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Aim. Demonstration of potentials of preoperative planning and implementation of surgical resection in patients with adrenal cysts. A clinical observation of a successful surgical treatment of a rare pathology cyst of the right adrenal is presented. The choice of surgical treatment tactics is determined by the size of tumor and clinical presentation of the disease. The surgical treatment was accomplished laparoscopically which permitted to reduce the time of recovery and rehabilitation of the patient. In this clinical observation, the benefit of using 3D-modeling of the surgical area was shown for visualization of topographic and anatomic peculiarities and facilitation of the intraoperative navigation with the help of Avtoplan program developed by Samara State Medical University. Conclusion. Preoperative 3D-modeling permits to prepare to surgical intervention taking into account individual anatomic peculiarities of a patient, and to determine the optimal volume of the operation.

The importance of treatment of patients with lymphedema of lower limbs arises from difficulties in their medical and social rehabilitation. At the expressed stages of the disease resection surgical operations are indicated which present complicated interventions. In the work clinical observation of a 33 yearold female patient with IV stage of primary lymphedema of the right lower limb is presented. In the course of conservative treatment after a complex examination including volumetry, ultrasound, computed tomography, the patient was made dermalipofascioectomy using method of shave therapy. The operation of modified dermalipofascioectomy of the shin was performed by Karavanov II method under spinal anesthesia with use of mono and bipolar coagulation. At the stage of elimination of fibrotically changed tissue dermatome Acculan 3Ti (GA 670) was used with controlled ranges of thickness within 0.21.2 mm and width within 878 mm. Intraoperative loss of blood and lymph was 800 ml and was compensated for with crystalloid, colloid solutions and fresh frozen plasma in the volume of 600 ml. Active drainage of the region of the postoperative wound was conducted by Redon method within 1012 days. Postoperative period ran without complications, with improvement of the patient’s condition. Clinical observation showed a positive role of application of shave therapy apparatus at the main stage of resection operations.

Ulcerative colitis (UC) is a common disease with the evident tendency to annual increase in incidence. The disease mostly affects young individuals of active working age. The peak of incidence of the disease is observed at the age of 20-29 and 50-55 years. The aim of study was optimization of diagnostics and management of patients with ulcerative colitis by correction of antibacterial therapy on the basis of the data of microbiological examination of the microflora of the wall of colon. Materials and Methods. 35 Patients with ulcerative colitis from 28 to 61 years of age with the average age 37.6 years who underwent outpatient and stationary treatment in colonoproctology and gastroenterology departments of SamSMU clinics in the period from January to May 2017 were examined. Of them, 18 were males (48.6%) and 17 females (51.4%). Results. Significant species diversity of microflora was identified that requires exact species identification and development of standard procedures for isolation of microorganisms from bioptates of patients with ulcerative colitis with the aim of administration of antibacterial treatment. In analysis of sensitivity of the isolated strains to antibiotics 45% of the isolated microorganisms were found to have signs of resistance to 1-2 groups of medical drugs, and 33% showed signs of resistance to 3 and more groups. Only 22% of strains were found to be sensitive to all tested preparations. Eradication of such flora presents certain difficulties, and in our opinion, requires administration of combined therapy after examination of bioptate. Conclusions. All patients with ulcerative colitis require examination of the microbial composition of the intestinal wall for optimization of diagnostics and treatment. 105-106 titer of microorganisms, their wide species diversity may support inflammation in the colon and prevent relief. It is necessary to continue study of microbiological composition of the colonic wall in the comparative aspect for optimization of diagnostics and management of patients with ulcerative colitis.

Pilonidal sinus is a disease which occupies an important place in Coloproctology profile and constituting 15% of all purulent diseases of the anus. The aim of this work is the analysis of the results of surgical treatment of patients with pilonidal sinus: by closing the wound with a continuous suture with the catch of the bottom of the wound (modified method) in comparison with excision of Pilonidal sinus and suturing wounds seams Moshkovich. All patients (n=82) were divided into 2 groups (30 and 52 patients), respectively completed the operational manual. We performed the analysis of the results of treatment according to operative time, early postoperative complications, disease relapses, the severity of pain, timing of rehabilitation, and identified the differences between the groups for the development of early postoperative complications (χ2=21.72; p=0.05). Thus, the obtained statistically significant data on the advantage of the method of wound closure with a continuous suture with the catch of the bottom of the wound over the method of suturing wounds seams Moshkovich.