[ARRHYTHMIAS IN PATIENTS OPERATED ON FOR HIATAL HERNIA].

The purpose of this publication is to identify the prevalence of arrhythmia as one of the manifestations of gastrocardial syndrome in patients with hernias of the esophageal orifice of the diaphragm and reflux esophagitis. To evaluate the results of antireflux surgery in the dynamics of arrhythmia regression. Materials and methods: the study included 101 patients with hiatal hernias who were undergoing inpatient examination and treatment. Arrhythmia was detected in 35 (34.6%) of 101 patients with hernias of the esophageal orifice of the diaphragm. Arrhythmias are characteristic of cardiofundal (40%), subtotal (66.6%) and total (100.0%) hernias of the esophageal orifice of the diaphragm, were recorded at a younger age, were dependent on the duration of the underlying disease. Clinical manifestations of arrhythmia depended on the degree of shortening of the esophagus, most often arrhythmias occurred with shortening of the esophagus of the II degree in cardiofundal hernias (68.7%), subtotal (60.0%) and total (100.0%). As a result of antireflux surgery, clinical manifestations of arrhythmia regressed in 19 (54.3%), in 26 (74.2%) patients, electrocardiogram and Holter monitoring indicators decreased or were absent altogether. In conclusion, it should be emphasized that arrhythmias on the background of hernia of the esophageal orifice of the diaphragm, associated with anatomotopographic and physiological features, are a frequent clinical situation characterized by the mutually aggravating effect of both diseases on each other. An instrumental study of the state of the cardiovascular system in the pathology of the upper gastrointestinal tract showed that there is an improvement in the indicators of cardiac arrhythmias associated with the underlying disease, the correction of which is possible only with surgical treatment of the underlying disease.

[Epiphrenic diverticulum of the lower third of the esophagus after previous antireflux surgery]. / Epifrenal'nyi divertikul nizhnei treti pishchevoda u patsientki posle provedennoi ranee antireflyuksnoi operatsii.

In this article is described a rare postoperative complication: epiphrenal diverticulum of the esophagus of the lower third of the esophagus in patient after antireflux surgery. Brief description of the main stages of surgical treatment. 96 patients with cardiofundal, subtotal or total hiatal hernias underwent operation. There were complications of I-II degree according to Clavien-Dindo in the early postoperative period in 11 patients (11.4%). Complications of IIIb degree were revealed in 2 patients (2.1%) in the early postoperative period and in 1 patient (1.0%) in the late postoperative period (2 months after hospitalization) - epiphrenal diverticulum of the esophagus. Laparotomy, the sagittal diafragmalnaya, diverticulectomy, valisesta pyloroplasty were performed. Postoperative period without complications. The patient's nutrition through the mouth is restored on the 5-th day. No dysphagia and reflux esophagitis were detected radiologically and endoscopically.

Lycurim (R-74) in the therapy of chronic lymphocytic leukaemia.

Lycurim was used in the therapy of 41 CLL patients, in 34 a positive clinical effect was found. The effect was marked in cases of CLL associated with autoimmune haemolytic anaemia. The immunodepressive property of Lycurim was confirmed by immunological investigation. It has been shown that the levels of IgG, IgA and IgM fall after Lycurim treatment of CLL patients. At the same time the T-lymphocyte count decreases and a tendency for EAC rosette-forming B-lymphocyte decrease is marked.