METHOD FOR SELECTING THERAPEUTIC APPROACH IN PATIENTS WITH SHORT CICATRICIAL OESOPHAGEAL STENOSIS Russian patent published in 2024 - IPC A61B17/00 A61B17/94 A61B8/08 A61B1/273 A61K35/16 A61K35/19 A61K38/39 A61B5/07 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to surgery, endoscopy, and can be used when choosing a therapeutic approach to cicatricial oesophageal stenosis. Method involves endoscopic ultrasonography of oesophagus with determination of depth of involvement of layers of oesophagus in cicatrical process, total thickness of oesophagus wall in unchanged part (TWu) and in area of constriction (TWc), thickness of muscular layers in unchanged part of oesophagus (TMu) and in area of constriction (TMc). Further, coefficients Ktw are determined in relation of TWc to TWu and Ktm is determined by the ratio of TMc to TMu. If the cicatricial process only covers the submucosal layer of the oesophageal wall without changes in the muscular layers, in the absence of disturbed differentiation of the submucosal layer and the circular muscular layer, Ktw>1.5, Ktm=1, bougieurage or endoscopic balloon dilatation of oesophageal stenosis is performed. If the cicatricial process spreads to the circulatory muscular layer, Ktw>1.5, 1<Ktm>1.5 and the submucosal and circulatory muscular layers are disturbed, oesophageal stenosis is stented with a self-expanding, completely covered metal stent and a platelet lysate is applied in the blood plasma under the proximal stent edge. If the cicatricial process spreads to the longitudinal muscular layer, Ktw>2, Ktm<1, and if the differentiation between the submucosal, circular and longitudinal muscular layers is impaired, the endoscopic resection of the cicatrical tissue is performed with simultaneous application of plasma-free platelet lysate and allogenic collagen of type 1. If the cicatricial process covers all layers of the oesophagus wall, Ktw>2, Ktm is not detected and differentiation of all muscular layers of the oesophagus wall is disturbed, a reconstructive surgical operation is performed.

EFFECT: invention increases the effectiveness of the treatment, reduces the length of staying in the hospital.

1 cl, 8 dwg, 1 tbl, 4 ex