The authors analyzed 60 clinical cases of follow-up study of patients aged 14 to 76 years old with otorhinosinusogenic intracranial complications and sepsis. Diseases of ENT organs were as the primary foci of infection-inflammatory processes. There were noted otitis media in 24 (40%) patients, rhinosinusitis - in 19 (31,7%) patients, combined purulent lesions of the middle ear and paranasal sinuses - in 17 (28,3%) patients. Purulent meningitis was diagnosed in 22 (46,7%) cases, purulent meningoencephalitis - in 38 (63,3%) patients. All treated patients were diagnosed with sepsis, including severe sepsis with multiple organ failure in 27 (45%) patients. The lethality consisted of 44,5% in group of patients with severe sepsis. The early diagnostics of systemic inflammatory response, sepsis, organosystemic disorders, practical application of modern algorithm of diagnostics and treatment, medico-economic standards of sepsis are necessary in order to start specialized intensive treatment on time. The patients should be transferred to septic center. Modern surgical and therapeutic methods must be applied. These approaches to treatment have a direct impact on the prognosis and outcome in each clinical case.

The article provides the data of information value of risk factors of disease development of mammary glands in women of various age. The authors presents the method of assessment of individual risk of pathology development of mammary glands with following choice of personal examination program, which allowed timely detection of pre-cancerous condition and early forms of tumorous processes in mammary glands. This method would facilitate to decrease of the rate of advanced forms in given pathology, morbidity and at the same time would improve prognosis and increase the quality of life for women.

The article analyzed the results of surgical treatment of 140 patients with surgery of abdominal aortic aneurism. The comparison group consisted of 80 patients with aortic aneurism more than 4,5 cm, who didn’t undergo surgery. The conventional method of Khardi-Pokrovskiy resection was complemented by a number of surgical methods in these cases. The results of surgery were improved due to application of these methods. All the patients (100%), who didn’t undergo surgery, passed away during 5 years, though 70% of them died because of aneurysm rupture. The early postoperative lethality was 5% in the main group, but 5-year survival was 81%.

The article presents an analysis of modern methods of the measurement, including classical and original methods and devices developed by the authors. The results of examination and treatment were analyzed in 397 patients with acute obturation intestinal obstruction and acute destructive pancreatitis, who had the abdominal compartment syndrome from I to IV degree. The authors showed that on-time decompressive laparotomy allowed the decrease of lethality from 25% to 15-17,8%.

The colon microflora was investigated by PCR method in real time before and after planned operation in 38 patients with colon cancer. A multifactor analysis showed absence of statistically significant dependence of revealed changes in microflora from sex, age of patients, volume and method of surgery, presence of tumor stenosis and infiltrate. An anaerobic imbalance was often registrated in postoperative period, especially after antibiotic prophylaxis and therapy. Clostridium difficile and Clostridium perfringens were often detected in patients with tumor of the right part of colon (p<0,05). The irritable colon syndrome was noted in 34% (n=13) patients after one month. Сlostridial infection was revealed in majority of these cases. The authors recommend to perform the microbiota analysis before and after surgery.

The article analyzed the results of surgical treatment of 1098 patients with urgent complications of colon cancer (acute intestinal obstruction, enterorrhagia, perforation, perifocal inflammation) in patients from Smolensk and Smolensk Region at the period from 2001 to 2013. The volume of surgical intervention depended on the age of patients, terms of hospital admission from the moment of complication development, common condition of patients, presence of severe accompanying pathology, localization of malignant tumor, presence of locally advanced process, regional metastasis, kind of urgent complication.

An analysis of results of endoprosthesis was made in 93 patients with initial shortening of lower extremity more than 3 cm. There were revealed the main factors influencing on the result and developed the criteria of prediction of adjustment of extremity length such as assessment of duration of the disease, presence of implications of earlier performed operations, sex, age, degree of tissue rigidity, evidence of hip-spine syndrome and scoliosis.

The authors designed and introduced into practice the method of percutaneous transsplenic drainage with single-stage installation of two drainages. The developed method allowed extension of indications for percutaneous drainage of liquid formations in the area of tail of pancreas in patients, whose the only possible way of mini-invasive percutaneous drainage was the transsplenic way. The method gives an option to apply this technique of percutaneous transsplenic catheter drainage of liquid formations in the area of tail of pancreas avoiding the more traumatic open methods of drainage.

The authors present their experience, methodology and advantages of the method of «hidden colostomy» in treatment of anastomotic leakage after low anterior resection of rectum. The operations using the method of «hidden colostomy» were performed on 67 patients. All the patients underwent the low anterior resection of rectum operation concerning cancer with anastomosis formation at the distance of 3-8 cm from anus. The leakage of rectal anastomosis was revealed in 6 (8,9%) patients. A delayed double-barrel transverse stoma using preventive turnpike was formed in surgical dressing room without typical relaparotomy according to described method. Continuity of large intestine was restored in all patients during 2 months after operation. The method of «hidden colostomy» allowed doctors to avoid formation of vain protective intestinal stoma. This method helped to treat patients in a very simple and effective way in case of leakage of colorectal anastomosis.

The results of diagnostics and treatment were analyzed in 155 patients. Low-invasive drainage of cyst was made under control of ultrasound in 67 patients. The external drainage was carried out in 12 patients, internal drainage with cystojejunoanastomosis - in 23, cystogastroanastomosis - in 3, sleeve pancreatojejunostomy- in 6, resection of the tail of pancreas - in 2. The authors considered that it is important to have the differentiated approach to different methods of operative treatment of cysts of the pancreas according to their localization, size and degree of wall formation.

The results of treatment were analyzed in 41 patients (the mean age 62,1 years old). Overall postoperative lethality consisted of 2,4%. The best functional results were reached in transmesenteric bringing down of the right parts of colon to small pelvis with isoperistaltic colorectal anastomosis. However, an application of this operation demands the presence of certain anatomic conditions. Limited mobilization of the right colon with antiperistaltic cecorectal anastomosis is feasible under any conditions.

The aim of this work was an optimization of surgical strategy and improvement of results of rectocele treatment. A clinical group consisted of 87 women suffered from rectocele of 2-3 degree. The patients were divided into 2 groups in dependence of surgical strategy. Levatoroplasty and colporrhaphy were performed from transvaginal access in patients of the first group (n=38). The plasty of rectocele was made in the second group (n=49) using combined transvaginal and transrectal accesses. The surgery included a sacrospinal fixation of cupula of the vagina, colporrhaphy supplemented by transrectal «11-hour» mucopecsia on the hight up to 5 cm from dentate line. There was stated that the major diagnostic criteria of functional insufficiency of pelvic floor were the sonoelastometric study of stiffness of the perineum muscles and tonometric research of gradient of vagina pressure in case of rest and tension. They were associated with the severity of rectocele. Operative intervention was more physiological, accompanied by less rate of recurrence, more high parameters of life quality and recommended for patients with 3 degree of rectocele in the second group. The expression of functional insufficiency of vagina muscles is the basis for choice of surgical strategy in case of prolapse.

The authors analyzed the results of 415 reconstructive operations. There was noted an advantage of Deep Fem-Pop Bypass as more effective operation than Fem-Pop Bypass according to the results of operations, number and structure of complications in early postoperative period. It was shown that the access to donor artery influenced on the rate of lymphorrhea.