Biomedical subjects
Publications and source records attributed to S I Peshekhonov.
The authors made an analysis of results of appendectomy in 1783 patients. Laparoscopic appendectomy was fulfilled in 1036 of them. Contraindications to laparoscopic appendectomy and possible complications are discussed. Its medical and social-economical advantages are shown (less number of unfounded appendectomies and wound purulent complications, duration of treatment in hospital and temporary disablement).
Results of treatment of 655 patients aged from 17 through 89 years for perforative ulcers of the stomach and duodenum were analyzed retrospectively. Simple suturing of ulcer was performed in 526 (80.3%) patients, laparoscopic methods included. Comparison of general results of treatment of 655 patients with the data of the control group consisting of 390 patients treated at the same hospital before introduction of laparoscopic operations failed to reveal statistically significant differences in frequency of postoperative complications and lethality. The authors defined general somatic, technical and tactical contraindications for laparoscopic operations.
Results of videolaparoscopy for suspected acute appendicitis are analyzed in 2165 patients (729 men and 1373 women) aged from 15 through 92 years. The diagnosis of acute appendicitis was excluded in 23.6% of men and 54.5% of women. Disagreement between the clinical and laparoscopic diagnoses took place more often in women aged younger than 20 and older than 70, and in men - younger than 20 and older than 50. Other diseases were found resembling acute appendicitis which required urgent operative treatment in half of the cases. In 88.7% of the observations the laparoscopic method was used. Laparoscopy resulted in sharply decreased number of appendectomies in patients with catarrhal (0.3%) and secondary (0.3%) appendicitis. The sensitivity of the videolaparoscopic method of diagnosing acute appendicitis was 98.7%, specificity - 91.1%, exactness - 95.9%.