[Plastic closure of large ulcers of duodenum posterior wall complicated with bleeding].

New method of organ-saving surgery for bleeding duodenal ulcer is described. Advantages of this method have been confirmed in experimental studies on 10 mongrel dogs and by successful clinical application at 3 patients with large bleeding ulcers of duodenum posterior wall.

[Surgical treatment of complicated ulcers of cardia and sub-cardia].

Two hundred and two patients with ulcers of a proximal part of the stomach (17.5% of all patients with gastric ulcer) were treated. In 135 (64.9%) patients these ulcers were complicated: in 28 (20.7%) -- malignant ulcers, in 42 (31.1%) -- bleeding ulcers, in 53 (39.3%) -- penetrating ones. Surgery was performed in 142 (70.3%) patients. A high rate of complications dictates a need to reduce period of conservative treatment of such ulcers to 6 months -- 1 year. Distal and proximal resection of the stomach are main surgeries in elective surgical treatment of patients with benign ulcers of cardia and sub-cardia. In malignant transformation gastrectomy is the most preferable. Suturing is indicated in perforated and bleeding ulcers, and if it is impossible -- distal subtotal resection of the stomach.

[Bougienage of esophagus in critical burn strictures]. / Buzhirovanie pishchevoda pri rubtsovykh ozhogovykh strikturakh.

Bougienage was made in 625 patients with burn strictures of the esophague which made up 59.4% of all patients (1053) who have undergone treatment since 1966 to October 1977 in Research Center of Surgery. Indications and contraindications for bougienage are discussed. In patients with short strictures (146) good effect was obtained in 83.1% of cases, in long strictures (803) the bougienage was effective in 61.1% of patients, in total strictures (104) good and favourable results were obtained in 26.2% of cases. Bougienage is an important method of treatment for patients with burn strictures of the esophagus, as well as a method of preoperative preparation.

[The experience of 1100 esophagoplasties]. / Opyt 1100 plastik pishchevoda.

The experience of esophagoplasties in various benign diseases (566) and cancer (534) of the esophagus is outlined. The operation of choice now is extirpation of the esophagus by cervico-abdominal approach with one-state posterior-mediastinal esophagoplasty by the stomach or (in case of impossibility to form the graft from the stomach)--large bowel. If there are contraindications to such operation or in case of necessity of one-stage reconstruction of the pharynx the optimal operation is sub- and total bypass esophagoplasty by the large bowel.

[Choice of esophageal plastic surgery]. / Vybor metoda plastiki pishchevoda.

The choice of an access to different parts of the esophagus, the need and scope of its resection, the choice of a surgical stage and an organ for creating the artificial esophagus, the position of a graft and the method for forming an esophageal anastomosis are the matters under discussion. A total of 1000 esophageoplasties were performed using different methods. In cancer of the esophagus and its benign diseases, the optimum intervention is esophageal extirpation with one-stage plasty using an isoperistaltic gastric tube; if there are contraindications to this operation, subtotal and total esophageoplasties with the colon are the operations of choice.

[One-stage esophagoplasty with pathologically changed or previously operated stomach]. / Odnomomentnaia ézofagoplastika patologicheski izmenennym ili operirovannym zheludkom.

The results of esophagus extirpation with subsequent one-stage esophagoplasty by pathologically changed or previously operated stomach in 50 patients are analysed. 2 patients had gastric and esophagus cancer and 48 patients esophagus strictures. 36 patients had been previously operated on their stomach, 10 patients had scar deformation of the stomach after thermal burns, 2 patients had a giant leiomyoma. Isoperistaltic gastric tube was used as an esophagus substitute. The postoperative mortality rate was 2,1%. The optimal method of surgical treatment of the combined gastric and esophagus lesions is recommended.

[The technic of esophageal extirpation with one-stage esophagoplasty using a stomach tube]. / Tekhnika ékstirpatsii pishchevoda s odnomomentnoi ézofagoplastikoi zheludochnoi trubkoi.

The article deals with the technical aspects of operation for extirpation of the esophagus through a cervico-abdominal approach in carcinoma (133 operations) and benign esophageal strictures (117 operations) with one-stage plastics by means of an isoperistaltic tube formed from the greater curvature of the stomach. The relative safety (2.8% of patients died) and high efficacy of the described operation allow it to be recommended for wide introduction into the practice of institutions engaged in surgery of the esophagus.

[The treatment of the sequelae of penetrating injuries to the esophagus]. / Lechenie posledstvii pronikaiushchikh povrezhdenii pishchevoda.

On the basis of experience in the treatment of the sequelae of penetrating esophageal injuries in 79 patients the authors divided the patients into 3 groups: those in whom the perforation healed and stricture of the esophagus developed; patients with incurable purulent complications and esophageal fistulas; patients who underwent various operative interventions for acute perforation or its sequelae and needed a reconstructive operation. Recommendations on the choice of adequate therapeutic tactics for each group are given. The method of examination of the patients and the peculiarities of surgical treatment are described in detail. The most frequently encountered complications and the produced results are analysed. It is concluded that patients with sequelae of esophageal perforation must be treated at specialized clinics experienced in the management of this severe condition.

[Results of conservative treatment of short burn-induced strictures of the esophagus]. / Rezul'taty konservativnogo lecheniia korotkikh ozhogovykh striktur pishchevoda.

The authors had 135 patients with short esophageal burn strictures, 120 of them were treated by bougienage. The immediate and late-term results of treatment of this category of patients were studied. A complex of methods for the examination of patients with short burn strictures of the esophagus was defined concretely. Bougienage along a string-guide under ++roentgeno-television control is the main method for the treatment of this category of patients, it produced good results in 83.3% of cases. The optimal bougienage methods and operative treatment of such patients were elaborated.

[Repeated anti-reflux operations]. / Povtornye antirefliuksnye operatsii.

The authors had under observation 73 patients who underwent various antireflux operations with poor results, 68 of them were subjected to repeated interventions, fundoplication in most cases. The causes of failure of primary and repeated antireflux operations are analysed, the indications for and the techniques of reconstructive interventions are discussed. It is emphasized that patients with hiatal hernia and reflux esophagitis must be concentrated in specialized medical institutions.