The article presents an assessment of postoperative period in patients with diffuse lung emphysema with large and giant bullas on the basis of surgical risk criteria, which were developed for the patients with diffuse emphysema without bullas. Retrospective study determined the group of patients who had high rate of surgical complications after bullectomy. The patients (46) were divided into 2 groups and it depended on the initial condition of the patients. There was stated, that the main criterion of surgical risk was a decrease of the level of OFL lower than 20% of the proper level in patients with large and giant bullas.

A comparative analysis of possibilities of visual methods of diagnostics was made in order to reveal the causes of obstructive jaundice in chronic opisthorchiasis. There was estimated the possibility of topical diagnostics of rate and character of the bile passages block while conducting MR-imaging cholangiography. Types of architectonics of the bile passages were specified in chronic opisthorchiasis. A differentiated algorithm of treatment was developed and applied in relation to the obtained data.

Fighting with progressive pyoinflammatory processes in cellular tissue area and in postoperative wound is an actual problem in treatment of patients with acute paraproctitis. There was carried out an experiment, which estimated electrochemical properties of wound’s effluent in dinamics in patients with acute anaerobic non-clostridial paraproctitis. Electrochemical properties of wound’s effluent fitted to clinical and laboratory data in 90,9% of cases: findings completely coincided in 54,5% cases, but some results were earlier than clinical and laboratory manifestations of inflammation on 24 hours in 36,4% cases.

Treatment and prevention of infectious complications remain the actual problems of surgery. Purulent complications very often arise in operative interventions with an application of various fixing devices. A study of the adhesive surgical antiseptic (ASA) «ARGAKOL» (Registration certificate № FS 012б2005/1878-05) was completed. The results of the preliminary antimicrobial activity of the developed composition showed that ASA «ARGAKOL» had a broad spectrum of antimicrobial action. There was used the method of twofold serial dilutions in a liquid medium and Cup-suspension. The study of the influence of the ASA «ARGAKOL» on the wound healing was made in the experiment on white outbred rats. There were carried out two series of experiments with 10 rats in each group: on the model of just contaminated wound (the first series) and on the model of infected wound with delayed application of the glue (after 3 days) after trauma (the second series).

The authors supposed the method of tendinous transplant application in tendoplasty of deep flexor muscle of fingers based on usage of a new variant of tendon suture and modified device for its external cutaneous fixation. Firm and safe junction of transplant with tendon parts of the deep flexor muscle allowed an early activation of the hand function and high efficacy of operative treatment.

The hip arthroplasty in case of destructive - dystrophic affection is considered as the most effective method, which provided social and home reintegration. A modern science development facilitates to this technique. However, specialists noted that the rate of endoprosthesis complication increased in the patients after osteosynthesis of proximal femur. The authors compared the results of patient’s treatment that applied hip arthroplasty methods after osteosynthesis of proximal femur. The main group consisted of 38 patients who underwent hip arthroplasty after osteosynthesis of proximal femur. The control group had 43 patients with hip idiopathic osteoarthrosis, who underwent primary arthroplasty. The endoprothesis replacement was associated with increase of the rate of intraoperative and postoperative complications in the main group of patients. According to the results, given group of patients requires a special approach to diagnostics and treatment.

The analysis of treatment results of 128 patients aged from 21 to 62 years old with chronic posttraumatic osteomyelitis of the long bones was made at the period from 2006 to 2013. The main group included 67 patients and the method of programmed irrigation aspiration sanation was applied for them. The comparison group consisted of 61 patients and drainage was performed for these patients using the conventional ways. The authors noted good immediate results in the main group in 56 (83,58%) out of 67 patients and in the comparison group - in 43 (70,49%) out of 61 patients. The long-term results were analyzed in 116 (90,6%) out of 128 patients in terms from two to five years after treatment. The rate of recurrences such as formation of purulent fistula were twice less in patients of the main group, than in the comparison group. According to the results of questionnaire SF-36, there was noticed, that patients of the main group got better mean indices of quality of life on all 8 scales compared with the other group.

An analysis of treatment results was made in 216 patients with intussusception of bowels at the period from 2000 to 2015. The authors showed that it would be reasonable to carry out a conservative therapy in the cases of recurrent intussusception in absence of peritonitis symptoms.

The authors admit the risks of blood transfusion, as well as the fact that the blood is a limited resource. These conclusions became the basis of the research in order to make an analysis and develop transfusion strategies in the hospital. An assessment of blood components application was performed in specific cases. There was changed the management of blood transfusion and further monitoring was continued. It was shown that the efficacy of an introduction of a new transfusion strategy confirmed the decrease of the rate of inappropriate blood transfusions, the quantity of patients who obtained transfusion of allogenic blood components and as a result, the new methods reduced the number of blood transfusions.

An analysis of the results of X-ray CT and MR-imaging was made in 46 patients aged from 13 to 78 years old. The patients were admitted to multifield hospitals in Kursk at the period from 2005 to 2015. The research included the nasal cavity, paranasal sinuses, mastoid and pyramid of the temporal bones and the brain. The study could be repeated with bolus contrast medium infusion. The condition of the patients was evaluated in dynamics at intervals of 5-7 days and these data was associated with clinical picture. The authors presents a complex of symptoms and an algorithm of differentiated X-ray diagnostics of diseases of the ENT organs and the main nosological forms of pyoinflammatory diseases of arachnoid membrane and substances of the brain.

The article presents an experience of diagnostics and treatment in 21 patients with esophageal perforation at the period from 1995 to 2015. The perforation was often (13 patients) the complication of interventional surgery which was directed to reconstruction of esophagus passing (scarry stricture of the esophagus, esophageal cancer, achalasia of esophagus). There was noted an esophageal rupture of lower third part of esophagus in 14 cases. These complications were diagnosed in all cases and the patients underwent an operation. There was performed the opening and drainage of the mediastinum in order to prevent mediastinitis. Complications had one patient in postoperative period. There wasn’t observed lethal outcome.

The authors determined the efficacy of main methods of MR-imaging and their part in differentiated diagnostics of focal liver lesions. There were examined 256 patients and 414 liver lesions were analyzed. It was shown that the efficacy of conventional research without application of contrast medium was very limited (efficacy of mathematical model 58%). The data obtained during dynamic contrast enchancement (efficacy of the model 67%) were the basis for differentiated diagnostics for majority of nosological forms. The investigation using hepatotropic contrast medium had the greatest possibilities (efficacy of the model 80%). MR-diffusion is the effective procedure for visualization of focal liver lesions, but its possibilities in differentiated diagnostics is limited.

The article analyzes treatment results of 482 patients of elderly and senile age with complicated colon cancer forms who were in the hospital for war veterans at the period from 2008 to 2014. The more frequent complication of colon cancer was an acute intestinal obstruction (76,8%). Peritumorous inflammation with abscess formation was noted in 13,5% cases, hemorrhage - in 5,6% tumor perforation - in 4,1% cases. The operations were performed by conventional methods and using endovideosurgical technologies in case of complication of colon cancer. Laparoscopic operations had less volume of intraoperative hemorrhage, lower rate of postoperative complications and reduction of the level of postoperative lethality. The rate of lethality was 31,18% after conventional operations and it consisted of 1,81% after laparoscopic surgery. Total postoperative lethality was 24,5%. The maximal level of postoperative lethality was noted in cases of colon cancer complications and it had an ultimate rate (100%) in cases of perforation of locally advanced tumor.

The authors presents the results of application of ultrasound investigation, diagnostic laparoscopy and multi-helical computer tomography in diagnostics of acute appendicitis. The research was applied on 139 patients whom clinical diagnosis was hard to establish using clinical - laboratory criteria. Ultrasound signs of acute appendicitis were revealed in 44 patients out of 139 (31,6%). Diagnostic laparoscopy was performed in 37 (26,6%) patients. According to the results of laparoscopy, the diagnosis of acute appendicitis was сonfirmed in 22 (70,2%) cases. The application of CT allowed the authors to confirm or reject the supposed diagnosis in 90,8% patients. The authors came to conclusion that this non-invasive method facilitated to diagnostics of vermiform appendix inflammation and had a high diagnostic accuracy.

A number of patients with problems of major joints increases every year. These patients need the replacement arthroplasty. The rate of thrombotic complications rises in given category of patients simultaneously with the increase of the number of performed operations. There weren’t well-defined instructions of management of the patients with associated chronic vein diseases at the preparation period for arthroplasty performance in spite of the presence of clinical recommendations for prevention of thromboembolic complications. The authors analyzed the experience of management of such patients and presented these data for doctors from polyclinic and hospitals in order to apply the common treatment strategy.

An analysis of the terms of hospitalization, cost of treatment was made. There were matched the real medical costs of treatment of the patients with chronic posttraumatic osteomyelitis of the shoulder using the method of transosseous osteosynthesis with application of Ilizarov’s apparatus and medical costs according to the medical standards of treatment for patients with osteomyelitis. It was shown that actual expenses on drug therapy and expendable materials on one patients were approximately three times higher, than planned expenses according to standard. The presence of different microflora was revealed throughout the bacteriological research of suppurative focus in 25(96%) patients. There was detected an excess of actual expenses on one patient with given nosology compared with standard of financial expenditure from the funds for high-technology medical care from 6 % (average case) to 58% (Bassilus pynocyaneus). The excess of actual expenses from the funds of local program of obligatory medical insurance achieved from 48% (average patient) to 100% (Bassilus pynocyaneus case).

The article presents an analysis of 107 cases of simultaneous operations of big volume with main stage as gastric resections (gastrectomy) or large intestine resections and mean volume interferences as cholecystectomy and removal of abdominal hernias. It was stated, that simultaneous operations compared with two steps treatment of combined surgical diseases obtained the high economical efficacy. This efficacy was determined by a single - stage routine presurgical examination, single anesthetic management, less medical expenses for medication and laboratory - instrumental studies in postoperative period, significant shortening the terms of hospitalization and disability terms. The authors proposed formulas to evaluate the economiс efficacy of simultaneous operations in system of paid medical service and system of rendering medical aid using paid medical insurance. The efficacy of large operations was 40 766 rubles and in case of mean volume interventions - 25 382 rubles for the paid medical system. The economical efficacy of simultaneous operations of large and mean volume was the same in the system of obligatory medical insurance. It consisted of 19 737,5 or 22 920,1 rubles and depended on the degree of operative anaesthetic risk of the second intervention in two steps treatment of patients.