[Surgical correction of disorders of intestinal phases of gastric secretion in the treatment of peptic ulcer and its complications]. / Khirurgicheskaia korrektsiia narushenii kishechnoi fazy zheludochnoi sekretsii v lechenii iazvennoi bolezni i ee oslozhnenii.

Shown in the paper is a possibility of surgical correction of disturbances in the intestinal phase of gastric secretion in treating peptic ulcer and its complications which are encountered in an overwhelming majority of patients. Sympathectomy of relevant vascular trees is regarded as a pathogenetically validated procedure as is correction of duodenal motility combined with selective proximal vagotomy and excision of the ulcer. It is shown that truncal and selective vagotomy can aggravate the existing disorders of the intestinal phase of gastric secretion.

[Methodology of investigations on the intestinal phase of gastric secretion depending on the methods for surgical treatment]. / Metodika issledovaniia kishechnoi fazy zheludochnoi sekretsii v zavisimosti ot metodov operativnogo lecheniia.

The paper presents the methodology of conducting those investigations designed to study the intestinal phase of gastric secretion, with the duodenal pH having been taken as the integral index. An acetylcholine test has been developed suggesting to us a preservation of the inhibitory duodenogastral reflex. The study into the gastric secretion in 69 patients with complications of peptic ulcer showed that the intraduodenal pH was disturbed in 39.1 percent of the patients, which fact warrants medicamentous and surgical correction to be instituted in them.

[Influence of vagotomy on pancreatic blood flow in surgical treatment of gastroduodenal ulcer complicated by hemorrhage]. / Vliianie vagotomii na krovotok v podzheludochnoi zheleze pri khirurgicheskom lechenii krovotochashchei gastroduodenal'noi iazvy.

In 56 patients with bleeding duodenal ulcer the influence of truncal, selective and selective proximal vagotomy on pancreatic blood flow was studied, basing on the intraoperative rheopancreatography data. The advantages of selective proximal vagotomy in correction of the disorders revealed were proved.

[Mediastinal drainage in patients with purulent mediastinitis]. / Drenirovanie sredosteniia u bol'nykh s gnoinym mediastinitom.

The results of treatment of 51 patients with mediastinitis using mediastinal drain were summarized. Postoperative mortality was 15.7%.

[Individualization and optimization of surgical treatment of the splenic traumatic injuries]. / Indyvidualizatsiia ta optymizatsiia khirunhichnoho likuvannia travmatychnoho ushkodzennia selezinky.

The frequency of organ-preservation was raised up to 24%, the frequency of the purulent-inflammatory complications was lowered to 15.7% as well as mortality--to 11.7% during performance of operations on spleen due to application of the proposed individualized staged approach and new methods of hemostasis.

[The influence of sympathectomy of the superior mesenteric artery on the pancreatic blood flow]. / Vliianie simpatéktomii verkhnei bryzheechnoi arterii na krovotok v podzheludochnoi zheleze.

The results of performance of intraoperative rheopancreatography in 8 patients, operated on for an ulcer disease, were presented. The performance of selective proximal vagotomy and sympathectomy of a mesenterica superior had promoted the pancreatic blood flow improvement. It is substantiated in patients with secondary chronic pancreatitis, caused by the ulcer disease.

[Electron microscopy of lymphocytes in patients with acute paralytic ileus]. / Elektronno-mikroskopicheskoe issledovanie limfotsitov u bol'nykh s ostroi spaechnoi neprokhodimost'iu kishechnika.

Characteristic changes of the cells were revealed while examination of 36 patients with an acute adhesional impassability of small intestine and of 14 healthy persons using electron-microscopic method of the peripheral blood lymphocytes studying. The authors consider the observed dystrophic nuclear changes, the nuclear membrane structure and mitochondrial architecture disorders, partial lysis of plasmatic membrane to be the morphological substrate of the intracellular power and the lymphocytes immunoactivity changes.

[The evaluation of pancreatic blood flow in patients with gastroduodenal ulcer complicated by hemorrhage, according to rheopancreatography]. / Otsenka sostoianiia krovotoka v podzheludochnoi zheleze u bol'nykh s gastroduodenal'noi iazvoi, oslozhnennoi krovotecheniem, po dannym reopankreatografii.

The results of the pancreatic gland (PG) blood flow was studied up in 121 patients with hemorrhage of different severity using intraoperative rheopancreatography. Under the influence of hemorrhage in the PG the arterial blood flow is lowering, the arteriovenous shunting mechanisms are starting.

[The meaning of gastric secretion intestinal phase disorders in the pathogenesis of ulcers and their surgical correction]. / Znachenie narushenii kishechnoi fazy zheludochnoi sekretsii v patologeneze iazvennoi bolezni i ikh khirirgicheskaia korrektsiia.

The data concerning the disorder of the gastric secretion intestinal phase in patients with complicated forms of ulcer disease and with recurrent ulcer as well are presented. The mechanism was shown, which if noneliminated can cause nonfavourable result of the operation performed for the ulcer disease complications. The data presented trust the necessity of more meticulous studying of disorders of the gastric acidproducing intestinal phase in surgical gastroenterology.

[The optimization of treatment outcomes in patients with the Mallory-Weiss syndrome]. / K optimizatsii iskhodov lecheniia bol'nykh s sindromom Mallori--Veisa.

Examined in the study were results of conservative and surgical treatment of 202 patients presenting with Mallory-Weiss syndrome. Etiological factors of the syndrome were studied, investigations designed to study the regional bloodflow of the stomach in the zone of ruptures and intact areas, the motor and acid-producing functions of the stomach were conducted. Based on the conducted general clinical and special examination of patients with Mallory-Weiss syndrome the importance was proved of ischemic atrophic gastritis, discoordination of the motor and evacuatory function of the esophagus and duodenum in the genesis of the above syndrome, which disorders tend to be more manifest in sudden impacts of predisposing factors. In this connection, an etiopathogenetic approach has been developed towards treating patients such as mentioned above. Surgical treatment was being undertaken only when specifically indicated.

[Pancreatic blood flow function in patients with duodenal peptic ulcer]. / Sostoianie krovotoka podzheludochnoi zhelezy u bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

The condition was studied of bloodflow in 29 patients with duodenal ulcer, operated on because conservative therapy proved to be ineffective. In patients with uncomplicated duodenal ulcer, disorders of the pancreas bloodflow are at their greatest in the area of the head of the gland at the level of arterioles, with arteriolospasm phenomena being most noticeable. The secured data are to be taken account of in selection of therapeutic measures to be instituted in the patients.

[The meaning of duodenostasis in the intestinal phase gastric secretion disorders in bleeding duodenal ulcer]. / Znachenie duodenostaza v geneze narushenii kishechnoi fazy zheludochnoi sekretsii pri krovotochashchei iazve dvenadtsatiperstnoi kishki.

The data on the duodenal motor-evacuational function investigation in 62 patients with an ulcer bleeding are presented. It was established that the degree of duodenal chronic impassability is correlating with the degree of disorders of the gastric secretion intestinal phase. That's why it is necessary to stipulate the elimination of hyperchlorhydria in all phases of gastric secretion while such complication correction.

[Comparative evaluation of the course of peritonitis caused by anaerobic non-Clostridia and aerobic bacteria]. / Sravnitel'naia otsenka techeniia peritonita, obuslovlennogo anaérobnymi neklostridial'nymi i aérobnymi mikroorganizmami.

Comparative estimation of clinical course and postoperative complications was done in 134 patients, operated on for diffuse and generalized peritonitis, caused by anaerobic nonclostridial microorganisms in 74 (55.2%) of them and aerobic--in 60 (44.8%). More severe course and enhanced frequency of the peritonitis complications occurrence, caused by anaerobic microorganisms, was noted. The studying of characteristic peculiarities of peritonitis permits to perform purposeful antibacterial therapy even when bacteriological identification of initiating microorganism is impossible.

[Strategies and techniques in the correction of the enteral insufficiency in peritonitis and acute ileus]. / Taktika i tekhnika korrektsii énteral'noi nedostatochnosti pri peritonite i ostroi neprokhodimosti kishechnika.

The correction principles of enteral insufficiency, playing essential role in the infectional-toxical shock and polyorganic insufficiency occurrence were elaborated basing on the analyses of the surgical treatment of 257 patients with peritonitis and an acute ileus. Application of the proposed tactics of surgical aid for patients, including the original methods of the gut intubation, had permitted to lower the lethality from 30.2 to 18.5%, to improve the treatment results.

[The aspects of erosive-ulcerative changes of the gastroduodenal tract mucous membrane in atherosclerosis of the aorta and major arteries]. / Osobennosti érozivno-iazvennykh izmenenii slizistoi obolochki gastroduodenal'noi zony pri ateroskleroze aorty i magistral'nykh arterii.

Complex clinico-instrumental examination and surgical treatment of 172 patients with erosive-ulcerative changes of the gastroduodenal zone mucosa and atherosclerotic affection of aorta and main arteries was conducted. Functional peculiarities of erosive-ulcerative changes of the gastroduodenal zone mucosa in atherosclerosis of aorta and main arteries were revealed.

[Postoperative complications in patients with a perforated gastroduodenal ulcer]. / Posleoperatsionnye oslozhneniia u bol'nykh s perforativnoi gastroduodenal'noi iazvoi.

The results of treatment of 538 patients, operated on for perforative ulcer (PU), are studied up. Perforative aperture was sutured in 75 patients, in 153 the ulcer was excised, in 291 the excision was supplemented by vagotomy, resectional methods were applied in 19. In 94 (17.5%) of patients 114 complications have occurred after the operation. Postoperative complications were divided into those from the wound, in the abdominal cavity organs and retroperitoneal space, from the abdominal cavity, respiratory and cardiovascular system. After the operation 37 (6.9%) of patients have died. Complications and mortality were observed more frequently in the patients to whom the perforative aperture suturing and the ulcer excision with truncal or selective vagotomy were conducted in the presence of the increased operative risk (the elderly and senile age, concurrent diseases, widespread peritonitis). The least frequency of postoperative complications and mortality were noted after the PU and the ulcer substratum excision supplemented by selective proximal vagotomy.

[Significance of duodenal stasis in the etiology of recurrent hemorrhage in duodenal ulcer]. / Znachenie duodenostaza v vozniknovenii retsidiva krovotecheniia iz iazvy dvenadtsatiperstnoi kishki.

In 92 patients the influence of duodenostasis on possibility of occurrence of rehemorrhage from duodenal ulcer was studied. It was established that the heightened risk of rehemorrhage is promoted by disorders of motility, blood flow and acid production.

[The surgical risk factors in the use of laparoscopic cholecystectomy]. / Faktory khirurgicheskogo riska pri primenenii laparoskopicheskoi kholetsistéktomii.

The increased risk factors--gender, age of the patient, the cholelithic disease existence duration, the acuteness of inflammation, the operations performed earlier on the abdominal cavity organs, influencing the laparoscopic cholecystectomy conduction for Courvoisier's gallbladder--were analyzed. The increase of intraoperative complications occurrence (hemorrhage, perforation of gallbladder, the outhepatic biliary ducts) in patients of elder age with durable disease was noted.