[Observation of successful treatment of patient with subtotal colonic necrosis occurring due to mesenteric thrombosis].
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Biomedical subjects
Publications and source records attributed to S A Aslanian.
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During ten-year period 1191 patients with perforative pyloroduodenal ulcer were operated on. Palliative intervention was conducted in 206 patients, conventionally radical one--in 677 and radical--in 308. Postoperative mortality have constituted 5.2%.
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The article discusses a complex of methods for the diagnosis of injuries to the duodenum in 18 patients. Laboratory and X-ray findings and laparocentesis with introduction of a "feeling" catheter into the abdominal cavity with lavage of the cavity facilitated the discovery of blood and intestinal contents and allowed the correct diagnosis to be established before the operation. In inspection of the duodenum mobilization after Kocher is insufficient, in rupture of the posterior wall in the region of the inferior horizontal part the duodenum must be mobilized for its whole length. It is advisable that the defect in the duodenum is closed with a double-row suture applied with an atraumatic needle (the first inner row of interrupted sutures). The methods for applying hemostatic sutures suggested by the authors by means of created devices provide reliable hemostasis in combined injuries to the parenchymatous organs. The operation was completed by leaving glove-tube drains. The postoperative mortality was 16.6%.
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The results of treatment of 410 patients with a perforated gastric and duodenal ulcer were summarized. A dependence of lethality and type of the operation performed on time elapsing from the moment of perforation, presence of concomitant diseases is shown.
The experience with treatment of acute ileus for the 5 years in 1032 patients is summarized. Operated on were 269 patients. The different types of operative interventions with a wide use of intubation, adsorbents, laparostomy were performed. The postoperative lethality was 9.2%.
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Examined were 164 patients 3-7 years after surgical intervention for chronic pancreatitis. The numerous diseases of the alimentary organs and complications leading to reduction and loss of working ability in a significant number of the patients operated on were revealed. Preservation of working ability in this population of patients largely depends on a degree of the use of a rehabilitative (medical, social and vocational) potential.
The results of treatment of 235 sufferers with open (142) and closed (93) intestinal injuries are analysed. One hundred and twenty one patients had isolated, 114-combined intestinal injuries. Suturing of the small, large intestine and other hollow organs was performed in 192 sufferers, resection of the small intestine-in 28, resection of the large intestine-in 5, resection of the large intestine with unloading cecostomy-in 4, right hemicolectomy-in 3, colostomy-in 3. Twenty eight patients developed complications after the operation, 14 (6.4%) died.
In examination of 286 patients, it was established that in 78.0% of them after isolated selective proximal vagotomy (SPV) by day 31-35, and after SPV with the draining stomach operations by day 40-45, the indices of homeostasis, functions of the alimentary organs normalize, regeneration of a postoperative scar occurs, the physical working ability restores.
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The investigation of factual terms of temporary invalidity after selective proximal vagotomy without draining operations of the stomach in a number of regions of the Ukrainian SSR has shown their considerable variability (56.4 +/- 13.8 days). Under observation were 178 patients. It has been established that normal indices of homeostasis, functions of the gastro-intestinal tract, regeneration of the postoperative scar and recovery of their physical labour capacity is taking place during 30-33 days. Criteria for the determination of terms of temporary invalidity after selective proximal vagotomy for the ulcer disease of the duodenum have been elaborated.
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