Cryosurgical method is used in treatment of patients with glial tumors which localized in depth and functionally meaningful brain areas. These patients are generally considered as inoperable and receive conservative treatment. Their prognosis has become worse as compared to the patients whose brain tumor is available for surgical removal. The authors used a multiway stereotactic destruction of tumors by cryosurgical cannula, which is inserted in bone cutter opening using manipulator. MR-imaging and PET/CT of brain were applied for stereotactic guidance. The majority of patients who underwent this operation didn’t noticed any loss of quality of life. The rates of survival were higher than corresponding indicators for patients who were treated only by chemo- or radiation therapy and the rates were equal to the patients underwent the radical operations. Thus, the multiway stereotactic cryodestruction is a new, safe and effective method of surgical treatment for the patients with tumor localization in such areas, that their location blocked an application of traditional surgical removal by open method.

The authors investigated the epidemiological and clinical features of otogenic and rhinosinusogenic intracranial complications in East-Siberian region of Russian Federation. The rate of intracranial complications consisted of 0,2±0,1% in patients of ENT hospitals in Sakha- Yakutia, Krasnoyarsk Territory, Irkutsk Region, Republic of Tuva. The intracranial inflammatory pathology of otogenic nature was diagnosed two times more frequent than rhinosinusogenic. Meningitis was revealed at the same rate as lesions of brain substance (encephalitis, epi- and subdural abscesses). The high clinical efficacy was shown in surgical treatment of purulent polysinusitis using W. Messerklinger method of functional endoscopic rhinosinusosurgery (FESS). The method of transtemporal incision and drainage of otogenic abscess of the brain temporal lobe has a number of essential defects, because of them, the indications for application of this method should be considered and specified. It is necessary to have an interdisciplinary approach and use the modern achievements of medical science in order to develop the efficacy of treatment of given category of patients.

The research proved an efficacy of autoarterial plasty performance of external carotid artery in case of internal carotid artery occlusion. It isn’t necessary to apply synthetic materials or an autovein for closing arteriotomic defect in plasty performance. According to data of ultrasonic scintiangiography and transcranial Doppler graphy, there was noted the significant increase of blood flow on medial cerebral artery in operated area after a year of surgical treatment (about 30%). Proposed operation is effective in prevention plan of ischemic stroke.

The reasonability of application computed tomography (CT) in differential diagnostics of adrenal tumors and navigation of rational surgical approach for adrenalectomy was specified by possibilities of method development. The special research of CT possibilities in adrenal tumor diagnostics and substantiation of choice of surgical interference were made in 188 patients. An analysis of clinical-laboratory and instrumental data allowed diagnostics of aldosteroma in 26% patients, corticosteroma in 33,0%, chromaffinoma in 24,5%, adrenocortical cancer in 8,5%, hormonally inactive tumor in 8,0%. Results of morphological investigations of removed adrenal tumors were matched with the preoperative CT data. There was revealed a certain density of tumors. On the basis of this density and clinical-laboratory data, the authors could reliably make a diagnosis the disease before the operation, which is very important in asymptomatic illness course and subclinical manifestations.

The article presents the results of examination and treatment of 2053 patients with acute pancreatitis. The operation was performed for 402 patients. There was defined a prognostic value of 175 signs of acute pancreatitis. The authors separated seventeen the most reliable and informative criteria and worked out an assessment grade for each criterion. It was demonstrated, that the score 17 indicated the possibility of conservative treatment. Low-invasive treatment should be applied in the score from 18 to 34. The wide laparotomy used in the score more than 34. The lethality declined on 12,3% (p<0,01) in the second group of patients, which was formed using the proposed diagnostic table.

The authors made an analysis of the results of experimental course of wound process on 120 rats of Vistar line and clinical research of 58 patients with purulent wounds, which were treated by ointment of following composition: chlorhexidine bigluconate 0,5-30,0; methyluracil -2,0; polymethylsiloxane polyhydrate -70,0. The animals and people were divided into 2 statistically uniform groups. The control group had a local treatment of wound by the ointment «Levomekol’». The experimental group used the immobilized forms of chlorhexidine. Dynamics of wound process was studied by planimetric, bacteriological and cytological methods of research. Results of planimetric, bacteriological and cytological investigations proved the more expressed positive effect of purulent wound treatment using immobilized form of chlorhexidine bigluconate.

The authors studied the treatment results of application of the laser-induced thermotherapy method in 414 patients with nodular colloid goiter. Dynamics of the nodule sizes was estimated in 298 (72, 0%) patients. Dynamics of thyroid status was assessed in 132 (31, 8%) patients. The average size was reduced more than 60% among the nodules with the volume up to 1 cm³. In case of nodules with the volume more than 8 cm³, the average size was decreased more than 40%. The majority of nodules with the volume of 1 cm³ were reduced more than 50% (45 out of 80), other nodules 19 (23,8%) were decreased more than 75% and 12 nodules completely vanished. The nodules with the volume of 1-2 cm³ were reduced more than half of them on 50% (41 out of 71), the rest of the nodules - on 75% and more than fifth part of them. At the same time, there wasn’t noted the decrease more than 75% in the nodules with the volume of 4 cm ³. However, the volume decrease was observed among such nodules, the majority of the nodules were reduced more than a quarter. During this procedure the patients 305 (73,7%) felt some discomfort and low-intensive pain in area of manipulation. The pains were completely arrested in 289 patients in the end of this procedure, but aching continued in the case of 16 patients for more long time (from 12 to 24 hours). There was noted the temperature rise up to the level of low grade fever in 11 (2,7%) patients during 12-24 hours. Complications of laser-induced thermotherapy had 21 (5,1%) patients. An intracutaneous unstrained haematoma was defined in 15 patients in injection area. There was noted a skin burn in spot of the injection in 5 (1,2%) patients. Paresis of the vocal ligament took place in one patient (0,2%), but it was treated in phonopedist and mobility of the vocal ligament was restored. Hyperthyroidism was caused in two patients and, according to the authors, it could be associated with drug intake of “сordaron”.

The observation research of victims with severe combined injury was made, the patients were treated by substrate antihypoxant (cytoflavin) in complex of medical care. The authors revealed a decrease of the number of lymphocytes, CD14+ monocytes and growing number of HLA-DR+ monuclear cells. There was noted a significant reduction of the growth of the number of HLA-DR+ monoclear cells and lower lethality rate in case of application of substrate antihypoxants in complex treatment of given patients.

The article is aimed to study morphological features of regeneration process of the Achilles tendon after its cross tenotomy with intersection of facial sheaths and damage of mesenteric vessels in experiment on growing rabbits. The experiment was made on 25 rabbits of «Shinshilla» breed of both sexes in the age of one month with the mass of 1376±124,8 g. The processes of reparative regeneration of heel tendon were investigated. There was used a rabbit’s output from the experiment on 15, 21,30,60 and 90 days after cross tenotomy in number of five animal units. According to results of carried out researches, the considerable part of defect was completed by dense connective tissue obtaining scarry character on 60 days. There was observed an opposite development of defect zone, a focal substitution of dense fibrous tissue by loose connective tissue with histiocytic, lymphoid cells and inclusions of foci of fatty tissue on 90 days. The authors didn’t noted the complete recovery of tendinous tissues «retitucica ad integrum» in the zone of tenotomy, because of circulatory disturbance in this area due to damage of facial sheats and mesenteric vessels. Thereby, the reparative regeneration of heel tendon was originated in unfavorable conditions, because of cross tenotomy performance with intersection of synovial sheath and damage of mesenteric vessels. The results obtained indicated that it is necessary to avoid the damage of synovial sheathes and mesenteric vessels in cross intersection of heel tendon during correction of foot element deformations.

The results of treatment of 75 children with spleen damage were studied. The conservative treatment was applied in 69 (92%) cases. A restoration of spleen structure was noted in case of spleen injury on 3-4 weeks. The complete normalization of the spleen structure occurred in terms of 3-4 months after trauma. Posttraumatic cysts appeared in case of large defects and hematomas after 2-3 weeks and disappeared by 5-6 months. The regenerative process of shallow ruptures was registered after 3-10 weeks, but the deep ruptures were healed after 6-30 weeks. The preservation of the spleen after trauma have led to structure and function recovery and could be considered as primary prevention of asplenism.

Necrotic enterocolitis is a common disease of the newborn children, which requires an emergency treatment. The results of children treatment depend on many factors, especially from well-timed diagnostics in case of transition from therapeutic to surgical stage. There was noted the tendency to lethality reduction because of necrotic enterocolitis (17% in developed countries, 42% in countries with low- and middle levels of economy) over the past decade. The authors followed-up 42 children with the diagnosis of necrotic enterocolitis. Sepsis, inflammatory bowel disease, toxic products in its lumen are the main source of severe condition of the child. The antibacterial and detoxication therapies should be performed for the newborn child with necrotic enterocolitis on admission to the hospital. An operative treatment have to be carried out in case of lack of condition improvement.

The article presents the results of diagnostics and treatment of 6 patients, whom the trachea-esophageal stenting was performed (5 men, 1 woman). The age of patients was from 49 to 78 years old. The indication to stent implantation was in cases of esophageal cancer in 4 patients. Metastatic lesions of the lymph nodes of the mediastinum was the reason of esophageal stenosis after previously performed surgery (type of Lewes operation) in one case. Another reason of surgery was central cancer of the right lung with invasion to the mediastinum, trachea and esophagus compression in one patient. Treatment management was determined by presence of respiratory failure and dysphagia evidence. The trachea stenting was carried out as the first stage of treatment in case of respiratory failure. The esophageal stenting was made in case of dysphagia. There weren’t any complications. The trachea-esophageal patency was restored.

The article presents the assessment results of efficacy of modern bariatric laparoscopic operation during 10 years of practice. This work analyzed the treatment results of 1018 operated patients at the period from 2007 to 2014. The laparoscopic regulated gastric bandage operation was performed in 275 (28, 8%) cases. The lapa roscopic longitudinal gastric resection (LLGR) was applied in 411 (43,1%) (231 operation used the developed modification and 180 used standard method). The laparoscopic gastric bypass surgery (LGBS) was carried out in 253 (26,5%) cases (56 used the developed modification and 197 used the Lontron modification). The laparoscopic biliopancreatic bypass surgery (LBBS) was made in 14 (1,4%) cases (11 used Hess Marceau Baltasar modifications and 2 - Fobi modification, 1 - Scopinaro operation). BIB was implanted in 65 (6,3%) cases. The diagnosis of metabolic syndrome had initially been established for 321 (31,5%) patients. The rest of the patients 697 (68,4%) have been operated for obesity of different degree. An initial body mass index (BMI) <35 kg/m² (28,5-34,2) was in 13 (1,3%) of these patients, who were followed-up for 3 years. All the patients were initially divided into groups with metabolic syndrome (MS) and obesity of different degree and subgroups according to operative treatment and in consideration of the sex, age (up to 40 or more than 40 years old). The efficacy of the operation was estimated in consideration of the sex, age, type of operation, different terms (initially, after 3 months, one year, three and five years) and earlier determined markers. The most remote term was 10 years. The individual features of the patient should be taken into account while choosing the «ideal candidate» for different methods of surgical treatment according to the results of given researches. The restrictive gastric operations have some limitations for an application. The laparoscopic regulated gastric bandage is reasonable to apply in young age female group with initial BMI not more than 43 kg/m². The operation isn’t rational in treatment of MS. The operation LLGR should be used in patients without MS and with IMT not more than 48 kg/ m² regardless the sex or age. The operation could be performed in young age group as the first stage of surgical treatment aimed to cure MS in conditions of high operative risks. Combined operations proposed an exceptional possibility in treatment of MS components and could be considered as alternative method for treatment of diabetes mellitus in strictly selected groups.

The article presents the experience of treatment of pancreatogenic retroperitoneal abscesses in 52 patients with the application of low-invasive surgery under ultrasonic inspection. The percutaneous abscess drainage was performed for all the patients. The most optimal conditions for drainage were determined with an allowance of localization, sizes and character of abscess content. An optimal approach to the abscess was chosen through the safe acoustic window in such a way, that the drainage was located in extraperitoneal position and outside the organs. The drainage was installed using «stylet-catheter» system in majority of cases. Drainage sizes and their number were selected on the basis of cavity sizes and its content. The fistulography was carried out after drainage for all the patients. This allowed detection of characteristics of purulent cavity and visual comprehension of its connection with the Wirsung’s duct. Recanalization and outwardly-internal drainage were used in the case of the blocked Wirsung’s duct in order to prevent pancreatic fistulas. The low-invasive drainage allowed avoiding an open operation and reducing the percentage of postoperative complications.

The article analyzed the results of surgical treatment of obturative tumorous obstruction of the left colon in 398 patients of different age categories. The authors developed and applied the method of retrograde lavage and sanation of the colon. A new model of vacuum aspiration-wash device was designed. An application of the method of intraoperative lavage and sanation of the colon allowed performance of primary-radical operations in 149 (77,6%) patients out of 192 patients of the main group with one-stage reestablishment of colon continuity in 68 (35,4%) cases. The rate of pyoinflammatory complications were reduced from 29,4 to 19,2% due to the developed strategy of surgical treatment. It was stated, that the immediate results of surgical treatment of obturative tumorous obstruction of the left colon were improved due to the optimization of methods of intra- and postoperative lavage and sanation of the colon by upgrading of technical equipment, the wide application of obstructive versions of radical operations in combination with multicomponent and pathogenetically based intensive care. This therapy was directed to adequate correction of metabolic disorders in homeostatic system.

The researches of morphometric parameters of the heart valves were performed in 315 female corpses of asthenic, normosthenic and hypersthenic constitutions. Statistically meaningful differences were revealed in the perimeter of the fibrous ring circle of the flap valves and noted in the length of the semilunar valve of the aorta and pulmonary trunk in women with different somatotypes. The most significant differences were determined in standard indices of the valves in women with asthenic and hyperstenic constitutions. The data obtained allowed broadening of conception of the constitutional variability of the heart.