[The radical surgical treatment of gastric cancer, complicated with gastric bleeding].

Data of the frequency of profuse gastric bleeding occurrence as the complication of gastric cancer are presented. Considering that endoscopic hemostatic procedures are ineffective in cancer bleedings, urgent radical surgery is indicated. Results of treatment of 10 patients with acute gastric tumor bleeding are analyzed. Authors emphasize that local invasion should not be the contraindication for the radical tumor resection.

[The choice of esophagoenteroanastomosis after gastrectomy].

The two years (2004--2006) experience of gastric cancer surgical treatment is analized and summarized. 137 had gastrectomy, 73 patients had a combined operation because of the extent of the disease. Overall morbidity rate was 19.7%, leathality--4,4%. Though, lethality in the group of radically operated patients was 0,9%, whereas for those, who could have only palliative surgery, it totaled 25%. It is established, that performing a Gilyarovitch esophagoenteroanastomosis allows to avoid its failure. Gastrectomy with a phrenic segment esophagus resection is not a contraindication for the Gilyarovitch esophagoenteroanastomosis. The method of small intestine mesentery extension is described. It allows to perform a loop anastomosis at the level of phrenic and retropericardial esophageal segments. Indications for Roux esophagoenteroanastomosis are worked out.

[Subtotal distal resection of the stomach in cancer: indications and immediate results]. / Subtotal'naia distal'naia rezektsiia zheludka pri rake -- pokazaniia i neposredstvennye rezul'taty.

Results of 193 subtotal distal resections of the stomach due to cancer are analyzed. Age of the patients ranged from 25 to 87 years (mean age 57+/-11 years). Reconstruction by Bilrot-I technique was performed most often (67% cases). When Bilrot-II technique was used, classical Gofmeister-Finsterer variant and method on "ultrashort" loop with transverse anastomosis were performed. Extended lymphadenectomy (LAE) was performed in the majority of patients -- 131 (68%) including in D2 volume -- 111 (58%), in D3 - 20 (10%). Combined surgeries were carried out in 23 (12%) patients. The following intraoperative complications were seen: trauma of the spleen (2 patients, splenectomy was performed) and an injury of the portal vein during removing of the lymph nodes of 8b group (1 patient, wound of the vein was sutured). Postoperative complications were seen in 37 (19,2%) patients. There was one case of insufficiency of gastric anastomosis due to surgical mistake. Two patients died (1 after stomach resection with LAE in D1 and 1 -- after one in D3), lethality was 1%. Mesenterial thrombosis and perforation of acute ulcer of the gastric stump were the causes of death. It is demonstrated that LAE in D2 scope doesn't influence immediate results of distal resection of the stomach in cancer. LAE in D3 scope compared with D2 is associated with increased number of complications.

[Immediate results of surgical treatment of stomach cancer]. / Neposredstvennye rezul'taty khirurgicheskogo lecheniia raka zheludka.

Results of surgical treatment of 346 patients with cancer of the stomach are presented. All the patients underwent extended D2 and D3 lymphadenectomy. Up-to-date aspects of surgical treatment of stomach cancer, including intraoperative staging of cancer, spectrum of surgeries, their technical features, postoperative complications, lethality are outlined. Extended lymphadenectomy increases insignificantly time of surgery, rate of postoperative complications, postoperative lethality compared with standard surgeries in cancer of the stomach.

[Increased rate of sodium-proton metabolism in erythrocytes of patients with occlusive thrombosis]. / Uvelichennaia skorost' natrii-protonnogo obmena v éritrotsitakh bol'nykh okkliuzivnymi trombozami.

The authors studied the kinetics of the yield of protons from erythrocytes with preliminary acidified cytoplasma in the presence of the inhibitor of anionic transport. It was observed that in patients with occlusive venous thromboses the yield of H+ increased 4 times in comparison to the control group.