[New possibilities of surgical treatment of Clatskin tumor and extended focal hepatic affection].

Modern approaches for surgical treatment of hepatic tumors are presented. Results of hepatic resection conduction in 220 patients were analyzed. The indications are substantiated, the main diagnostic methods in hepatic tumors are suggested, and issues on surgical tactics and technique of extended resection performance are put on light. New methods of combined resection of liver and main vessels are elaborated. Their introduction has permitted to lower mortality, to raise the tumors resectability, and to enhance the patients' survival indices.

[Hepatic transplantation from living relative donor].

Modern approaches for hepatic transplantation in adults and children are enlighten. Analysis of 34 transplantation operations of hepatic part from living relative donor was conducted. Data on need for hepatic transplantation performance are adduced, indications for its conduction are determined. There are also suggested the main methods of hepatic transplantation from living relative donor, together with immunosuppression issues, and the justice and deontological problem aspects.

[Problems with infection in surgical hospital. Meeting with XXI century].

Uncontrollable application of antibiotics (AB), changing nature of microorganisms, insufficient intrahospital epidemiological control causes significant difficulties in the treatment of severe intrahospital infections. Strategy for the therapy quality improvement includes elaboration of the AB application formularies in every division, the nosocomial infections treatment protocols, restriction of certain AB application by special indications, the AB administration change in 48-72 h of its application in accordance to indications, and, if possible, change of the wide specter AB by preparations of more specific action, education of medical personnel on following prophylaxis regimen for hospital infections.

[Diagnosis and treatment of Zollinger-Ellison syndrome].

In 1970-2005 yrs. 65 patients with Zollinger-Ellison syndrome were observed and operated on in the clinic. The decisive meaning in diagnosis owes radioimmunological determination of gastrin level in the blood and its changes while conduction of tests with calcium and secretin. Surgical tactics was determined by localization, number and character of gastrinomas. During the first period of work gastrectomy with complete excision of gastrinproducing tumor constituted the operation of choice. Implementation of intraoperative method of ultrasonography have permitted to excise the benign gastrinoma when her localization was favourable with preservation of stomach. Minimal life span after gastrectomy, performed for nonresectable malignant gastrinoma, have constituted 9 years.

[Modern approaches to the problem of temporary closure of the abdominal cavity].

The literature data are adduced concerning the problem of the abdominal cavity temporary closure after performance of operative intervention in the enhanced intraabdominal pressure conditions, in particular in patients with diffuse peritonitis, extended abdominal wall defect, abdominal trauma and intestinal ischemia. Retrospective analysis of the treatment results was conducted in 35 patients with peritonitis and abdominal trauma, in whom the laparostomy method was applied in the clinic. The operations for the abdominal wall restoration or the operative wound edges approximation were performed under the intraabdominal pressure control. Application of the method of the abdominal cavity temporary closure in the treatment of severe forms of peritonitis have promoted the complications rate lowering, the treatment duration reduction and the patients quality of life improvement.

[The experience of hepatic transplantation from living relative donor in Ukraine].

Modern approaches to hepatic transplantation in adults and children are suggested. The data concerning the need in the hepatic transplantation performance are adduced, indications for it are established, there were also discussed the principal methods of hepatic transplantation from cadaver and from living relative donor, immunosuppression therapy issues, as well as the law and deontological problems.

[Main principles of antibiotic prophylaxis and antibacterial therapy in abdominal surgery].

The principles of antibioticoprophylaxis and antibacterial therapy in abdominal surgery were expounded. There are adduced the most frequently revealed pathogenic microorganisms, inducing intraabdominal infection, the ways of lowering of the antibacterial therapy expenses, new approaches to application of immunocorrection and directed transport of antibiotics in surgery as well as empirical and etiotropic treatment, basing on the taking account of the spread and antibioticosensitivity of pathogenic microorganisms of nosocomial infections. There was shown, that concentration of interleucin-1beta and tumor necrosis factor-alpha in the blood serum is connected with the severity of patient state. Significant rising of this cytokines concentration constitutes the trustworthy criterion of the ineffective therapy and mortality risk. The influence of microorganisms and some antibiotics on induction of interferons was studied. Amoxicyllin, polymixin, vancomycin, cephalosporins and fluconazol are the most active inductors of gamma-interferon. Maximal efficacy of antibacterial therapy is possible only if an adequate surgical intervention was performed.

[The experience of diagnostic and surgical treatment of Barrett's oesophagus]. / Opyt diagnostiki i khirurgicheskogo lecheniia pishchevoda Barreta.

There were analyzed five-year late results of prospective investigation on surgical treatment of 23 patients, suffering long-segment Barrett's esophagus (BE). Esophagoplasty and esophagocardioplasty was performed in 7 (30.4%) patients and total fundoplication in combination with endoscopic ablation of metaplastic epithelium--in 16 (69.6%). Excellent and good results marks in 19 (827%) of patients, including those with antireflux operation, and satisfactory--in 4 (17.3%), witnessing high efficacy of surgical treatment in the BE correction.

[Assessment of risk of thromboembolism in patients undergoing surgery]. / Otsenka riska vozniknoveniia venoznogo tromboza i émbolii u khirurgicheskikh bol'nykh.

The risk factors of venous thromboembolism (VTE) in 1146 patients who were underwent operated for the diseases of digestive organs, for obliterating atherosclerosis of abdominal aorta and peripheral arteries, diseases of bones and joints were studied. The methods of VTE prevention in these patients were studied. To evaluate the risk of VTE we designed the special chart. Three levels of risk of VTE: low, moderate and high were distinguished. The specific prophylaxis of the VTE using low molecular weight heparin fraxiparine was given to the patients moderate (90.7%) and high (93.3%) risk degree.

[Strategies in surgical treatment of ulcers at present time]. / Taktika khirurgicheskogo lecheniia iazvennoi bolezni na sovremennom étape.

Modern state of a problem concerning the ulcer disease (UD) of stomach and duodenum conservative and operative treatment was suggested. Possibilities and perspectives of medicinal therapy were evaluated critically. Indications for surgical treatment of UD were substantiated. Method of choice in duodenal UD is performance of organ preserving intervention, in gastric UD--piloro--and antrumpreserving resection.

[Stomach shunting in the surgical treatment of pathologic obesity]. / Shuntirovanie zheludka v khirurgicheskom lechenii patologicheskogo ozhireniia.

Gastric shunting (GS) constitutes one of the most effective surgical methods of treatment of morbid obesity. In USA and European countries GS constitutes standard bariatric intervention, in Ukraine these operations were not performed before. The technique of the most popular GS operations was depicted, own results of their application were presented.

[Performance of restoration surgeries in postburn stenosis of the esophagus and stomach]. / Vypolnenie vosstanovitel'nykh operatsii pri posleozhogovom stenoze pishchevoda i zheludka.

The thirty-years experience of treatment of 987 patients with postburn stenosis of the gut upper parts was summarized. Of the total amount of restorational operations performed in 431 patients there were: esophagoplasty using colon--in 313 (72.62%), small intestine--in 26 (6.04%), stomach--in 66 (15.32%), segment of colon and ileum on the vascular pedicle--in 10 (2.31%), autotransplantation of jejunal segment--in 2 (0.47%), esophagocardioplasty--in 5 (1.15%), plasty with application of local tissues--in 9 (2.09%). Total mortality had constituted 6.96%, but during last 12 years it had subsided down to 1.91% due to perfection of the operations technique performed, new procedures introduction, the anesthesiological support improvement, wide usage of prophylactic measures for possibly occurring complications.

[First experience of laparoscopic esophagocardiomyotomy for achalasia of the cardia]. / Pervyi opyt laparoskopicheskoi ézofagokardiomiotomii pri akhalazii kardii.

The first experience of extramucosal laparoscopic esophagocardiomyotomy performance in 12 patients for achalasia of cardia was summarized. There were presented main technical stages of the operation, indications, early and immediate results of its application as well.