RESUMEN
Antireflux resection of mucous membrane of esophagogastric anastomosis (ARMS) was performed on 6 patients with typical symptoms of gastroesophageal reflux disease (GERD). The patients had a short segment of Ñolumnar-celled metaplasia (1-2 cm) without radiological and endoscopic signs of hiatal hernia. All the patients received medicamentous therapy by antisecretory agents more than 3 years. The operation included the endoscopic resection of2/3 circle of mucous membrane of esophagogastric anastomosis and resection of the area of columnar-celled metaplasia. The results of treatment were assessed during 3-7 months after ARMS. There was noted an absence of clinical manifestations of GERD, regression of inflammatory signs of mucous coat of esophagus in 4 out of 6 patients. Symptoms of GERD remained in 2 patients, although the intensity of signs significantly decreased.
Asunto(s)
Esófago de Barrett , Resección Endoscópica de la Mucosa/métodos , Unión Esofagogástrica , Reflujo Gastroesofágico/complicaciones , Adolescente , Adulto , Esófago de Barrett/diagnóstico , Esófago de Barrett/etiología , Esófago de Barrett/cirugía , Unión Esofagogástrica/diagnóstico por imagen , Unión Esofagogástrica/patología , Unión Esofagogástrica/cirugía , Esofagoscopía/métodos , Femenino , Reflujo Gastroesofágico/diagnóstico , Humanos , Masculino , Metaplasia , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Gastroesophageal reflux disease is a widespread among population in economically developed countries including Russia. It was analyzed the results of 34 903 endoscopic examinations of upper gastrointestinal tract in ethnically and socially homogeneous population of Leningrad region with symptoms of gastric dispepsia. Procedures were performed for the period 2007-2013. Prevalence of erosive esophagitis was 4.9%. Peptic esophageal strictures due to chronic reflux-associated inflammation were revealed in 0.2% of examined patients (3.7% of patients with erosive esophagitis). Obtained data allow to considergastroesophageal reflux disease as a socially significant problem in Russia requiring close attention and further study.
Asunto(s)
Estenosis Esofágica/epidemiología , Esofagitis Péptica/epidemiología , Úlcera Péptica/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Endoscopía Gastrointestinal , Estenosis Esofágica/diagnóstico , Estenosis Esofágica/etiología , Esofagitis Péptica/diagnóstico , Esófago/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Úlcera Péptica/complicaciones , Úlcera Péptica/diagnóstico , Prevalencia , Estudios Retrospectivos , Federación de Rusia/epidemiología , Adulto JovenAsunto(s)
Isquemia Fría/métodos , Trasplante de Hígado/métodos , Perfusión/métodos , Humanos , TemperaturaRESUMEN
The article analyzed disadvantages of "Atlanta-92" classification of acute pancreatitis and its two modifications: APCWG-2012 and IAP-2011. The school of Saint-Petersburg pancreatologists suggested the classification AP of Russian Surgical Society (2014), which represented the concept of disease staging.
Asunto(s)
Clasificación/métodos , Pancreatitis , Enfermedad Aguda , Humanos , Pancreatitis/clasificación , Pancreatitis/diagnóstico , Gravedad del PacienteRESUMEN
The abnormalities of myoelectrical activity of gastrointestinal tract were detected in 80 victims with severe combined trauma. There were observed a decrease of total electrical activity and dyscoordination of electrical activity of sections of gastrointestinal tract. An application of substrate antihypoxants should normalize the indices of myoelectrical activity of gastrointestinal tract. This approach allowed elimination of imbalance of total power between superposed (the stomach, the duodenum) and other sections of gastrointestinal tract. This would remove dyscoordination contraction of the jejunum and the ileum.
Asunto(s)
Mononucleótido de Flavina/administración & dosificación , Motilidad Gastrointestinal/efectos de los fármacos , Inosina Difosfato/administración & dosificación , Traumatismo Múltiple , Complejo Mioeléctrico Migratorio/efectos de los fármacos , Niacinamida/administración & dosificación , Choque Traumático , Succinatos/administración & dosificación , Procedimientos Quirúrgicos Operativos/métodos , Administración Intravenosa , Adulto , Combinación de Medicamentos , Electrodiagnóstico/métodos , Femenino , Tracto Gastrointestinal/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Traumatismo Múltiple/complicaciones , Traumatismo Múltiple/diagnóstico , Traumatismo Múltiple/mortalidad , Traumatismo Múltiple/cirugía , Fármacos Neuroprotectores/administración & dosificación , Cuidados Preoperatorios/métodos , Choque Traumático/diagnóstico , Choque Traumático/etiología , Índices de Gravedad del Trauma , Resultado del TratamientoRESUMEN
The article presents an analysis of 34.903 esophagoscopy results performed for population of Leningrad region at the period from 2007 to 2013. A prevalence of erosive esophagitis was 4.9%, peptic strictures--0.18%, columnar-celled metaplasias--1.43% and esophageal adenocarcinoma--0.645%. The data obtained showed a high prevalence of GERD-associated syndromes with injury of mucous coat of esophagus in the local population of Russians.
Asunto(s)
Enfermedades del Esófago , Esofagoscopía/estadística & datos numéricos , Esófago/patología , Reflujo Gastroesofágico , Adulto , Enfermedades del Esófago/diagnóstico , Enfermedades del Esófago/epidemiología , Enfermedades del Esófago/etiología , Femenino , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/epidemiología , Humanos , Masculino , Prevalencia , Federación de Rusia/epidemiologíaAsunto(s)
Costo de Enfermedad , Urgencias Médicas , Servicios Médicos de Urgencia/organización & administración , Oncología Médica/organización & administración , Neoplasias , Procedimientos Quirúrgicos Operativos , Urgencias Médicas/clasificación , Urgencias Médicas/economía , Asignación de Recursos para la Atención de Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Neoplasias/clasificación , Neoplasias/economía , Neoplasias/cirugía , Federación de Rusia , Procedimientos Quirúrgicos Operativos/economía , Procedimientos Quirúrgicos Operativos/estadística & datos numéricosRESUMEN
The article analyzes the experience of application of polymeric (mesh) implants for hiatal closure in patients with gastroesophageal reflux disease (GERD). The authors showed the main principles of the choice of mesh implants and recommendations to their usage. Principal technical stages of surgery are described. It is noted, that the application of prostheses had the high efficiency and safety in antireflux surgery.
Asunto(s)
Fundoplicación , Reflujo Gastroesofágico , Mallas Quirúrgicas , Adulto , Investigación sobre la Eficacia Comparativa , Endoscopía Gastrointestinal/métodos , Femenino , Fundoplicación/instrumentación , Fundoplicación/métodos , Reflujo Gastroesofágico/diagnóstico , Reflujo Gastroesofágico/fisiopatología , Reflujo Gastroesofágico/cirugía , Humanos , Masculino , Diseño de Prótesis , Ajuste de Prótesis/métodos , Resultado del TratamientoRESUMEN
The article is devoted to the choice of antireflux procedure in surgery of gastroesophageal reflux disease. The mechanisms of the most popular antireflux operations are described. The criteria for selecting options of reconstructions gastroesophageal junction are presented in the article. The theoretical propositions are supported by the results of clinical observations.
Asunto(s)
Trastornos de la Motilidad Esofágica , Unión Esofagogástrica/cirugía , Fundoplicación , Reflujo Gastroesofágico/cirugía , Investigación sobre la Eficacia Comparativa , Técnicas de Diagnóstico del Sistema Digestivo , Trastornos de la Motilidad Esofágica/complicaciones , Trastornos de la Motilidad Esofágica/diagnóstico , Unión Esofagogástrica/fisiopatología , Femenino , Fundoplicación/efectos adversos , Fundoplicación/métodos , Fundoplicación/estadística & datos numéricos , Reflujo Gastroesofágico/diagnóstico , Reflujo Gastroesofágico/etiología , Reflujo Gastroesofágico/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
This article presents the analysis of 24384 endoscopic investigations of the upper gastrointestinal tract in population of Leningrad region with symptoms of dyspepsia during the period 2007-2011.The results revealed erosive esophagitis in 5.4%, peptic strictures of the esophagus--0.2%, the columnar-lining esophagus (Barrett's esophagus)--1.1%, and esophageal adenocarcinoma--0.045%. This data shows a high prevalence of esophageal complications of GERD in a local population of Russians.
Asunto(s)
Adenocarcinoma , Esófago de Barrett , Neoplasias Esofágicas , Esofagitis Péptica , Reflujo Gastroesofágico , Adenocarcinoma/epidemiología , Adenocarcinoma/etiología , Esófago de Barrett/epidemiología , Esófago de Barrett/etnología , Neoplasias Esofágicas/epidemiología , Neoplasias Esofágicas/etiología , Esofagitis Péptica/epidemiología , Esofagitis Péptica/etiología , Femenino , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/epidemiología , Humanos , Masculino , Federación de Rusia/epidemiologíaRESUMEN
The article presents an analysis of results of 24 384 endoscopic examinations of the upper gastrointestinal tract in population of the Leningrad oblast with symptoms of gastric dyspepsia during the period from 2007 to 2011. The detection of the columnar-celled metaplasia was 1.1%, adenocarcinoma of the esophagus--0.045%. Esophageal adenocarcinoma occurred in 3.95% of cases of the column-celled esophagus. Barrett's esophagus was revealed in males more often than in women (56.5% and 54.5% respectively). The peak incidence of esophageal adenocarcinoma in males was at the age from 46 to 60 years (36.4% of patients), in females--from 61 to 75 years (27.3% of patients). Intestinal metaplasia was detected in 72.7% of cases with esophageal adenocarcinoma: The diagnosis of long and short segment of column-celled esophagus revealed no significant difference in the development of esophageal adenocarcinoma.
Asunto(s)
Adenocarcinoma/patología , Esófago de Barrett/patología , Endoscopía del Sistema Digestivo/métodos , Neoplasias Esofágicas/patología , Esófago/patología , Adulto , Anciano , Esófago de Barrett/epidemiología , Diagnóstico Diferencial , Progresión de la Enfermedad , Neoplasias Esofágicas/epidemiología , Femenino , Humanos , Incidencia , Masculino , Metaplasia/epidemiología , Metaplasia/patología , Persona de Mediana Edad , Estudios Retrospectivos , Federación de Rusia/epidemiologíaRESUMEN
Operations of transplantation of kidneys taken from donors with expanded criteria with satisfactory results were made on 27 recipients of the older age group (from 60 through 76 years). Standard transplantation of the kidney was made to 20 recipients, and dual renal transplantation to 7 recipients. Mean level of creatinine in elderly patients on the 21st day was (340.9 +/- 49.3) microM/l, on the 90th day (124.6 +/- 6.9) microMl/l.
Asunto(s)
Selección de Donante , Trasplante de Riñón , Riñón , Preservación de Órganos , Recolección de Tejidos y Órganos , Anciano , Cadáver , Causas de Muerte , Selección de Donante/métodos , Selección de Donante/normas , Femenino , Humanos , Fallo Renal Crónico/fisiopatología , Fallo Renal Crónico/cirugía , Pruebas de Función Renal , Trasplante de Riñón/métodos , Trasplante de Riñón/normas , Masculino , Persona de Mediana Edad , Preservación de Órganos/métodos , Preservación de Órganos/normas , Selección de Paciente , Recolección de Tejidos y Órganos/métodos , Recolección de Tejidos y Órganos/normas , Resultado del TratamientoAsunto(s)
Antifibrinolíticos/administración & dosificación , Úlcera Duodenal , Úlcera Péptica Hemorrágica/tratamiento farmacológico , Úlcera Gástrica , Ácido Tranexámico/administración & dosificación , Anciano , Relación Dosis-Respuesta a Droga , Endoscopía Gastrointestinal , Femenino , Estudios de Seguimiento , Hemoglobinas/metabolismo , Humanos , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Úlcera Péptica Hemorrágica/sangre , Úlcera Péptica Hemorrágica/diagnóstico , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The examination and treatment of 64 patients have shown that inclusion of complex antioxidant cytoflavin in intensive therapy at the postoperative period of diffuse peritonitis allows the hypoxia degree to be decreased that in its turn results in quicker recovery of the antioxidant system and decreased activity of peroxidation and endotoxicosis level. The clinical course of the postoperative period of diffuse peritonitis with cytoflavin included in intensive therapy is characterized by shorter terms of artificial lung ventilation, shorter time of staying in critical condition, more favorable course of complications.
Asunto(s)
Antioxidantes/uso terapéutico , Endotoxemia/tratamiento farmacológico , Mononucleótido de Flavina/uso terapéutico , Radicales Libres/metabolismo , Inosina Difosfato/uso terapéutico , Niacinamida/uso terapéutico , Peritonitis/tratamiento farmacológico , Complicaciones Posoperatorias/tratamiento farmacológico , Succinatos/uso terapéutico , Adulto , Combinación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo PosoperatorioRESUMEN
In order to improve radicalism of emergency surgical interventions an appropriate method of total mesocolonectomy and D3-lymph node dissection in the medial-lateral direction and the principle of "no-touch technique" were used in 14 patients. This technique is safe, effective, does not prolong the duration of operation and postoperative period, is not followed by increased number of complications and lethality.
Asunto(s)
Neoplasias del Colon/cirugía , Urgencias Médicas , Tratamiento de Urgencia/métodos , Obstrucción Intestinal/cirugía , Anciano , Neoplasias del Colon/complicaciones , Neoplasias del Colon/patología , Femenino , Humanos , Obstrucción Intestinal/etiología , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
The authors have analyzed experience with treatment of pain syndrome in 45 patients, in 31 of them thoracoscopic sympathsplanchnectomy was fulfilled. The operation was shown to give a pronounced analgetic effect and improved quality of life of patients.
Asunto(s)
Dolor Intratable/etiología , Dolor Intratable/cirugía , Páncreas/lesiones , Neoplasias Pancreáticas/complicaciones , Nervios Esplácnicos/cirugía , Toracoscopía , Femenino , Humanos , Masculino , Dimensión del Dolor , Resultado del TratamientoRESUMEN
The author reports results of clinical assessment of cytoflavin for injections in the treatment of different pathological condition including critical ones. It was shown that therapy reduces mortality among patients with acute disturbances of cerebral circulation to 4.8-9.6% compared with 11.7-17.1% in controls. Positive dynamic of neurologic status was documented in 79% of the patients with dyscirculatory encephalopathy versus 25% in control. Duration of comatose state decreased 1,7-fold, length of stay in resuscitation and intensive therapy wards 1.8-fold, and frequency of internal complications secondary to the effect of neurotropic poisons 2-fold. Cytoflavin corrected the level of metalloproteides and stabilized antioxidative potential of sera and cerebrospinal liquid in patient with meningitis including that of zoonotic etiology. In the period of post-narcosis rehabilitation cytoflavin restored conscience in 77% of the patients within 20 min. The drug also inhibited pathological alcohol addiction within 5 days after the onset of therapy as apparent from the improvement of intellectual-mnestic status and activization of attention. The frequency of infectious complications in patients with acute surgical abdominal pathology decreased by 5.1% and lethality by 3.6% compared with placebo group. Cytoflavin exhibited cardioprotective action in patients with myocardial infarction, during cardiosurgical intervention, and chronic brucellosis. It had hepatoprotective effect in iatrogenic hepatic conditions as well as ophthalmo- and oto-protective activity.