[Surgical tactics in the ulcer pyloroduodenal stenosis in decompensation stage].

In the ulcer pyloroduodenal stenosis the stages of complete and noncomplete decompensation are suggested. In 73% of observations, while performing an adequate preoperative preparation it was possible to convert pyloroduodenal stenosis from the stage of complete decompensation into the stage of noncomplete decompensation, in which the performance of organpreserving operation is possible. In the patients, suffering pyloroduodenal stenosis in the stage of noncomlete decompensation, resection of 2/3 of stomach is performed.

[Quality of life in patients after restorative operations].

The analysis of the results of the surgical treatment of colon cancer, ulcerative colitis, Crohn's disease, polyposis of colon, diverticular disease of colon on the bases of quality of life scale indexes, questionnaire SF-36 was carried out. The authors have compared the quality of life of patients who underwent surgical treatment using restorative operations after removing functional parts of the colon. The quality of life indexes in 11-12 days after the operation were higher in the first group compared with the second one. Positive influence of laparascopic intervention on quality of life considerably differs from that in the second group in 3 and 6 months and in one and three years after the operation was done.

[Relaparotomy: determination of the indications and results]. / Relaparotomiia: opredelenie pokazanii i rezul'taty.

The indications for relaparotomy in cases of bleeding, peritonitis, acute ileus and abdominal abscess were determined. Using the indications gave a possibility to perform the relaparotomy on 1-st postoperative day right after first signs of those complications. The mortality dropped from 46% to 20.5%.

[Lethality after emergency relaparotomies]. / Letal'nost' posle neotlozhnykh relaparotomii.

An experience with treatment of 396 patients with complications at the postoperative period requiring emergency relaparotomies at the period from 1 to 21 days is presented. General lethality after the relaparotomies made up 44.9%.

[Intra-abdominal hemorrhages in the early postoperative period and their diagnosis]. / Vnutribriushnye krovotecheniia v rannem posleoperatsionnom peride i ikh diagnostika.

In the period from 1977 to 1987, after 13,306 operations carried out on the abdominal organs in the clinic, intra-abdominal hemorrhages occurred in 34 (0.25%) patients which had to de managed by emergency relaparotomy. From analysis of case records (28 taken from the archives and 6 of patients who were under observation) of the relationship between the large number (195) of signs represented by a block of clinico-laboratory and radiological data, an integral diagnostic criterion of intra-abdominal hemorrhages was obtained. The diagnostic significance of the criterion was 98.6%. Its practical application comes to recognition of intra-abdominal hemorrhage by identifying the symptoms and syndromes found in the patient with this early postoperative complication with the symptoms and syndromes composing the integral criterion. A revealed integral diagnostic criterion is a concrete indication for undertaking emergency relaparotomy.

[Prognosis in the outcome of relaparotomy]. / Prognozirovanie iskhoda relaparotomii.

The analysis and processing with the use of a special method of 54 direct observations and 342 case records of the patients with early postoperative intraabdominal complications were carried out. A method for syndrome prediction of the outcomes of relaparotomy has been developed. The syndromes of the most significant predictive value have been revealed: those of intoxication, respiratory and hepatorenal failure, impaired hemodynamics and electrolytic metabolism, hemocoagulation. Use in clinical practice of the method mentioned as well as the methods promoting timely detection of the intraabdominal complications permitted to reduce lethality after relaparotomy from 21.4 to 15.3%.

[Indications for relaparotomy in acute postoperative intestinal obstruction]. / Pokazaniia k relaparotomii pri ostroi posleoperatsionnoi neprokhodomosti kishechnika.

For the period of 1977-1987, operations on the abdominal organs were performed in 13,306 patients. Of them, 115 (0.86%) developed 1 to 21 days after the operation acute ileus requiring the performance of emergency relaparotomy. Lethality in this complication was 33.9%. A retrospective analysis of 103 case records and observations on 12 patients who underwent at the early postoperative period emergency laparotomy for acute ileus were performed. The data were entered on a formalized card. The material was processed by means of a computer. The integral criteria for diagnosis of acute postoperative ileus which permitted to predict with an accuracy of 99% the complication serving an indication for relaparotomy were developed.

[Incidence of development and the results of treatment of post- operative peritonitis]. / Chastota vozniknoveniia i rezul'taty lecheniia posleoperatsionnogo peritonita.

In the clinic at the period of from 1977 to 1987 after 13,006 operations on the abdominal organs, 185 patients (1.4%) ranging in age from 16 to 89 years developed peritonitis. The lethality after relaparotomy performed within the first 24 hours of the complication development was 15.9%, later on--73.7%. In spite of the large extent and trauma of radical relaparotomy, the lethality after it was 56%, after palliative one--90%. Timely is the performance of relaparotomy within the first 6 h from the moment of the complication development, in prolongation of the time to 7-12 h, the lethality was 12.5%.

[Optimization of diagnosis of postoperative peritonitis]. / Optimizatsiia diagnostiki posleoperatsionnogo peritonita.

The syndrome approach to diagnosis of the postoperative intraabdominal complications was used. Analysed were 170 case records and 15 observations of the patients with postoperative peritonitis. The data were registered in a specially compiled for every patient formalized card. Materials were computer-processed. The integral criterion for diagnosis of postoperative peritonitis has been obtained.