Preservation of microcirculation in the suture zone is considered the most important among the prerequisites for successful healing of a postoperative wound [3, 4].
Clinical, radiological and pathological data of a number of authors testify to the frequent defeat of the lymph nodes of the mediastinum with cancer metastases (MN Goryunova, 1951; Ya. G. Dillon, 1947; BK Osipov, 1959, etc.). Anatomical works of Ruvier (1932), DA Zhdanov (1947) and others testify to broad afferent connections of bifurcation lymph nodes in normal conditions with the organs of the chest cavity. These factors create the possibility of lymphogenous metastasis of cancer of the lung and esophagus in the mediastinal lymph nodes, in particular, in the bifurcation.
Developed and applied in patients with hernias of the anterior abdominal wall a method of plasty with own tissues using a mechanical suture. 109 patients with postoperative and recurrent ventral hernias were operated on. This method of ventral hernia repair allows to restore the anatomy and function of the abdominal wall, standardizes and simplifies the technique of the operation, reducing the time of its implementation, and gives 95.4% positive long-term results.
In 83 patients, cholecystectomy was performed from the median approach using rack retractors. Incisional hernia was detected in 1 of them, or in 1.2%, while in the group of patients who underwent cholecystectomy through oblique approaches, incisional hernia developed in 9.1% - in 3 of 33 operated patients. Optimality of access was studied by measuring the depth of the wound before and after correction, with the elimination of obstacles (liver and right costal arch). In order to eliminate interference, a universal rack-mount expander for the liver and gallbladder has been designed.
Qualified medical care of the population to a great extent depends on the quality of diagnostic work at the polyclinic stage.To study the causes of delayed diagnosis of gastrointestinal tumors we analyzed case histories of 2120 patients treated at the gastroenterology department during three years. Gastric tumors of various localizations were revealed in 32 patients, in 9 patients - tumors of large intestine. The average age of the patients was 56 years.
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