[Surgical treatment of large intestines obstruction caused by colorectal cancer]. / Khirurgichno lechenie na debelochrevniia ileus, prichinen ot kolorektalen rak.

Large intestinal obstruction like a life-threatening steatement is a subject of investigation in the present study. In such prospection are included 65 patients undergone surgery for large intestinal obstruction of cancer in period of seven years. Analyzed are after undertaken surgical procedures. It is clear that tendency of more security after surgery is concerned with the principles of radicalization after lower morbidity and mortality.

[Surgical treatment outlook for gastric carcinoma (a 10-year retrospective study)]. / V'zmozhnosti za operativno lechenie na stomashniia kartsinom (retrospektsiia za 10 godini).

After analyzing clinical material of 159 patients with gastric cancer into Surgical department of the Regional hospital in Dobrich, the authors signified the tendency of later coming for surgery of predominant patients. The part of 66.8% patients coming in 3rd and 4th stage of disease is disturbing. The subtotal resection and gastrectomy like a method of choice are 40.4% with a something more true survival chances.

[Esophagojejunostomy after Roux following gastrectomy for cancer of the stomach]. / Ezopfagoeiunoanastomoza po Roux sled gastrektomiia po povod kartsinom na stomakha.

Not big number of cases (17) operated for cardia cancer are subject of retrospective analyzing. Ezophagoejunoanastomosis by termino-lateral plastic, type of Roux is realized in more of cases (9). Termino-terminal junction and this after proximal gastric resection performed on hand, are subject of discussion.

[Intestinal stomas and internal splinting of the intestine in the combined treatment of peritonitis and ileus]. / Chrevnite stomi i vutreshnoto shinirane na chervata v kompleksnoto lechenie na peritonit-ileusa.

Personal experience with the operative management of 28 patients presenting acute purulent peritonitis with ensuing ileus using a complex approach, based on total "internal" splinting of the small intestine, is shared. The 4-channel sound, designed and constructed in the clinic for intubation and simultaneous lavage of the small intestine, promotes effective staged evacuation of the toxic content from the disconnected bowel segments. What is more, a possibility is created for the formation of controlled adhesions between the intestinal loops. The significant clinical effect of bowel intubation in conjunction with adequate peritoneal cavity lavage plus infusional therapy with antibiotics and antianaerobic agents contribute greatly to the prompt recovery of patients.

[The urological and surgical effects of the Goebell-Stoeckel operation. The results after 3 years]. / Urologichni i khirurgichni efekti ot operatsiiata na Goebell-Stoeckel. Rezultati sled tri godini.

Operative treatment of stress incontinence using Goebell-Stoeckel's procedure is undertaken in a rather limited number of patients. As shown by the analysis of the postoperative results, the scope of intervention is by no means warranted from anatomical viewpoint. The comparatively similar postoperative results in the contingent being examined point to the necessity of performing mandatory and more detailed functional examinations prior to operation, as well as broadening the scope of intervention under urologic, gynecologic and surgical aspects.

[The suturing of the bladder as a factor affecting urinary infection]. / Zashivaneto na pikochniia mekhur kato faktor za povliiavane na uroinfektsiiata.

Problems relating to suture of the urinary bladder wall are discussed against the background of experimental and clinical studies on ten laboratory animals (pigs) and a series of urological patients subjected to bladder operation. The somewhat different technique of the bladder-wall suture employed is characterized by features such as being anatomically justified, atraumatic and antibacterially reasonable. The simple and readily performed suture of the bladder wall, and the positive experimental and clinical results attained are a prerequisite for practical implementation in the routine clinical practice of this type of bladder suture. Early removal of the catheter from the urinary bladder reduces the hazards of urinary tract and wound infection.

[The postoperative results of the surgical treatment of hepatic echinococcosis using a closed surgical method]. / Sledoperativni rezultati ot khirurgichnoto lechenie na chernodrobniia ekhinokok po zakritiia operativen metod.

The authors examined critically no big one series of 41 patients undergone surgical procedures about liver hydatid cyst after so called "covered method". The simplicity of the method is signified and the lower risk, mortality and morbidity makes it convenient for surgeons with different degree and ability. The post operative application of 30% NaCl solution remove the risk of protoscolices into the fibrous capsule.

[Our experience with the surgical treatment of complicated duodenal ulcer using truncal vagotomy]. / Nashiiat opit pri khirurgichnoto lechenie na uslozhnenata iazva na dvanadesetoprustnika s trunkularna vagotomiia.

Personal ten-year-long surgical and clinical experience with the application of truncal vagotomy in 51 patients with complicated duodenal ulcers-23 with hemorrhage, 19 with perforation and nine with stenosis, is shared. Emphasis is laid on the superiorities and comparatively low lethality (5.8 per cent) of the application of this type of vagotomy during the surgical management of complicated duodenal ulcers, as well as on the great diagnostic relevance of fiber gastroscopy applied on the apex of hemorrhage in case of bleeding duodenal ulcers.

[Endoscopic prosthesis in malignant stenoses of the esophagus and the cardioesophageal junction]. / Endoskopsko protezirane pri maligneni stenozi na khranoprovoda i kardioezofagealniia prekhod.

The palliative treatment results in 41 patients presenting intractable malignant stenosis of the esophagus--carcinomas among which one carcinoid and three branchial carcinomas--following endoscopic implantation of a plastic prosthesis (tubus) are analyzed. It is stressed that it is a matter of a palliative method, promptly eliminating the nutritional passage impairment; in case of tracheoesophageal fistula is a method of choice, but leads to a comparatively high incidence of serious complications-perforations of the esophagus (7.3 per cent) all with lethal outcome.

[Pneumatic balloon dilatation with a Rigiflex dilator in the treatment of patients with achalasia]. / Pnevmatichna balonna dilatatsiia s Rigiflex-dilatator pri lechenie na bolni s akhalaziia.

In a clinical series including 32 patients with achalasia an assessment is done of the possibilities afforded by palliative management using the method of pneumatic balloon dilatation with Rigiflex dilatator. Emphasis is laid on the simplicity and efficacy of this endoscopic procedure, seldom giving rise to serious complications--one esophageal perforation only (3.1 per cent) out of the total of 32 patients treated over a 10-year period. Application of the method is recommended in all cases presenting achalasia, and more particularly in patients with achalasia I and II stage.

[The endoscopic therapy of benign stenoses of the esophagus and cardioesophageal junction using Eder-Puestow instrumentation]. / Endoskopska terapiia na benignenite stenozi na khranoprovoda i kardioezofagealniia prekhod s instrumentariuma na Eder-Puestow.

The results of palliative endoscopic treatment by bougienage using Eder-Puestow instrumentation, performed in a limited contingent of patients presenting benign esophageal strictures, are analyzed. It is underscored that the method is readily carried out and effective, and seldom leads to noteworthy complications, such as esophageal perforations--one patient alone presenting cicatricial stricture out of the total of 42 cases given treatment with bougienage over a 10-year period. The commonest cause of benign strictures of the esophagus in the series being examined is reflux (peptic) esophagitis against the background of hiatus hernia.

[The surgical treatment of acute necrotic pancreatitis (the experience of 37 patients)]. / Otnosno khirurgichnoto lechenie na ostriia nekrotichen pankeatit (opit ot 37 bolni).

The results of the operative management of 37 patients with acute necrotic pancreatitis, covering a ten-year period (1984-1993), are discussed. It is stressed that regardless of the complex conservative and subsequent precisely indicated operative management, acute necrotic pancreatitis remains an exclusively serious and problem disease, accounting for a still very high overall lethality--35.1 per cent according to the case material analyzed. In the authors opinion the most opportune time for surgical intervention is within 5-7 days after the onset of the disease.

[A rare case of gallbladder interposition in the extrahepatic bile ducts]. / Riaduk sluchai na interpozitsiia na zhluchniia mekhur v ekstrakhepatalnite zhluchni putishta.

This is a report on an exclusively rarely met with anomaly, consisting in interposition of the gallbladder within the extrahepatic bile ducts where ducti hepatici open into the gallbladder. Ductus cysticus assumes the role of ductus choledochus, and terminates in papilla duodeni major. Ductus hepaticus communis is completely lacking. The aforementioned anomaly of the biliary system in the female patient reported on is supplemented by a vascular variation, consisting in the following: a. hepatica dex. passes over the isthmus of the gallbladder, and after forming a kink it is directed to hilus hepatis. At the apex of the kink a. cystica divides with blood supply being secured by the latter and the branches of a. hepatica dex. A similar anomaly is described by Nell Krug (2), whereas J. Denes (1) reports on a case where only ductus hepaticus dex. opens into the gallbladder.

[The diagnostic value of echography in hepatic echinococcosis]. / Dianostichna stoinost na ekhografiiata pri ekhinokok na cherniia drob.

The ultrasound method of examination led to revolutionary changes in the diagnosis of liver echinococcosis [correction of Echinococcus]. The ultrasound image of this disease, which is common in the region, is presented. The ultrasound method is compared with other diagnostic methods and its importance is pointed out. The ultrasound method of examination is a reliable means for the diagnosis of liver echinococcosis [correction of Echinococcus].

[Late results of multi-layer plastic surgery of the posterior wall of the inguinal canal]. / Otdalennye rezu'ltaty mnogosloinoi plastiki zadnei stenki pakhovogo kanala.

The author discusses results of operations on 159 patients for inguinal hernias who were divided into three groups depending on the kind of plasty of the inguinal canal. A comparison of long-term results obtained by the author's method of multilayer inguinal hernioplasty has been made with those of operations by the method of Postempski and after Bassini. Side complications (in the spermatic cord) made up 18% in patients operated upon by the Bassini method, 13% by the Postempski method and only 3% after multilayer plasty. Recurrent hernias were less frequent after the multilayer plasty as compared with other methods.