Shaprynskyi Y. Reconstructive surgery in the treatment of stenosing esophageal diseases (experimental-clinical research).

The research is devoted to the problem of increasing efficiency of surgical treatment of patients with stenosing esophageal diseases. In the result of experimental and clinical investigations the diagnostic-therapeutic algorithm has been developed taking into account the risk of complications. Medical tactic is that patients with a high risk of complications are subject only to miniinvasive methods of treatment, correction of the trophic status in the intensive care unit; patients with average degree of risk of development of complications are subject to intensive infusional therapy with correction of the trophic status before further esophagoplasty in the intensive care unit; patients with low degree of risk of development of complications are subject to reconstructive surgery with previous preoperative preparation in the surgical department. The presented treatment technology consists in consecutive performance of its three stages with application of techniques of graft preparation and the developed surgical interventions. The stenting of the esophagus in case of developed complications allows to avoid lethal outcomes and in 24,68 % repeated traumatic surgery. The introduction of treatment technology has allowed to reduce the level of specific postoperative complications from 34,00 до 15,58 % (p<0,05) and the level of a postoperative lethality to 2,60 %.