The basis of surgical treatment for extensive postoperative abdominal hernia

The hernioplasty method was elaborated by the authors. The method stipulates the prosthesis of polyurethane placement in the duplicature from the hernial sac and parietal peritoneum and is sewn under the hernial defect edge, which are then sewn contactly. With the application of method elaborated 36 patients were operated on, suffering from large abdominal hernia. In 2 patients the lymphorhagia was observed in postoperative period during 9 days, in 1 the wound have suppurated and the prosthesis was removed. The late follow-up results were observed from 3 months till 3 years, the hernia recurrence was not revealed.     

H mesh prosthesis in the treatment of ventral hernia

The Authors report their experience in the treatment of ventral hernias using a Marlex mesh moulded in an original way with a technique partially derived from plastic surgery. The complete mobilization of the umbilicus through a circular incision allows to fit this prosthesis symmetrically below the rectus abdominis muscles for the entire extension of the hernia.     

A modified suture in the surgical treatment of middle ventral hernias

Mechanical stability of the front abdominal wall median anatomic structure tissues has been examined in 49 experiments on cadavers. It was found that aponeurotic tissue of the edges of sheaths of the rectus abdominis is the most firm one. The article analyses different types of sutures used in hernioplasty. The authors propose original method of hernioplasty using the most stable anatomic structure, formation of narrow tissue duplication with a minimal amount of suture material. This method has been used in surgical treatment of 58 patients with umbilical, postoperative and linea alba hernias. There were no recurrences for 3 years.     

Laparoscopic ventral hernia repair: a community hospital experience

OBJECTIVE: To study the suitable age for intraocular lens (IOL) implantation in children. METHODS: 240 (240 eyes) normal children aged 3-13 years old were selected. Their corneal refraction, anterior chamber depth, lens thickness and ocular axial length were measured with Roden-Stock Keratometer C-MES and Eyescan Model 55 separately. RESULTS: The corneal refraction of 3-year-old children, the anterior chamber depth and lens thickness after 5 years old, and the ocular axial length after 9 years old approach the adult magnitude. CONCLUSIONS: A 3-year-old child has been qualified with IOL implantation, the child younger than 9 years old should be implanted with a normal adult IOL and then corrected with glasses, and a child after 10 years old should be directly implanted with a proper dioptric IOL.     

Morpho-functional aspects of pathogenesis and surgical treatment of the abdominal wall hernia in elderly and senile patients

The abdominal wall tissues atrophy was revealed while histological and electromyographic investigation in 16 patients with primary hernia (the mild one) and in 17--with secondary, recurrent and postoperative (much more significant atrophy). The data obtained are applied for the choice of optimal method of operation conduction.     

Combined surgical treatment with prosthesis of recurrent ventral and inguinal hernias

The presence of associated incisional and groin hernias is relatively rare and it represents an important problem in surgical treatment. The authors here report their experience of three patients treated with no reabsorbable prostheses placed according to Rives' technique for incisional hernias, and according to Stoppa's for inguinal hernias.     

The causes of early postoperative complications in the surgical treatment of hemorrhaging gastroduodenal ulcers

Based on the material of 1201 patients who had been operated on for complicated gastroduodenal ulcers, the causes are analyzed of the early postoperative complications (EPC) development. The EPCs were encountered in 15.5%. The most important risk factors identified in the study included peptic ulcer complications, the degree of severity of ulcer bleeding, time for the surgical intervention to be done, the technique employed, with the effects thereof having been studied on the EPC occurrence. Stenosis presenting with penetration and gigantic ulcers was found out to have the most apparent impact on the origination of EPC.     

Laparoscopic treatment of large paraesophageal hernia with totally intrathoracic stomach

Calcific deposits located within the tendons of the rotator cuff are frequently seen in patients presenting with shoulder pain. The pathogenesis of calcific tendinitis and the optimum management of patients presenting with acute symptoms are unclear. This paper reviews the incidence, proposed etiologies, and a unique treatment approach of rotator cuff calcific tendinitis. A case report of a patient with acute calcific tendinitis and subsequent shoulder motion and strength deficits is presented. A rational evaluation and treatment plan is outlined, which includes management and posttreatment changes, and radiographic findings are discussed. A team-management approach by physical therapy and orthopaedics services is emphasized.     

The large window ductus: a surgical trap

A rare window type of patent ductus arteriosus is reported that was large (15 mm in maximal transverse dimension) but had virtually no length and hence was externally invisible. The smaller aortic isthmus (4 mm in diameter), which was intrapericardial, was mistaken for the ductus and was inadvertently clip-occluded, leading to death. After a specific diagnosis is made, the large window ductus should be patched on cardiopulmonary bypass with a transpulmonary approach.     

Kidney transplantation in patients over 60 years of age. Study of 37 patients

Between February 1975 and September 1993, 735 renal transplantations have been performed 37 of which took place in 60+ year-old subjects. All grafts were from corpse donors. 34 were first time transplants and 3 were re-transplants. In general, immunosuppression has been accomplished with Cyclosporin, Azathioprine, and Prednisone. Annual patient and graft survival is 87% and 69%, respectively. A review is made of the complications developed and the success rate with and without a functioning graft. Considering long-term results, many patients lead a normal live with stable renal function.     

The DIC syndrome as a complication of the surgical treatment of urolithiasis in urology patients

The authors discuss the causes of the DIC syndrome in urological patients operated on for urolithiasis. They enumerate the factors predisposing to the DIC syndrome and causing it. The predisposing factors are chronic renal insufficiency and metabolic disorders caused by azotemia, infectious inflammatory complications of urolithiasis, and intoxication. The causes of the disease are massive blood loss involving disorders of the hemodynamics and blood rheology, bacterial shock, and other stress conditions. A protocol for treating this complication and validation of pathogenetic therapy is offered.     

The late results of combined surgical treatment in peptic ulcer patients

The authors submit a successful case of penile replantation. They discuss the course of the procedure and document the immediate and long-term result of this procedure.     

The results of the surgical treatment of bladder cancer patients

A new method for accommodation training making use of a computer is proposed. A specially generated dynamic grid of concentric rings serves the stimulus. Changes of the accommodation parameters (the nearest and farthest points of clear vision) were examined in 11 display users aged 30 to 50 during a training session and in the course of 15 sessions. The training improved the accommodation volume by an average of 0.9 diopters at the expense of approximating the nearest and withdrawing the farthest clear vision points. In 4 subjects anisoaccommodation disappeared almost completely. The proposed method may be used to normalize the accommodation of display users.     

The prevention of infectious-inflammatory complications in the postoperative period in percutaneous surgical interventions in patients with urolithiasis

The paper describes a number of modifications in the operative procedures, pre-, intra- and postoperative antibacterial treatment introduced to decrease the number and severity of infectious-inflammatory complications of endourological surgery for urolithiasis; presents the results of anti-bacterial prophylaxis of urinary infection aggravation in 29 patients suffering from urolithiasis combined with renal anomalies. Antibacterial treatment was performed with ftorquinolone drug ciprinol (ciprofloxacin hydrochloride) made in Slovenia. 18 patients received ciprinol twice a day at a dose 500 mg 3-5 days before the operation and within 5-7 postoperative days. The other 11 patients received the drug intravenously (100 mg in drops) in parallel with initial anesthesia and during 1-2 postoperative days. It was continued orally within the next 5-6 postoperative days. The analysis of ciprinol pharmacokinetic profile showed its concentrations in the blood and urine to surpass minimal inhibitory concentration for the majority of the isolated microorganisms. Out of 18 patients treated with oral ciprinol, postoperative aggravation of pyelonephritis occurred in 3 (16.7%) versus 8 (40%) cases out of 20 controls. 11 patients on intravenous ciprinol developed no complications. The conclusion is made on high efficacy of preoperative antibacterial preparation and of intraoperative antibacterial therapy continued for some time after the surgery in cases of percutaneous endoscopic surgical interventions for urolithiasis attended by chronic urinary infection. The antibacterial treatment brings about a 2-3-fold decrease in the occurrence of postoperative inflammatory complications.     

The late results of the surgical treatment of patients with a pathologically mobile kidney

Long-term (1-10 years) results of wandering kidney surgery were followed-up for 118 patients. The outcomes were found dependent on the duration of the disease, variety and severity of the lesion, age of the patients. The response appeared better in younger patients, in those with shorter duration of the disease and with unessential changes in the kidney. Recommendations are provided on the regimens, jobs, outpatient and inpatient follow-up for the subjects treated surgically for wandering kidney to reinforce the correction results achieved.     

Pre- and postoperative correction of hyposiderosis in surgical treatment of portal hypertension]

The pharmacological properties of the new nondepolarizing myorelaxant IEM-1213 and of its mixture with tercuronium were studied in experiments on anesthetized cats. Intravenous infusion of a blocking dose of IEM-1213 did not cause a change in the level of arterial pressure and blockade of the sympathetic ganglia but induced blockade of the heart muscarine receptors. The effect of IEM-1213 develops more rapidly and lasts for a shorter time than that of dithylin. Intravenous infusion of a mixture of IEM-1213 and tercuronium constituting 35 and 60% of the blocking dose of the former and, respectively, 35 and 20% of the blocking dose of the latter causes an effect similar in the time of its development to that of intravenous infusion of a total dose of IEM-1213 alone.