Bytyak S. Treatment and prevention of complications in patients with failure of esophageal anastomosis.

The dissertation is devoted to the solution of the problem of improving the results of surgical treatment of patients with failure of esophageal anastomosis by developing an optimal surgical treatment tactic aimed at reducing lethality and frequency of complications. Differentiated introduction of various minimally invasive methods in the treatment of patients from this category has allowed improving the efficiency of treatment and reducing the number of complicated traumatic surgical procedures. The most probable pathogens of infectious complications in different treatment periods are determined, differentiated approach to the choice of schemes of empirical antimicrobial therapy is developed. It has been established that the use of self-expanding esophageal stents is a method of choice in the treatment of such complication as the failure of esophageal anastomosis. The introduction of analysis of changes in the level of cytokines and adhesion molecules can reveal patients at risk of development of early postoperative complications. The use of esophageal stents for the methods developed and methods for correction of technical complications of stenting developed in the course of work, as well as the observance of developed indications and contraindications for stenting, allows qualitative improvement of medical assistance to patients with insufficiency of seams of esophageal anastomoses.