ABSTRACT
The experience with 233 stomach resections in "difficult" ulcers is analyzed. The main cause of complications and lethality after these surgeries is duodenal stump sutures insufficiency seen in 17 (7.3%) patients, and in 10 (4.3%) patients it was the cause of death. Original duodenal stump cover was performed in 86 patients. There were no cases of suture insufficiency, two patients died of pneumonia and hepatic failure.
Subject(s)
Duodenum/surgery , Gastrectomy/methods , Postoperative Complications/epidemiology , Stomach Ulcer/surgery , Aged , Female , Humans , Liver Diseases/etiology , Liver Diseases/mortality , Male , Middle Aged , Pneumonia/etiology , Pneumonia/mortality , Postoperative Hemorrhage/mortality , Survival RateABSTRACT
An experience with treatment of iatrogenic and criminal traumas of the esophagus included 57 patients. There were 36 patients with iatrogenic traumas (perforation of the esophagus during diagnostic and curative manipulations and operations on the lungs and esophagus). Different kinds of operations were made depending on the localization of the injury. Three patients of this group died. Criminal traumas of the esophagus (wounds with cold steel) were treated in 21 patients, sutures on the esophagus were put in 19 of them, drainage--in 2 patients. All the patients recovered. Better results of treatment of the penetrating iatrogenic and criminal injuries of the esophagus can be achieved by timely diagnosis and operation using the proper volume and method.
Subject(s)
Esophageal Diseases/diagnosis , Esophageal Diseases/therapy , Esophagus/injuries , Forensic Medicine , Adolescent , Adult , Esophageal Diseases/etiology , Female , Humans , Male , Middle Aged , Violence , Wounds and Injuries/diagnosis , Wounds and Injuries/therapyABSTRACT
A differential approach to surgical interventions corresponding to the system of treatment of patients with gastrointestinal bleedings developed by the authors gave considerably less lethality in patients with bleedings caused by acute gastric and duodenal ulcers and by the Mallory-Weiss syndrome. General lethality among these patients was 3.3% and 5.1% correspondingly. This system was most effective at large specialized centers for treatment of patients with acute gastrointestinal bleedings. However many of its principles are easy for a great number of practical surgeons.
