The formation of an incisional hernia remains the most common complication in abdominal surgery. It is known that a number of preoperative risk factors contribute to an increase in the number of complications after surgical treatment. The most significant risk factors affecting the development of complications: age, obesity, diabetes, oncology, smoking. Quantifying individual risk factors and their combination can help surgeons reduce complications in the postoperative period, and thus improve treatment outcomes for patients with giant postoperative ventral hernias.In our work, we evaluated the impact of these risk factors on the development of complications in patients with incisional hernia who underwent separation surgery.

Background. Spontaneous rupture of the esophagus (Burhave syndrome) is a rare pathology and emergency condition for the patient. With the diversity of the clinical view, this pathology is usually diagnosed out of time, over 24 hours, and therefore the postoperative mortality remains high. The group of authors provides a clinical case: patient, 60 years old, on the 6th day of the disease falls into the clinic, where a spontaneous rupture of the esophagus is diagnosed. Given the severe physical status of the patient, as well as the size and location of the perforation hole, it was decided to go for a laparoscopic surgery. Sanitation and drainage of the mediastinum, suturing of the perforation hole were performed. After the operation, а positive response to treatment was observed. In the postoperative period, right-sided pneumonia was diagnosed, which required a change in the antibacterial drug. The patient was discharged in satisfactory condition on day 29. A group of authors believes that a minimally invasive approach to the treatment of spontaneous esophageal rupture is the alternative method for patients with severe somatic status and a small perforated opening of the esophagus.

Aim. Of the study was to study the complications in patients with thrombosis of a heart attack-responsible artery of various sizes three six and twelve months after the endovascular treatment.Materials and methods. The study included 270 patients (216 men, 54 women) with acute coronary syndrome. Depending on the treatment, patients are divided into three groups. In group 1 (n = 110) - with emergency percutaneous intervention supplemented with thrombospiration for a responsible heart attack without thrombolytic therapy; Group 2 (n = 70) - with emergency emergency transdermal intervention supplemented with thrombospiration on a heart attack artery with prehospital thrombolytic therapy; group 3 (n = 90) - with emergency percutaneous intervention on a heart attack artery, without thrombolytic therapy and without thrombaspiration .Results. Based on the results of the risk analysis of the Complications target, we can conclude that the three key statistically significant factors for the development of the Complications risk are LVEF,% <0.5, Group (Without TA (PCI)) and Type interventions (Without TA (PCI)) ”with absolute risk levels of “ Complications ”of more than 30.0%. The presence of one of three key factors increases the risk of Complications by more than 7 times

The development of varicocele causes a decrease in the reproductive potential of men. Varicocele, fertility and paternity are terms that are often used in the general topic of the clinical and pathological conditions of infertility, while not having a direct connection with each other. The presence of varicocele in boys, adolescents and adults can be a variant of the norm and not affect paternity? Regarding the relationship between varicocele and fertility, we identify several problems: temperature, volume and growth of the testicle, as well as the number of spermatozoa. An important role in confirming this connection is indicated to us by the improvement of sperm parameters after completed varicocelectomy. However, a boy, teenager, or man with varicocele has a chance of fatherhood without performing a surgical treatment. This article presents observational data and research on the choice of active observation or surgical treatment of patients with varicocele.

The article describes complex clinical cases that may occur in the practice of an otosurgeon. The difficulty lies in the fact that there is no clear algorithm of surgical approach, operating procedures in a given situation. Undoubtedly, the difficult cases in otosurgery may include the common temporal bone paragangliomas with the damage of the vital structures of the lateral skull base.

Ascending aortic aneurysms are serious diseases of the cardiovascular system with an unfavorable prognosis in their "natural" course and the absence of adequate surgical treatment. Isolated aneurysms of the ascending aorta are quite rare, for the most part, they are combined with pathology of the valvular apparatus of the heart, more often with pathology of the aortic valve. If with ascending aortic aneurysm and aortic valve defect, most cardiac surgeons have no doubts about their prosthetics with a valve-containing conduit according to the Bentall - De Bono method or separate prosthetics of the aortic valve and the ascending aorta, then with borderline aortic ectasia up to 5 cm, there are still numerous discussions about the method of surgical treatment. The question of indications for surgical treatment in patients with the size of the root and ascending aorta up to 5 cm is not sufficiently covered in the modern literature and requires further study.

The aim of this study was to clarify the efficacy of the ERAS protocol for gastric cancer surgery.We provided a systematic review of randomized controlled trials and retrospective cohort studies involving either enhanced recovery after surgery (ERAS) or fast track surgery (FTS) for patients after gastrectomy for cancer. EMBASE, Pubmed, Cochrane were searched. Primary outcomes were early postoperative morbidity, mortality and length of hospital stay. Inclusion criteria were: studies published from 2010 to 2019, in English, at least 60 patients enrolled, with a detailed protocol of enhanced recovery. Secondary outcomes: early postoperative results (pain scale, mobilization, first defecation, soft food taken) and cost. 10 trials were eligible for review. Compared with conventional care group, ERAS led to decreased incidence of overall complications and didn't influence the leakage rate. ERAS implementation resulted in rapid postoperative recovery of gastric cancer patients after gastrectomy. It was associated with less pain, early defecation, early start of soft food intake. The readmission rate was comparable to conventional care group. Also, ERAS showed economical benefits because of decreasing the length of hospital stay, decreased cost of treatment and same readmission rate. Conclusion: Our systematic literature review showed that ERAS programs are safe and feasible for gastric cancer patient after gastrectomy. Future prospective randomized clinical trials are necessary to detect the role of ERAS programs in European gastric cancer patients, elderly and «high risk» patients.