[Use of novocaine solution in intravenous regional anesthesia].
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Biomedical subjects
Publications and source records attributed to I A Kozak.
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The work presents results of surgical treatment of 38 patients with chronic disturbance of duodenal patency. It was established that operations aimed at the improvement of the passage of food through the duodenum, gave unsatisfactory results in remote period in 30% of cases. Operations are recommended aimed at the improvement of the passage of contents of the duodenum in combination with operations excluding the duodenum from the passage of food. Surgical correction of coexistent diseases of the digestive system is recommended.
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The results of treatment of 6 patients with duodenostasis, caused by cancer of the duodenum (2) and pancreas (3), metastasis of the sigmoid colon cancer (1) are analysed. Creation of duodenojejunoanastomosis with Brown's interintestinal stoma should be the obligatory condition of palliative operation. For diversion of the main food mass, the anterior gastroenteroanastomosis with Brown's interintestinal stoma was created.
An evaluation of 340 characteristic features of duodenal ulcer in 198 patients suffering of this disease revealed 32 risk factor concerning long-term results of selective proximal vagotomy (SPV) expressed in points. Four risk degrees are distinguished. Dependence of SPV results on risk degrees, preoperative care, pathological changes in the pyloroduodenal zone was established. The efficacy of SPV and gastric resection in identical clinical situations was studied.
Examined were 128 patients with peptic ulcer of the anastomosis and jejunum. Of them, 117 were operated on. In 58 patients, the major gastric resection was performed, in 8--gastric resection with gastroenteroanastomosis, in 38--truncal vagotomy, in 3--gastrectomy, in 10--operations in gastrojejunocolonic fistula. Complications after the operation developed in 22.2% of cases. Postoperative lethality was 5.9%.
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Based upon an analysis of results of gastrectomies in 463 patients with gastric cancer the authors discuss problems of diagnostics, indications for operation, preoperative management, operation technique and postoperative therapy. During the period of from 1967 to 1986 postoperative lethality was reduced from 13.1 to 4.1%.
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