ABSTRACT
Follow-up treatment results of 892 patients with duodenal ulcer (DU) are presented and the choice of surgical policy in its combination with chronic duodenal obstruction (CDO) in 307 (34.4%) patients is substantiated. Depending on peculiarities of DU, the kind and the stage of CDO, organ saving (140) or stomach resection (167) in combination with correction CDO interventions (287) were carried out. The course of the postoperative period was characterised by basic morphofunctional changes and by achievement of completeness of duodenal passage. Intermittent motor-evacuatory disorders were observed in 55 (17.9%) patients. Lethal outcome was in 1 case. Long-term functional results of the operations were studied in 267 patients. Excellent and good results were obtained in 66.3%, favorable-in 32.24% and unfavorable-in 1.44% of patients. The dependence of immediate and remote results of the operations on the effectiveness of the correction of associated CDO was established.
Subject(s)
Duodenal Obstruction/surgery , Duodenal Ulcer/surgery , Surgical Procedures, Operative , Adult , Aged , Chronic Disease , Decision Making , Duodenal Obstruction/complications , Duodenal Ulcer/complications , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications , Retrospective Studies , Surgical Procedures, Operative/adverse effects , Surgical Procedures, Operative/methods , Treatment OutcomeSubject(s)
Candida albicans/isolation & purification , Digestive System/microbiology , Enterobacteriaceae/isolation & purification , Gastrectomy , Peptic Ulcer/microbiology , Staphylococcus/isolation & purification , Streptococcus/isolation & purification , Vagotomy , Anti-Bacterial Agents/administration & dosage , Candida albicans/drug effects , Digestive System/drug effects , Enterobacteriaceae/drug effects , Humans , Peptic Ulcer/surgery , Postoperative Care , Staphylococcus/drug effects , Streptococcus/drug effectsABSTRACT
The hormonal status of the endocrine glands (the hypophysis, thyroid, adrenals, pancreas, gastrin-producing cells of the stomach, gonads), was evaluated in patients with gastroduodenal ulcer operated (gastric resection, vagotomy) 6, 12 or 36 months before. Hormonal balance was found affected, the gonads underwent gross changes responsible for gonadal depletion in the long-term postoperative period. Recommendations for relevant correction are provided.
Subject(s)
Hormones/metabolism , Peptic Ulcer/physiopathology , Adolescent , Adrenal Cortex Hormones/metabolism , Adult , Follow-Up Studies , Gonadal Steroid Hormones/metabolism , Humans , Male , Peptic Ulcer/surgery , Pituitary Hormones/metabolism , Thyroid Hormones/metabolism , Time FactorsABSTRACT
The results of treatment of 317 patients with concurrent burn of the esophagus and stomach are generalized. Various restorative operations were carried out in 214 of them. The pyloroplasty-type plasty with local tissues was performed in short strictures of the pylorus, cardioesophageal junction, duodenum, and the initial portion of the small intestine. Resection of the stomach after Billroth I was conducted in cicatricial affection of the distal part of the stomach. The Billroth II operation or gastroenterostomy is indicated in subtotal burn and combined cicatricial stenosis of the stomach and duodenum. Enterostomy with subsequent restorative operation is indicated in total burn of the stomach. Preoperative management with consideration for the operative risk, elaboration of a rational therapeutic tactics and improvement of operative techniques with the use of laser and microsurgical techniques facilitated a decrease in the number of complications and in the mortality rate.
Subject(s)
Burns/surgery , Cardia/injuries , Esophagus/injuries , Gastrectomy/methods , Gastroenterostomy/methods , Pylorus/injuries , Burns/complications , Cardia/surgery , Esophageal Stenosis/etiology , Esophageal Stenosis/surgery , Esophagus/surgery , Humans , Pyloric Stenosis/etiology , Pyloric Stenosis/surgery , Pylorus/surgeryABSTRACT
The article generalizes the experience in the treatment of 317 patients with burns of the esophagus and stomach, 140 of them underwent restorative operations on the esophagus. The indications for the choice of the restorative operations are determined by the character of the burn and the condition of the patient's organism before the accident. Retrosternal plastics of the esophagus with the colon is the operation of choice in this group of patients. The elaboration of rational therapeutic tactics, improvement of preoperative management, and the introduction of effective methods of treatment into practice with the use of microsurgical and laser techniques improved considerably the results of restorative operations on the esophagus in patients with combined burn pathology.
Subject(s)
Burns, Chemical/complications , Cardia/injuries , Esophageal Stenosis/surgery , Esophagoplasty/methods , Esophagus/injuries , Cardia/surgery , Colon/transplantation , Esophageal Stenosis/chemically induced , Esophagus/surgery , HumansABSTRACT
High efficiency and safety of bougieurage of the oesophagus with a metallic cord is shown. Conservative treatment of the postburn narrowing of the oesophagus associated with preventive bougieurage proved to be highly effective in patients admitted to the hospital with an early stage of the disease. There were no lethal outcomes. The continuous purposeful complex treatment of patients with cicatrical narrowing of the oesophagus is recommended during 1,5-2 years after burn.
