The work is a comprehensive study of the methods of surgical treatment of patients with residual polyps of the stomach. In this work, the study of microcirculation of the gastric mucosal microcirculation in patients with gastric polyps has been performed, and a comprehensive method for preventing recurrence after endoscopic polypectomy has been developed, due to the use of endoscopic NILV and intravenous administration of L-arginine as a substrate for the synthesis of NO. The work is based on an analysis of the results of endoscopic diagnosis and treatment of 1450 patients with gastric polyps. Of these, residual polyps were diagnosed in 113 (7.8%). Residual polyps are found to be mainly localized in the anthral region and the angle of the stomach. The peculiarities of their appearance are the presence of a broad base, a small height and convergence of folds to the base. In patients with residual polyps of the stomach, the reduction of tissue blood flow in the mucous membrane of the stomach is most pronounced in comparison with patients without relapses. The maximum reduction in the parameters of microcirculation is observed in the region of the tip of the polyp. In the region of the top of the polyps, the critical numbers of tissue perfusion were recorded, and these figures did not depend on the clinical picture, the number of relapse, the number of polyps, and the age of the patients. Histologically, polyps were mostly hyperplasiogenic (70,19%), located predominantly in the antrum and stomach area (516 polyps), which was 62,62% of the total number of hyperplasiative polyps. In patients with gastric polyps, the state of anacidity was recorded in 82,71% of patients with predominant localization of polyps in the antral department. Hypoacidic and normatsidnom condition ? in 11,93% and 5,35% of patients respectively. There are no regularities between the number of polyps and acid production. The level of tissue perfusion in the mucous membrane of the stomach depends on the acid-forming function of the stomach ? with an increase in Rn of the gastric contents the level of microcirculation decreases. When confirming the quality of the process, the irradiation of the polyp and area around the polyp with a helium-neon laser LH-75 with a radiation power of 20 mW, a wavelength of 0,632 microns and a power density of 0,05-0,10 MW/cm2 was performed within 3 minutes. Performed polypectomy according to the standard method. The course of irradiation of acute ulcer after polypectomy and mucous around was performed daily for 5 days. All patients received a course of conservative therapy aimed at H. pylori eradication and substitution therapy (hydrochloric acid and gastric enzymes) was prescribed to patients with an anticidal type of secretion. The third stage was the intravenous administration of the dasg "Tivortin", at an initial rate of 10 drops/min-1, after 20 min-1. From the beginning of the injection speed was increased to 30 drops/min-1. The daily dosage of the drug was 4,2 g (100 ml). The course of treatment was two weeks. Mucosal defecation in 88,9% of patients in the main group ended on 3-4 weeks, scarring was more mild, without excessive formation of granulation tissue. While in the control group, complete epithelization in 76,5% of patients was completed at 4-5 weeks, the scar tissue was strongly expressed, so it was sometimes difficult to differentiate it from the onset of relapse. The use of the developed comprehensive method of prevention allowed to 1,7 times improve the results of treatment in patients with residual polyps of the stomach of the main group, in comparison with the control group and prevent recurrence of the disease. With dynamic observation, recurrence of polypeptide is not noted.
