Role of local lymphatic stimulation in the prevention of early complications after stomach surgeries

Experiments were conducted on 120 albino rats and 16 dogs with the use of scanning and electron microscopy as well as the radionuclide method of microcirculation study to substantiate the method of regional lymphostimulation after operations on the stomach for the prevention of early postoperative complications. Some lymphagogues (lidase, heparin, procaine hydrochloride) were infused in the early postoperative period through a catheter introduced into the hepatoduodenal ligament. This zone is represented by a large group of lymph nodes receiving lymph from the stomach and the adjacent organs and the intercellular space of the hepatoduodenal ligament. The study showed that lymphostimulation improves the circulation of lymph and blood which are disturbed as the result of the operation and improves the local homeokinesis in the wall of the stomach after its resection and vagotomy. Lymphostimulation increases the resorption and transport activity of the lymphatic system and improves drainage of the edema fluid and the products of disturbed metabolism from the interstitium of the gastric mucosa. The results of using the method of regional lymphostimulation in 441 patients after various operations on the stomach for peptic ulcer showed the possibility of reducing the number of early postoperative complications, such as inadequacy of the sutures of the gastroduodeno--entero--anastomosis, anastomositis, infectious-inflammatory complications, and others.     

Functional results of surgical repair of chronic duodenal insufficiency associated with duodenal ulcer

The results of 312 patients examination in late follow-up period after conduction of the organ preserving intervention, gastric resection and reconstructive operation with chronic duodenal insufficiency correction, concurrent with duodenal ulcer, its acute complications, postvagotomy and postresection syndrome are adduced. An excellent and good result was noted in 70.2% of patients, fair--in 23.4%, bad--in 6.4%.     

Giant stomach ulcers after selective proximal vagotomy

On the basis of experimental and clinical investigations the role of vascular microcirculation disorders of gastric wall in pathogenesis of recurrent and peptic ulcers and, in particular, giant ulcers of the stomach after selective proximal vagotomy was established. Giant ulcers of the stomach are considered as trophic or ischemic ulcers, and are shown to be resistant to therapy. Early surgical treatment is recommended. The method of choice is gastric resection of ladder-type.     

The changes of serum cortisol and aldosterone in patients with cancer of vestibular section of larynx after irradiation and with and without surgery

Enzyme immunoassay was used to measure serum levels of hydrocortisone and aldosterone in 85 patients with vestibular laryngeal cancer before treatment and after it. The treatment consisted of either radiation alone or radiation followed by surgery. Pretreatment examination revealed adrenal dysfunction evident from enhanced glucocorticoid and inhibited mineral corticoid activity. Radiotherapy alone or in combination with surgery gave rise to a trend to a decline in glucocorticoid activity and stimulated mineral corticoid activity.     

Endoscopic diagnosis of chronic obstruction of the duodenum in association with peptic ulcer

The results of gut endoscopic examination in 460 patients with duodenal ulcer disease concurrent with its chronic obstruction (CI) are adduced. Direct and indirect endoscopic signs of duodenal CI are revealed in 399 (86.73%) of patients. Endoscopic criteria of the CI stage determination are described: duodenal stenosis, pyloric sphincter deformity and insufficiency, reflux-gastritis and the gastrostasis signs while satisfactory pyloric passability.