Increase in abundance incidence of an urolithiasis led to the fact that patients with this pathology make 30-40% of patients with urological pathology. Still remains the main method of treatment quick, and the most terrible complication in the postoperative period is bleeding.Research objective was to develop a way of the forecast of development of hemorrhagic postoperative complications in patients with an urolithiasis. Materials and methods: The basis of development of the offered way was formed by results of a research of 574 patients operated concerning an urolithiasis, who were on treatment in JSC DorozhnayaKlinicheskayaBolnitsa at the station Krasnoyarsk during the period from 2015 to 2017.Results: The risk of development of hemorrhagic complications at an urolithiasis increases in the postoperative period in the presence of large stones with high density and also decrease in quantity of thrombocytes and to lengthening of AChTV, PV and TV and emergence of a hematuria. The original way was approved in clinical practice: accuracy was 96.5%, sensitivity 92.3%, specificity 97.1%, a prognostic significance positive result 91.2%, a prognostic significance of the negative result 94.8%.Conclusion: Prediction of hemorrhagic complications at patients with an urolithiasis will allow to define treatment tactics in the preoperative period.

The experience of performing 7 total extraperitoneal hernioplasty under epidural anesthesia is presented. There are no intraoperative complications, the postoperative period was smooth, there were no recurrences during follow-up. The duration of hospitalization was 3.3±1.2 days. Given our findings, we can assume that the total extraperitoneal plastic combined with epidural anesthesia can be an alternative operation of Lichenstein.

Aim of the study was a comparative assessment of the main echocardiographic parameters after various types of surgical treatment performed for ischemic heart disease.Methods: The results of surgical treatment of 40 patients with moderate to moderate ischemic disease with the left ventricular ejection fraction less than or equal to 40% are analyzed. Men were 35, women-5. The average age of patients is 55.6 ± 6.8 years. 20 patients underwent isolated coronary bypass surgery in combination with mitral valve plasty (PMK-1st group) and 20 patients - only isolated coronary bypass surgery (KSh-2 group). All patients underwent echocardiography with color Doppler mapping before surgery, before discharge, after 12 months. The average periods of control examinations were 18.6± 3.2 and 325.1 ± 61.3 days after surgery, respectively. echocardiography parameters were evaluated according to the recommendation of the American Association of echocardiography.Results: In ischemic cardiomyopathy, transesophageal echocardiography is a highly sensitive and highly specific diagnostic method. echocardiographic signs of ischemic mitral insufficiency include such criteria as: preservation of the structures of the mitral valve cusps, expansion of the fibrous ring, restrictive position of the valves relative to the fibrous ring manifested in the form of changes in the depth of coaptation of the valves, lengthening the distance of the mitral valve tension and the presence of mitral regurgitation .Conclusions: In patients with coronary heart disease, transshepatic echocardiography performed in the long-term period after CABG operations in combination with mitral valve surgery is more favorable than after CCP operations.

Calf augmentation is a quite popular surgery in Russia. However, there is insufficient data on complications after the implants’ installation, its analysis is missing, and methods for correction and prevention of complications are not developed.The author has the experience of 53 re-surgeries after calf plasty with implants. The incorrect selection of implants was the cause of correction in 36 patients, the surgeon’s errors in their installation in 7, the implant displacement in 4, and its contouring in 6 women. The analysis of each group of complications was performed.The author considers the installation of implants under the medial head of the gastrocnemius muscle as the method of choice for secondary surgery, which prevents implant displacement and isolates it from the previously formed cavity. The result of the correction directly depends on the proper selection of implants. The author recommends using his own method of implant selection, considering the length of the gastrocnemius muscle and the harmony of the leg contour. Sufficient knowledge of the anatomy of the lower leg is necessary to eliminate technical errors.Implant visualization after calf augmentation for aesthetic reasons was observed in 26 out of 561 cases, and in 3 of those cases an implant replacement surgery was required. To a large extent, contouring of the implant is observed due to its design. The advantage of custom-made implants of improved shape is shown.

Purpose: To assess effectiveness of intravenous laser blood irradiation (ILBI) with laser light wavelength 405 nm in the complex treatment of elderly patients with acute cholecystitis.Materials and methods: The researchers studied results of examination and treatment of 48 patients with acute cholecystitis aged 65-88 for who cholecystectomy was not indicated due to severe concomitant diseases or when patients refused of surgery. All patients had percutaneous transhepatic gallbladder drainage under ultrasound control. Depending on the subsequent treatment, patients were divided into two groups. In the control group, 28 patients had complex medicamentous treatment, and in the studied group 20 patients had also medicamentous treatment which was added with ILBI (laser light wavelength - 405 nm).Results: ILBI added to the complex medicamentous therapy after percutaneous transhepatic drainage of the gallbladder in elderly patients with acute cholecystitis shortens terms of regression of local inflammatory changes, normalizes intoxication indexes, lipid peroxidation indexes as well as antioxidant protection; it also reduces length of hospitalization.

Objectives: To improve the immediate results of treatment of patients with pancreatic pseudocysts.Materials and methods: The article presents the results of treatment of 15 patients with pseudocyst pancreas, 4 of them patients were operated on. The age of patients was from 30 to 70 years. The average hospital stay was 14 bunk days.Results: Acute pancreatitis is a severe pathology and causes great interest in abdominal surgery. The cause of pancreatic pseudocyst is a previous acute pancreatitis due to alcohol abuse and an alimentary factor. Diagnosis is difficult to diagnose during the initial examination. Upon admission, a preliminary diagnosis of acute pancreatitis was made, and during the examination, the clinical diagnosis of pancreatic pseudocyst was established. The treatment was started with conservative measures - starvation, epigastric hypothermia, infusion therapy, except for patients with peritonitis as a result of perforation of the pseudocyst into the abdominal cavity. If you suspect suppuration, antibacterial drugs are prescribed. In parallel, conducted diagnostic activities. They included, along with standard laboratory tests and ultrasound of the abdominal organs, FGDS, CT and / or MRI with intravenous contrast enhancement.Conclusion: Conservative treatment was successfully carried out in 11 of 15 patients, as a result of which the pain syndrome regressed, clinical and biochemical blood tests were normalized.

Today, laparoscopic interventions on the abdominal organs cover an increasing range of application in both planned and emergency surgery. The case-study presents a clinical observation of the successful application of laparoscopic technology in a 59-year-old patient with a giant neuroendocrine tumor of the pancreas, admitted to hospital for emergency reasons with acute diagnosis of acute pancreatitis. Abdominal mass formation. According to the patient, she was not previously examined on an outpatient basis, was not observed by specialized specialists. In connection with the increase in pain and the lack of positive dynamics on the background of the ongoing conservative treatment after a full examination, the patient is served in the operating room for diagnostic laparoscopy, in which the picture of cystic neoplasm of the pancreatic tail. Performed laparoscopically assisted corporal coronary resection of the pancreas, drainage of the abdominal cavity.The histological conclusion: the wall of the cyst adjacent to the pancreatic tissue is represented by the growth of endocrine large cell carcinoma. The wall of the second cyst is represented by fibrous tissue with foci of hemorrhage and diffuse lymphocytic infiltration.Diagnosis of neuroendocrine tumors is based on the identification of a clinical picture due to hormonal dysfunctions; however, in patients with non-functioning neuroendocrine tumors, it is a difficult task to identify or suspect such a disease. The modern development of laparoscopic surgery after the period of mastering almost all types of surgical interventions has not exhausted its potential and requires improvement in new sections of surgery, including interventions on the pancreas in a first-aid hospital.

Fistula in ano is one of the most common diseases in coloproctology, but the pathogenesis of fistula in patients with Crohn’s disease is different. Surgical treatment of perianal Crohn’s disease is carried out according to the same rules as in case of crypto-glandular rectal fistula, however, the results of treatment remain disappointing. Unlike other methods, VAAFT is the most safe and minimally invasive procedure that allows you to accurately visualize the fistulous primary and secondarytract, branches and flows, while not leading to such a serious complication as anal incontinence. This crown is relevant, due to the lack of large randomized studies, with the help of which it was possible to obtain long-term and qualitative results.This technique is relevant, in the absence of large randomized trials in which it was possible to get a long-term and high-quality results.

Today, the treatment of inflammatory diseases of periodontal tissues, their prevention and prediction remains an urgent problem of modern dentistry. Of particular importance is this problem in young people.In recent years, the main etiological factors of localized inflammatory periodontal diseases have been identified.Separate pathogenetic links of these diseases development are studied. However, the increase in the prevalence of localized inflammatory periodontal diseases among the population and mainly the young age of patients indicates that the existing methods of their prediction and prevention are imperfect, and the methods of treatment are not effective enough. In this regard, the development of available criteria for their prediction at a young age is an urgent and insufficiently studied issue.

Incontinence of intestinal contents is a serious disease that leads to disability of the patient, excluding him from active work and social life, puts him in a complex relationship with others, reduces the level of social activity. In the adult population, it can occur against the background of closure of defects in patients undergoing rectal extirpation and removal of the obturator apparatus, in patients with injuries and injuries of the rectum. In children, anorectal malformations can be the cause of this disease. Currently, there are many methods to eliminate fecal incontinence.

The main milestones of life and S.R. Mirotvortsev’s creativity are given in article. The little-known facts from the biography of professor are noted. Rewarding with two gold medals for student’s works is analyzed: «Vessels and nerves of sinews of foot of the person» (in common with the studentV.P. Vorobyov) and «Dislocations of bones of a wrist». It is noted that during the Russian-Japanese war spent 11 months in the besieged Port Arthur and remained with the wounded who were taken prisoner to Japanese there. From 1905 to 1914 worked in VMA at first under the leadership of professorS.P. Fedorov, then the assistant for professor V.A. Oppel. It is shown that since 1914 until the end of life worked in Saratov, occupying department of the general surgery, and since 1920 - faculty surgical clinic. From 1922 to 1928 the rector of the Saratov university. In the period of the Great Patriotic War was the chief surgeon of Saratov and the Saratov region. S.R. Mirotvortsev published about 150 scientific works on questions of clinical and field surgery. In work it is analyzed that he in 1908 offered original operation of change of ureters in a rectum, having defended the doctoral dissertation (1909) on this subject. It is noted that the broad popularity was gained by its researches about malignant new growths, in particular sarcomas of tubular bones. It developed methods of unilateral switching off of a large intestine, plasticity of a firm meninx the sealing gland, processing’s of burn wounds potassium permanganate solution. S.R. Mirotvortsev suggested to use haemo static properties of a catgut for a local stop of bleedings from parenchymatous bodies and sine of a firm meninx. From numerous works on field surgery detailed statistical development of 180 thousand cases of a gunshot wound is especially valuable during World War I of 1914-1918. It is noted that the department of faculty surgery of the Saratov medical institute and the street in Saratov is called by the name of S.R. Mirotvortsev. It is awarded with awards of the Labour Red Banner, the Red Star and medals.