Uncomplicated gastric ulcer: prediction of course and treatment tactics
DOI:
https://doi.org/10.11603/2414-4533.2016.3.6805Abstract
Modern trends in the development of practical medicine in the world and our country require the development and implementation of a clear step-by-step programs-algorithms, standardized treatment regimens, indications for surgical treatment and prevent complications. Based on the results of a survey of 185 patients with complicated and uncomplicated peptic ulcer disease of the stomach (esophagogastroduodenoscopy with Express biopsy of the ulcer and periulcerous infiltration with subsequent immunomorphological examination of the biopsy specimens, the determination of the degree of dysplastic processes of the epithelium of the mucous membrane of the stomach), developed criteria for predicting complications and clear indications for preventive surgery. Based on our findings, a preventive surgical intervention was done tо 23 patients with a significantly poor prognosis to the development of acute complications and 14 with precancerous changes. Indications for organsaving operations considered did not healed ulcers with the presence of prognostic indicators of high risk of acute complications of gastric ulcer on a background of light dysplasia and precancerous changes, uncomplicated stomach ulcers, recur 3–4 times per year or annual recurrence for 4–5 years, before resection of giant or did not healed ulcers ulcers with the presence of precancerous changes the backdrop of severe dysplasia.
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