This research includes 74 patients with syndrome of the sinus node asthenia. The application of permanent bilocular pacing was indicated for these patients. An atrial electrode was located in the right atrial auricle in 37 patients and it was in the area of Bakhman’s fascicles in other 37 patients. All the patients had a stimulated atrio-ventricular delay on 250 ms, but sensing delay was shorter on 20 ms. Given data were analyzed after operation in the periods of 6 and 12 months. Cumulative percent of ventricular stimulation was significantly less in the group with electrode in the area of Bakhman’s fascicles (6%) as compared with the group where electrode installed in the right atrial auricle (41%) after 6 months. There were 4% in comparison with 43% after 12 months. The localization of atrial electrode in the area of Bakhman’s fascicles led to reduction of cumulative percent of ventricular stimulation on 35% after 6 months and on 39% after 12 months. Permanent pacing in the area of Bakhman’s fascicles could be an effective mode to decrease the part of amotivational stimulation of the right ventricle.

The article presents the results of thoracoscopic surgeries in case of bullous emphysema of the lung in 88 patients. The patients have been divided into 2 groups according to the method of treatment: 1) destruction of pulmonary bullas and pleurodesis using diathermic electrocoagulation (42 people); 2) destruction of pulmonary bullas and subtotal pleurectomy (47 people). The operative periods weren’t statistically differentiated in patient’s groups. The volume of hemorrhage and exudation period from the pleural cavity were significantly higher in patient’s group, where patients underwent pleurectomy. However, lung spreading terms and ending of air leakage, periods of drains removal from the pleural cavity, hospital stay and rate of pneumothorax recurrence were considerably smaller in the group without application of pleurodesis.

Differential diagnostics of papillospasm and papillostenosis should be based on the complex of clinical and instrumental researches with the priority to endoscopic technologies. Conservative therapy should be considered as optimal option of treatment for the patients with papillospasm. Preference of endoscopic operations have to be in case of revealed papillostenosis of different degree. Similar differentiated diagnostics and treatment management justified in 90% of cases and led to improvement of patient’s conditions and their recovery.

This work analyzed the results of surgical treatment of 380 patients who underwent the laparoscopic adjustable gastric banding (LAGB) at the period from 2004 to 2015. The patients were initially divided into 2 groups with metabolic syndrome (MS) and without MS according to the sex, age (up to 40 years old or older). As the result of performed analysis, there was stated that LAGB operation wasn’t effective and couldn’t be recommended for an application on the patients with MS. The patients have to follow necessary advice for life. Otherwise, the probability of complication development and recurrent operation would be really high and because of this, the more effective surgical treatment should be initially used. LAGB operation didn’t influence on pathogenetic mechanisms of main components of MS and couldn’t be regarded as effective. This LAGB operation is reasonable to apply in women without MS of young age group with initial body mass index lower than 43 kg/m². These women have to be able strictly follow doctor’s advice for life.

Late diagnostics of colon cancer along with high specific weight of the patients of elder age groups indicated the urgency of study of application of cytoreductive surgery in elderly and senile patients of with colorectal cancer. A comparative assessment of the results of cytoreductive operations (primary tumor resection) was made in two groups of patients with disseminated colon cancer (younger and older than 60 years old). It was stated, that the performance of palliative resection allowed them to obtain of encouraging remote results, provide more higher survival rates than in patients of young and mean age groups. The more frequent development of complications after cytoreductive operations was associated with decompensation of accompanying pathology in patients of elder age groups. These data confirmed the need of their adequate correction in preoperative period. The application of cytoreductive surgery significantly improved the quality of life of the patients of elder age groups with disseminated forms of colon cancer.

An analysis of demographic and epidemiologic situation was made in cases of otogenic and rhinosinusogenic intracranial complications on the area of 32 regions of Russian Federation at the period from 2009 to 2014. The state of ENT-service of examined subject is characterized by reduction of provision of during ENT-beds and lower level of hospitalization of population over indicated period. There was revealed a reliable correlated dependence of the main medical statistical indices from the intracranial complications with climatic and demographic factors, the rate of morbidity and activities of ENT-service in the area of this region.

The results of diagnostic and treatment were analyzed in 111 victims with abdominal multitrauma at the period from 2010 to 2013. Abdominal traumas were diagnosed on the basis of instrumental investigations and laparascopic data. Combined injuries were often observed in 3-5 areas. The abdominal hemorrhages were in 66 patients as a result of injury of the parenchymatous organs. Diagnostic value of clinical symptoms wasn’t more than 45,9% in abdominal catatrauma, though in case of plan radiography it was from 41,2% to 66,4% and in case of ultrasound study - 91,6%. The laparotomy was performed for 28 patients. The laparoscopy was applied in 66 cases. However, there were revealed the cases of continuing bleeding in 31 patients and because of these complications, the operations were converted to laparotomy in 27 cases. Different variants of laparoscopic coagulation were performed on 4 patients. The rate of lethality consisted of 27%. The authors proposed an algorithm of treatment of the patients with closed abdominal injury on the basis of score assessment of hemoperitoneum (according to USS), which allowed significant rise of treatment efficacy, decrease the rate of postoperative complications and lethality.

The article analyzed treatments results of 76 patients with deep burns. It was stated that magneto-plasma therapy facilitated to the change from an inflammatory type of burn cytograms to regenerative type. These changes were expressed in reducing of neutrophil quantity in wound on the fifth day, decreasing of degenerative changed leukocytes on the tenth day, increasing of phagocytic activity of neutrophils in all terms, growing of macrophage reaction by the fifth day and multiplication of fibroblast quantity in wound on the tenth day. The neutrophil and macrophage quantities were increased in the wound after necrectomy due to influence of magneto-plasmatic therapy on the third day. There was synthesized interleukin-8. The quantity of cells producing IL-8 was reduced on the tenth day.

This work analyzed 47 cases of oto- and rhinosinusogenic suppurative meningoencephalitis, abscesses and empyemas of the brain in children at the age from 3 months to 17 years old. The article presents the treatment strategy, results and the volume of diagnostic measures. On the basis of this research, the authors came to conclusion, that care of the children with otogenic and rhinosinusogenic suppurative diseases of the brain required an interdisciplinary approach and effective cooperation of a neurosurgeon, otolaryngologist, pediatrician, resuscitation specialist, infectionist and a clinical pharmacologist.

The article presents the results of anatomical studies aimed to develop modelling of facial allografts taking into account the peculiarities of blood supply. The allografts should meet both aesthetic and functional needs of the recipient for further use in clinical practice. There were selected 3 facial composite tissue allografts out of 50 modifications, which are more suitable for required parameters. On basis of these data, there was successfully performed the facial composite tissue allograft transplantation on the patient.

The authors analyzed noninfectious complications (dislocation of endoprosthesis head, periprosthesis fractures) in 8 patients out of 40 with hip arthroplasty. There were estimated clinical, biomechanical results and quality of life of the patients. An application of the external fixator-orthezes should be recommended in order to prevent complications of hip replacement. The wearing of brace is considered to be reasonable after revision interventions.

This work aimed to reveal the statistically reliable clinical and laboratory markers, which are associated with fatal outcomes in patients with hemorrhagic shock of the III degree on the stage of hospital treatment. It was stated that decrease of body temperature (till 35,9 °C), pH of venous blood (till 7,19) and content of ionized calcium (till 0,32 mmole/l) in venous blood and increase of lactate content (up to 4,1 mmole/l) in venous blood and rise of activated partial thromboplastin time (up to 59 sec) are connected with fatal outcomes.

The authors analyzed complications in peroral endoscopic myotomy in case of esophageal achalasia in 27 patients. There were noted hypercapnia, carboxyperitoneum, hemorrhage, perforation of mucous coat of esophagus. These complications were suppressed during endoscopic manipulations.

The article analyzed the structure, incidence rate and results of surgical treatment of paracolostomal complications in 69 patients out of 134 (aged from 23 to 77 years old). The patients were divided into 2 groups according to the variant of terminal colostomy. The single-barrel colostomy was formed by classical (intraperitoneal) method using «proboscis» design in 58 patients (43,3%) of the first group. Various complications were developed in the area of colostomy in 42 (72,4%) patients. The single-barrel flat colostomy was applied at the skin level using the method modified by the authors in 76 (56,7%) patients of the second group. The authors designed the method of controlled intra- and postoperative decompression and lavage of the colon by a new model of aspiration-irrigation device in order to unload the colon through colostomy. There were noted complications in the area of colostomy in 27 (35,5%) cases. The developed rational method of terminal colostomy formation, upgrading the ways of intra- and postoperative decompression and lavage of the colon facilitated to decrease of the rate of postcolostomy complications more than two times (from 72,4 to 35,5%). The author’s method led to optimization of immediate and long-term results of surgical treatment.

An analysis of treatment results was made in 26 patients with postnecrotic cysts of different degree of maturity. The laparotomy with trans-gastral cystogastrostomy on the external drainage were performed on 11 patients. A new modified operation underwent 15 patients. This operation was transgastric cystogastrostomy on the external drainage from mini-access, which was developed in 2011. The laparotomy of 4-5 cm was made in pseudocyst projection of the pancreas using a standard set of tools «mini-assistant». Postoperative period have passed without complications in all the patients. The drainage was removed on 30-40 days of postoperative period. The terms of hospital stay reduced from (14,4±0,9) bed/ days to (10,8±0,5) bed/days due to application of proposed method of treatment.

The method based on formation of ileal reservoir with following invagination of pancreas stump inside it. A presence of the ileal reservoir with regulated vertical incision of the intestine excepted the possibility of compression of the pancreas stump by the intestine wall in glands invagination to the lumen. The method could be used in the existence of main risk factors: soft tissues of the gland and the diameter less than 3 mm. This means was applied in 19 patients. There was noted inconsistence of pancreatoanastomosis in 3 (15,8%) patients. One female patient died (5,3%). The reason of death wasn’t associated with features of anastomosis forming. The results obtained indicated about good preventive properties of the proposed pancreatoanastomosis in relation to complication development in case of unfavorable conditions for anastomosis formation.

The article raises the problem of optimization and legitimization of work of the Heart Team. It also described the background and international experience, provided an overview of the recent international guidelines in relation to management of revasculization in patients with stable coronary artery disease. The article presents an experience of the I. P.Pavlov First Saint-Petersburg State Medical University.

The results of treatment of 75 women with perforated ulcers have been studied. There were prevailed women of middle and elderly age groups among patients who underwent surgery. A wound closure of perforated opening and abdominal sanation were performed by laparoscopic means in 30,7% of patients and using midline laparotomy in 29,3% cases. There were carried out the laparoscopic sanation of the abdominal cavity and the wound closure of perforated ulcer from mini-access using the set of mini-assistant in 10,7% patients. Radical operations were applied in 16% cases. The early postoperative complications took place in 8,1% of the patients, the rate of lethality was 4,0%. The long-term results were evaluated and considered as good in 55,5% women, satisfactory - in 30,1% and unsatisfactory - in 14,2% cases.

The work evaluated the long-term treatment results of 103 patients with complicated diverticular disease, who underwent the elective surgery in the volume of left hemicolectomy. The first group included 53 patients with recurrent diverticula. The second group consisted of 50 patients, who underwent the operation on diverticula of sigmoid colon with formation of sigmostoma on the first stage. The number of patients with functional gastro-intestinal and psyco-emotional disorders was more significant in the first group compared with the second group and it was associated with presence of these disorders before the operation. There was noted the reliable decrease of quality of life rates according to questionnaire scales MOS-SF 36 in the first group. The average indices of scales had some matching to the rates of health people in the patients of the second group. The authors came to conclusion, that indications for elective surgery should be determined very carefully in case of recurrent diverticula.