[Diagnosis and surgical procedures in postbulbar duodenal ulcers].
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Biomedical subjects
Publications and source records attributed to A F Chernousov.
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The authors have observed 203 patients with ulcers of the cardiac portion of the stomach. Especially great diagnostic importance is attached to the endoscopic method with the obligatory examination of the biopsic material taken from different portion of the ulcer. Resection of the cardiac portion with the creation of an invagination anastomosis is considered by the authors to be the most rational operation in ulcers localized in the cardia. The operation of choice in ulcers localized in the subcardia should be subtotal resection of the stomach.
It is suggested to use the medico-mathematical "decisive rules" for the differential diagnosis of esophageal cancer in non-specialized medical institutions. As the first step the examination cards were written, based on the data of 1195 patients with verified diagnosis. The "decisive rules" were worked out basing on the examination cards of 597 patients (in 267--esophageal cancer and in 330--benign lesions: cardiospasm, benign tumors, cysts, burn and scarring strictures, esophagitis, diverticulum). The suggested "decisive rules" using 63 and 87 clinical signs were tested elsewhere for a retrospective diagnosis in 167 patients. Using the "decisive rules" with 63 clinical signs esophageal cancer was recognized in 96% of cases, non-cancer--in 92%, while using 87 signs--in 92 and 94% accordingly. The rule comprising 63 signs-questions is recommended for practical purposes.
The experience with the treatment of 139 patients suffering cancer of the esophagus and stomach indicated that preoperative irradiation (3000-4500 rad) improves considerably late results of the treatment.
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