Comparative description of approaches in surgical treatment of aneurysms of descending thoracic aorta

Surgical treatment of patients with thoracic and thoracoabdominal aortic aneurysms is one of the most difficult and topical problems of up-to-date cardio-vascular surgery. Right choice of surgical approach is important condition for effective surgery. This study is dedicated to comparative evaluation and definition of clear indication for choice of surgical approach in reconstruction of thoracic aneurysms. It is concluded that thoracotomy through 3(rd) intercost is preferable in isolated lesion of isthmus and proximal part of descending aorta. Approach through 5(th) intercost is not recommended in this localization of aneurysm. Prosthesis of all descending thoracic aorta (from arch to diaphragm) must be performed through double left-sided thoracotomy with single skin incision (left-sided double thoracotomy through 3(rd) and 6(th) intercosts from single S-type skin incision). This approach always permits to perform surgical reconstruction of distal part of aortic arch, isthmus and all descending aorta, forms optimal conditions for creation of proximal and distal anastomosis.     

Radical retropubic prostatectomy accompanied with inguinal hernioplasty via preperitoneal approach

Radical prostatectomy is now widely practiced in the treatment of prostatic cancer (PC). If PC patients have inguinal hernia, hernioplasty can be made simultaneously with radical prostatectomy without one more surgical approach. The article presents pathogenetic rationale of hernioplasty from preperitoneal approach and an original technique of the simultaneous operation. Positive experience with 32 radical prostatectomies with hernioplasty is described.     

The state of children in the early period after adenectomy

Sixty-three children, aged 3 to 12, were examined after adenotomy made with general anesthesia. The parameters of central hemodynamics and of cardiointervalography describing the state of the vegetative nervous system as well as the postoperative clinical course were analyzed in children after adenotomy. A high sympathoadrenal activity with a trend to reduction was noted in children immediately after adenotomy. The psycho-emotional state and the postoperative pain severity got back to the normal values within 1 postoperative hour.     

Organic anions induce colonic secretion

Experiments were conducted by instilling test solutions into the cleaned colon of anesthetized rats. Isotonic test solutions at an acid (2.9) or neutral (7.0) pH and containing acetic acid or acetate ions were used. At the lower pH, acetic acid was absorbed and water was secreted. At the higher pH, acetate ions were less well absorbed and the colon absorbed fluid. The secretory effect could not be reproduced by hydrochloric acid solutions at pH 2.9. Fluid secretion induced by acetic acid was associated with discharge of mucus from goblet cells. The interference of colonic absorption by acetic acid might be important in some diarrheal diseases.