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The experience of performance of urgent simultant operations (SO) on abdominal cavity organs in 63 patients (of them in 12--using laparoscopic technologies) was summarized. The material was compared and analyzed using statistical methods in three clinical groups, suffering concomitant surgical diseases in patients of gastroenterological, coloproctological and herniological profile. There were shown the possibilities and proved the expediency of SO performance in environment of the abdominal cavity urgent surgery in multiprofile general surgery clinic for enhancement of the patients treatment and an optimal surgical tactics choice.

The literature data concerning the problem of simultant operative interventions were analyzed and the unsolved topics were delineated. Basing on the detailed analysis of results of the operations obtained in 78 patients, performed for coexistent diseases, the authors consider the simultant operative interventions in elective surgery of the abdominal cavity the method of choice in presence of two-three coexistent diseases, which must be surgically treated.

Results of performance of reconstructive-restoration operation in 7 patients with ascendostomy were analyzed. Of them in 4 as the first stage supraanal rectal resection was performed and in 3 - Gartmann operation. There was proposed the method for colonic continuity restoration after Gartmann operation performance, in which pancreatic stump is mobilized along its posterior wall, securing nutrient vessels up to highest point and lower surface of the pelvic peritoneum sheet. The pelvic peritoneal sheet is dissected from the peritoneal cavity side under guidance of surgeon hand and the rectoscope tube, introduced into rectal stump. During performance of second stage in all the patients massive adhesions were revealed. Postoperative complications were absent.

Results of surgical treatment of 88 patients were presented, to whom radical surgery for nonspeciphic ulcerative colitis and Krohn's disease was performed. In 92% of observations the first-stage operation consisted of subtotal colectomy procedure with formation of separate ileostoma and sygmostoma, which was modified in the clinic. The reconstructive-restoration operation was performed in 61 (69.4%) of patients in 12 months after the first operation. The necessity to estimate the degree of the excluded colon readiness for the reconstructive-restoration operation performance was established, the terms of its application as well as the method and character of the operation were substantiated. The postoperative complications rate was (45,5+/-5,3)%. The result of reconstructive-restoration operation was considered good in 12, fair--in 61, unfair--in 15 patients. All the patients are alive.

Results of performance of reconstruction-restoration operations in 208 patients with one-barrel colostomy were analyzed. Earlier operation according to Hartmann procedure modification was performed in 138 (66.3% +/- 3.3%) of them, operation according to Hartmann--in 70 (33.7% +/- 3.3%). There were elaborated and introduced: the method of the intestinal continuity restoration, and also of the colonic anastomosis formation. The most frequent complications during performance of reconstructive operations were: deserosation of small intestine and colon, dissect of the hollow organ lumen, hemorrhage from the small pelvis veins. Cicatricial changes and adhesions in abdominal cavity and cavity of small pelvis were the main causes of the complications occurrence, making the intestinal loops and the colonic stump mobilization difficult, disordering the topographoanatomic arrangement of organs.

For 2001-2003 yrs period laparoscopic prosthesis hernioplasty was performed in 127 patients. Oblique reducible inguinoscrotal hernia had constituted the main nosological form of the disease. Peculiarities of preoperative preparation, anesthesiological support, operative procedures, complications postoperative management and medicinal securing of patients, immediate and late follow-up results of their surgical treatment were lighted on. The advantages of laparoscopic prosthesis hernioplasty were proved, such as the recurrence frequency lowering, social-economic efficacy, associated with reduction of the patients stationary stay, their labour rehabilitation and the recurrence absence.

In 194 patients with one--barrel colostoma experience of the reconstructive-restoration operations stage) performance was summarized. The surgical tactics was studied depending on the main disease nature, peculiarities and complications of the first operative treatment, presence of accompanying diseases, terms of the restoration operation performance, length of colonic stump. Period from the moment of radical intervention performance to restoration operation had constituted from 5 months to 12 years. It is recommended to apply the end--to the stump side anastomosis after performance of the Gartmann type operation and in presence of a short stump--the colonic descendence into the rectum stump. Method of colonic descendence via the rectum stump after the tunnel formation using perineal access was proposed. The most frequent complications were observed after the Dyuahmel type of operation performance. For successful surgical treatment the authors recommend conduction of measures directed for prophylaxis of purulent--inflammatory complications, application of rational surgical tactics, adequate blood supply of transplant.

The results of surgical treatment of 600 patients with rectal fistula were analyzed. Intrasphincter fistula was observed in 204 patients (34%), transsphinctered fistula--in 72 patients (12%), extrasphincter fistula--in 324 patients (54%). In order to decrease the rate of recurrence of fistula, during performance of plastics of internal hole of the fistula the graft of all the wall of rectum (not only its mucosa) was mobilized up to the level of anal sphincter. Post-operative complications and recurrence of fistula occurred in 4% of patients.

The experience of treatment of 9 patients with metachronous megacolon and colonic cancer was analyzed. Clinical signs of the disease are diverse. Radical surgical intervention is singularis method of treatment of such patients.

A total of 182 critical patients with sepsis (n = 62), prolonged compression syndrome (PCS) (n = 41), toxic allergic dermatitis (TAD) presenting as Lyell's and Stevens-Johnson's syndromes (n = 54), and stages I-II status asthmaticus (SA) (n = 25) were examined. Statistical computer processing of the data by the method of comparing the means and analysis of correlations revealed a cascade of numerous mediators and metabolites which can be regarded as manifestations of the systemic inflammatory response syndrome (SIRS). This syndrome develops as a reaction to infection, toxic products of microorganisms, ischemic reperfusion lesions, and humoral cytotoxic reactions and is responsible for the formation of multiple organ disorders. Inefficiency of 7-10-day traditional intensive care necessitated active repair of the natural defense mechanisms and addition to the therapeutic complexes of hemo- and plasmaxenosplenoperfusion variants developed by the authors. Despite multiple organ disorders, splenoperfusion decreased the period of critical state from 24 to 12 days in sepsis, from 28 to 18 days in TAD, from 14 to 10 days in PCS, and from 17 to 7 days in SA. The mortality in sepsis dropped from 32.4 to 8%, in TAD from 10.7 to 4%, in PCS from 38.8 to 14.7%, and in SA from 15.9 to 5%. No additional drug therapy or equipment was needed.