[Remote results of the treatment of patients for Barrett's esophagus].

Prospective analysis of the results of clinic-laboratory investigations in patients, treated for Barrett's esophagus (BE) in 2000 - 2006 yrs, was conducted. In some of the patients BE was diagnosed together with other complications of gastroesophageal reflux disease. Statistical analysis of remote results concerning the patients surgical and conservative treatment, using mathematic method, according to the rule 3s and 3s(1), was performed. Higher efficacy of surgical method was established concerning the treatment of hiatal hernia, shortened esophagus, reflux-esophagitis, gastroesophageal and duodenogastric refluxes, duodenal ulcer and esophageal epithelium dysplasia.

[Diagnosis and treatment of primary peptic stricture of the esophagus].

Results of treatment of 271 patients, suffering primary peptic stricture of the esophagus (PPSE), were analyzed. Application of antireflux operation on esophagogastic junction with forceful esophageal bougienage had permitted to achieve recovery in majority of them. Esophageal resection is indicated in PPSE, which do not submit instrumental dilatation and in presence of high-grade dysplasia, situated within the organ segments, affected by metaplasia.

[Surgical treatment of patients suffering esophageal cancer and stomach cancer spreading to the esophagus using abdominocervical access].

Radical operative interventions using abdominocervical access were performed in 145 patients for esophageal and gastroesophageal cancer. Of them in 99 (68.3%) patients isoperistaltic esophagoplasty was performed: in 54 (54.5%)--using isoperistaltic tube, formatted from gastric big curvature, in 23 (23.2%)--portion of jejunum, in 18 (18.2%)--portion of colon and in 4 (4.1%)--ileocecal angle. Retrosternal way of transplant transposition toward the neck was choused in 86 (86.9%) patients, via the resected esophagus bed--in 10 (10.1%) and subcutaneous one, presternal--in 3 (3%). Postoperative mortality had constituted 10.3%. For locally advanced cancer, affecting thoracic esophagus or gastroesophageal one the performance of subtotal-total esophageal resection is indicated. Application of abdominocervical access owes essential advantages for the patient and surgeon, comparing with lateral thoracotomy, because it secures less traumatic, adequately wide and visually controlled approach to mediastinal structures in esophageal cancer, and is characterized by oncological loyalty and surgical utility.

[Diagnosis and treatment of esophageal leyomyoma].

Radical operations for benign esophageal leyomyoma were performed in 50 patients in 1976-2006 in the clinic. Highly informative roentgenologic, endoscopic and ultrasonographic (including intraesophageal) methods were applied in the disease diagnosis, permitting to establish the diagnosis, as a rule, accurately before the operation. The diagnosis was verified definitely, basing on intraoperative revision data and the results of express-histologic investigation of the tumor excised. Extramucosal enucleation of benign leyomyoma with plastic closure of esophageal muscle defect or its suturing was done in 33 (66%) patients. Subtotal esophageal resection was performed in 11 (22%) patients, reconstructive operations--in 10 (20%), including in 5 (10%)--retrosternal esophagocolonoplasty, in 2 (4%)--intrathoracic esophagogastroplasty and in 1 (2%)--retrosternal esophagojejunoplasty. In 2 (4%) patients with small benign leyomyoma the esophageal wall portion resection was performed using suturing apparatus and in 1 (2%)--gastrostomy. Postoperative mortality had constituted 2%. Results of treatment were studied in 46 (92%) patients in 1-18 yrs, 4.8 at average. There were no recurrences. The result was estimated as good in 39 (78%) patients and fair--in 7 (14%).