[Two unusual causes of peptic anastomotic ulcer]. / Dve neobychnye prichiny pepticheskoi yazvy anastomoza.

Two unusual cases of anastomotic ulcer complicated by bleeding after gastric resection are reported. There were retained antrum in one patient and long 'dry' intestinal loop after laparoscopic Roux resection in another one. Emergency gastric stump resection with Haberer procedure were successfully performed in both cases.

[Metastasis of clear cell renal cell carcinoma into small bowel in 5 years after nephrectomy]. / Metastaz svetlokletochnogo pochechnokletochnogo raka v podvzdoshnuyu kishku spustya 5 let posle nefrektomii.

Small bowel tumor causes gastrointestinal bleeding in 1-4% of cases. Gastrointestinal bleeding from metastases of renal cell carcinoma is a rare and little-known manifestation of this disease. We report a rare clinical case of a solitary metastasis of clear cell renal cell carcinoma into small bowel in 5 years after nephrectomy. The first symptom was intestinal bleeding. This example emphasizes the need for more thorough examination of patients with symptoms of latent and anamnestic blood loss.

[The 'missing' of the duodenum]. / Sluchai 'otsutstviia' dvenadtsatiperstnoi kishki.

The article presents the outcome in patient with duodenal congenital abnormality caused by defective intrauterine rotation of the intestinal tube with premature turn of back intestine.

[Evolution of complex treatment of patients with non-specific pleural empyema]. / Évoliutsiia metodov kompleksnogo lecheniia bol'nykh s nespetsificheskoi émpiemoi plevry.

AIM: To analyze long-term own experience of NPE treatment in view of evolution of surgical sanitation of pleural cavity. MATERIAL AND METHODS: The analysis included 5115 patients with NPE for the last 39 years (1977-2015). Morbidity, features of microflora of purulent exudate, changes in the structure of surgical methods were assessed. The role of computed tomography in the diagnostic algorithm and treatment of NPE was studied. RESULTS: The evolution of NPE surgical management includes introduction of video technologies, thermal surgical instruments and widespread use of computed tomography in the diagnosis of pleural empyema. So, significant reduction of patients who were discharged with residual cavities was observed. Postoperative mortality was 19.5% for the period 1977-1996 when traumatic open surgery was used. At the same time there were no deaths within 1997-2015 due to introduction of VATS pleural drainage. Overall mortality decreased from 4.9% to 3.2% for the same period due to reduced postoperative complications. CONCLUSION: The introduction of minimally invasive technologies, new thermal surgical instruments changed management of NPE patients, reduced the number of traumatic open procedures. So, improved outcomes were achieved.

[Transhiatal esophagectomy for cardia and esophagus cancer]. / Transkhiatal'naya ezofagektomiya pri rake kardii i pishchevoda.

AIM: To present the result of transhiatal esophagectomies with simultaneous repair. MATERIAL AND METHODS: The study included 67 procedures. In 35 cases surgery was carried out for adenocarcinoma of distal esophagus or cardia with high transition to esophagus, in 32 cases - for epidermal carcinoma of the esophagus. Gastric graft and left half of the colon were used in 60 and 7 cases respectively for simultaneous repair. 29 patients underwent transhiatal instrumental esophagectomy using author's original technique.

[Surgical and combined correction of tracheal and laryngotracheal cicatricial stenosis and restenosis]. / Lechenie trakheal'nykh i laringotrakheal'nykh rubtsovykh stenozov i restenozov.

AIM: To improve treatment of patients with cicatricial tracheal stenosis using different methods of recanalization and circular resection. MATERIAL AND METHODS: Analysis involved 57 patients with cicatricial tracheal stenosis including 2 post-traumatic cases, 27 post-intubation cases, 25 cases after tracheostomy and 3 restenoses after previous circular resection. There were 5 cases of tracheal stenosis combined with tracheoesophageal fistula, 1 patient with chest nodular goiter, 8 cases of unclosed tracheostomy and 3 patients with long-existing laryngotracheal fissure. There were 25 women and 32 men aged 15-65 years. Stenosis length ranged from 3.0 to 4.5 cm in 66.6% of patients. There were 13 (22.8%) patients with subcompensated stenosis (d=0.5-0.7 cm) and 44 (77.2%) cases of decompensated stenosis (d<0.5 cm) combined with suppurative tracheobronchitis that required endosurgical recanalization with stenting or balloon dilatation. 45 patients underwent upper tracheal third resection, 9 - middle third resection, 3 - upper third and cricoid cartilage resection. Length of excised segment was 2.5-9.5 cm. Simultaneous suturing of esophageal anterior wall defect was performed in 5 cases. RESULTS: Complete recovery of tracheal lumen was achieved in 54 patients (93%). Restenosis occurred in 4 (7%) cases (3 of them underwent repeated resection with good results and 1 - stenting). CONCLUSION: Circular resection is optimal treatment of cicatricial tracheal stenosis. Endosurgical recanalization is preparatory method prior to radical surgery.