1995. All updated methods are used in diagnosing. The commonest intraoperative complications recorded in a series of 188 nephrectomies (48.45%) include: 1. Pus collections in the kidney--88 cases (46.80%). 2. Opening of peritoneum--64 (34.04%). 3. Decompressive puncture of the kidney--15 (7.97%). 4. Neoplastic masses escaping from the renal parenchyma into the operative field--7 (3.72%). 5. Opening of pleura--5 (2.66%). 6. Purposeful opening of the tumor itself for decompression--3 (1.95%). 7. Kidney removal gives rise to diffuse bleeding necessitating inserting a tampon for hemorrhage control--2 (1.06%). 8. Splenectomy--1 (0.53%). 9. Because of advanced neoplastic process only biopsy is taken--1 (0.53%). 10. Hemicolectomy--1 (0.53%). 11. Injury to v cava inferior--1 (0.53%). As shown by the experience gained, nephrectomy is a technically difficult operation, particularly in case of altered topoanatomical interrelations during secondary interventions on the kidney and ureter, or in case of concomitant pyelonephritis. Intraoperative complications are not life endangering provided treatment is undertaken in opportune time.

Adult↗