[Effectiveness of laparoscopic esophagocardiomyotomy combined with various modifications of fundoplication in the treatment of achalasia cardia]. / Sravnitel'naya otsenka effektivnosti laparoskopicheskoi ezofagokardiomiotomii v sochetanii s razlichnymi modifikatsiyami fundoplikatsii v lechenii akhalazii kardii.

OBJECTIVE: To analyze the results of laparoscopic esophagocardiomyotomy with original fundoplication and Dor fundoplication. MATERIAL AND METHODS: Laparoscopic esophagocardiomyotomy with fundoplication was performed in 196 patients with achalasia cardia. Patients with achalasia stage 2 comprised 48.5% (95/196), stage 3 - 51.5% (101/196). Two groups were distinguished depending on surgery: Dor fundoplication (group 1, n=53) and Allakhverdyan fundoplication (group 2, n=143). Statistical analysis of data was carried out. RESULTS: Surgery time in the first group was longer by 35 minutes (p=0.000), blood loss - by 30 ml (p=0.000), postoperative hospital-stay - by 3 days. Pulmonary complications occurred in 34% and 2% of patients, respectively (p=0.002). In the first group, reflux esophagitis in 3 months after surgery was found in 62% of patients, after 6 months - 72%, after a year - in 74% of patients. In the second group, these values were 24%, 8% and 3%, respectively. Dysphagia developed in 2% and 1% of cases, respectively (p=0.767). CONCLUSION: Dor fundoplication demonstrates unsatisfactory long-term results and should be currently considered as historical stage in surgical treatment of achalasia cardia.

[Laparoscopic transhiatal resection of the lower third of the esophagus for late recurrence of achalasia cardia after laparoscopic esophagocardiomyotomy: a 12-year follow-up]. / Rezektsiya nizhnei treti pishchevoda laparoskopicheskim transkhiatal'nym dostupom po povodu pozdnego retsidiva akhalazii kardii posle laparoskopicheskoi ezofagokardiomiotomii: 12 let nablyudeniya.

The choice of treatment for recurrence after esophagocardiomyotomy is individual. Repeated esophagocardiomyotomy is appropriate in patients without malignancy and significant deposition of food masses in distal esophagus followed by severe pulmonary complications. Esophagectomy is desirable in case of unadvisable or failed repeated esophagocardiomyotomy. The authors presents laparoscopic transhiatal resection of the lower third of the esophagus (2019) in a patient with recurrent achalasia of the cardia stage 3-4 and cicatricial peptic stricture of the lower third of the esophagus after previous laparoscopic esophagocardiomyotomy with fundoplication (2009). The immediate results of redo surgery and physical status of the patient after 3 years (12-year follow-up) are described.

[Koblenz algorithm for open abdomen management]. / «Koblentsskii algoritm¼ lecheniya bol'nykh s laparostomoi.

The issue of laparostomy treatment is still controversial, since there are insufficient evidence-based data. German military surgeons have developed and implemented the «Koblenz algorithm¼ of laparostomy treatment into everyday practice. The algorithm was developed at the Bundeswehr Central Hospital in Koblenz (Germany). Today, approximately 50% of German civilian hospitals use the «Koblenz algorithm¼. The database for laparostomy treatment was created on the basis of international platform European Registry of Abdominal wall Hernias (EuraHS) in May 2015. These data will be valuable for further multipla-center studies. This manuscript is devoted to analysis of clinical effectiveness of the «Koblenz algorithm¼ in the treatment of patients with laparostomy. Searching of Russian, English and German studies devoted to «Koblenz algorithm¼ in the treatment of patients with laparostomy was carried out in the eLIBRARY, Elektronische Zeitschriftenbibliothek, the Cochrane Library and the PubMed databases. The authors comprehensively described «Koblenz algorithm¼. Mortality in the group of VAC - therapy was 57% (31/54), in case of «Koblenz algorithm¼ - 33% (33/100). Between-group differences were significant (OR 0.36, 95% CI 0.18-0.72, p=0.003). However, an efficacy of «Koblenz algorithm¼ should be confirmed in further multiple-center studies including national evidence-based trials.

[Long-term results following mandibular resection in newborns with autogeneous rib graft for reconstruction of mandibular defects].

The authors report on the clinical course of two children, in whom benign tumors with destruction of the mandible were diagnosed at the age of 4 and 6 months respectively. Following mandibular continuity resection the lateral mandible was reconstructed with autogenous rib grafts. In both children craniofacial and mandibular growth was assessed during yearly clinical and radiological follow-up visits. A slight vertical overgrowth and transversal growth inhibition could be detected.

[Surgical treatment of osteomyelitis defects of long bones].

Results of treatment of 116 patients with gunshot osteomyelitis are analyzed. Positive and negative moments of different surgical methods (sequestrnecrectomy, Ilizarov's method, auto- and alloplasty) are discussed. Two-stage method of treatment of long bones gunshot osteomyelitis (with osteoplastic surgeries after elimination of inflammation and before severe scarring process into tissues) is developed.

[Restoration of limb long bone defects after gunshot osteomyelitis].

The authors analyze treatment results of 116 patients with gunshot osteomyelitis in conditions of military hospital. The positive and negative aspects of the surgical methods used were discussed. The operative treatment included sequestrnecrectomy, perosseous osteosynthesis by Ilizarov's method, auto- and alloplasty with demineralized bony implants. The method of two-stage treatment of long bone gunshot osteomyelitis with osteoplastic operations after relief of inflammatory process in the focus before development of rough scarring changes in the tissues was proposd.