A scientific review on the topic “Diverticular disease of the colon” is presented. The study provides a definition of diverticulum, diverticulosis
and diverticulitis of the colon. The prevalence and incidence of the disease among different age and ethnic groups in developed and
developing countries is shown. The etiology and pathogenesis of the disease is revealed taking into account the views of different researchers.
Various methods of treatment, both the disease itself and its complications are viewed. Several treatment variants are shown, using traditional
and recent techniques with corresponding results.

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A review of the literature on the problem of the surgical reconstruction of the membranous department of urethra is presented, which
includes, in fact, the membrane section as well as the bulbous membrane transection. The epidemiological situation, the main causes of urethral
involvement are briefly described. The questions of anatomical features of this department of the urethra with histological characteristics, peculiarities
of innervation and blood supply are discussed in detail. The history of the development the surgery of the urethra, in general, and this
department, in particular, as the previously used treatment techniques are described. The present state of the problem, current possible ways
of surgical and conservative treatment, possible ways of further development are presented. Positive and negative aspects of various presented
methods are considered with indication of data on their effectiveness, possible frequency of relapses. The auxiliary methods of treatment with
the indication of their possible combination with surgical methods are described

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Aim of the research. To analyse the results of the bioflavonoids use and hyperbaric oxygenation (HBO) in the complex treatment of extensive
long-term non-healing wounds.
Material and methods. The main group (MG) – 27 patients, the group of clinical comparison (GCC) – 25. Inclusion criteria:
age – from 18 to 80; the area of extensive long-term non-healing wounds - from 50 cm2 to 400 cm2; the duration of the wound process – from
20 days or more. Exclusion criteria: extensive long-term non-healing wounds and ulcers of vascular and endocrine origin. MG patients were
treated with antioxidant therapy and HBO. As antioxidants, a mixture of bioflavonoids of dihydroquercetin and arabinogalactan (1: 3) was used
as a biologically active additive “Lavitol-B” orally for 21 days and a powder of dihydroquercetin “Lavitol cosmetic” was placed on the wound
surface. Simultaneously with antioxidant therapy and surgical treatment of wounds, MG patients were given 3-4 sessions of HBO, then delayed
autodermoplasty was performed by a free split skin flap. From the first day of the postoperative period, HBO and the bioflavonoids were taken.
In the GCC, traditional treatment was used.
Results. The wound process with extensive long-term non-healing wounds in MG patients proceeded more favorably than in the GCC. The
use of bioflavonoids of HBO allowed to reduce the hyperproduction of pro-inflammatory interleukins (IL-1β, IL-6, IL-8, TNF-α), to decrease
the intensity of lipid peroxidation processes and to activate the antioxidant defense system in MG patients in comparison with GCC. Due to
elimination of persistent inflammation and stimulation of reparative processes, preoperative wound preparation time was shortened and full
engraftment of free split autodermotransplants in MG was achieved.
Conclusion. The use of bioflavonoids of HBO is pathogenetically justified and allows to positively influence the course of the wound process in
patients with extensive long-term non-healing wounds.

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Kozka AA, Kiridon OI № 2015108492/14; Register 11032015; Publish
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Aim of the research. To study the frequency, nature and risk factors of cardiac arrhythmias associated with planned cholecystectomy.
Material and methods. 101 patients with a chronic calculous cholecyst were examined. In 47 patients, concomitant pathology was identified
in the form of IHD and AH. In a planned order in 63 patients laparotomy and cholecystectomy were performed, in 38 - endovideosurgical
removal of the gallbladder. Heart rhythm disturbances were assessed using a dynamic ECG on a Hellig SMS 181 device and a Cardiotechnika-
4000 device for 12 hours, before, during and for 12 hours after operation.
Results. During the operation, the number of persons with sinus rhythm and sinus bradycardia significantly decreased due to a significant
increase in the number of cases of sinus tachycardia, supraventricular and ventricular extrasystole, including high grades by B.Lown. At the
same time, supraventricular extrasystole during surgery was significantly more common in men. Life-threatening cardiac arrhythmias were
detected during surgery, mainly in males (p <0.05), as well as in patients older than 40 years, (p <0.05), with ischemic heart disease and
hypertension (p < 0.05), as well as during cavitary cholecystectomy (p <0.05). When analyzing the Echo KG values as possible predictors of
intraoperative cardiac arrhythmias, it was found that an increase in such parameters as the size of the left atrium, the finite-diastolic size of
the left ventricle, the thickness of the posterior wall of the left ventricle, and the volume of the right ventricle significantly cause the occurrence
of dangerous cardiac arrhythmias in the intraoperative period.
Conclusion. The parameters of temporal analysis of heart rate variability, as well as a tendency to increase the heart cavity and hypertrophy
of its walls (according to ECHO-KG) are associated with a higher probability of the appearance of life-threatening CA during cholecystectomy.

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Aim of the research. To study the morphofunctional changes in the esophagus in the long-term period after video-laparoscopic cardiomyotomy
at cardiac achalasia, various especially the IV stage of the disease, as well as the results of antireflux operations for GERD in patients with
axial hernia of the esophageal aperture of the diaphragm.
Material and methods. Long-term results of video-laparoscopic operations in 198 patients with a violation of the closure function of the cardia
of functional genesis – cardiac achalasia (74 patients) and GERD (124 patients) in patients with hernia of the esophageal aperture of the
Эндохирургия функциональных нарушений замыкательной функции кардии
32 Сибирское медицинское обозрение, 2017, 3
diaphragm were studied. All patients with achalasia of cardia (AK) had modified by us video-laparoscopic esophagocardiomyotomy according
to Geller with anterior hemi-esophage-perfusion by Dore, which provides the effect of a stretched myotomy. In patients with GERD with a hernia
of the esophageal aperture of the diaphragm, a video-laparoscopic dosed esophagofunduplication with intraoperative manometry was developed
for correction of the cardiac closing function with diaphragmohiatoplasty (71 patients) or without (53 patients).
To study the remote results, special methods of investigation were used - X-ray and endoscopic studies of the esophagus and stomach, daily intra-
esophageal pH-metry, manometry of the esophagus and esophageal-gastric junction. In addition, questionnaires using international questionnaires
were conducted in GERD patients: GERD-HRQL (gastroesophageal reflux disease, health quality of life scale) - the main symptoms of
GERD before and after antireflux surgery, GIQLI (gastrointestinal index of life quality) and SF-36 (general indicators of life quality).
Results. The high efficacy of the modified stretch cardiomyotomy according to Geller with anterior hemiosephagefundoplication according
to Dor, regardless of the stage of the disease, is established. The developed dosage esophagofunduplication in combination with diaphragmocytoplasty
allows obtaining better results in comparison with patients without correction of the esophageal opening of the diaphragm.
Conclusion. Correction of functional disorders of the cardiac closure function can be successfully accomplished by endovideosurgical interventions.

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postoperative dysphagia and recurrence. Langenbeck’s Archives of
Surgery. 2012;397(1):19–27. DOI: 10.1007/s00423-011-0829-0.
14. Peters MJ, Mukhtar A, Yunus RM, Khan S, Pappalardo J,
Memon B. Meta-analysis of randomized clinical trials comparing
open and laparoscopic anti-reflux surgery. The American Journal of
Gastroenterology. 2009;104(6):1548–61. DOI: 10.1038/ajg.2009.176.
15. Siddiqui M, Abdulaal Y, Nisar A, Ali H, Hasan F. A
meta-analysis of outcomes after open and laparoscopic Nissen’s
fundoplication for gastro-oesophageal reflux disease in children.
Pediatric Surgery International. 2011;27(4):359–66. DOI: 10.1007/
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16. Stefanidis D, Hope WW, Kohn GP, Reardon PR, Richardson
WS, Fanelli RD. Guidelines for surgical treatment of gastroesophageal
reflux disease. Surgical Endoscopy. 2010;24(11):2647-69. DOI:
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17. Basso N, DeLeo A, Genco A, Rosato P, Rea S, Spaziani E,
Primavera A. 360° laparoscopic fundoplication with tension – free
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disease. Surgical Endoscopy. 2000;14(2):164-9.
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Reflux Disease. Wien: Springer-Verlag; 2006. 320 p. DOI: 10.1007/3-
211-32317-1.
19. Varela J, Jacks S. Laparoscopic circular biomeshhiatoplasty
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Fedorov VV, Kazaryan VM. Videoendoscopic esophagus surgery.
Barnaul: Az Buka; 2004. 159 p. (In Russian)
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severity instrument. Diseases of the Esophagus. 2007;20(2):130–4.
DOI: 10.1111/j.1442-2050.2007.00658.x.
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on the course of sanitary statistics. Kemerovo: KGMA; 1995. 101 p.
(In Russian)
23. Kolyado VB, Plugin SV, Dmitrienko IM. Nonparametric
criteria. Comprehensive health assessments of the population.
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possibilities of daily pH monitoring in the esophagus in the
diagnosis and treatment of patients with GERD. Rossiyskiy Zhurnal
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The aim of the research. Conducting a comparative analysis of the number of hospitalizations, types of hernioplasty, the nature
of postoperative complications in patients with strangulated abdominal hernias.
Material and methods. A study of 4 groups of patients with strangulated abdominal hernias hospitalized in the Kemerovo Region
and in the M.A. Podgorbunsky Regional Clinical Hospital of Emergency Medical Care over the past twenty years was conducted.
A nonparametric Mann-Whitney test was used to perform statistically significant differences in the indices.
Results. When comparing groups 1 and 2, 3 and 4, statistically significant differences in the number of hospitalizations between
these groups were obtained.
Conclusion. A significant increase in treated patients with strangulated abdominal hernia in the dynamics over the past two
decades has been revealed. Among the operated patients with strangulated hernias, umbilical, inguinal and postoperative ones
predominate. Hernia prosthesis with the usage of polypropylene mesh over the past decade has been performed in Regional Clinical
Hospital of Emergency Medical Care in more than half of all patients. Wound infection has developed in the lowest percentage of
cases compared with autoplasty. The healing was carried out by secondary intension without the removal of prostheses

1. Zakharash MP, Kucher ND, Poyda AI, Zakharash YuM,
Skums AV, Mel’nik VM. Surgery. Vinnitsa : Novaya kniga;
2014.688 p. (In Russian)
2. Ryzhkov PA. The restrained internal hernias of the
abdominal cavity. Bulletin of Northern State Medical University.
2009;23(2):131-2. (In Russian)
3. Zhebrovsky VV. Abdominal hernia surgery. Moscow
: Meditsinskoye informatsionnoye agentstvo;2005.364 p.
(In Russian)
4. Timoshin AD, Yurasov AV, Shestakov AL. Features of
conducting postoperative wounds after allogernioplasty.
Annaly Khirurgii. 2003(2):77–80. (In Russian)
5. Pryakhin AN. The choice of the method and technical
aspects of hernioplasty prosthetics in the treatment of
complex forms of inguinal hernia. The Messenger of Surgery of
I. I. Grekov. 2007(2):96–9. (In Russian)
6. Zhukov BN, Shestakov EV, Bystrov SA, Katorkin SE.
The Regionarny lazerterapiya in treatment of patients with the
restrained hernias of anterior abdominal wall. The Messenger of
Surgery of I. I. Grekov. 2015;174(5):66-70. (In Russian)
7. Lassandro F, Iasiello F, Pizza NL, Valente T, Luisa M, di
Santo Stefano M. Abdominal hernias: Radiological features.
World Journal of Gastrointestinal Endoscopy. 2011;6(3):110-17.
DOI: 10.4253/WJGE.v3.i6.110.
8. David C, Sabiston JR, Davis C. Sabiston Textbook of
Surgery. London : Elsevier Health Sciences;1981.12 p.
9. Dabbas N, Adams K, Pearson K, Royle GT. Frequency of
abdominal wall hernias: is classical teaching out of date? Journal
of the Royal Society of Medicine Short Reports. 2011;2(1):5.
DOI: 10.1258/shorts.2010.010071.
10. Hair A, Duffy K, McLean J, Taylor S, Smith H, Walker
A, Macintyre IMC, O’Dwyer PJ. Groin hernia repair in
Scotland. British Journal of Surgery. 2000;87(12):1722–6.
DOI: 10.1046/j.1365-2168.2000.01598.x.
11. Abd Ellatif ME, Negm A, Elmorsy G, Al-Katary M, Yousef
Ael-A, Ellaithy R. Feasibility of mesh repair for strangulated
abdominal wall hernias. Internationale Journale of Surgery.
2012;10(3):153-56.DOI: 10.1016/j.ijsu.2012.02.004.
12. Vinnik YuS, Petrushko SI, Nazaryants YuA, Kochetova
LV, Pakhomova RA, Kuznetsov MN, Markelova NM, Vasilenya
ES, Solovyeva NS. The current state of the question about a
methods of surgical treatment anterior abdominal wall hernia.
Sovremennye Problemy Nauki i Obrazovanija. 2013(1):24.
(In Russian)
13. Kovalenko АA, Veselov YE, Levin LA. The structure of
mortality in acute surgical diseases of the abdominal cavity
and the role of endovideosurgical technology in its reduction.
Vestnik Sankt-Peterburgskogo Universiteta. 2007;11(3):80-95.
(In Russian)
14. Strizheletskiy VV, Rutenburg GM, Guslev AB,
Rumyantsev IP. Place of endovideosurgical interventions in
the treatment of inguinal hernias. The Messenger of Surgery
of I. I. Grekov. 2006(6):15–20. (In Russian)
15. Shlyakhovskiy IA, Chekmazov IA. Modern aspects
of surgical abdominal hernia’s treatment. Abdominal’naya
khirurgiya. 2002;4(7):44-7. (In Russian)
16. Korovin AYa, Vystupets VV, Kulish VA. Laparoscopic
hernioplasty at bilateral inguinal hernias. Gerniologiya.
2007(1):18–21. (In Russian)
17. Kharnas SS, Samokhvalov AV, Ippolitov LI. Hernias of
anterior abdominal wall. Russkiy Vrach. 2009(84):4. (In Russian)
18. Datsenko BM, Kutepova YeV, Zakharchuk AP. Features
of allogernioplasty of postoperative ventral hernias in primarily
infected tissues. Mezhdunarodnyy Meditsinskiy Zhurnal.
2006(4):76–81. (In Russian)
19. Ermolov AS, Upyrev AV, Il’ichev VA. About a modern
classification of postoperative abdominal hernias. Gerniologiya.
2006;11(3):16–17. (In Russian)
20. Myasnikov AD, Kolesnikov SA. Herniology for
general surgery doctors. Belgorod : Izd-vo Belgorodskogo
gosudarstvennogo universiteta;2005.348 p. (In Russian)
21. Hakeem A, Shanmugam V. Inguinodynia following
Lichtenstein tension-free hernia repair: a review. World Journal
of Gastroenterology. 2011;17(14):1791–6.DOI: 10.3748/wjg.
v17.i14.1791.
22. Prishvin AP, Maystrenko NA, Singayevskiy SB.
Optimization of laparoscopic hernioplasty. Vestnik Khirurgii.
2003(6):71–5. (In Russian)
23. Tatar C, Tüzün İS, Karşıdağ T, Kızılkaya MC, Yılmaz
E. Prosthetic Mesh Repair for Incarcerated Inguinal Hernia.
Balkan Medical Journal. 2006;33(4):434-440.DOI: 10.5152/
balkanmedj.2016.150137.
24. Nesterenko YuA, Gaziev RM. Inguinal hernias. Moscow
: BINOM. Laboratoriya znaniy;2015.146 p. (In Russian)
25. Kolokol’tsev MV, Shvetsova LR. On the prevention of
postoperative complications in alloplasty of large abdominal
wall defects. Vesti Khirurgii. 1974(12):73-5. (In Russian)

Aim of the research. To develop a clinical-diagnostic algorithm for substantiating early surgical interventions in patients with
severe acute pancreatitis.
Material and methods. A retrospective study was carried out – analysis of treatment of 20 patients with severe acute pancreatitis
of autonomous etiology, operated on in early terms for 2-4 days, and a prospective study – analysis of human serum samples
by HPLC. The severity assessment and prognosis of the disease were made using integrated scales: APACHE II, BISAP, the MSCT
configuration of pancreatic necrosis was evaluated.
Results. The obtained data indicate that the configuration of the necrosis of the pancreas is the determining factor in the formation
of the internal pancreatic fistula, and then the prevalent parapancreatitis, which is the main danger to the life of the patient
and is prognostically unfavorable factors and raise the question of conducting surgical interventions in the early stages.
Conclusion. In 90% of patients with severe acute pancreatitis, intraperitoneal hypertension develops and in 45% - abdominal
compartment syndrome. The intra-abdominal pressure correlates with the index of the ARASNE II scale, BISAP and the level of
CRP, while early intervention with persistent intraperitoneal hypertension reliably reduces the scores of the integral scales, the
level of CRP on day 2-3, which reflects the regression of multi-organ failure and reduces the risk of unfavorable outcome. Severe
acute pancreatitis with total damage to the pancreas, as well as with damage to the head of the pancreas with a depth of necrosis of
at least 50%, with a predominance of the fluid component above the infiltrative in the inflammatory changes in the retroperitoneal
tissue are unfavorable factors in the course of the disease and serve as an indication for early surgical intervention. A group of
13 metabolites of pancreatitis unique for severe course and a group of 7 normal metabolites, markers of severe pancreatitis, were
isolated using high-performance liquid chromatography. The principal possibility of predicting severe course of pancreatitis in
early periods is shown.

1. Krivoruchko IA, Boyko VV, Ivanova YuV, Povelichenko MS.
Actual problems of surgical hepatology. In: Materials of the XXth
International Congress of the Association of Surgeons-Hepatologists of
Countries of CIS : collection of research papers. Donetsk;2013:189–90.
(In Russian)
2. Merzlikin NV, Brazhnikova NA, Tskhay VF. Pankreatitis. Moscow
: Medical;2014.528 p. (In Russian)
3. Pel’ts VA. The current state of diagnosis and surgical treatment
of acute pancreatitis. Siberian Medical Journal. 2010(4):27-33.
(In Russian)
4. Vinnik YuS, Dunayevskaya SS, Antyufriyeva DA. Risk of development
of complications at sharp alcohol - associated pancreatitis.
Novosti Khirurgii. 2012;20(4):38-41. (In Russian)
5. Mariam N, Guy E, Michael RC. Acute Pancreatitis: Update on
management. The Medical Journal of Australia. 2015;202(8):420-3.
6. Pezzilli R. Antibiotic Prophylaxis in Severe Acute Pancreatitis:
Do We Need More Meta-Analytic Studies? Journal of the Pancreas.
2009;10(2):223–4.
7. Lankisch PG, Pflichthofer D, Lehnick D. No strict correlation
between necrosis and organ failure in acute pancreatitis. Pancreas.
2000;20(2):319-22.
8. Mofidi R, Duff MD, Wigmore SJ, Madhavan KK, Garden
OJ, Parks RW. Association between early systemic infl ammatory
response, severity of multiorgan dysfunction and death in acute
pancreatitis. The British Journal of Surgery. 2006;93(6):738–44.
DOI: 10.1002/bjs.5290.
9. UK Working Party on Acute Pancreatitis. UK guidelines for
the management of acute pancreatitis. Gut. 2005;54(suppl 3):iii1-9.
DOI: 10.1136/gut.2004.057026.
10. Alsfasser G, Rau BM, Klar E. Scoring of human acute pancreatitis:
state of the art. Langenbeck’s archives of surgery. 2013(398):789-797.
DOI: 10.1007/s00423-013-1087-0.
11. Kho ME, McDonald E, Stratford PW, Cook DJ. Interrater
Reliability of APACHE II Scores for Medical-Surgical Intensive Care
Patients: A Prospective Blinded Study. American Journal of Critical
Care. 2007;16(4):378-83.
12. Koperna T, Semmler D, Marian F. Risk Stratification in Emergency
Surgical Patients: Is the APACHE II Score a Reliable Marker
of Physiological Impairment? Archives of Surgery. 2001;136(1):55-9.
13. Kuo VC, Tarnasky PR. Endoscopic Management of Acute Biliary
Pancreatitis. Gastrointestinal Endoscopy Clinics of North America.
2013;23(4):749-68.DOI: 10.1016/j.giec.2013.06.002.
14. Cheatham ML. Abdominal Compartment Syndrome: pathophysiology
and de nitions. Scandinavian Journal of Trauma, Resuscitation
and Emergency Mmedicine. 2009;17:10.DOI: 10.1186/1757-
7241-17-10.
15. Kochetova LV, Dunayevskaya SS. Metabolic correction in
complex treatment of patients with sharp pancreatitis. Kazan Medical
Journal. 2011;92(3):315-8. (In Russian)
16. Deanne B, Margaret K, Stephen P. Acute pancreatitis. Medicine.
2014;43(3):174-81.DOI: 10.1016/j.mpmed.2014.12.005.
17. van Brunschot S, Schut AJ, Bouwense SA, Besselink MG,
Bakker OJ, van Goor H, Hofker S, Gooszen HG, Boermeester MA,
van Santvoort HC. Abdominal Compartment Syndrome in Acute
Pancreatitis A Systematic Review. Pancreas. 2014;43(5):665-74.
DOI: 10.1097/MPA.0000000000000108.
18. Neoptolemos JP, Kemppainen E, Mayer J, Fitzpatrick J, Raraty
M, Slavin J, Beger H-C, Hietaranta A, Puolakkainen P. Early prediction
of severity in acute pancreatitis by urinary trypsinogen activation
peptide: a multicenter study. Lancet. 2000;355(9219):1955-60.
19. Wu C, Ke L, Tong Z, Li B, Zou L, Li W, Li N, Li J. Hypertriglyceridemia
is a Risk Factor for Acute Kidney Injury in the Early Phase
of Acute Pancreatitis. Pancreas. 2015;43(8):1312-1316.DOI: 10.1097/
MPA.0000000000000180.
20. Patsay DI, Blakhov NY. Diagnostic and prognostic significance
of C-reactive protein and serum ferritin in acute pancreatitis. Military
Medicine. 2008(4):32-6. (In Russian)
21. Cardoso FS, Ricardoa LB, Oliveiraa AM, Hortaa DA, Papoila
AL. C - reactive protein at 24 Hours after Hospital Admission May
Have Relevant Prognostic Accuracy in Acute Pancreatitis: A Retrospective
Cohort Study. Portuguese Journal of Gastroenterology.
2015;22(3):198-203.DOI: 10.1016/j.jpge.2015.03.002.
22. Kumar A, Heaton JC, McCalley DV. Practical investigation
of the factors that affect the selectivity in hydrophilic interaction
chromatography. Journal of Chromatography. A. 2013;1276:33-46.
DOI: 10.1016/j.chroma.2012.12.037.
23. Rafferty JL, Siepmann JI, Schure MR. A molecular simulation
study of the effects of stationary phase and solute chain length in
reversed-phase liquid chromatography. Journal of Chromatography.
A. 2012;1223:24-34.DOI: 10.1016/j.chroma.2011.11.039.
24. Lankisch PG. Conservative therapy of acute pancreatitis.
The pancreas: an integrated textbook of basic science, medicine and
surgery. 2008(2):273-80.
25. Dyuzheva TG, Dzhus EB, Ramishvili VS, Shefer AV, Platonova
LV, Gal’perin EI. Early CT signs of predicting various forms
of parapancreonecrosis. Annals of Surgical Hepatology. 2009(4):54-63.
(In Russian)

Aim of the research. To create a method for disabling high unformed jejunal fistula, not associated with difficulties in detecting the coming
gut and with dangers of viscerolysis.
Material and methods. The experience of treatment of 35 patients with high delimited unformed, exhausting fistulae of the jejunum is presented.
To 22 patients of them, included in the comparison group, fistulas were closed or diactivated by known methods. On the basis of other
172 patients operated on acute adhesive intestinal obstruction, the topography of visceroparietal planar adhesions of the peritoneum was studied.
The study of visceroparietal adhesions and their location made it possible to develop a method for proximal exclusion from posterolateral
access, which was performed in 13 patients of the main group of observations.
Results. Clinical application of proximal disconnection of high unformed jejunal fistula from posterolateral access, reduced the duration and
traumatism of the intervention, and also eliminated the risk of prolonged intestinal deserosis. The result was a significant reduction in postoperative
mortality from 59.1 ± 9.2% to 23.1 ± 11.2% (t = 2.5; p).
Conclusion. Posterolateral access prevented long viscerolysis and allowed reliably and atraumatically perform intercusive anastomosis, disabling
fistula. The proximal disconnection of the jejunal fistula relieved the inter-intestinal anastomosis in the postoperative period, similar to the definitive
Maydl jejunostoma. The positive qualities of the proposed operative intervention led to a significant reduction in postoperative complications
and lethality, compared with the results of known surgical operations of the same purpose.

1. Vancjan JeN. External and internal fistulas. Moscow : Medicine;
1990.224 p. (In Russian)
2. Fjodorov VD, Sarkisov DS, Cvirkun VV, Zhukov AO, Savina TV.
Morphofunctional aspects in the treatment of patients with intestinal
fistulas. Surgery. 1994(10):36-9. (In Russian)
3. Velichko AV, Dundarov ZA. Pathogenetic justification of
application of an early enteroalimentation in treatment of patients
with high intestinal fistulas. Surgery News. 2007;15(3):27-34.
(In Russian)
4. Zhao Q, Li X, Li X, Wang J. Experience of the three-stage
strategy for intestinal fistula complicated with complex abdominal
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5. Rudin JeP, Bogdanov AV, Koshelev AP, Kurilovich VK, Chernyshev
BC. Tactics of treatment of external intestinal fistulas of the
gastrointestinal tract. Surgery. 1991(5):56-60. (In Russian)
6. Blashentseva SA, Panfilova EV, Kozlov MN, Morozova OV,
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fistula (clinical case). Bulletin of Medical Institute of REAVIZ:
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7. Vicyn BA, Atamanov VV. Treatment of patients with unformed
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8. Zhebrovskij VV, Toskin KD. Postoperative external intestinal
fistula. Postoperative complications and dangers in abdominal surgery
: monograph. Moscow;1990:257-90. (In Russian)
9. Berry SM, Fischer JE. Classification and pathophysiology
of enterocutaneous fistulas. The Surgical Clinics of North America.
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10. Baranov GA, Karbovskij MJu. Remote results of operative
elimination of adhesive intestinal obstruction. Surgery. 2006(7):56-
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11. Lavery IC. Colonic fistulas. The Surgical Clinics of North
America. 1996;76(5):1183-90.
12. Rots WI, Mokoena T. Successful endoscopic closure of a benign
gastrocolonic fistula using human fibrin sealant through gastroscopic
approach: a case report and review of the literature. European
Journal of Gastroenterology & Hepatology. 2003;15(12):1351-6.DOI:
10.1097/01.meg.0000085504.01212.f7.
13. Goverman J, Yelon JA, Platz JJ, Singson RC, Turcinovic M. The
Fistula VAC, a technique for management of enterocutaneous fistulae
arising within the open abdomen: report of 5 cases. The Journal of
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14. Volenko AV, Lobakov AI, Volenko IA. Diagnosis of not created
external intestinal fistulas. Applied Medicine. 2014;81(5):29-32.
(In Russian)
15. Popandopulo DA. Dynamics of morphological data at patients
with external inexact tubular intestinal fistulas at an obturation their
composite from fibroblasts. Messenger of Urgent and Reduction
Medicine. 2008;9(3):284-6. (In Russian)
16. Kanshin NN. Unformed intestinal fistula and purulent peritonitis.
Moscow : Profile;2007.160 p. (In Russian)
17. Miminoshvili OI, Popandopulo DA. The modern views on a
problem of treatment of external inexact tubular intestinal fistulas.
Messenger of Urgent and Reduction Medicine. 2006;7(3):509-10. (In
Russian)
18. Antonyuk SM, Akhrameev VB, Plaksin EA, Timofeev VD,
Derevyanko AA, Martyushev EE. To a question of diagnostics and
treatment of not created enteric fistulas. Urgent Problems of Transport
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19. Askerkhanov RP. Intraperitoneal external intestinal fistulas
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20. Beresneva EA, Pautkina NU. Radiodiagnosis of external
intestinal fistulas. Messenger of Roentgenology and Radiology.
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21. Fjodorov VD, Cvirkun VV, Zhukov AO. Unformed intestinal
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22. Bensman VM, Shherba SN. Removable draining aponeurotic
and muscular-aponeurotic seams in the prevention of suppuration of
laparotomic wounds. Herald of Surgery. 2000;159(1):64-7. (In Russian)
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Aim of the research. Morphologically justify the improvement of arterial and venous blood flow in the tissues of the zone of the small
intestine anastomosis when forming its “end-to-end” with the intersection of the gut segments at an angle of 600 in conditions of widespread
purulent peritonitis.
Material and methods. An anatomical study was conducted – from the corpses of 20 men and 20 women who died from purulent peritonitis,
fragments of the small intestine were collected. The intestinal wall intersected at an angle of 600 and 900. The preparations were
stained with hematoxylin-eosin. Also, processing with antibodies against CD-34 antigen was carried out. A histological and immunohistochemical
study was performed with an increase in x400 and x630. The number and total area of arterial and venous vessels in the
muscular and submucosal layers per 1 mm2 of the intestinal section were counted. The results of the study were statistically processed in
accordance with uniform requirements for manuscripts submitted to biomedical journals.
Results. In the muscular and submucosal layers of the intestinal wall, at its intersection at an angle of 600, a much larger number of arterial
and venous vessels was noted than with a cut at an angle of 900 to the axis of the intestine. This is due to the fact that the cut line at
the intersection at an angle of 600 receives a blood supply from 2 or 3 adjacent straight arteries. In contrast, when the cut is made at an
angle of 900, the blood supply to the cut line is accomplished by the branches of only one straight artery.
Conclusion. When forming an intestinal anastomosis “end-to-end”, the intersection of the coming and outgoing loops at an angle of 600
helps to improve the blood supply of the seam line, which may be accompanied by a decrease in the probability of anastomosis failure.

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Moscow : Vidar;2004.304 p. (In Russian)
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Oral Polyphosphate Suppresses Bacterial Collagenase Production
and Prevents Anastomotic Leak Due to Serratiamarcescens
and Pseudomonas aeruginosa. Annals of surgery. 2017(3):3.
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Aim of the research. To show the changes that took place over 15 years in the views on the indications for performing radical prostatectomy in
patients with different cancer risk, and also describe the changes in the technique of performing the operation regarding the choice of surgical
access, the volume of lymphadenectomy, the possibility of nerve-saving.
Material and methods. The data of literature sources of 2001-2016 indexed in pubmed and elibrary are analyzed. In addition, the experience
accumulated in the Urology Clinic of the I.M. Sechenov First Moscow State Medical University is given (based on intra-clinical databases).
Results. The indications for radical prostatectomy are expanding, especially in groups of patients with poor prognosis, as this operation gives
the greatest advantage in this category, in comparison with other methods of treatment. The local spreading process, as well as previous interventions
in the pelvic and prostate areas, are not contraindications for minimally invasive approaches – laparoscopic and robotic. Selective
lymphadenectomy is currently at the stage of study, so if patients have indications for lymphadenectomy, it should be enlarged.
Conclusion. Radical prostatectomy is a balance between oncological and functional results. Its achievement is facilitated by a good knowledge
of anatomy, as well as modern technologies - water jet dissection, robotic surgery, mapping of the lymph drainage pathways.

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Aim of the research. To improve immediate and long-term results of treatment of cardiac achalasia II-III degree by experimental development
and introduction of a new method of surgical treatment of achalasia in the clinic.
Material and methods. A new method of surgical treatment of cardiac achalasia of grade II-III was developed in the experiment by
circular removal of the serous-muscular layer of the cardial section of the esophagus and formation of the areflux mechanism in the area
of cardioesophageal junction. The method of forming an artificial cardiac valve was developed on 20 rabbits of chinchilla breed of both
sexes weighing 5-10 kg. The study of the anatomy of the antireflux valve was studied using the method of freezing an isolated organ according
to the canons of «ice anatomy» according to N.I. Pirogov (1851) in the modification of A.A. Sotnikov and I.B. Kazantsev.
Results. The valve is represented as a circular fold of mucous and submucous layers. According to the results of an experimental study,
it is shown that the formed invagination valve retains its structure at all times of observation, without interfering with the natural passage
of food. Complications associated with the proposed procedure in the early and late postoperative period were not revealed.
Conclusion. The undertaken variant of operative intervention promotes the formation on the border of the esophagus and stomach of
a kind of antireflux structure that retains its anatomical consistency at all times of observation

1. Korolyov MP, Tkachenko OB. Treatment of achalasia
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2. Razumovskiy AYu, Mitupov ZB, Alhasov AB, Rachkov
VE, Pavlov AA, Feoktistova EV, Shchapov NF, Geodakyan
OS. Laparoscopic cardiomyotomy in children with esophagus
achalasia. Hirurgiya. Zhurnal im. N.I. Pirogova. 2009(5):58-63.
(In Russian)
3. Chikinyov YuV, Drobyazgin EA, Berkasova IV, Porshennikov
IA. Aktualnyie voprosyi hirurgicheskogo lecheniya
bolezney pischevoda i kardii. Novosibirsk : Sovetskaya
Sibir;2009.288 p. (In Russian)
4. Gonchar NV, Karavayeva SA, Ivanov DV, Volert TA,
Rubanik AP, Popova EV. Problems of diagnostics and treatment
of an akhlaziya of a gullet in children. Children’s medicine of
the Northwest. 2012;3(3):28-31. (In Russian)
5. Fomin PD, Kurbanov AK. Remote results of surgical
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6. Lopes LR, Braga N da S, de Oliveira GC, Coelho Neto Jde
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S, Yokobori T, Inose T, Nakajima M, Fukuchi M, Kato H,
Kusano M, Kuwano H. Primary esophageal motility disorders;
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770-5.
8. Richards WO, Torquati А, Lutfi R. The current treatment
of achalasia. Advances in Surgery. 2005(39):285-314.
9. Sweet МР Nipomnick I, Gasper WJ, Bagatelos K, Ostroff
JW, Fisichella PM, Way LW, Patti MG. The outcome of
laparoscopic Heller myotomy for achalasia is not influenced by
the degree of esophageal dilatation. Journal of Gastrointestinal
Surgery. 2008(12):159-65.DOI: 10.1007/s11605-007-0275-z.
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of achalasia in the era of high-resolution manometry. Annals of
Gastroenterology. 2015;28(3):301-8.
11. Vasnev OS, Nikanorov AV, Kim DO Masharova
AA, Yanova OB. Surgical treatment of neuromuscular
diseases of the esophagus. Eksperimentalnaya i klinicheskaya
gastroenterologia. 2011(2):126-30. (In Russian)
12. Belevich VL, Khokhlov A, Eliseev AV, Ovchinnikov
DV. Diagnosis and treatment of cardiac achalasia. Voennomeditsinskiy
zhurnal. 2014(12):32-6. (In Russian)
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of achalasia. Clinical and Experimental Gastroenterology.
2011(4):33-41.
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angle. Aktualnyie voprosyi neotlozhnoy i vosstanovitelnoy
hirurgii : . Krasnoyarsk;2011:163-4. (In Russian)
17. Hulselmans M, Vanuytsel T, Degreef T, Sifrim D,
Coosemans W, Lerut T, Tack J. Long-term outcome of pneumatic
dilation in the treatment of achalasia. Clinical Gastroenterology
and Hepatology. 2010(8):30-5.
18. Kadakia SC, Wong RK. Graded pneumatic dilation
using Rigiflex achalasia dilators in patients with primary
esophageal achalasia. The American Journal of Gastroenterology.
1993(88):34-8.
19. Eckardt VF, Gockel I, Bernhard G. Pneumatic dilation for
achalasia: late results of a prospective follow up investigation.
Gut. 2004(53):629-33.
20. Zerbib F, Thétiot V, Richy F, Benajah DA, Message L,
Lamouliatte H. Repeated pneumatic dilations as long-term
maintenance therapy for esophageal achalasia. The American
Journal of Gastroenterology. 2006(101):692–7.
21. Uppal DS, Wang AY. Update on the endoscopic
treatments for achalasia. World Journal of Gastroenterology.
2016;39(22):8670-83.DOI: 10.3748/wjg.v22.i39.8670.
22. Vela MF, Richter JE, Khandwala F, Blackstone EH,
Wachsberger D, Baker ME, Rice TW. The long-term efficacy
of pneumatic dilatation and Heller myotomy for the treatment
of achalasia. Clinical Gastroenterology and Hepatology.
2006(4):580-7.
23. Cheng JW, Li Y, Xing WQ, Lv HW, Wang HR.
Laparoscopic Heller myotomy is not superior to pneumatic
dilation in the management of primary achalasia: Conclusions
of a systematic review and meta-analysis of randomized
controlled trials. Medicine (Baltimore). 2017;96(7):5525.
DOI: 10.1097/MD.0000000000005525.
24. Boeckxstaens GE, Annese V, des Varannes SB, Chaussade
S, Costantini M, Cuttitta A, Elizalde JI, Fumagalli U, Gaudric
M, Rohof WO, Smout AJ, Tack J, Zwinderman AH, Zaninotto
G, Busch OR. Pneumatic dilation versus laparoscopic Heller’s
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D, Lutfi R, Sharp KW. Heller myotomy versus Heller myotomy
with Dor fundoplication for achalasia: a prospective randomized
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405–12.

The aim of the research. Improvement of surgery results in patients with abdominal pathology by use in operations of new biologically
active surgical suture materials (BASM).
Materials and methods. The prospective randomized controlled research of the early postoperative period in 654 patients with abdominal
pathology is executed. Surgical interventions to 539 patients are executed with newly developed BASM: «Nikant», «Nikant-P»,
«Tveran-HC» and «Tveran-HCG» (main groups). The control group included 115 patients. Operations were done with «Kapron» threads.
Results of surgical treatment were analyzed, including surgery results in different categories of interventions and various degrees of a
microbial contamination.
Results. The difference in number of systemic complications in patients of the main and control groups is not statistically reliable. The
total number of local postoperative complications in the main groups was almost twice less, than in control. Use of BASM decreases
the frequency of surgical site infection (SSI) in all categories of surgical interventions. Reliable depression of SSI in the main groups in
comparison to control was observed in case of contaminated and dirty operations. Lethal outcomes do not depend on type of used suture
material. Use of BASM promoted reduction of early postoperative period duration.
Conclusion. Use of new BASM for operations in patients with abdominal pathology promotes depression of SSI frequency and reduction
of early postoperative period duration. Use of BASM is indicated for operations which high risk of microbial dissemination of tissues
(contaminated and dirty operations) during an intervention.

Aim of the research. To study the effectiveness of minimally invasive interventions with the use of the tools developed by us (multichannel
retroperitoneoscope and multifunctional drainage) in comparison with traditional open operations in patients with acute severe
pancreatitis complicated by infected pancreatic necrosis and retropancreonecrosis.
Material and methods. In a randomized clinical study, a comparison was coducted of the treatment results of 42 patients with acute
severe pancreatitis complicated by infected pancreatic necrosis and retropancreonecrosis, treated with the use of minimally invasive and
hybrid techniques with the help of the tools developed by us (research group) and 41 patients of the comparison group treated traditionally.
Results. Differences in the number of postoperative complications were found from 73.8% to 31.7% (p <0.001), lethality from 54.7% to
17.5% (p <0.001), postoperative pain intensity from 7.67 ± 0.38 Score to 4.83 ± 0.34 points on the VAS scale (p <0.001), hospitalization
from 33.9 ± 3.4 to 21.4 ± 1.7 days (p <0.001) in the comparison and study groups respectively.
Conclusion. The use of minimally invasive techniques allows to reduce significantly the number of postoperative complications and
lethality, and also to stop pain syndrome quickly and shorten the duration of treatment in a hospital

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AJ, Camargo CA Jr. Direct medical costs of acute pancreatitis
hospitalizations in the United States. Pancreas. 2007;35(4):302-7.
DOI: 10.1097/MPA.0b013e3180cac24b.
4. Peery AE, Dellon ES, Lund J, Crockett SD, McGowan
CE, Bulsiewicz WJ, Gangarosa LM, Thiny MT, Stizenberg K,
Morgan DR, Ringel Y, Kim HP, Dibonaventura MD, Carroll
CF, Allen JK, Cook SF, Sandler RS, Kappelman MD, Shaheen
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6. Kondratenko PG, Kon’kova MV, Vasilyev AA, Epifantsev
AA, Dzhansyz IN, Shirshov IV, Yudin AA. Surgical tactics for acute
necrotic pancreatitis. Ukrainian Journal of Surgery. 2013(3):150-5.
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7. Mikhaylusov SV, Moiseenkova EV, Tronin RYu. Minimally
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8. Shirshov IV. The role and place of lumbotomy in the surgical
treatment of acute non-biliary infected necrotic pancreatitis.
Ukrainian Journal of Surgery. 2014(1):80-4. (In Russian)
9. Ermolov AS, Shlyakhovsky IA, Khramenkov MG On the state
of urgent surgical care for acute diseases of the abdominal cavity in
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10. Ivanov YuI. How to get out of the vicious circle. Medical
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11. Bukhvalov AG, Lebedeva YuV, Grekova NM, Bordunovsky
VN, Bukhvalova SA. Economic efficiency of minimally invasive
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12. Malorodova TN, Afanasyev YuI, Pokrovskaya TG, Kazakova
EE, Anikanova ТV. Microbiological landscape and antibacterial
therapy for infected pancreaticecrosis. Scientific Gazette. Series
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13. Safronova NN, Rudnov VA, Prudkov MI. Comparative
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14. Chernov VN, Belik BM, Alibekov AZ. Choice of treatment
tactics for patients with destructive forms of acute pancreatitis with
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15. Galimzyanov FV, Prudkov MI, Shapovalova OP. Infected
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16. Andryushchenko VP, Andryushchenko DV. The principle
of stage in the surgical treatment of acute pancreatitis with the
use of minimally invasive and traditional operating technologies.
Actual problems of surgical hepatology : materials of the XXth international
Congress of the Association of Surgeons-Hepatologists
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17. Andryushchenko DV, Kogut LN, Andryushchenko VP.
Minimally invasive intervention technologies in assessing the
severity of the clinical course of acute necrotic pancreatitis. Ukrainian
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18. Galimzyanov FV, Prudkov MI, Shapovalova ОP. Infected
forms of severe acute pancreatitis, choice of surgical
tactics. Journal of Ural Medical Academic Science. 2009(3):67-70.
(In Russian).
19. Galimzyanov FV, Shapovalova OP, Bogomyakova TM.
Some questions of diagnosis and treatment of an infected pancreatogenic
infiltrate. Ural Medical Journal. Surgery. 2009(1):60-3.
(In Russian).
20. Bugiantella W, Rondelli F, Boni M. Necrotizing pancreatitis:
A review of the interventions. International Journal of Surgery.
2016(1):163-71.
21. Kochetova LV, Dunayevskaya SS. Metabolic correction
in complex treatment of patients with sharp pancreatitis. Kazan
Medical Journal. 2011;92(3):315-8. (In Russian).
22. Loveday BP, Petrov MS, Connor S. A comprehensive Classification
of invasive procedures for treating the local complications
Of acute pancreatitis based on visualization, route, and purpose.
Pancreatology. 2011(11):406-13.
23. Vinnik YuS, Dunayevskaya SS, Antyufriyeva DA. Risk of
development of complications at sharp alcohol - associated pancreatitis.
Novosti Khirurgii. 2012;20(4):38-41.
24. Papachristou GI, Takahashi N, Chahal P. Peroral endoscopic
drainage/debridement of walled-off pancreaticnecrosis.
Annals of Surgery. 2007;245:943-51.
25. Van Baal MC, van Santvoort HC, Bollen TL. Systematic
Review of percutaneous catheter drainage as primary treatment
for Necrotizing pancreatitis. British Journal of Surgery. 2011;98:
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26. Prudkov MI Evolution of infected pancreatonecrosis, topical
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for necrotizing pancreatitis: an overview of current
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2013;7(5):463-75.

Aim of the research. To optimize the diagnosis of postoperative ventral hernia at performing multispiral computed tomography.
Material and methods. There were examined 967 patients on a 16 - slice computer tomography scanner General Electric Brightspeed
(USA). Among these patients there were 34 (3.5%) persons who had a reliably visualized tumor on the anterior abdominal wall.
During the study, the topography of muscular aponeurotic tissues was described: the location of the defect in the framework,
the size of the hernial sac, the gates, the connective tissue fusion between the wall of the hernial sac and its contents, and tissue
changes: its structure, density, thickness.
Results. The anatomical and topographic relationships of the elements of the anterior abdominal wall in patients with postoperative
hernia of the abdomen were significantly disturbed. On the basis of the data obtained, the forms of abnormal topography
abnormalities in the area of the hernial defect were identified.
Conclusion. MSCT is the most informative in the diagnosis of the condition of the anterior abdominal wall tissue in patients with
postoperative ventral hernia. The use of this technique makes it possible to obtain a more detailed and clear description of the
picture that influenced to the change in the topography and structure of the elements of the muscular aponeurotic framework. The
received forms of topography disorders will allow to develop rational preparation of the patient before the operation, depending on
the size of the hernia, and also to choose the optimal way of hernioplasty individually for each patient

1. Eriksson A, Rosenberg J, Bisgaard T. Surgical treatment for
giant incisional hernia: a qualitative systematic review. Hernia.
2014;18(1):31–8.DOI: 10.1007/s10029-013-1066-y.
2. Fedorov VD, Adamyan AA, Gogia BSh. Treatment of large
and giant postoperative ventral hernias. Surgery. 2000(1):11-14.
3. Gogia BSh, Alyautdinov RR, Kopyltsov AA, Tokarev ТV.
Modern view on the treatment of postoperative hernia of the
abdominal wall. CONSILIUM MEDICUM, Surgery. 2016(2):6-9.
4. Gossios K, Zikou A, Vazakas P, Passas G, Glantzouni A,
Glantzounis G, Kontogiannis D, Tsimoyiannis E. Value of CT after laparoscopic repair of postsurgical ventral hernia. Abdominal
Imaging. 2003;28(1):99-102.DOI: 10.1007/s00261-001-0156-y.
5. Killeen KL, Girad S, DeMeo JH, Shanmuganathan K, Mirvis
SE. Using CT to diagnose traumatic lumbar hernia. American
Journal of Roentgenology. 2000;174(5):1413-5.DOI: 10.2214/
ajr.174.5.1741413.
6. Martínez-Serrano MA, Pereira JA, Sancho JJ, López-Cano
M, Bombuy E, Hidalgo J. Risk of death after emergency repair
of abdominal wall hernias. Still waiting for improvement. Langenbeck’s
Archives of Surgery. 2010;395(5):551-6.DOI: 10.1007/
s00423-009-0515-7.
7. Gough VM, Vella M. Timely computed tomography
scan diagnosis Spieghelian hernia: a case study. Annals
of The Royal College of Surgeons. 2009;91(8):676.
DOI: 10.1308/147870809x450629.
8. Langer C, Schaper A, Liersch T, Kulle B, Flosman M, Füzesi
L, Becker H. Prognosis factors in incisional hernia surgery: 25
years of experience. Hernia. 2005;9(1):16-21.DOI: 10.1007/
s10029-004-0265-y.
9. Hood K, Millikan K, Pittman T, Zelhart M, Secemsky
B, Rajan M, Myers J, Luu M. Abdominal wall reconstruction:
a case series of ventral hernia repair using the component
separation technique with biologic mesh. The American Journal
of Surgical Pathology. 2013;205(3):322-7.DOI: 10.1016/j.
amjsurg.2012.10.024.
10. Aguirre DA, Casola G, Sirlin CB. Abdominal wall hernias:
MDCT findings. American journal of roentgenology. 2004;83:681-
90.DOI: 10.2214/ajr.183.3.1830681.
11. Aguirre DA, Santosa AC, Casola G, Sirlin CB. Abdominal
Wall Hernias:Imaging Features, Complications, and Diagnostic
Pitfalls at Multi-Detector Row CT. Radiology and RadioGraphics.
2005;25(6):1501-20.DOI: 10.1148/rg.256055018.
12. Emby DJ, Aoun G. CT technique for suspected anterior
abdominal wall hernia. American Journal of Roentgenology.
2003;181(2):431-3.DOI: 10.2214/ajr.181.2.1810431.
13. Gutierrez De la Pena C, Vargas Romero J, Dieguez Garcia
JA. The value of CT diagnosis of hernia recurrence after prosthetic
repair of ventral incisional hernias. European Radiology.
2001;11(7):1161–4.
14. Yurasov AV, Shestakov AL, Kurashvili DN, Abovyan
LA. The modern concept of surgical treatment of patients
with postoperative hernia of the anterior abdominal wall.
Vestnik Experimental and Clinical Surgery. 2014;4(7):405-13.
(In Russian)
15. Chevrel JP, Rath AM. Classification of incisional hernias
of the abdominal wall. Hernia. 2000;4(1):7-11.DOI: 10.1007/
BF01230581.
16. Dietz UA, Hamelmann W, Winkler MS, Debus ES, Malafaia
O, Czeczko NG, Thiede A, Kuhfuss I. An alternative classification
of incisional hernias enlisting morphology, body type
and risk factors in the assessment of prognosis and tailoring of
surgical technique. Journal of Plastic, Reconstructive & Aesthetic
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17. Dietz UA, Winkler MS, Härtel RW, Fleischhacker A,
Wiegering A, Isbert C, Jurowich Ch, Heuschmann P, Germer
CT. Importance of recurrence rating, morphology, hernial gap
size and risk factors in ventral and incisional hernia classification.
Hernia. 2014;18(1):19-30.DOI: 10.1007/s10029-012-0999-x.
18. Muysoms FE, Miserez M, Berrevoet F, Campanelli G,
Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I,
Hauters P, Hidalgo Pascual M, Hoeferlin A, Klinge U, Montgomery
A, Simmermacher RK, Simons MP, Smietański M,
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of primary and incisional abdominal wall hernias. Hernia.
2009;13(4):407-14.DOI: 10.1007/s10029-009-0518-x.
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Abdominal wall hernias: imaging with spiral CT. European
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American Journal of Roentgenology. 1993;161(6):1209-13.
DOI: 10.2214/ajr.161.6.8249727.
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22. Zarvan NP, Lee FT Jr, Yandow DR, Unger JS. Abdominal
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24. Tanaka EY, Yoo JH, Rodrigues Jr AJ, Utiyama EM, Birolini
D, Rasslan S A. Computerized tomography scan method
for calculating the hernia sac and abdominal cavity volume in
complex large incisional hernia with loss of domain. Hernia.
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25. Jaffe TA, O’Connell MJ, Harris JP, Paulson EK, DeLong
DM. MDCT of Abdominal Wall Hernias: Is There a Role for
Valsalva’s Maneuver? American Journal of Roentgenology.
2005;184(3):847-51.DOI: 10.2214/ajr.184.3.01840847.

Aim of the research. To present the experience of using water-jet dissection (WD) in robot-assisted radical prostatectomy (RaRPE) for nerve saving.
Material and methods. This technique was used in the course of operations in 10 patients with low and medium cancer risk.
Results. The first experience of using this technique showed good results of early recovery in urine retention and erectile function.
Conclusion. For aim to achieve more reliable evaluation of the effectiveness of the method, the study will be continued

1. Schurr M, Wehrmann M, Kunert W, Melzer A, Lirici M, Trapp
R, Kanehira E, Buess G. Histologic effects of different technologies
for dissection in endoscopic surgery: Nd: YAG laser, high frequency
and water-jet. Endoscopic Surgery and Allied Technologies. 1994;2
(3-4):195-201.
2. Lantis JC, Durville FM, Connolly R, Schwaitzberg SD. Comparison
of coagulation modalities in surgery. Journal of Laparoendoscopic
& Advanced Surgical Techniques. 1998;8(6):381-94.
3. Guru KA, Perlmutter AE, Butt ZM, Peabody JO. Hydrodissection
for preservation of neurovascular bundle during robot-assisted
radical prostatectomy. Canadian Journal of Urology. 2008;15(2):4000-3.
4. Gargollo P, Lee B, McGovern F, Dahl D. Hydrodissection of
the neurovascular bundles during laparoscopic radical retropubic
prostatectomy: A new technique. AUA 2004; Abstract V1979.
5. Patel MI, Spernat D, Lopez-Corona E. Hydrodissection of
neurovascular bundles during open radical prostatectomy improves
postoperative potency. The Journal of Urology. 2011;186(1):233-37.
DOI: 10.1016/j.juro.2011.03.022.

Aim of the research. To demonstrate clinical observations of the successful treatment of acute mesenteric thrombosis in the
Surgical Department No.1 of the NUZ “DKB at st. Samara” JSC “RZD “.
Material and methods. We describe two clinical cases of mesenteric thrombosis in elderly patients on the background of severe
concomitant cardiovascular diseases.
Results. After a number of surgical interventions and effective intensive care, in both cases, patients were recovered and the
quality of life was preserved.
Conclusion. Based on the experience of our observation, we consider it advisable not to impose an interintestinal anastomosis
in the primary operation, it is preferable to initially remove the ileostomy followed by restoration of the gastrointestinal continuity
1-3 days after stabilization of the patient’s condition and to obtain objective data on the absence of continuing intestinal necrosis

1. Shugayev AI, Vovk AV, Babkin VYa. Acute disorders of
mesenteric circulation – an urgent problem in the emergency
surgery of abdominal organs. Out-patient Surgery. Inpatient
Replacing Technologies. 2005;20(4):112. (In Russian)
2. Greenberg AA. Urgent abdominal surgery : the handbook for
doctors. Moscow : Triada-H;2000.496 p. (In Russian)
3. Yermolov AS, Popova TS, Pakhomova GV. A syndrome of
intestinal insufficiency in urgent abdominal surgery (from the
theory to practice). Moscow : MedAekspertPress;2005.460 p.
(In Russian)
4. Kokhan EP, Belyakin SA, Ivanov VA, Obraztsov AV,
Mironenko DA. Diagnostics and surgical methods of treatment of
patients with chronic abdominal ischemia. Angiology and Vascular
Surgery. 2010(4):135-8. (In Russian)
5. Savelyev VS, Spiridonov IV. Sharp violations of mesenteric
blood circulation. Moscow : Medicine;1979.232 p. (In Russian)
6. Davydov YuA. Infarction of intestine and chronic mesenteric
ischemia. Moscow : Medicine;1997.2008 p. (In Russian)
7. Bayeshko AA, Klimuk SA, Yushkevich VA. The reasons and
features of damage the intestines and its vessels at sharp violation
of mesenteric circulation. Surgery. 2005(4):57-63. (In Russian)
8. Bagdasarov VV, Bagdasarova EA, Chernookov AI,
Ramishvili VSh, Atayan AA, Yarkov SA. Medical and diagnostic
tactics at sharp intestinal ischemia. Surgery. 2013(6):44-9.
(In Russian)
9. Tarasenko SB, Leonchenko SB, Faber MI, Simonov IA,
Zatsarinny VV. A subtotal resection of intestines at the patient with
thrombosis of initial part of the upper mesenteric artery. Surgery.
2014(4):60-1. (In Russian)
10. Kozachenko AV. Violation of mesenteric blood circulation
as a problem of urgent practice. Medicine of Medical Emergencies.
2007;11(4):28-32. (In Russian)
11. Lubyansky VG, Zharikov AN. Use of primary and delayed
interintestinal anastomosing in patients with postoperative
widespread peritonitis. Bulletin of the East Siberian Scientific
Center of the Siberian Branch of the Russian Academy of Medical
Sciences. 2011;82(6):54–8. (In Russian)

There are single references in the world literature to clinically significant small pelvic cysts, requiring surgical intervention. Most often
these cysts are echinococcal or cysts of the not completely degenerated Mullerian duct. This clinical observation is devoted to the diagnosis
and treatment of the symptomatic cyst of the small pelvis, most likely, from the Mullerian duct.

1. Higashi TS, Takizawa K, Suzuki S, Nagashima J, Tamura S,
Obuchi M, Katayama M. Mullerian duct cyst: ultrasonographic and
computed tomographic spectrum. Urologic Radiology. 1990;12(1):39-44.
2. Moore RA. Pathology of the prostatic utricle. Archives of
Pathology. 1937;23:517–24.
3. Morgan RJ, Williams DI, Pryor JP. Mullerian duct remnants in
the male. British Journal of Urology. 1979;51(6):488-92.
4. Lucey DT, McAninch JW, Bunts RC. Genital cysts of the male
pelvis: case report of Mullerian and ejaculatory duct cysts in the same
patient. The Journal of Urology. 1973;109(3):440-3.
5. Ritchey ML, Benson RC Jr, Kramer SA, Kelalis PP. Management
of mullerian duct remnants in the male patient. The Journal of
Urology. 1988;140(4):795-9.
6. Rosi P, Bussani F, Vespasiani G, Virgili G, Cesaroni M, Pelliccioli
G. Mullerian duct cyst. Clinical evaluation and role of ultrasonography
and computed tomography in diagnosis. Rays. 1985;10(3):77-84.
7. McDougall EM, Clayman RV, Bowles WT. Laparoscopic excision
of mullerian duct remnant. The Journal of Urology. 1994;152(2
Pt 1):482-4.
8. Desautel MG, Stock J, Hanna MK. Mullerian duct remnants:
surgical management and fertility issues. The Journal of Urology.
1999;162(3 Pt 2):1008-13; discussion 14.
9. Krstic ZD, Smoljanic Z, Micovic Z, Vukadinovic V, Sretenovic
A, Varinac D. Surgical treatment of the Mullerian duct remnants.
Journal of Pediatric Surgery. 2001;36(6):870-6.
10. Goon HK, Tan KC, Sakijan AS. Mullerian duct cyst (utricular
cyst): treatment with the transvesical, transtrigonal approach. The
Australian and New Zealand Journal of Surgery. 1987;57(9):683-6.

The clinical picture of acute aortic dissection is diverse. However, like most patients entering the department of emergency cardiology, chest pain remains its main manifestation in 83% of cases. Aortic dissection is an acute life-threatening condition in which, during the first two days, every hour of delay in diagnosis increases mortality by 1%. The presented clinical case describes acute aortic dissection in
a 38-year-old male, type A by Stanford, with spread to common carotid arteries, a brachiocephalic trunk complicated by aortic valve failure of
grade IV. This case demonstrates a multidisciplinary approach and continuity in the treatment of this group of patients, that allowed to conduct
successful surgical treatment timely.

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LE, Rothwell PM. Population based study of incidence and
outcome of acute aortic dissection and premorbid risk factor
control 10-year results from the Oxford Vascular Study. Circulation.
2013(127):2031-2037.DOI: 10.1161/CIRCULATIONAHA.
112.000483.
3. Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF,
Casey DEJr, Eagle KA, Hermann LK, Isselbacher EM, Kazerooni
EA, Kouchoukos NT, Lytle BW, Milewicz DM, Reich DL, Sen S,
Shinn JA, Svensson LG, Williams DM. ACCF/AHA/AATS/ACR/
ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and
management of patients with Thoracic Aortic Disease: a report
of the American College of Cardiology Foundation/American
Heart Association Task Force on Practice Guidelines, American
Association for Thoracic Surgery, American College of Radiology,
American Stroke Association, Society of Cardiovascular
Anesthesiologists, Society for Cardiovascular Angiography
and Interventions, Society of Interventional Radiology, Society
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DOI: 10.1161/CIR.0b013e3181d4739e.
4. Diaz-Buschmann I, Castro A, Galve E, Calero MJ, Dalmau
R, Guzman G, Cordero A, Facila L, Quiles J, Arrarte V, Alonso
Gomez AM, Cequier A, Comin J, Fernandez-Ortiz A, Pan M,
Fernandez Lozano FW, Sanmartin M, Ferreira I, Brotons C, Lopez
Sendon JL, Mazon P, Alonso J, Abeytua M, Gonzalez Juanatey
JR, de Pablo C, Worner F, Castro - Beiras A. Comments on the
ESC guidelines on cardiovascular disease prevention (version
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2012.08.001.
5. Pape LA, Awais M, Woznicki EM, Suzuki T, Trimarchi
S, Evangelista A, Myrmel T, Larsen M, Harris KM, Greason
K, Di Eusanio M, Bossone E, Montgomery DG, Eagle KA,
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and Outcomes of Acute Aortic Dissection : 17-Year
Trends From the International Registry of Acute Aortic Dissection.
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6. Sampson UKA, Norman PE, Fowkes GR, Aboyans V,
Song Y, Harrell FE, Forouzanfar MH, Naghavi M, Denenberg
JO, McDermott MM, Criqui MH, Mensah GA, Ezzati M, Murray
C. Global and regional burden of aortic dissection and
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gheart.2013.12.010.
7. Knipp BS, Deeb GM, Prager RL, Williams CY, Upchurch
GRJr, Patel HJ. A contemporary analysis of outcomes for
operative repair of type A aortic dissection in the United States.
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8. Olsson C, Thelin S, Stahle E, Ekbom A, Granath F. Thoracic
aortic aneurysm and dissection: increasing prevalence
and improved outcomes reported in a nationwide populationbased
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106.630400.
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Karavite DJ, Russman PL, Evangelista A, Fattori R, Suzuki T,
Oh JK, Moore AG, Malouf JF, Pape LA, Gaca C, Sechtem U,
Lenferink S, Deutsch HJ, Diedrichs H, Marcos y Robles J, Llovet
A, Gilon D, Das SK, Armstrong WF, Deeb GM, Eagle KA. The
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Patients with ischemic heart disease suffer not only from this disease, but also from number of concomitant conditions that make it
difficult to select the optimal therapy. The most actual problem of comorbidity is manifested when there is a need for surgical treatment, primarily
with the use of artificial circulation. A multidisciplinary team of specialists is needed, which will discuss issues of the patient’s operability,
the choice of the revascularization method, the stage of interventions, and, finally, the conduct of combined procedures. The article presents the
clinical case of simultaneous surgical intervention – CB and gastrectomy – in a patient with ischemic heart disease and gastric cancer

1. Barbarash LS, Sumin AN, Bezdenezhnykh AV, Zhuchkova
EA, Barbarash OL. Prevalence of polyvascular disease in patients with
ischemic heart disease. Complex Issues for Cardiovascular Diseases.
2013; (3):4-11. (In Russian). DOI:10.17802/2306-1278-2013-3-4-11.
2. Sumin AN, Bezdenezhnykh NA, Bezdenezhnykh AV,
Kuz’mina AA, Ivanov SV, Belik EV, Barbarash OL. The renal filtration
function and diabetes mellitus type 2 as predictors of postoperative
complications after coronary artery bypass grafting. Kardiologiya
i serdechno-sosudistaya khirurgiya. 2015; 8(1): 17-25. (In Russian).
DOI: 10.17116/kardio20158117-25.
3. Parikh SV, Parikh A, Brilakis ES, Banerjee S. Simultaneous
dual coronary very late stent thrombosis following noncardiac
surgery. Cardiovascular revascularization medicine. 2010; 11(3):172-4.
DOI: 10.1016/j.carrev.2009.07.002.
4. Yoshio T, Nishida T, Hayashi Y, Iijima H, Tsujii M, Fujisaki
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The current trends in work of urology department include introduction of multi-modal strategy of active surgery treatment of
patients with urological diseases - fast track surgery, laparoscopy and robot assisted surgery. Our experience of fast track surgery and
minimally invasive treatment of urological patients has shown that they can improve the early postoperative period, reduce the pain and
risk of postoperative intestinal paralysis, decrease the recovery time and hospital time. Complex application of described principles allows
to achieve good results with various urological patients.

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