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    1. Federal State Budgetary Educational Institution of Higher Education “South-Ural State Medical University” of the Ministry of Healthcare of the Russian Federation (454092, Chelyabinsk, Russia)

    Keywords: portal hypertension, portal hypertensive gastropathy, mucosa, bleeding, liver currosis

    Abstract: A study of the state of the mucosa of the upper gastrointestinal tract (GIT) in patient with portal hypertension (PH) is necessary to stratify the risk of bleeding and correct of treatment. The purpose of the study was to study the state and dynamics of changes in mucosa of upper gastrointestinal tract in patient with PH. Materials and methods: Esophagogastroduodenoscopy (EGD) and sessions of endoscopic ligation (EL) were performed in 190 patients with PG. The cause of PG was liver cirrhosis (LC) in 170 cases and portal vein thrombosis (PVT) in 20 cases. Results: Becides varices, portal hypertensive gastropathy and GAVE -syndrome, chronic gastritis, ulcerous lesions, polyps, erosive esophagitis, tumors were found in 48%, 34,7%, 10,5%, 13,4%, 2,1% accordingly. 130 patients bled previously, and 8.6% of them had not variceal cause of bleeding. Conclusions: Pathological changes of mucosa of upper gastrointestinal tract in patients with PG are diff erent and can lead to a bleeding. There are not signifi cant diff erence in pathology between diff erent types of portal block. Eradication of varices leads to an increase in pathology of the mucosa and PHG. The level of blood pressure in varices correlates with the severity of PHG.

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    Full text is published :
    Olevskaya E. R., Dolgushina A. I., Tarasov A. N., Naumenko O. V., Shamaeva T. N., Klepinina Yu. I., Koksharov V. N. The state of upper gastrointestinal mucosa in patient with portal hypertension. Experimental and Clinical Gastroenterology. 2018;158(10): 52–56. DOI: 10.31146/1682-8658-ecg-158-10-52-56
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    1. Public budgetary educational institution of higher education “First Saint-Petersburg State Medical University n. a. I. P. Pavlov” of the Ministry of Healthcare of the Russian Federation (Saint Petersburg, Russia)
    2. N. I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation (Moscow, Russia)

    Keywords: Achalasia, Peroral endoscopic myotomy, high-resolution esophageal manometry, esophagus, complications, esophageal motility

    Abstract: Aim. To evaluate the number and structure of complications associated with peroral endoscopic myotomy procedure. Materials and methods. Retrospective analysis of 3-year experience of peroral endoscopic myotomy (POEM) for achalasia in one center was performed. The analysis included data of 120 cases. Diagnosis of achalasia was established with the use of water-perfused high-resolution manometer (MMS; Solar GI, Netherlands). Descriptive statistics was used to perform the analysis. Results. Treatment was successful in all 120 cases, mean Eckardt score before and after POEM was 6.2±1.4 and 1.4±0.9, accordingly. The following complications occurred: perforation of mucosa (n=6), suture failure after endoscopic clips application (n=4), submucosal hematoma (n=1). In one case of suture failure it caused mediastinitis, that was managed by toracotomy and drainage of the mediastinum. Other complications were managed by endoscopic methods. Conclusion. POEM is an eff ective method for achalasia treatment. However, during the operation and in early postoperative period may occur complications that can be treated conservatively or by using minimally invasive procedures.

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    Full text is published :
    Smirnov A. A., Lubchenko M. E., Kiriltseva M. M., Dvoretskiy S. Y. at al. Complications of peroral endoscopic myotomy. 3-year experience of one center. Experimental and Clinical Gastroenterology. 2018;158(10): 57–61. DOI: 10.31146/1682-8658-ecg-158-10-57-61
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