[Postoperative reflux in treatment of complicated forms of duodenal ulcer disease].

There were examined 46 patients, in whom operative treatment of perforative duodenal ulcer was conducted. Organ-preserving operations were performed in conjunction with selective proxymal or truncal vagotomy. In far-remote terms after the operation in 12 patients gastrooesophageal reflux have occurred, DeMeester index have constituted 17.5-38.5. Impact of operative trauma on antireflux power of gastro-oesophageal junction was noted.

[Electrocardiotherapy using pericardoscopy].

The standard transvenous electrocardiostimulation (ECS) is currently used in many specialized hospitals. The authors offered and launched systematic application of simple but available technique of epymiocardiac ECS using pericardoscopy since middle of 80th. According to this principle, the authors developed some diversities of manipulation which are distinctive due to their availability, reliability and supersafety. The method could be recommended for wide-spread usage in practice because of high efficacy, few complications and absence of fatal outcomes in correct intervention. Described methods used in treatment of considerable quantity of patients and adapted to real work conditions of public health hospitals.

[Combined reconstructive hernioplasty for small and middle-size hernia of the abdominal wall].

The results of prosthetic hernioplasty, performed in 61 patients for a small- and middle-size abdominal wall hernia (AWH) were analyzed. In a control group in 18 (29.5%) patients the IPOM-procedure was applied and in the main group in 43 (70.5%)--the combined plasty. Complications, which have had occurred in 2 (11.1%) patients of a control group and in 4 (9.3%)--of the main, were cured using conservative methods. While five-year followup the AWH recurrence was not noted. The introduction of the elaborated tactic of treatment, named the combined reconstructive hernioplasty, have permitted to improve the late functional and cosmetic results due to restoration of abdominal linea alba integrity.

[Antihelicobacteric therapy for the patients with recurrent complicated postoperative gastroduodenal ulcer: indications, principles of conduction, efficacy].

After performance of organ preserving operations the cytotoxic stamms of H. pylori were revealed in 47 (94%) patients with recurrent ulcer. after gastric resection--in 27 (58.6%). The conduction of antihelicobacteric therapy is indicated to all the patients, in whom recurrent ulcer had occurred after organ preserving operations performance, its indication after gastric resection performance must be individual, after the patient examination succession. Application of a combined preparation, consisting of 20 mg of omeprazol, 500 mg of clarithromycin, 1000 mg amoxicillin, in a standard dosage of 3 tablets twice a day during 7 days have permitted to achieve the H. pylori cytotoxic stamms eradication in 94.2% of the patients. The preparation is well endured by the patients, the adverse reactions are minimal, temporary, their occurrence does not necessitate the preparation abolition.

[Treatment of trophic ulcers using the method of constant vacuum extraction]. / Lechenie troficheskikh iazv s primeneniem metoda postoiannoi vakuumékstraktsii.

The results of application of constant vacuum extraction, a new method of the lower extremities trophic ulcers treatment, are adduced. There was shown the method efficacy in the treatment of the varicose disease complications, there were noted the reduction of the wound healing terms in comparison with such using conventional methods of treatment, the advantages and peculiarities of the method as well.

[Regional blood flow in stomach in duodenal ulcer disease complicated by under-compensated or decompensated gastric exit stenosis]. / Regional'nyi krovotok v zheludke pri iazvennoi bolezni dvenadtsatiperstnoi kishki, oslozhnennoi subkompensirovannym ili dekompensirovannym stenozom vykhoda iz zheludka.

The state of the gastric mucosa regional blood flow and microcirculation in 148 patients with duodenal ulcer disease, complicated by sub-compensated or decompensated stenosis of gastric outlet, was studied. The lowering of indexes in various parts of stomach, along curvature minor especially, was revealed. These date substantiate the necessity of application of the organ-preserving operation with the ulcer excision and the dilating pyloroduodenoplasty performance in late stage of stenosis. If is recommended application of preparations, promoting normalization of the blood rheologic properties and mucosal microcirculation, for prophylaxis and the regional blood flow restoration in the early postoperative period.

[Surgical treatment of thoracic esophageal obstruction of neoplastic genesis]. / Khirurgicheskoe lechenie neprokhodimosti grudnoi chasti pishchevoda opukholevogo geneza.

The results of operative treatment of 126 patients with esophageal cancer, localized on different level, were analysed. In 73 of them the thoracic esophagus affection was revealed. Radical operations were performed in 46 and the palliative--in 27 patients. As a rule, one-staged esophagoplasty was done, using stomach and colon. The original method of the gastric transplant lengthening was proposed, permitting to perform one-staged retrosternal esophagoplasty with construction of cervical esophagogastroanastomosis. Complications have occurred in 6 patients.

[A method for determining the tonus of the stomach wall in patients with duodenal peptic ulcer complicated by organic pyloroduodenal stenosis]. / Sposob opredeleniia tonusa stenki zheludka u patsientov s iazvennoi bolezn'iu dvenadtsatiperstnoi kishki, oslozhnennoi organicheskim piloroduodenal'nym stenozom.

Method of gastric wall tone determination before the operation in patients with gastroduodenal ulcer disease, complicated by pyloroduodenal stenosis (PDS) was elaborated. There were examined 86 patients with sub- and 62 with decompensated PDS using method of electrogastrography and of the intragastric pressure registration--using method of the opened catheter. Three degrees of the gastric motor function disorder were delineated. Tactics of treatment of such patients was elaborated.

[Aspects of excision of the perforative duodenal ulcer complicated by penetration and stenosis]. / Osobennosti issecheniia perforativenoi iazvy dvenadtsatiperstnoi kishki, oslozhnivsheisia penetratsiei i stenozom.

The results of treatment of 259 patients with perforative duodenal ulcer, complicated by penetration and stenosis, were analysed. The original methods of ulcer excision are proposed. Excellent and good late follow-up result was noted in 159 (84.6%) patients, fair--in 15 (8.2%), bad (ulcer recurrence)--in 8 (4.4%).

[Translocated gastroduodenal anastomosis in surgical treatment of penetrating duodenal ulcer]. / Peremeshchennyi gastroduodenoanastomoz v khirurgicheskom lechenii penetriruiushchei iazvy dvenadtsatiperstnoi kishki.

The method of operative treatment of complicated duodenal ulcer disease consisting gastroduodenostomy, translocated by 3-4 cm medially and lower from the ulcer crater and strengthened by a spur on a small curvature side.

[The comprehensive prevention of suppurative wound infection in the postoperative period in diabetic patients]. / Kompleksnaia profilaktika gnoinoi infektsii ran v posleoperatsionnom periode u bol'nykh sakharnym diabetom.

The strict acceptance of the radicalism principles while the purulent inflammation origin eliminate, an accurate sanation and early placement of suture on the operation wound, its adequate and active drainage in combination with expedient local with the help of foamy aerosol "Dioxizol" and stable compensation of hyperglycemia, correction of the homeostasis disorders are necessary in the treatment of diabetes mellitus patients with local purulent-necrotic disease of the soft tissues.

[Analysis of the outcome in surgical treatment of cancer of the organs of the pancreatoduodenal region]. / Analiz rezul'tatov khirurgicheskogo lecheniia raka organov pankreatoduodenal'noi zony.

The surgical treatment results of the hepatopancreatoduodenal zone cancer in the clinic from 1987 till 1992 are adduced. Of 91 operated patients in 31 of them the radical or conditionally radical operations were done. The modifications of their own of conventional methods were applied. Further improvement of the diagnosis methods is needed as well as the search of possibilities to augment the frequency of the radical operations accomplishment.

[Use of different methods of quantum hemotherapy in the treatment of suppurative wounds in middle-aged and aged patients]. / Primenenie razlichnykh metodov kvantovoi gemoterapii dlia lecheniia gnoinykh ran u patsientov pozhilogo i starcheskogo vozrasta.

The experience with the use of the different methods of quantum hemotherapy in the treatment of elderly and senile patients with purulent-inflammatory diseases of the soft tissues has been summarized. Comparative characteristic of their effectiveness is presented. The authors consider the most expedient the use of intravascular quantum hemotherapy and combined methods.

[The immune protection of the gastroduodenal area after the surgical treatment of duodenal peptic ulcer]. / Immunnaia zashchita gastroduodenal'noi zony posle khirurgicheskogo lecheniia iazvennoi bolezni dvenadtsatiperstnoi kishki.

The complex study of the indices of local immune and natural resistance in the parietal mucus of the gastroduodenal zone and general immunity in 174 patients with duodenal ulcer disease before and after surgical treatment was performed. Pronounced suppression of local immunity, presence of autoimmune processes having influence on its indices were noted. After the organ-preserving operations with an ulcer excision, the immune indices restored more rapidly than after gastric resection and vagotomy without an ulcer excision.

[Combined selective proximal vagotomy in the surgical treatment of duodenal ulcer]. / Kombinirovannaia selektivnaia proksimalnaia vagotomiia v khirurgicheskom lechenii iazvennoi bolezni dvenadtsatiperstnoi kishki.

Preservation of adequate blood supply to a gastric wall and resistance of mucosa of the gastroduodenal region with simultaneous full-value parasympathetic denervation of its acid-producing zone in performance of selective proximal vagotomy contributes to decrease in incidence and pronouncement of ischemic disorders in motor-evacuatory function of the stomach at the early postoperative period, effective and stable reduction in acid production, shortening of duration of the postoperative treatment and rehabilitation of the patients, prophylaxis of ulcer recurrences.