[The significance of urgent laparoscopy and mathematical prognosis in diagnosis of patients with combined trauma (preliminary communication) ]. / Znachenie neotlozhnoi laparoskopii i matematicheskogo prognozirovaniia v komplekse diagnosticheskikh meropriiatii pri sochetannoi travme (predvaritel'noe soobshchenie).

Results of 376 laparoscopies for combined traumas performed during 3 years were analyzed. Characterization of the contingent of the patients and mechanisms of the traumas is given. The diagnosis was correct and exact in 100%, in 78.2% of the patients it was possible to find out the injured organ. The expedience to expand the indications to laparoscopy for combined traumas and to fulfill the operations in the shortest time after admission was stressed. A mathematical evaluation of the strategy of doctor's behavior was made for objectivization of the psychological solution of the doctor concerning the methods of treatment of patients with a combined trauma.

[External intestinal fistulae following gynecological operations and their treatment]. / Naruzhnye kishechnye svishchi posle ginekologicheskikh operatsii i ikh lechenie.

The authors share their experiences with treatment of 38 patients with external intestinal fistulas after operations on internal genitals. The patients were divided into three groups: patients with pyo-inflammatory diseases, patients with benign tumors and patients with malignant neoplasms. It is noted that preoperative diagnosis of involvement of the intestine in the process is rather difficult, instrumental methods of examination in patients with pyo-inflammatory diseases are poorly informative. In patients with malignant diseases of the uterus and uterine appendages the sigmoid colon should be examined in order to exclude the penetration of the tumor. Adhesive processes resulting from previous operations are considered to be a predisposing factor. Relaparotomies must be performed with the obligatory participation of the surgeon. Operation on the intestine should be performed before the intervention on the internal genitals. The unloading colostomy must be made in suturing the defect of the colon. The use of the method described allowed to save the life of 36 patients (lethality was 5.3%).

[The current problems of the surgical procedure in acute hemorrhages from gastroduodenal ulcers]. / Sovremennye problemy khirurgicheskoi taktiki pri ostrykh krovotecheniiakh iz gastroduodenal'nykh iazv.

The article presents results of treatment of bleeding gastroduodenal ulcers in 1010 patients for 23 years. The active temporizing policy during the first 8 years resulted in 8.1% lethality while the active methods gave 8.24% lethality in six times greater number of patients. In the active policy urgent and emergency operations were performed on 43.6% of the patients with postoperative lethality 12.9%. Lethality among non-operated patients was 4.6%. Using the active surgical methods allowed lethality to be substantially decreased in the group of non-operated patients. The postoperative lethality was stabilized due to a less amount of recurrent bleedings and of "operations of despair". Recommendations are given to restrict the indications for Billroth-2 gastric resections because of a great risk of incompetent stump of the duodenum. Wider using the organ-saving operations is recommended, especially in elderly patients and against the background of haemorrhagic shock. The growing amount of patients with ulcerous gastroduodenal bleedings (which has become 2.4 times greater for the recent 15 years) makes further investigations in this direction very actual.

[The choice of the type of vagotomy in the planned surgery of peptic ulcer]. / Vybor vida vagotomii v planovoi khirurgii iazvennoi bolezni.

An analysis of 175 organ preserving operations for duodenal ulcer is presented. Lethality was 1.24%; intraoperative complications--2.48%; postoperative complications--6.83%. Long-term results were followed in 61.5% of the patients. They are analyzed according to the kind of vagotomy and draining operations used. The author recommends to use drainage of the stomach more often, combined vagotomy should be chosen as the kind of vagotomy.

[Techniques of anastomoses in the gastrointestinal tract]. / O tekhnike anastomozov na zheludochno-kishechnom trakte.

The authors analysed 718 operative interventions in which gastrointestinal anastomoses were formed at various levels of the gastrointestinal tract. It was established that the more distal the anastomosis is, the greater the risk of its incompetence and a fatal outcome due to it are. The advantages of the "closed" method for forming the anastomosis in operations on the ileum and colon were revealed. A method for creating anastomoses by the closed technique with a single-row suture is suggested.

[Characteristics of the functional state of the gastroduodenal system in complicated duodenal ulcers]. / Osobennosti funktsiona'lnogo sostoianiia gastroduodena'lnoi sistemy pri oslozhnennykh duodena'lnykh iazvakh.

Results of the examination of 207 patients with duodenal ulcer are presented. General parameters of secretory activity of the gastric glands, acid-peptic aggression of glycoproteins of the gastric mucosa were studied. It was established that in the complicated course of ulcer there was a tendency to the increase of acid-peptic aggression and inhibition of glycoprotein mucosa products. The correlation of production of hydrochloric acid and pepsin, on the one side, and mucosa glycoproteins, on the other side, may be used for prognosis of the course of the disease.

[Analysis of the results of organ-preserving operations in duodenal ulcer]. / Analiz rezul'tatov organosokhraniaiushchikh operatsii pri duodenal'noi iazve.

An analysis of 185 vagotomies for chronic duodenal ulcers has been made. It has been established that the surgery was an adequate method in 92,1% of the patients. Lethal outcomes and complications were given a detailed consideration. A conclusion was made that for the improvement of results of organ-preserving operations of special significance was analysis of the course of the ulcer disease and the anatomical alterations. It facilitates solution of the question of expediency of vagotomy and correct selection of its variant.