Import Substitution Possibilities in Palliative Medicine

Abstract

Nutrition is an important problem of palliative care. If oral feeding is not possible, percutaneous endoscopic gastrostomy (PEG) is the method of choice. The wide application of the procedure is limited by the cost of single-use sets produced in other countries. The aim of the study was to review methodic of the PEG and to find an opportunity to reduce its cost. A reusable device was developed for the application of the PEG with use of a Pétzzer catheter. Approbation of the device and methodic was carried out in experiment with 10 rabbits. In 2 cases animals died on the 5th and 6th day after the operation because of acute pneumonia and enterocolitis, complications from the operating wound and gastrostomy were absent. Remaining 8 rabbits were withdrawn from the experiment on the 10-13 day after the operation. In 3 cases purulent infection of the postoperative wound and formation of abscesses of abdominal cavity were revealed, while the gastrostomic fistula was without any signs of failure. In 5 cases were no complications. The gastrostomic fistula was placed next to laparotomic wound and was not complicated in all cases. All the described complications are considered to features of laparotomy and postoperative period in animals. The constructed analogue of the PEG allow significantly reduce costs and increase the economic efficiency of minimally invasive gastrostomy, reduce dependence on foreign materials. Encouraging results obtained in animal experiments allow testing of the technique in clinical settings.

Study of the feeding tube optimal diameter for enteral nutrition in a model experiment

“…Первоначально использовались трубки диаметром около 1 см, что позволяло вводить жидкую пищу из обычных продуктов [10]. Развитие науки и промышленности привело к появлению специализированных смесей для энтерального питания [2,11,12]. Параллельно развивались способы его доставки в пищеварительный тракт.…”

Medical Sovereignty and Ways to Achieve It on the Example of Minimally Invasive Gastrostomy

“…1).Прототипы изобретений успешно опробованы в экспериментах на разработанном симуляторе для пункции желудка и передней брюшной стенки при наложении чрескожной эндоскопической гастростомы (патент RU 2765110 C1)[5] и в экспериментальных операциях на кроликах (рис. 2, 3)[6].Полученные в ходе исследования теоретические и экспериментальные данные позволили разработать альтернативный способ малоинвазивной гастростомии -минимальную гастростомию через мини-лапаротомию (патент RU 2745655 C1)[7]. В операции использован прижимной способ формирования свища с гастропексией, аналогичный пункционной гастростомии.…”