The objective of the study is to assess the efficacy of the invented in the clinic technique of sclerosurgical treatment of the ruptured abdominal aortic aneurisms.

Material and methods. The analysis of the treatment of 40 patients with ruptured abdominal aortic aneurism was done. All patients were divided into two groups consisted of 20 patients. The first group of patients were treated using conventional technique. Patients from the second group were treated using sclerosurgical treatment. The aneurysm was neither opened nor resected. The aneurism was punctured and injected 4 ml of 70 % ethanol under ultrasound guidance.

Results. The second group of patients had decreased both the postoperative complications and mortality rate by 10 % and 30 % respectively.

Conclusion. The original technique of sclerosurgical treatment of the ruptured abdominal aortic aneurisms is effective and pathogenically supported.

The objective of the study is to consider the main problems and to define the ways to improve the efficiency of surgical treatment of hiatal herniae.

Material and methods. 518 patients were operated, the plasty of hiatal hernia – posterior cruroraphy – was carried out in 191 (26.9%) of patients, the prosthetic materials via the method «mesh-reinforced» were used in 327 (63.1%) of patients.

Results. The general surgical complications were noted in 43 (8.3 %) patients, the delayed side effects were in 118 (22.8 %) patients, relapse of hiatal hernia were in 27 (5.9 %) patients.

Conclusion. The high frequency of relapses remains the main problem in surgery of hiatal hernia.

The objective is to study the results of different methods of surgical treatment of patients with infected pancreonecrosis and to conduct a comparative analysis of minimally invasive and traditional surgical interventions.

Material and methods. The results of treatment of 206 patients with infected pancreonecrosis were analyzed. In accordance with the used method of surgical treatment, the patients were divided into 2 groups: 105 (51.0%) patients with “traditional” open interventions were included in the first group (comparison), and 101 (49.0%) patients treated with various miniinvasive technologies, or a combination of minimally invasive and “open” interventions were included in the second group.

Results. It was found that the mortality rate in the second group was less than in the first group by 12.8% (p<0.05).

Conclusion. Minimally invasive surgical techniques are the method of choice for delimited pancreatogenic ulcers. The use of combined surgical interventions leads to a significant reduction of postoperative mortality and duration of inpatient treatment.

The objective was to study the efficacy of transcatheter arterial embolization of gastric and duodenal vessels and to determine the indications for its use in gastroduodenal ulcer bleeding.

Material and methods. The study was based on the results of arterial embolization in 61 patients with gastroduodenal ulcer bleeding.

Results. Transcatheter arterial embolization of the left gastric artery, its branches and the gastroduodenal artery with an adhesive glue composite based on N-butyl-2-cyanoacrylate is highly effective in arresting bleeding permanently and preventing its relapse.

Conclusion. Transcatheter arterial embolization is an alternative to the surgical treatment in patients with gastrointestinal bleeding.

The objective of the article is to discuss diagnostic peculiarities of artificial pyoinflammatory diseases of soft tissues (APIDST).

Material and methods. We analyzed the clinical data of 302 military men.

Results. As compared to the non-artificial pyoinflammatory diseases of soft tissues of level 2-4 (PIDST of level 2-4), APIDST are characterized by the presence of local self-induced skin injuries that are mostly located on shins, the crepitation during palpation in the projection of the abnormal focus, and the signs of anaerobic infection (86.1%) and cellular-fascia-myositis (57.6%) during the surgical intervention in the lesion.

Conclusion. The revealed clinical features of pathology should be taken into account in the treatment. 

The objective of the study is to evaluate the efficacy of valvular bronchoblocation in the treatment of patients with purulent diseases of the lungs and pleura.Material and methods. 28 patients aged 15 to 66 years with bronchopleural fistulas were treated.Results. Positive dynamics was observed in 23 patients during the first 10–15 hours after blocking (cessation or reduction of air leakage through drainage or into the residual pleural cavity). In four patients, it was possible to stop the purulent-inflammatory process in the pleural cavities and perform thoracomyoplasty with good clinical results. In the presence of an inconsistency of the stump of the bronchus in 4 out of 5 patients, it was possible to effectively close the fistula and eliminate the residual pleural cavity.Conclusion. The use of valvular bronchoblocation in patients with acute purulent diseases of the lungs and the pleura allows achieving good results. The objective of the study is to evaluate the efficacy of valvular bronchoblocation in the treatment of patients with purulent diseases of the lungs and pleura.Material and methods. 28 patients aged 15 to 66 years with bronchopleural fistulas were treated.Results. Positive dynamics was observed in 23 patients during the first 10–15 hours after blocking (cessation or reduction of air leakage through drainage or into the residual pleural cavity). In four patients, it was possible to stop the purulent-inflammatory process in the pleural cavities and perform thoracomyoplasty with good clinical results. In the presence of an inconsistency of the stump of the bronchus in 4 out of 5 patients, it was possible to effectively close the fistula and eliminate the residual pleural cavity.Conclusion. The use of valvular bronchoblocation in patients with acute purulent diseases of the lungs and the pleura allows achieving good results. 

The objective of the study is to evaluate the safety and efficacy of the using of minimally invasive endoscopic methods in the treatment of submucosal esophageal tumors.

Material and methods. The study included 89 patients with benign tumors of the esophagus. Endoscopic ultrasonography (EUS) was performed to determine the esophageal wall layer from which the tumor grows the size of the tumor and its relationship with the surrounding organs.

Results. Submucosal tunneling resection was performed successfully in 73 patients. The average operation time was 84.5 minutes. In 16 patients, the tumor was removed by submucosal endoscopic dissection (SED). The average duration of ESD was 39.4 minutes. Among this group of patients we faced nonstandard cases of practical interest: leiomyomas of the upper part of the esophagus, plexiform leiomyomas and multiple leiomyomas. Each of the above types had its own specificity in diagnosis, treatment and postoperative management of patients.

Conclusion. Submucosal esophageal tumors vary in types of growth, sizes, number of tumors, localization and its relationship with the surrounding organs. Scrupulous diagnosis of each case is necessary which will allow choosing the most appropriate treatment tactics for the patient.

The objective of the study is еo evaluate the possibilities of videothoracoscopy in the cases of pleurisy of inflammatory nature of specific and non-specific etiology.
Material and methods. We carried out the retrospective analysis of medical histories of 135 patients.. Parapneumonic pleurisy was diagnosed in 68 (54.4 %) patients, tuberculous pleurisy – in 57 (45.6 %) patients.
Results. Videothoracoscopy was diagnostic procedure in 61.6 % of patients and was performed for the defragmentation of pleurisy in 38.4 % of patients. Videothoracoscopy allows exactly diagnosing the tuberculous pleurisy by means of biopsy in the absence of lesions on the pleura. Resistant parapneumonic pleurisy was diagnosed in 34.9 % of patients. In cases of parapneumonic resistant pleurisy, the pleurodesis reduces the time of the drainage by means of injection through the drainage of mixtures of betadine and concentrated solution of glucose.

The objective of the study is to make the analysis of the results of total cement knee arthroplasty in the most difficult age group of 85–95 years old patients.

Material and methods. 40 patients with terminal knee arthrosis were selected based on their comorbidity.

Results. Patients with the Charlson comorbidity index of 5–8 points need hospitalization for the treatment of aggravating somatic pathology, as preparation for a future knee arthroplasty. In the operated patients, the result on the KOOS was (76±7.19), and on the WOMAC was (151±4.83) a year after the arthroplasty.

Сonclusion. Surgical intervention – total knee arthroplasty in patients of 85–95 years old is possible only if its risk is minimized.

The objective of the study is to evaluate the effect of perioperative administration of dexmedetomidine on the frequency of delirium after myocardial revascularization.
Material and methods. A retrospective analysis of the results of 1733 operations of myocardial revascularization was performed, as well as a prospective comparative study of postoperative period features in 568 patients.
Results. The use of perioperative administration of dexmedetomidine at a rate of 0.2–0.4 μg/(kg•min) resulted in a significant (3.4 times,) decrease in the frequency of delirium, and in the case of the development of a syndrome resulted in the reducing its duration from (3,24±1,6) to (1,6±0,7) days and the need for prolonged artificial lungs ventilation (ALV), a decrease in the dose of haloperidol for arresting excitation.
Conclusion. Perioperative infusion of dexmedetomidine reduces the frequency of delirium after coronary artery bypass grafting (CABG). In the case of delirium progression, the inclusion of dexmedetomidine in therapy reduces the duration of delirium, the need for ALV, and reduces the need for neuroleptics.

The objective of the study is to evaluate the results and compare the methods of different variants of surgical treatment for the occlusive-stenotic lesion in extracranial parts of the carotid arteries.
Material and methods. Comparative analysis of immediate and remote results, and evaluation of patency after 450 carotid endarterectomy performed by classic and eversion technique.
Results. A significant advantage of eversion carotid endarterectomy was confirmed.
Conclusion. The good results show not only the high qualification of each operating surgeon as well the entire staff, providing competent logistics and selection of patients for both planned and emergency surgical interventions.

Objective. To assess the outcomes of the treatment of patients with suppurative necrotic complications of diabetic foot syndrome (DFS) without critical ischemia with the use of programmed rehabilitation technologies (PRT).

Material and methods. The study included 82 patients. 40 patients (reference group) underwent conventional rehabilitation, while 42 patients (study group) were treated with PRT with the use of the original equipment AMP-01.

Results. Use of PRT has been established to significantly improve the quality of rehabilitation, which helps to reduce the duration of inpatient treatment. The number of suppurative complications in the study group proved to be significantly less (p=0.014), and postoperative mortality was lower. The long-term outcomes of the treatment (number of late suppurative complications, ischemia progression, maintenance of foot support ability) in the study group was also found to be significantly better compared to the reference group.

Conclusion. The use of PST promotes the improvement of short-term and long-term outcomes of the treatment of the patients with DFS suppurative necrotic complications.

The article describes the clinic, diagnosis and treatment of esophageal rupture complicated with purulent-necrotic mediastinitis, pleural empyema and sepsis in the 45 years old patient.

The article describes the observation of successful total hip arthroplasty of protrusion coxarthrosis in the patient with end-stage renal disease.

The review includes the analysis of the literature data on the features of etiopathogenesis, clinic, tactics and results of treatment of infrarenal aortic aneurysm.

The article presents the data on the dynamics of cerebrovascular reserve indices according to various methods in the perioperative period of reconstructive surgical interventions. We analyzed the relationship between the cerebrovascular reserve and the comorbid factors, the informative value of its indices in predicting ischemic strokes and postoperative hyperperfusion complications.

The paper includes the statistics of liver abscesses, etiology and related features of the diseases. The most common methods of conservative and surgical treatment of liver abscesses, currently used in surgical clinics of the Russian Federation, are presented. A small historical excursus about the existed methods of treatment is given in the paper. A comparative analysis of the currently used methods, their advantages and disadvantages is carried out. Some possible criteria for a certain method of treatment of liver abscesses are listed as well.

The review includes the analysis of the evolution of surgical suture in case of repairing the damaged flexor tendons of the fingers.