Appendicular peritonitis is one of the most complicated purulent-inflammatory diseases in children. More than 60% emergency operations children performed at non-specialized general surgical departments. Staff are not sufficiently familiar with the peculiarities of pediatric surgery. This is the main cause of treatment-tactical and technical errors. Analysis of the data errors and determining factors of their controllability are the main reserves in terms of optimization of medical care for children with appendicular peritonitis.

The technique of computer-aided planning of surgical intervention in patients with trauma of the midface, to effectively carry out surgical procedures in the field of anatomical structures of the orbit and ethmoid labyrinth. The developed method allows to reduce the invasiveness of surgical intervention, to reduce the number of postoperative complications, shorten the rehabilitation period.

Nowadays late-onset hypogonadism in men is considered as one of the risk factors of cardiovascular diseases as well as obesity and type 2 diabetes. The pathogenetic mechanisms of testosterone metabolic effects on carbohydrate and lipid metabolism, the current data about the role of the imbalance of proinflammatory cytokines - interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα), C-reactive protein (CRP) in the pathogenesis of metabolic disorders and late-onset hypogonadism in men considered in this review.

The review analyzes a background and history of miniinvasive percutaneous hepatopancreatobiliary surgery. Some negative trends of this field are discussed. Authors describe positive perspectives of modern technologies but on the other hand they avoid to feel unreasonable euphoria of methods’ possibilities and invite to use the full experience cumulated by previous surgical generations.

Esophagectomy remains a challenging procedure both for the patient and the surgeon. Patient selection and evaluation aims at preventing individuals unfit for surgery or without chance of cure from this operation. The use of modern operative techniques and in some cases sequential strategies help reduce the operative trauma. Regional anesthaesia and an individualized concept of perioperative pain treatment, early extubation, fluid restriction, mobilisation and physiotherapeutic assistance aims at the prevention of pulmonary complications, one of the dominant threats to this patient population. Rapid recognition and aggressive diagnostic work-up of any complication, especially anastomotic leaks, in the post-operative period is essential to prevent an uncontrolled progression of pathophysiologic cascades. A close multidisciplinary cooperation of surgeons, anaesthetists, endoscopists, radiologists and other associated disciplines is essential to further reduce the perioperative morbidity and mortality in this demanding surgical procedure.

Adhesion formation in the peritoneal cavity due to surgical operating trauma may cause an infertility, abdominal pain and bowel obstruction. Nowadays the poor knowledge of the adhesion formation within abdominal cavity limits treatment methods for such patients. This review is dedicated to estimating of features of adhesion formation and implementation of methods of prevention and treatment strategy of adhesion formation during postoperative period in abdominal cavity.

Purpose: to determine effectiveness of new technologies together with the methods included in the standards of treatment of malignant astrocytic tumors, by evaluating long-term results of integrated treatment of patients with malignant astrocityc tumors.
Materials and methods: we have evaluated long-term results of treatment of 356 patients with malignant astrocytic supratentorial tumors (anaplastic astrocytomas, glioblastomas, giant cell glioblastomas, gliosarcomas). In addition to standard treatment (surgery, chemo- and radiotherapy) 37 patients had photodynamic therapy, 82 – specific antitumor immune therapy, 19 – both therapies. In 201 patients the structure of integrated treatment included only standard methods. A separate group was composed of 17 patients who had only stereotaxic biopsy as a stage of surgical treatment. Data obtained 6 months and later after surgery are referred to as long-term results.
Results: photodynamic and specific antitumor immune therapy in patients with  malignant supratentorial astrocytic tumors was safe and did not result in any adverse events increasing in comparison with control group. Better results were achieved in the group of patients who had photodynamic therapy. Photodynamic therapy application revealed to increase medium life expectancy (up to 50.79 and 47.86 months in patients with anapestic astrocitomas and glioblasomas respectively), and median survival (up to 35 months in patients with anaplastic astrocitomas and up to 30 months in patients with glioblastomas), as well as it decreases the risk of tumor recurrence. The use of photodynamic therapy together with specific antitumor immune therapy in addition to standard treatment methods did not reveal any significant advantages in comparison with photodynamic or standard treatment methods application only. Specific antitumor immune therapy based on autologous dendritic cells, also increases both medium life expectancy (anaplastic astrocytomas – 50.21 mths., glioblastomas – 23.72 mths.) and median survival (32 and 24 months respectively), when 3 courses and more are administered. 1 or 2 courses of immune therapy have no significant impact on medium life expectancy or median survival.
Summary: development and clinical practice application of photodynamic therapy and specific antitumor immune therapy based on autologous dendritic cells is a perspective trend for future investigation and study, which will allow to improve long-term results of treatment of patients.

Purpose: to improve the results of treatment of patients with replanted upper limb segments.
Materials and methods: the results of treatment of 62 patients with traumatic amputation of the forearm and fingers and necrotic complications are analysed. 30 patients (I research group) received in postoperative period lymphotropic antibiotic therapy using 1% Мethylene blue in combination with Сeftriaxone. Evaluation of the results was carried out using standard clinical and laboratory tests. Colonic forming units (CFU) assay and quantification of microorganisms per 1 g of tissue obtained from the wound were studied.
Results: Clinical study of the main group of patients showed a reduction of bacterial contamination of surgical wounds from 3,22×105±1,09×105 to 8,5×103±1,65×103 in 1 ml of the test material (p <0,001) and decrease of average hospital stay from 38,4 ± 2,98 to 32,7 ± 3,45 days (F = 1,1, p = 0.03).
Summary: use of lymphotropic antibiotic therapy in the treatment of patients after upper limb replantation allows reduce necrotic complications in 26,25% cases and treatment duration significantly.

Purpose: to improve the results of surgical treatment of giant ventral hernias using a new method of hernioplasty.
Materials and methods: 78 patients with giant hernias of anterior abdominal wall were operated on in the period from 2006 to 2013 using the new method of hernioplasty.
Results: modeling of rectus abdominis muscle using of mesh endoprosthesis allows to minimize the tension of tissues and allocation of the muscles during early and late postoperative period. The postoperative period was uneventful. There was allowed to patient to approve an activity using a bandage at 3th-4th day after surgery. Compartment-syndrome wasn’t registered.
Summary: the new method of abdominal wall repair improves blood supply of the edges of hernial defect. It allows to increase the volume of abdominal cavity and prevents of compartment syndrome after surgical treatment of giant ventral hernias.

Purpose: consideration of the timing of initiation of antibiotic therapy in the identification of pathogenic infekt, schemes and duration of treatment, the appropriateness of antibiotic therapy at very early preterm delivery.
Materials and methods: a total of 111 pregnant women in terms of 22-25 weeks of gestation with the threat of premature birth. Depending on the condition of the vagina biocenosis are divided into three groups: normotsenoz (n = 35), bacterial vaginosis (BV) (n = 40) vaginitis (n = 36). All pregnant women were examined in accordance with the order number 572n Health Ministry. A comprehensive microbiological research. All pregnant at admission was conducted therapy aimed at prolongation of pregnancy leads to: medical protective regime, diet agravatsiey protein tocolytic therapy, normalization of biocenosis of the genital tract.
Results: in pregnant women with threatened preterm birth at 22-25 weeks of gestation duration of pregnancy depend in particular on the state of the biocenosis of the genital tract. Adverse predictors of premature birth is a combination of BV with persistence of Ureaplasma urealyticum, Mycoplasma hominis and Mycoplasma genitalium in the cervical canal pregnant. Enabling correction of biocenosis of the genital tract in the complex therapy aimed at prolongation of pregnancy in women with BV and vaginitis, does not lead to a significant reduction in the incidence of preterm birth.
Summary: conducted correction of biocenosis of the genital tract, including antibacterial therapy, in terms of 22-25 weeks of gestation is not able to reduce the rate of preterm birth, as the process of infection of the membranes is already running. The development of preterm labor depends on the area of infection and membranes.

In the work are elucidates advanced approaches to local treatment of hepatic tumors. Such modalities as super-selective intra-arterial chemoembolization, cryoablation, laser and radio-frequency ablation, as well as most modern technique based on high intensity focused ultrasound (HIFU) for distant local tumor destruction are presented in a comparative format. A classification of local ablation techniques based on degree of invasiveness (factor of local tumor destruction) is proposed. The authors present through analysis of published data, describing benefits and disadvantages of all local ablation techniques, indications and contraindications, associated complications and long-term clinical outcomes.

Purpose: to improve the results of surgical treatment for diastasis of rectus abdominis muscles.
Materials and methods: there were observed 2 groups of patients: the first one - 68 patients with diastasis of rectus abdominis muscles of 1-2 degrees and the second one – 9 patients with diastasis of rectus abdominis muscles of 2-3 degrees, aged of 40-65 years who received 2 ways of correction in diastasis of rectus abdominis muscles.
Results: in the first group of patients there were observed the formation of seroma in one case and hematoma in two cases during early postoperative period. Recurrence of the disease was registered in one patient in 3 years after surgical interventions. In the second group there were no any complications and relapses during one year after operations.
Summary: the surgical treatment of diastasis of rectus abdominis muscles by restoration of white abdominal line is one of the important questions of contemporary herniology.

Purpose: to study the molecular and biochemical changes underlying the PG and immunohistochemical characteristics of accumulation of collagens I and III and elastin in the sacro-uterine and round ligaments of the uterus at PG.
Materials and methods: the examined 15 patients aged from 42 to 65 years with full and partial prolapse of the uterus and vaginal walls, which have had a hysterectomy vaginal access. The control group consisted of 15 women ranging in age from 35 to 52 years with no signs of GHGs, which have had a hysterectomy abdominal access for uterine fibroids, adenomyosis, endometrial pathology. All patients were comparable in parieto birth. In the groups evaluated the results of morphological and immunohistochemical research biopsies of the sacro-uterine and round ligaments.

Purpose: to study methods of prophylaxis of venous thromboembolism (VTE) in oncologic patients.
Materials and methods: results of treatment of 92 patients with various options of an abdominal cancer were analysed. 43 patients (I group) received low-molecular-weight heparin (LMWH) as agent of anticoagulant prevention (enoxaparin 40 mg subcutaneuosly per day for 10 days). The 2nd group was presented by 49 patients, not received anticoagulant therapy. Coagulation profiles, D-dimers and liver function tests were studied.
Results: in I group popliteal vein thrombosis was revealed in 2 (4,7%) cases. In two patients (4,7%) varicothromboflebitis was revealed. In 2nd group femoropopliteal thrombosis was diagnosed in 5 patients (10,2%) and thrombosis of superficial veins of lower extremities in 3 patients (6,1%).

Summary: it is more preferable to use LMWH for prevention of VTE. An adequate laboratory control in such patients and selection of an individual dose depends on results of APTT (activated partial thromboplastin time). Especially it concerns to patients with metastatic liver cancer and another groups of high-risk cancer patients.

Purpose: to estimate changes and dynamics of the options of circulating blood erythrocytes in artificial human adaptation to intermittent normobaric hypoxia.
Materials and methods: Sixteen healthy male volunteers aged 20-24 years were underwent to course of artificial adaptation to intermittent normobaric hypoxia (AAINH): 1,5 h daily for 30 days in the gas atmosphere with an oxygen content of 13.5%. Venous blood samples were collected before exposure (day 0), day after exposure, then after 3 and 6 months.
Results: adaptive changes of red blood cells after the course of AAINH were registered in all cases. Moderate reduction of the number of circulating erythrocytes, hematocrit and average erythrocyte volume were noticed. At the same time such parameter as hemoglobin concentration and it’s content in red blood cell was significantly higher than an average one. The long-term follow up demonstrated that the registered trends were continued.
Summary: use of AAINH accompanied with increasing oxygen capacity of circulating blood (due to the synthesis of improved oxygen capasity of red cells), while «determination» to prevent the deterioration of its rheological properties.

Purpose: to improve the results of treatment of patients with distal colon cancer, complicated by acute intestinal obstruction.
Materials and methods: 385 patients with colonic cancer complicated by acute obstruction were operated on at our clinic.Among them were 221 (57,4%) men and 164 (42,6%) women.
Results: 1 stage of colon obstruction was revealed in118 (30,6%) patients, 2 stage in 137 (35,6%), 3 stage in 87 (22,6%) and 4 stages (peritonitis) in 43 (11,2%) patients. In 355 (92.2%) patients radical or cytoreductive resections were performed, in 30 (7,8%) patients were performed colostomy. 122 (31,7%) patients were underwent combined treatment. In post-operative period 4,9% (19) patients have died. Different complications were registered in 70 (18,2%) patients.
Summary: proposed diagnostic and treatment algorithm improves the immediate results and create conditions for the combined and complex treatments.

Purpose: to estimate the risk of postoperative complications and frequency of them after radical cystectomy and to study the specific parameters of influence to survival and postoperative mortality.
Materials and methods: 311 patients with urinary bladder cancer were underwent RCE, bilateral pelvic lymphadenectomy and urinary diversion’s various methods.
Results: there are various complications after RCE accompanyed with different methods of urinary diversion were registered in 82.0% of patients with bladder cancer. In 18.0% of patients with bladder cancer who underwent RCE there were no observed any complications. During an early follow-up period the average frequency of complications associated with the urine reservoir was not exceed than 6.75 per 100 patients, whereas in the later period of observation it increased to 11 times and reached 71.93 per 100 patients.
Summary: Orthotopic methods of derivation were performed in 47,0% of patients with bladder cancer and external methods were used in 37,6%. Among patients with external and especially internal forms of derivation the worst survival rates and high rates of various kinds of complications were registered.

Purpose: to estimate the primary patency rate and clinical improvement in patients with atherosclerotic lesions of superficial femoral artery (SFA) after it’s angioplasty and stenting.
Materials and methods: 114 patients in an age of 40-86 yo with occlusive-stenotic lesions of the SFA were operated on using endovascular angioplasty with stenting. All patients were evaluated clinically and using duplex ultrasound; in some cases CT-scanning and angiography were also selected.
Results: at the 30-months follow-up period were estimated. Acute technical success was achieved in all patients. Restenosis occurred in 15 (13,1%) and reocclusion in 9 (7,9%) lesions at 6 months. At 30 months restenosis was revealed in 24 (21%) and reocclusion in 25 (21,9%). These complications demand restenting in 5 (4,4%) with restenosis, in 8 (7,1%) - femoropopliteal open bypass and in 12 (10,5%) - amputation.
Summary: the primary patency of SFA after 30-months follow-up period was revealed in 57,1% patients.

Purpose: to improve results of treatment of patients with pilonidal sinus by developing and implementing of some modifications of operations
Matherials and methods: 267 patients with different clinical forms of pilonidal sinus were underwent surgical treatment. A new treatment strategy and some modification of operations are studied.
Results and Summary: it’s necessary to identify risk groups of excessive (pathological) scarring and administer antiscarring treatment among the patients with pilonidal sinus. It is shown that such a treatment strategy has significantly improved the patients outcome with pilonidal sinus: the number of relapses reduced from 8,1% to 2,4%;discomfort phenomenon as a result of rough scar deformation in the sacrococcygeal region from 21,8% to 7,3%; number of patients with persistent recovery increased from 91,9% to 95,3%;time of hospital cure reduced in the main group in average:a stage without inflammation on 1,7 b/d(bad day), in remission stage – 2,1 b/d; in the stage of chronic inflammation – 2,6 b/d.

Purpose: to improve results of treatment of patients with postoperative ventral hernias using of different methods of abdominal wall repair, to study patients’ quality of life in postoperative period.
Materials and Methods: the study presented results of treatment of 288 patients with postoperative ventral hernias. Based on the treatment type all patients divided on 2 groups. 144 patients (50,0%) (first group) were operated on using traditional surgical methods of abdominal wall repair (Meyo, Sapejko, Yanov). In surgical treatment of another 144 (50,0%) patients (Second group) were used tension-free surgical technics of hernioplasty (by methods of «оn lay», «sub lay», «in lay») as well as traditional methods of repair depending on individual features of patients. Basic clinical data, laboratory investigations, diagnostic of external phenotypical signs of the syndrome of connective tissue dysplasia, monitoring of intraabdominal pressure in dynamic were studied. Indicators of patients quality of life in both groups were searched.
Results and summary: created complex of tactical and treatment measures lead to decrease frequency of early postoperative complications in 2,4 times , recurrence of diseases in 8,5 times, mortality – in 3 times.

Purpose: to study a surgical anatomy of posterior wall of inguinal canal in lipomas of spermatic cord (round ligament of uterus).
Materials and Methods: surgical anatomy of the posterior wall of inguinal canal was studied in 164 fresh cadavers after sudden death of persons due to diseases not connected with abdominal trauma. The height and length of inguinal gap and deep inguinal ring and length of inguinal canal were measured. The location of deep inguinal ring relatively to the edge of abdominal internal oblique muscle using original authors’ method was studied..
Results: lipomas of spermatic cord and round ligament of uterus have a dual nature background. In some cases lipomas arise primarily as a result of weakness of posterior wall of an inguinal canal, influencing progression of pathological changes of tissues and inguinal hernia’s formation. In other cases lipomas appear after inguinal hernia’s formation. A fatty degeneration of lower edge of abdominal internal oblique muscle in cases of inguinal hernias marks frequently, following by disturbance of valve mechanism of inguinal canal.
Summary: Verification of spermatic cord lipoma demands its’ surgical removal.

Purpose: to estimate an influence of the collagen biopolymer («collost») to tissues of a living organism in experimental study.
Materials and methods: laboratory rats divided in two comparable experimental groups were underwent to implantation of collost plate thickness of 1.5 mm and 4 mm (the third group was control). Proliferative and secretory activity of fibroblasts were studied at 10 day, 3 and 6 months of postimplantation period by immuno-histochemical method. Process of neovascularization in the area of implantation using a quantitative method of calculating the length of capillaries per unit volume of the granulation tissue, including on a background of artificial immune were studied also.
Results: better proliferative and secretory activity of fibroblasts and angiogenesis activity were revealed in the group of implanted 4 mm-collagen plates.
Summary: the experimental results allow the use of the collagen plate in the surgical treatment of postradiation urogenital fistulas.

Purpose: To study pathologic processes of the venous wall, prior to the appearance of it’s irreversible changes for prevention of venous diseases and improve results of treatment of patients with varicose veins of lower extremities.
Materials and Methods: Conditions of endothelium was studied in 92 patients with varicose veins of lower extremities by determining the level of markers of endothelial dysfunction: P-selectin, E-selectin, tissue plasminogen activator, endothelin-1, adhesion molecules vascular endothelial type 1 (sVCAM-1), circulating endothelial cells.
Results and Summary: the severity of examined markers can be an indication of the activity of varicose processes of transformation veins. Patients with varicose veins of lower extremities in postoperative and long-term follow-up are advisable to determine commissions, VCAM-1, P - and E-selectins, t-PA and endothelin-1 in order to perform diagnostics of the functional state of the endothelium, inflammatory processes in varicose veins. Indicators of endothelial dysfunction prospectively also be used to monitor the effectiveness of conservative treatment of chronic venous insufficiency.

Purpose: to study the results of coronary artery bypass grafting (CABG) in patients with ischemic heart disease.
Material and methods: the results of 622 patients with ischemic heart disease from the surgical ward were analyzed. Patients were divided into groups according to the level and character of surgical risk. Hospital mortality rate, frequency of perioperative complications and a range of time indices were taken into consideration.
Results: the postoperative period went smoothly in patients with low surgical risk, regardless of the method used in performing the operation. On-pump coronary artery bypass grafting beating heart in patients with postinfarction myocardial disability resulted in a decline in the frequency of perioperative complications. Collected data points to an obvious advantage of off-pump coronary bypass grafting in patients with severe comorbidity.
Summary: no method of coronary bypass grafting has an absolute advantage over the others. Each of them should be taken into consideration as the optimal variant of operation only after evaluating all clinical and diagnostic indicators.

Purpose: to evaluate different methods of surgical treatment of liver echinococcosis. Hydatid disease of the liver is one of important problems of surgical hepatology. It’s represents a serious social and economic problem at many countries. The relevancy of the problem is due to the ever-increasing incidence of echinococcosis in Russia, the lack of consensus of experts on key issues relating to the diagnosis, strategy and tactics of treatment, relapse prevention of infestation.
Materials and Methods: results of surgical treatment of 123 patients with liver hydatidosis are analyzed.
Results: an analysis of the results of treatment showed that the operation of choice is open echinococcectomy with obliteration of residual cavity.
Summary: use of this technique reduces the surgical trauma, provides blood loss during intervention and after it and allows to eliminate blood products. Parameters of postoperative period in this group of patients were better than in patients after cystopericystectomy and liver resection.

Purpose: to study the levels of lactoferrin (LF) and macroglobulin (MG) in the serum of patients with acute pancreatitis depending on the severity of inflammation and prediction of disease outcome.
Materials and methods: 93 patients were observed with various forms of acute pancreatitis in the serum of them in the dynamics by radial immunodiffusion method there were investigated the concentration of MG and ELISA - the level of LF.
Results: there was an increase in the level of WBF patients depending on various forms of acute pancreatitis and severity of inflammation and clear tendency to decrease with increasing level of MG severity in pancreatitis DIF sequence, SP, IP.
Summary: In patients with acute pancreatitis there was a high concentration and low level of LF - MG which may indicate serious destructive processes in the pancreas. Following the treatment the level of LF decreases and MG - rises to normal which is an important diagnostic criterion for assessing the severity of the inflammatory process and the effectiveness of treatment for this disease. Considering these, indexes of LF and MG can be included into the standard of diagnostics and monitoring of treatment in various forms of acute pancreatitis.