The authors investigate the results of prophylaxis of venous thromboembolic complications (VTC) during 24 years in oncological surgery. The multicentric study shows that common frequency of occurrence of such VTC was reduced due to period of routine prophylaxis of VTC to 3,4%. The strategy of active revision and escalation of preventive measures in the third period of study in comparison with the second period resulted in the decrease of VTC. Patients with moderate risk degree had the results from 3,2% to 1%, patients with high risk degree moved from 4,1% to 1,3%. The fatal thromboembolism of the lung artery was 0,1%.

Dynamics of mean value indices and mean dispersion doesn’t exclude the feedback (Mayanskiy D. N., 2008) in process of study the disease according to cooperative processes using system leukocyte-monocyte-lymphocyte (L+M+LM). The authors investigated a dynamic balance between these cell substratums and collagen formation. Acute inflammatory processes in tissues of maxillofacial area accompanied by leukemoid response of peripheral blood in the form of leukocytosis (10·10⁹-15·10⁹/l and more). The authors completely agree with the opinion of M. M.Solov’yov (2012) and N. K. Artyushenko (2008) that mechanism of this reaction is associated with both the leukocyte redistribution in the inflammation zone and with changes of hematopoietic rostock which aimed to balance the affected compensatory mechanisms of nonspecific resistance.

The standard transvenous electrocardiostimulation (ECS) is currently used in many specialized hospitals. The authors offered and launched systematic application of simple but available technique of epymiocardiac ECS using pericardoscopy since middle of 80^th. According to this principle, the authors developed some diversities of manipulation which are distinctive due to their availability, reliability and supersafety. The method could be recommended for wide-spread usage in practice because of high efficacy, few complications and absence of fatal outcomes in correct intervention. Described methods used in treatment of considerable quantity of patients and adapted to real work conditions of public health hospitals.

Numerous available results of investigations confirmed the important role of prophylactic bilateral laparoscopic salpingo-oophorectomy and contralateral prophylactic subcutaneous mastectomy in decrease of risks of malignant tumors of the reproductive system when mutation carriers of BRCA1 and BRCA2 presented. Recommendations to surgical treatment of hereditary breast cancer are considered as a very difficult task which should be based on risks and advantages of prophylactic surgical interventions. Presented surgical operations could be applied in mutation carriers of reparation DNA genes and patients with hereditary breast cancer aimed to improve the indices of general survival rate and quality of life.

An analysis of surgical treatment of 187 patients with chronic pancreatitis was made during 3-year period in the department of surgery clinic of Byelorussian Medical Academy of Post-Graduate Education. Drainage operations were performed on 28 patients, resection-drainage operations were carried out on 130 patients and resection operations had 19 patients. The laser beam technologies were successfully applied during operations on the pancreas in 43 patients. Postoperative complications (14,8%) were analyzed and structured. Methods of corrections and ways of prophylaxis of complication development were provided. On the basis of the complication analysis and new conception concerning peripheral pancreatic hypertension the authors offered the rational approaches to choice of operations on the pancreas in case of chronic pancreatitis. The authors developed the classification of pancreatoductolitiasis, pancreatic hypertension and a new strategy of surgical management of chronic pancreatitis.

The rate of metastasis of high differentiated carcinoma of the thyroid glands to the neck lymph nodes was studied in people of Kemerovo Region. The metastatic lesions of pretracheal lymph nodes (VI group) were detected in 49,5% patients with papillary carcinoma and 21,0% of patients with follicular cancer. Metastases in jungular lymph nodes were revealed in 37,3% patients with papillary carcinoma. It was noted that an extension of metastatic lesions of regional lymph nodes was observed in the case of primary tumour foci spread beyond borders of the capsula glandularis in patients with papillary carcinoma. There wasn’t such a relation in a case of follicular cancer. Metastases in regional lymph nodes were detected more often (67,6%) in the case of papillary carcinoma in uncontaminated zone of the thyroid gland compared with other thyroid pathology (31,7%).

A frequency of postoperative complications varied from 1-2% after endoscopic thoracal operations to 4-12% after open operations using thoracotomic access. There isn’t any common approach to indications and terms of the recurrent endoscopic intervention. An analysis of postoperative complications was made after 2795 thoracothomies and 3632 videothoracoscopies required the recurrent operation in 139 patients (2,2%). The rethoracoscopies were performed on 62 patients (44,6%), thoracoscopies were carried out after thoracotomies in 40 cases (28,8%) and rethoracotomies were in 37 cases (26,6%). The more frequent indication to recurrent operation was bleeding (26,6%), pleural empyema (20,9%), fragmented pleuritis (11,5%).It was shown that thoracoscopy was an alternative to rethoracotomy as the rethoracoscopy in case of nonmassive intrapleural bleeding, clotted hemothorax, postoperative fragmented pleuritis, non-sanitized empyema region, the presence of sequestrums in this area, limited postoperative pleuritis, chylothorax, bronchopleural fistula of the size of 1-2 mm, leakage of the lung, a foreign body in pleural cavity. The lethality consisted of 35,1% after rethoracotomies and it was 12,7% after recurrent endoscopic operations.

On the basis of an analysis of 2200 cases of left sections colon cancer complicated by obturation intestinal obstruction the authors showed the possibility and reasonability of two-step operation performance. The first operation formed unloading part and the second was the radical operation in one hospitalization. Given method allowed improvement of the results and quality of life of the patients.

The authors analyzed clinical (size, tissue oxygenation), histological (light microscopy) and immunohistochemical (CD68, MMP-9, TIMP-1) features of reparative processes of soft tissue of lower extremities in patients with diabetes mellitus against the background of vacuum therapy in comparison with standard local treatment. Patients (31 cases) with diabetic foot ulcers were followed-up after surgical d-bridement and before plastic closure of the wound. During perioperative period 13 patients obtained the negative pressure wound therapy (NPWT of 90-120 mmHg) and 18 patients had the standard care. Given results supported higher efficacy of NPWT as compared with standard local care. The therapy caused rapid reduction of wound and its depth, increased local microcirculation and reduced inflammation. These data were confirmed by the histological and immunohistochemical studies. The high efficacy of the method of local treatment could significantly reduce the time of wound preparation for the next step of surgical treatment.

The authors offered the apparatus for external fixation of the hand. A medical plastic is used for making the support of an improvised apparatus. The pins «sealed» in plastic and fixed bone fragments. The proposed apparatus has a number of advantages in comparison with analogous devices and could be useful for surgeons who provide emergency care for the patients with hand injuries.

A search of residual tissues is complicated in recurrent operations on the thyroid gland. The Saint-Petersburg Centre of Surgery of the Endocrine System and Oncology developed the method of detection of residual tissues of the thyroid gland with the aim of preoperative chromothyroidolymphography under control of ultrasound. The method consisted of US performance during 15-20 minutes before the operation and an introduction of 1% sterile water solution of methylene blue in revealed residual tissues of the thyroid gland. The volume of injected coloring agent was 0,5-2 ml in the residual tissue volume smaller than 9 cm³ and 2-3 ml injected in case of more than 9 cm³. The residual tissues of the thyroid gland accurately visualized during the following operation. Described method gives the possibility to detect all regions of residual tissues which should be removed and at the same time it shortens a revision and surgery trauma.

On the basis of study and treatment of 98 victims it was stated that the absorption of isotonic glucose electrolytes solutions in the small intestine was saved even increased in case of large hemorrhage in severe polytrauma with chest, abdominal injury and other regions trauma. An application of early enteral infusions allowed reducing of the volume of parenteral introduction solutions and facilitated to a reliable decrease of development frequency of nosocomial pneumonia of attributive lethality.