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Year 2010 Vol. 18 No 5
GENERAL AND SPECIAL SURGERY
ZUBAREV P.N., KOCHETKOV A.V., BOYARINOV D.YU., KHOKHLOV A.V.
TREATMENT TACTICS OF REFLUX-ASSOCIATED INFLAMMATORY DISEASES OF THE ESOPHAGUS AND THEIR COMPLICATED FORMS
Objectives. To improve the diagnostics algorithm of the reflux-associated inflammatory diseases of the esophagus and its complicated forms as well as to improve the results of treatment.
Methods. Treatment analysis of 112 patients with reflux-associated inflammatory diseases of esophagus was performed, including cases complicated with peptic stricture, esophageal bleeding, Barrett esophagus. The optimal algorithm of examination of these patients was worked out using modern methods such as zoom-endoscopy, chromoscopy (including NBI-regimen), examination of motor function using impedometry, twenty-four-hour pH-metry. Surgical treatment in case of a complicated course included mini-invasive endoscopic supplies used to eliminate complications as the first step; the second step was correction of gastric sphincter complex using endovideosurgical methods.
Results. The suggested algorithm permitted to individualize treatment tactics depending on the pathogenetic mechanism of the disease progressing. At the evaluation of the distant treatment results in the group of patients with the worked out algorithm, excellent and good results were noted in 86,4% of cases. While using conventional diagnostics methods to determine surgical tactics this parameter was twice as low; in the nearest postoperative period excellent and good results were compared in both groups and they were 92,8% and 88,4% correspondently.
Conclusions. The suggested algorithm of examination and worked out treatment tactics permitted to improve results in patients with reflux-associated inflammatory diseases of the esophagus in the nearest and distant periods
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