Novosti
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Year 2014 Vol. 22 No 3
GENERAL AND SPECIAL SURGERY
Y.T. TSUKANOV, V.N. NIKITIN
THE TREATMENT RESULTS OF PATIENTS WITH PERFORATED ULCERS AND CICATRICIAL DEFORMITY OF THE PYLORODUODENAL ZONE
SBEE HPE “Omsk State Medical Academy”,
The Russian Federation
Objectives. The assessment of treatment results of patients with the perforated ulcer at prestenotic scar deformity with application of perforation suturing with the original “two-layer” continuous suture and individualization of the post-operative treatment based on the ultrasound monitoring.
Methods. 101 patients were enrolled into the prospective study. In 50 (49,5%) of them the perforation suturing was performed with the original “two-layer” continuous suture, in 51 (50,5%) – with double-row suture one. Based on the results of endoscopic and ultrasound monitoring the comparison of ulcer healing process with the determination of dynamic changes of trophic disorders index has been performed.
Results. The worked out method of the perforation suturing permits to shorten time of the ulcerous defect healing in 1,7– folds due to the reduction of the perifocal inflammation volume in 10,9-folds and prevalence of the ulcerous defect scarring on the linear type in 4,9-folds as well as it reduced the risk of a scarring deformation in 1,3-folds in the distant period. An average score according to the Visick scale made up 4,7±0,5 in the main group, 6,5±0,8 (p=0,049) – in the comparison group that testifies to a greater satisfaction in the long-term period in the main group.
The designed method of the ultrasound monitoring of gastric and intestinal wall wound healing after the operation on the pyloroduodenal segment allows carrying out a noninvasive monitoring of ulcer healing status in dynamics. Index of trophic disorders provides a quantitative assessment healing and allows influencing timely their deviation from the norm, reaching the individualization of postoperative treatment.
Conclusions. Application of the methods of perforation suturing with the use of the two-level contiguous stitch and ultrasound monitoring of ulcer healing status permits to correct treatment program timely and reasonably and decrease the complication rates.
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644043, Rossiyskaya Federatsiya, g. Omsk, ul. Lenina, d. 12, GBOU VPO «Omskaya gosudarstvennaya meditsinskaya akademiya MZ RF», kafedra khirurgicheskih bolezney i urologii PDO,
e-mail: nikitin-1966@inbox.ru,
Nikitin Vyacheslav Nikolaevich
Tsukanov Yu.T. MD, professor, a head of the surgical diseases and urology chair of SBEE HPE “Omsk State Medical Academy of MH of RF”.
Nikitin V.N. PhD, an assistant of the surgical diseases and urology chair of SBEE HPE “Omsk State Medical Academy of MH of RF”.
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