[Method of gastric drainage in connection with vagotomy in treatment of complicated posbulbar ulcers].

New surgical technique for treatment of "low" duodenal ulcers--transversal posterior retrocolic gastroenteroanastomosis with selective proximal vagotomy--was worked out and introduced by the authors. 78 patients (61 men and 17 women at the age of 14-76 years) with "low" duodenal ulcers were operated using this technique during 1982-2007 years. Short-term and long-term results of treatment were studied. Advantages of this technique and indications for the operations were determined. Obtained results indicate that this surgical approach is reliable and effective and can be applied in clinical practice.

[Substantiation of perineal access to internal pudendal artery].

Perineal access to a. pudenda interna (API) was elaborated. Variants of the a. iliaca interna and her branches localization and topographic-anatomic peculiarities of perineal portion of API were studied. The proposed perineal (extraperitoneal) access to API is most expedient in the perineal region bleeding stopping. Morphometrical parameters of perineal portion of API permit to apply her for formation of vascular anastomosis in the procedure of revascularization of the descended colon while the intestinal continuity restoration.

[Functions of the stomach after parasympathetic denervation of the fundus and uncoupling of the fundus and antral portions]. / Funktsii zheludka pri parasimpaticheskoi denervatsii fundal'nogo otdela i razobshchenii fundal'nogo otdela s antral'nym.

Selective proximal vagotomy (SPV) evoked the same alterations in the motility of fundal part of the dog stomach as truncal vagotomy. Within 2-3 months the fundal motility was completely normalized. If the SPV were carried out with preserved innervation in the cardial zone, the motility restoration was accelerated to 7-10 days. But is SPV was added to the disconnection of antral part with proximal stomach, its motility did not restore at all. SPV initially suppressed the insulin secretion to 70-85 per cent; in 6-12 months this suppression decreased to 60 per cent and stabilized on this level. The Auerbach plexus seems to differ from the Meissner plexus in that the former can transfer the gaval influence from the innervated zone into the denervated one. Judging by the functional indices the growth of vagal fibers from the innervated zone into the denervated one did not take place.

[Effect of various types of vagotomy on gastric secretion of histamine in dogs]. / Vliianie razlichnykh vidov vagotomii na gistaminovuiu zheludochnuiu sekretsiiu u sobak.

The chronic experiments on dogs with fundal fistulas have revealed that the partial stomach denervation (selective proximal, selective distal and subcardial vagotomies) decreases the gastric secretory responses caused by submaximal and maximal doses of histamine. Selective and extragastral vagotomies do not change the histamine gastric secretion in dogs, stimulated by the maximal histamine dose.

[The effect of extragastric vagotomy on gastric emptying and motility of the small intestine]. / Vliianie ékstragastral'noi vagotomii na zheludochnuiu évakuatsiiu i motoriku tonkoi kishki.

Selective parasympathetic denervation of small and some large intestine has been performed in dogs. Chronic experiment on these dogs has revealed that this operation: has no effect on frequency and amplitude of intestine contractions during the first phase of the digestive process but it is accompanied by significant relaxation of the motor intestine activity in the second phase, causes a retardation of the rate of evacuation from stomach by 56.0% in dogs subjected to extragastric vagotomy as well as pH of chyme in the duodenum by 1-1.5 units above the norm.

[Surgical treatment of ischemic colitis in patients with abdominal aortic aneurysm]. / Sposob khirurgicheskogo lecheniia ishemicheskogo kolita pri anevrizme briushnoi aorty.

The authors suggest an original method for revascularization of the inferior mesenteric artery for the prevention and treatment of ischemic colopathy in operative treatment of abdominal aortic aneurysm. The essence of the method consists in shunting the blood flow from the channel of the celiac trunk by anastomosing the right gastroepiploic artery with the inferior mesenteric artery by the end-to-end techniques. Topographoanatomical studies of the right gastroepiploic and inferior mesenteric arteries were conducted on 22 cadavers for experimental substantiation of the suggested method. Besides that, selected angiograms of the celiac trunk and its branches were studied in 50 patients. The suggested method for revascularization of the inferior mesenteric artery in resection of aneurysm of the abdominal aorta with intraluminal prosthetics was applied in eight patients with good results.

[Acute gastroduodenal ulcers following vagotomy]. / Ostrye gastroduodenal'nye iazvy posle vagotomii.

The authors describe 7 patients who developed acute bleeding (in 2) and perforating (in 5) erosions and peptic ulcers after different kinds of vagotomy within the terms of from 2 to 20 days. On the basis of the literature data and personal clinical investigations the authors analyze the causes responsible for the appearance of ulcers following vagotomy.

[Surgical treatment of acute erosions and ulcers of the digestive organs complicated by profuse hemorrhage]. / Khirugicheskoe lechenie ostrykh érozii i iazv organov pishchevareniia, oslozhnennykh profuznym krovotecheniem.

Under analysis were results of the surgical treatment of 32 patients with bleeding acute ulcers and erosions of organs of digestion. The analysis has shown that the most effective procedures for this pathology are devascularization of the stomach and vagotomy in combination with suturing and ligation of sources of the bleeding.

[The functional status of esophago-gastric transition segment in patients with burns of esophagus]. / Funktsional'noe sostoianie pishchevodno-zheludochnogo perekhoda u bol'nykh s ozhogom pishchevoda.

We examined 57 patients with burns of esophagus at the age of 18-76 years old. We analyzed the symptoms and medical history of the patients, used contrast X-ray examination, endoscopic imaging with biopsy of esophagogastric crossing, the test for gastroesophageal reflux, gastric intubation and pH-metry. The advanced gastroesophageal reflux was registered 1.5-2 years after surgery, then the function of gastroesophageal sphincter recovered. The information about reflux is essential before the intervention is conducted, in order to correct it during operation.

[Outcome prognosis of esophagoplasty of esophagus burns with colonic segment ]. / Prognozirovanie iskhoda ézofagoplastiki s ispol'zovaniem segmenta tolstoi kishki pri ozhogovoi bolezni pishchevoda.

Peculiarities of postburn esophagitis course and subsequent rehabilitation of patients with burn of esophagus were studied. The authors had systematized and proposed classification of postburn esophagitis, considering prognosis of autoplastic results using segment of colon for postburn esophageal impassability. Right calculation and logical interpretation, determination of significance of postburn esophagitis will provide success of autoplastic rehabilitation of patients with burn disease of the esophagus.

[Prognosis of the long-term results of selective proximal vagotomy]. / Prognozirovanie otdalenykh rezul'tatov selektivnoi proksimal'noi vagotomii.

A selective proximal vagotomy risk map was created on the basis of risk factors of selective proximal vagotomy (SPV). The severity of initial state of the patient was determined by the map and expressed in scoring system. Four degrees of risk of unfavourable remote results of the operative procedure were established. The result was found to depend on the sum of scored points and risk degree. It was found that recurrent ulcers were most probable after isolated SPV, dumping syndrome followed SPV with the Finney pyloroplasty, other functional disorders took place after SPV with gastroduodenostomy after Jabuley.

[Strategies in surgical treatment of ulcers at present time]. / Taktika khirurgicheskogo lecheniia iazvennoi bolezni na sovremennom étape.

Modern state of a problem concerning the ulcer disease (UD) of stomach and duodenum conservative and operative treatment was suggested. Possibilities and perspectives of medicinal therapy were evaluated critically. Indications for surgical treatment of UD were substantiated. Method of choice in duodenal UD is performance of organ preserving intervention, in gastric UD--piloro--and antrumpreserving resection.