[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.

[Extensive purulent processes after combined phlebectomy]. / Obshirnye nagnoitel'nye protsessy posle kombinirovannoi flebéktomii.

OBJECTIVE: To analyze the causes and develop methods for the treatment of extensive purulent processes after combined phlebectomy in patients with lower limb varicose veins. MATERIAL AND METHODS: The authors reported 3 cases of extensive phlegmon after phlebectomy for the period from 2014 to 2018. It is shown that comprehensive debridement of purulent-inflammatory lesion with application of additional methods including high-energy exposure by the air-plasma flow is essential for effective treatment of this complication. In addition, literature review showed only few observations of severe septic complications after traditional varicose vein surgery. RESULTS: Radical debridement of purulent wounds with wide excision of necrotic subcutaneous tissue and fascia, combination of standard surgical technique and plasma scalpel, as well as subsequent plasmodynamic staged wound repair in a therapeutic mode prevented severe purulent-inflammatory process, stopped systemic inflammatory syndrome and resulted fast wound healing. CONCLUSION: Active surgical approach combined with air-plasma technology was followed by high-quality correction of extensive suppurative process. Minimally invasive management of varicose disease with improvement of surgical techniques will minimize the likelihood of these complications.

[AIR-PLASMA TECHNOLOGY IN COMPLEX TREATMENT OF WOUND INFECTION].

THE PURPOSE OF THE STUDY: optimization of the results of treatment of wound infection. The authors analyze the results of treatment of 589 patients with wound infection for the period from 2004 to 2017. During the surgical treatment and further local therapy, air-plasma technology was used. The results were compared with those in 280 people, treated according to the standard method (control group). It was found, that air-plasma treatment of the suppurative inflammation of soft tissue in the cutting-coagulation regime significantly accelerates the necrolysis of the wound surface and the subsequent repair of postnecretomic wounds (in 1.5-1.8 times), regardless of the level and extent of the lesion of the integumentary tissues. Plasmodynamic sanation in the NO-therapy regimen stimulates the growth of granulation tissue and processes of epithelialization, allows to significantly reduce the degree of microbial contamination of the focus, and also to shorten the period of inpatient treatment. Similar trends relate to other important indicators. In patients with wound infection of soft tissue, air-plasma technology must be included in the complex of local therapeutic measures.

[The comparative analysis of laparoscopic and minilaparotomic techniques in emergency abdominal surgery].

Owing the experience of 16 101 miniinvasive operations by acute diseases of the abdominal cavity, the authors pose that the introduction of polytechnological methods has certain perspectives. The combination of different methods with the use of modern technologies lead to better results.

[The use of modified diagnostic scale in patients with acute appendicitis].

The diagnostic scale of acute appendicitis was combined using literature review and retrospective analysis of patients' data. Clinical symptoms, laboratory tests and ultrasound investigation were comprehensively analyzed. Thus, all patients could be divided in three groups: 1st group (1-3 points according to the used scale) had low possibility of the acute appendicitis; 2nd group (4-7 points) united patients, requiring further diagnostic challenges and dynamic follow-up; 3rd group (8 points and more) had patients, who should have been operated on. Intraoperative view and histological investigation of the appendix were considered as reference diagnostic methods. Thereby, sensitivity, specificity, accuracy and prognostic value of positive and negative results the suggested diagnostic scale were 87,0, 96,7%, 91,3, 94,0 and 89,2%, respectively. Number of vain appendectomy was 12,3%.The scale allows to perform the right surgical treatment tactics with no regard of personal doctor's experience.