The method of pylorus-preserving gastrectomy. The method of pylorus-sparing gastrectomy It is impossible to prepare for the diagnosis of cancer

Dear readers, today we visited a new hospital in Makhachkala - ANO "Gorodskaya clinical Hospital No. 3”, in particular, the surgical department. The head of the surgical department is a candidate of medical sciences, a surgeon of the highest qualification category, a member of numerous Russian and international surgical and oncological scientific communities Saparchamagomed Magomedov. We took the opportunity to ask him a few questions.

- Saparchamagomed Magomedovich, tell us about the structure of the surgical department.

The surgical department of City Clinical Hospital No. 3 is located on the fourth floor of the main medical building of the clinic and is deployed for 20 beds. The structure of the surgical department includes a block intensive care for seven beds, where postoperative patients are under the supervision of resuscitators with round-the-clock monitoring of vital functions.

The operating block includes two operating rooms with modern system ventilation and purification of air supplied by laminar flows.

- What diseases are most often treated by patients and what operations are performed in the department?

Patients are hospitalized in the surgical department with liver pathology (cysts), gallbladder(cholelithiasis, polyps), pancreas (pancreatitis, cysts), kidneys (cysts), spleen (cysts), stomach (complicated ulcers, polyps, tumors), duodenum (ulcerative cicatricial stenosis), colon (diverticula , tumors), with pathology of the anterior abdominal wall (hernias: inguinal, femoral, umbilical, white line of the abdomen, postoperative ventral; diastasis of the rectus abdominis muscles), with benign diseases of the skin, subcutaneous tissue (lipomas, fibromas, etc.).

The department conducts wide range various surgical interventions, mainly using minimally invasive modern technologies. The surgeons of the clinic have at their disposal a modern laparoscopic system in Full HD high-resolution format, which allows performing surgical interventions with more precision (jewelry).

We have introduced navigational surgery in the department, which allows us to perform surgical interventions without incisions under the control of modern ultrasonic system. All used modern technologies are aimed at reducing the trauma of operations and allow the patient to return to his usual way of life as quickly as possible.

- The operations performed in the clinic are probably costly, do patients have to bear the financial costs?

The opening of this hospital was initiated by the Muftiyat of the Republic of Dagestan in order to help people who find themselves in difficult life situation because of illness. All expenses for the treatment of patients both in the department of surgery and in the therapeutic department are borne by the hospital operating under the CHI system.

Patients do not incur any financial expenses, however, receiving a modern technological surgical care using foreign (Ethicon, Cavidien, Bard) consumables (endoprosthetic meshes, suture material, catheters, drainage systems, etc.).

- The surgical department opened in January. And how many operations were performed during this period in the department?

To date, more than 170 operations of varying complexity have been performed in the Department of Surgery. All operated patients were discharged with recovery (Al-hamdu li-llah). All of them left satisfied with both the doctors and the middle and junior medical staff.

- Tell us a little about yourself and your professional growth.

In 2001, I graduated from the Makhachkala secondary school No. 30 with a gold medal and entered the Dagestan State Medical Academy, which I graduated with honors in 2007.

Further, a two-year training in clinical residency in surgery under the guidance of Professor Saigid Alievich Aliyev at two clinical bases (surgical and oncology department). After completing his clinical internship, he was employed in the thoracoabdominal oncosurgical department of the Dagestan Center for Thoracic Surgery, at the same time he studied at the postgraduate course, the result of which was the defense of his Ph.D. thesis in 2013.

For his contribution to the development of inventions in medicine (patents) by the Presidium of the Academy of Sciences (Moscow) he was awarded the gold medal of Alfred Nobel. During his studies (residency, postgraduate studies) and work, he underwent numerous internships in Moscow, St. Petersburg, Kazan, Rostov, etc.

In May-June I have an internship in Munich, Germany. Surgery is constantly evolving, like all medicine in general, so we, doctors, need to improve ourselves and master new approaches and techniques that allow us to help patients as efficiently as possible.

- Why did you decide to become a surgeon?

It is difficult to unambiguously answer this question. Since childhood, I have been drawn to difficult decisions, and surgery is one of the most difficult areas of medicine. This, on the one hand, and on the other hand, my love for surgery was strengthened by the stories of my neighbor, a surgeon on the landing, who described all the stages of operations, how he managed to get out of difficult non-standard situations and help people.

- Do you think doctors are born or made?

If we consider a doctor from the position of professionalism, then, of course, they become doctors, but this is not easy, it is everyday work aimed at self-education and self-improvement. However, a doctor also needs personal qualities (humanity, compassion, honesty, and others) with which one must be born, and these qualities should be fundamental before choosing a medical practice.

- Is it difficult to win the trust of the patient?

You correctly noticed the importance of the patient's trust for the doctor. Winning the patient's trust is not an easy task, especially in surgery, but it can be done. Each patient is individual, and it is necessary to find a certain psychological approach to each.

We pay great attention primary contact with the patient, we try to listen to all his worries and experiences, doubts. The patient should see empathy and a desire to jointly solve the patient's problem in the eyes of doctors.

As a rule, patients come to us in several state of shock, since the very fact of the need for an operation scares people a lot, and this is normal, so we have to reassure the patients, inspire hope for favorable outcome, we describe all stages of stay in the clinic, and patients trust us.

- What is the place of religion in your life?

My whole life is religion.

- And what is paramount for you - religion or profession?

This formulation of the question is not entirely correct, because I appreciate the importance of my profession from the point of view of religion. After all, every day doing our job, helping people, we serve the ALL. We consider patients as slaves of GOD who came for help, and we ask the CREATOR to make us the reason for delivering people from diseases and ailments.

- To what extent did religion play a role in your choice of profession?

In the beginning, I just liked surgery and was drawn to it. But later came the understanding of the importance of the profession from the point of view of religion, responsibility for the life and health of people before the CREATOR. Medicine is a rather interesting field of science for people who think: understanding even elementary processes occurring in human body for fractions of seconds, it is enough to realize the greatness of the CREATOR.

- Last question. Do you read our portal IslamDag.ru, and what would you wish our readers?

To be honest, I rarely read, unfortunately, there is not much time, but when religious questions arise, your portal is a priority. I want to wish readers good health and iman, these are two inextricably linked components of a full-fledged person, the weakening of one of them reduces the other.

Interviewed Makhach Gitinovasov

It is impossible to prepare for a diagnosis of cancer. Faced with this disease, a person scrolls through a lot of questions in his head, the main ones being “what to do?” and “where to go?”.

For problems in the thoracic and abdominal areas, there can be only one answer - to the Dagestan Center for Thoracic Surgery. For three years of fruitful highly qualified work of the clinic staff, more than 2,500 patients have been treated. The center is headed by a doctor with a capital letter, doctor of medical sciences, professor, head of the department of oncology and UV of the DSMA, chief oncologist of the Republic of Dagestan Saygid Aliyev.
On the appointed day for the interview, we came to Saigid Alievich, but before meeting him, we talked with the patients of the center, they all shared only positive feedback: “These are doctors from God, they have magical hands, when I came here, I didn’t even hope for a recovery, but now I’m enjoying life again, thanks to them”, “I want to especially note the very kind attitude of all the staff. The talented hands of the surgeon, the kindness and care of the entire team gave me a second life. I did not think that such doctors still exist - competent and decent, caring and attentive, with one kind look they are able to calm and give hope. I am eternally grateful to them!”
After these words, we were eager to talk to Saigid Aliyev himself in order to learn more about the activities of the center. But Saygid Alievich turned out to be not one of those who talk a lot and like to brag, he immediately told us: “Let me show you our work visually.” And we went on a tour of the department of the Dagestan Center for Thoracic Surgery. “Just don’t be afraid,” Saigid Alievich warned us, “mostly, those patients come to us who were refused by other doctors and clinics, and they receive the necessary medical care from us. First, we will go to the intensive care unit where the patients stay during the first days after the operation. We perform high-tech thoracoabdominal oncosurgical operations on the organs of the thoracic, abdominal cavity and on the neck. This is very complex operations, on average they last 6-7 hours. But the main thing is that the very next day after the operation, patients show signs of life. Although our center is not sufficiently equipped with modern equipment for diagnostics and minimally invasive surgical treatment oncosurgical patients. In terms of the breadth of operational activity, complexity and the results of interventions performed (modified methods of Lewis, Garlock, Savinykh-Karyakin, M.I. Davydov, A.F. Chernousov up to options for pancreato-duodenal resection), the Dagestan Center for Thoracic Surgery is one of the best in the North Caucasus. But the subject of our special pride is the team. The medical staff of the Center strives for excellence in the field of patient care, which is manifested, first of all, in the high professionalism of the treatment provided, as well as in providing personal attention and the necessary support to the patient and his family members, both during hospitalization and during follow-up. The most important thing we usually say to our patients is that a diagnosis of cancer is no longer a death sentence. People are dying from the flu. No one faints when he hears that he has the flu, although a person also has a chance to die from the flu. We hide the diagnosis from the patient when we understand that the prognosis is poor. But, as a rule, we ask the patient to cooperate. When a patient understands what disease we are fighting, he responds much more adequately to medical prescriptions and tries to fulfill everything. Botkin is credited with the phrase: “There are three of us: you, me and your illness. And if you are with me, we will defeat her, if you are with her, I alone will not cope. This is a correct thesis, and it is especially important in relation to cancer patients.”
With bated breath, we listened to Saygid Alievich and watched the work of doctors. I would like to note that the center is clean and tidy, patients are satisfied with the attitude and level of care medical care. And the staff of the Dagestan Center for Thoracic Surgery treat their work with great responsibility. For them, this is more than a job, it is the meaning of life. “We are happy that every day we go into battle with the diseases of our patients. And there is no higher reward for us than victory in this battle,” Saigid Alievich told us in the end. And these words speak volumes - the professionalism and decency of the specialists of the Dagestan Center for Thoracic Surgery, their indifference and sincere desire to help each patient!

The invention relates to surgery, may be applicable for pylorus-sparing gastrectomy. Ligate the right gastric artery parietal 1 cm above the pyloric sphincter. The stomach is removed, while crossing it, departing from the pylorus by 20 mm. The ends of the esophagus and the pre-pyloric segment are anastomosed with the formation of a single-row precision suture with the restoration of the closing function of the pylorus. EFFECT: method makes it possible to prevent tension of the organs to be sutured, to create a physiological anastomosis, to reduce the risk of developing reflux, dumping syndrome. 3 ill.

Drawings to the RF patent 2417771

The invention relates to medicine, namely to surgery, can be used for the reconstructive stage of gastrectomy.

High-tech, organ-preserving operations in functional surgical gastroenterology for precancerous and oncological diseases are increasingly spreading in world practice and are considered promising.

Today, the surgical method of treating a number of organic diseases of the stomach is the main one, and gastrectomy occupies one of the main places in the arsenal of surgeons. A frequent and formidable complication of gastrectomy in the early postoperative period is the failure of the esophago-intestinal anastomosis (1.5-25%), the mortality rate in which reaches 25-100% (Chernousov A.F. et al., 2004; Davydov M.I. et al., 1998; Doglietto G. B. at all., 2004; Isguder A. S., 2005). The development of failure of the esophago-intestinal anastomosis is influenced by a large number of factors, but the leading role is played by the method of fistula formation. In addition, long-term results of reconstructive interventions in gastrectomy are due to the presence of postgastrectomy syndromes (dumping syndrome, afferent loop syndrome, reflux esophagitis, etc.). The development of many postoperative pathological syndromes is associated with the elimination of duodenal transit.

Several methods have been proposed to preserve duodenal transit during gastrectomy by directly connecting the esophagus to the duodenum and interposition with a small intestine graft. These methods require mobilization of the duodenum and the head of the pancreas, mobilization of the esophagus in the mediastinum, an increase in the number of anastomoses during gastroplasty, the inevitable tension of the tissues of the sutured organs, in some cases the inability to match the ends of the esophagus and duodenum 12. In addition, with all the proposed methods, there is no sphincter (closing) mechanism in esophagoduodenostomy, which leads to severe postoperative suffering in patients with the development of postgastrectomy syndromes.

An analogue of this model is the proposed P.M. Gaziev terminolateral esophagoanastomosis (patent No. 2266064 dated February 2, 2004).

Mobilize duodenum together with the head and partially the body of the pancreas. The stump of the duodenum is sutured with two-row interrupted sutures. Terminolateral esophagoduodenoanastomosis is applied with the formation of a reservoir from the duodenal stump above the anastomosis at an angle of 30 degrees to the anastomosis, for which back wall the abdominal portion of the esophagus is fixed to the stump of the duodenum, applying three seams on the sides in the oral direction. Impose an anastomosis between the esophagus and the anterolateral wall of the duodenal bulb, opening it transversely 4 cm from the end of the stump. An anastomosis with a diameter of 2-2.5 cm is formed. The duodenal stump is fixed to the diaphragmatic pedicle.

Disadvantages:

1) Mobilization of the duodenum with the pancreas leads to the destruction of the pacemaker zone, which affects its motor-evacuation function.

2) Deterioration of blood supply to the duodenum during the mobilization stage ( high risk anastomotic failure).

3) When forming a reservoir from the stump of the duodenum, a "blind" sac is formed above the anastomosis. Food masses can accumulate in it, which leads to overstretching, manifestation and perforation of the intestinal wall.

4) In the early postoperative period, the development of insolvency of the duodenal stump is possible.

The prototype of the proposed method is the method of direct esophageal-duodenal anastomosis according to A.M. Karyakin (Ivanov M.A. Comparative evaluation of variants of esophago-intestinal anastomoses and the possibility of correcting functional disorders of the intestine during gastrectomy: Dis. Doctor of Medical Sciences. St. Petersburg, 1996; 368), which consists in manual mobilization of the lower thoracic and abdominal sections of the esophagus, followed by comparison of the anastomosed segments of hollow organs.

This method also has its drawbacks:

1) The rhythm of activity is disturbed digestive tract in the absence of a locking device.

2) The imposition of an end-to-end anastomosis without preserving the pyloric sphincter leads to duodeno-esophageal reflux disease with the development of Barrett's esophagus, dumping syndrome.

3) The systematic implementation of direct esophagoduodenoanastomosis encounters significant difficulties associated with the tension of the sutures in the anastomosis zone.

Thus, the prevention of early and late postgastrectomy complications is an urgent problem.

The aim of the invention is to develop a method for pylorus-preserving gastrectomy, which eliminates the need to mobilize the lower thoracic esophagus and the lower horizontal segment of the duodenum with no tension on the sutured organs, which makes it possible to prevent the development of early and late postgastrectomy complications with the expansion of indications for more physiological surgery.

This goal is achieved by the fact that the border of the mobilization of the stomach passes 20 mm proximal to the pylorus with the preservation of the marginal vessel, innervation, systemic normotension in the vessels of the suture strip of the prepyloric segment, followed by the formation of a single-row suprapyloresophageal anastomosis. The method of pylorus-preserving gastrectomy is the most physiological, it allows you to maintain the rhythm of the digestive tract, i.e. portioned intake of food into the duodenum, prevents the development of early surgical postoperative complications and diseases of the operated stomach in the long term: esophagoduodenal reflux disease, Barrett's esophagus, dumping syndrome.

The essence of the invention

The essence of the proposed method is illustrated in the drawing, where pos.1 - esophagus, pos.2 - pyloric pulp, pos.3 - duodenum, pos.4 - anastomosis, pos.5 - right gastric artery. Presented (Appendix 1) photographs of the successive stages of operations on experimental animals. Presented (Appendix 2) are X-ray images of the control study of patient V., 40 years old, who underwent an operation - pylorus-preserving gastrectomy, where the preservation of the function of the pyloric sphincter, portioned intake of barium suspension into the duodenum, and free patency of the anastomosis are clearly noted.

The proposed method of pylorus-preserving gastrectomy is as follows.

The operation itself consists of resection and plastic stages. Diagnosis of duodenostasis with a statement of periodic activity of the intestine and a consistently high intraluminal pressure of at least 30 mm of water column, associated with retrograde spread of frontal activity, makes it possible to avoid operational and tactical errors when establishing indications for surgery with the inclusion of the duodenum in digestion.

One of the indispensable conditions for ensuring the full functional state muscular-vascular sphincter - pyloric sphincter, is the preservation of blood supply and innervation. Adequate preservation is achieved by parietal ligation of the branch of the right gastric artery located 2 cm proximal to the pyloric sphincter. At the same time, against the background of extraorganic vagal denervation, intramural nervous regulation is preserved.

The resection stage is performed in compliance with the basics of oncological radicalism in the volume of D2 lymph node dissection in cardiogastric cancer with a distal lesion border not lower than the corner of the stomach and in benign diseases: diffuse gastric polyposis, post-burn extended strictures.

Proximally, the stomach is cut from the esophagus, the distal line of intersection runs along the line of mobilization, 20 mm away from the pylorus.

After removal of the stomach, the end of the esophagus and the pre-pyloric segment are compared, an end-to-end anastomosis is applied with a precision atraumatic suture material 3/0-4/0 between the segments of the digestive tract. At the same time, the valve mechanism of the pyloric sphincter is preserved.

An essential feature of the proposed method of operation is the implementation of parietal mobilization with preservation of the pyloric sphincter, the right gastric artery is ligated 1 cm higher with cutting out the pre-pyloric segment - a strip 20 mm wide.

Thus, ensuring vascularization and innervation of one of the most important reflexogenic zones - "pyloric sphincter-bulb of the duodenum" is one of the essential points in our work.

Comparative analysis of the features of the prototype and the proposed invention

Prototype Features

Access transhiatal, abdomino-posterior mediastinal for mobilization of the esophagus;

Mobilization of the duodenum according to Kocher is widely used;

The plastic stage of the operation is performed without preserving the pyloric sphincter and by forming a direct esophagoduodenal anastomosis.

Invention features

Lack of wide mobilization of the esophagus with transhiatal expansion of access;

Ensuring vascularization and innervation of the most important reflex zone- "pyloric pulp - duodenal bulb";

The implementation of parietal mobilization with the preservation of the pyloric sphincter, the right gastric artery is ligated 1 cm higher with cutting out the pre-pyloric segment - a strip 20 mm wide;

The right gastric artery is ligated parietal 1 cm above the pyloric sphincter, and for plastic stage of the operation, a pre-pyloric segment of a 20 mm wide suture strip is cut out, with the preservation of vascular connections of the muscular-vascular sphincter - pyloric sphincter against the background of preserved intramural nervous regulation with the formation of a single-row precision suture of the anastomosed segments of the digestive tract with the restoration of the closing function of the pylorus.

Example of a specific implementation

Extract from the laboratory journal of the Department of Operative Surgery of the DSMA

The study was conducted on 12 outbred dogs, which were divided into two groups: experimental (n=6) and control (n=6). The dogs of the experimental group under intrapleural anesthesia underwent upper median laparotomy, parietal mobilization of the stomach with preservation of the pyloric sphincter, while the right gastric artery was ligated 1 cm higher with cutting out the prepyloric segment of the i-band 20 mm wide. Proximally, the stomach is cut from the esophagus, the distal line of intersection runs along the line of mobilization, 20 mm away from the pylorus. After removal of the preparation, the end of the esophagus and the pre-pyloric segment were compared with the imposition of an end-to-end anastomosis with a precision atraumatic 3/0-4/0 suture between the segments of the digestive tract. Animals of the control group underwent gastrectomy according to the standard method (without saving the pyloric sphincter), mobilization of the esophagus transhiatally, mobilization of the duodenum according to Kocher with the imposition of esophagoduodenostomy according to A.M. Karyakin (prototype). The evaluation of the results of surgical intervention was carried out on the 5th, 7th, 14th and 30th days. Morphological changes from the side of the esophagus, duodenum, anastomosis were evaluated visually, recorded and photographed. The anastomosis was resected, followed by histological examination preparations stained with hematoxylin and eosin, according to Romanovsky-Giemsa, according to van Gieson and silver nitrate according to Foote.

In the clinic of faculty surgery No. 2 of the DSMA, the method of pylorus-preserving gastrectomy was used in 4 patients, and the control group consisted of 11 patients who underwent direct esophagoduodenoanastomosis according to A.M. Karyakin. The results of gastrectomy options were assessed clinically, radiologically and endoscopically with a biopsy of the anastomosing segment and subsequent histological examination of the preparations.

Patient V., aged 56, case history No. 456, was hospitalized in the clinic of faculty surgery No. 2 of the DSMA on April 13, 2009 with a clinical diagnosis of low-grade adenocarcinoma of the cardiac part of the stomach, stage III (T 3 N 1 M 0). After preoperative preparation On April 21, 2009, an operation was performed - pylorus-preserving gastrectomy.

A comparative analysis of the results of experiments and clinical observations showed:

Experimental series. In the experimental group of animals postoperative period proceeded without complications, no lethal outcomes were noted, on the contrary, two dogs of the control group died on the 4th and 7th days after surgery. On the section, in both cases, diffuse peritonitis was found against the background of failure of the esophageal-duodenal anastomosis. An anastomotic defect was observed along the anterior wall. Further observation of laboratory animals showed earlier recovery motor activity and feeding in the group of animals that underwent pylorus-sparing gastrectomy.

Clinical observations. AT clinical trial, both in the study and in the control group of patients, there were no lethal outcomes, however, clinical, radiological and endoscopic evaluation of the results of surgical intervention showed a significant advantage of pylorus-preserving gastrectomy, which is expressed in an improvement in general well-being (absence of bitterness, heartburn), early restoration of intestinal motor function , motor activity of patients and enteral nutrition.

The postoperative period of patient V., 56 years old, proceeded smoothly, without complications. Removed on the 6th day nasogastric tube, on the 7th day, enteral nutrition was established. At the control x-ray examination- the anastomosis is freely passable, the pyloric sphincter functions satisfactorily, the evacuation of the barium suspension into the duodenum is free and timely. The patient was discharged on the 10th day after the operation in a satisfactory condition.

Usefulness of the invention

The method of pylorus-preserving gastrectomy was tested four times in the clinic of faculty surgery No. 4 of the State Educational Institution of Higher Professional Education "Dagestan State Medical Academy".

In oncosurgical gastroenterology, organ-preserving, saving operations are becoming more and more widespread. The functional advantages of maintaining the duodenal passage, pyloric sphincter have been proven. Therefore, the search for and improvement of technology and more functionally advantageous operations continues.

Gastrectomy with preservation of the pyloric sphincter is the most "physiological" operation among other methods of gastrectomy, as it allows you to save the natural passage through the duodenum, provide portioned evacuation, prevent duodenal esophageal reflux, dumping syndrome. Expansion of indications for esophagoduodenostomy with preservation of the pylorus after gastrectomy allows to obtain good functional results of gastrectomy.

The method causes less trauma, is shorter in duration, and therefore is accompanied low percentage postoperative complications.

The method of pylorus-preserving gastrectomy is the most physiological, allows you to save portioned food intake into the duodenum, prevent anastomosis failure by maintaining adequate blood supply, lack of tension of the anastomosing ends, prevents the development of postgastrectomy complications

Expansion of indications for organ-preserving operations with preservation of the pylorus and the inclusion of duodenal digestion is the key to the prevention of postgastrectomy complications; this prevents the development of postgastrectomy syndromes: reflux esophagitis, Barrett's esophagus, dumping syndrome.

The proposed method of gastrectomy can be used in abdominal surgery as a reconstructive stage after removal of the stomach.

Information sources

1. Chernousov F.A., R.V. Guchakov. Methods of reconstruction and methods of formation of anastomoses after gastrectomy in gastric cancer. // Surgery. Journal them. N.I. Pirogova, 2008; 1: pp.58-61.

2. R.M. Gaziev Terminolateral esophagoanastomosis - patent No. 2266064 dated 02.02.2004

3. Ivanov M.A. Comparative evaluation of variants of esophageal-intestinal anastomoses and the possibility of correcting functional disorders of the intestine during gastrectomy: Dis. Dr. med. Sciences. St. Petersburg, 1996; 368 - prototype.

CLAIM

The method of pylorus-preserving gastrectomy, which consists in removing the stomach, characterized in that the right gastric artery is ligated parietal 1 cm above the pyloric sphincter, the stomach is transected 20 mm away from the pylorus, while maintaining the vascular connections of the sphincter - pyloric sphincter against the background of preserved intramural nervous regulation, the ends of the esophagus and the pre-pyloric segment are anastomosed with the formation of a single-row precision suture with the restoration of the closing function of the pylorus.

Aliev Saygid Alievich is a leading doctor in the region oncological pathology Republic of Dagestan. He has the honorary title of Professor in the field of oncological and surgical pathologies. Doctor of Medical Sciences, doctor of the highest qualification category. Head of the Department of Oncology, Dagestan State medical academy. He is the chairman of the regional society of oncologists, specialists in chemotherapy. Chief oncologist at the Ministry of Health of the Republic of Dagestan. Head of the republican clinic specializing in the treatment of cancer patients.

Brief biography of Professor Aliyeva Saygida Aliyevichna

Aliev Saygid Alievich is one of the most honored residents of the Republic of Dagestan. He huge contribution carried in the development of medical care for cancer patients. Thanks to him, one of the best departments with the latest equipment and the best oncologists appeared in Dagestan. The leading oncologists of the city work on the basis of the department. A huge number of patients are served on the basis of this medical institution. The professor is known not only for his ability to operate and good positive dynamics in the treatment of cancer processes. But, so, on his account a huge amount scientific achievements. He organized a school for leading doctors, future oncologists on the basis of the Dagestan Medical Academy. His personal awards and achievements include many printed resources published under his strict guidance.

Scientific achievements of the doctor.

Aliyev Saygid Alievich - oncologist

Aliyev Saygid Alievich - inventor. So, he is the owner of a number of patents. Under his leadership, written and successfully defended scientific work for the competition different degrees. On his professional account, doctor Aliev S.A. has several thousand successful surgical interventions. The doctor is a big supporter of organ-preserving interventions, so he tries to preserve the organ and its function to the maximum. Many of the patients quickly return to a normal lifestyle, forgetting about the experience. Aliyev Saygid Alievich is a very good teacher. He regularly lectures and teaches his subject to students. For many wards, the Professor is an example and an incentive. Repeatedly, the doctor speaks at symposiums and congresses of oncologists in Russia. With great pleasure, he completes courses that contribute to professional development. Has the highest qualification.