Biomedical subjects
Publications and source records attributed to G A Ambalov.
The results of treatment of 53 patients with benign esophageal tumors are discussed. The diagnosis was mainly established by the radiologic and endoscopic methods. Leiomyoma of the esophagus was recognized in 29 patients, fibroma in 19, a cyst in 2, a polyp in 2 patients and a lipoma in one patient. Operations were carried out on 42 patients. Complications and fatal outcomes did not occur in the postoperative period. All patients recovered fully.
The authors analyse the results of diagnosis and surgical treatment of various forms of reflux esophagitis in 426 patients. The disease was caused by hiatal hernia in 60.4% of patients, by various operations on the cardia in 22%, and by gastric and duodenal ulcer in 8.2% of patients. Various diagnostic methods are evaluated, among which intraesophageal pH measurement and esophagofibroscopy are particularly important. The indications for operative treatment are formulated. Operations were carried out on 349 patients, complications occurred in 15%. The lethality was 0.6%. Nissen's fundoplication is the operation of choice.
A total of 53 patients after gastrectomy were examined by hepatobiliary scintigraphy with i.v. administration of 25 MBq of 99mTc-BIDA. Evacuation of the duodenal content proximally of enteroenteroanastomosis was revealed in 24 patients. Reflux-esophagitis was noted in 14 patients, in 10 of 11 patients, duodenal content got into the esophagus. The results of hepatobiliary scintigraphy were compared with those of endoscopic and x-ray diagnostic methods. A high informative value and significance of the results of hepatobiliary scintigraphy in the detection of reflux-esophagitis after gastrectomy were noted.
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On the basis of an analysis of the surgical treatment of 325 patients with hiatal hernias the authors consider Nissen fundoplication to be the operation of choice in such cases. The operation was performed in 277 patients. Postoperative lethality was 1,2%. Good remote results were obtained in 88% of the patients. Recurrent hernias were noted in 1,8% of cases.
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In 30 of 242 patients with reflux-esophagitis the stenozing form of reflux-esophagitis was found. Esophagofibroscopy with biopsy of the esophagus mucosa is considered to be of special significance for diagnosis of the stenozing reflux-esophagitis. The treatment of such patients consisted in conservative measures and bougieurage of the esophagus. Later on, 8 patients were subjected to surgery. The anti-reflux operation (Nissen's fundoplicacy) was fulfilled in 7 patients with good results. Plasty of the esophagus was made in 1 patient. Observations continued from 1 to 3 years.
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