Mohammed Jafar Augi. Perioperative and Early Postoperative complications in surgical management of the Post-gastric Operative Syndromes. (Prognosis, diagnosis, treatment and prophylaxis). – Manuscript. Dissertation for the degree of candidate of medical sciences in the specialty 14.01.03 – surgery. – Crimea State Medical University named after S. I. Georgievsky, Simferopol, 2002.

The work was dedicated to the important problem of intraoperative and early postoperative complications following reconstructive operations in patients with post gastric operation syndromes.

Clinical research was carried out on 1318 cases (1009 cases were analyzed retrospectively while 309 were investigative prospectively.) 161 different complications were found in 108 (8.2%) patients.

Given in the work were the clinical characteristics of the patients and results of their investigation. Using clinical diagnostics, topographic anatomy (Intraoperatively), bacteriological, and biochemical methods.

Among the risk factors, analyzed were: аge of patients, concomitant illnesses, protein synthetic function of the liver, lipid metabolism, intraoperative factors (intensity of adhesions in the upper abdominal cavity, microbial penetration at different stages during surgery.) Of importance was the index of endogenic intoxication. Different clinical and laboratory studies were carried out to define the intensity of plasma toxicity.  Leucocytic index of intoxication, levels of middle molecular weight oligopeptides, levels of lipid peroxidation products, intraerythrocytic metabolism (intensity of glycolytic reactions and modification of hemoglobin through spontaneous glycosylation). These indices were not only markers of endogenic intoxication but also factors that validate the use of antioxidants in the complex management of this group of patients before and after surgery.

Algorithms of both uncomplicated and complicated course of postoperative period and also, of the early postoperative complications were created and introduced into the data bank of an expertise diagnostic computer system.  The informative importance of different signs and symptoms were calculated using Student’s method, which allows the integration of qualitative and quantitative criteria in both complicated and noncomplicated course of the post-operative period. This has helped to optimize early diagnosis of operative complications.

A classification of intraoperative and early postoperative complications was suggested. It classifies the complications into iatrogenic, aseptic, purulent — septic, and inflammatory.

Main achievements of this research work have since been introduced into practical medicine in 3 surgical departments.

Key words: Postgastric Operation Syndromes, Surgical management, Complications, Prognosis, Diagnosis, Treatment, Prophylaxis.