[Postoperative reflux in treatment of complicated forms of duodenal ulcer disease].

There were examined 46 patients, in whom operative treatment of perforative duodenal ulcer was conducted. Organ-preserving operations were performed in conjunction with selective proxymal or truncal vagotomy. In far-remote terms after the operation in 12 patients gastrooesophageal reflux have occurred, DeMeester index have constituted 17.5-38.5. Impact of operative trauma on antireflux power of gastro-oesophageal junction was noted.

[Regional blood flow in stomach in duodenal ulcer disease complicated by under-compensated or decompensated gastric exit stenosis]. / Regional'nyi krovotok v zheludke pri iazvennoi bolezni dvenadtsatiperstnoi kishki, oslozhnennoi subkompensirovannym ili dekompensirovannym stenozom vykhoda iz zheludka.

The state of the gastric mucosa regional blood flow and microcirculation in 148 patients with duodenal ulcer disease, complicated by sub-compensated or decompensated stenosis of gastric outlet, was studied. The lowering of indexes in various parts of stomach, along curvature minor especially, was revealed. These date substantiate the necessity of application of the organ-preserving operation with the ulcer excision and the dilating pyloroduodenoplasty performance in late stage of stenosis. If is recommended application of preparations, promoting normalization of the blood rheologic properties and mucosal microcirculation, for prophylaxis and the regional blood flow restoration in the early postoperative period.

[Surgical treatment of thoracic esophageal obstruction of neoplastic genesis]. / Khirurgicheskoe lechenie neprokhodimosti grudnoi chasti pishchevoda opukholevogo geneza.

The results of operative treatment of 126 patients with esophageal cancer, localized on different level, were analysed. In 73 of them the thoracic esophagus affection was revealed. Radical operations were performed in 46 and the palliative--in 27 patients. As a rule, one-staged esophagoplasty was done, using stomach and colon. The original method of the gastric transplant lengthening was proposed, permitting to perform one-staged retrosternal esophagoplasty with construction of cervical esophagogastroanastomosis. Complications have occurred in 6 patients.

[A method for determining the tonus of the stomach wall in patients with duodenal peptic ulcer complicated by organic pyloroduodenal stenosis]. / Sposob opredeleniia tonusa stenki zheludka u patsientov s iazvennoi bolezn'iu dvenadtsatiperstnoi kishki, oslozhnennoi organicheskim piloroduodenal'nym stenozom.

Method of gastric wall tone determination before the operation in patients with gastroduodenal ulcer disease, complicated by pyloroduodenal stenosis (PDS) was elaborated. There were examined 86 patients with sub- and 62 with decompensated PDS using method of electrogastrography and of the intragastric pressure registration--using method of the opened catheter. Three degrees of the gastric motor function disorder were delineated. Tactics of treatment of such patients was elaborated.

[Aspects of excision of the perforative duodenal ulcer complicated by penetration and stenosis]. / Osobennosti issecheniia perforativenoi iazvy dvenadtsatiperstnoi kishki, oslozhnivsheisia penetratsiei i stenozom.

The results of treatment of 259 patients with perforative duodenal ulcer, complicated by penetration and stenosis, were analysed. The original methods of ulcer excision are proposed. Excellent and good late follow-up result was noted in 159 (84.6%) patients, fair--in 15 (8.2%), bad (ulcer recurrence)--in 8 (4.4%).

[Translocated gastroduodenal anastomosis in surgical treatment of penetrating duodenal ulcer]. / Peremeshchennyi gastroduodenoanastomoz v khirurgicheskom lechenii penetriruiushchei iazvy dvenadtsatiperstnoi kishki.

The method of operative treatment of complicated duodenal ulcer disease consisting gastroduodenostomy, translocated by 3-4 cm medially and lower from the ulcer crater and strengthened by a spur on a small curvature side.

[Analysis of the outcome in surgical treatment of cancer of the organs of the pancreatoduodenal region]. / Analiz rezul'tatov khirurgicheskogo lecheniia raka organov pankreatoduodenal'noi zony.

The surgical treatment results of the hepatopancreatoduodenal zone cancer in the clinic from 1987 till 1992 are adduced. Of 91 operated patients in 31 of them the radical or conditionally radical operations were done. The modifications of their own of conventional methods were applied. Further improvement of the diagnosis methods is needed as well as the search of possibilities to augment the frequency of the radical operations accomplishment.

[Defence system of gastroduodenal mucous glands in ulcer disease]. / Sostoianie zashchitnoi sistemy slizistoi obolochki organov gastroduodenalnoi zony pri iazvennoi bolezni.

As a result of complex investigation of the dafence mucosal barrier of gastroduodenal zone (studying of glicoproteins and immunoglobulins secretion), the acid-producing stomach function and its colonization with helicobacter pylori bacteria it was determined that side by side with infringement of polysaccharide-albuminous complexes secretion the weakening of humoral and nonspecific local immunity occurs. The infringement degree depends on severity of ulcer disease. On the background of autoimmune aggression the stress in common immunity system was noted. The presence of helicobacteria negatively influences the state of defence mucosal barrier.

[The use of ozone for treating suppurative wounds]. / Primenenie ozona dlia lecheniia gnoinykh ran.

Pathogenetic substantiation of the use of ozone for the treatment of purulent infection in surgery is given. A technique for the use of the method and its advantages as compared to antimicrobial remedies is described. A comparative assessment of the effectiveness of the suggested and existing methods was carried out.

[The immune protection of the gastroduodenal area after the surgical treatment of duodenal peptic ulcer]. / Immunnaia zashchita gastroduodenal'noi zony posle khirurgicheskogo lecheniia iazvennoi bolezni dvenadtsatiperstnoi kishki.

The complex study of the indices of local immune and natural resistance in the parietal mucus of the gastroduodenal zone and general immunity in 174 patients with duodenal ulcer disease before and after surgical treatment was performed. Pronounced suppression of local immunity, presence of autoimmune processes having influence on its indices were noted. After the organ-preserving operations with an ulcer excision, the immune indices restored more rapidly than after gastric resection and vagotomy without an ulcer excision.

[Combined selective proximal vagotomy in the surgical treatment of duodenal ulcer]. / Kombinirovannaia selektivnaia proksimalnaia vagotomiia v khirurgicheskom lechenii iazvennoi bolezni dvenadtsatiperstnoi kishki.

Preservation of adequate blood supply to a gastric wall and resistance of mucosa of the gastroduodenal region with simultaneous full-value parasympathetic denervation of its acid-producing zone in performance of selective proximal vagotomy contributes to decrease in incidence and pronouncement of ischemic disorders in motor-evacuatory function of the stomach at the early postoperative period, effective and stable reduction in acid production, shortening of duration of the postoperative treatment and rehabilitation of the patients, prophylaxis of ulcer recurrences.

[Status of the protective mucous barrier of the stomach after organ-sparing operations for duodenal ulcer]. / Sostoianie zashchitnogo slizistogo bar'era zheludka posle organosokhraniaiushchikh operatsii po povodu iazvennoi bolezni dvenadtsatiperstnoi kishki.

A protective mucous barrier of the stomach was studied in 153 patients with duodenal ulcer disease. Before the operation in 70 patients, decrease in concentration of protective factors of gastric mucus, especially in complicated form of ulcer disease was noted. More complete restoration of a protective barrier was noted after organ-preserving operations with excision of ulcerous substrate (in 54 patients) than after those without its excision (in 29).