[Nasointestinal intubation in the treatment of acute adhesive small bowel obstruction]. / Nazointestinal'naya intubatsiya v lechenii ostroi spaechnoi tonkokishechnoi neprokhodimosti.

Proximal gastrointestinal decompression is essential in the treatment of acute adhesive small bowel obstruction. Improvement of endoscopic methods, surgical instruments and radiological methods of control makes it possible to timely assess lavage and intra-intestinal therapy. The review presents current views on upper gastrointestinal decompression and other options for the treatment of adhesive small bowel obstruction.

[Treatment of reflux esophagitis in patients with cardiofundal, subtotal and total hiatal hernias]. / Lechenie refliuks-ézofagita u bol'nykh s kardiofundal'nymi, subtotal'nymi i total'nymi gryzhami pishchevogo otverstiia diafragmy.

AIM: To analyze treatment of patients with reflux esophagitis and large hiatal hernia. MATERIAL AND METHODS: There were 85 patients with reflux esophagitis and large hiatal hernia. Laparoscopic repair was performed in 33 patients, laparotomy - in 52 cases. All patients underwent fundo- or gastroplication by A.F. Chernousov, correction of large defect of hiatal orifice by cruroraphy was applied in 55 (64.7%) patients. RESULTS: Postoperative morbidity was near 10% after laparoscopic and conventional surgery despite more difficult video-assisted endoscopic technique. Complications Clavien-Dindo grade I-II were noted in 4 (12.1%) patients after laparoscopic treatment and in 6 (11.5%) patients after laparotomy. Medication was effective in all cases. Two patients with subtotal hernias had complications Clavien-Dindo grade IIIB after endoscopic surgery: recurrent hiatal hernia followed by severe reflux esophagitis and dysphagia. These complications required redo surgery. Repair of hiatal orifice is always possible without mesh reinforcement. Posterior cruroraphy is feasible and effective in all patients. Incidence of intraoperative and postoperative complications is comparable in both approaches (p<0.05). Mean hospital-stay after laparotomy was 7.3 days, after laparoscopy - 5.8 days. CONCLUSION: Endoscopic formation of antireflux cuff by A.F. Chernousov is appropriate and effective in patients with reflux esophagitis and large/giant hiatal hernias.

[Laparoscopic appendectomy for mucinous cystadenoma of the appendix]. / Laparoskopicheskaia appendéktomiia pri mutsinoznoi tsistadenome cherveobraznogo otrostka.

Treatment of acute and chronic appendicitis is still an actual problem. There are some rare courses of the disease besides well-known complications of appendicitis. Mucocele is one of the rarest forms of chronic appendicitis. Mucocele is not accompanied by clinical symptoms and diagnosed accidentally in more than 25% of cases. The most serious complication of mucocele of the appendix is malignization observed in up to 36% of cases. Ultrasound, CT and colonoscopy are the most effective methods of perioperative diagnosis. Unclear symptoms, delayed diagnosis and surgical treatment increase the risk of complications (i.e. cystadenocarcinoma).