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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.

The article describes the results of laparoscopic cholecystectomy in patients with acute cholecystitis. 97 patients including 13 men and 84 women aged from 20 to 74 years were included in the study. There was not the conversion to laparotomy and intraoperative complications in all cases. 83 patients, which amounted to 85.7% of the patients, were discharged on the next day after operation. The last 14 patients had the variation of postoperative hospitalization period from 2 to 4 days. Laparoscopic cholecystectomy is a safe and effective procedure in patients with acute cholecystitis.

The article presents the results of surgical treatment of 1038 patients with cholelithiasis, acute and chronic calculous cholecystitis and complicated forms of the disease. Operations were performed with traditional laparotomic and minimally invasive approaches. Indications for choosing access, as well as the advantages and disadvantages of various options of surgery in patients with cholelithiasis are discussed.

It was done the analysis of surgical treatment results of 383 patients with the exacerbation of chronic calculous cholecystitis and acute obstructive calculous cholecystitis. All patients were operated from traditional and minilaparotomy approaches. Positive results were obtained in 93.2% of patients operated from minilaparotomy approach with a low rate of intraoperative and postoperative complications. Minilaparotomy cholecystectomy can be considered as a reliable mini invasive method of surgical treatment of patients with cholelithiasis, including purulent destructive forms of cholecystitis.

The article presents the results of surgical treatment of 596 patients with cholelithiasis, operated with minilaparotomy access. Good results were obtained in 93% of patients with chronic calculous cholecystitis, as well as acute inflammation. This access is provided a low number of intraoperative and postoperative complications. In addition, the minimal access allows to extend, if necessary, the intervention and control the complications.

The results of 165 laparoscopic cholecystectomies were analyzed. All patients were divided into two groups according their age: the 1st group embrased patients from 60 years and older and the 2nd group included younger patients. The mean operative time was 89.5 min among the patients of the 1st group and 94.8 min among the patients of the 2nd group. For the 1st and 2nd groups, respectively, the overall hospital stay was 13.1±0.6 and 9.4±0.3 days; and the postoperative treatment lasted for 6.7±0.5 and 7.5±0.3 days, respectively. Complications were registered in 1.3 and 2.2% of patients, respectively. Thus, the results and outcomes of the laparoscopic cholecystectomy in elderly patients are comparable with those in younger contingent.

The laparoscopic cholecystectomy in elderly patients. The treatment results of 142 patients with the cholelithiasis aged 23-84 years are represented. The operated patients were divided in two groups: those, younger 60 years; and the older patients, who were operated on laparoscopically. The authors proved, the the majority of the senile patients can be operated on laparoscopically.

289 patients were operated on the reason of perforative duodenal ulcer. Omental tamponade of the ulcer after Oppel-Policarpov was performed in 260 (90%) cases; traditional ulcer closure with omental support - in 13 (4,5%); excision of the ulcer - in 4 (1,4%); truncal vagotomy and pyloroplasty - in 9 (3,1%) and gastric resection was performed in 3 (1%) patients. After 277 operations "of minimal volume" major complications were registered in 21 (7,6%) patients with lethal outcomes in 9 cases. All patients received adequate antiulcer drug treatment. Follow-up results, obtained in 153 patients, demonstrated good results of the operation and nonrecurrent course in 133 (86,9%) cases. The omental tamponade of the ulcer after Oppel-Policarpov proved to be the method of choice in treatment of the perforative duodenal ulcer. Early beginning of antiulcer conservative treatment after the operation provide excellent results and stable recovery.

The study is based on the examination of 12 patients with perforative duodenal ulcer and 24 patients operated on recurrent bleeding duodenal ulcer. Some component of the immune system, such as T- and B-lymphocytes rates, immunoglobulin rate and macrophagal activity, were decreased prior the beginning of the complex treatment. Normalisation of humoral and cell immunity was registered on 10-12 days after the beginning of the ozone and low-intensive laser irradiation.

43 patients aged 60-84 years were operated on calculous cholecystitis. Patients were divided according to the operative technique: laparoscopic and traditional. The laparoscopic cholecystectomy demonstrated good early results. The goal of the study was to define criteria of the elderly patients selection for the laparoscopic operation.

Treatment results of 1048 elderly patients, operated on the cholelithiasis, were analyzed. The group of minilaparotomic access cholecystectomy numbered 488 (46,6%) patients; the second group consisted of 560 (53,4%) patients, who had the traditional operation. All patients were operated on in a single hospital during 1998-2008 yy. The cholecystectomy from minilaparotomic access proved to be less traumatic and preferable for elderly patients. The rate of postoperative morbidity was 5,7%, mortality - 0,2%. The procedure, though, is subjected to the experienced surgeons.

Surgical treatment of 27 patients with chronic colostasis and dolichocolon was analyzed. Groups of patients with cologenic and proctogenic colostasis were defined, diagnostic criteria were formulated and optimal surgical tactics were described for each group. Short and long-term results were analyzed and proved to be excellent and satisfactory in majority of patients.

53 patients with dolichocolon and chronic cologenic constipations were operated on. Results of comprehensive preoperative check-up, as well as results of surgical treatment were assessed. 88,7% of patients demonstrated good and satisfactory results. Active surgical tactics in respect of these patients, such as wider use of total colectomy and ileorectostomy is suggested.

Surgical treatment of 27 patients with chronic colostasis and dolichocolon was analyzed. Groups of patients with cologenic and proctogenic colostasis were defined, diagnostic criteria were formulated and optimal surgical tactics were described for each group. Short and long-term results were analyzed and proved to be excellent and satisfactory in majority of patients.

Method of the combined surgical treatment of patients with coloproctogenic constipation and dolichocolon and internal rectal prolapse had been worked out. The use of the suggested technique effectively prevents anorectal obstruction relapse.

Data of surgical treatment of 17 patients with proctogenic coprostasis and dolichocolon are summarized and analyzed. In spite of the colon stretching, the main reason of coprostasis in all patients was pelvic floor muscles disfunction. Etiologically aimed treatment provided good and satisfactory immediate and long-term results. An importance of scrupulous preoperative diagnostic and active surgical tactics are stressed.

Treatment data of 1279 patients with gastroduodenal ulcer bleeding are analyzed. Outcomes are comparatively analyzed depending on the chosen treatment modality. Optimal treatment algorithm is worked out. The expediency of conservative ulcer bleeding treatment, including primary and repeated endoscopic hemostasis, is proved. It allows performing deferred planned reconstructive operations, thus decreasing the operative risk substantially. Indications for the operative treatment of ulcer bleeding are specified, as well as efficacy and safety of organ-saving methods is proved.

Overall 162 patients with recurrent ulcers after previous operations for ulcer disease were treated. Resection of stomach was performed in 69 (42.6%) of them, vagotomy--in 93 (57.4%). Episodes of bleeding were revealed in anamnesis at 56 (81.2%) patients with peptic ulcers after stomach resection, and at 15 (16.1%)--with ulcers after vagotomy. Bleeding was the cause of urgent hospitalization at 39 (28.1%) patients. One hundred and thirty-six from 162 patients have been operated (including 52 patients after primary resection and 81--after primary vagotomy). Vagotomy at the patients with ulcers after primary resections demonstrates good results. Repeated resection of gastric stump with vagotomy is indicated in great penetrating ulcers. Resection of stomach is the operation of choice in majority cases of recurrent ulcers after primary vagotomy. Stem re-vagotomy demonstrates good result an the patients with ulcers of gastro-intestinal anastomosis after primary selective proximal vagotomy.

Results of treatment of 495 patients who has undergone various cardiac operations with artificial circulation are analyzed. The complex program "Blood-free surgery" was used at 388 (78.4%) of them. Among the patients treated traditionally the acute gastroduodenal erosions and ulcers were diagnosed at 25.7% patients, the rate of gastroduodenal bleedings was 3.0%. Complex of prophylactic measures permits to reduce the rate of acute erosions and ulcers in 1.5 times (18.4%) and the rate of postoperative gastroduodenal bleedings--to 0.7%. Control of risk factors, timely diagnosis, complex prophylaxis and treatment of acute gastroduodenal erosions and ulcers are effective way to improvement of operations results at cardiosurgical patients. "Blood-free" program doesn't lead to increase of acute postoperative gastroduodenal erosions and ulcers rate. Endoscopic (including repeated) hemostasis at acute ulcero-erosive gastroduodenal bleedings is available method and permits to achieve the stable hemostasis.

New method of organ-saving surgery for bleeding duodenal ulcer is described. Advantages of this method have been confirmed in experimental studies on 10 mongrel dogs and by successful clinical application at 3 patients with large bleeding ulcers of duodenum posterior wall.

Experience of surgical treatment of 73 patients with different postvagotomic syndromes was analyzed. The recurrent ulcers were seen most often -- in 54 (74.0%) patients. All the patients have undergone selective proximal vagotomy including isolated surgery in 19 patients and in combination with different drainage surgeries in 54 patients. High gastric secretion was the cause of recurrent ulcers in all the cases. Resection of the stomach was the most often reconstructive surgery -- 58 (79.5%) patients. Three (4.1%) patients died. It is concluded that postvagotomic syndromes are severe diseases of operated stomach with difficult treatment, further studies are necessary.

Experience with treatment of 262 patients with late complications after operations for duodenal ulcer was analyzed. Eighty-four (32.1%) patients underwent earlier suturing of perforated duodenal ulcer, 97 (37.0%) -- resection of the stomach and 81 (30.9%) -- various types of vagotomy. In recurrent ulcers after sutured perforation organ-saving operations (62, or 73.8%) have important advantages over resection of the stomach. Combined postgastrectomy syndromes (18, or 18.6%) were most difficult for surgical treatment. Resection of the stomach (70, or 86.4%) patients is the best reconstructive operation for postvagotomy syndromes.

Results of surgical treatment without transfusion of donor's blood in 58 patients were compared with ones in 40 patients treated with allogenous transfusions. Blood-saving program included preoperative storage of autoplasma, acute normovolemic hemodilution, recombinant human erythropoietin and perftoran. Both groups of patients were similar by types of surgeries performed on gastrointestinal tract. Results of treatment in the study group (58 patients) were better: there were less postoperative complications; period of postoperative rehabilitation was shorter. It is demonstrated that it is possible to refuse allogenous hemotransfusion in 96.6% cases of traumatic surgeries on gastrointestinal tract.

Two hundred and two patients with ulcers of a proximal part of the stomach (17.5% of all patients with gastric ulcer) were treated. In 135 (64.9%) patients these ulcers were complicated: in 28 (20.7%) -- malignant ulcers, in 42 (31.1%) -- bleeding ulcers, in 53 (39.3%) -- penetrating ones. Surgery was performed in 142 (70.3%) patients. A high rate of complications dictates a need to reduce period of conservative treatment of such ulcers to 6 months -- 1 year. Distal and proximal resection of the stomach are main surgeries in elective surgical treatment of patients with benign ulcers of cardia and sub-cardia. In malignant transformation gastrectomy is the most preferable. Suturing is indicated in perforated and bleeding ulcers, and if it is impossible -- distal subtotal resection of the stomach.

Over 15 years 208 patients with ulcers of the proximal part of the stomach (36 cardial and 172 subcardial) underwent surgery that constitutes 17,5% of all gastric ulcers. Seventy-two patients had uncomplicated ulcers, complications were diagnosed in 135 including 34 (16,4%) cases of malignant transformation. Successful surgical treatment of a proximal part of the stomach is based on timely complex diagnosis. High rate of complications dictates that conservative treatment of these ulcers should be limited to 6 months - 1 year. Indications for surgery must be also regarded when up-to-date drug therapy is ineffective during 2-3 months. Proximal and distal resection of the stomach are the main methods in surgical treatment of patients with benign ulcers of the cardia and subcardia. In malignant ulcer gastrectomy is recommended.

Complex program "Surgery without blood" was developed and introduced into a broad clinical practice. The main elements of this program are stimulation of erythropoesis, preparing in autoserum and autoblood before surgery with acute normovolemic hemodilution method, precise surgical technique, reinfusion of blood from wound and drainages, adequate anesthesia and correction of hemostasis system. This program permits one to minimize infusion of donor's blood components (DBC) in elective surgery (cardiosurgery, orthopedic surgery, neurosurgery, oncology, general surgery) and reduce significantly transfusion of DBC in urgent surgery. Rejection of DBC transfusion decreases number of postoperative complications and hospital stay, improves results of treatment and is cost-effective.

The method of plastic repair of the duodenal stump with an invaginated cone formed from the antral part of resected stomach was developed experimentally on 10 cadavers. Experimental surgeries on 16 mongrel dogs demonstrated primary healing and fast epithelisation of this duodenal stump. The method was used in 2 patients with giant penetrating ulcers of the posterior wall of the duodenum, promising results were seen.

The authors propose a complex program aimed to refuse completely using donor's blood components in surgeries on organs of digestive tract. This method was used in 25 patients who underwent surgeries with 380-1500 ml of blood loss. No patients received transfusion of donor's blood components before, during and after surgery.

Six patients aged from 27 to 62 years were operated for subtotal burn strictures, cancer and glandular polyp of a low-thoracic part of the esophagus using a complex program of non-blood surgery. The following methods were used: collection of autoplasma before surgery by plasmapheresis, collection of autologic packet red cells, normovolemic hemodilution during surgery, use of perftoran for oxygen transport and recombinant human erythropoetin to stimulate erythropoiesis and raise preporative level of hemoglobin. Components of donor blood were not used in these patients. There were no complications associated with these methods. Partial failure of esophagol-colonic anastomosis on the neck was seen in 1 patient. The complex program permits one to avoid completely transfusion of donor blood components in esophagol surgery.

Selective proximal vagotomy (SPV) was fulfilled in 440 patients with ulcer of the duodenum, 30.0% of them being operated upon for relative indications, and 70.0% for different complications of the ulcer. Different draining operations were made in 219 patients with stenosis. Draining operations were made in 10.6% of 254 patients without stenosis of the pylorus who had big and deep penetrating ulcers which could disturb duodenal passage on their healing. Resections of the stomach after Billroth-I were fulfilled in 20 of 43 patients with combined gastric and duodenal ulcers, and after Hofmeister-Finsterer in 23 patients in view of a danger of malignization. The best results were obtained after proper SPV and after operations eliminating stenosis and saving the evacuating mechanism of the pylorus (transversal duodeno-duodenostomy in 10 patients and duodenoplasty--in 22). Resection of the stomach should be performed by the Billroth-I method.

From 1989 to May 1999 selective proximal vagotomy (SPV) was performed in 400 patients with duodenal ulcer, 190 (47.5%) of them had pyloric stenosis. Various drainage operations were performed in 180 patients with stenosis, in 10 patients compensated pyloric stenosis was eliminated by excision of the scars around the ulcer. Out of 210 patients without pyloric stenosis drainage operations were performed in 23 (11.0%) patients with large penetrating duodenal ulcers, which at healing could cause stenosis. The best results were received after SPV in combination with drainage operations, which save the pyloric mechanism of gastric evacuation--transverse duodenojejunostomy (5) and duodenoplasty (15); the results after them do not differ from results after SPV without drainage operations.

In the period from 1985 to Sept. 1990 operations were conducted on 288 patients with duodenal ulcer; 165 of these patients (group I) were treated by selective proximal vagotomy (SPV) by the old method--without extensive mobilization of the cardia, esophagus, and fundus of the stomach; draining operations were used in 97% of patients. A perfected operative method was applied in 123 patients (group II)--besides extensive dissection of the zone of the esophagogastric junction all of them underwent circular esophagomyotomy 2 cm above the cardia and modified fundoplication. The indications for draining operations were limited (51.2% of patients). The results studied in 2.3 patients in follow-up periods of 6 months to 5 years confirmed the advantages of the perfected method of SPV: the number of recurrent ulcers reduced from 11.8% to 1.7%, that of the dumping syndrome from 9.2% to 4.5%, and the incidence of diarrhea from 7.8% to 3.3%. In groups I and II the results were excellent and good in 66.7% and 88.3% of patients, satisfactory in 21.6% and 10.0% of patients, and poor in 11.8% and 1.7% of cases, respectively. Perfection of the SPV method is directly reflected in its results which must be studied in follow-up periods of over 5-10 years for the evaluation to be more objective.

The authors characterize signs of the spread of carcinoma of the esophagus to the neighboring and remote structures, which were revealed by computerized+ tomography. The value of the method in identifying the stage of esophageal carcinoma is discussed. It is shown that the complex of signs must be taken into account in determining growth of the tumor into the neighboring organs. It is concluded that computerized+ tomography helps in dividing the patients into 3 main groups: patients with curable tumors; inoperable patients; patients in whom the volume of the operative intervention can be determined only during the operation. Conduction of computerized+ tomography in patients with carcinoma of the esophagus before the operation is considered expedient.