Materials and methods. In research took part 43 patients (26 patients in basic group A and 17 patients in control group B) in age from 41 to 82 years (middle age was 67.1 ± 0.1 years) with the severe lower extremities atherosclerotic ischemia (III–IV of the stages). Among them there 36 were men and 7 women. Distributing of patients by the disease stages was following: IIIA stage – in 31 (72.1 %) patients (rest pain), IV stage of disease – in 12 (27.9 %) patients (pains of rest + trophy disorders as trophy ulcers, superficial necropsies or limited gangrene of fingers feet). Patients in A group applied simvastatin (10 mg) once a day during 60 days. Patients of B group were treated by standard schemes with direct or indirect anticoagulants, antiplatelets. Patients of both groups used L-arginin during 10 days, patients with skin lesions – antibiotics according to its sensibility. In research such indexes were appraised as: blood stream linear systole speed, blood stream volume speed, peripheral resistance indexes, and also stage of pain syndrome, morphological state of vascular wall of arteries of lower extremities on the thickness of complex intima-media, degrees of stenosis, to the dynamics of growth of atherosclerotic plaque in the deep femoral artery, biochemical indexes of blood. The period of research time made 3 month.

Results and discussion. Findings testify the substantial diminishing of pain syndrome in patients of group A: on 57.1 % among patients IIIA stage, on 38.5 % among patients IIIB stage and on 48.4 % among the patients of the IV stage. At the same time among the patients of group A there was a pain syndrome progressive increase: on 33.0 % in patients with IIIA, on 21.7 % in patients with IIIB and on 16.4 % in patients with IV. Among the patients of group A new trophy disorders was not fixed. The trophic ulcer area increase and necrosis were found out in 2 (8.0 %) patients on the average on 1.1 ± 0.2 sm on 10th and 60 days of research. Among the group B patients in 3 (12.0 %) new trophic disorders as a trophic ulcer and necropsies were found out. Life quality index, appraised in an analog scale, increased from 3.51 ± 0.18 to 8.3 ± 0.4 in the group of Simvatin, to 7.0 ± 0.5 in a group B (p < 0.05). The improvement of hemodynamic indexes was marked in patients of group A with IIIA ischemia stage. Among the group B patients, in opposite, there was worsening of hemodynamic indexes. In 16 (61.5 %) group A patients he sizes of plaques diminished more than on 20 % and partial atherosclerotic plaques transformation from hypoechogene to hyperoechogene in 21 (80.8 %) patients. Through 60 days of Simvatin treatment the reliable decline of general cholesterol and cholesterol of high-density levels was marked (p < 0.001).

Conclusions. In patients with the atherosclerotic lower extremities ischemia of III–IV stages after 2 month Simvatin course (daily dose is 10 mg) peripheral hemodynamic improvement, blood stream linear speed increasing in the lower extremities arteries and peripheral resistance reducing were revealed. The course of Simvatin statistically for certain diminishes the complex intima-media thickness in the lower extremities arteries, in 61.5 % patients diminishes the sizes of atherosclerotic plaque, in 80.8 % hypoechogene atherosclerotic plaque transformed to hyperoechogene and heterogeneous, had expressed hypolipidemic action. The Simvatin application is accompanied with endothelial function improvement improves a peripheral hemodynamic, lipid metabolism that grounds to recommend Simvatin for pharmacological treatment in this patient’s category.

Keywords: chronic ischemia of lower extremities, multicentre research, simvastatin.

The aim – improvement of treatment results of shin bones open diaphiseal fractures by small- and minimal-invasive osteosynthesis methods practical usage, planed repeated wound treatment (second look) and fixing method changing.

Materials and methods. 108 patients with 111 shin bones open diaphiseal fractures were operated in Kiev Regional Clinical Hospital N 1 from 2004 to 2008. The mean age of patients was 35.1 years. Men were – 88 (81.5 %), women – 20 (18.5 %). There were 42А – 33, 42В – 47, 42С1 – 31 open tibia fractures according to АО/ASIF classification. Open shaft shin bones fractures were classified according to Gustilio: 1degree – 30 (27 %) fractures, 2 degree – 65 (58.5 %) fractures, 3А degree – 12 (10.8 %) fractures, 3В degree – 3 (2.7 %) fractures, 3С degree – 1 (0.9 %).The definitive tibia fractures fixation methods were external fixators АО – 76 (68.5 %), external fixators Ilizarov – 5 (4.5 %), plates – 26 (23.4 %), locking intramedullary nails – 4 (3.6 %). Changing of fixing method from external fixation to plate was carried out in 5 (4.5 %) cases.

Results and discussion. Treatment results were studied in 108 patients in accordance with order № 41 from 30.03.1994 by Ministry of Health of Ukraine requirements in terms from 1 to 4 years after trauma. Good results were marked in 71 (65.74 %) patients, satisfactory – 26 (24.07 %) patients, unsatisfactory – 11 (10.1 %) patients. The pledge of open shaft shin fractures successful treatment is in the complex of resources, which includes preventive contamination wounds maintenance, accurately primary wound treatment, faultless fracture stabilization, massive antibiotic therapy. Planned repeated surgical wound treatment at 3 degrees open fractures is especially important stage of wounds treatment which gives the chance to reduce the infectious-inflammatory complications rate as in early, and the remote postoperative period. Changing the tibia diaphiseal fractures fixing method by dipping osteosynthesis allows to excess complete extremity rehabilitation, that’s very important for adjacent joints contractures prevention and best anatomicfunctional results reception.

Conclusions. The received positive treatment results in 89.8 % indicates the given treatment tactics efficiency in victims with open shaft shin bones fractures.

Keywords: open diaphyseal fractures of shin bones, extrafocal osteosynthesis in external fixation device.

The aim – to estimate selective antibiotic therapy efficiency in patients with acute cholecystitis destructive forms.

Materials and methods. The treatment results of 112 patients with acute destructive cholecystitis were estimated. Patients were divided on two groups depend on antibiotic therapy method: the control groups (53 patients with acute phlegmonic cholecystitis and 28 – with acute gangrenous cholecystitis) and the research group (19 patients with acute phlegmonic cholecystitis and 12 – with acute gangrenous cholecystitis). 81 (72.3 %) patients who were treated by open cholecystectomy with traditional intravenous antibiotic therapy (cefoperason 1 gram 3 times per day during 5–7 days) consist control group. 31 (27.7 %) patients who were treated by open cholecystectomy with intra-arterial antibiotic therapy by erythrocyte’s shadows by common hepatic artery catheter way (cefoperason 1 gram 2 time in day – 3 days) consist the research group.

Results and discussion. 18 (22.2 %) patients of the control group have complications: pneumonia – 5 (6.2 %), postoperative wound infection – 11 (13.6 %), subhepatic abscess – 2 (2.5 %). 3 (3.7 %) patients of the control group was dead. Average duration of in-patient treatment in the control group was 11.7 ± 1.2 days, average duration of antibiotic therapy – 6.2 ± 0.4 days, average cefoperason course dosage – 18.6 ± 0.7 grams. 4 (12.9 %) patients of research group had complications: hematoma in femoral artery catheterization focus 3 (9.7 %), postoperative wound infection – 1 (3.2 %). Average in-patient treatment duration in research group was 5.1 ± 0.42 days, average antibiotic therapy duration – 3.0 ± 0.1 days, average cefoperason course dosage – 6.1 ± 0.2 grams.

Conclusions. Selective antibiotic therapy by erythrocyte’s shadows makes it possible to certain (p < 0.05) reduces of postoperative complications rate in patients with acute cholecystitis destructive forms (phlegmonic and gangrenous) from 22.2 to 12.9 %, avoids lethal results of treatment, reduces average duration of in-patient treatment from 11.7 to 5.1 days, decreases time of antibiotic therapy from 6.2 to 3.0 days and certain (p < 0.05) decreases average dose of cefoperason from 18.6 to 6.1 grams.

Keywords: acute destructive cholecystitis, surgical treatment, antibiotic therapy, cefoperason, erythrocyte’s shadows.

The aim – studying of cefepim application clinical efficacy in patients with burns.

Materials and methods. Basic complex therapy, with which research was carried out, included traditional burn treatment. Original cefepim (comparison group) and a Ukrainian medication (Kvadrocef by Arterium; the basic group) appointed in the presence of burn wounds big area (from 10 to 35 % of the body surface area) and system inflammatory clinical symptoms answer since first days after a burn trauma during 8–12 days. Basic group 25 patients have compounded, comparison group – 20 patients at the age from 20 till 65 years with burn wounds, depth of a lesion – ІІ–III degrees, from January till December, 2009

Results and discussion. Cefepim was clinically effective in 20 (80 %) patients with a burn trauma. Burn wound microbic contamination, clinical expression of system inflammatory reaction, a microbic sensibilization, conservation of systems of natural detoxification at the subcompensated level that is important for preventive maintenance of development of infectious complications reduction were observed after its application.

Conclusions. Cefepim possesses high clinical efficacy (80 %) in patients with extensive burns and clinical symptoms of system inflammatory reaction. Efficacy of a Ukrainian medication did not concede that original. Cefepim course application in patients with burns promotes decrease in clinical signs of system inflammatory reaction, qualitative and quantity microbe wounds contamination indicators, to natural detoxification systems activity conservation at the subcompensated level.

Keywords: burn disease, infection, sepsis, phagocytes functional activity, cefepim

The aim – to estimate the developed burns depth diagnostics method based on perfusion indicators, received by laser Doppler fluorimetry.

Materials and methods. Since 2007 for burn wounds microcirculation research was used laser Doppler fluorimetry, carried out by means of capillary blood-groove analyzer «LAAK-02». Object of research were 42 miners injured with explosion of a methane-coal mix during the period with 2007 for 2009 which were treated with above described method (the basic group). The second group (comparisons) have generated as from 42 burnt explosions which have burnt by a flame during the period with 2006 for 2009 by which laser Doppler fluorimetry was not used in the preoperative period. For an estimation of efficiency of a method of diagnostics compared the area of a burn wrongly accepted for deep or for superficial.

Results and discussion. Due to developed diagnostics way application it was possible to reduce in 2.1 times the area of incorrectly estimated depth of a superficial burn and in 1.65 times to lower the area wrongly executed xenotransplantation on sites of a deep burn.

Conclusions. Developed defeats depth diagnostics method allows defining more precisely in the burn shock period the perfusion presence in the amazed skin that testifies to its viability. Burn wounds depth diagnostics quality improvement in victims with the considerable defeat area has allowed to execute effectively operative treatment in the burn shock period as much as possible and to improve burn illness currency.

Keywords: laser Doppler fluorimetry, burn depth, diagnostics.

The aim – to study frequency and features of second ptosis surgical correction, to conduct its results analysis and to develop the optimal methods of operative treatment.

Materials and methods. From 1996 till 2009 year 568 primary augmentations had been done. For the same period 17 operations had been done for a reason of the second ptosis.

Results and discussion. Three different forms of ptosis were observed: combining breast tissue ptosis with implant (9 cases), breast tissue ptosis with optimal implant position – «snoopy breast» (5 cases) and implants ptosis with normal position of the nipple-areolar complex – «bottoming out» (3 cases). In case of combining ptosis – reduction of dermoglandular «cover», moving NAC in cephalic direction and modification of tissues is required. In case of glandular ptosis – reduction of dermoglandular «cover» and moving NAC in cephalic direction is required without modification of tissues. In case of implant ptosis diminishing of dermoglandular «cover» and modification of tissues required without moving NAC.

Conclusions. Secondary ptosis appears as a result of tactical mistakes during primary augmentation, and also as a result of change properties of tissues after operation revealed in 3 %. During correction of the secondary ptosis it is necessary to use adequate methods taking into account individual features of the breast tissues.

Keywords: augmentation, breast ptosis, mastopexy, implant.

Materials and methods. Allohernioplasty results during 2004–2009 in 176 patients with different kinds of anterior abdominal wall hernias were analyzed. 140 patients were operated for postoperative ventral hernias, for umbilical – 10 and for inguinal – 26 patients. Allohernioplasty was done by sublay procedure in 67cases of postoperative ventral and umbilical hernias, by sublay intraabdominal – in 20, inlay – in 15 і onlay – in 15 patients, for inguinal – hernioplasty by Liechtenstein. Patients have been divided into two groups. The first (basic) included 116 patients’ diosmin and hesperidin to which diosmin and hesperidin were prescribed: in the first days of the postoperative period dose was 2 tablets three times a day, since the second day – 1 tablet three times a day before complete operational wound healing and suture removal. In the second group (comparisons, 60 patients) in the postoperative period the traditional medications were appointed. An assessment of wound complications preventive efficacy after allohernioplasty was done by following indicators: expressiveness and duration of a pain syndrome in the early postoperative period; character and duration of drainage tubes abjections established in paramesh space; drainages fluid excreted cytological research results; wound complications as seromas, infiltrations, hematomas; duration of postoperative in-patient stay.

Results and discussion. Diosmin and hesperidin were appointed under the developed scheme. Analysis of wound complications prevention efficacy testifies, that on a number of indicators (pain syndrome expressiveness and duration, term of serous abjections, data of cytological research, presence of operational wound complications, duration of postoperative in-patient stay) the offered mean of preventive has advantages before traditional methods of treatment and promotes reduction of frequency of complications (accordingly 2.6 and 15 %).

Conclusions. Alloplasty materials use in anterior abdominal wall hernias surgical treatment can be accompanied by wound postoperative complications occurrence. Diosmin and hesperidin application after allohernioplasty is effective for wound complications prevention and it can be recommended for introduction in medical practice.

Keywords: allohernioplasty, postoperative complications prevention, diosmin, hesperidin.

The aim – to study bemiparin influence on coagulation indexes tests in patients after ventral hernias plasty of and simultaneous operations.

Materials and methods. In 39 patients who were included in research at the age from 23 till 70 years from 01.02.2009 till 01.02.2010 operations for ventral hernias with simultaneous pathology were the executed. Patients have been distributed on two groups. The basic group was compounded by 20 patients, which applied bemiparin in the postoperative period for thromboembolic complications preventivion (Zibor, by Berlin-Chemie Menarini) in a dose of 2500 anti-Xa factor IU activity hypodermically 1 time a day through 6 hours after operation. 19 patients were included in control group, which with the same purpose received dalteparin (Fragmin, Pfizer) in the same dose hypodermically 1 time a day through 6 ч after operation. For the thromboembolic efficacy control coagulation time, prothrombin time, blood fibrinogen rate, prothrombin index and solvable fibrin-monomeasured complexes level (SFMK) in a blood plasma were defined. Laboratory researches were carried out before operation, on 3 and 7 days of the postoperative period.

Results and discussion. Both basically, and in control group in no one patient thromboembolic and hemorrhagic complications was revealed as well as Heparin-induced thrombocytopenia. The average blood loss volume in the postoperative period in bemiparin and dalteparin group did not differ and has compounded 66.25 ± 57.8 ml (M ± s) in the basic group and 94.7 ± 79.5 ml – in control (р = 0.207). At carrying out of correlation analysis by Spearman it is revealed authentic positive correlation of average SFMK level with average duration of operative intervention (r = 0.467, р = 0.044) and with average intraoperative blood loss volume (r = 0.673, р = 0.002), other correlation dependences statistically are not significant. In the basic group the authentic correlation dependences it is not revealed. It testifies that in case of bemiparin application for thromboembolic complication prevention the risk of their development depends less from operative trauma.

Conclusions. Bemiparin application for thromboembolic complication prevention in patients after hernioplasty simultaneous operations in a dose of 2500 anti-Xa factor IU activity hypodermically 1 time has a day caused authentically less SFMK blood plasma level in comparison with dalteparin application in the same dose that testifies to its higher activity concerning prevention of intravascular coagulation. In case of bemiparin application SFMK peak growth and correlation between SFMK blood plasma level and intraoperative blood loss volum and operation duration that gives it certain advantages in thromboembolic complication prevention after long and traumatic operative interventions were not found.

Keywords: hernioplasty, ventral hernias, simultaneous operations, bemiparin.

The aim – to analyze the preventive alloplasty efficiency for incision ventral hernias prevention in patients with simultaneous abdominal pathology

Methods and materials. In 102 patients surgical treatment of simultaneous abdominal pathology were performed in period from 2004 to 2009 in Kyiv City Clinical Hospital N 15. 52 patients were operated with simultaneous alloplasty of front abdominal wall by «sublay» technique in first group. In second group 52 patients were operated with conventional closing of laparotomy wound.

Results and discussion. Early treatment results were evaluated for 52 patients of first group and for 52 patients of second group. Those results were evaluated as good ones. Remote results in terms from 1 to 3 years were evaluated by repeated inspections and questionnaire design. In first group 48 patients were investigated for incision ventral hernia that was not found. In second group 47 patients were investigated, and in 5 (9.8 %) of them incision ventral hernia was found.

Conclusions. For patients with risk of incision ventral hernia, especially under simultaneous pathology of abdominal cavity organs, preventive alloplasty can be used as a method of choice for incision ventral hernias prevention.

Keywords: simultaneous operations, preventive alloplasty, complex prevention of incision ventral hernias.

The aim – to determine ultrasonography diagnostically potential for the preoperative examination in the patients with pilonidal sinus and its significance for the choice therapy option.

Materials and methods. The diagnostics and treatment results of 84 patients with pilonidal sinus, including 40 acute and 44 chronic forms, were analyzed. All patients underwent ultrasonography of the natal cleft region with subsequent differential surgery staging choice, methodic and preoperative preparation.

Results and discussion. In 38 (95 %) patients with acute and 29 (66 %) with chronic pilonidal sinus form the ultrasonography revealed cavital formations with determination of its sizes, capsule thickness, contents volume, symmetry to the natal cleft. Correlation between visual and ultrasonographic borders of inflammation was analyzed. There were 28 % patients with acute form who underwent primary radical surgery, for patients with chronic forms applied methodic with optimal rehabilitation period. Rate of septic complications – 4.5 %, recurrence – 5.4 %.

Conclusions. Ultrasonography permits to reveal and localize the cavital formations at the 95 % patients with acute and 66 % with chronic forms of pilonidal sinus. Results of the ultrasonography for pilonidal sinus permits to apply the differential approach for the choice of the method of surgery with determination of surgical staging, methodic and preoperative preparation.

Keywords: ultrasonography, pilonidal sinus, rhomboid flap, abscesses of the natal cleft.

The aim – a clinical material analysis for medical management optimization in victims with the closed and opened abdominal trauma with the intestine mesentery damage.

Materials and methods. The retrospective treatment analysis in 83 patients with the closed and opened abdominal trauma in polytrauma unit of the Kiev city clinical medical first-aid hospital for period from 2004 to 2009 was conducted. From them with the closed trauma of abdominal region there was 111 (60.6 %), with the opened trauma – 72 (39.4 %). There were 146 (79.8 %) men, women – 37 (20.2 %). The main cause mechanism of closed abdominal trauma was traffic accident – 78 (70.3 %), of the opened trauma were blunt wounds – 68 (94.4 %).

Results and discussion. Most victims with the closed abdominal trauma and intestine mesentery damage as a component of combined and plural trauma were admitted in severe and very severe state. The majority of them had the shock signs of ІІ and ІІІ degrees – 66 (59.5 %). 20 (18.0 %) victims were delivered in the terminal state, 22 (19.8 %) sufferings were delivered with shock of the II degree, 3 (2.7 %) – without the signs of shock. In victims with the closed abdominal trauma the consciousness violation were marked in 86 (77.5 %) cases. In a state of the moderate stunning was delivered 28 (25.2 %), deep stunning – 15 (13.5 %), in sopor – 13 (11.7 %), in a coma – 25 (22.5 %) sufferings. There were 25 (22.5 %) patients in complete consciousness. A closed abdominal trauma with the intestine mesentery damage was in 104 (93.7 %) cases, and the opened abdominal trauma with the intestine mesentery damage – in 9 (12.5 %) cases, chest X-ray study was conducted. At the closed abdominal trauma with the intestine mesentery damage was found out the chest organs damage in 42 (37.8 %) victims, while at the opened abdominal trauma with the intestine mesentery damage the thorax organs damage percentage was 9 (12.5 %).

Conclusions. Trauma of the abdominal cavity with intestinal mesentery damage as a component of combined injuries was 10.1 %. The injury nature has no specific clinical signs, but requires additional measures to restore the intestinal passage in the postoperative period. Volume of haemoperitoneum is not significantly different in closed and open abdominal injury, part of which was damage to the mesentery. Higher mortality in closed abdominal trauma compared with open abdominal trauma is due to prolonged course of traumatic disease unstable adaptation stage with emphasis cranial-thoracic component of multiple organ failure.

Keywords: abdominal trauma, mesentery of intestine, peristalsis, multiple trauma, polytrauma.

(Based on Zaporozhe Regional Bureau of Forensic Medicine data, 2009)

The aim – to analyze the reason and structure of pre-hospital mortality caused by mechanical trauma depending on age of the patients. Data were limited to certain region and based on Regional Bureau of Forensic Medicine data.

Materials and methods. The retrospective study of 273 autopsies of patients died from mechanical injuries in pre-hospital stage has been made. Mean trauma severity index by Injury Severity Score (ISS) was defined. It is revealed, that fatal trauma rate is 34.12 per 100.000 population. Victims older than 60 years have made 23.8 %. In the senior age group trauma was mostly low-kinetic and mean score on ISS was lower compare to young and middle age groups. More than half of the victims were under the influence of alcohol.

Results and discussion. In the present study we show that cause of trauma depends on age of victims. It is shown, that older patients have different mechanisms and power of trauma with fatal outcome. In senior age group 3 out of 4 people were under the influence of alcohol.

Conclusions. In older people the mortality rate caused by mechanical low-energy trauma is higher. Severe isolated injury is more favorable for older people compared to combination of mild and moderate injuries. It is necessary to optimize prevention of injuries and efficiency of ambulance help during the pre-hospital stage.

Keywords: mechanical trauma, pre-hospital stage, mortality rate, age.

The aim – to determine the current aspects of venous thromboembolism (VTE) problem and clarify the expediency of 8th АССР Guidelines basic recommendations use.

Materials and methods. Retrospective investigation of 53,078 patients, who underwent surgery in 1990–2008. Age of patients was from 18 till 95 years. Women were 52.1 %. In urgent order 79.2 % of patients are hospitalized for abdominal organs acute diseases. In 27.3 % cases the different degree peritonitis was diagnosed. The executed urgent surgical interventions have been referred on elimination of complications dangerous to a life, planned – on a definitive pathology repair and patients health recovery condition creation. 1673 (3.2 %) patients have died after operation. The pulmonary artery thromboembolism (PATE) appeared in 178 (0.3 %) patients after urgent operations. VTE prevention (appointment of direct anticoagulants – enoxaparin sodium (Klexan manufactures by Sanofi-Аventis) has been applied in 56.4 % patients.

Results and discussion. Simplification of VTE risk evaluation in 8th АССР Guidelines is the way to optimize it prophylaxis. Comparative analysis of patients’ stratification according to 7th and 8th АССР Guidelines had revealed the decrease of number of patients with low and increase of those with high risk. The latter fact is expected to emphasize the importance of drug prophylaxis of VTE. Substantial rise of lowmolecular heparins’ administration throughout the investigation period had lead to decline fatal PATE rate from 12.2 to 0.3 %.

Conclusions. Risk levels stratification in patients according to 8th АССР Guidelines is convenient. Current aspects of the problem include the decrease of number of patients with low risk and increase of those with high risk of VTE. Optimization of solving this problem lies in expansion of indications for direct anticoagulants’ administration. Klexane is an effective drug for prophylaxis of venous thromboses and embolisms in general surgery.

Keywords: venous thromboses and embolisms, prophylaxis, enoxaparin sodium.

The aim – to estimate efficiency in the remote period (till 3th years) of tissue-protecting high-frequency electrowelding laryngectomy in patients with throat cancer.

Materials and methods. 118 patients with throat cancer of ІІI–IV stages hospitalized from 2005 till 2009 were operated and underwent radical surgical treatment. Patients have been divided on two groups: control (57 patients) – operation was performed by traditional technique; the study group (61 patients) were operated with high-frequency electrowelding. Patients of control and study groups by age, sex, localizations, stages and the morphological characteristic of a tumor, and also character and operation extension statistically did not differ. The estimation of the remote results (till 3 years) of surgical treatment included death rate, absence of relapses and metastasizes.

Results and discussion. In patients after operative treatment mean death rate from the main disease in about one year was 5.1 %, and, rather in groups: death rate after electrowelding technique makes 4.9 %, and after traditional surgical intervention – 5.3 %. In one patient (0.8 %) coronary insufficiency – a myocardium heart attack-caused the death. relapses occurrence for the three-year period authentically was more frequent in patients from control group (8.8 %) in 1.8 times, than in patients from the study group (4.9 %). Occurrence of regional metastasizes after electrowelding is ascertained in 8.2 %, and after traditional surgical treatment – 7 % (a difference is not statistically significant; p > 0.05).

Conclusions. The method of surgical intervention (traditional or electrowelding) which have been used for throat cancer treatment, has no influence on death rate on 3th years. Electrowelding reduces relapse occurrence rate in 1.8 times, than in patients after traditional technique operation. An authentic difference on an indicator regional metastasizes between investigated groups was not established. Considering results of the spent researches, it is possible to draw a conclusion that laryngectomy with electrowelding is radical and ablastic surgical intervention.

Keywords: a throat cancer, electrowelding, death rate, relapses, metastasizes.

Keywords: acute small bowel obstruction, laparoscopy, surgical treatment, laparoscopic adhesiolysis.

Keywords: endoscopic thoracic sympathectomy, intrathoracic bleeding, postoperative pain syndrome, compensatory sweating, Horner's syndrome.

Keywords: transient bacteremia, infectious endocarditis, antibiotics prophylaxis.

The review includes domestic and foreign literature on chronic anal fissure management. Technical aspects of modern chronic anal fissure management techniques are discussed. Types and incidence of potential complications and relapses associated with different techniques are analyzed in detail.

Keywords: anal fissure, conservative management, surgical management, sphincterotomy.