RESUMO
During 19 years (from 1974 to 1992) 5205 operations for complicated ulcer disease of duodenum (4201 observation), stomach (915) and of double localization (89) were conducted. In 585 of 5205 patients complications occurred: of operative wound healing-in 17.4%, in the region of intervention--in 56%, dysfunction of other organs and systems--in 26.6%, 44 (0.84%) of them died. The mortality after conduction of stomach resection according to Bilroth-I was 0.8%, according to Bilroth-II--5.5%, after vagotomy--1%.
Assuntos
Úlcera Duodenal/mortalidade , Úlcera Duodenal/cirurgia , Úlcera Gástrica/mortalidade , Úlcera Gástrica/cirurgia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Criança , Duodeno/cirurgia , Gastrectomia , Humanos , Jejuno/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estômago/cirurgia , VagotomiaRESUMO
Of the 2704 patients operated on for duodenal ulcer disease within the 10-year period, a benign tumour of the duodenum was revealed in 8 (polyp--in 6, myoma--in 1, fibroma--in 1), and a malignant one--in 3. Endoscopic polypectomy was performed in 6 patients. For malignant tumours, pancreaticoduodenal resection was performed in 1 patient, resection of 2/3 of the stomach with removal of the suprapapillary duodenal portion--in 1, resection of the distal duodenum--in 1. The result of operation is good.
Assuntos
Adenocarcinoma/cirurgia , Neoplasias Duodenais/cirurgia , Fibroma/cirurgia , Pólipos Intestinais/cirurgia , Mioma/cirurgia , Adulto , Úlcera Duodenal/complicações , Úlcera Duodenal/cirurgia , Endoscopia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Within 8 years, 3903 patients underwent surgical treatment. Of them, 2426--for gastric and duodenal ulcer disease, 1433--for diseases of the gallbladder and bile ducts, 21--for diseases of the operated stomach etc. Simultaneous operations were performed in 262 patients. The incidence of postoperative complications and lethality after simultaneous operations is not higher than after the common ones. The advantages of combined interventions are shown.
Assuntos
Doenças dos Ductos Biliares/cirurgia , Doenças do Esôfago/cirurgia , Doenças da Vesícula Biliar/cirurgia , Gastroenteropatias/cirurgia , Complicações Pós-Operatórias/cirurgia , Adulto , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/mortalidade , Reoperação , Procedimentos Cirúrgicos Operatórios/métodosRESUMO
From experience with various types of vagotomy in 3,102 patients and study of the late-term results, it was established that recurrent ulcer developed in 4.7%, dysphagia in 2.9%, incompetence of the esophagogastric junction in 9.7%, reflux esophagitis in 3.8%, dyskinesia of the duodenum in 2.6%, duodenostasis in 5.3%, the dumping syndrome in 5.4%, diarrhea in 6.1%, and hiatal hernia in 0.3% of cases. The surgical correction of disorders after vagotomy is marked by specific techniques which must be borne in mind to improve treatment.
Assuntos
Complicações Pós-Operatórias/diagnóstico , Vagotomia , Úlcera Duodenal/complicações , Úlcera Duodenal/cirurgia , Humanos , Úlcera Péptica Perfurada/cirurgia , Complicações Pós-Operatórias/classificação , Complicações Pós-Operatórias/cirurgia , Recidiva , Reoperação , Vagotomia/métodosAssuntos
Duodenopatias/etiologia , Úlcera Duodenal/cirurgia , Gastrectomia/efeitos adversos , Intussuscepção/etiologia , Doenças do Jejuno/etiologia , Síndromes Pós-Gastrectomia/etiologia , Adulto , Duodenopatias/cirurgia , Humanos , Intussuscepção/cirurgia , Doenças do Jejuno/cirurgia , Masculino , Síndromes Pós-Gastrectomia/cirurgiaAssuntos
Gastrectomia/efeitos adversos , Gastroenterostomia/efeitos adversos , Doenças do Jejuno/diagnóstico , Úlcera Péptica/diagnóstico , Síndromes Pós-Gastrectomia/diagnóstico , Humanos , Doenças do Jejuno/etiologia , Doenças do Jejuno/cirurgia , Úlcera Péptica/etiologia , Úlcera Péptica/cirurgia , Síndromes Pós-Gastrectomia/etiologia , Síndromes Pós-Gastrectomia/cirurgia , Recidiva , ReoperaçãoRESUMO
The authors disposing of a great number of observations of patients operated upon for peptic ulcer of the anastomosis (570), give an account of main principles of performing surgical procedures. They are: the detection and elimination of the causes of the anastomosis ulcer, wider use of truncal vagotomy, and for gastro-intestino-colonic fistula a less traumatic intervention should be chosen--the disconnection of the fistula and suturing the colon. The ways of reduction of postoperative lethality of the patients with this severe disease are shown.
Assuntos
Doenças do Jejuno/cirurgia , Úlcera Péptica/cirurgia , Complicações Pós-Operatórias/cirurgia , Anastomose Cirúrgica , Doenças do Colo/etiologia , Doenças do Colo/cirurgia , Feminino , Gastrectomia , Fístula Gástrica/etiologia , Fístula Gástrica/cirurgia , Humanos , Fístula Intestinal/etiologia , Fístula Intestinal/cirurgia , Doenças do Jejuno/complicações , Doenças do Jejuno/etiologia , Jejuno/cirurgia , Masculino , Úlcera Péptica/complicações , Úlcera Péptica/etiologia , Complicações Pós-Operatórias/etiologia , Reoperação , Vagotomia , Síndrome de Zollinger-Ellison/cirurgiaRESUMO
On the basis of surgical treatment of 3230 patients with the ulcer disease, of them 582 operated on for an ulcer localized in the stomach, the authors have formulated the indications for the performance of operation in these patients, substantiated the principles of choice of its method. The use of different types of operative interventions permitted to establish that in 98.5% of the patients, it was technically possible to preserve passage through the duodenum in comparatively low lethality (0.86%). A new method for formation of gastroduodenal anastomosis is described. The long-term results of the use of selective proximal vagotomy in gastric ulcer are studied.
Assuntos
Gastrectomia/métodos , Síndromes Pós-Gastrectomia/prevenção & controle , Úlcera Gástrica/cirurgia , Vagotomia Gástrica Proximal/métodos , Feminino , Humanos , MasculinoRESUMO
On the basis of the experience with treatment of cancer of the gallbladder and bile ducts in 21 patients, the difficulties of preoperative diagnosis are shown. The results of surgical treatment of the patients are unsatisfactory.
Assuntos
Neoplasias dos Ductos Biliares/cirurgia , Neoplasias da Vesícula Biliar/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The probe small intestine nutrition was used in 1455 patients. In 96.4% of the patients the probe was introduced during operation, in 3.6% it was used both prior to it in order to prepare the patient to surgery and in cases with pronounced anastomositis and incompetent sutures in the postoperative period. Wide usage of the probe nutrition allowed the postoperative lethality after difficult surgical interventions to be reduced to 0.56%. The change of the infusion therapy by products introduced through the probe gave a considerable economic effect.
Assuntos
Nutrição Enteral , Gastrectomia , Úlcera Péptica/cirurgia , Duodenostomia , Humanos , Cuidados Intraoperatórios , Intubação Gastrointestinal , Jejunostomia , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , CicatrizaçãoRESUMO
The investigation of factual terms of temporary invalidity after selective proximal vagotomy without draining operations of the stomach in a number of regions of the Ukrainian SSR has shown their considerable variability (56.4 +/- 13.8 days). Under observation were 178 patients. It has been established that normal indices of homeostasis, functions of the gastro-intestinal tract, regeneration of the postoperative scar and recovery of their physical labour capacity is taking place during 30-33 days. Criteria for the determination of terms of temporary invalidity after selective proximal vagotomy for the ulcer disease of the duodenum have been elaborated.
Assuntos
Avaliação da Deficiência , Úlcera Duodenal/cirurgia , Vagotomia Gástrica Proximal/reabilitação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Vocacional , Fatores de TempoAssuntos
Ascite/diagnóstico , Cistos Ovarianos/diagnóstico , Adulto , Erros de Diagnóstico , Feminino , HumanosAssuntos
Doenças do Sistema Digestório/cirurgia , Hemorragia/cirurgia , Obstrução Intestinal/cirurgia , Peritonite/cirurgia , Complicações Pós-Operatórias/cirurgia , Adulto , Idoso , Feminino , Hemorragia/etiologia , Humanos , Obstrução Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Peritonite/etiologia , Complicações Pós-Operatórias/etiologia , ReoperaçãoRESUMO
An analysis of treatment of 1304 patients has shown the best immediate results to be after resection and re-resection of the stomach after Billroth-I as compared with Billroth-II: they had less amount of postoperative complications and lower lethality and maintained the passage of food through the duodenum.
Assuntos
Gastrectomia/métodos , Úlcera Péptica/cirurgia , Adolescente , Adulto , Idoso , Úlcera Duodenal/mortalidade , Úlcera Duodenal/cirurgia , Gastrectomia/mortalidade , Humanos , Pessoa de Meia-Idade , Úlcera Péptica/mortalidade , Complicações Pós-Operatórias/mortalidade , Reoperação , Úlcera Gástrica/mortalidade , Úlcera Gástrica/cirurgia , Deiscência da Ferida Operatória/prevenção & controle , Vagotomia/métodosRESUMO
During 16 years operations were performed on 423 patients with peptic ulcers of anastomoses, in 13 of them the disease was complicated by gastro-intestinal-colonic fistulas. Of 7 patients operated upon during first 11 years four patients died, of 6 patients operated upon during the second period (the last 5 years) there were no lethal outcomes. The less lethality was due to using less traumatic operations and longer preparing the patients for operations.