[Application of ultrasonographic investigation and computer tomography in diagnosis and the treatment method choice of complex postoperative hernias of the abdominal wall].

The work is based on analysis of the results of the abdominal hernia (AH) and the anterior abdominal wall state investigation in 48 patients of the main group and in 20--of a control one, using ultrasonographic examination (USE) and computer tomography (CT). The parameters of hernial localization, the hernial sac size and content, the hernial gates size and quantity, as well as the degenerative changes severity of the abdominal wall musculo-aponeurotic structures were investigated in the patients, suffering complex postoperative AH. Degenerative changes in the anterior abdominal wall musculo-aponeurotic structures, more pronounced in the patients older than 50 years, and also in the presence of large and giant AH, especially while their durable persistence, were revealed according to the USE and CT data obtained.

[Specifics of surgical correction of the oblique inguinal hernia depending on the size].

The results of surgical treatment of 257 patients aged from 10 to 50 years with the oblique inguinal hernia were analyzed. The structure of inguinal channel was studied up using anatomical dissection and measurement on 35 male cadavers aged from 12 to 60 years old. There was substantiated the expediency of surgical correction of the intrachannel and not large external oblique inguinal hernia in the presence of the three-wall-fissure-like inguinal channel using the improved method of the hernial sac mobilization from its neck.

[Surgical and experimental-biological aspects of inguinal hernia].

In experiment on 57 animals the method of plasty of anterior wall of inguinal channel by forming of the aponeurosis of m. abdominis obliqus ext. and suturing together the aponeurotic edges was simulated.

[Treatment of acute ulcerous gastroduodenal hemorrhage].

Basic principles of infusion-transfusional therapy, methods of endoscopic hemostasis as well as indications for surgical treatment of acute hemorrhagic ulcers of the stomach and the duodenum are presented. If is stated that valid use of endoscopic methods of hemostasis provides possibility for temporal hemostasis in 70% of patients. It endoscopic hemostasis is ineffective in hemorrhage from ulcer or in recurrent hemorrhage it is recommended to perform urgent surgical interventions.

[Reoperations after closure of perforative gastroduodenal ulcer].

Results of surgical treatment of 271 patients with malady recurrence after perforative gastroduodenal ulcer closure were adduced. Resectional methods of treatment were conducted in 118 patients, vagotomy combined with the stomach draining procedure--in 106, in combination with ulcer extraduodenization and duodenoplasty--in 47. Conduction of organpreserving operation with ulcer extraduodenization and duodenoplasty must be supposed mostly rational.

[The diagnosis and treatment of a malignant stomach ulcer].

The results of treatment have been analyzed in 587 patients with stomach ulcer in 52 of whom ulcer was found to be malign. Methods of diagnosing of ulcer malignization are not reliable. Difficulties in differential histodiagnosis, absence of trustworthy diagnostic tests as well as advisability of additional mucus assays are underlined.

[The surgical treatment of malignant stomach ulcers].

The authors analyse the specific features of the clinical picture, diagnosis, pathomorphological changes and surgical treatment in 52 patients with gastric ulcer which underwent malignant degeneration. It is noted that malignancy occurs most frequently in close vicinity to the ulcerative defect and rarely in the mucosa beyond the ulcer. The morphostructural reorganizations are determined to a certain degree by the peculiarities of extension of the tumor along the mucosa and the organ as a whole.

[Early diagnosis and treatment of a pyloroduodenal ulcer complicated by stenosis of gastric outlet].

Treated were 193 patients with pyloroduodenal ulcer complicated by stenosis of gastric outlet. Compensated stenosis was noted in 14 (7.2%) patients, subcompensated--in 147 (76.

[Some problems of the surgical treatment of stomach and duodenal ulcer].

The analysis of the results of surgical treatment of the gastric and duodenal ulcer disease in 191 patient under conditions of surgical department of the central district hospital was carried out. It was established that performance of the organ-preserving operation with vagotomy in duodenal ulcer disease permitted to reduce the mean duration of postoperative treatment and temporary invalidity, reduce the lethality. In gastric ulcer, the best result was obtained when using Billroth-I and stepped resection of the stomach.

[Indications for relaparotomy].

From 1980 to 1987, 10,446 patients were operated on. In 152 patients, the necessity of a repeated operative intervention arose. In 106 patients the emergency, in 42--delayed, and in 4--elective relaparotomies were performed.

[Late results of the conservative treatment of patients with cholecystitis].

It is shown that conservative treatment of cholelithiasis in young patients is not effective. In the long-term period these patients show as a rule recurrences, the frequency and degree of functional disorders of the liver and pancreas rises, the number of complications increases. The authors recommend early surgical treatment of this contingent of patients.

[Immunologic reactivity in patients with gastroduodenal ulcers].

Immune system factors were studied in 158 patients with ulcer disease of the stomach and duodenum before and after different operative procedures. More pronounced alterations of immune reactivity as compared with the parameters in patients with noncomplicated ulcer disease were found which manifested themselves in decreased indices of cell immunity, activation of processes of autoallergization, inhibition of nonspecific factors of defense.

[Late results of the surgical treatment of chronic calculous cholecystitis in young patients].

Long-term results of surgical treatment of chronic calculous cholecystitis were investigated in 139 patients of young age. Good results were observed in 83.5% of cases, satisfactory--in 11.

[Acute appendicitis in patients with diabetes mellitus].

The peculiarities of clinical picture, preoperative preparation and postoperative course in 157 patients with acute appendicitis, who suffered from diabetes mellitus, are shown. The direct dependence of pathomorphologic changes in the vermiform process on the severity degree and the state of diabetes compensation is noted. For correction of carbohydrate metabolism in the patients' contingent considered, it is the most expedient to use the fractional injection of common (crystalline) insulin at low doses.