[Surgical treatment of patients with gastrointestinal stromal tumor of the stomach]. / Operativnoe lechenie bol'nykh s gastrointestinal'noi stromal'noi opukhol'yu zheludka (s kommentariem).

AIM: to evaluate objectively the effectiveness of currently used diagnostic and curative approaches to gastrointestinal stromal tumors (GIST). MATERIAL AND METHODS: Early and remote results of treatment of 49 patients with gastric GISTs were presented. Herewith in 20 (40.8%) patients the disease was complicated by gastrointestinal bleeding. 43 (87.7%) of 49 patients with gastric GIST were operated. Conventional surgery was performed in 24 (55.8%) cases, laparoscopic interventions - in 12 (28%) cases, endoscopic endoluminal - in 7 (16.2%). 6 (14.2%) patients were not operated. RESULTS: Intraoperative complications were observed in 2 (4.65%) patients. In postoperative period complications occurred also in 2 (4.65%) patients. In long-term postoperative period tumoral process progression was observed in 3 (8.3%) patients. Recurrence was diagnosed in 2 (5.6%) patients.

[Combination of endoscopic methods in diagnostics and surgical treatment of perforative duodenal ulcer].

AIM: To present the results of perforative duodenal ulcer surgical management using combination of endoscopic methods. MATERIAL AND METHODS: The study included 279 patients with perforative duodenal ulcer who were operated for the period from 1996 to 2012. Diagnostics and medical tactics were based on developed in our clinic algorithm that includes use of both esophagogastroduodenoscopy and laparoscopy. CONCLUSION: Presented technique confirmed correct diagnosis, defined medical tactics and choice of surgery in 100% of cases. 67 patients had contraindications for laparoscopic suturing and underwent conventional operations. Herewith postoperative complications and death were observed in 25 (37.3%) and 9 (13.4%) patients respectively. Laparoscopic suturing was performed in 212 patients. Complications were diagnosed in 19 (8.9%) cases including 8 (3.7%) intraoperative and 11 (5.2%) postoperative. Deaths were absent.

[Endoscopic treatment of bleeding due to Mallory-Weiss syndrome]. / Endoskopicheskoe lechenie krovotechenii, obuslovlennykh sindromom Mellori-Veissa.

Experience in diagnosis and treatment of 276 patients with Mallory--Weiss syndrome (MWS) is presented. Definition of the syndrome and brief historical review (from first description of disruption of esophageal-gastric connection to first report of successful hemostasis through endoscope) are given. Particular attention is devoted to etiology and pathogenesis of this syndrome. Clinical material and picture of disease, results of endoscopic diagnosis are analyzed, efficacy of endoscopic hemostasis and prophylaxis of hemorrhage is demonstrated. Indications to various methods of endoscopic hemostasis are regarded, results of treatment and lethal outcomes are analyzed. It is demonstrated that endoscopic procedures are the method of choice in the treatment of this disease reducing emergency surgery rate to 0.4%.

[Surgical treatment of ulcerous pyloroduodenal stenosis]. / Khirurgicheskoe lechenie iazvennogo piloroduodenal'nogo stenoza.

From 1990 to 2001 531 patients underwent surgery for ulcerous pyloroduodenal stenosis, from 1990 to 1995 312 operations were performed with lethality 0.9%, from 1996 to 2001--312 surgeries with one lethal outcome (0.4%). Surgical policy is based on a differential approach to choice of surgical method with consideration of stage of stenosis and level of gastric secretion, and also surgical risk. Organ-saving operations including laparoscopic vagotomy were performed in forming and compensated stenosis. At late stages (sub- and decompensated stenosis) resections (chiefly with vagotomy) were performed. In long-term period excellent and good results were achieved in 91.4% patients.

[Surgical treatment of perforated and bleeding gastroduodenal ulcers]. / Khirurgicheskoe lechenie probodnykh i krovotochashchikh gastroduodenal'nykh iazv.

Twelve-year experience of surgical treatment of gastroduodenal ulcers complicated by perforation and bleeding is analyzed. Modern antisecretion and antihelicobacter drugs have changed conception of pathogenesis and treatment of ulcers. Choice of surgical method is the key moment of surgical policy. Perforation and bleeding in ulcer disease are life-threatening complications especially in elderly patients with concomitant diseases. In these patients technical simplicity and tolerance to surgery are very important.

[Results of pre- and postoperative treatment of complicated duodenal ulcers with proton pump inhibitors ]. / Rezul'taty lecheniia ingibitorami protonnoi pompy oslozhnennykh duodenal'nykh iazv do i posle operativnykh vmeshatel'stv.

Benefit of monotherapy of duodenal ulcers by lanzap in 36 patients was compared to that of combined therapy including panitidin in 26 patients. Lanzap brought about ulcer healing within 7-10 days in 55.6%, within 14-16 days ulcer scarring was observed in 35 patients (97.2%). Ulcer healing progressed depending on ulcer size. Combined treatment with ranitidine promoted ulcer scarring in 14-16 days in 73% patients. Lanzap monotherapy in preoperative period promoted fast healing of ulcer defect anf provided optimal conditions for surgery.

[Treatment of gastroduodenal ulcer hemorrhages]. / Lechenie iazvennykh gastroduodenal'nykh krovotechenii.

The results of treatment of 901 patients with acute ulcerogenic gastroduodenal bleedings in 1986 to 1997 are analysed. The tactics of the treatment, developed in the clinic, combines active diagnostic and curative measures with differentiated determination of the indications for urgent operative treatment. Improvements of the method for urgent operative treatment, wide implementation of the organ-saving and mini-invasive surgical procedures, usage of new methods for nonoperative (endoscopical) hemostasis, as well as an improvement of the complex for intensive and anti-ulcerogenic therapy enabled in the last group of patients (1994-1997 years) to decrease the postoperative lethality up to 5.9%, and general lethality--to 6.4%.