We studied the results treatment of acute intestinal obstruction in 156 patients. The average age 56.8±2.6 years. Among them patients of working age is 78.4 %, females - 43.0% of men - 57,0 %. The cause of acute adhesive intestinal obstruction in 58.6% of patients were adhesions in the lower floor of the abdominal cavity. The greater omentum was involved in the development of acute adhesive intestinal obstruction in 29,4 % of patients. Postoperative complica- tions were present in 12.4% of patients, of which 88 % were complications in the abdominal cavity. Failure of sutures of anastomosis occurred in 14.4% of cases and postoperative mortality was 1.4 %.

An obstacle to the use of minimally invasive video-endoscopic approaches for radical surgical operations for cardioesophageal cancer is the need of resection and lymphadenectomy in the two anatomical areas. The resolution of the problem of injuries surgical accesses actualizes the problem of optimal postoperative management of these patients. In 2015-16, we performed 27 resection of the proximal stomach and lower esophagus with one-stage intrapleural esophagogastroplasty a combined laparoscopic and right thoracoscopic access. Prevailed patients in III stage of disease - 9 14 (51,9 %) patients. In 4 cases ( 14,8%) cases were identified with stage IV. R0 resection was performed in 24 (88,9%) patients, R1 - 3 (11,1 %). Histological examination was studied on average 42±3 lymph node. The advantages of radical operations for cardioesophageal cancer a combined laparoscopic and right thoracoscopic approaches: the clarity of the visualization, good control of hemostasis, ease of mobilization of the stomach and esophagus, early activation of patients in the postoperative period (4 days), reduced length of hospital stay (7.3 days). The use of early rehabilitation after surgery technology (ERAS or “fast-track”) allows to reduce the duration of hospitalization, accelerate recovery and rehabilitation of patients.

The article is devoted to studying of pathogenetic mechanisms of skin regeneration after the implantation of the filaments based on polydioxanone.The aim of the study: analysis of the effect of fibres based on polydioxanone, on the processes of biostimulation of the dermis.Design: prospective, independent, placebo-controlled study.Materials and methods: the authors performed a prospective, independent, placebo-controlled clinical and morphological study in the period 2015-2017, in which the conditions of voluntary informed consent were included 22 patients with age associated skin changes, ranging in age from 35 to 50 years. General morphological examination was performed on hematoxylin and eosin, and used histochemical staining of biopsy specimens according to the method of van Gieson, allowing you to visualize collagen and elastic fibers of the dermis. To assess the nature of intercellular cooperation of different cell lines visualized using immunohistochemical (IHC) techniques.The results showed that the basis of morphogenetic restructuring of the skin after implantation of filaments based on polydioxanone, is the activation of repair mechanisms through the inclusion of M2-macrophages. This process is manifested by angiogenesis through stimulation of VEGF expression and reorga- nization of the vascular bed of the skin and stimulation of the private reserve of cells fibroblastic series through the activation of the stromal vascular fraction. It should be noted that in addition to activation of neocollagenogenesis leading to the restructuring of the dermis and epidermis, the introduction of threads based on polydioxanone, has a positive impact on the balance of MMP/TIMR, limiting degradation mechanisms and contributing to the accumulation matrix of the connective tissue of the dermis.Conclusion: The results of the study allow us to conclude that the filament implant with filaments based on polydioxanone having pathogenetically substanti- ated pronounced regenerative effect on the dermis.

The article presents the analysis of scientific literature on high strictures of the common bile duct and biliary-enteric anastomoses. The current classification of pathology, highlighted the main tasks which are solved by the surgeon during the operation to restore the patency of the biliary tract, it covers the issues of prevention of cholangitis, stone formation, and estensione. Reviewed operative treatment of strictures of the bile ducts, which can be divided into recon- structive surgery, reconstructive surgery and minimally invasive surgical techniques. The long-term results of surgical treatment is significantly influenced by the active form of peritonitis during the operation, the combination of bile duct damage and vascular damage, location of damage, the width of the anastomosis, the number of previous operations, and duration frame drainage. The paucity of information and divergent views do not accurately reflect the effectiveness, indica- tions, techniques, in addition virtually no long-term results and few publications on the quality of life of patients after reconstructive operations on bile ducts.

The clinical experience of 2-nd surgical department of Samara state medical university clinic of propaedeutic surgery in applying of negative pressure wound therapy in patients with type 2 diabetes and septic surgical infection of soft tissues is presented in the article. 30 patients with type 2 diabetes and pyogenic infection of soft tissues were treated with septic wounds with negative pressure and traditional methods in complex therapy after surgical focus lancing and sanitation. Objective appraisal of efficiency of local wound treatment with negative pressure usage in comparison with traditional methodic in complex treatment is assessed. Cytological, morphological and microbiological features of wound process were estimated wherein. The results of study evidence higher efficiency of local wound treatment with negative pressure usage in complex of measures in patients with type 2 diabetes.

The necessity of obtaining cytological deployed conclude, of the nature and features of adrenal tumors, allowing half of objectify planning of surgical treatment. Proposition-on method of performing fine needle biopsy of the adrenal tumors, depending on their location, size and structure with increased safety puncture access into the retroperitoneal space.

The article the choice and volume of the operative allowance in the treatment of acute cholecystitis against the background of concomitant pathol- ogy of the heart. Taking into account the age of the patients, the comorbid background, the results of cli-nical laboratory and instrumental studies, taking into account the data of ECHO-CG (the indicator of the fraction of ejection from the left ventricle) the optimal strategy must be chosen. The basis for the clinical study were 48 patients with acute cholecystitis who were on inpatient treatment between 2015 and 2017. There were -14 women, 32 men. Patients were divided into study groups, and the comparison group (II) included 24 patients with severe concomitant pathology (bronchial asthma, diabetes, chronic cerebral ischemia, obesity). The main group (I) consisted of 24 patients who had a history of myocardial infarction on a background of hypertension. In determining the tactics of treating patients (efficiency, choice of type of surgery and its volume), we took into account the degree of gallbladder damage, clinical and laboratory data, ECG and ECHO-CG results, and the presence of concomitant Disease (Charlins index). Undoubtedly, considering laparoscopic cholecystectomy as the «gold standard», one should point to a justified alternative in the form of a mini-access operation that minimizes the risk of anesthesia and provides urgent surgical care in general to such a severe group of patients.

The article presents the results of the analysis of static documentation, questionnaires of members of the Russian Society of Plastic, Reconstructive and Aesthetic Surgeons, personal files and questionnaires for students of additional professional education in the field of plastic surgery. There was an increase in the number of posts and a shortage of plastic surgeons in the public health system. Most plastic surgeons carry out professional part-time work in a private healthcare system, they have low operational activities, performing a truncated spectrum of surgical interventions, unevenness of different types of surgical interventions, bias of professional activity in primary specialization.

Analysis of data of follow up care for the period 2012-2016 showed that there was a decrease in the number of people under observation at the end of the reporting year: 2012 - 558.1‰, 2016 - 183.4‰. There was a statistical meaningful change in the proportion of patients undergoing dispensary follow-up from the number of patients with registered diseases for some classes of diseases. Patients with diseases of the eye and its adnexa moved to the third place in the structure of the dispensary group. Intensification of withdrawal from dispensary registration for all nosologies and separate classes was detected, despite a decrease in mortality and mandatory life-long observations for similar reasons.