Asunto(s)
Carcinoma Papilar Folicular/cirugía , Coristoma/cirugía , Enfermedades del Esófago/cirugía , Esofagoplastia , Glándula Tiroides , Neoplasias de la Tiroides/cirugía , Enfermedades del Esófago/diagnóstico , Enfermedades del Esófago/diagnóstico por imagen , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Factores de Tiempo , Tomografía Computarizada EspiralRESUMEN
An experience with 48 intrathoracic esophagoplasties in patients with "waning" stomach or its absence is generalized. The results obtained show that scarry-ulcerous damages of the pyloroduodenal and cardioesophageal portions, local surgical procedures, gastrostomy included, are not considered as deterrent factors for using the stomach as the plasty material for esophagoplasty. For the resected stomach or its absence the small intestine should be preferred in the formation of the anastomosis within the limits of the thoracic cavity and large intestine--when putting anastomosis on the neck. A complete clinical effect was obtained in 45 patients. Three patients died (6.25%).
Asunto(s)
Enfermedades del Esófago/cirugía , Esofagoplastia/métodos , Estómago/trasplante , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Esofágicas/cirugía , Estenosis Esofágica/cirugía , Muñón Gástrico/cirugía , Humanos , Intestino Grueso/trasplante , Intestino Delgado/trasplante , Persona de Mediana Edad , Estómago/irrigación sanguínea , Neoplasias Gástricas/cirugía , Resultado del TratamientoRESUMEN
The investigation has shown that the due level of blood supply of the wound surfaces of the organs being sutured, the obligatory absence of a strain, perfect technique of the proper manual putting the end-to-end type anastomosis and the rational placing of the transplant in the posterior mediastinum with a strictly vertical rectilinear orientation, without bends and rotation, allowed to get a smooth course in 98.8% of the operated patients. Incompetent sutures took place in 1.2% of cases. It was also shown that the anastomosis of choice might be an invagination variant of the applying of it having not only high degree of reliability, but also the marked antireflux properties. The dynamic endoscopic control with the correction of forming anastomosis during 2-3 months allowed minimization of possibility of the development of scary stenosis. The results obtained suggest that the problems of intrathoracic esophageal anastomosis in clinic have been solved.
Asunto(s)
Esófago/cirugía , Estómago/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Anastomosis Quirúrgica/efectos adversos , Anastomosis Quirúrgica/métodos , Estenosis Esofágica/etiología , Estenosis Esofágica/terapia , Esofagoplastia/efectos adversos , Esofagoplastia/métodos , Esófago/irrigación sanguínea , Femenino , Gastrectomía/efectos adversos , Gastrectomía/métodos , Reflujo Gastroesofágico/etiología , Humanos , Masculino , Persona de Mediana Edad , Estómago/irrigación sanguínea , Resultado del TratamientoRESUMEN
Results of diagnosing pyelonephritis in 106 patients using ultrasonography, CT and thermovision were analyzed. Purulent pyelonephritis (PP) was diagnosed in 57 patients, serous pyelonephritis--in 49 patients. The sensitivity of ultrasonography in the diagnosing of PP was more than 80%, that of CT--90%. The methods used allowed the 100% improvement of the differential diagnosis of renal abscess, apostematous nephritis and pyonephrosis. The greatest problems were met in the diagnosis of renal carbuncle which was detected in 50% of cases by ultrasonography and in 54% of patients by CT. The minimum sizes of the destruction focus when the diagnosis could be reliable were 2 cm for ultrasonography and 1.5 cm for CT. Only using the findings of CT could diagnose emphysematous pyelonephritis. Thermovision could not find any definite criteria of PP. The timely diagnosis of PP allowed the organ-saving operations to be fulfilled in the overwhelming amount of the patients. Positive results of the treatment using the above mentioned diagnostic methods were obtained in 98.8% of the patients.
Asunto(s)
Pielonefritis/diagnóstico , Adolescente , Adulto , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pielonefritis/diagnóstico por imagen , Sensibilidad y Especificidad , Supuración , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Data on 90 patients with gastric carcinoma involving only the mucosa of the stomach wall are presented. All the patients were operated upon according to oncological principles. No regional metastasizing was observed at this level of invasion. Squamous-infiltrative tumors were found to be most typical (46.7%). Five-years survival after radical surgical treatment was 90.3%.
Asunto(s)
Adenocarcinoma/patología , Carcinoma de Células Escamosas/patología , Carcinoma/patología , Neoplasias Gástricas/patología , Adenocarcinoma/mortalidad , Adenocarcinoma/cirugía , Adulto , Anciano , Biopsia , Carcinoma/mortalidad , Carcinoma/cirugía , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/cirugía , Femenino , Estudios de Seguimiento , Gastrectomía/métodos , Mucosa Gástrica/patología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/cirugía , Factores de TiempoRESUMEN
The data on the morbidity, time of diagnosis and results of treatment of esophageal cancer in St. Petersburg and Leningrad Region (1992-1994) were analyzed. The morbidity rates were higher in women than in men, the predominant age being over 60. Morphological verification data were not available in almost half the cases. Stage I-II tumors were detected in 15.7-26.5%. Specialized treatment was given to 25%, combination one-to nearly 2%. To raise the standards of medical aid, it is suggested that measures be taken to ensure stable operation of the Cancer Register, St. Petersburg, and to offer treatment to esophageal cancer patients at specialized medical facilities.
Asunto(s)
Neoplasias Esofágicas , Calidad de la Atención de Salud , Distribución por Edad , Terapia Combinada , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sistema de Registros , Federación de Rusia , Distribución por SexoRESUMEN
For the period from 1982 to 1994 subtotal resection of the stomach (96) or gastrectomy (10) was performed on 106 patients by the Bilroth-I method. Efficiency of this method is confirmed by the 5 year survival data, which was determined by dynamic method in 42 patients and was 69.8%. Total postoperative lethality was 6.7%, and gastrectomy-4.2%.