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Biomedical subjects

A F Chernousov

Publications and source records attributed to A F Chernousov.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Radical surgical treatment of Barrett's esophagus].

In the light of modern scientific knowledge, pathogenesis of Barrette's esophagus (BE) is presented as an integral neoplastic process. Indications to operation and policy of radical surgical treatment in BE, including in combined esophageal diseases (burn and peptic strictures, reflux esophagitis, short esophagus) were developed. From 1990 to 2000 radical operations were performed in 14 patients (11 males, 3 females) with BE. Mean age was 54.1 years. About 80% patients had clinical signs of reflux esophagitis at the moment of hospitalization. In all the patients the diagnosis of BE was verified in microscopic examination of operative material. 4 patients with cylindrical metaplasia associated with ulcers and esophageal peptic strictures were operated, 3 patients--with epithelium dysplasia, 7 patients--with adenocarcinoma. All the patients underwent extirpation of thoracic portion of esophagus with one-stage plasty with isoperistaltic gastric tube, supplemented with mediastinal and abdominal lymphodissection in cancer. Affection of the regional lymph nodes was revealed in 43% patients with esophageal adenocarcinoma. 50% patients had complications in postoperative period. There were no cases of hospital lethality. The expansion of indications for early surgical treatment of BE at the stage of meta-, and dysplasia, before adenocarcinoma development, is thought valid.

Adult↗
PubMed2001

[Diagnosis and treatment of diffuse esophagospasm].

123 patients with diffuse esophagospasm were observed, including 56 (45.5%) with primary and 67 (55.5%) with secondary esophagospasm. Since 1986 due to unsatisfactory treatment results an original therapeutic complex including spasmolytics, neuroleptics, vitamins B, was used. In secondary esophagospasm therapy was complemented by pneumocardiodilatation, not more 5 sessions per course. Good and satisfactory clinical results were achieved in 30 (66.7%) patients with primary diffuse esophagospasm and in 45 (67.2%) patients with secondary esophagospasm.

Combined Modality Therapy↗
PubMed2000

[Gastrostomy as a stage of esophagoplasty].

The description of a modified technique of gastrostoma formation on small flexure is presented. Indications for this operation in patients with tumor and cicatrical esophageal strictures, planned for gastric esophagoplasty are formulated. The are authors regard a correctly created gastrostoma as the first stage of esophagoplasty. The main mistakes in gastrostoma creation that donTt permit to use the stomach for esophagus replacement are noted. The main principles and techniques of stoma creation on small flexure are described. The presented method is recommended for use in specialized esophageal departments and in general surgical hospitals.

Esophageal Stenosis↗
PubMed1998

[Surgical treatment of reflux esophagitis and peptic stricture of esophagus].

Reflux-esophagitis is wide-spread and frequently diagnosed disease, which is found in persons of young and adult age. The main kind of treatment is conservative one, however sometimes reflux-esophagitis is accompanied by complications, dangerous for life, which require surgical treatment. Experience of surgical treatment of 720 patients is available. Fundoplication procedure in RCS modification combined with SPV is main and optimal operation. This operation is possible in more than 2/3 cases of surgical treatment of reflux-esophagitis and peptic stricture of the esophagus. If it is found to be impossible to carry out organ saving procedure in severe reflux-esophagitis and irreversible peptic stricture of the esophagus the operation of choice should be extirpation of the esophagus and gastroplasty with gastric tube or large bowel and simultaneous creation of anastomosis in the neck. This was carried out in 38 patients with favourable outcomes.

Adult↗
PubMed1998

[The experience of 1100 esophagoplasties].

The experience of esophagoplasties in various benign diseases (566) and cancer (534) of the esophagus is outlined. The operation of choice now is extirpation of the esophagus by cervico-abdominal approach with one-state posterior-mediastinal esophagoplasty by the stomach or (in case of impossibility to form the graft from the stomach)--large bowel. If there are contraindications to such operation or in case of necessity of one-stage reconstruction of the pharynx the optimal operation is sub- and total bypass esophagoplasty by the large bowel.

Contraindications↗
PubMed1998

[Bougienage of esophagus in critical burn strictures].

Bougienage was made in 625 patients with burn strictures of the esophague which made up 59.4% of all patients (1053) who have undergone treatment since 1966 to October 1977 in Research Center of Surgery. Indications and contraindications for bougienage are discussed. In patients with short strictures (146) good effect was obtained in 83.1% of cases, in long strictures (803) the bougienage was effective in 61.1% of patients, in total strictures (104) good and favourable results were obtained in 26.2% of cases. Bougienage is an important method of treatment for patients with burn strictures of the esophagus, as well as a method of preoperative preparation.

Adolescent↗
PubMed1997

[Choice of esophageal plastic surgery].

The choice of an access to different parts of the esophagus, the need and scope of its resection, the choice of a surgical stage and an organ for creating the artificial esophagus, the position of a graft and the method for forming an esophageal anastomosis are the matters under discussion. A total of 1000 esophageoplasties were performed using different methods. In cancer of the esophagus and its benign diseases, the optimum intervention is esophageal extirpation with one-stage plasty using an isoperistaltic gastric tube; if there are contraindications to this operation, subtotal and total esophageoplasties with the colon are the operations of choice.

Decision Making↗
PubMed1996

[One-stage esophagoplasty with pathologically changed or previously operated stomach].

The results of esophagus extirpation with subsequent one-stage esophagoplasty by pathologically changed or previously operated stomach in 50 patients are analysed. 2 patients had gastric and esophagus cancer and 48 patients esophagus strictures. 36 patients had been previously operated on their stomach, 10 patients had scar deformation of the stomach after thermal burns, 2 patients had a giant leiomyoma. Isoperistaltic gastric tube was used as an esophagus substitute. The postoperative mortality rate was 2,1%. The optimal method of surgical treatment of the combined gastric and esophagus lesions is recommended.

Adolescent↗
PubMed1996

[First experience with vertical gastroplasty in the treatment of patients with 4th-degree obesity].

The article discusses four operations for vertical gastroplasty performed for the first time in Russia at the Research Centre of Surgery, RAMS, for degree IV obesity (the body weight of the patients ranged from 115 to 183 kg). The suturing instruments CEEA-28, TA-90, and CIA-90 manufactured by Auto Suture Instruments, USA, were used. Subsequent examination of patients in follow-up periods of as long as 4 months showed a favorable effect of the operations: body weight reduced, the patient's health and the course of concomitant diseases was milder.

Adult↗
PubMed1995

[Current approaches to the surgical treatment of cancer of the cardioesophageal junction].

Results of surgical treatment of 264 patients with carcinoma of the cardio-esophageal region are analysed. Operability was 89.0 +/- 1.9%, resectability was 64.3 +/- 3.1% in the group of patients who underwent operation and 57.2 +/- 3.1% in the group of patients admitted to the clinic. The total number of complications in the group of patients subjected to radical (151) operations came to 41.7 +/- 4.0% and the number of patients with complications 21.2 +/- 3.3%. Incompetence of sutures of the esophageal anastomosis was encountered in 9.3 +/- 2.4% of cases, total postoperative mortality was 5.1 +/- 1.4%, mortality in the group of patients who underwent radical operation was 7.9 +/- 2.2%. Operative interventions with extended lymphadenectomy were performed in 106 cases, histologically verified metastases in the lymph nodes were found in 79.2 +/- 3.9% of cases. Five-year survival was recorded in 27.8% of cases, patients treated by extended lymphadenectomy live twice longer than those not subjected to lymphadenectomy.

Adenocarcinoma↗
PubMed1995

[Enteral tube feeding of patients after esophagoplasty].

A method for enteral catheter feeding is suggested. It was applied in 60 patients after esophagoplasty. The main group consisted of 23 females and 37 males aged from 18 to 68 years. Esophageal carcinoma was observed in 31, burn stricture of the esophagus 18, and other benign diseases of the esophagus in 11 cases. All patients were subjected to extirpation of the esophagus with one-stage posteromedial esophagoplasty in 57 patients with an isoperistaltic gastric tube and in 3 patients with the colon. The control group was formed of 20 patients who underwent the same operations. Inpitan, ovolact, and hypernutril were used for enteral catheter feeding. The catheter was introduced via the nasal passage and transplant into the proximal segment of the jejunum. The mixtures were administered in drops of 5 to 7 days after the operation. Only parenteral feeding was conducted in the control group. The disorders of the alimentary status were removed quicker in patients of the main group than in the control and the incidence of postoperative complications was less. Body weight and the nitrogen balance were restored within a shorter time in the main group patients and incompetence of the esophageal anastomoses developed in a lesser number of cases.

Adolescent↗
PubMed1995

[Diagnosis and treatment of afferent loop syndrome].

In the period from 1981 to 1990, 43 patients were treated for the afferent loop syndrome. Their ages ranged from 20 to 76 years. Hofmeister-Finsterer gastric resection was the most frequent (81.40%) primary operation, in four patients (9.30%), primary resection was performed with anterocolonic anastomosis on a long loop after Braun. In two patients (4.65%) the syndrome had developed after Roux resection. In 12 patients (27.90%), the afferent loop syndrome was combined with the dumping syndrome, and in 24 (55.81%) with peptic ulcer of the gastrojejunoanastomosis, which along with other causes was the etiologicl al factor of the syndrome due to stenosis and deformity of the intestine. The afferent loop syndrome was classified into two degrees of severity according to the need for operative treatment and the presence of other diseases, "postgastroectomy syndromes", for which surgery was also needed. There were 8 patients (18.6%) with a mild afferent loop syndrome and 35 (81.40%) with the severe form. Patients of the last-named group were subjected to various reconstructive operations. Reconstruction of the anastomosis after Billroth-I is the method of choice in the afferent loop syndrome, particularly in patients with concurrent dumping syndrome (they were treated also by reconstructive gastrojejunoduodenoplasty). In patients with concomitant peptic ulcer of the anastomosis the creation of Braun anastomosis and resection after Roux are sometimes ineffective.

Adult↗