[Modern surgical tactics in Crohn's disease].

Surgical tactics of Crohn's disease (CD) treatment was elaborated on base of modern information analysis, concerning pathogenesis, peculiarities of clinical course, possibilities of diagnosis, experience in the disease treatment. The tactics provides a timely diagnosis of the disease, prognostication for the recurrence occurrence and postoperative complications, the indications and the method of surgery optimization. Application of the elaborated surgical tactics in CD in 121 patients have permitted to improve the objective estimation of the disease severity, to prognosticate complications, to optimize surgical indications, as well as a choice of the method of a conditionally-radical, restorational, reconstructive-restorational stages of operative intervention, to reduce the disease recurrences rate, postoperative complications, postoperative lethality.

[Compression anastomoses of the large intestine under complicated conditions]. / Kompressionnye tolstokishechnye anastomozy v oslozhnennykh usloviiakh.

Results of the application of apparatus AKA-2 for the formation of compressive anastomoses under complicated conditions are discussed. Among them are: acute and chronic ileus, peritonitis, diabetes mellitus etc. Common negative factors for all the patients were symptoms of secondary immune deficiency and specific endogenous intoxication resulting from chronic internal irradiation by radionuclides (consequences of the disaster in Chernobyl atomic power station in 1986). In 1987-1990 operations were performed on 84 patients. Compressive colonic anastomoses were made with apparatus AKA-2. All the patients lived in Kiev and neighbouring regions from 1986. From the patients operated upon 81% had colorectal cancer localized in left portions of the colon, 19% of the patients had inflammatory diseases of the colon. The application of compressive colonic anastomoses under the complicated conditions proved to be sufficiently reliable in the nearest and late terms of observations.

[T-cell immunodeficiency and the status of the reparative processes in patients with Crohn's disease of the large intestine]. / T-kletochnyi immunodefitsit i sostoianie reparativnykh protsessov u bol'nykh bolezn'iu Krona tolstoi kishki.

Clinico-immunological examination of 35 patients with chronic colostasis at the stage of subcompensation and 10 patients with Crohn's disease of the colon before and after operative treatment (subtotal colectomy) revealed that presence of marked T-cellular immunodeficiency mainly due to helper subpopulation and inversion of helper-suppressor index in patients operated on for Crohn's disease of the colon, inhibiting the reparative processes and weakening anti-infection defense in these patients.