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Biomedical subjects

V A Kubyshkin

Publications and source records attributed to V A Kubyshkin.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Assessment of pancreatoduodenal resection completion methods].

The nearest outcomes of 305 pancreatoduodenal resections (PDR) for malignant and benign diseases of the pancreas head and periampullar zone are presented. Necessity of differential approach to choice of method of pancreatodigestive anastomosis formation is demonstrated. In unectatic main duct of the pancreas and unchanged pancreatic parenchyma there is a high risk of postoperative pancreatitis and lethal outcome which achieved 29.8% in the group of 57 patients. In patients with diameter of main pancreatic duct more than 3 mm and fibrotic changes of its parenchyma, the majority of methods of pancreas inclusion the in digestive canal were characterized by favorable results, lethality was 7.7% among 248 patients. Recently, the increase of rate of PDR with pylorus preservation permits to apply widely pancreato-, bilio-, and duodenoenteroanastomosis on the same jejunal loop.

Adult↗
PubMed2001

[Characteristics of immunologic disorders in patients with acute destructive pancreatitis].

Examination of immunological status in patients with acute destructive pancreatitis with uncomplicated (14 patients) and complicated (infectious-inflammatory processes--18 patients) postoperative period illustrated depression of T- and B-links of immunity, reduction of absolute and relative number of TFU- and TFC-lymphocytes. All the patients demonstrated reliable elevation of phagocytic rate, phagocytic index and number of circulating immune complexes. These changes were more significant in patients with complicated postoperative period. Level of lactoferrin in patients with complicated period was by 10% higher than in patients without complications. Significant elevation of tumor necrosis factor Ia in blood was registered in patients of both groups. During all the periods of examination the level of interleukin-8 was higher in patients with complicated postoperative period than in the patients with favorable postoperative period. This interleukin-8 is a reliable marker of postoperative complications in acute destructive pancreatitis.

Acute Disease↗
PubMed2001

[Current problems of the surgical treatment of uncomplicated duodenal ulcer].

How to choose treatments for uncomplicated duodenal peptic ulcer is discussed. The data available in the literature suggest that there is a high incidence of recurrent ulcers even after regular. This is evidenced by experience in examining and treating 1414 patients at the Institute of Surgery. A large number. The authors consider a great deal of patients to be unresponsive to drug therapy, in whom the disease is characterized by frequent recurrences and complications. These patients require organ-saving surgical treatment. Selective proximal vagotomy that present the minimum risk is the operation of choice. A five-year follow-up revealed 21.4% of recurrences, which effectively responded to drug therapy. This rate is much less than that observed after drug therapy alone.

Drainage↗
PubMed2001

[Functional results of laparoscopic antireflux surgery and causes of postoperative dysphagia].

Results of functional examination of 176 patients with gastroesophageal reflux disease are presented. 94 patients were were followed up from 1 month to 4 years after laparoscopic antireflux operation (82--by Nissen and Nissen--Rossetty, 6--by Dor, 6--by Toupet). After Nissen operation the pressure in the region of lower esophageal sphincter (LES) increased more than after partial fundoplication and remained the same during 4 years of follow-up (p < 0.05). Postoperative dysphagia in the majority of cases was associated with excessive increase of pressure and length of LES region, decrease of it capacity to relaxation during swallowing (p < 0.05). 360 degrees-fundoplication can not be recommended only in complete loss of contractile capacity of the esophagus.

Adult↗
PubMed2000

[Differential diagnosis of pancreatic head cancer].

The results of clinical, instrumental and laboratory examinations were analyzed for 99 patients. 59 of them had pancreatic head cancer, 40--chronic pseudotumorous pancreatitis. The importance of complex ultrasonic diagnosis in detection of pancreatic diseases (98%), in true diagnosis of unresectable tumors (96.7%), and also in determination of bile ducts lesion level in obstructive jaundice is shown. It was revealed that spiral computed tomography (SCT) had an advantage over computed tomography in diagnosis of pancreatic tumors and in assessment of their resectability. Sensitivity of combined use of US, SCT and tumor marker CA 19-9 in pancreatic cancer diagnosis increases to 95.2%. High diagnostic value of laparoscopy with laparoscopic ultrasonic examination as a method of final assessment of tumor resectability is shown.

Biomarkers, Tumor↗
PubMed1999

[Clinical features, diagnosis and treatment of benign nonepithelial tumors of stomach].

The results of treatment of 24 patients with benign nonepithelial tumors of the stomach (BNTS) are presented. The majority of the tumors were leiomyomas (42%). The preoperative diagnostic algorithm included x-ray examination of upper gastrointestinal tract, endoscopic examination with histologic study (biopsy), ultrasound examination and CT. The best results were obtained in CT. The operation of choice in BNTS are wedge-resection of the stomach and enucleation (78.3% of patients).

Adolescent↗
PubMed1999

[Leiomyomas of small bowel].

The analysis of our own country and foreign literature, devoted to the problems of clinical aspects, diagnosis and treatment of leiomyomas of the small bowel for the last 48 years has been carried out. The authors present their personal experience in follow-up of 6 cases of the small bowel leiomyomas, the main clinical manifestations of which being recurrent intestinal bleedings and in lesser degree--small bowel obstruction. The results of preoperative examination evidence that besides thorough physical, endoscopical and ultrasound examination the necessity may arise to use for diagnosis angiographic and computed-tomographic methods. The subject of special attention of each clinical physician should be the danger of malignant transformation of benign leiomyomatous neoplasms of the small bowel, which the authors encountered in 2 patients.

Adult↗
PubMed1999

[Use of ceftriaxone in the prevention of postoperative purulent complications after surgery on the stomach and small intestine].

Ceftriaxone was administered intravenously in a single dose of 1.0 g 15 minutes prior to surgical intervention for peptic ulcer and gastric or duodenum tumor in 31 patients at the age of 33 to 74 years. In all the patients primary adhesion of the surgical wound was recorded. No signs of local or general infection were observed. The indices of the total blood count, urinalysis and blood biochemical analysis came to normal by the 5th or the 7th day of the postoperative period. The levels of ceftriaxone in the blood, urine, stomach wall, small intestine tissues and subcutaneous fat were evaluated. The indices of the cellular and humoral immunity in the pre- and postoperative periods in the patients prophylactically treated with ceftriaxone were analyzed.

Adult↗
PubMed1999

[Recurrent profuse hemorrhage in gastric angiodysplasia].

Dieulafoy's disease--i.e. arteriovenous malformation--is a rare cause of gastric bleedings, which makes up 1.5-3% of all sources of hemorrhage. All the armory of diagnostic modalities may require to reveal arteriovenous malformations. Angiography of the stomach appeared to be the most informative method for diagnosis of this disease in 2 patients. Radical treatment of patients with Dieulafoy's disease implies resection of the proximal part of the stomach or gastrectomy. Endoscopic hemostasis (with the use of coagulation and injections of sclerogenous preparations around the diseased area) results in temporary effect.

Adult↗
PubMed1999

[Lipid peroxidation in acute surgical diseases of abdominal cavity organs].

The study of lipid peroxidation (LPO) characteristics in patients with acute mesenterial circulatory disturbances (64), acute pancreatitis (44) and acute bowel obstruction (46) allowed the conclusion on informative value of determination of malonic dialdehyde and diene conjugates in the blood for staging these diseases and the degree of severity of endotoxicosis. On the basis of the state of LPO it became possible to evaluate the extent of bowel failure. According to LPO in postoperative period the process of development of vascular rethrombosis in the bowels could be assessed. The varieties of lipid peroxidation products in peripheral venous blood can be used for differential diagnosis of such diseases, similar in their clinical symptoms, as acute pancreatitis and acute bowel obstruction.

Acute Disease↗
PubMed1999

[Place of laparoscopic surgery in the treatment of gastroesophageal reflux].

62 patients (57 females and 5 males, mean age 42.3 years) with gastroesophageal reflux disease were treated and followed up in the A.V. Vishnevsky Institute of Surgery. The diagnosis was established at endoscopic examination, which revealed esophagitis of the 1st degree in 39 patients, of the 2nd--in 20, of the 3d--in 2 and of the 4th--in 1. Roentgenologic examination of the esophagus and the stomach revealed manifestations of the reflux in 43 patients, hernia of the esophageal orifice (of the diaphragm)--in 27. According to esophageal manometry data, basal pressure in the area of the lower esophageal sphincter made up 9.8 +/- 5.7 mm Hg; in 24-hour pH-metry the index of the De Meester exceeded normal 4-5 times and made up 61.1 +/- 33.8. All the patients have undergone a course of conservative antireflux therapy which in the majority of patients resulted in temporary improvement. Laparoscopic operations were carried out in 41 patients (fundoplication by Nissen--in 32, Toupet procedure--in 4 and--by Dor--in 5). In 23 patients cruroraphy and in 32 cholecystectomy have been performed. The patients were followed up from 1 to 36 months. In the majority of them the results were good and favourable.

Adult↗
PubMed1998

[Spiral computer tomography in diagnosis of hepatic diseases].

Spiral computer tomography (SCT) is a new method of computer tomography by which, in contrast to conventional CT, the information about absorptional capacity of tissues is obtained without omission of images which makes it possible to build MPR and 3D of a very high quality. 205 patients with diseases of hepatopancreatoduodenal area were examined, in 189 patients the diagnosis being verified. Optimal technique of intravenous bolus contrasting in SCT was developed. Using various time interval between the start of the scanning and the beginning of infusion of contrast media, it is possible to obtain primary image of the arteries (arterial phase of contrasting, time of delay 18-25 sec.), the picture of veins and the image of saturation of hepatic parenchyma--(venous return phase, time of delay 60-80 sec.), to reveal characteristics of contrasting of the liver masses during delay (8-15 min) phase. The largest quantity of masses are revealed in arterial phase of contrasting. Specific features of contrasting in hemangiomas and malignant tumors of the liver has been revealed. Hemangiomas absorb contrast medium already at the early phase as hypercontrasted lacunas in an outlying areas, at a late phase they are hyperdenced in relation to hepatic parenchyma. Primary and metastatic tumors of the liver accumulate contrast medium in an early phase along the whole area and quickly lose contrast medium during parenchymal phase. The method of contrast intensification enables evaluation of interrelation between tumor and vessels, to determine passage of hepatic arteries and branches of portal and hepatic veins, to visualise choledochal duct, to determine the distance between hepatic and tumor surface, and to produce these data as a view of multiplanar and three-dimensional image (reconstruction). The effectiveness of obtained reconstructions in planning of the extent of surgical intervention is demonstrated.

Contrast Media↗
PubMed1998

[Clinical and laboratory study of cefodizime (Modivid) in prophylaxis and treatment of surgical patients].

The results of the clinical and laboratory study of the efficacy of the prophylactic and therapeutic use of cefodizime (modivid) in patients with chronic calculous cholecystitis and burns are presented. Expediency of the preoperative prophylactic use of the drug and its significance in the treatment of infectious complications of the burn disease were verified. The immunological investigation gave evidence of an increase of the phagocytosis functional activity when cefodizime (modivid) was used prophylactically in cholecystectomy.

Adolescent↗