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This article presents results of surgical treatment of 2963 patients with cholelithiasis. The majority of them (71.8%) had an elective surgery, though 28.2% of patients underwent an emergency operation. A comparative assessment of obligate treatment criteria was made in 2 groups. A first group consisted of 803 patients and it was before introduction of Roman selection criteria used for surgical treatment of patients. A second group included 2963 patients in the period after introduction of selection criteria. Preoperative planning of surgery with evaluation of technical complexity of all stages of intervention with prognosis for possible complications should be the base of reasonable choice of surgical method of treatment of cholelithiasis and safety protection of surgery. The study completed and results obtained allowed decrease of the rate of postoperative complications to 1.4% and lethality--to 0.3%, respectively.

To study the results of simultaneous abdominal and retroperitoneal interventions.The article presents analysis of 856 simultaneous operations whose proportion was 3.49% of total number of operations. Most of them was performed via videolaparoscopic approach (697, 81.4%), open access and mini-laparotomy were used rarer (111, 12.9%) and 48 (6,7%) respectively). Severity of great number of interventions corresponded to degree I and II of D. Lochlein and R. Pichlmayer classification. Modern diagnostic methods including sonography, computed tomography, magnetic resonance imaging, angiography, endoscopy and laboratory data were used to define diagnosis.Simultaneous approach increases duration of surgery 30.3% on the average that is significant risk factor in case of surgery of severity degree III and videolaparoscopic interventions. Simultaneous surgery does not significantly increase ICU-stay and incidence of postoperative complications.Проанализированы результаты симультанных операций на органах брюшной полости, частота которых по отношению к общему числу всех хирургических вмешательств составила 3,49%. Большинство операций (697) выполнено видеолапароскопическим методом, из минилапаротомного (48) и открытого (111) доступов. Чаще производили сочетанные гинекологические (83,2%), абдоминальные хирургические (14,3%), реже урологические (0,8%) операции. Большинство сочетанных операций (89,8%) отнесено к I и II степени тяжести по классификации D. Lochlein и R. Pichlmayer. Сочетанные операции увеличивают продолжительность вмешательства в среднем на 30,3%, что является значимым фактором при операциях III степени тяжести и видеолапароскопических операциях. В то же время сочетанные операции не вызывали статистически достоверного увеличения срока проведения послеоперационной интенсивной терапии, а также летальности и частоты послеоперационных осложнений. Цель - изучение результатов симультанных операций у больных с заболеваниями органов брюшной полости и забрюшинного пространства. Материал и методы. В статье представлен анализ 856 симультанных оперативных вмешательств, доля которых к общему числу операций составила 3,49%. Большинство операций выполнено видеолапароскопическим способом (n=697, или 81,4%), реже из открытого (n=111, или 12,9%) и минилапаротомного (n=48, или 6,7%) доступа. Большая часть сочетанных операций отнесена к I и II степени тяжести по классификации D. Lochlein и R. Pichlmayer. При обследовании больных использованы современные методы лучевой (УЗИ, КТ, МРТ, ангиография), эндоскопической и лабораторной диагностики. Результаты. Выполнение симультанных операций увеличивает их продолжительность в среднем на 30,3%, что является значимым фактором при операциях III степени тяжести, видеолапароскопических операциях. Симультанные операции не вызывают статистически достоверного увеличения длительности пребывания больного в отделении интенсивной терапии и реанимации, а также - роста послеоперационных осложнений.

Results of treatment of postcolostomy patients are analyzed. In 74.7% cases colostoma was created due to tumor of the rectum or colon, in 6.5% -- due to diverticulosis, in 3.5% -- due to nonspecific ulcerative colitis, Krohn's and other diseases. Complications were diagnosed in 15.2% patients. Surgical treatment was carried out in 714 (43.6%) patients, 568 (79.5%) of them underwent reconstructive surgeries, 146 (20.4%) were operated for stoma complications. New methods of rectal stump preparation for surgery were used: method of differentiation of rectal stump and urether during surgeries, methods of delayed anastomosis. Laparoscopic mobilization of the colon during reconstructive surgeries led to a decrease of surgical trauma and number of complications.

Results of hemorrhoidectomy in 185 patients were analyzed. In 82 patients of the study group surgery was performed with "LigaSure" generator. Control group consisted of 103 patients who underwent surgery by Milligan-Morgan method. Appliance of "LigaSure" generator to reduced time of surgery by 3.5 times (from 48+/-10.3 min to 13+/-3.7 min), pain syndrome -- 2.2 times, and dysuric disorders -- 2.4 times.

The results of treatment of 645 patients with diverticular disease of the colon have been analysed. There were 65.4% of women and 34.6%--of men, 54.4% of patients were hospitalized urgently and 45.6% electively. 82.5% of patients underwent conservative treatment, 24.8% of them were operated. In hyperkinetic type of bowel motor activity preference was given to mini-invasive organ-saving operations. In 28 cases Laparoscopic serosa myotomy by Reilly and Hodson were carried out (in 17 cases through miniapproach). In hypokinetic type various types of resection of the colon (20 patients) were performed. In necessity for urgent operation various methods of operations may be made depending on general condition of the patient and extension of the pathologic process. In 29 cases initial resection with anastomosis has been performed. Postoperative complications developed in 20.5% patients. There were no lethal outcomes. In 66 cases 2-stage operations were carried out, lethality being 10.6%, and complications--23.7%.