[Modern approach to prognostication of the acute hemorrhage recurrence from duodenal ulcer].

There was 2223 of 2285 patients, treated in the Kyiv's municipal center of gastrointestinal hemorrhage in 1994-1996 yrs (the control group) and in 2004-2008 yrs (the main group) for an acute hemorrhage from duodenal ulcer. The integral prognostic index (IPI) was determined for the early recurrence risk (ERR) assessment. The point prognostication system, based on the step by step discriminant analysis, was transformed while its application. While in a control group of an acute hemorrhage early recurrence prognostication and its low risk (ERR was 5.6%) the IPI have had constituted 7-9 points, in the middle risk (ERR was 34%) the IPI have measured 10-16 points and in the conditions of a high risk (ERR have constituted 89.1%), the IPI was 17-22 points, vs in the main group in conditions of application of potent intravenous proton pump inhibitors and effective endoscopic hemostasis measures in a low risk group (the realized ERR was 1.2%) the IPI have measured 7-12 points, in middle ERR (realized ERR 7.15%) the IPI raised to 13-19 points and in a high ERR (realized ERR was 23.81%) 20-22 points.

[Surgical treatment of Meckel diverticulum complicated by an acute hemorrhage].

Mekkel's diverticulum (MD)--is the inborn anomaly, caused by incomplete yolk duct development, it is present in near 2% of population and in 95% of observations lacks clinical manifestations. Symptoms of the disease manifest while complications occurrence only--in presence of peptic ulcer with possible hemorrhage and perforation occurrence, while ileus, diverticulitis, hernia, umbilicus fistula and tumor development. Eight patients, suffering MD, complicated by gastrointestinal hemorrhage, were treated during 1983-2006 yrs in Kyiv's city center for giving the aid to patients suffering gastrointestinal hemorrhage (GIH). These had constituted 6.6% of general quantity of adult patients, suffering rare causes of GIH occurrence, and 0.03% of all the patients, suffering GIH. For the diagnosis establishing in all the patients colonoscopy, barium enema and abdominal ultrasonography were applied. Definitive diagnosis was established only postoperatively. MD was extirpated in 5 patients, the wedge ileum resection with MD was accomplished in 1 patient and ileum resection with MD--in 2 patients. All the patients are alive.

[Prognosis of disability after performance of operation for complicated gastroduodenal ulcer].

Quality of life of a patient constitutes integrated index of the treatment efficacy. One of parts of the "quality of life" term is a restriction of vital activities - disability. It is for the first time, when the prognostication system was proposed for the risk estimation of disability occurrence in patients, operated on for complicated gastroduodenal ulcer, which was elaborated on background of the step by step discriminant analysis. Application of prognostication system, in particular, its simplified variant, permits to apply it widely for choosing of optimal operative treatment method, which prophylaxes the risk of disability occurrence.

[Comparative evaluation of remote results of surgical treatment of complicated gastroduodenal ulcer]. / Porivnial'na otsinka viddalenykh rezul'tativ khirurhichnoho likuvannia uskladnenoï hastroduodenal'noï vyrazky.

Results of operative treatment of 1588 patients with complicated gastroduodenal ulcer in immediate and of 667--in late postoperative period were analyzed. Best results were obtained after performance of organ preserving operations in combination with proper full complex medical rehabilitation of operated patients.

[Ways for improvement of medical, occupational, and social rehabilitation of patients operated for complicated gastroduodenal ulcer]. / Shliakhy pokrashchannia medychnoï, profesiinoï ta sotsial'noï reabilitatsiï khvorykh, operovanykh z pryvodu uskladnenoï hastroduodenal'noï vyrazky.

Based on the analysis of the early post-operative period in 1588 patients and long-term results in 667 patients having been operated for complicated gastroduodenal ulcers, algorithms are submitted of medical, occupational, and social rehabilitation, which fact permitted improving results of surgical treatment. The proposed rehabilitation project envisages staging and continuity of measures aimed to restore the patients' capacity for work and their social status.

[Complex rehabilitation of patients operated on for complicated peptic ulcer]. / Kompleksna reabilitatsiia khvorykh, operovanykh z pryvodu uskladnenoï vyrazkovoï khvoroby.

Results are submitted of sanatorium-and-health resort treatment of 104 patients operated on with the aid of the organ-sparing and resection techniques for complicated forms of gastroduodenal ulcers. An algorithm of therapeutic measures taking account of sanatorium-and-health resort treatment has been worked out. It allows to lessen considerably the postoperative complications, to shorten duration of temporary disability, to reduce permanent disability after resection of the stomach 3-fold.