[Significance of esophagojejunogastroplasty in the surgical treatment of chronic and malignant ulcers of the cardial part of the stomach]. / Znachenie ézofagoeiunogastroplastiki pri khirurgicheskom lechenii khronicheskikh i malignizirovannykh iazv kardial'nogo otdela zheludka.

A new method of esophagojejunogastroplasty with a continuous loop of the small intestine in proximal resection of the stomach was developed experimentally and introduced into clinical practice. The techniques of the operation are described in detail. Proximal subtotal resection of the stomach with esophagojejunogastroplasty was performed in 14 patients for chronic and malignant ulcers of the gastric cardia. Foci of adenocarcinoma were found in the edges of the ulcer in one patient and epithelial changes corresponding to CaC2 in situ in 3 patients. One patient died after the operation from pulmonary artery thromboembolism. The course of the early postoperative period in the remaining 13 patients was uneventful. Follow-up in postoperative periods of 4 weeks to 12 months did not reveal any postresection disorders. All patients were capable of working and did not observe a special diet.

[Formation of horizontal esophago-small intestine anastomosis in gastrectomy for cancer]. / Formirovanie gorizontal'nogo pishchevodno-tonkokishechnogo anastomoza pri gastréktomii po povodu raka.

A new modification of horizontal esophago-enterostomy has been introduced into clinical practice. The operative techniques is described in detail. Gastrectomy was performed in 76 patients for carcinoma; there were 49 males and 27 females whose ages ranged from 39 to 70 years. Such complications as incompetence of the sutures of the anastomoses did not occur in the immediate postoperative period. Examination of patients in follow-up periods of 4 weeks to 2 years after the operation revealed neither cicatricial stenosis of the esophago-enteric anastomosis nor reflux esophagitis.

[The importance of esophagojejunogastroplasty in the surgical treatment of cancer of the proximal stomach]. / O znachenii ézofagoeiunogastroplastiki pri khirurgicheskom lechenii raka proksimal'nogo otdela zheludka.

The study discusses the efficacy of a new method of esophagojejunogastroplasty during subtotal and maximum subtotal proximal resections of the stomach. The surgical technique is described in detail. Seventeen patients aged 47-70 years were operated on for stage II-III cancer of the cardia, subcardia and fundus of the stomach. Extensive sagittal diaphragmotomy was performed in 15 cases whereas two patients were operated on through the combined abdomino-thoracic access. Pancreonecrosis and unrecognized microperforation of the gallbladder accounted for two fatalities whereas the other 15 patients were discharged from the clinic in good condition. They were followed for 1-30 months and, within this period, no postresection disorders such as reflux-esophagitis, cicatricial stricture of esophageal anastomosis or dumping syndrome were observed.

[A method of creating the esophago-small-intestinal anastomosis in gastrectomy]. / Metodika formirovaniia pishchevodno-tonkokishechnogo anastomoza pri gastréktomii.

In order to prevent postoperative complications related with incompetence of esophago-intestinal anastomoses in gastrectomies, fulfilled for gastric cancer, a modification of the formation of anastomosis of the esophagus with the small intestine is proposed. Operations were performed on 47 patients, in 26 of them combined gastrectomies were fulfilled, in 9 patients the formation of esophageal anastomosis followed sagittal diaphragmotomy. The patients operated upon had no complications associated with incompetence of the esophago-intestinal anastomosis.

[The place of gastrectomy and the possibilities of prevention of post-gastrectomy disorders in the surgical treatment of gastric cancer]. / O meste gastrektomii i vozmozhnostiakh profilaktiki post- gastrektomicheskikh narushenii pri khirurgicheskom lechenii raka zheludka.

Observation of 157 patients subjected to subtotal resection or gastrectomy for gastric cancer were performed. In 37 patients the duodenum was included in the process of digestion after gastrectomy with the help of T-shaped duplication of the small intestine and its partly isolated portion. This method was not followed in the early postoperative period by incompetence of the formed anastomoses, paresis of the displaced intestine; in the more remote period manifestations of the agastral asthemia became less and no reflux-esophagitis was observed. The investigation has shown that the relative value of gastrectomies with regard for the diagnosed recurrent carcinoma of the gastric stump must make up not less than 50% of the total amount of radical operations performed for this pathology of the stomach.

[The prevention of postresection disorders in the surgical treatment of cancer of the distal stomach]. / Profilaktika postrezektsionnykh rasstroistv pri khirurgicheskom lechenii raka distal'nogo otdela zheludka.

Four hundred and forty-seven patients who had undergone various surgical procedures for stage II-III cancer of the distal part of the stomach and 35 operated cases of chronic gastric ulcer were followed for three years. The study showed distal subtotal resection of the stomach using transversal gastroenteroanastomosis with a long loop and additional transversal enteroenteric anastomosis to offer functional advantage in cancer patients. These valve anastomoses prevented reflux of duodenal contents to the gastric stump, assured a stepwise emptying of the resected stomach and precluded passing of food to efferent intestine thus preventing dumping and afferent loop syndromes.