[Synchronous left atrial myxoma and gastric cancer: a case report]. / Sinkhronnye miksoma levogo predserdiya i rak zheludka. Klinicheskii sluchai.

The authors present a 57-year-old patient with synchronous left atrial myxoma and gastric cancer undergoing staged treatment. Distal gastrectomy with gastroduodenostomy at the first stage was followed by resection of the left atrial myxoma after 22 days. Postoperative period was uneventful after both interventions. The follow-up examination revealed favorable clinical status and no cancer progression.

[Features and results of minimally invasive treatment of recurrent achalasia]. / Osobennosti i rezul'taty maloinvazivnogo lecheniya retsidiva akhalazii kardii.

OBJECTIVE: To evaluate the early and long-term postoperative outcomes in patients with recurrent achalasia, as well as the main features of surgical treatment. MATERIAL AND METHODS: There were 7 patients (4 men and 3 women) with recurrent achalasia. Mean age of patients was 42.3±13.5 years, body mass index - 22.7±3.3 kg/m2. Physiological status ASA grade 1-3 was observed in all patients. Concomitant diseases were diagnosed in 5 (71.4%) cases. Six (85.7%) patients underwent laparoscopic Heller cardiomyotomy with Dor fundoplication. Peroral endoscopic myotomy (POEM) was performed in 1 (14.3%) patient. Mean preoperative Eckardt score was 10.7±1.4 points, mean GERD-HRQL score - 42.7±6.4 points. According to preoperative radiography, 5 (71.4%) patients had achalasia stage III, 2 (28.6%) ones - stage IV. RESULTS: All patients underwent laparoscopic Heller esophagocardiomyotomy with anterior Dor fundoplication and posterior partial fundoplication with posterior cruroraphy. Intraoperative complications (perforation of esophageal mucosa) occurred in 3 (42.9%) patients. Mean surgery time was 130±56 min, mean blood loss - 37 ml (35-205 ml), mean hospital-stay - 11.3±7.7 days. Postoperative complications Clavien-Dindo grade 3-4 were detected in 1 (14.3%) patient. One patient was diagnosed with bilateral pneumonia (SARS-Cov-2 infection) in 4 postoperative days. Median postoperative follow-up period was 22 months. Mean BMI in 6 months after surgery was 25.3±3.1 kg/m2, mean Eckardt score - 2.1±0.7 points, mean GERD-HRQL score - 3.3±0.9 points. CONCLUSION: Our data confirm the effectiveness and safety of the modified laparoscopic Heller procedure with Dor fundoplication as the main method for recurrent achalasia.

[Esophageal achalasia: possible pathogenic concepts from the perspective of modern notions]. / Akhalaziya kardii: vozmozhnye patogeneticheskie kontseptsii s pozitsii sovremennykh predstavlenii.

Esophageal achalasia is an esophageal motility disease characterized by impaired relaxation of lower esophageal sphincter (LES) and severe clinical symptoms. The main etiological factors and other essential aspects of pathogenesis and progression of this disorder are actively studied. To date, the question of significance of etiological factors is experimental and requires further study. In this review, the authors analyzed and summarized the modern data on etiology and pathogenesis of this disease considering the new researches devoted to this issue.