Smikodub O. Surgical Treatment of Bleeding Gastroduodenal Ulcers and Correction of Post-Hemorrhagic Anemia with Hematopoietic Stem Cells

Thesis for the degree of Master of Medical Science; major 14.01.2003. - Surgery. - O.O. Bogomolets National Medical University, Ministry of Health of Ukraine, Kyiv, 2010. The goal of this thesis is solving scientific tasks aimed at improving the results of surgical treatment of acute bleeding gastroduodenal ulcers by developing surgical approach algorithm and new methods of surgical intervention, and correction of post-hemorrhagic anaemia with hematopoietic stem cells. Research involved 1696 patients with acute bleeding gastroduodenal ulcers: Group 1a - main (3-rd period) - 616 patients in 2008; Group 2a - control (2-nd period) - 514 patients in 2007; Group 3a - control (1-st period) - 566 patients in 2006. Embryonic stem cells were administered to 11 patients (Group 1-main), while the rest - 9 patients (Group 2-control) underwent conventional therapy. Analysis of the research results allowed for the development of actively-customized surgical approach for acute bleeding gastroduodenal ulcers with action algorithm and focus on urgent (preventive) surgeries within 6-12 hours after admission as well as for invention of two already patented surgical approaches, which resulted in the reduction of the number of surgeries at the peak of haemorrhage from 62% to 9,5%, or 6,5-fold (p<0,05), overall mortality reduction from 4,7% reported in Group 2a-control to 3,1% Group 1a-main, as well as 0% postoperative mortality in Group 1a-main. Correction of post-hemorrhagic anaemia was performed with embryonic hematopoietic stem cells. On day 28 after hematopoietic stem cell transplantation, Group 1 patients presented 16% higher Hb, 20% higher erythrocyte count, 45% higher HCT and 4,6 - fold higher total protein. Keywords: bleeding gastroduodenal ulcer, surgical treatment, post-hemorrhagic anaemia, hematopoietic stem cells.