Кафедра медичної та біоорганічної хімії

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    Transchiatal Esophagogasroplasty with Gastrostomia on the Neck
    (Scholars research library, 2017-09) Boyko, Valeriy; Savvi, S.; Korolevska, A.; Zhidetsky, V.; Makarov, Vitalii; Syrovaya, A.; Makarov, Volodymyr; Zavada, O.
    Introduction: The formation of esophageal anastomosis with esophagogastroplasty is still associated with a high incidence of complications. The main cause of mortality after esophagogastroplasty is the failure of esophageal anastomosis. Aim: The aim of the research was to improve results of esophagogastroplasty by prevention of postoperative complications. Materials and methods: The research is based on the analysis of gastrostomy on the neck whith esophagogastroplasty in patients who were treated during 2010-2017 years. The method of surgery which includes the extirpation of the esophagus with transhiatal esophagogastroplasty simultaneously with the formation of a single esophagogastroanastomosis and contact gastrostomy on the the left side of the neck. Results: Intraoperatively nasogastral tube in patients who had got a partial failure of formed on the neck esophagogastroanastomosis as postoperative complications was not removed and it was used for enteral feeding and limited a zone of the anastomotic failure till its closure. Mortality rate is 5% (acute cardiovascular insufficiency caused the death of 1 patient). Conclusions: Developed and implemented in Clinic of the Institute method of a one-step transhiatal esophagogastroplasty with a single esophagogastroanastomosis and contact gastrostomy on the the left side of the neck in patients with extended postburn esophageal stricture in a condition of compensation and subcompensation can be considered as the treatment of choice.
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    Transchiatal Esophagogasroplasty with Gastrostomia on the Neck
    (Scholars research library, 2017) Boyko, Valeriy; Savvi, S.; Korolevska, A.; Zhidetsky, V.; Makarov, Vitalii; Syrovaya, A.; Makarov, Volodymyr; Zavada, О.
    Introduction: The formation of esophageal anastomosis with esophagogastroplasty is still associated with a high incidence of complications. The main cause of mortality after esophagogastroplasty is the failure of esophageal anastomosis. Aim: The aim of the research was to improve results of esophagogastroplasty by prevention of postoperative complications. Materials and methods: The research is based on the analysis of gastrostomy on the neck whith esophagogastroplasty in patients who were treated during 2010-2017 years. The method of surgery which includes the extirpation of the esophagus with transhiatal esophagogastroplasty simultaneously with the formation of a single esophagogastroanastomosis and contact gastrostomy on the the left side of the neck. Results: Intraoperatively nasogastral tube in patients who had got a partial failure of formed on the neck esophagogastroanastomosis as postoperative complications was not removed and it was used for enteral feeding and limited a zone of the anastomotic failure till its closure. Mortality rate is 5% (acute cardiovascular insufficiency caused the death of 1 patient). Conclusions: Developed and implemented in Clinic of the Institute method of a one-step transhiatal esophagogastroplasty with a single esophagogastroanastomosis and contact gastrostomy on the the left side of the neck in patients with extended postburn esophageal stricture in a condition of compensation and subcompensation can be considered as the treatment of choice.
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    Formation of a gastrostomy at treatment of patients with extended cicatrical strictures of a gullet
    (Scholars Research Library, 2017) Boyko, Valeriy; Syrovaya, Anna; Savvi, Sergey; Zhidetskiy, Vitaliy; Bodrova, Alla; Makarov, Vitalii; Makarov, Volodymyr; Kalinenko, Olga
    The method of treatment of patients with extended cicatrical strictures of a gullet by an establishment of gastrostomy is offered in this article. 87 patients who were on hospitalization in GI “V. T. Zaytsev IGES of NAMS of Ukraine” were investigated. Patients were divided into two groups: the main (43 patients) and control group (44 patients). The contact gastrostomy was created in Institute clinic for patients of the main group. Other gastrostomy was created by the standard technique according to Kader for patients of the control group. Disadvantages of Kader`s gastrostomy is eruption of purse-string suture, loss of the gastrostomy tubes, impossibility to use a esophagogastroplasty. And also, such operations are longer, difficult and traumatic. In this regard, two-stage tactics of the treatment of such patients is developed and introduced in our clinic. At the first stage the contact gastrostomy is applied to the patient (the patent of Ukraine № 92441 of August 11, 2014). At the second stage the plasticity of the gullet is performed using the interponat from stomach walls prepared at the first stage.Advantages of the developed type of a gastrostomy are: decrease of a trauma and deformation of a stomach, minimization of disturbance of a circulation, considerably reduce a operation time and a disease severity. Thus, the developed way of a contact gastrostomy promotes improvement of treatment results and also the state of health of the operated patients.