[Organization and results of surgical care for ulcerative gastroduodenal bleeding in the hospitals of Central Federal District]. / Organizatsiya i rezul'taty khirurgicheskoi pomoshchi pri yazvennom gastroduodenal'nom krovotechenii v statsionarakh tsentral'nogo federal'nogo okruga.

AIM: To present treatment of 52 149 patients with ulcerative gastroduodenal bleeding (UGDB) who were treated in different regions of Central Federal District (CFD) for the period 2011-2014. It is noted that UGDB incidence per 100 thousands is increased proportionally from 32.9 to 77.8 according to population less than 20 and over 100 thousands, respectively. In hospitals of small and medium settlements the number of UGDB patients without surgery reaches 81.6 and 81.1%, the number of operated patients - 18.4 and 18.9% respectively. In hospitals of large settlements this ratio is 90.1 and 90.6%, the number of operated patients - 9.9 and 9.4%, respectively. In areas of Central Federal District the mortality rate in patients without surgery is 3.9-8.2%, in operated patients - 17.4-36.9%. RESULTS: Structured analysis of the organization of surgical care in Central Federal District revealed the relationship between outcomes and efficient use of endoscopic diagnostics and haemostasis. In municipal hospitals of Central District endoscopic technologies are insufficiently used for final elimination of ulcerative bleeding.

[The ways to improve the efficiency of surgical care service].

AIM: To examine the work of surgical service in the Central Federal District and to define the main directions to improve the efficacy of surgical care in case of acute abdominal diseases. MATERIAL AND METHODS: The results of surgical service of the Central Federal District for the period 2011-2014 in treatment of 2.5 millions patients were analyzed. RESULTS: Parameters in elective and emergency surgery persuasively prove stable work of surgical service of the Central Federal District for recent years. Obtained results were compared with the indicators of emergency surgical care in Moscow for objective assessment. It was revealed 2-4-fold decrease of overall and postoperative mortality in Moscow. CONCLUSION: Conditions for all-day diagnostic and medical assistance for emergency abdominal diseases should be created to improve the effectiveness of surgical service of the Central Federal District.

[Effects of inguinal hernioplasty mesh implant on reproductive function].

In vivo experiment involved 95 white breedless male rats of pubertal age. The animals were divided in three groups: 1st group had unilateral hernioplasty with mesh implant; 2nd group had bilateral mesh implantation and 3rd group had animals with hernioplasty with lavsan thread. The results were assessed with the use of morphological method, the state of reproductive organs - with the use of biological method and compared with the control (intact) group. Stable progressive increase of thickness of epithelium and spermatic duct wall during the whole observation time was registered after hernioplasty with mesh implantation. In the group after hernioplasty with lavsan thread the above mentioned changes returned to normal values by the end of the first month after the operation. Disorders of the reproductive system in animals after bilateral mesh implantation turned out to be essential and resulted in sterility within the whole time of the observation. Mildly decreased or average fertility was observed among animals after unilateral mesh implantation and hernioplasty. Notably, that after hernioplasty with lavsan thread, fertility was sufficient. The study demonstrated the negative influence of mesh implant on spermatic duct structure, which may cause infertility.

[Method of laparoscopic treatment of gastroesophageal reflux with mesh implant]. / Sposob laparoskopicheskogo lecheniia gastroézofageal'nogo refliuksa s ispol'zovaniem setchatogo implantata.

Modern potential of endoscopic surgery promoted expansion of indications for surgical treatment of gastroesophageal reflux disease. The majority of laparoscopic methods has a number of significant disadvantages. Methods of laparoscopic treatment of gastroesophageal reflux using the implant with partial anterior fundoplication or without it were developed. These methods simplify surgical technique, permit to save topographoanatomical relationships of organs and at the same time restore Hiss angle and ensure work of sphincter that satisfy requirements to antireflux operations.