Object of the study: Cardial ulcer (CU), complicated with a haemorrhage. Purpose of the study: Improvement of the results of the surgical treatment of patients with bleeding ulcers in the cardial portion of the stomach by the way of perfecting a complex of medical-diagnostic measures. Methods of the investigation: Clinical, laboratory, instrumental (radiological, endoscopic, pH-metric, electron microscopic), statistical methods. Theoretical and practical results: The application of modified techniques and an algorithm of the surgical tactics in patients with CU, complicated with a haemorrhage, make it possible to reliably decrease the rate of the development of postoperative complications, to reduce the postoperative lethality and achieve higher indices of the patients’ life quality during the remote period. The use of the individual-active surgical tactics for treating patients with CU, complicated with a haemorrhage, proved that it helped to the rational determination of the scope and way of operation in patients with a high operation risk. The devised modified techniques “A way for treating cardiooesophageal gastric ulcers” (Declaration Patent of Ukraine No. 10024 (UA) A 61B17/00 dated October 17, 2005) and “A way for surgical correction of the oesophagogastric transition in an ulcerous process” (Declaration Patent of Ukraine No. 15912 (UA) A 61B17/00 dated July 17, 2006) can be used in the practice of health establishments. Novelty: For the first time, peculiarities in the morphological state of the periulcerous region of the mucosa of the stomach and its functional state in different degrees of haemorrhages were studied. It was revealed that the excision of an ulcer crater in combination with vagotomy and pyloroplasty in the urgent surgery of a bleeding cardial ulcer caused significantly less stomach dysfunctions (namely: motor, secretory, reservoir) versus resection techniques. For the first time, it was found out that a degree of dystrophic and destructive changes in the stomach wall around the ulcer crater together with other factors depended upon the blood loss volume. On the basis of the complex studied conducted, a differential access was established to the choice of a technique for the surgical treatment of bleeding cardial ulcers. Original techniques were devised for the surgical treatment of CU, complicated with a haemorrhage. An algorithm was developed for the surgical tactics in patients with bleeding cardial ulcers. Degree of introduction: Results of the studies were introduced into the work of the Department of Oesophageal and Gastrointestinal Diseases, the Centre for Treating Acute Gastrointestinal Haemorrhages on the base of the Department of Urgent Surgery for Abdominal Organs of State Institution “Institute of General and Urgent Surgery of the Academy of Medical Sciences of Ukraine” of the City of Kharkiv. The basic propositions of the researches conducted are used in the teaching process at the Department of Hospital Surgery of Kharkiv National Medical University. Sphere of application: medicine, surgery.
