The aim of the research: To study the incidence of erosive lesions of the gastric mucosa in patients with cardiovascular diseases receiving ASA drugs and under the supervision of outpatient physicians. Material and methods: The analysis of outpatient cards of 2215 patients of the city polyclinic Moscow, who underwent an endoscopic examination of the upper gastrointestinal organs and treatment from August 2017, was performed until April 2018. All patients underwent esophagogastroduodenoscopy using Olympus GIF-Q150 and Olympus GIF-XQ30. The results of the study: The study shows that the number of patients with erosive lesions of the mucosa of ARV and receiving ASA drugs is several times greater than patients with erosive lesions of the mucosa of the non-taking ASA. These results confirm the effect of the disaggregant therapy of cardiovascular diseases on the occurrence of erosive lesions. Conclusion: More than 25% of patients with cardiovascular diseases who are prescribed therapy for the underlying disease have erosive lesions of the gastric mucosa. These patients simultaneously need a preventive intake of drugs that protect the mucous membrane.

The aim of the research. Assess postoperative pain, pain medication intake, and side effects resulting from the use of kinesiotape daily, up to discharge from hospital Materials and methods. In our study, thirty-nine patients participated (mean age was 51 years) who underwent hernia repair. We evaluated postoperative pain, pain medication consumption, as well as side effects resulting from using the tape daily until discharge from the hospital. Results. All patients after hernioplasty, which were glued kinesioteypy decrease pain in the early postoperative period, in contrast to patients from the comparison group. No side effects from using tape were observed. Conclusion. The use of Kinesio® after hernia repair is an inexpensive, non-pharmacological, cost-effective and promising method to reduce postoperative pain, reduces the consumption of painkillers and, consequently, the potential adverse effects of analgesics.

The article presents the author’s work on the implementation of stapleless band-separated creation of a gastric pouch with hand-sewn gastrojejunostomy and enteroenterostomy. The original technique is described in comparison with the standard Roux-en-Y stapled gastric bypass for morbid obesity patients.As a result of the study, it was revealed that the surgical technique for performing stapleless band-separated creation of a gastric pouch with hand-sewn gastrojejunostomy and enteroenterostomy is laborious, longer than with standard stapling technique of gastric bypass surgery.Indicators of weight loss were no differences of statistical significance in both groups.

Objective: To evaluate effectiveness of our designed method of cardiac injury prevention during hiatal hernia mesh repair. Methods: We performed hiatal hernia repair in 317 patients and hiatal hernia mesh repair in 41 patients with large hernia size and weak of hiatal tissues. We used sutures in 15 patients, straight tackers in 2 patients, flexible tackers with absorbable tacks in 14 patients and combination of straight tackers and sutures in 9 patients. Results: Several techniques were developed to prevent cardiac injury. Reccurence of hiatal hernia was detected in 3 patients with large paraesophageal her- nia and in 5 patients with mixed type hernia after mesh-free hiatoplasty. No recurrence after mesh hiatoplasty was detected. Conclusions: The optimal is using flexible tackers and absorbable tacks. Mesh should be fixed except left upper part of hiatus (from 12:00 to 16:00). Tacks should be inserted near the edge of mesh aperture from pericardium to esophagus perpendicular to crura. Cruroraphia is advisable when possible. Further studies needed to evaluate the outcome-related significance of this techniques.

In addition to the usual complications of peptic ulcer like bleeding, perforation, stenosis, and their combinations, hepatoduodenal ligament can be involved in the ulcerative process in some cases of postbulbar ulcer with formation of the choledochoduodenal fistula. The authors provide the case report of successful surgical treatment of a patient with a post-bulbar duodenal ulcer complicated by subcompensated stenosis and penetration into the hepatoduodenal ligament with the formation of choledochoduodenal fistula without dilatation of the common bile duct and mechanical jaundice. The presence of a fistula between the duodenum and hepaticocholedochus was detected by X-ray of the stomach with use of barium sulfate. Combined vagotomy with transverse duodenoplasty, cholecystectomy, and the drainage from the T-tube was chosen as the method of surgery in this case. The authors emphasize the importance of a comprehensive clinical examination of patients suffering from peptic ulcer for a long time due to the possible development of complications from nearby organs, in particular, penetration into the hepatoduodenal ligament with the formation of choledochoduodenal fistula. In the absence of biliary hypertension and extrapapillary localization of scar-ulcerative changes in the duodenum, it is possible to use organ-sparing surgery with vagotomy, cholecystectomy and temporary external drainage of the common bile duct.

Objective: a pilot project for the comprehensive correction of motor-evacuation disorders in the postoperative period in patients with common forms of secondary peritonitis using transcutaneous resonant electrostimulation. Materials and methods: The treatment outcomes of 125 patients with common forms of secondary peritonitis for the period 2015-2018 have been analyzed. Gender distribution with a predominance of the male sex (2.7: 1), the average age is 35.5 ± 2.02 years. The 2nd study groups were formed based on blind distribution: group 1 (n-67; management of the postoperative period using resonance stimulation in complex treatment) and group 2 (n-58; postoperative management of patients strictly according to regulatory documentation). The groups were fully representative by sex, age, volume of operation, as well as the initial severity of the condition according to APACHe II (p≥0.05). Pre-operatively and in the postoperative period, on the 1st, 3rd, 5th and 7th days,intra-abdominal pressure manometry (IAP) was performed transvesically according to the generally accepted method. All patients were monitored for peristaltic activity on the “selective gastrointestinal polygraph” on the 1st, 3rd, 5th and 7th, in group 1 the following ReS was performed (patents of the Russian Federation 2648819 and 2655788).Results: In the postoperative period, the initial peristaltic activity had low oscillation values. Against the background of resonance stimulation in group 1, a faster recovery period of the motor-evacuation function of the intestine was noted, an increase in oscillations in all departments, which differed qualitatively and quantitatively from the identical parameters of group 2 (p≤0.05). By the 5th day of treatment, the complete recovery of the motor-evacuation function of the digestive tract was observed: in group 1 in 63 (96.9%), in group 2 in 48 patients (82.7%; p≤0.05). There was a significant dissociation of IHD in favor of the 1st group: on the 3rd, 5th and 7th day of treatment (p≤0.05). The analysis of “large” complications revealed in total in 10 patients (17.2%) the need to perform re-operations in group 2 (p≤0.05): 6 cases of perforations of acute ulcers of the small intestine, 4 cases of dynamic ileus, resistant to therapy. In group 1, a laparotomy was performed in 1 patient. The duration of inpatient treatment in group 2 was significantly higher (10.3 ± 0.8 days) than in group 1 (7.4 ± 0.7 days; p≤0.05). Conclusion: Based on the data obtained, the introduction of resonant electrostimulation for the prevention of motor-evacuation disorders in the postoperative period in patients with common forms of secondary peritonitis helps accelerate the recovery of intestinal motility, normalize the physiological passage of chyme, reduce IAP and thus minimize the risk of multiple organ failure.

Current epidemiological data indicate that the prevalence of obesity is increasing everywhere. Obesity contributes to the development of many complications of pregnancy and childbirth. Recently, therapy of the obesity has undergone many changes, new treatment principles are being developed. However, today there is no systematic approach to this problem and algorithms for diagnosing and treating women with this disease have not been developed yet, and therefore the effectiveness of therapy remains low.

Rectovaginal fistulas are the most popular complications of radiation therapy for the underlying disease (cancer of the female genital organs). Purpose of research: to analyze modern methods of treating radiovascular rectovaginal fistulas, to evaluate their effectiveness. Material and methods: the object of the study is the patient and radiation rectovaginal fistulas that have emerged as complications of radiation therapy for the underlying disease (cancer of the female genital organs). Methods used: analysis of literary sources, publications, review of used treatment methods, analysis of statistical data, analysis of history and results of treatment, generalization, systematization, classification of literature data. Results: the main method for treating PBC is a surgical method. For complex rectovaginal fistulas (which include radiation fistulas), fistuloplasty, various types of fistula repair using skin grafts, and microinjections of autologous adipose tissue are used. Often, prior training in the form of a colostomy is required. Conclution: despite the fact that more than 100 methods of surgical intervention for rectovaginal fistulas have been developed, a single approach to the selection of the optimal method of operations has not yet been developed. Treatment is still accompanied by a large number of recurrences of the disease, numerous complications. Therefore, the search for new effective treatments for PBC still does not lose its relevance.