[Cancer of gastric stump after surgery of peptic ulcer].
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Biomedical subjects
Publications and source records attributed to G I Dudenko.
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The experience to use in the treatment of duodenal ulcer disease the new methods of vagotomy: selective distal antral cellular vagotomy (SDAV) and selective distal vagotomy with pyloroplasty (SDV) is substantiated. By means of these operations, the suppression of phase II of gastric secretion is achieved due to denervation of gastrin-producing antral portion of the stomach. The results of experimental studies in 15 dogs, and the results of treatment of 37 patients with duodenal ulcer disease caused by the increased production at phase II of alimentation are presented. SDAV was performed in 20 patients, SDV--in 17. A result of treatment was studied in 34 patients at the period of up to 3 years. A pronounced acid inhibiting effect of the new methods of vagotomy was noted. No ulcer recurrence was revealed.
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The article deals with the experience in the treatment of 134 patients with concurrent gastroduodenal ulcers. The authors substantiate the necessity for performing early operative treatment by means of organ-preserving and organ-sparing operation with consideration for the depth of the ulcerous defect. Attention is drawn to the need for operative correction of chronic duodenal obstruction. Two (1.5%) patients died after the operation. The late-term results were studied in follow-up periods of up to 10 years. Recurrences of peptic ulcer and syndromes of an operated on stomach requiring operative treatment were not encountered.
To simplify the techniques of the operation and attain a good cosmetic effect the authors suggest a new scalpel for excising the communicating veins. The method of the operation with the use of the scalpel and its results in 256 patients are described. Comparative analysis by means of modern complex diagnostic methods gives hope. The disease recurred in 3.6% of cases. The good cosmetic effect with simultaneous shortening of the hospitalization period allows the new method of epifascial communi- cant vein surgery to be recommended for application in practice.
The article deals with the results of study of the effect of the degree of inhibited gastric acid-producing activity on the frequency of the development of postvagotomy disorders (PVD) in 158 patients with duodenal ulcer after treatment by various methods of proximal gastric vagotomy (PGV) and PGV with a stomach-draining operation. The frequency and severity of PVD were found to correlate intimately with the degree of inhibition of the gastric acid-producing activity by the PGV and the character of the draining operation. PVD were more severe and encountered more frequently in patients in whom HCl secretion was inhibited by 80% and 100% as compared to the initial value, especially in patients who underwent a stomach-draining operation. Organic PVD (stenosis, an indolent or a recurrent ulcer adhesions) are mostly encountered in the late-term postoperative period.
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The endolymphatic administration of antibiotics, which was used in the complex treatment of 78 patients with purulent-inflammatory processes in the soft tissues, contributed to acceleration of the transition of a wound process from hydratation phase into the dehydratation phase, shortening of the duration of treatment.
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The authors show that isolated selective proximal vagotomy (SPV) causes no significant changes in duodenal motor activity, whereas patients treated by SPV with gastroduodenostomy after Jaboulay suffer from disorders of duodenal motor function which are manifested by reduced depth and frequency of contractions of the intestinal wall.
Low-intensity helium-neon laser (LG-75) radiation produces a marked analgesic, desensitizing, hypocoagulative, and immunostimulating effect, which can be used in the treatment of acute thrombophlebitis of the lower limbs. Laser therapy alters the phase course of the wound process and in this way improves microcirculation and oxygenation of the tissues, shortens the terms of wound healing, and may be used as the method of choice in the treatment of trophic ulcers of the lower limbs.
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An analysis of 917 fiber gastroscopies of patients with ulcer disease and chronic gastritis has been made. Results of the complex examination of 140 patients after vagotomy for pyloroduodenal ulcer have been discussed. Gastroduodenal reflux has been found to be a complication of vagotomy. It most frequently follows draining operations on the stomach. The search for new means of surgical correction of duodenogastric reflux is required.
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