[Clinical-economic analysis of antibacterial therapy of acute peritonitis].

Clinic-economic analysis of antibacterial therapy of an acute peritonitis was conducted, using the method of modeling with "the tree of expanses" building. Economic advantages of ertapenem application as a start therapy of an acute peritonitis were proved.

[Original clinical classification of a complicated diabetic foot syndrome].

Original clinical classification of a complicated diabetic foot syndrome (DFS), based on summarizing of experience, concerning surgical treatment of 1532 patients, suffering complicated DFS, was proposed, necessitating determination of clinical form (symbol C), anatomic localization (symbol Z) and etiological factor (symbol E) of the lower extremity tissues affection. The classification applied permits to choose a surgical tactics depending on presence of specific complication of DFS, and this creates conditions for unification and universal registration of form and severity of a complicated DFS, as well as the volume of a surgical aid

[Postoperative complications and mortality in peptic ulcer of the duodenum and stomach]. / Posleoperatsionnye oslozhneniia i letal'nost' pri iazvennoi bolezni dvenadtsatiperstnoi kishki i zheludka.

During 19 years (from 1974 to 1992) 5205 operations for complicated ulcer disease of duodenum (4201 observation), stomach (915) and of double localization (89) were conducted. In 585 of 5205 patients complications occurred: of operative wound healing-in 17.4%, in the region of intervention--in 56%, dysfunction of other organs and systems--in 26.6%, 44 (0.84%) of them died. The mortality after conduction of stomach resection according to Bilroth-I was 0.8%, according to Bilroth-II--5.5%, after vagotomy--1%.

[Tumors of the duodenum (excluding the major duodenal papilla)]. / Opukholi dvenadtsatiperstnoi kishki (krome bol'shogo sosochka dvenadtsatisperstnoi kishki).

Of the 2704 patients operated on for duodenal ulcer disease within the 10-year period, a benign tumour of the duodenum was revealed in 8 (polyp--in 6, myoma--in 1, fibroma--in 1), and a malignant one--in 3. Endoscopic polypectomy was performed in 6 patients. For malignant tumours, pancreaticoduodenal resection was performed in 1 patient, resection of 2/3 of the stomach with removal of the suprapapillary duodenal portion--in 1, resection of the distal duodenum--in 1. The result of operation is good.

[Simultaneous operations in the elective surgery of abdominal viscera]. / Simultannye operatsii v planovoi khirurgii organov briushnoi polosti.

Within 8 years, 3903 patients underwent surgical treatment. Of them, 2426--for gastric and duodenal ulcer disease, 1433--for diseases of the gallbladder and bile ducts, 21--for diseases of the operated stomach etc. Simultaneous operations were performed in 262 patients. The incidence of postoperative complications and lethality after simultaneous operations is not higher than after the common ones. The advantages of combined interventions are shown.

[The diagnosis and treatment of postvagotomy disorders]. / Diagnostika i lechenie postvagotomicheskikh narushenii.

From experience with various types of vagotomy in 3,102 patients and study of the late-term results, it was established that recurrent ulcer developed in 4.7%, dysphagia in 2.9%, incompetence of the esophagogastric junction in 9.7%, reflux esophagitis in 3.8%, dyskinesia of the duodenum in 2.6%, duodenostasis in 5.3%, the dumping syndrome in 5.4%, diarrhea in 6.1%, and hiatal hernia in 0.3% of cases. The surgical correction of disorders after vagotomy is marked by specific techniques which must be borne in mind to improve treatment.

[The principles of the surgical treatment of peptic ulcer of the anastomosis and jejunum]. / Printsipy khirurgicheskogo lecheniia pepticheskoi iazvy anastomoza i toshchei kishki.

The authors disposing of a great number of observations of patients operated upon for peptic ulcer of the anastomosis (570), give an account of main principles of performing surgical procedures. They are: the detection and elimination of the causes of the anastomosis ulcer, wider use of truncal vagotomy, and for gastro-intestino-colonic fistula a less traumatic intervention should be chosen--the disconnection of the fistula and suturing the colon. The ways of reduction of postoperative lethality of the patients with this severe disease are shown.

[Tactical and technical principles of the surgical treatment of stomach ulcer]. / Takticheskie i tekhnicheskie printsipy khirurgicheskogo lecheniia iazvennoi bolezni zheludka.

On the basis of surgical treatment of 3230 patients with the ulcer disease, of them 582 operated on for an ulcer localized in the stomach, the authors have formulated the indications for the performance of operation in these patients, substantiated the principles of choice of its method. The use of different types of operative interventions permitted to establish that in 98.5% of the patients, it was technically possible to preserve passage through the duodenum in comparatively low lethality (0.86%). A new method for formation of gastroduodenal anastomosis is described. The long-term results of the use of selective proximal vagotomy in gastric ulcer are studied.

[Immediate results of gastric resection by Billroth I and Billroth II in peptic ulcer]. / Blizhaishie rezul'taty rezektsii zheludka po sposobu Bil'rot-I i Bil'rot-II pri iazvennoi bolezni.

An analysis of treatment of 1304 patients has shown the best immediate results to be after resection and re-resection of the stomach after Billroth-I as compared with Billroth-II: they had less amount of postoperative complications and lower lethality and maintained the passage of food through the duodenum.