[The surgical treatment of perforated gastric and duodenal ulcers in middle-aged and elderly patients--an analysis of the 1985-1996 period].

The problem relating to perforated gastric and duodenal ulcers (PGDU) treatment is still pressing nowadays not only on account of the constant mortality rate (6.7-14.55 per cent according to personal data), but also on account of the lack of universally accepted tenets for their management, irrespective of the fact that the first operative interventions were done more than 100 years earlier, and so far, more than 50 palliative and radical procedures have been suggested.

[Hemorrhages from the gastrointestinal tract in middle-aged and elderly patients--the diagnostic-treatment procedures and mortality dynamics].

Hemorrhages from the upper part of the gastrointestinal tract pose serious surgical problems because of their rather elevated incidence, diverse etiopathogenesis, difficulties in diagnostic and therapeutic approach, and last but not least, owing to the high mortality rate. The incidence of patients with ulcers amount to 420 per 100,000 population, with those in advanced and old-age accounting for 15-40 per cent of the total number of affections. In this contingent ulcers run a course associated with a number of peculiarities conditioned by severe lesions, caused by an acute and prolonged blood loss, not infrequently associated with a serious co-morbidity typical of this age.

[Relaparotomy in middle-aged and elderly patients with peritonitis following a primary operation for digestive pathology--II].

The study covers 39,233 patients presenting biliodigestive pathology of which 12,230 in advanced and senile age, admitted to the emergency surgery section of the EMI "NI Pirogov" over a 12-year period (1985 through 1996). Of the total number, 6555 or 53.71 per cent are subjected to operation, with postoperative deaths amounting to 477 (7.

[A clinico-morphological parallel in peptic ulcer in middle and old age].

Based of clinical and obduction case material covering the period 1990-1997, the clinical profile, morphological patterns and therapeutic approach, consistent with the specificity of age, complications of the basic disease and presence of concomitant diseases, are summed up. The results of biopsy and necropsy studies, following statistical processing by the methods of variation and correlation analysis, afford information on the morbidity in either gender, as well as on the location and morphological patterns of ulcers, their complications and associated diseases. Over the period 1990 through 1997, a total of 5425 cases are subjected to obduction study.

[Diaphragmatic injuries in thoracoabdominal trauma].

In closed thoracoabdominal trauma the diagnosis rupture of the diaphragm is usually made in 5 per cent of the casualties. Over a 12-year period (1985 through 1996), in the Pirogov Institute are admitted 3018 cases presenting polytrauma. Among the contingent of closed thoracoabdominal trauma lesions to the diaphragm are registered in 151 cases, and among those with open injuries--in 21 cases.

[Bronchoscopic assessment algorithms for the practical evaluation of the rheological properties of the tracheobronchial secretion and the classification of the degree of the disordered drainage function of the tracheobronchial tree (TBT) in chest and combined trauma with chest trauma as the leading injury].

Ventilation impairment, due to ineffective elimination of the mucous-hemorrhagic content from the tracheobronchial tree (TBT), obstructs the upper airways with the ensuing ventilation reduction giving rise to atelectases and progressive alveolar block. There is evidence of transudation and exudation into the pulmonary pathways and pleural cavity. A series of 276 patients presenting closed chest trauma are subjected to fibrobronchoscopy (FBS) and follow-up study.

[Rib fractures and flail chest in closed chest trauma--stabilizing operations and the results].

A contingent of patients presenting closed chest injuries, sustained over a 12-year period (1985-1996), are analyzed. Of the total of 6938 traumas, chest injuries amount to 3286 (47.06 per cent) of which 2842 (40.

[Organization, diagnosis and the treatment procedure in chest, abdominal and combined trauma].

Thoracic and associated injuries pose problems demanding enormous interdisciplinary efforts regardless of the improved organizational, diagnostic and treatment potentialities. As shown by the experience of the Emergency Surgery Section at the Pirogov Institute, rendering medical services to patients presenting chest and associated injuries require coordinated integration of specialists from various profiles along with specification of the priorities and hierarchy of the emergency measures undertaken. Over a 12-year period (1985 through 1996), a total of 6983 patients with chest, abdominal and multiple trauma are admitted.

[Percutaneous transthoracic drainage in pleural collections--the pros and cons from the surgical viewpoint].

An attempt is made at specifying the indications for inserting percutaneous transthoracic drain after Seldinger's method. The clinical case material analyzed for the purpose covers 761 patients over a three-year period (1993 through 1995), with 329 of them drained for pneumothorax, 266--hemothorax, and 66--hemopneumothorax. In 54 cases (7.

[Combined trauma--an analysis of a 10-year period].

Proceeding from retrospective analysis of 1802 casualties presenting open and closed combined trauma (CT), treated in the Emergency Medicine Institute "Pirogov" over the period 1985 through 1994, attention is focused on the changes in incidence and patterns of associated injuries. Problems relating to organization of the treatment of such patients at the various stages are discussed. The basic requirements of diagnosing and establishing the indications for operation are outlined from the standpoint of general surgery.