RESUMO
A detailed analysis of clinico-endoscopic peculiarities of gastric ulcer type I and II was presented. The peculiarities of a clinical course and the complications character of differently localized gastric ulcers were determined. There was shown the connection between concomitant disorders of esophagogastroduodenal motor-evacuation function and gastric ulcer localization and type. While tactics of treatment and operative procedure choosing it is mandatory to take into account the clinical course peculiarities and the results of endoscopic investigation.
Assuntos
Gastroscopia , Úlcera Gástrica/patologia , Diagnóstico Diferencial , Refluxo Duodenogástrico/complicações , Refluxo Duodenogástrico/patologia , Refluxo Duodenogástrico/fisiopatologia , Feminino , Mucosa Gástrica/patologia , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/patologia , Refluxo Gastroesofágico/fisiopatologia , Motilidade Gastrointestinal/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Gástrica/complicações , Úlcera Gástrica/fisiopatologiaRESUMO
The literature data and own experience results concerning treatment of relatively rare multiple and prepyloric ulcers were summarized. The peculiarities of functional diagnosis methods of these ulcers are adduced. The tactics of surgical treatment, depending on localization, the complication character and gastric functional state was substantiated.
Assuntos
Antro Pilórico/cirurgia , Piloro/cirurgia , Úlcera Gástrica/cirurgia , Adulto , Feminino , Gastrectomia , Ácido Gástrico/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Antro Pilórico/metabolismo , Piloro/metabolismo , Úlcera Gástrica/diagnóstico , Úlcera Gástrica/metabolismo , Adulto JovemRESUMO
The literature data are presented on the nature and characteristics of acid-production on gastric ulcer disease. Functional status and gastric acid-production indicators related to duration of ulcer disease, especially its clinical course, the nature of complications. The advantage as aspiration probe method, and stomach pH-metry were shown. Indicators of stomach acid-production should be taken into account when determining the surgical tactics and choice of intervention method for ulcer disease.
Assuntos
Ácido Gástrico/metabolismo , Mucosa Gástrica/metabolismo , Úlcera Gástrica/metabolismo , Determinação da Acidez Gástrica/instrumentação , Humanos , Concentração de Íons de Hidrogênio , Índice de Gravidade de DoençaRESUMO
Anastomositis and abdominal cavity infiltrate constitutes the most frequent early inflammatory complications, occurring after gastrointestinal operations. The informativity of diagnostic methods of these complications, the volume and efficacy of conservative curative procedures were shown. Introduction of antihomotoxic preparations in complex of treatment measures, in part, of Traumeel C, Lymphomyosot, Mucosa compositum C, Echinacea compositum C had promoted the efficacy raising and the shortening of the treatment duration of these complications.
Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Procedimentos Cirúrgicos do Sistema Digestório , Inflamação/tratamento farmacológico , Materia Medica/uso terapêutico , Complicações Pós-Operatórias/tratamento farmacológico , Anti-Inflamatórios não Esteroides/administração & dosagem , Terapia Combinada , Quimioterapia Combinada , Humanos , Materia Medica/administração & dosagem , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapiaRESUMO
The indices of local and the system immunity were studied up in the patients, suffering gastroduodenal ulcer disease. The local immunity peculiarities were noted, characterizing the lowering of the reparative processes activity and gastric ulcers refractivity to conservative treatment, thus confirming the necessity of active surgical tactics application in such patients.
Assuntos
Úlcera Duodenal/imunologia , Úlcera Gástrica/imunologia , Adulto , Idoso , Citocinas/sangue , Citocinas/imunologia , Úlcera Duodenal/sangue , Úlcera Duodenal/cirurgia , Duodeno/imunologia , Feminino , Humanos , Imunidade Celular , Imunidade Humoral , Imunoglobulinas/sangue , Imunoglobulinas/imunologia , Masculino , Pessoa de Meia-Idade , Neutrófilos/imunologia , Fagocitose/imunologia , Estômago/imunologia , Úlcera Gástrica/sangue , Úlcera Gástrica/cirurgia , Adulto JovemRESUMO
The results of quality of life estimation in the patients are presented, in whom infrared photocoagulation was applied for chronic internal hemorrhoids, including in 141 (58%) of them--performed, according to the standard method (control group) and in 102 (42%)--according to the elaborated method of selective infrared photocoagulation of distal branches of a. rectalis superior under Doppler control (the group of investigation). The patients quality of life was estimated with the help of SF-32 questionnaire according to WHO protocol (WHOQOL, 1993) before the treatment and in 6 mo, 1 and 2 years after the miniinvasive treatment conduction. In the patients of investigation group all the quality of life indices were trustworthy better (P < 0,01), comparing with those before the treatment.
Assuntos
Hemorroidas/terapia , Raios Infravermelhos/uso terapêutico , Fotocoagulação/métodos , Qualidade de Vida , Adolescente , Adulto , Idoso , Doença Crônica , Feminino , Hemorroidas/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto JovemAssuntos
Gastrinoma/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adulto , Feminino , Gastrinoma/diagnóstico por imagem , Gastrinoma/patologia , Gastrinoma/cirurgia , Humanos , Laparoscopia , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , UltrassonografiaRESUMO
The literature data and the results of own investigations on gastric recurrent ulcers occurrence after organpreserving operations performance for the ulcer disease are summarized. The data on gastric recurrent ulcers occurrence rate are adduced. Modern views on possible causes of occurrence, necessary volume and informativity of investigation methods and tactics of treatment are presented. Gastroduodenal motor-evacuation function disorders, duodenogastric reflux and gastric hypersecretion are suggested as a most frequent causes of gastric recurrent ulcers occurrence. The method of operative intervention choice for recurrent gastric ulcer is determined by the cause of its occurrence, as well as the character of ulcer complication and the kind of previous surgical procedure performed.
Assuntos
Úlcera Duodenal/cirurgia , Gastrectomia/efeitos adversos , Síndromes Pós-Gastrectomia/cirurgia , Úlcera Gástrica/cirurgia , Vagotomia Gástrica Proximal/efeitos adversos , Adulto , Úlcera Duodenal/diagnóstico , Úlcera Duodenal/etiologia , Úlcera Duodenal/metabolismo , Úlcera Duodenal/fisiopatologia , Refluxo Duodenogástrico/diagnóstico , Refluxo Duodenogástrico/etiologia , Feminino , Ácido Gástrico/metabolismo , Motilidade Gastrointestinal/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes Pós-Gastrectomia/diagnóstico , Síndromes Pós-Gastrectomia/etiologia , Recidiva , Reoperação , Úlcera Gástrica/diagnóstico , Úlcera Gástrica/etiologia , Úlcera Gástrica/metabolismo , Úlcera Gástrica/fisiopatologia , Resultado do TratamentoAssuntos
Apendicite/cirurgia , Apêndice/anormalidades , Doença Aguda , Idoso , Apêndice/cirurgia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
In 1970-2005 yrs. 65 patients with Zollinger-Ellison syndrome were observed and operated on in the clinic. The decisive meaning in diagnosis owes radioimmunological determination of gastrin level in the blood and its changes while conduction of tests with calcium and secretin. Surgical tactics was determined by localization, number and character of gastrinomas. During the first period of work gastrectomy with complete excision of gastrinproducing tumor constituted the operation of choice. Implementation of intraoperative method of ultrasonography have permitted to excise the benign gastrinoma when her localization was favourable with preservation of stomach. Minimal life span after gastrectomy, performed for nonresectable malignant gastrinoma, have constituted 9 years.
Assuntos
Gastrectomia , Síndrome de Zollinger-Ellison/diagnóstico , Síndrome de Zollinger-Ellison/cirurgia , Adolescente , Adulto , Idoso , Endoscopia Gastrointestinal , Feminino , Gastrectomia/métodos , Gastrinas/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Resultado do Tratamento , Ultrassonografia , Cirurgia Vídeoassistida , Síndrome de Zollinger-Ellison/diagnóstico por imagemRESUMO
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.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Úlcera Duodenal/cirurgia , Úlcera Gástrica/cirurgia , HumanosAssuntos
Anastomose Cirúrgica , Motilidade Gastrointestinal/fisiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/terapia , Úlcera Gástrica/cirurgia , Infecção da Ferida Cirúrgica/terapia , Terapia Combinada , Humanos , Complicações Pós-Operatórias/prevenção & controle , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/prevenção & controleRESUMO
Complex of diagnostic measures in patients with gastroduodenal ulcer disease includes conduction of investigations for revealing of helicobacteriosis, dysbacteriosis, helminthosis; esophagogastroduodenoscopy with optical biopsy and biopsy for histological and cytological investigation; computeric analysis of the blood neutrophils and buccal epithelium. Conservative treatment is conducted under endoscopic control, curative endoscopy and investigation for Helicobacter pylori are done additionally if necessary. In the absence of the conservative treatment efficacy various kinds of organpreserving surgical interventions are applied.