Sizy M. Complex treatment of patients with after burn strictures of esophacus with the use of end do-prosthesis and balloon dilatation.

Object of the study: disease of after-burn stricture of the esopha-gus. Purpose of the study: improvement of the results of treating pa-tients with after-burn strictures of the esophagus on the basis of complex development of individualized surgical tactics which en-visages broader indications for using modern methods of balloon dilatation and endoprosthesis. Methods of the investigation: general clinical, biochemical, morphological, videoendoscopy with biopsy, X-ray contrast study of the esophagus of all the patients and X-ray TV one during bal-loon dilatation and endoprosthesis, manometry of the esophagus. Practical significance of the obtained results: formulas were devised to make it possible to prognosticate results of treating pa-tients with ABSO by the methods of bougienage or BD on the ba-sis of the data about his state at the time of the referral to hospital. An improved technique and a device for esophagus endoprosthet-ics developed by the author make it possible to effectively restore the state of the patient's feeding and ensure compensation for wa-ter-electrolyte and protein metabolism. A possible use of the im-proved technique of balloon dilatation in patients with long stric-tures of the esophagus was proved, it increasing the quality of en-dosurgical treatment of patients with significant stages of stenoses. A method and a device for prolonged dilatation of the esophagus were developed, they helping to reduce the number of sessions of the supportive treatment. The study of the results of treating pa-tients with endosurgical and surgical methods made it possible to create a diagnostic-medical algorithm for patients with ABSO. The use of this algorithm improved general results of treating pa-tients and reduced the number of those people who needed recon-structive plasty of the esophagus, and, when it was indicated, to increase the level of preparation for the operation. Novelty: during the research, a mathematical statistical analysis of the patients' initial state at the time of the referralto hospital was made, and for the first time a statistical relationship between the indices of the patients' state and results of their treatment with dif-ferent endosurgical methods was revealed. A pathomorphological picture of changes in the esophagus and surrounding fatty tissue after a chemical burn was studied in dynamics with help of light microscopy, which in a complex of the study of macrostructural transformations makes it possible to prognose further develop-ment cicatricial impairment. Changes of protein-electrolyte and some other indices of the patients' homeostasis indices were studied. A technique for studying the heterogeneity of the esophagus stricture was developed, its data determining the choice of a certain method of treatment. The technique of esophagus endoprosthetics was improved and its effect on the patients' general state and local changes in the tissues adjacent to the esophagus was studied. Degree of introduction: recommendations by the results of the research were introduced intothe work of the Department of Esophageal and Gastrointestinal Diseases of the Institute of General and Urgent Surgery of the Academy of Medical Sciences of Ukraine, into the practical work of Surgery Departments of Meshchaninov City Clinical First Aid Hospital (Kharkiv) and Kharkiv City Clinical Hospital No. 26. Results of the research are used in the educational process at the Department of Hospital Surgery of Kharkiv State Medical University. Sphere of application: medicine, surgery.