Biomedical subjects
Publications and source records attributed to V I Onopriev.
20-year (1984-2004) experience in surgical treatment of recurrent and complex hernias in 220 patients after reconstruction of the posterior wall of inguinal canal with sewn-in filamentous frame is analyzed. Results of this treatment are compared with those after standard methods of hernioplasty: Bassini's, Martynov's, Postempsky's, Kukudzhanov's, Bobrov-Girard-Spasokukotsky operations (control group).
Combined use of sodium hypochlorite and intravenous laser irradiation of the blood in the postoperation therapy of 24-h bile peritonitis improved recovery of engulfing and digestive activity of neutrophilic granulocytes in the early postoperation period. Enzyme activity of neutrophilic granulocytes in earlier postoperation periods returned to normal after treatment with sodium hypochlorite alone.
Experience in surgical treatment of bleedings from varicose veins of the esophagus and stomach is analyzed. Two new methods of azygo-portal separation are offered, indications and contraindications, main principles of treatment before and after surgery, short- and long-term results are described.
The paper compares the apparent blood viscosity (BV)-shift rate (SR) curves, by using uni- and multidimensional dispersion analysis. The study has indicated that when admitted to hospital, patients with maxillofacial phlegmons have higher BV due to worse blood rheological and coagulative properties. An analysis of the BV-SR curves has shown that there are the most significant differences between the parameters at moderate and high SR while the differences are frequently insignificant at low SR (on admission, on days 3 and 10). For hemocorrection of increased BV, co-administration of disaggregatory agents is indicated during the treatments proposed. Uni- and multidimensional analyses used to examine the curves of the apparent BV to the individual value of SR and throughout its range are the most informative tools for assessing the quality of treatment in patients with maxillofacial phlegmons and a statistically warranted method for multiple comparisons.
The indices of endogenous intoxication were investigated in 45 dogs. It was shown that the development of 24-hour bile peritonitis was accompanied by pronounced endogenous intoxication with injured cell membrane structure and impaired activity of NO-synthases.
Experience with surgical treatment of 147 patients after gastrectomy with jejunogastroplasty and creation of end-loop esophageal-intestinal anastomosis is analyzed. Original methods of jejunogastroplasty are based on end-loop construction of esophageal-intestinal anastomosis simulating anatomic-functional analog of lost cardia and pylorus and replacing reservoir function of the stomach. One year and later after surgery 83 patients with end-loop esophageal-intestinal anastomosis and 73 patients with anastomosis were examined. It is demonstrated that jejunogastroplasty with end-loop anastomosis is characterized by low frequency (6%) and degree of reflux-esophagitis. Passage of food through duodenum in end - loop jejunogastroplasty decreases frequency and degree of demping-syndrome. Active isolating function of end-loop anastomosis was demonstrated with x-ray and manometric methods. Primary jejunogastroplasty with end-loop anastomosis leads to reduction of frequency and severity of postoperative pathological syndromes and permits to improve quality life of operated patients.
The article presents the results of a study of the hydrodynamical characteristics of the end-to-loop gastroenteroanastomosis by the method of multichannel intraluminal manometry. The study was carried out on 7 outbreed dogs. The function of anastomosis was studied at the constant speed of liquid passage as well as at modeling short-term rises of pressure similar to those created by stomach and gut peristalsis. The results of the study testify that the end-to-loop anastomosis is a dosed obstacle to the antegrade passage comparable with those in the normal state and has expressed antireflux properties.
Immediate results of 151 pancreatoduodenal resections (PDR) were analyzed. This surgery was performed for tumors of gastropancreatoduodenal region in 88.1% patients, for chronic complicated pancreatitis--in 11.9%. Pylorus-saving PDR was performed in 82.8% patients, in combination with stomach resection--in 17.2%. Extended and regional pancreatectomy was performed in 20.3% patients with tumors of periampullar zone, extended lymphadenectomy--in 44.4%. Pancreatoenteroanastomosis was created in 82.8% patients, end-loop Wirsungenteroanastomosis by original author's method--in 52.3% of them, traditional Wirsungenteroanastomosis end-to-side--in 30.5%, complete external drainage of pancreas stump was performed in 13.9%, suturing of pancreas stump--in 2.6%, pancreatogastroanastomosis was created in 1 (0.7%) patient. There was no insufficiency of pancreatoduodenoanastomosis performed with original method, while in traditional Wirsungenteroanastomosis it was seen in 4.4% patients. End-loop anastomosis permitted to reduce number of complications after PDR 1.6--3 times. General lethality was 11.3%, in end-loop anastomosis--3.8% that significantly lower than after other methods of treatment of pancreas stump.
20-year experience of total two-stage esophagoplasty with a flap made of a left half of the colon in 57 patients with burni strictures, the second stage was anastomosis between the transplant and the esophagus. Original cologastral are flux anastomosis created in the zone of air bubble (then zone of anastomosis was invaginated in fundus of stomach) was used. Long-term results were studied in 15-20 year follow-up. Excellent results were achieved in 68.2% cases, good--in 27.2%. It is demonstrated that are flux cologastral anastomosis provides good protection of the transplant from aggressive gastric contents.
Transformations of parameters of pancreatic exocrine secretion after the direct operations on the pancreas of a dog were studied during the experiment. It was determined that the early post-operative period proceeds in the conditions of the expressed pancreatic hypersecretion, hyperenzymemia and ductal hypertension. Their intensity reduces as the destructive process in pancreas develops. This results in changes of pancreatic exosecretion in two phases: the increasing and decreasing hypersecretion. The role of augmentation of the secretory activity of pancreas in pathogenesis of the acute postoperative pancreatitis is discussed. Its development was observed in all operated animals. This enabled us to resolve all contradictions and to prove the expediency of the application of pancreas secretion inhibitors at the prevention of acute post-operative pancreatitis.
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Ulcerative gastroduodenal bleedings have remained one of the most complicated problems of emergency abdominal surgery up to the present. According to the literature, they make up approximately one half of all gastroduodenal bleedings and are accompanied by high lethality--from 10 to 30%. At that the highest percentage of lethality falls at elderly and old patients.
The authors propose to classify colorectal anastomoses by anatomical signs: high (supraampular), medial (ampular), low (subampular), utmost low (suprasphincteral) and sphincteral. Forty colorectal one row suture anastomoses were performed in patients with carcinoma of the rectum. Incompetent sutures were registered in 3 (7.5%) patients with subampular anastomoses. There were no lethal outcomes.
Radical duodenoplasty is the optimum operation in the patients with duodenal peptic ulcers that are complicated with stenosis. Radical duodenoplasty in the patients with ulcer that is cicatrized reduces their stay in the resuscitation's department, reduces the reactive pancreatitis development, makes easier the early postoperative period and decreases of treatment expenses. So, preoperative rehabilitation is necessary in the patients with duodenal peptic ulcers.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.