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Objective: To evaluate the results of using titanium thread mesh implants in the treatment of anterior abdominal wall hernias., Material and Methods: This article evaluates the titanium thread mesh implant used by us in the treatment of 240 patients with anterior abdominal wall hernias; describes the features of this type of implants and the technical features of various types of operations using them., Results: The overall rate of postoperative complications was 2.9%. Hernia recurrence was observed in 2.4% of patients after laparoscopic transabdominal preperitoneal hernioplasty., Conclusions: The use of a mesh implant made of titanium thread did not reveal any specific complications for this implant. At the stage of gaining experience with a mesh implant made of titanium thread, technical difficulties may occur when placing and fixing it, which increases the duration of surgery.

Aim: Study of the results of the use of titanium thread mesh implants in the treatment of postoperative ventral hernias., Methods: The study included 84 patients with postoperative ventral hernias. All performed open-access prosthetic hernioplasty. 2 groups were formed: the main group consisted of 32 patients who used a mesh implant made of titanium thread as an implant, the comparison group consisted of 52 patients whose hernioplasty was performed using a polypropylene mesh implant. There were no statistically significant differences between groups of patients by age, gender, average body mass index, risk class of anesthesia (ASA), size and location of hernias., Results: The frequency of postoperative complications in the main group was 6.2%, in the comparison group - 3.8%. There were no statistically significant differences in this indicator between the groups. At the time of discharge from the hospital, the level of plasma C-reactive protein in patients of the main group was significantly lower than in patients of the comparison group., Conclusion: The use of titanium thread mesh implants in the treatment of postoperative ventral hernias is accompanied by a less inflammatory response of the body to the implant and does not lead to an increase in the frequency of postoperative complications.

Objective: To analyze the results of minimally invasive surgical treatment of patients with urgent colon diseases., Material and Methods: There were 89 patients with urgent colon diseases. All patients were divided into 2 groups: the main group - 31 patients who underwent laparoscopic surgeries, the control group - 58 patients operated via open access. Both groups were comparable by age and underlying disease. However, significant differences in gender, severity of comorbidities and complications of the underlying disease were observed., Results: Surgery time, postoperative morbidity (9.7% vs. 6.9%) and postoperative hospital-stay were similar in both groups. Quality of life was significantly better in the main group compared with the control group if colostomy was absent. In case of stoma, there were no between-group differences., Conclusion: Laparoscopic surgery is associated with reduced need for analgesics, similar duration of intervention and postoperative morbidity. Complete restoration of quality of life in these patients is observed in 6 months after surgery. Colostomy results similar quality of life after laparoscopic and open surgery.

Objective: To analyze surgical (including minimally invasive) treatment of advanced age patients with colon cancer and severe comorbidities., Material and Methods: Advanced age patients with colon cancer (≥60 years) were compared with younger ones. Concomitant diseases were detected in 94,4% of older patients and in 45,9% of patients in the control group (χ 2 =51,747; p <0,001)., Results: Surgery time, intraoperative blood loss, length of hospital-stay, postoperative morbidity and mortality were similar., Conclusion: Severe comorbidities did not significantly affect surgical outcomes in these patients and did not increase postoperative morbidity and mortality.

Aim: To develop rational tactics of surgical treatment of patients with acute calculous cholecystitis with their subsequent discharge within 1 day since admission., Material and Methods: There were 283 patients with acute cholecystitis and 58 patients with chronic cholecystitis. All patients underwent laparoscopic cholecystectomy. Patients with acute cholecystitis were divided into 2 groups: main group - 136 patients were discharged within 1 day since admission, control group - 147 patients who were discharged later. Age, gender, duration of attack and ASA score were similar in both groups., Results: Incidence of intraoperative complications was significantly higher in the control group compared with the main group (6.1% vs. 0.7%). There were no postoperative complications in the main group; postoperative morbidity in the control group was 6.1%. Criteria preventing discharge within 1 day since admission were developed. Uneventful early postoperative period after laparoscopic cholecystectomy allows us to discharge 48% of patients with uncomplicated acute calculous cholecystitis within 1 day since hospitalization. The developed algorithm of treatment is followed by reduced hospital-stay by 4 days., Conclusion: The developed algorithm of treatment of patients with acute calculous cholecystitis can reduce hospital-stay up to 1 day. Favorable early postoperative period and follow-up of patients after discharge are essential for safe treatment.

Aim: To assess advisability of video-assisted surgery in advanced age patients with colorectal cancer., Material and Methods: The study involved 44 patients with large intestine tumors. There were 30 patients with colon cancer aged 78.0±1.1 years and 14 patients with rectal neoplasms aged 75.0±1.8 years. All of them underwent elective video-assisted resections without conversion of the approach., Results: Good and satisfactory results were achieved in 95.5% of patients. Postoperative complications occurred in 5 (11.4%) cases followed by redo surgery in 2 (4.5%) patients. Mortality was absent., Conclusion: Video-assisted procedures are preferable in elective surgery of colorectal cancer in advanced age patients regardless stage and localization of the process.

Aim: To evaluate the role of laparoscopic surgery for colorectal cancer in advanced age patients., Material and Methods: 290 patients with colorectal cancer were enrolled including 121 patients with rectal cancer and 169 patients with colon cancer. Main group consisted of 171 patients over 60 years old, control group - 119 patients younger 60 years old., Results: Radical advanced procedures on different parts of colon including laparoscopic approach were performed in the majority of advanced age patients. Outcomes were considered as good, we did not notice serious complications (5.4% after rectal surgery, 3.9% after colon surgery). Differences were not significant compared with younger patients including laparoscopic interventions for emergency indications. Nevertheless, surgical treatment of advanced age patients with colorectal cancer makes special demands for equipping of the clinic and physicians' qualification., Conclusion: Advanced age is not a serious limitation in choice of laparoscopic access in both elective and emergency surgery in patients with colorectal cancer.

Aim: To assess the role of endoscopic technologies in treatment of complicated forms of colorectal cancer., Material and Methods: Our trial included patients after endoscopic intervention (n=18) and open surgery (n=11)., Results: Mean time of surgery in this group was 158.8±10.7 minutes. In elective surgery group this value was 161.3 minutes (p>0.05). Mean blood loss was not great (near 122.5±17.9 ml). Overall and postoperative hospital-stay was 23.1±2.4 and 8.6±0.5 days, respectively. There were no intraoperative and postoperative complications., Conclusion: Endoscopic interventions may be performed for colon cancer for emergency indications including patients with severe complications.

Aim: To evaluate endoscopic technologies in treatment of patients with colorectal cancer and severe comorbidities., Material and Methods: Two groups of patients after endoscopic (group 1, n = 58) and open (group 2, n = 40) surgery were assessed., Results: Comorbidities were observed in 90.7% patients in group 1 and 83.3% patients in group 2 (p > 0.05). Mean comorbidity index was 6.9±0.3 (2-14) and 7.1±0.7 (2-18) in both groups respectively. Comorbidities ASA grade 3-4 were observed in 88.2% patients of group 1 had and in 71.4% patients of group 2 (p > 0.05). One patient of group 1 with intra-abdominal bleeding required conversion of surgical approach. In another case the conversion was due to technical difficulties during intestinal resection. Postoperative complications were noted in 2 patients (3.4%). There were no intraoperative complications in group 2. Postoperative complications were observed in two cases (5.0%)., Conclusion: Severe comorbidities do not impose serious restrictions on the choice of endoscopic approach in colorectal cancer patients.

Aim: To assess laparoscopic surgery in treatment of colon cancer patients., Material and Methods: The results of laparoscopic treatment of patients with colorectal cancer are presented in the article. It was estimated the influence of various clinical parameters including age, gender, comorbidities, tumor localization and stage and complications on laparoscopic management of these patients., Conclusion: It was revealed that efficiency of laparoscopic surgery in patients with colon cancer is affected by tumor stage and presence of complications.

Aim: To develop the protocol of surgical management of cholelithiasis in short-stay hospital., Material and Methods: Surgical treatment of 161 patients with cholelithiasis was analyzed. All of them underwent elective cholecystectomy. Short-stay hospital group included 41 patients. 120 patients were operated in surgical department (group 2)., Results: Incidence of intraoperative complications was 2.4% and 3.4% in both groups respectively (p>0.05). Postoperative complications were more frequent in group 2 (8.3% vs. 2.4%, p<0.05). Mean hospital-stay was 1 and 4.4 days in both groups respectively., Conclusion: Treatment of chronic calculous cholecystitis is advisable in short-stay hospital. Indications for this approach and its safety in certain patients were determined. The protocol of surgical management of chronic cholecystitis in short-stay hospital was develped.