[Results of dynamic observation of patients with polyps in the stomach].

This work is based on the analysis of data doing 409 patients with polyps in the stomach. Among them 200 men (48.9%) and 209 women (51.1%) aged 18 to 91 years. The average age of men was 67.4 years, and women 66.8 years. All these patients were find 1034 neoplasms of various sizes. At all of this patients polyps were identified on a background of chronic gastritis, as a rule, has the character of atrophic process. Histological research was conducted 775 (74.6%) polyps, of which focal hyperplasia and hyperplastic polyps detected in 49% of cases, and adenomas in 51% (including adenomas with varying degrees of dyspiasia, and prostatic adenocarcinoma cells). Endoscopic polypectomy performed 367 patients, and the remaining 42 was merely the dynamic monitoring of the identified entities. In 79 (28.8%) patients after polypectomy noted relapse formations and in 10 cases (3.65%) diagnosed with cancer in the intervention area. 4 (0.98%) patients from 409 cancer in polyps detected during the initial survey and in 4 patients the cancer originated in the not associated with polyps of stomach. As a result of the research of the dependence of the size of neoplasms on the nature of destruction and histological structure. For most existing polyps characteristic of the stability of their morphological structure and the absence of its transformation.

[Immediate, early and late results of endoscopic papillosphincterotomy]. / Neposredstvennye, blizhaisie i otdalennye rezul'taty éndoskopicheskoi papillosfinkterotomii.

Clinico-instrumental examination of 226 patients showed that there were no fatal outcomes directly after endoscopic papillosphincterotomy, the number of complications was approximately the same as after transduodenal operations on the major duodenal papilla but they took a much easier course. The high effectiveness of an endoscopic operation was confirmed in the immediate postoperative period (absence of biliary hypertension, jaundice, pancreatitis, cholangitis). In the late-term periods after EPST restenosis was rarely encountered (3.9%); duodeno-biliary reflux caused no serious disorders, while the functional activity of the sphincter Oddi which had been operated on was partly maintained in 84.2% of patients.

[Possibilities of laparoscopic decompression of the gallbladder in middle-aged and elderly patients with diseases of the biliary tract]. / Vozmozhnosti laparoskopicheskoi dekompressii zhelchnogo puzyria u bol'nykh pozhilogo i starcheskogo vozrasta s zabolevaniiami biliarnogo trakta.

It is established that laparoscopic cholecystostomy presents the most acceptable method of gall bladder decompression in acute cholecystitis patients of advanced age comprising a high-risk group for surgery. Cholecystostomy efficiency reaches 97.2%. In case the procedure is not feasible in acute cholecystitis patients with intrahepatic position of the gall bladder or perivesicular adhesions the preference should be given to transhepatic drainage of the gall bladder whose effectiveness is 88.5%. An expedient method of laparoscopic decompression of the biliary tracts in mechanical jaundice due to tumor obstruction of the terminal part of the common bile duct is the formation of an external biliary fistula and "continuous" direct drainage of the gall bladder warranting satisfactory results in 93.3 and 100% of cases, respectively. Patients with a 1.5-week history of mechanical jaundice are not recommended transhepatic drainage, in longer duration of the jaundice (more than 1 month) it becomes contraindicated.

[Combined endoscopic treatment of villous adenoma of the stomach and large intestine in middle-aged and elderly patients]. / Kombinirovannoe éndoskopicheskoe lechenie steliushchikhsia adenom zheludka i tolstoi kishki u bol'nykh pozhilogo i starcheskogo vozrasta.

Electroexcision combined with laser photocoagulation was performed in 12 patients with creeping neoplasms of the stomach and in 39 patients with the same condition of the large intestine. One-year follow-up studies showed that 2 patients with a malignant gastric tumour had recurrence 9 months after the combined treatment; I patient has recurrence in the same terms after similar treatment of creeping benign adenoma. Combined treatment proved to be more effective in 39 patients with large-intestinal tumour, including invasive cancer, with no recurrence during a year. It follows that the effectiveness of combined treatment was 94.2 per cent.