Naso-intestinal endoscopic intubation in the complex treatment of postoperative intestinal obstruction

The long-tube decompression was used for treatment of 54 selected patients with diagnosis of early postoperative intestinal obstruction. For this purpose a silicon double-lumen wire-guided tube has been endoscopically introduced into the proximal portion of the small intestine. In 40 cases continuous decompression of the small bowel brought about a successful resolution of intestinal obstruction by nonoperative therapy. Failure of the conservative treatment within the first 48 hours after intubation has led to operation in 14 cases. Six patients died in this series (4 patients died of multiple organ failure, 2--of thromboembolism). The study has shown that the method can be successfully used.     

Resection of the esophagus in patients with sequelae of chemical burns

Indications for resection of the esophagus in cicatricial constriction were elaborated on the basis of 58 cases of resection of cicatricially changed thoracic esophagus. Comparative analysis of gastric secretory and motor-evacuative function after two variants of esophageal resetion (after Dobromyslov-Torek and with preservation of the trunks of the vagus nerves) showed the efficacy and expediency of leaving intact the vagus nerves in resection of a cicatricially changed esophagus in the presence of appropriate indications.     

Surgical technique and approaches in orthotopic liver transplantation]

The first clinical experience with orthotopic transplantation of the liver was summarized. Within the period of from February 1990 to May 1991, 8 operations were performed, including one retransplantation of the liver. The peculiarities and variants of surgical technique, general principles of the performance of operation, methods for vascular and biliary reconstruction are presented. After the operation, 3 patients are alive, no surgical complications were observed.