The task of this study is to evaluate the results of surgical (traditional and laparoscopic) treatment of elderly and old patients with rectal cancer. Material and methods: the study included 121 surgical patients with rectal cancer with morphologically confirmed diagnosis and radicality of the performed operation. All patients received informed consent for the study and access to information. There were 56 males and 65 females aged 30 years to 83 years (average age 61.7±1.8 years). The main study group (older age) included 63 patients aged 60 years and older, and the comparison group (younger age) included 60 patients under the age of 59 years.Results: surgical treatment performed in 104 patients with large rectal cancer, including 56 patients of older group and 48 patients of the younger group. Surgical interventions were varied and performed using both laparoscopic techniques (54 patients) and traditional approaches (50 patients). The article presents the results of surgical treatment of patients with large rectal lesions of older age groups operated using traditional and laparoscopic surgical techniques, analyzes the causes of complications and access conversion during laparoscopic interventions. Laparoscopic operations are the method of choice in the group of elderly and old patients with large rectal lesions in the absence of local or general contraindications.Conclusion: the data presented a high efficiency and safety of surgical treatment in the group of elderly and old age patients with rectal cancer.

Aim: This case demonstrates the successful result of urgent open surgery in a patient with polysymptomatic manifestations of aortocaval fistula. Clinical observation: Patient N., 61 years old, was taken to the hospital by an ambulance team 10 days after the onset of the disease with complaints of shortness of breath, swelling of both lower extremities, pain, localized in the lumbar region. The deterioration of the condition notes in the last 2 days with the occurrence of shortness of breath at rest. Based on clinical and instrumental data, a diagnosis was established: Aortic atherosclerosis. Aneurysm of the infrarenal aorta. Complication: Spontaneous aortocaval fistula. Compression of the inferior vena cava. Secondary lymphovenous insufficiency. Operation highlights: Aneurysm has a saccular-fusiform shape, spreading to the proximal part of the common iliac arteries, measuring 150 mm in length and from 70 to 90 mm across. After systemic heparinization, the aorta and iliac arteries are pinched longitudinally, an aneurysmal sac is opened, 150 ml of red blood was evacuated from the cavity of the aneurysm to Cell-Saver. After this, an intense flow of dark blood was noted. A massive thrombotic cup was removed in the lower third. A proximal anastomosis of the InterGard Silver 18-9-9cm bifurcation prosthesis was formed with an aortic 4/0 proline thread of the end-to-end type, the prosthesis branches were placed on the hips. An anterolateral wall of the common femoral arteries was excised and anastomoses formed with 6/0 proline thread of end-to-side type. Smooth postoperative course.Conclusion: The development of the aortocaval fistula with abdominal aortic aneurysms should be considered an extremely rare complication. In turn, based on our own experience of 587 operations of similar operations performed in our clinic over the past 18 years, we first encountered the above complication of abdominal aortic aneurysms (frequency was 0.1%)

The main method of treatment of wounds is still surgical, but unfortunately, for various reasons, its use does not always allow you to completely remove all nonviable and infected tissue,restore the lost skin in diseases and injuries of various etiologies. In this case, the leading role is played by the tactics of local conservative therapy of wounds.A kind of medicinal form is hydrogel compositions, the use of which can significantly improve the effectiveness of treatment even longterm nonhealing or sluggish wounds by creating an ideal wound environment formed during granulation and epithelization. Modern technologies make it possible to solve complex clinical problems: with the help of hydrogel dressings, it is possible to influence various mechanisms of the wound process, preventing the negative impact of such factors as hypoxia, infection, delayed regeneration. Hydrogels developed recently demonstrate effective hemostatic, antibacterial characteristics, have high biocompatibility. All this makes the development of new hydrogel wound coatings promising.

In patients with localized high-risk prostate cancer, according to the recommendations of the European Association of Urology, as well as the Association of Russian Oncologists, the main treatment methods in most cases are radical prostatectomy or radiation therapy (in combination with adjuvant hormone therapy). In some patients, surgical treatment may be limited by age, risk of complications, or refusal to perform surgery. A combination of radiation therapy or brachytherapy with hormone therapy may be an alternative treatment option. These treatment options have a significant risk of developing complications such as urinary incontinence, radiation cystitis and radiation proctitis, etc. Cryoablation is an alternative treatment option in patients with high-risk prostate cancer.

The pace of modern life explains the desire of man to be slim and trim, sports and aesthetically natural body shape has already become a necessity. However, the number of patients with deformities of the anterior abdominal wall caused by sagging skin in this area, sagging abdomen, diastases of rectal abdominal muscles, presence of ventral hernia and various deforming postoperative scars that require surgical treatment continues to grow today. These changes to the anterior abdominal wall are, as usual, combined and have a single pathogenesis, covering the entire abdominal wall, mutually supporting each other, so they should be understood as a single pathological process called anatomical-functional insufficiency of the anterior abdominal wall. One in six persons of working age suffers from various manifestations of anatomical-functional failure of the anterior abdominal wall, and the most common being females. One of the reasons for the development of this process is the frequent births, which have been particularly characteristic in recent years, due to the introduction of the presidential programme to improve the level of demography in the country, physical inactivity and changes in lifestyle and nutrition.

The aim of the study was to study the predictors of the development of complications in the early and distant period after 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 by thrombospiration for a responsible heart artery infarction 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:The main predictors of complications were SYNTAX> 22, a group of patients without thrombospiration, history of diabetes mellitus and COPD, the number of affected arteries was less than 2.

Laparoscopic sleeve gastrectomy is gaining popularity every year. The sleeve gastrectomy took the leading position in Russia.The patient can return to his usual lifestyle after 48 hours after the operation with proper rehabilitation.We have formed the basic principles of postoperative rehabilitation of patients after sleeve gastrectomy for morbid obesity.Materials and Methods: 10 patients with morbid obesity were operated sleeve gastrectomy during the period from June 1 to November 2019. Patients were operated at the surgical hospital of the Ekaterininskaya Clinic.Results: All patients were discharged home in satisfactory condition. There are no postoperative complications or deaths. The length of stay of such patients in the hospital did not exceed 3 days.Discussion: There is relatively a few information in the literature about the early postoperative rehabilitation of patients after sleeve gastrectomy. The principles of Fast Track certainly need to be applied in the rehabilitation of such patients to reduce postoperative complications.Conclusion: Clinical experience of adapting Fast Track principles to patients after sleeve gastrectomy for morbid obesity was presented. It is necessary to continue the study of adapted Fast Track principles at the preoperative and postoperative stages in order to assess their effectiveness for this group of patients.

The article briefly presents the achievements of the Soviet military field surgery. The scientific and practical activity of Professor Mikhail Nikiforovich Akhutin (1898-1948) is covered. The article analyzes the combat experience of the General of the medical service and his participation in the organization of treatment of the wounded. It is noted that after the end of VMA (1920) he was left in the clinic of Professor V.A. Oppel, under whose guidance he worked for 10 years. During the fighting at lake Hassan and on the Khalkhin-Gol river M.N. Akhutin was one of the organizers and leaders of surgical care for the wounded. In 1939 he headed the Department of hospital surgery in the Kuibyshev VMA. During the Soviet-Finnish war (1939-1940) M.N. Akhutin was an army consultant surgeon. During the great Patriotic war (1941-1945) - chief surgeon of the Bryansk, and then the 2nd Baltic and 1st Ukrainian fronts. Since 1945-Deputy chief surgeon of the Soviet Army and head of the Department of faculty surgery of the 1st MMI named after I.M. Sechenov. M.N. Akhutin is the author of more than 70 scientific works, 40 of them relate to military field surgery and are devoted to the experience of surgical work in the active army, the treatment of various combat injuries (chest, main vessels, large joints), as well as issues of transport immobilization, wound infection and other important surgical problems. It is noted that he was a good lecturer, teacher and talented organizer. M.N. Akhutin made a significant contribution to the development of Soviet military field surgery.

The article presents the main scientific and practical achievements of Professor A.V. Melnikov. Little-known facts from the life of the scientist are highlighted. It is shown that A.V. Melnikov in different years worked in clinics under the leadership of outstanding professors V.N. Shevkunenko andS.P. Fedorov. In 1920 he defended his doctoral dissertation on "surgical anatomy of the costal-diaphragmatic sinus". It is noted that in 1928 he organized in Ukraine the first cancer clinic in the Soviet Union. During the great Patriotic war, he headed the work of large specialized hospitals for the wounded in the abdomen. It is emphasized that A.V. Melnikov has published more than 120 scientific works, including 11 monographs. He developed one of the methods of opening the subdiaphragmal space without damage to the pleura, which has not lost its practical significance in our days. He proposed a test for the early diagnosis of anaerobic infection of the extremities ("embedding ligature"), which entered the medical literature as the " Melnikov test»; original methods of extraperitoneal closure of tubular and lip-shaped fistulas after gunshot wounds of the abdominal cavity have been developed. A.V. Melnikov was one of the first to develop the doctrine of precancerous stomach and summarized it in the monographs "Clinic of gastric cancer" (1950) and "Clinic of precancerous diseases of the stomach" (1954). It is noted that in 1955 at the International Congress of surgeons in Denmark he made a keynote speech on liver resections.A.V. Melnikov was an honorary member of the Ukrainian society of oncologists (1956), Leningrad (1952) and Kuibyshev (1954) societies of surgeons. Alexander Vasilyevich's services to the Fatherland were highly appreciated by the government of the Soviet Union. It is noted that in different years he was awarded the orders of the red banner, the red banner of Labor, the red Star and medals