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Experience of organization of the surgical care in the military hospital to 438 wounded in extremities during armed conflict in Republic of Chechnya is generalized. Maximum reduction of stages of medical evacuation of the wounded in extremities, approaching of the qualified and urgent specialized surgical care directly to the region of battle actions, use of opportunities for it one-moment rendering corresponded to principles of the modern military-medical doctrine. Due to realization of the requirements of the doctrine life of many wounded ++ was saved, terms of treatment, medical and social rehabilitation are reduced. Besides lethality, treatment cost and numbers of transferring to the reserve from the Armed Forces were reduced.

In 50% of afflicted pilots, cholelithiasis is asymptotic and develops with the minimum anatomicomorphological changes of the biliary system. An early diagnostics of cholelithiasis in the pilots will enable one to treat them timely with the aim of returning the pilots to flying activity in the future. The introduction of nonsurgical treatment methods into the clinical practice with an application of distance shock-wave cholelithotripsy will elevate the percentage of pilots returning to flying activities. A need for developing domestic special devices for cholelithotripsy is ripe.

The evolution of the domestic-certified lithotriptors has made a complete professional rehabilitation of all pilots (100%) suffered from urolithiasis without operative intervention possible. Of 156 pilots who have been exposed to remote shock-wave lithotripsy (RSWL) in recent three years 120 individuals (93%) had the urate stones in the renal calyces. Before introducing the RSWL in clinical practice such concrement were recognized as inoperable and the urolithic pilots have no prospects for continuation of their flying activities. After the RSWL application there was a decrease in the secretory-excretory renal function due to the disturbed urodynamics by the migratory fragments of crushed stones in the renal system. The recovery of renal function occurred after complete passage of the crushed stone fragments. Depending on the composition of a crushed concrement, severity of inflammatory process taking place in the kidneys and urinary tracts, the special program of countermeasures to prevent relapsed lithogenesis was recommended for use by the patients. The relapse of renal stone formation after RSWL application was noted in 4 (3.2%) pilots. In these pilots, the concrements were recrushed by the mentioned method and professional qualification of above individuals was retained. Until recently, the treatment of cholelithic disease was recognized as a purely surgical problem--with the introduction of RSWL of renal stone into clinical practice there appeared real possibility to apply the similar approach to crushing the gallstones. To attain these ends, the experimental studies with the use of lithotriptor "URAT-P" have been performed. 140 gallstones of 0.5 to 2.0 cm in size were crushed. The parameters of shock waves are determined.(ABSTRACT TRUNCATED AT 250 WORDS)