[Laser technologies in treatment of posttraumatic rectal fistulas]. / Lechenie bol'nykh posttravmaticheskimi svishchami priamoi kishki s ispol'zovaniem lazernykh tekhnologii.

AIM: To assess the results of surgical treatment of posttraumatic rectal fistulas using current laser technology. MATERIAL AND METHODS: Surgical treatment of 134 (10.9%) patients with posttraumatic rectal fistulas was analyzed. The control group of conventional treatment included 58 (43.3±3.4%) patients, the main group - 76 (56.7±3.4%) patients. In the main group we used carbon dioxide laser device 'Lancet-2' (Russia) with a wavelength of 10.6 microns, capacity up to 20 W, and contact laser device 'Atkus-15' (Russia) with a wavelength of 0.81 microns and output power up to 15W. In postoperative period all patients underwent daily infrared laser irradiation of wound surface with an exposure of 5-10 min, wavelength of 0.635±0.005 microns, output power 25 mW ('UZOR-3 KS' (Russia, Kaluga)). RESULTS: The complex surgical treatment with modern laser technologies have reduced the incidence of complications from 19.0±5.1% to 7.9±3.1% (OR=0.37; 95% CI; 0.13-1.06, p<0.05). The long-term results improved in 50.0±13.4% of the control group and in 77.8±6.9% of the main group (χ2=5.22; p<0.05). CONCLUSION: Thus, laser technology has reduced twice the number of postoperative complications and improved long-ter. RESULTS: 98.2% of patients achieved medical and social rehabilitation in main group and 96.4% of patients in control group.

[New approaches in surgical treatment of acute paraproctitis].

The results of treatment of 77 patients, ageing 18-71 yrs old, for an acute paraproctitis in 2010-2014 yrs were analyzed. A preventive puncture-flush enzymosanation of purulent foci, using immobilized bacterial proteinases (imozimase), metrogyl P in conjunction with low-intensive laser irradiation have permitted to conduct the optimal preoperative preparation of patients, to improve their state, to reduce the local inflammatory reactions intensity significantly.

[The immediate and long results of treatment of posttraumatic fistulas of the rectum with application of modern laser technologies].

The immediate and long-term results of the posttraumatic rectal fistulae treatment in 134 patients were analyzed. The differentiated choice of surgical tactics, the use of modern laser methods and the original complex of diagnostic and treatment measures allowed to decrease the frequency of such posttraumatic complications from 19.0 to 7.9%. Good medical and social adaptadion and rehabilitation rates were achieved in 98.5% of patients.

[New methods of surgical correction of the puerperal anal sphincter insufficiency].

Treatment results of 612 patients aged from 17 to 71 years, with benign perineal diseases were analyzed. The rectovaginal fistula was diagnosed in 84 (13,7%), puerperal anal sphincter insufficiency - in 88 (14,4%) and rectocele was diagnosed in 139 (22,7%) of patients. 237 (38,7%) cases of perineal ruptures were analyzed retrospectively and 64 (10,5%) acute ruptures were analyzed prospectively. The suggested modified levatoroplasty includes the dissection of the proper fascia of the puborectal muscle, followed by the placation of the anterior muscle wall of the rectum and the posterior fascial sheet. After secure fixation of the first suture line, the second line sutures are applied on muscle tissue using monofilament resorbable material. The third line of the sutures connects anterior sheets of the proper fascia of the levators. Long-term follow up results were obtained in 80 (95,2%) of the operated patients. 63 patients reported excellent results, sphincter function had improved in 15 patients and operation had no effect in 2 cases.

[Extracorporeal detoxification by plasmapheresis in the complex treatment of acute intestinal obstruction]. / Ekstrakorporal'naia detoksifikatsiia metodom plazmafereza v kompleksnom lechenii ostroi kishechnoi neprokhodimosti.

The article deals with problems of performing detoxication in complex treatment of acute ileus. A method of plasmapheresis is proposed for treatment of patients with a pronounced intoxication syndrome. Criteria for the estimation of the patient's state are presented which are considered as indications for extracorporal detoxication and for effectiveness of plasmapheresis both by clinical criteria of the estimation of the patient's state and by laboratory findings. High efficiency of the method is shown in complex treatment of patients with acute ileus with a pronounced intoxication syndrome.

[Toxemia syndrome in patients with acute intestinal obstruction]. / Sindrom intoksikatsii u bol'nykh ostroi kishechnoi neprokhodi- most'iu.

The results of examination and treatment of 216 patients with acute intestinal obstruction of benign genesis are discussed. The values of blood plasma toxicity and the values of hemostasis determined before and after the operation were compared. Intoxication of patients was found to increase in the postoperative period. Its increase was appraised according to the duration of the disease. The causes of mortality were analysed and the risk factors of intoxication increase in the postoperative period were revealed. The authors suggest a classification of the phases of intoxication in patients with acute intestinal obstruction on the basis of the degree of intoxication and the condition of homeostasis.

[Use of the CO2 laser in the surgical treatment of complicated echinococcosis of the liver]. / Primenenie CO2-lazera pri khirurgicheskom lechenii oslozhnennogo ekhinokokkoza pecheni.

The article discusses experience in the use of high-energy CO2 laser in the treatment of 108 patients with complicated forms of echinococcosis of the liver. The diagnostic efficacy of instrumental methods of examination is determined. The most informative are ultrasonic echolocation (96.8%) and computered tomography (100%). They allow exact localization of the cyst, which is important in the choice of the operative approach. The use of the laser for excising the fibrous capsule and treating the residual cavity makes is possible to: abandon the traditional methods for completing echinococcectomy (drainage of the residual cavity, marsupialization, capitonnage), exclude suppuration of the residual cavity, reduce markedly the period of the patient's hospitalization.