[Treatment of patients with lower limb varicose veins disease]. / Lechenie patsientov s varikoznoi bolezn'iu nizhnikh konechnostei.

Modern data on the prevalence and pathophysiology of lower limb varicose disease are presented. The results of studies of modern approaches to the surgical correction of this state are demonstrated. Conclusions about the unresolved number of problems.

[Endoscopic and roentgenovascular interventions in treatment of patients with bleeding from a gastroduodenal ulcer].

The authors analyzed the results of treatment of 965 patients with bleeding from gastroduodenal ulcers. The endoscopic hemostasis was carried out in 20.2% patients, however a recurrence of bleeding was noted in 12.8% cases. The combined endoscopic hemostasis was performed in 76.9% patients, though the relapse of bleeding had only 4.2% and 49 patients were safe. A surgery was required for 3.2% patients.

[Laparoscopic interventions in left sections colon cancer complicated by obturation intestinal obstruction].

On the basis of an analysis of 2200 cases of left sections colon cancer complicated by obturation intestinal obstruction the authors showed the possibility and reasonability of two-step operation performance. The first operation formed unloading part and the second was the radical operation in one hospitalization. Given method allowed improvement of the results and quality of life of the patients.

[Endovideosurgical interventions for thoracoabdominal wounds].

The authors presented results of examination and treatment of 1347 patients with different injuries of the chest and abdomen. Medico-diagnostic measures used in treatment of such kind of patients with rational application of endovideosurgical techniques such as thoraco- and laparoscopy are described which proved to be the final kind of operative treatment.

[Diaphragmatic hernias. Diagnosis and surgical treatment].

The authors present results of the examination and treatment of 106 patients with hernias of the diaphragm of different genesis. In 79 of them there were non-incarcerated hernias, in 27--there were incarcerated hernias. The authors suggest necessary medico-diagnostic measures with rational application of endovideosurgical technologies such as thoraco- and laproscopy which were used in 74%.

[Ways of optimization of standards of treatment of acute cholecystitis].

The article presents an analysis of tactical approaches in patients with acute cholecystitis on the basis of an experience with treatment of acute cholecystitis under conditions of multiprophile hospital in Saint Petersburg and modern ideas of the problem in the world.

[Endoscopic methods of hemostasis in treatment of Mallory-Weiss syndrome].

Results of treatment of Mallory-Weiss syndrome using endoscopic methods of hemostasis in 549 patients were analyzed. The patients were divided into two groups: in 2000-2004 years without endoscopic methods, in 2004-2008 years using the endoscopic methods in the diagnostics and treatment. Considerably decreased operative activity and death rate was established in cases of treatment with endoscopic methods.

[Thoracoscopy in verification and treatment of pleural exudate syndrome under conditions of a multifield hospital].

Under an analysis of results of treatment of 186 patients with pleural exudate syndrome there were 139 patients treated by traditional methods, 47 patients treated using the proposed medico-diagnostic program based on using thoracosopy under local anesthesia. Using the proposed medico-diagnostic measures can be used at any multifield hospital where patients with pleural exudate syndrome are admitted although the hospital has neither phthisiatrical nor phthisiothoracic departments.

[Chronic complicated pancreatitis. Diagnostics and surgical treatment].

The article presents an analysis of surgical treatment of 186 patients with complicated forms of chronic pancreatitis. Potentials of different instrumental techniques of investigations in diagnostics of complications of chronic pancreatitis are analyzed. Performance of retrograde cholangiopancreatography in chronic pancreatitis was shown to be expedient. Potentials of minimally invasive technologies and effectiveness of these interventions in different complicated forms of chronic pancreatitis were studied. Differentiated approach to decision on the kind and volume of operation depending on the complication character was shown. The proposed diagnostic algorithm and medical strategy allowed satisfactory immediate results to be obtained in this difficult group of patients.

[Thoracoscopy in the diagnostics and treatment of chest injury].

The authors have analyzed their experience with treatment of 67 casualties with injuries of the chest of different character. The diagnostic and treatment algorithm was based on the principle of using primary thoracoscopy with local anesthesia during draining the pleural cavity. The proposed algorithm can be used at any hospital rendering emergency to casualties with injuries of the chest independent of the level of available equipment.

[Diagnostics and surgical treatment of isolated and associated injuries of the liver].

The authors have analyzed results of treatment of 388 patients with open and closed injuries of the liver and the diagnostic potential of different instrumental methods. The optimal diagnostic algorithm is proposed. The validity of using videoscopic interventions in injuries of the liver were studied as well as the indications for using them. A differentiated approach is proposed to the decision on the kind of surgery in patients with a severe isolated or combined trauma of the liver. The expediency of two-stage interventions is shown. A strategy of treatment for central ruptures of the liver and hemobilia is substantiated. It was shown that the application of minimally invasive and traditional technologies of treatment of patients with injuries of the liver allowed the incidence of postoperative complications and lethal.

[The diagnosis and treatment of enteroparesis in patients with acute pancreatitis].

Two leading moments in endotoxicosis of acute pancreatitis pancreatogenic and enterocologenic should be emphasized. A new noninvasive method is proposed for objective determination of the degree of enteroparesis in patients with acute pancreatitis. A conversion of the gastroenterocolonogram curves into digital parameters gave quantitative data which help to reveal the form of acute pancreatitis. the degree of endogenous intoxication and shows the course of the treatment.

[Perforation of diverticula of the sigmoid colon]. / Perforatsiia divertikulov sigmovidnoi kishki.

An experience with treatment of 27 patients with diverticulosis of the sigmoid colon complicated by perforation is described. 9 patients died, 18 patients recovered. Under consideration are questions of diagnosis and surgical treatment of diverticula of the sigmoid colon complicated by perforation.

[Surgical treatment in chronic gastroduodenal ulcers]. / Khirurgicheskoe lechenie pri khornicheskikh gastroduodenal'nykh iazvakh.

Operative treatment was carried out in 1197 patients with chronic gastroduodenal ulcers. Among the most frequent complications of the ulcers there were penetration of the III-IV degree, compensated, subcompensated and decompensated pyloroduodenal stenosis. The operative interventions included Billroth-II resections of the stomach in modification of Hofmeister-Finsterer, Billroth-I, with saving the pyloric sphincter, after Roux and gastrectomies. Postoperative complications developed in 127 (10.6%) patients, postoperative lethality was 0.7%. Excellent and good long-term results were noted in 846 (94.5%) patients, in 14 (1.6%) patients they were estimated as satisfactory and in 35 (3.9%) as unsatisfactory. The causes of unsatisfactory results were recurrent ulcers (0.7%), peptic ulcer of the gastroenteroanastomosis (0.6%), dumping-syndrome of a severe and medium degree (1.5%), diarrhea of a severe degree (0.3%) and erosive-ulcerous reflux-esophagitis (0.3%).

[The efficacy of Neovir in the combined treatment of patients with operable tumors of the gastrointestinal tract]. / Effektivnost' Neovira v kompleksnom lechenii bol'nykh s operabel'nymi opukholiami zheludochno-kishechnogo trakta.

Under observation there were 32 patients with operable tumors of the gastro-intestinal tract. The average age of the patients was (64.8 +/- 7.5) years. Patients of the control group (18 patients were given the routine complex treatment. The main group (14 patients) were additionally given the interferonogenic immunomodulator "Neovir" which resulted in lower risk of the appearance of pyo-septic complications. It was confirmed by positive dynamics of the indices of cellular immunity, intensified production of proinflammatory cytokines and interferon-alpha.