An analysis of 293 victims with cardiac and pericardium injuries was made. Cardiac complications could appear suddenly and be registered on any stage of treatment process. They differentiated by character and duration of wound process. Pericarditis took place in 288 patients. The syndrome of system inflammation reaction was noted in 47,9% of patients, a sepsis (sometimes severe sepsis) was in 14,3%. Complications in postoperative period were determined by posthypoxic and hemic hypoxia, coagulopathy. They were manifested by myocardial ischemia and thromboembolic complications. An acute myocardial infarction took place in 29 (9,8%) cases and rhythm and conductivity abnormalities were in 23 (7,8%) patients. The circulatory failure with clinical picture of pulmonary edema was developed in 12 (4,1%) cases. The lethality consisted of 44 (15%) patients.

The authors investigated features of diagnostics and surgical treatment of lung cancer which was complicated by purulent destructive process. The possibilities of radical operative intervention were considered after preliminary adequate treatment of purulent complications in 226 patients. It was noted, that the diagnostic thoracotomy should be used in doubtful cases in order to estimate the resectability of lung cancer.

The percutaneous endoscopic gastrostomy takes an important place in operative endoscopy of the digestive system. At the same time it is the method of choice in patients who need a long-term administration of enteral feeding. Given article reflects the main indications, contraindications and complications of the percutaneous endoscopic gastrostomy and presents the basic stages of the method. The authors hope, that the data would be useful for both entry-lever surgeon-endoscopists and specialists who used the method.

The article presents the research of the early postoperative period in 64 patients with postoperative ventral hernias who underwent the operation by two different ways. The method of patch applied on the hernial orifice was used in 30 cases. In these cases prosthesis contacted with hypoderm. The modified way of Toskin-Zhebrovskiy was carried out in 34 patients. In these cases the prosthesis was isolated from hypoderm using the hernia bag flap. It was shown, that the frequency of seromas formation was significantly less in comparison with standard method of nonstrain hernioplasty in early postoperative period. Given method allowed shortening the terms of inpatient treatment on 3 days.

An analysis of complex examination and treatment was made in 116 patients with necrotic suppurative complications. Patients were divided into two statistically homogeneous groups. An ointment «Levomekol» was used in control group and immobilized forms of chlorhexidine bigluconate was applied in the main group. The dynamics of traumatic process course was learned by planimetric, bacteriological and cytological methods. The percentage of area reduction of wounds in the main group was higher, than in control group: on the third day - on 1,59%, on the fifth day - on 3,16%, on the seventh day - on 5,86%, on the tenth day - on 6,83%, on the fourteenth day - on 7,80%, on the twenty-first day - on 7,62%. A microbial contamination of wounds (generated colony units in 1 g of tissue) was less, than in control group on the third day of treatment - on 1,6×10⁶, on the fifth day - on 26,2×10⁵, on the seventh day - on 77,8×10, on the tenth day - on 2,2×10⁴ and on the fifteenth day - on 0,3×10³ (p<0,05). The number of granulocytes was less in main group: on the third day - on 11,8%, on the fifth day - on 14,2%, on the seventh day - on 8,8%, on the tenth day - on 5,2%. The quantity of fibroblasts (a number of reparative cells) was more in wounds of the main group in the same terms: 2,9%, 5,8%, 3,6%, 4,4%, respectively. Thus, the treatment of suppurative wounds by the immobilized form of chlorhexidine bigluconate was proved pathogenetically reasonable and effective.

The article analyzed the results of surgery using tree gastric restriction laparoscopic operations which led to high possibility of the development of gastroesophageal reflux disease (GERD). Laparoscopic stomach length resection was performed in 327 (68,1%) out of 480 (62,1%) patients. Laparoscopic gastric bypass surgery took place in 142 (29,5%) cases and laparoscopic biliary-pancreatic bypass surgery - in 11 (2,3%). The diagnosis of GERD was established in 193 (40,2%) patients before the operation and it was usually accompanied by hernia of the esophageal opening (HEO). The patients were arranged in 4 groups. The first group had operations using the standard method and it included 287 (59,8%) patients without any signs of GERD or HEO. The patients of the second group (84 (17,5%) had signs of GERD and HEO and standard operations with a hernia removal and cruroraphy were carried out. The patients of the third group 109 (22,7%) had initial signs of GERD and the standard method was used for them. The developed method was applied for patients of the fourth group (132 (27,5%). All the operations were completed by antireflux valve formation, but in the cases of GERD and HEO presence, they accomplished by hernia removal, cruroraphy. After performing standard operations, the signs of GERD were noted in 51,5% of cases. Thus, patients of the first group (148 (51,5%) had the signs of GERD. It was noted, that the signs of GERD were presented in patients of the second group (79 (94%) and it numbered 97 (89%) patients of the third group. In the case of the fourth group, signs of GERD were in 14 (10,6%) patients.

The results of examination and treatment of 445 patients with chronic pancreatitis were analyzed. It was established, that 298 (67%) patients had indications for treatment in the conditions of surgical hospital. The patients were divided into t hree groups according to the modified pancreatitis classification of Marseilles-Rome 1988. There were the calcifying form (n=78), obstructive form (n=81), inflammatory form (n=139). The application of modern methods of diagnostics and treatment of chronic pancreatitis allowed modifying the classification by selection of subgr oups for each form of the disease. It was stated, that the substantiation of variants of surgical treatment of chronic pancreatitis in consideration of morphological changes in the pancreas could improve the possibilities of medical care plan for patients with minimal complications and good quality of life in long-term period of time.

The authors studied the clinical characteristics and terms of the development of postoperative intraperitoneal complications in patients undergoing colon cancer surgery. It was stated, that the diversity of clinical data depended on complication characteristics. Results of investigation allowed defining of the most dangerous terms of intraperitoneal complications and risk factors.

The comparative assessment of preoperative fluid therapy was made in 56 patients with acute intestinal obstruction. Parameters of central hemodynamics, the intra-abdominal pressure and water sectors of organism were investigated. The fluid therapy was conducted during 3 hours and included Tetraspan and Sterofundin on average 615 ml and 1585 ml, respectively. It was shown, that the fluid therapy facilitated to the elimination of water-electrolytic and hemodynamic shifts and to some extent it improved the outcomes of surgical treatment.

The authors present the investigation of inpatient treatment of 137 patients with trophic ulcers of venous aethiology. All the patients were hospitalized in the «Road clinical hospital» on the Krasnoyarsk station. A comparative analysis of treatment results of the patients with trophic ulcers using different medical methods was made. The efficacy of combined use of low-frequency ultrasound and ozone therapy was proved.

The article presents the results of surgery outcomes in 127 elderly patients with colon cancer. The patients were divided into two groups: the main group (prospective, n=52) and control group (retrospective, n=75). The combined preoperative nutritive status assessment by BMI and a prognostic hypotrophy index were used. It included the optimization of nutritive support on all stages and an early tube removal, an enteral feeding during postoperative period. It was stated, that it significantly reduced the level of complications, period of intensive care unit stay on 2 days and a hospital stay on 4 days in main group. All the patients of the main group improved the quality of life during 7 days (EORTC QIQ CR29). Proposed nutritive support program allowed improvement of the quality of life and positive treatment outcomes in elderly patients with colon cancer.

It is important to improve the medical care system and treatment of victims, introduce new methods of treatment and attract the multidisciplinary specialists in the cases of multitrauma. An integrated approach is required for the identification of different character and severity of multiple craniofacial injuries and the development of rational surgical strategy on this base. Different scales such as AIS, CRIS, ISS, PTS, TRISS, TRISSCAN, CRAMS et.al. were created abroad. Another approach to medical strategy was developed in the department of military surgery of Kirov Military Academy in the late nineties. It was based on investigating of possibilities of surgical strategy optimization by application of objective evaluation of the severity of injuries (military surgery - SP, SG, SS). Given treatment strategy of victims with multiple craniofacial trauma resulted in double reduction of quantity of suppurative and septic complications (from 10,5% to 4,1%). It gave the possibility to reduce the lethality from 6,4% to 4,0%. At the same time a hospital stay was shortened and the strategy allowed obtaining satisfactory functional results of treatment and avoiding reinterventions for removal of posttraumatic facial deformations.

An analysis of the results of the treatment of 132 patients with isolated traumatic parenchymatous injury of the frontal lobes of the brain was made. The treatment strategy was determined in consideration of the traumatic substratum volume and a combination of neurologic status and instrumental data. There were unfavorable risk factors to the course of traumatic parenchymatous injury of the frontal lobes of the brain such as low initial GCS score, the progression of neurologic deficiency in the presence of contusion hemorrhagic foci in the frontal lobe with the volume more than 25 cm³, shifting of midline structures on 5 mm and more or signs of deformation of basilar region cisterns and the presence of mass-effect according to the tomographic data. The developed algorithm allowed improving the results of treatment and the quality of life for patients with traumatic parenchymatous injury of the frontal lobes of the brain.