[Posteromediastinal esophagogastroplasty in esophageal surgery]. / Zadnemediastinal'naia ézofagogastroplastika v khirurgii pishchevoda.

The results of esophagogastroplasty in 101 patients are analysed. 41 patients had benign esophageal structure, 60 patients--benign esophageal tumors. Certain improvements of abdomino-cervical access and closed one-stage esophagogastroplasty have been proposed. The improvements include: use of the fibro-optical systems for esophageal mobilisation under the visual control, bringing down of duodenojejunal transition for prevention of esophageal reflux, posterior mediastinum tamponade with a muscle for prevention of mediastinitis, aseptic invaginational esophagogastric anastomosis. A significant reduction in the rate of purulent complications was observed. The rate of mortality was 7.9% (8/101).

[Invaginational antireflux esophageal anastomosis in gastrectomy and proximal resection of the stomach]. / Invaginatsionnyi arefliuksnyi pishchevodnyi anastomoz pri gastréctomii i proksimalnoi rezektsii zheludka.

Incompetence of esophageal anastomoses and reflux esophagitis are frequent complications occurring after gastrectomy and proximal resection of the stomach. The authors examined 149 persons who underwent operations for carcinoma of the stomach and lower third of the esophagus. In a group of 47 patients who underwent gastrectomy or proximal resection of the stomach with the formation of the ordinary not areflux anastomoses, nine died from incompetence of the sutures. In study of the late-term results gastroduodenoscopy revealed reflux esophagitis in 22 persons. Intraesophageal pH measurement showed values of 2.0 to 3.0. In 20 patients of this group piezo-resonance manometry demonstrated an essential unfavorable feature of the intraluminal pressure gradient--the intraluminal pressure was lower in the esophagus than in the stomach stump anastomosed with it or in the loop of the small intestine. This facilitated the development of reflux esophagitis. The authors developed a method of invagination areflux esophageal anastomosis by the closed techniques with the use of laser. The anastomosis is formed by two continuous sutures of a synthetic absorbable thread with an autraumatic needle. Incompetence of the sutures occurred in two patients. Piezoresonance manometry revealed a zone of increased intraluminal pressure in the region of the esophageal anastomosis. Mild reflux esophagitis was encountered in three patients. The authors recommend a new modification of esophageal anastomosis for surgical practice.

[The use of sodium gamma-oxybutyrate and gutimine for decreasing metabolic disorders in the heart, caused by exotoxic shock in acetic acid poisoning]. / Primenenie gamm-oksibutirata natriia i gutimina dlia umen'sheniia metabolicheskikh narushenii v serdtse, vyzvannykh ékzotoksicheskim shokom pri otravlenii ukusnoi kislotoi.

Exotoxic shock was simulated in non-linear rat males anesthetized with barbital after intragastric administration of 70% acetic acid at a dose of 4 ml/kg using a gastric tube. Energy metabolism and the rate of lipid peroxidation were studied in heart muscle during the decompensated and terminal periods of exotoxic shock. Sodium hydroxybutyrate (200 mg/kg) and gutimine (75 mg/kg), administered alone within 30 min after the poisoning, prolonged the period before manifestation of the decompensated and terminal steps of the shock; these drugs decreased the rate of metabolic impairments in the myocardium by decreasing the rates of adenine nucleotide catabolism, of glycolysis, lipolysis and lipid peroxidation.