[The role of macroscopic traits in the diagnosis and prognosis of the polyp morphological type].

The aim of this work was to compare macroscopic traits of polyps and their morphological structure. A total of 97 (82.9%) patients with hyperplastic polyps and 20 (17.1%) with adenomatous polyps were examined. It was shown that neither the shape, colour, surface structure nor the degree of erosion reflects morphological features of the polyps. Hyperplasia of polyps can be reliably (p < 0.01) diagnosed only from the combination of their multiple character and localization in the stomach. All isolated and single polyps are subject to morphological examination.

[Diagnostics of the residual stomach polyps].

This article presents the comparative analysis of the macroscopic and the morphological characteristics of primary and remote residual stomach polyps. There were significant signs of macroscopic residual polyps, allowing them to diagnose by endoscopic examination. Histological features allow us to attribute residual polyp group of hyperregeneratory.

[Polyposis of the stomach. Endoscopic treatment or follow-up?].

Out of 3243 patients with gastric polips, polyposis was diagnosed in 298 ones including 135 cases of complicated and 163 cases of uncomplicated forms. Hyperplastic polips were diagnosed in 281 patients. Along with hyperplastic polyps, solitary adenomas were diagnosed in 9 cases, Peitz-Jegerc polyps - in 6, and juvenile polyps - in 2. Polypectomy was performed in 153 patients: partial - in 104, and total - in 49. Follow-up was carried out in 98 non-operated patients, indications for endoscopic surgery were seen in 18 cases. After partial endoscopic polypectomy, repolypectomy was performed in 24 cases: single - in 8, multiple - in 16. Repeated endoscopic treatment after total polypectomy was performed in 3 patients. There were no cases of polyp transformation into cancer. Open surgical treatment was not performed. There were no severe complications after endoscopic treatment.

[Morphofunctional parallels in patients with chronic gastritis].

The main method of chronic gastritis diagnostics today is morphologic study of biopsy materials obtained during the endoscopic study. However, morphologic data do not reflect the functional state of the stomach and, first of all, its acid production function. Certain restrictions of morphologic gastritis diagnostics are the small size of biopsy materials, problems with atrophy diagnostics in marked inflammatory infiltration and loss or metaplasia of specialized cells. Endoscopic pH-metry reflects impartially the state of the acid production function of the stomach, which helps not only to specify the diagnosis but also to choose the right therapy method and management tactics.

[Diagnosis and treatment of patients with acute postintubation and post-tracheostomy stenosis of the larynx and trachea]. / Diagnostika i lechenie bol'nykh s ostrymi postintubatsionnymi i posttrakheostomicheskimi stenozami giortani i trakhei.

The data on diagnosis and treatment of 200 patients with acute postintubation laryngostenosis (LS) and tracheostenosis (TS) are reviewed. Peculiarities of tracheostomy technique practiced in critical care units are specified. Postintubation and posttracheostomy alterations in the larynx and trachea detected endoscopically are described. Effective endosurgical methods are proposed to avoid multistage surgical rehabilitation for recovery of the respiration function in 97% LS and TS patients.

[The surgical and endoscopic treatments of benign submucosal tumors of the esophagus, stomach and duodenum]. / Khirurgicheskoe i éndoskopicheskoe lechenie dobrokachestvennykh podslizistykh opukholei pishchevoda, zheludka i dvenadtsatiperstnoi kihki.

Analysis of the results of various modes of treatment and follow-up of 160 patients with benign submucosal tumors (BST) was carried out. Most often histological type of BST was leiomyoma (43.7%). BST were mainly located in the stomach (68.7%). 22 patients underwent open operations, 37--endoscopical removal of BST, 101 patients were followed-up from 5 to 10 years. The analysis of the material makes it possible to come to the conclusions about advisability of endoscopical treatment. The results of which are not inferior to surgical method of treatment. In patients with absence or slow growth of BST endoscopic follow-up is valid.

[Vibration bouginage in the cicatricial strictures of esophagus]. / Vibratsionnyí sposob buzhirovaniia pri rubtsovykh strikturakh pishchevoda.

In 66 patients for the dilation of the cicatricial stricture of the esophagus vibration method was used. In 48 patients the vibrator was attached to proximal end of the bouge, in 18 patients the vibration device was introduced directly in the area of the stricture. The suggested method provided an easy and fast dilation of the stricture in 63 patients. In 3 cases surgical treatment was carried out because multiple strictures in separate areas resulted in complete obliteration of the esophagus. There were no complications due to the vibrobouginage. For the treatment of inflammatory disorders of the esophagus and for prophylaxis of the scar formation in the area of stricture in 29 patients the therapeutic laser irradiation was used. This treatment has ensured promising results.

[Endoscopic diagnosis and treatment of cicatricial esophageal strictures]. / Endoskopicheskaia diagnostika i lechenie rubtsovykh striktur pishchevoda.

The paper summarizes the experience gained by the authors in 10-year treatment of esophageal cicatricial strictures. Work-up and treatment results available on 107 relevant patients provided evidence on the leading role of endoscopic diagnosis in cicatricial strictures, while endoscopic bouginage is effective treatment of the strictures. To prevent recurrences esophageal bouginage should be combined with drug and laser therapy. The immediate response was reached in 91 (85%) patients. Long-term response was good only in 34 (46.6%) patients. Six slight complications passed off without special treatment.

[Endoscopy in the diagnosis and treatment of abdominal adhesions]. / Vozmozhnosti éndoskopicheskogo metoda pri spaechnoi bolezni briushnoi polosti.

Therapeutic and diagnostic laparoscopy was performed in 48 patients with chronic abdominal pain due to an adhesive process in the abdominal cavity. Laparoscopic treatment was applied only in patients who experienced pain when the adhesions were pulled with instruments. The adhesions were divided, the vessels were coagulated, and the organs were separated from the adhesions with instruments introduced into the abdominal cavity through additional punctures made in the anterior abdominal wall. The immediate results of the treatment were good in 44 out of 48 patients (91.6%). The late-term results were studied in 46 patients in follow-up periods of 12 months to 6 years. Recurrences were found in only 4 cases. Complications requiring special treatment were not encountered. Therapeutic and operative endoscopy is an effective and safe method for treating patients with adhesive disease manifested by abdominal pain.

[Auto-recanalization of anastomosis in the surgery of esophagus and large intestine ]. / Autorekanaliziruiushchiesia anastomozy v khirurgii pishchevoda i tolstoi kishki.

The authors developed a techniques of anastomosis formation after gastrectomy, proximal resection of the stomach, and resection of the descending colon and rectum in which the anastomosis begin functioning a few days after the operation. They called them autorecanalizing anastomoses. From the moment of the operation and to autorecanalization the lumina of the anastomosed organs are drained by original methods. The purpose of the developed techniques for the formation of autorecanalizing anastomoses and the methods for decompression and draining of the operated on organs is to reduce the risk of suture incompetence and the hazardous effect of this complication on the patient's life.

[Esophagogastroduodenoscopy in the diagnosis of benign nonepithelial tumors of the esophagus, stomach and duodenum]. / Ezofagogastroduodenoskopiia v diagnostike dobrokachestvennykh neépitelial'nykh opukholei pishchevoda, zheludka i dvenadtsatiperstnoi kishki.

Benign non-epithelial tumors cannot be detected unless endoscopy is used. When coupled with certain other procedures and biopsy it provides means for detection of these tumors as well as identification of their size, site, type of growth and concomitant complications. Single tumors were found in 156 and multiple ones in 4 cases. During the follow-up study, growth of tumor from 1 to 10 mm was observed in 11 cases only.

[Endoscopic treatment of patients with benign non-epithelial tumors of the esophagus, stomach and duodenum]. / Endoskopicheskoe lechenie bol'nykh s dobrokachestvennymi neépitelial'nymi opukholiami pishchevoda, zheludka i dvenadtsati- perstnoi kishki.

The authors discuss the results of endoscopic removal of benign nonepithelial tumors (BNET) in 45 patients. The data on the character of the process, the site of BNET, its size, rate of the growth, complications, obtained during endoscopy and histological examination of the biopsy material are of definite importance in the choice of the treatment method for BNET. Electric excision alone was used for endoscopic removal of BNET. No complications were recorded. No relapses were revealed within the observation periods from 1 to 14 years. Endoscopic treatment is feasible and tolerable; it does not require the long patient's stay at the hospital. In part of patients, the endoscopic technique can be employed under ambulatory conditions.

[The importance of bronchoscopy in the comprehensive examination and treatment of patients with deforming bronchitis]. / Znachenie bronkhoskopii v kompleksnom obsledovanii i lechenii bol'nykh s deformiruiushchim bronkhitom.

5-year experience gained in three Moscow hospitals with bronchoscopic examinations of tracheobronchial lesions is analyzed. Out of 10809 procedures performed 337 were indicative of deforming bronchitis. Diagnostic evidence was furnished by x-ray, bronchography, fiber bronchoscopy with biopsy, radiologic evaluation of the lungs. Local bronchoscopic treatment was delivered to 209 patients. As a rule, the course involved 5-6 therapeutic bronchoscopies and was repeated on demand. The response was achieved in 97.6% of the patients.

[Value of bronchoscopy in the diagnosis and treatment of foreign bodies of the trachea and bronchi]. / Znachenie bronkhoskopii v diagnostike i lechenii bol'nykh s inorodnymi telami trakhei i bronkhov.

10-year experience gained at the Moscow Endoscopic Center attached to S. P. Botkin City Hospital with bronchoscopic investigations for tracheobronchial pathology verification covers 14542 procedures. Foreign bodies were detected in 38 patients, of these 12 patients had aspirated the bodies long before the investigation. There were 18 males and 20 females aged from 15 to 85 years. To remove the foreign bodies, a bronchofibroscope was used in 34, a rigid bronchoscope in 4 patients. Sharp bodies and dentures were extracted with a metal loop, those of complex configuration were pulled out by a forked forceps. The removal was followed by toilet bronchoscopy. Complications due to the diagnostic or therapeutic bronchoscopy in patients with foreign bodies were not recorded.

[Complications of endoscopic examinations of the upper segments of the gastrointestinal tract]. / Oslozhneniia pri éndoskopicheskom issledovanii verkhnikh otdelov pishchevarite'lnogo trakta.

A ten-year experience with 106610 diagnostic esophagogastroduodenoscopies provided evidence of a 0.03% rate of relevant complications and 2.38% mortality. Out of 39 patients with endoscopy-related complications 5 were operated on: 4 had esophageal perforations, 1 had hemorrhage following biopsy of the ulcer. Out of 7384 therapeutic and operative endoscopies none were associated with lethal outcome. Surgery was avoided either. Complications developed in 45 patients (0.036%): in 44 patients hemorrhages occurred after electroexcision of the polyps.

[Endoscopic treatment of cicatricial stenosis of the esophagus]. / Endoskopicheskoe lechenie rubtsovykh suzhenii pishchevoda.

On the basis of experience in the examination and treatment of 118 patients with cicatricial stenoses of the esophagus the authors came to the conclusion that endoscopic examination is the main method for identifying the character of the narrowing and that esophagoscopy should be performed in all cases of recognized or suspected cicatricial stenosis of the esophagus. Endoscopic methods of treatment were also applied: removal of foreign bodies from the cicatricially changed esophagus, the advancement of a guiding string during esophagoscopy for therapeutic bougienage, cutting the cicatricial tissue with an electric knife.