The article presents the main stages of the development of ideas about a fairly rare pathology in clinical practice the syndrome of compression of the ventral trunk. Until the mid-nineteenth century, reports of the clinical picture of chronic abdominal ischemia were more descriptive. Serial pathoanatomic studies, comparison of anatomical features revealed at autopsy with clinical manifestations accompanying these changes, contributed to the isolation of chronic ischemic disease of the digestive system in a separate nosological form. The discovery of angiography contributed to the significant development of vascular surgery and the isolation of the ventral trunk compression syndrome as an independent disease, since it allowed for a lifetime comparison of the detected changes in blood vessels with the clinical manifestations of the disease. The term ventral trunk compression syndrome was first introduced by P. Harjola when describing a case of abdominal pain in a patient with compression of the ventral trunk by the neuroganglionic tissue of the ventral plexus. Later, J. Dunbar confirmed the Association of clinical manifestations of chronic abdominal pain with compression of the ventral trunk by the median arched ligament of the diaphragm. In English-language literature, the disease was named Dunbar syndrome. The effectiveness of eliminating the symptoms of this disease by surgical dissection of compression structures has been proven. Further study of this problem developed in parallel with the development of surgery in General in accordance with the emergence and introduction of new surgical technologies. The purpose of numerous studies was to study the etiopathogenetic mechanisms of the occurrence of a variety of clinical manifestations of this syndrome and improve the results of its treatment by improving known surgical techniques and introducing new ones.
The article discusses modern methods of treatment of morbid obesity and associated diseases. It is known that obesity leads to disability in people, including young people, due to the frequent development of severe comorbid diseases. According to current clinical guidelines, the main goals of treating obese patients are: weight loss, achieving good metabolic control, and improving the course of diseases associated with obesity. A small selection of drugs for the treatment of obesity, the need for strict adherence to indications and contraindications to their appointment, significantly limits the possibilities of drug therapy for morbid obesity. With morbid obesity, the effectiveness of conservative treatment is only 510%. Up to 60% of patients cannot maintain the result of weight loss within 5 years of observation. Long-term use of bariatric surgeries, the purpose of which was initially to reduce body weight in patients with morbid obesity, showed certain possibilities of surgery in compensating for a number of diseases associated with obesity. Therefore, at present, the concept of bariatric surgery is not only to reduce the patients weight, but also to achieve beneficial metabolic effects (normalization of glycemia, lipid metabolism). In this regard, modern bariatric interventions are united by the term metabolic surgery. It has been proven that compensation of non-insulin-dependent diabetes mellitus after bariatric interventions is observed in 4295% of patients, depending on the type of surgery, duration of non-insulin-dependent diabetes mellitus and basal C-peptide level. As a result of many years of research, bariatric surgery has allowed for the first time to formulate the term remission of non-insulin dependent diabetes mellitus.
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