The article presents the scale developed by authors of prognostic assessment of ischemic colitis evolution in patients after planned resection of infrarenal aortic aneurism. A retrospective analysis of medical histories of 201 operated patients and statistical data manipulation were made at the period from 1985 to 2016. It was stated, that score less than 2 points represents patients of high risk group of ischemic colitis development. The scale of sensitivity consisted of 80% and scale of specificity - 63,4%. The score of developed scale depended of passability and blood flow condition in the inferior mesenteric, the right and left internal iliac arteries being evaluated during surgery. The aim of surgeons is to increase the number of points in the scale using revascularization of the inferior mesenteric and at least one of internal iliac artery in patients of the high risk group of ischemic colitis development.

The article presents the results of valve bronchoblocation of 20 operated patients with bullous emphysema. These patients had an air leak in the area of drainage from the pleural cavity and lack of unfolding of the lung in postoperative period. All surgeries were performed under local anesthesia. A blocker was placed in the bronchus using flexible endoscope. There weren’t noted any complications during process of blocking. Positive dynamics was observed in the majority (15) patients during the first 3-5 hours after surgery. Venting was decreased on pleural drainages. Positive dynamics such as absence of air leaks on the drainage from the pleural cavity and unfolding of the lung had 17 patients. Drainages were removed from pleural cavity on 3-4 days in case of unfolding of the lung and air leakage absence. The results obtained indicated the possibility of method application in practice of surgical departments.

The authors evaluated the efficacy of endoscopic submucosal dissection in treatment of early gastric cancer. The study included 60 patients who underwent endoscopic submucosal dissection in cases of differentiated early gastric cancer. RESULTS. The radical surgeries were performed on 59 (98,3%). Complications were noted in 9 (14,9%) of cases and they were removed by endoscopic method. The early recovery period consisted of 24 hours. There weren’t observed any local recurrence or progression of the disease during 6-48 months of follow-up study. The method efficacy was 98,3%. The authors have taken into account the results of the study and a literature analysis. Endoscopic submucosal dissection is the choice of treatment strategy in case of early gastric cancer T1aN0M0 and T1bN0M0 in differentiated adenocarcinoma. The method is highly effective and relatively safe. This approach corresponds with oncological principles of radicalism, thus it reduces the rate of postoperative complications and the period of social rehabilitation of patients. The surgery maintains the high quality of life after treatment without decline of long term results.

The authors researched the influence of different methods of laparoscopic suturing of perforated pyloduodenal ulcers on motor-evacuation function of the stomach and duodenum in 133 patients with peptic ulcer. There were used different methods such as single-row endo-stitch, two-row endo-stitch, omentopexy. The motor-evacuation function of the stomach and duodenum was studied by roentgenocinescopy in the early postoperative period. It was stated, that frequency and intensity of violation of motor-evacuation functions were reliably low in case of imposing the single-row endo-stitch than using the two-row endo-stitch and the omentopexy in the early postoperative period.

The article presents the results of treatment of 68 patients who underwent laparoscopic sleeve gastric resection (LSG) and laparoscopic gastric bypass (LGB) at the period from 2014 to 2015. The efficacy of operations on the course of nonalcoholic fatty liver disease (NAFLD) was estimated. There were performed a liver biopsy and histological studies with determination of histological activity index, the rate of severity of fibrosis according R. G. Knodell scale and METAVIR system, nature and degree of manifestation of steatosis of hepatocytes and intrahepatic cholestasis. NAS activity scale was used to evaluate morphological changes. The results of 1,5-year follow-up study were assessed in dynamics. Fibro Test results were in the range from 0 to 1 depending of fibrosis severity using METAVIR system (from F0 to F4), Knodell and Ishak scales. It was stated that there was an improvement of histological and functional findings in cases of hepatic steatosis, inflammation and fibrosis. All the patients (100%) initially had the signs of NAFLD and 12 patients (22,6%) - fibrosis. The complete regression of NAFLD was noted in 43(81,1%) cases and signs of previous fibrosis were smoothed over in 6 patients (41%). Liver function tests have deteriorated at 6-month period, but tests improved to normal rates at the end of 1-year period. The bariatric surgeries are effective methods of NAFLD treatment and Fibro Test is non-invasive and reliable method of liver state assessment.

Recent researches left no doubt in clinical efficacy of allogenic fibroblasts transplantation in case of burn treatment. There are several problems concerning indications and terms of transplantation performance of cell culture in treatment of boundary burns. The authors would like to prove an application of allogenic fibroblast culture in surgical treatment of victims with extensive dermal burns. The authors analyzed the results of surgical treatment of 36 miners, who were cured in burn department of V.K. Gusak Institute of Emergency and Plastic Surgery (Donetsk) at the period from 2004 to 2013. It was found that the application of fetal allogenic fibroblasts reduced the number of repeated autoplasty on 36% in main group of patients due to optimization of wound healing in case of burns.

Current approach to operative treatment of varicose veins of lower extremities doesn’t suggest interventions on perforating veins due to the fact that they restore their function following surgery in majority of cases. The article presents the results of 2-year of follow-up study after phlebectomy without ligation of perforating veins the shin in patients with varicose veins of lower extremities C2-C3. Localization and extension of venous reflux were evaluated by duplex scanning. The main sign of incompetent perforating vein is a retrograde blood flow more than 0,5 sec. Varicose tributaries of incompetent perforating veins were preoperatively marked and removed using Muller’s hooks in zone not more than 1 cm from perforating vein. Postoperative duplex scanning showed¹/3 of all perforating veins (surgery mainly resulted in Cockett ligation of perforating veins above mascular fascia). Visual signs of varicose disease relapse weren’t noted at examination of the patients, but according to duplex scanning the retrograde blood flow on perforating veins in proximal compression was kept in 45,1% of cases.

The study developed the system of therapeutic and prophylactic methods in patients with recurrent postoperative goiter. These patients (103) have been accepted and registered in the medical records since 2007. Only 48 patients underwent recurrent operation. The subtotal resection of the thyroid gland was performed on 20 patients and thyroidectomy was carried out in 28 patients. The perioperative visualization of recurrent laryngeal nerves was made in 58,3% cases. Postoperative period was complicated by unilateral recurrent nerve trauma in one patient and transient hypoparathyroidism was noted in two patients. The recurrent operative interventions must be performed in specialized centers and it should be extremely radical operation with visualization of recurrent laryngeal nerves.

Diagnostics and treatment of ductal cholangiocarcinoma is an actual and complicated problem of modern hepatopancreatobiliary surgery. The data of preoperative examination using modern methods weren’t always well-defined. This fact didn’t allow clinicians to choose the common treatment strategy and improve the prognosis. The main problem of diagnostic stage was a low morphological verification of the disease, so the diagnosis was confirmed in 17,5% patients. The article presents the results of examination and surgical treatment of 40 patients with suggested diagnosis of ductal cholangiocarcinoma. Indications to operation were based on examination data (CT, MRI, cholangiography, angiography, tumor markers tests) and signs of complications (jaundice, cholangitis, liver abscess). The absence of morphological verification couldn’t be the reason for rejection from the operation. Radical operative intervention had a distinctive advantage. The surgery gave the chance for positive long-term prognosis in case of cancer and allowed doctors to cure patients in case of benign tumor. Functional state of the liver and morphological changes of the removed share should be considered in case of hilus carcinoma. This approach has to be strictly individual and medical care should be applied in special medical centers.

The study evaluated the results of introduction of enhanced recovery protocol in elderly and senile patients who underwent planned colon cancer surgery. The largest rate of colon cancer was noted in elderly and senile patients in Russia and majority of countries. These patients had an increased rate of complications, hospital stay and mortality compared with young patients. The authors proposed the enhanced recovery protocol for gerontological patients based on clinical data and literature analysis. The protocol implementation decreased the number and severity of complications, shortened the postoperative patient day and improved the quality of life of the patients.

The authors analyzed the results of treatment of 489 patients with surgical soft tissue infection at the period from 2004 to 2015. The argon and air-plasma flows in different regimes were applied in following local therapy during surgical d-bridement. The results obtained were compared with results of 280 patients who were treated using common me thod (control group). There was revealed that plasma processing of necrotic suppurative focus significantly accelerated wound cleansing and following reparation of post-necrotic wounds in 1.5-1,8 times regardless the severity and extent of covering tissue lesion. The method allowed doctors to decrease significantly the rate of microbial contamination of the focus and shorten the hospital stay. Similar trends were noted in terms of fever relief, pain syndrome and other important indices.

The aim of the study was a comparative analysis of results of different approaches to two-stage treatment of malignant colonic obstruction on the stage of recovery of the integrity of intestinal tract. The main group included 260 patients. A double-barreled colostomy was formed at the first stage, than resection of the colon with tumor removing and stoma excision were performed. The control group consisted of 192 patients. An obstructive resection of the colon was made at the first stage with following reconstructive operation. Intraoperative damage of the small intestine was observed in 6,9% patients of the main group and 18,2% patients of the control group. Postoperative mortality consisted of 1,2% in the main group and it was 1,5% in the control group. The early postoperative complications numbered 9,2% and 17,7%, respectively. The main risk factor of complication development was an expressed adhesion process of the abdominal cavity in the control group of patients. CONCLUSIONS. The method, which included the colostomy formation at the first stage with following radical surgery at the second stage, had advantages in case of elimination of malignant colonic obstruction.

The study analyzed the course of gangrene Fournier and applied methods of treatment. The author presented 25-year experience of treatment of 15 patients with gangrene Fournier. The article showed biochemical indices of the patients, surgical procedures and methods of intensive infusion therapy. There was noted, that the necrosis area had a prevailing value among lesion sizes of necrotic process. An intensity of endotoxemia was essential. Thus, the presence of failure of more than three systems of internal organs was an unfavorable sign of disease outcome.

The study evaluated the efficacy of reamberin in complex treatment of patients with acute small bowel obstruction. Methods. The research is based on the results of complex examination of 202 patients with acute small bowel obstruction (ASBO). The patients were hospitalized in Ivano-Frankovsk central municipal clinical hospital at the period from 2009 to 2015. The patients were divided into two groups according to the method of treatment. The complex treatment using common method was applied for the first group of 100 patients with ASBO. The complex treatment using common method and reamberin intravenously (800 ml/day) during 7 days was applied for the second group of 102 patients. Results. The application of reamberin reduced a lot of indices such as leukocytic intoxication, intoxication index, level of middle mass molecule, formation of malonic dialdehyde. The drug stimulated antioxidant system and normalized organ-specific liver enzymes. Conclusions. The application of reamberin is pathogenetically validated in cases of ASBO.

The authors analyzed the positioning error for branchytherapy needle inserted with original robotic system «Oncorobot» (Central Research Institute of Robotic And Technical Cybernetics, St. Petersburg) compared with traditional methods of insertion and other technical systems. The gelatin phantom of prostate gland was used for experiments. Needle insertion robotic program was written according to coordinates of dosimetric plan of microsourse localization. A coordinate of the needle tip location was measured after each injection of the needle into phantom and the mean-square error was calculated. It was shown that needle tip positioning error wasn’t more than 0,5 mm at insertion speeds from 3,0 to 30,00 mm/sec. Positioning error enlarged with increase of insertion speed. Needle positioning accuracy of insertion was significantly higher in case of developed robotic system, than in manual brachytherapy. The accuracy indices of the system were correlated with other described robotic systems.