[Advanced endoscopic vacuum therapy for anastomotic leakage in the upper gastrointestinal tract]. / Usovershenstvovannaya endoskopicheskaya vakuumnaya terapiya pri nesostoyatel'nosti anastomozov verkhnikh otdelov zheludochno-kishechnogo trakta.

OBJECTIVE: To evaluate the effectiveness and clinical aspects of advanced endoscopic vacuum therapy for esophagogastric, esophagointestinal and gastrointestinal anastomotic leakage, to identify disadvantages and further possibilities for its improvement. MATERIAL AND METHODS: The study included 69 people. Esophagodudodenal anastomotic leakage was detected in 34 patients (49.27%), gastroduodenal anastomotic leakage - in 30 patients (43.48%), esophagogastric anastomotic leakage - in 4 (7.25%) patients. Advanced endoscopic vacuum therapy was used for these complications. RESULTS: Vacuum therapy in patients with esophagodudodenal anastomotic leakage led to complete healing of defect in 31 (91.18%) cases. In 4 (14.8%) cases, minor bleeding was noted during replacement of vacuum dressing. There were no other complications. Three (8.82%) patients died from secondary complications. Treatment of gastroduodenal anastomotic failure resulted complete healing of defect in 24 (80%) patients. Six (20%) patients died including 4 (66.67%) cases associated with secondary complications. Vacuum therapy for esophagogastric anastomotic leakage resulted complete healing of defect in 4 (100%) patients. CONCLUSION: Advanced endoscopic vacuum therapy is a simple, effective and safe method of therapy for esophagogastric, esophagoduodenal and gastrointestinal anastomotic leakage.

[Therapeutic hygiene of eyelids in dry eye disease prior to cataract phacoemulsification]. / Terapevticheskaya gigiena vek pri sindrome «sukhogo glaza¼ pered provedeniem fakoemul'sifikatsii katarakty.

PURPOSE: The study evaluates the effectiveness of eyelid hygiene (EH) in correction of the ocular surface (OS) condition in patients with dry eye disease (DED) ahead of cataract phacoemulsification (CPE). MATERIAL AND METHODS: The study included 90 patients with cataract: the first group consisted of 45 DED patients with lipid deficiency, the second group - 45 DED patients with lipid/mucous deficiency. Prior to CPE, all patients were randomized into three subgroups of 15 people each. In subgroups 1.1 and 2.1 patients did not receive any treatment for correction of the state of ocular surface. Patients in subgroups 1.2 and 1.3 were instilled 0.18% sodium hyaluronate (SH); in subgroups 2.2 and 2.3 - fixed combination of 0.15% SH and 3% trehalose. In subgroups 1.3 and 2.3 EH was performed (with «Blefarogel cleansing¼, «Blefarolotion¼, «Blefarogel-1¼ two times a day for one month before CPE). The control points were: 1) at study inclusion; 2) after correction of the ocular surface condition; 3) 30 days after CPE. The following parameters were evaluated: OSDI, TBUT (Norn's test), severity of meibomian gland dysfunction (MGD), patient satisfaction with CPE (CPE-PS). Statistical analysis: M±SD calculation, Mann--Whitney, Kruskal-Wallis and Wilcoxon tests. RESULTS: At the second control point, a statistically significant more pronounced OSDI decrease and bigger increase in TBUT were observed in subgroups 1.3 and 2.3 compared to subgroups 1.2 and 2.2 (Mann-Whitney U-test). Apparently, this was associated with a reduction in MGD severity in patients who received EH. At the third control point, significant lower values of OSDI and MGD severity, higher TBUT values and greater CFE-PS were recorded in subgroups 1.3 and 2.3 (Kruskal-Wallis test, Wilcoxon two-sample test). CONCLUSION: Carrying out EH using the «Blefarogel cleansing¼, «Blefarolotion¼, «Blefarogel-1¼ and artificial tear in patients with DED and cataract can increase the efficiency of correction of ocular surface condition and improve patient satisfaction with the outcome of CPE.