[Enteral nutrition in the treatment of acute pancreatitis]. / Enteral'noe pitanie v lechenii ostrogo pankreatita.

The review presents literature data on enteral nutrition in the treatment of acute pancreatitis. The authors provide pathophysiological substantiations of the need for nutritional support in patients with various forms of acute pancreatitis and basic principles of enteral nutrition in this disease. The results of numerous studies evaluating the outcomes of enteral nutrition are presented. These data indicate advisability of early enteral nutrition in acute pancreatitis because this approach reduces systemic inflammatory response, risk of bacterial translocation and purulent-septic complications, improves treatment outcomes.

[Disconnected pancreatic duct syndrome in acute pancreatitis]. / Sindrom raz"edinennogo glavnogo protoka podzheludochnoi zhelezy pri ostrom pankreatite.

The review is devoted to diagnosis and treatment of disconnected pancreatic duct syndrome (DPDS) in patients with acute pancreatitis. Data on terminology, indications and options for endoscopic transluminal interventions are presented in detail. The results of numerous studies evaluating clinical efficacy of various endoscopic and open surgical procedures are analyzed. Available data confirm advisability of staged treatment of DPDS with primary endoscopic drainage of pancreatic fluid accumulations in specialized centers.

[Endoscopic transluminal interventions in the treatment of acute necrotizing pancreatitis]. / Endoskopicheskie translyuminal'nye vmeshatel'stva v lechenii ostrogo nekrotiziruyushchego pankreatita.

The review is devoted to endoscopic transluminal interventions in the treatment of acute necrotizing pancreatitis. Terminology, indications and options for transluminal drainage procedures and endoscopic sequestrectomy are presented in detail. The authors analyzed the results of numerous studies devoted to effectiveness of endoscopic interventions and possible combination of treatment options. Modern international clinical guidelines indicating the feasibility of endoscopic treatment of acute necrotizing pancreatitis in multi-field specialized centers are considered.

[Enteroenterostomy in surgical treatment of malignant colonic obstruction]. / Primenenie mezhkishechnogo anastomoza v khirurgicheskom lechenii obturatsionnoi tolstokishechnoi neprokhodimosti opukholevoi étiologii (s kommentariem).

AIM: To consider surgical tactics and to study the immediate results of primary enteroenterostomy in surgical treatment of malignant colonic obstruction. MATERIAL AND METHODS: Radical surgery was performed in 170 (63.9%) out of 266 patients with malignant obstructive colonic obstruction. Colonic resection followed by anastomosis was performed in 68 patients. Conventional hemicolectomy (9 patients) and various original techniques of Y-shaped ileotransversanastomoses (27 patients) were used for right-sided tumor process. In case of left-sided tumor we used intraoperative colonic irrigation with enterosorption (20 operations), Y-shaped anastomoses (9 operations) and subtotal colectomy (3 operations). RESULTS: There was significantly increased mortality in patients with sub- and decompensated stages of malignant colonic obstruction. Postoperative mortality after radical surgery was 10.6%, after palliative interventions - 21.9%. There was similar postoperative mortality after various types of radical interventions with/without enteroenterostomy (8.8% and 11.8%, respectively). CONCLUSION: In favorable clinical situation radical surgery with tumor removal at the first emergency stage should be preferred for malignant colonic obstruction. At the specialized hospital segmental colonic resection with primary anastomosis is possible after comprehensive assessment of surgical risk, intraoperative colonic irrigation is obligatory for left-sided tumor. This approach increases surgical effectiveness and provides early rehabilitation.

[Latex ligation in treatment of chronic hemorrhoids].

We analyzed the results of treatment of 432 patients with chronic hemorrhoids using different variants of latex ligation. New technique including ligation of mucosa and submucosa of low-ampullar rectum providing ligation of hemorrhoidalvessels, lifting and recto-anal repair is developed and suggested. This method is advisable to use in case of chronic internal hemorrhoids stages I and II. The authors recommend simultaneous combined ligation of mucosa of low-ampullar rectum and internal hemorrhoids for stages III and IV. Different variants of latex ligation with external hemorrhoids excision were used in 103 patients. Pointed variants of latex ligation preserve important advantages including mini-invasiveness, simplicity and wide availability, low cost. Good remote results were obtained after these procedures in 87.3% of observations. Suggested tactics extends use of latex ligation and increases its effectiveness in treatment of different stages and forms of chronic hemorrhoids.

[Ultrasound-controlled minimally invasive surgical interventions in abdominal abscesses]. / Maloinvazivnye khirurgicheskie vmeshatel'stva pod ul'trazvukovym kontrolem pri abstsessakh briushnoi polosti.

Results of ultrasound-controlled minimally invasive surgical interventions (UAMISI) for abdominal abscesses are analyzed. 84 operations were performed in 72 patients with good results. Puncture method was used in 12 patients, drainage operation--in 58, endoscopy-guided puncture method--in 2 patients. Indications for different ultrasonic-assisted interventions are developed. It is concluded that at present the UAMISI are the alternative to conventional "open" treatment of abdominal abscesses.

[Surgical treatment of complicated forms of cancer of the right side of the colon]. / Khirurgicheskoe lechenie oslozhnennykh form opukholeí pravoí poloviny obodochnoí kishki.

The results of the treatment of 53 patients with complicated forms of the right side colon cancer are analysed. The radical surgical method with primary removal of the tumor is preferable in this situation. It was possible to perform radical surgery in 69.8 of the cases. In older patients with marked anemia and in patients with decompensated forms of ileus various modifications of hemicolectomy were used. 3 variants of U-shape ileotrasversoanastomosis are described.

[Selection of the most effective method of lateral subcutaneous sphincterotomy in the treatment of fissure in ano]. / Vybor naibolee effektivnoi metodiki bokovoi podkozhnoi sfinkterotomii pri lechenii anal'nykh treshchin.

Under study were results of treatment of 203 patients with chronic anal fissures operated upon with the use of lateral subcutaneous sphincterotomy: 159 patients were subjected to the open variant of this operation, 44 patients--to the closed variant. An analysis of the results has shown advantages of the open technique of the lateral subcutaneous sphincterotomy.

[Lateral subcutaneous internal sphincterotomy]. / Bokovaia podkozhnaia vnutrenniaia sfinkterotomiia.

An original technique of the lateral subcutaneous internal sphincterotomy was used for the treatment of 134 patients with acute and chronic anal fissures, cryptitis, papillitis, aggravation of chronic recurrent paraproctitis and structures of the anus. Recovery was noted in 79 of 80 patients with anal fissures examined repeatedly. No disorders of the obturative function of the anal constrictor were observed after the operation.