[The creation of a bladder from the ileum via automatic sutures after radical cystoprostatectomy].
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Adult↗
Biomedical subjects
S Chakŭrov
Publications and source records attributed to S Chakŭrov.
[An orthotopic bladder from the ileum after total cystectomy--the technic of the operation].
This is a description of the operation proper with explanation of the motivation for giving preference to one or another technique of execution. Presumably, proceeding from experience accumulated hitherto, it will serve the purpose of instructions to Bulgarian urologists willing to implement in practice this difficult and complex operative procedure. After careful assessment of the methods existing, and in compliance with the logic of anatomy and physiology of the structures involved, two innovations concerning the formation of new urinary bladder and implantation of the ureters therein are introduced. The latter merit special attention since they contribute greatly to improve the functions of the new organ.
Anastomosis, Surgical↗
[An orthotopic bladder from the ileum after total cystectomy].
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Aged↗
[Tumors of the urethra].
For a period of 6 years 416 men with bladder tumors have been treated by transurethral resections and hemotherapy. The bladder disease was associated with tumors of the urethra: 15.6 per located in its prostate portion and 3.1 per cent in the cavernous part. The urethral tumors were also treated by transurethral resections, ureterotomy and total cystectomy. It was shown that the numerous transurethral resections of bladder tumors contribute to the appearance of urethral tumors: 79 per cent of these developed after the 5. transurethral resection. The results of this study led to a number of inferences: Tumors in the cavernous portion of the male urethra appeared at a relatively younger age (mean 57.8 years); the membranous portion of the urethra is a particular borderline in the histologic structure and the prognosis; appearance of tumors in the cavernous part of the urethra is a poor prognostic sign--tumors in this zone may run a fulminant course with rapid lethal outcome. Inferences were drawn on the methods of choice of treatment of combined bladder tumors and tumors in the cavernous portion of the urethra.
Aged↗
[Contamination during transurethral manipulations of the upper urinary tract].
A four-year observation was carried out on a series of 289 patients who had undergone miscellaneous transurethral operations and manipulations on the upper urinary tract. Clinical and microbiological studies were performed in an attempt to record the incidence of urinary tract infections as a consequence of contamination following transurethral manipulations. Random groups of in-lying patients at two urologic clinics served as controls. It was found that the hazard of contamination with pathogenic bacteria causative agents of urinary tract infections in the study group was smaller than usually believed. The mean infection rate was 17.3 per cent, vs. 35.6 and 45.5 per cent respectively in the control groups. Higher was the risk of contamination after manipulations terminating without temporary drainage of the urine from the upper urinary tract. In the contamination processes was involved a broader spectrum of microorganisms with more resistant strains. Conclusions are drawn on the possibilities to reduce the contamination levels and to prevent the consequences of infection. This should be achieved not by limiting the manipulations, but by mastering the endoscopic technique and nontraumatic work with this technique.
Adolescent↗
[A comparison between clinical and echographic staging in bladder tumors].
In a series of 94 consecutive unselected patients with bladder tumors the authors determined the tumor infiltration stage (tumor staging) by two methods. In all patients the echographic stage was previously and independently established by transurethral echography. The clinical staging was subsequently made according to the requirements of the International Union for Cancer Control (IUCC). The results obtained by the two methods were compared and a high degree of coincidence (81 per cent) was found. The lack of coincidence in the borderline stages between superficial and infiltrative lesions is discussed. The ultimate staging in bladder tumors is recommended to be based on the complex data of all methods: echography, computer axial tomography and clinical examination.
Carcinoma, Papillary↗
[Correlations in bladder tumors].
Detailed and complete investigations for determining the tumor characteristic were made in 137 patients with bladder tumors. The study included: establishing the gross parameter (gross appearance, localization, size, multiplicity, mode of growth and dissemination), infiltration stage, degree of differentiation, cytophotometric parameters (ploidy and proportion of cells in S-phase) and immunologic data (indirect immunofluorescence and serum IgA and IgG levels). The results were correlated and a number of correlations between the individual qualities of the tumors were determined. On the basis of proven interrelations, staging and grading the two basic tendencies in tumor development--weak or strong malignancy--were outlined. Conclusions were drawn on the need of more detailed investigation of the correlations in bladder tumors, in order to facilitate the diagnostic process, when full-fledged investigations are not available, as was the case in the author's patient series.
Aged↗
[The prevention of postoperative suppurative complications in stomach cancer].
Bacteriologic studies of gastric juice and purulent drainage fluids in the event of complications were carried out in 80 patients who had undergone gastric resections and had been on conventional parenteral antibiotic treatment (control group). Another (experimental) group of 37 patient, having undergone the same operations, received prophylaxis of the suppurative complications with 5-nitrox and Flagyl solutions through nasogastric probe once in 3 hours for 6 to 8 days. The suppurative complications in the experimental group were reduced from 47.5 to 8.1 per cent and of the postoperative lethality due to suppurative complications from 22.5 to 0 per cent.
Anti-Bacterial Agents↗