Savvi S. Complex treatment of patients with post-burn esophageal strictures (clinical-experimental study).

Dissertation is devoted to the optimization of treatment of patients with post-burn esophageal strictures by improvement of methods of conservative treatment, dilation therapy and reconstructive operations. The new experimental model of esophageal corrosive burn was developed, thanks to which knowledge about flow of post-burn esophageal strictures under influence of new methods of local conservative therapy with Thiophosphamidum, cryotherapy and microwave irradiation was expanded. In clinical part the retrospective and prospective analysis of case histories of 314 patients with corrosive esophageal burns from 1993 till 2008 is performed. As a result of research new classification of the corrosive esophageal burns and their consequences and algorithm of complex treatment with use of new and advanced methods of local conservative and dilatation therapy is offered at each stage of treatment of patients. New methods of operative interventions with use of videothoracoscopy technologies and two-stage operations were developed and introduced, that has allowed to lower frequency of esophageal anastomotic leak and postoperative lethality from 12 % to 5,9 %, and also to improve indicators of quality of a life. Introduction of the offered algorithm has allowed to lower frequency of unfavorable results of treatment of post-bum esophageal strictures of Grade III for 11,3% and Grade IV - for 16,7%.