[Simultant operative interventions for diseases of the colon and other abdominal organs].

In the clinic of general surgery, basing on surgical department No 2, for the 2012 - 2013 yrs period 469 patients were operated for the large bowel diseases (LBD). In 60 (12.8%) patients in LBD and concomitant diseases of abdominal cavity simultant operative interventions (SOI) were performed. Rate of postoperative complications have constituted 15%. All the patients are alive. Performance of SOI, not depending from duration and significant volume of the operative intervention, we consider optimal and feasible, because the complications rate in the patients did not differ trustworthy from such after a standard operative interventions.

[Combined operative interventions for locally-spread diseases of large bowel].

In the clinic of general surgery, based on The Rural coloproctological centre, in 2012-2013 yrs 469 patients were operated for various diseases of large bowel. There were analyzed the results of treatment in 51 (10.8%) patients, to whom the combined operative interventions (COI) were conducted. For the large bowel tumors 48 (94.1%) patients were operated, for nontumoral diseases--3 (5.9%). COI, as a palliative procedures for the large bowel tumors of various localization, were performed in 22 (13.1%) patients, in 34 (67%)--with resection and excision of one organ, and in 17 (33%)--of two organs and more. In 49 (96%) patients the operation was completed by formation of interintestinal anastomosis or using colonic descendence. In adequate conduction of diagnostic measures and preoperative preparations of patients the COI performance is expedient, because it do not compromise the indices of the patients quality of life. For estimation of the COI risk grade it is necessary to take into account the volume and severity of each stage, expressiveness of the disorders in the organs and systems function as well as the tumors resectability.

[Reconstructive-restoration surgeries for nonspeciphic ulcerative colitis and colonic Crohn's disease].

Results of surgical treatment of 88 patients were presented, to whom radical surgery for nonspeciphic ulcerative colitis and Krohn's disease was performed. In 92% of observations the first-stage operation consisted of subtotal colectomy procedure with formation of separate ileostoma and sygmostoma, which was modified in the clinic. The reconstructive-restoration operation was performed in 61 (69.4%) of patients in 12 months after the first operation. The necessity to estimate the degree of the excluded colon readiness for the reconstructive-restoration operation performance was established, the terms of its application as well as the method and character of the operation were substantiated. The postoperative complications rate was (45,5+/-5,3)%. The result of reconstructive-restoration operation was considered good in 12, fair--in 61, unfair--in 15 patients. All the patients are alive.

[Intraoperative complications in performance of reconstruction-restoration interventions in patients, to whom one-barrel colostomy was constructed]. / Intraoperatsyonnye oslozhneniia pri vypolnenii rekonstruktivno-vosstanovitel'nykh vmeshatel'st u bol'nykh , kotorym nalozhena odnostvol'naia kolostoma.

Results of performance of reconstruction-restoration operations in 208 patients with one-barrel colostomy were analyzed. Earlier operation according to Hartmann procedure modification was performed in 138 (66.3% +/- 3.3%) of them, operation according to Hartmann--in 70 (33.7% +/- 3.3%). There were elaborated and introduced: the method of the intestinal continuity restoration, and also of the colonic anastomosis formation. The most frequent complications during performance of reconstructive operations were: deserosation of small intestine and colon, dissect of the hollow organ lumen, hemorrhage from the small pelvis veins. Cicatricial changes and adhesions in abdominal cavity and cavity of small pelvis were the main causes of the complications occurrence, making the intestinal loops and the colonic stump mobilization difficult, disordering the topographoanatomic arrangement of organs.

[Experience of laparoscopic hernioplasty in the treatment of inguinal hernia]. / Opyt laparoskopicheskoi gernioplastiki v lechenii pakhovoi gryzhi.

For 2001-2003 yrs period laparoscopic prosthesis hernioplasty was performed in 127 patients. Oblique reducible inguinoscrotal hernia had constituted the main nosological form of the disease. Peculiarities of preoperative preparation, anesthesiological support, operative procedures, complications postoperative management and medicinal securing of patients, immediate and late follow-up results of their surgical treatment were lighted on. The advantages of laparoscopic prosthesis hernioplasty were proved, such as the recurrence frequency lowering, social-economic efficacy, associated with reduction of the patients stationary stay, their labour rehabilitation and the recurrence absence.

[Specifics of restorative surgeries in patients with unilateral colostomy]. / Osobennosti vypolneniia vosstanovitel'nykh operatsii u bol'nykh s odnostvol'noi kolostomoi.

In 194 patients with one--barrel colostoma experience of the reconstructive-restoration operations stage) performance was summarized. The surgical tactics was studied depending on the main disease nature, peculiarities and complications of the first operative treatment, presence of accompanying diseases, terms of the restoration operation performance, length of colonic stump. Period from the moment of radical intervention performance to restoration operation had constituted from 5 months to 12 years. It is recommended to apply the end--to the stump side anastomosis after performance of the Gartmann type operation and in presence of a short stump--the colonic descendence into the rectum stump. Method of colonic descendence via the rectum stump after the tunnel formation using perineal access was proposed. The most frequent complications were observed after the Dyuahmel type of operation performance. For successful surgical treatment the authors recommend conduction of measures directed for prophylaxis of purulent--inflammatory complications, application of rational surgical tactics, adequate blood supply of transplant.