[Advanced endoscopic vacuum therapy for anastomotic leakage in the upper gastrointestinal tract]. / Usovershenstvovannaya endoskopicheskaya vakuumnaya terapiya pri nesostoyatel'nosti anastomozov verkhnikh otdelov zheludochno-kishechnogo trakta.

OBJECTIVE: To evaluate the effectiveness and clinical aspects of advanced endoscopic vacuum therapy for esophagogastric, esophagointestinal and gastrointestinal anastomotic leakage, to identify disadvantages and further possibilities for its improvement. MATERIAL AND METHODS: The study included 69 people. Esophagodudodenal anastomotic leakage was detected in 34 patients (49.27%), gastroduodenal anastomotic leakage - in 30 patients (43.48%), esophagogastric anastomotic leakage - in 4 (7.25%) patients. Advanced endoscopic vacuum therapy was used for these complications. RESULTS: Vacuum therapy in patients with esophagodudodenal anastomotic leakage led to complete healing of defect in 31 (91.18%) cases. In 4 (14.8%) cases, minor bleeding was noted during replacement of vacuum dressing. There were no other complications. Three (8.82%) patients died from secondary complications. Treatment of gastroduodenal anastomotic failure resulted complete healing of defect in 24 (80%) patients. Six (20%) patients died including 4 (66.67%) cases associated with secondary complications. Vacuum therapy for esophagogastric anastomotic leakage resulted complete healing of defect in 4 (100%) patients. CONCLUSION: Advanced endoscopic vacuum therapy is a simple, effective and safe method of therapy for esophagogastric, esophagoduodenal and gastrointestinal anastomotic leakage.

[Results of anterior abdominal wall repair with mesh implants in patients with postoperative ventral hernia]. / Rezul'taty vosstanovleniia perednei briushnoi stenki pri posleoperatsionnykh ventral'nykh gryzhakh s ispol'zovaniem setchatykh implantatov.

AIM: To analyze the results of the restoration of the anterior abdominal wall in postoperative ventral hernias using mesh implants. MATERIAL AND METHODS: The study was of 680 patients, who underwent abdominal wall reconstruction using mesh implants. RESULTS: A total of 105 postoperative complications (15.44%) in 84 (12.35%) patients; the postoperative period was without complications in 596 (87.65%) patients. The greatest number of complications was noted after laparoscopic IPOM - 13 patients (20.31%); the smallest - after posterior component separation - 24 (7.5%). Also described 10 systemic complications: 8 of which were stopped by conservative therapy, in 2 cases repeated surgical intervention was required with a change in the type of wall reconstruction. Statistical analysis did not show statistically significant differences in the incidence of complications between the different versions of the performance of hernioplasty, except for the posterior muscular plastics. Statistical analysis also showed a link between the likelihood of various complications and the type of ventral hernia repair. CONCLUSION: Conducting different methods abdominal wall reconstruction using mesh implants is techniques with a low level of postoperative complications and comparable results when performing various types of plastics.