- "Lunch, I often replaced a cigarette and earned an ulcer"
- “People without a stomach often have to sleep half-sitting”
Thanks to the new technique of Donetsk doctors, the 70-year-old Kharkiv-born Anatoly Nakonechny was able to eat food a day after the operation. Only six such operations were performed in Ukraine.
"Lunch, I often replaced a cigarette and earned an ulcer"
With a resident of Kharkov Anatoly Nakonechny I met in the Donetsk Regional Antitumor Center on the fourth day after the operation to form a so-called artificial stomach for him. 70-year-old Anatoly Stanislavovich doctors were already allowed to get out of bed, and he vigorously showed me a neat bandage covering the postoperative suture.
“By the end of the first day, they gave me some water, and then some kind of nutrient mixture, like baby porridge,” says Anatoly Nakonechny. - And today the spouse brought kefir and broth.
True, the first time after the operation, water and mixtures were poured into the patient through a probe. On the third day the probe was removed. And now, according to the doctor, a person who has undergone surgery for plastic stomach, the main thing - to follow a diet and a fractional diet: take 100-150 grams of food sparing every two to three hours. Over time, portions can be increased.
“I am no stranger to fractional nutrition,” says Anatoly Nakonechny. - When 12 years ago I was diagnosed with a stomach ulcer, I began to pay due attention to my diet. Interestingly, I spoiled my stomach in my mature years, working as a teacher at the Kharkov Railway Institute. He went to work, having had a light snack at eight in the morning. Lunch is often replaced by a cigarette. In the evening, at home I tried to “make up the uneaten”, combining both dinner and lunch at once.
Strict observance of all prescriptions of the doctor and the transition to a balanced diet then helped the teacher to avoid surgery. Anatoly Stanislavovich began to take sandwiches from home. At noon, I looked into the institute's buffet, where I ordered hot tea or broth, so as not to eat a dry meal. The disease has receded for many years. However, about three months ago, the man began to feel nauseous in the morning. The wife and daughter insisted that the head of the family be examined. Doctors diagnosed the tumor and reported that surgery to remove the stomach is inevitable.
The interlocutor admitted that he was frightened not so much by the operation as by its consequences: the man was used to an active lifestyle. He taught at the institute even after retirement, he helped his wife in the country. But with an old bad habit - smoking - Anatoly Stanislavovich could not part, despite the warnings of gastroenterologists.
“Now, with smoking, I will definitely finish off,” the Kharkovite’s beloved wife Zoya Stepanovna, with whom they have lived for 46 years, swears.
All women in the Nakonechny family are doctors. His wife is a dermatologist, her daughter followed in the footsteps of her mother, her granddaughter plans to become a psychiatrist - she is studying in the third year of the medical institute. It was the granddaughter who found on the Internet information that the Donetsk surgeons form an artificial stomach from the intestinal tissues instead of a remote one. Anatoly Stanislavovich immediately went to Donetsk.
“People without a stomach often have to sleep half-sitting”
“Nakonechny told us an article about an artificial stomach and demanded:“ Do me exactly the same! ”- smiling is the candidate of medical sciences, head of the surgical department of the antitumor center Sergey Gotovkin.
A 70-year-old Kharkiv citizen became the sixth patient who had an artificial stomach in the center. The first such operation was done in February of this year.
“Our first patient, a 30-year-old woman, we actually saved a life,” says the director of the Donetsk Regional Antitumor Center, Grigory Bondar, MD. - After removing the stomach she was facing starvation. The digestive system practically did not work, the patient could eat no more than 100 grams of food or drink the same amount of liquid. Restore the necessary functions helped only the operation on the formation of an artificial stomach. Of course, the organ given to man by nature is better created by surgeons. But removal of the stomach is a necessary measure for a tumor or a total (extensive) ulcer. Usually, after an operation on plastic surgery, an artificial organ of the patient is discharged in two weeks. The man quickly returns to active life.
As Gregory Bondar said, for more than 30 years, which he headed the center, four thousand patients had to remove the stomach. About 150 people undergo such operations every year. Thanks to the resection of the stomach, life was saved by the sick. But after that, patients began to experience significant discomfort.
“People who live without a stomach are often forced to sleep half-sitting, because they suffer from belching - the return of food into the esophagus,” explains Gregory Bondar.
At the same time, as the doctor explained, the digestion process goes according to the “accelerated program”. After all, the natural reservoir, where food is delayed and processed by enzymes, is removed. All that a person absorbs, passes unhindered to the lower intestinal sections and, not having time to absorb and digest, leaves the body five to six times a day. In addition, patients no longer feel hunger (do not act receptors 12 duodenal ulcer) and take food, only focusing on time.
“Gastric plastic surgery, to which we have arrived thanks to many years of practice, allows patients to return many digestive functions,” says Professor Bondar. - Therefore, we are trying to put them on stream as soon as possible. We have learned to artificially form a reservoir that replaces a removed stomach from the tissues of the jejunum.
According to Professor Cooper, an artificial stomach is formed by making a kind of loop from the intestine just above the pulp (the sphincter that opens and closes the esophagus). Thus, food moves only in one direction. Next, the artificial reservoir is connected to the duodenum 12, which has natural pulps that prevent the stomach contents from passing too quickly to the lower intestinal sections. Nutrients have time to digest and absorb.
“We put the stitches in a special way in the loop of the jejunum — so that they do not touch the tissues of the abdominal cavity,” says Gregory Bondar. “This allows an operated person to be transferred to a natural diet in a very short time, without fear of seam rupture. Previously, with the usual removal of the stomach, the patient was fed through a tube for seven to ten days. Now, as you can see for yourself, if there are no complications, the patient is fed through a probe the very next day after the operation, and after two or three days he begins to feed on his own. Moreover, the appetite returns to the patient who was operated on according to the new method - the duodenal receptors are again involved in the digestive processes.
“In the first days after the operation, infant formulas that are sold in a pharmacy will be suitable as food,” says Sergey Gotovkin, head of the surgical department. - They are balanced all the nutrients and elements. Then you can eat kefir, broth, semolina and pureed soup. Then the body itself will tell you that it is “possible” and “how much”. The main thing: eat a little and often, but not later than two hours before bedtime.
“I considered the possibility of carrying out such operations as a student when I was operating ... experimental dogs,” Professor Bondar admits. - My teachers also studied this issue in the 70s of the last century (the doctor demonstrates the 1973 monograph “Methods for restoring gastrointestinal continuity during gastrectomy.” - Auth.) But we decided on such surgical interventions only now, when we prepared the team. The operation lasts about three hours, as a rule, three surgeons and an anesthesiologist participate in it. Due to the fact that 20 specialists have already mastered this technique (three in our center), it is possible to plan operations for the formation of an artificial organ to half of the patients who had to remove the stomach. If there is no, of course, contraindications.
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