Biomedical subjects
Publications and source records attributed to Ia V Goer.
The results of treatment of 410 patients with a perforated gastric and duodenal ulcer were summarized. A dependence of lethality and type of the operation performed on time elapsing from the moment of perforation, presence of concomitant diseases is shown.
The results of treatment of 185 patients with complicated gastric and duodenal ulcer disease have been analysed. The results of operative treatment in 132 patients followed up for the period of from 1 to 7 years were studied. In gastric ulcer, resection of the stomach with preservation of the pyloric sphincter, or its reconstruction by means of the flaps taken from the antrum, is indicated; in duodenal ulcer--vagotomy, ulcer excision added by pylorus-preserving and pylorus-reconstructing methods of drainage operations.
The results of treatment of 450 patients with duodenal ulcer have been analysed. Of them, in 198 (44%), ulcer penetration into the adjacent organs was revealed. An excellent and good results were noted in 80.3% of the patients. Vagotomy with an ulcer excision and subsequent restoration of the pyloric sphincter function in penetrating duodenal ulcer permits to reduce lethality and achieve stable recovery of the majority of patients.
The experience with treatment of acute ileus for the 5 years in 1032 patients is summarized. Operated on were 269 patients. The different types of operative interventions with a wide use of intubation, adsorbents, laparostomy were performed. The postoperative lethality was 9.2%.
Of the 450 patients with complicated duodenal ulcer disease, in 23 (5.8%) the ulcer was located distally to the duodenal ampulla. On the basis of studying the results of surgical treatment, a conclusion is made, that the selective proximal vagotomy in combination with the ulcer excision and duodenoplasty is an operation of choice in complicated retroampullary ulcers. The operative interventions correcting the disturbances in the duodenal patency in preserved function of the pyloric sphincter contribute to prevention of duodenogastric reflux and alkaline reflux-gastritis.
On the basis of treatment of 105 patients operated on for complicated duodenal ulcer disease, it was established that performance of the organ-preserving operation with the ulcer excision supplemented with the pylorus-restoring and pylorus-preserving intervention permitted to reduce considerably the incidence of duodenogastric reflux.
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Examined were 305 patients with complicated duodenal ulcer disease, in 28--the giant ulcers were revealed. The operative treatment of such patients should be early and aimed at preservation, or restoration of the pyloric sphincter function. This permits to achieve good functional results.
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