RESUMO
A comparative analysis of results of the pre- and postoperative investigations carried out in 232 patients with gastric ulcerations of different nature has shown a relatively low effectiveness of fibrogastroscopy with biopsy in the recognition of malignant ulcers. The sensitivity of this method was found to be (83 +/- 3)%. The results obtained show the necessity to widen the operative treatment of patients with ulcer disease of the stomach, patients with the so called relative indications included.
Assuntos
Gastroscopia , Lesões Pré-Cancerosas/patologia , Neoplasias Gástricas/patologia , Úlcera Gástrica/patologia , Estômago/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Feminino , Tecnologia de Fibra Óptica , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/cirurgia , Estudos Prospectivos , Reprodutibilidade dos Testes , Estômago/cirurgia , Neoplasias Gástricas/cirurgia , Úlcera Gástrica/cirurgiaRESUMO
A group of patients operated upon for ulcer disease of the stomach was selected from 1279 patients with this disease in which the nearest results of the surgical treatment were followed-up retrospectively. Seven patients died. The average period of postoperative treatment in the hospital was (17.7 +/- 1.5) days. Complications developed in 78 patients. A comparison of results of preoperative examinations with the conclusions of the morphologist according to data of studying the operative specimens has established low sensitivity of the current methods of diagnosing the cancerous nature of ulcers--as low as (72 +/- 5)%. The final diagnosis of a malignant ulcer was made in 81 patients, only in 58 of them the malignization was suspected before operation, in 23 patients the tumoral process was a "chance" finding. This fact speaks in favour of widening the indications for operative treatment of noncomplicated gastric ulcers.
Assuntos
Úlcera Gástrica/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Doença Crônica , Emergências , Endoscopia do Sistema Digestório , Feminino , Tecnologia de Fibra Óptica , Gastrectomia/métodos , Gastrectomia/estatística & dados numéricos , Mucosa Gástrica/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/diagnóstico , Úlcera Péptica Hemorrágica/cirurgia , Úlcera Péptica Perfurada/diagnóstico , Úlcera Péptica Perfurada/cirurgia , Úlcera Gástrica/complicações , Úlcera Gástrica/diagnósticoRESUMO
Based on an analysis of treatment of 734 patients, among them 301 patients with destructive cholecystitis, the authors consider that it is necessary to widen indications to conservative treatment in acute period. As a result, lethality after treatment of acute cholecystitis was reduced to 0.4%.
