[The determination of the level of resection of the esophagus taking into account its blood supply]. / Opredelenie urovnia rezektsii pishchevoda s uchetom ego krovosnabzheniia.

Inadequate blood supply is one of the major reasons of esophageal anastomosis incompetence. The authors have examined esophageal blood supply as regards of the operative technique. The esophageal vascular system was studied by the method of intraarterial impregnation in 40 cadavers. Two segments, crucial for esophageal anastomosis, have been determined: retropericardial segment in case of the lower esophageal artery ligation and the upper segment of the thoracic esophagus in case of its extreme mobilization in proximal direction and ligation of lower thyroid arteries. The results of 175 operations were analysed. The direct correlation between the frequency of anastomotic incompetence and the level of its formation was determined. In the zone with an inadequate blood supply the complication occurred in 4 patients of 25 (16%). In other cases the rate of incompetence was 3.2%. No cases of incompetence were observed in 61 patients after anastomosis was performed with due regard for esophageal blood supply.

[Resection of the esophagus with single-stage intrathoracic esophagogastroplasty]. / Rezektsiia pishchevoda s odnoétapnoi vnutrigrudnoi ézofagogastroplastikoi.

An experience with treatment of 152 patients with diseases of the esophagus who were subjected to resection of the esophagus with a one-step esophagoplasty is analyzed. A principally new approach is presented to the method of forming the gastric transplant, to choice of the level of the esophagus resection and to preoperative examination of the patients. Postoperative lethality was 9.9% with the complete absence of the esophageal anastomosis incompetence.

[The determination of the level of esophageal resection taking into account its blood supply]. / Opredelenie urovnia rezektsii pishchevoda s uchetom ego krovosnabzheniia.

The anatomical and polarographic investigations allowed the authors to establish two critical portions for forming the esophageal anastomoses. Risk of incompetence of the anastomoses in these portions is great because of an insufficient blood supply.

[A method of forming the gastric transplant for esophagoplasty]. / Metodika formirovaniia zheludochnogo transplantata dlia ézofagoplastiki.

A principally new method of forming the gastric transplant was developed on the basis of the anatomical investigation of the stomach blood supply, based on the intraorganic vascular way between 3 main collectors of the stomach--the right gastro-omental, left gastric and left gastro-omental arteries. The method was used in 65 patients operated upon with good results.