The authors present dopplerographic predictors of cognitive status dynamics of patients undergoing carotid angioplasty with stenting. It was stated that the cognitive status dynamics depended on the initial condition of patients and reactivity coefficient on hypercapnia in target vascular pool.

The article presents an analysis of 34.903 esophagoscopy results performed for population of Leningrad region at the period from 2007 to 2013. A prevalence of erosive esophagitis was 4,9%, peptic strictures - 0,18%, columnar-celled metaplasias - 1,43% and esophageal adenocarcinoma - 0,645%. The data obtained showed a high prevalence of GERD-associated syndromes with injury of mucous coat of esophagus in the local population of Russians.

The authors analyzed the results of treatment of 965 patients with bleeding from gastroduodenal ulcers. The endoscopic hemostasis was carried out in 20,2% patients, however a recurrence of bleeding was noted in 12,8% cases. The combined endoscopic hemostasis was performed in 76,9% patients, though the relapse of bleeding had only 4,2% and 49 patients were safe. A surgery was required for 3,2% patients.

The author offered an algorithm of definition of optimal ways of pancreaticodigestive fistula formation in pancreaticoduodenal resection. It is based on the following factors such as tissue conditions of the pancreas gland stump, a diameter of pancreatic duct and compliance with cut dimensions of gland stump of anastomotic loop of the jejunum. A comparative analysis of pancreaticodigestive fistulas performance was made in 2 groups. An algorithm of choice of pancreaticodigestive anastomosis was applied in the main group (n=35). An inconsistency of pancreaticodigestive fistula was noted in the main group (5,7%) and in the comparative group (n=59) - 17% (p=0,205). There weren’t any cases of destructive pancreatitis and lethality, which were directly specified by pancreaticodigestive anastomosis in the main group. Destructive pacreatitis developed in 10,1% cases in the comparative group. The lethality consisted of 5,1%. The results obtained confirmed the efficacy of individualized approach to formation of pancreaticodigestive fistulas and showed the practical value of investigation in this way.

The authors analyzed the experience of 517 appendectomies during last three years. There weren’t any differences in postoperative course in patients with immersion and ligature methods of stump processing of appendix vermiformis. The ligature method should be considered as leading method in appendectomy in consideration of long-term experience in surgery. The immersion method would be used in presence of contraindications to the ligature method.

The article presents the results of 16 operations for the parastomal hernias. The operations were differentiated: the colostomy was relocated to the left retroperitoneal space and in case of hernioplasty it was performed with use of mesh transplant. The fascial defects were closed using the mesh transplant. There weren’t any complications in early postoperative period. Long-term five-year results showed no recurrence.

The authors analyzed the experience at the period from September 2000 to January 2014. The total exenterations of the small pelvis were performed on 23 patients (12 men and 11 women) at the age from 37 to 71 years old. Supralevator total exenterations with full visceral reconstruction were carried out in 13 cases out of 23. Total infralevator pelvic exenterations were used in 10 cases. There wasn’t the intraoperative lethality. Patients (3 cases) died in postoperative period. Postoperative complications developed in 10 patients, though serious complications, which required an application of surgical strategy were noted only in 3 cases. The mean life span consisted of 29 months. The performance of total exenteration of the small pelvis considerably increased the life span of the patients and in case of application of reconstructive methods allowed restoration of quality of life to high level and obtaining moral, psychological and social rehabilitation.

The results of surgical treatment of 139 patients with metabolic syndrome, obesity and dislipodemia were analyzed. Modern bariatric operations (4 types) were performed by using laparoscopic method. There were regulated bandages of the stomach (RBS), lengthwise gastric resections (LGR), biliopancreatic and stomach bypass surgeries (BBS, SBS). Results of five-year follow-up indicated that restrictive operations on the stomach (RBS, LGR) aimed to correct overweight and dislipodemia had some limitations to application in a varying degree. The RBS operation should be appropriate to use for women of the young age group, when an initial body-weight index wasn’t more than 43 kg/m². The LGR operation was effective for men of the young age group and women in case of moderately expressed dislipodemia and in case when the initial body-weight index didn’t exceed more than 45 kg/m². Combined bariatric operations (BBS, SBS) were most likely effective on body weight and dislipodemia.

The secondary hyperparathyroidism was observed in 23 patients using a program hemodialysis. The parathyroidectomy was applied as a medical aid. A relapse was noted in one case. Clinical signs of hyperparathyroidism were completely terminated by 6 months.

The efficacy of total parathyroidectomy was shown in 18 patients with renal hyperparathyroidism after 6-12 years period after operation. The authors accepted the total parathyroidectomy as a reasonable way for treatment of secondary hyperthyroidism in patients with long-term dialysis therapy.

An investigation included 33 patients with cancer of thoracal section of the esophagus at the age from 42 to 74 years old. A surgical method of treatment was applied as only one in 13 patients and methods of nonadjuvant chemoradiation therapy were used for 20 patients. A hybrid minimally invasive esophagectomy (laparoscopic mobilization of the stomach and right-side thoracotomy) was performed on 16 patients. The rate of postoperative complications consisted of 31%. The minimally invasive esophagectomy (performed by totally endovideosurgical approach) was carried out in 15 cases. Postoperative complications developed in 53% of follow-up patients. There weren’t cases of lethality. The experience of minimally invasive methods indicated the satisfactory results of application of given methods in patient treatment of esophageal cancer. The use of endovideosurgical approaches allowed performing oncologically adequate volume of operative interventions.

The article is based on an analysis of results of complex treatment of 497 patients with pancreatonecrosis at the period from 2010 to 2014. All patients were admitted to the surgical departments of Republican hospital № 2 and Centre of Emergency Medicine of Republic of Sakha (Yakutia). The investigation allowed adaptation and development of antibiotic prophylaxis and therapy management in pancreatonecrosis in multifield surgical hospital. More than 80% of patients avoided a contamination of necrotic destruction zones. The level of lethality was reduced in group of patients with infectious complications of pancreatonecrosis from 45,8% to 37,7%.