The investigation included 45 patients with coronary heart disease operated for aorto-(mammaro)-coronary artery bypass grafting. It was found that surgical treatment resulted in the improvement of subjective symptoms of angina and increased contractile reserve of the myocardium during the first days after surgery. Significantly increased subjective and objective exercise tolerance, improvement of local myocardial contractility, diastolic function and symptoms of myocardial remodeling were registered only within 6 months after surgery. Assessment of the dynamics of the myocardial contractile reserve can be used as an objective criterion of the earliest positive result of surgical treatment of coronary artery disease.

The authors made a retrospective analysis of 51 patients with non-small-cell lung cancer with pleural effusion, not associated with tumor lesion of pleural leaves. Out of 51operated patients 45 (88%) proved to be resectable. Among 45 patients (20 pneumonectomies, 24 lobectomies and 1 bilobectomy) combined interventions were fulfilled in 15 patients. In 27 (60%) out of 45 patients there was an injury of mediastinal lymph nodes, in 13 (29%) — intrapulmonary and root nodes. Complicated course of the postoperative period was noted in 27% of patients, lethality was 2%. One year survival after resection was 86%, three and five year survival was 54% and 30% respectively. The indices of survival reliably depended on the degree of lymphogenic dissemination. The presence of pleural effusion can not be a reason for refusal to fulfill radical surgical intervention.

On the basis of an analysis of results of treatment of 123 patients by different methods of pleurodesis the authors have shown advantages of the method of videothoracoscopy.

An analysis of results of examination and treatment of 8 young patients (from 25 to 17 years of age) with generalized emphysema of the lungs, pulmonary failure of the II and III degrees was made. The functional examination of the patients before operation has revealed changed respiration by obstructive type. Symptoms of dysplasia of the connective tissue were found in 4 patients. Surgical reduction of the lung volume was performed in 5 patients for correction of respiratory failure. There were neither serious complications nor lethality. Dyspnea by MMRC scale decreased in all the patients at minimum by 1 point during the first months after operation. Three years later 4 out of the operated patients (80%) had retained positive effect of operation. In patients who had no operative treatment the frequency of infectious complications, level of dyspnea during three years of follow-up remained at the same level, while functional indices continued worsening. The surgical method of treatment of severe respiratory failure allowed tolerance of physical exercise to be increased and quality of life of patients with diffuse lung emphysema to be improved.

The authors have performed 18 circular resections of the trachea (CRT) for adenocystic cancer and typical carcinoid. In 10 of these patients more than 5 cm of the tracheal segment were ablated. Postoperative radiotherapy was made on 8 patients with adenocystic cancer with lengthy CRT. Immediate and long-term results were good that allowed the authors to recommend a single-stage circular resection of the trachea in treatment of high differentiated forms of cancer.

The examination included 340 patients with gastroesophageal reflux disease (GERD) (200 patients with ulcer disease of the stomach and duodenum, 112 patients after Billroth II resection of the stomach, 58 with formed transverse gastroenteroanastomosis and 28 with hiatal hernia). Characteristics of clinical, endoscopic and morphological manifectations of GERD against the background of the disease in question were revealed which must be taken into consideration in differential diagnostics, medicamentous and operative treatment.

The authors present results of the examination and treatment of 106 patients with hernias of the diaphragm of different genesis. In 79 of them there were non-incarcerated hernias, in 27 — there were incarcerated hernias. The authors suggest necessary medico-diagnostic measures with rational application of endovideosurgical technologies such as thoraco- and laproscopy which were used in 74%.

The authors made an analysis of observations of 46 patients. They describe algorithm and problems of clinico-instrumental and X-ray diagnostics, strategy of operative treatment and postoperative complications.

The authors have performed an analysis of main indicators of celiac duplex scanning in 180 patients with celiac compression syndrome before operation, during decompression and at the postoperative period. All the patients underwent trunk decompression. The indicators of the intraoperative celiac surgical celiac duplex scanning (stenosis degree, linear peak systolic circulation rate) of the celiac trunk shower hemodynamic reliable stenosis and were sufficiently different from preoperative findings. The stenosis degree and linear peak systolic circulation rate were less during intraoperative examination than before the operation. Intraoperative, duplex canning allowed compressive stenosis of the seliac trunk to be differentatied in some patients from intravasal one (atherosclerosis and arteritis), and its adequate decompression to be performed. When performing the celiac trunk decompression it is thought to be necessary to fulfill its intraoperative ultrasound duplex scanning before and after elimination of the compression.

The influence of modern detoxic preparation Reamberin on indicators of oxidative stress syndrome (OSS) — the content of lipoperoxidation products was investigated. It was established that inclusion of Reamberin in the complex of surgical treatment of destructive forms of erysipelas on the background of type 2 DM accelerates the liquidation of OSS.

In two statistically uniform groups of observation of oncocoloproctological patients a comparative analysis was made of healing median laparotomy wounds sutured traditionally (layerwise, hermetically) and with irrigating prolonged drainage of the subcutaneous fat. Traditional suturing of the wounds was followed by suppuration in 66%, while in laparotomy wounds where irrigating prolonged drainage was used there were no cases of suppuration.

Adequate treatment of the burned is not always possible by traditional local conservative methods. Combustologists face considerable difficulties when the patients have non-healing wounds against the background of concomitant diseases or there is a shortage of donor resources for critically burned patients. Results of using wound coverings «Suprasorb» are analyzed in patients with superficial and deep wounds. The clinical course of the wound process, pains during bandage and the dynamics of microbial dissemination of the wounds are assessed.

The work presents the data of complex clinical investigation and treatment of 371 patients with the syndrome of brain compression of traumatic etiology. Valid indications for using differentiated operative interventions have been developed and results of treatment of patients with intracranial hematomas, depressed fractures of the cranial bones inducing the symptoms of brain compression have been analyzed.

Reoperations were fulfilled on 71 patients (2.73%) after 2576 thoracotomies for diseases and injuries of the chest, rethoracotomies were fulfilled on 34 patients, in 37 patients the interventions were fulfilled endoscopically. The indication for thoracoscopy were continuing intrapleural bleeding, fragmented pleurisy due to pleural empyema, not arrested chylothorax, foreign body (drainage tube). Nine patients died (24.3%). Lethality was one third less as compared with rethoracotomy.

In the article, with 72 patients, taken as an example, with tuberculosis of respiratory organs the authors present their clinical experience with using various methods of surgical correction of the hemithorax volume (by means of extrapleural, intrapleural, extra-intrapleural correcting thoracoplasties and diaphragmplasty) during performing resections on the lungs and/or pleura. Substantiation is given to the necessity of correcting hemithorax volume in patients with tuberculosis of respiratory organs in performing resections of great volume.

The article presents an analysis of results of 24 384 endoscopic examinations of the upper gastrointestinal tract in population of the Leningrad oblast with symptoms of gastric dyspepsia during the period from 2007 to 2011. The detection of the columnar-celled metaplasia was 1.1%, adenocarcinoma of the esophagus — 0.045%. Esophageal adenocarcinoma occurred in 3.95% of cases of the column-celled esophagus. Barrett’s esophagus was revealed in males more often than in women (56.5% and 54.5% respectively). The peak incidence of esophageal adenocarcinoma in males was at the age from 46 to 60 years (36.4% of patients), in females — from 61 to 75 years (27.3% of patients). Intestinal metaplasia was detected in 72.7% of cases with esophageal adenocarcinoma. The diagnosis of long and short segment of column-celled esophagus revealed no significant difference in the development of esophageal adenocarcinoma.

The article presents an analysis of tactical approaches in patients with acute cholecystitis on the basis of an experience with treatment of acute cholecystitis under conditions of multyprophile hospital in Saint Petersburg and modern ideas of the problem in the world.

The article presents an algorithm of diagnostics and treatment of renal cysts and other liquid neoplasms of the retroperitoneal space on an analysis of 270 case histories. The algorithm takes into account the achievements of modern medical technologies developed in the recent years. The application of the proposed algorithm must elevate efficiency of the diagnosis and quality of treatment of patients with renal cysts.

On the basis of clinical experience the author substantiates the algorithm of clinico-laboratory emergency diagnostics and differential diagnostics of acute bleedings caused by disturbances of the primary and secondary hemostasis.