The objective of this study was to improve the results of surgical treatment for patients with perforated gastroduodenal ulcers and peritonitis (PGDU-P) by applying the preperitoneal blockade. Materials and Methods:The study included 102 patients with perforated gastroduodenal ulcers (PGDU) complicated by peritonitis. Patients between 18 and 30 years were predominant. Pain was measured using the Visual Analog Scale (VAS) for Pain. The measurements of intra-abdominal pressure (IAP) by indirect infravesical tensometry were performed daily from the first day after the operation. Surgical interventions (laparotomy, laparoscopic suturing of PGDU, sanitation and drainage of the abdominal cavity) was performed under endotracheal anesthesia in all patients.Patients were divided into two groups depending on the method of postoperative analgesia. Patients of Group 1 (n=62) were subjected only to systemic opioid analgesia (an intramuscular injection of 1% solution of Promedol 1ml 4 times a day). Patients of Group 2 were subjected to systemic opioid analgesia and catheterization of the preperitoneal space for infusion of 0.5% solution of Novocaine in the postoperative period.Results: Postoperative analgesia using preperitoneal blockade after laparotomy and suturing of perforated gastroduodenal ulcers reduced the pain intensity by 2 times in comparison with conventional analgesia. The preperitoneal blockade after laparotomy in PGDU-P patients promotes the effective reduction of intra-abdominal hypertension (IAH) for 2 days. The comparative evaluation of the incidence of the early postoperative complications showed that using preperitoneal blockade contributed to significantly reducing the complications in Group 2. Postoperative mortality was 1.6% in Group 1 and 0 in Group 2. The average length of stay was reduced by approximately 3 days in Group 2 compared to traditional anesthesia. (Int J Biomed. 2016;6(2):114-118.).
The objective of this study was to evaluate the immediate results of the use of ureterointestinal anastomosis according to the Bricker technique at radical cystectomy (RC) for bladder cancer (BC). Materials and Results:The study included 96 patients (11.5% women and 88.5% men) with BC, aged from 31 to 74 years (mean age 63.8±7.2), who underwent RC in the Lipetsk Regional Oncology Center, in the period from 2005 to 2014.Among the early postoperative complications, we identified dynamic ileus (16.7%), inflammatory complications of the surgical wound (12.5%), acute pyelonephritis (10.4%), and failure of ureterointestinal anastomosis (4.2%). The frequency of postoperative acute pyelonephritis corresponded to the findings of other authors. Two (2.1%) patients died from early postoperative complications because of concomitant diseases (ischemic heart disease, myocardial infarction); thus, postoperative mortality in the early postoperative period was 4.2%. Chronic pyelonephritis with chronic renal failure detected in 15(15.6%) patients after one year after surgery was the most frequent late postoperative complication. The stricture of ureterointestinal anastomosis in 9(9.4%) patients has been eliminated through relaparotomy and resection of anastomosis. The development of urolithiasis in 12(12.5%) patients after one year after surgery has required the implementation of contact lithotripsy and litholytic therapy. (Int J Biomed. 2016;6(2):110-113.).
THE RESULTS OF THE DIAGNOSIS OF POSTTRAUMATIC HEPATITIS IN PATIENTS WITH CLOSED LIVER INJURYCharyshkin A. L., Gafiullov M. R., Demin V. P. Ulyanovsk State University, Ulyanovsk, e-mail: charyshkin@yandex.ru
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