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CURRENT ISSUE

№3' 2020

SURGERY

International Medical Journal, Vol. 26., Iss. 3, 2020, P. 23−27.


DOI (https://doi.org/10.37436/2308-5274-2020-3-5)

CAUSES OF ADVERSE SURGERY EFFECTS IN TREATMENT OF PATIENTS WITH ESOPHAGUS STENOTIC DISEASES


Valerii Volodymyrovych Boiko, Savvi S. O., Korolevska A. Yu., Bityak S. Yu., Zhidetskyi V. V., Starikova A. B., Novikov Ye. A.

Kharkiv National Medical University
V. T. Zaitsev Institute of General and Emergency Surgery, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
V. N. Karazin Kharkiv National University, Ukraine

Esophageal stenosis requires a responsible approach to the choice of rational treatment tactics. Intraoperatively, bleeding, interponate necrosis, complications associated with the wrong choice of the path of the interponate imposition to the neck, damage to the nutrient vessel (the arcade rupture), pleural leaves during the formation of the thoracic tunnel, n. vagus and its branches, pneumothorax, hemothorax, uncontrolled mediastinal bleeding, the need for drainage of the pleural cavity due to injury to the latter, iatrogenic splenectomy, membranous tracheal tear. Post−surgery complications are developed at different times after esophagoplasty. Most often, early postoperative complications occur because of the wound: bleeding and failure of the sutures of the anastomosis line. Complications resulted from the respiratory system are as follows: tracheobronchitis, pleurisy, "congestive", nosocomial pneumonia and atelectasis, pleural empyema. In the remote post−surgery period, the patients may experience: stenosis of the esophageal (or pharyngeal) anastomosis, adhesions, fistulas, reflux, peptic ulcers of the esophagus, pain, inflections and excess loops, complications associated with mechanical trauma of implant, scar−altered cancer esophagus, polyposis of the colon, various disorders associated with primary trauma, nonspecific complications. Damage to the recurrent nerve in patients causes constant hoarseness and difficult swallowing. Occasionally there are cardiac arrhythmias in the form of atrial fibrillation, "sympathetic" pleurisy, reflux, post−vagotomy symptom and dumping syndrome, delayed gastric emptying due to insufficient dilated pyloromyotomy in the patients with a combination of stenosis of the esophageal lumen and esophageal lumen hernia.

Key words: esophageal stenosis, esophageal anastomosis, postoperative complications.


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