The aim — to improve the results of ischemic stroke surgical treatment by adjusting the pathology of the extracranial arteries in the acute phase of stroke and recovery.

Materials and methods. A prospective study of 246 patients with pathology of the extracranial arteries in age from 45 to 70 years who had surgery in 2008 — 2011 in hospital was done. The control group consisted of 75 patients with ischemic stroke who were treated with medication. The modern methods of diagnosis: duplex scanning, transcranial Doppler ultrasound, magnetic resonance imaging with vascular program and X-ray contrast angiography were used.

Results and discussion. Duration of the period from the beginning of a stroke before surgery ranged from 3 — 6 hours to 10 days. The majority of patients (231, or 93.9 %)) were operated on within the first 3 days, 15 (6.1 %) — within 3 weeks after a stroke, the other — within 3 months. Performed surgery: classical carotid endarterectomy for internal carotid artery (ICA) stenosis (plastic with PTFE patch — in 79 (32.1 %) patients, autologous vein patch, xeno-pericardial patch of), eversion endarterectomy for stenosis of internal carotid artery — in 27 (11.0 %) cases, prosthetics ICA — in 15 (6.1 %), the removal of pathological tortuosity — in 42 (17.0 %), resection of the internal carotid artery with external carotid artery plastic — in 34 (13.8 %), thromb-endarterectomy for ICA occlusion — 27 (11.0 %), the ICA stenting — 22 (9.0 %). Drug treatment included the appointment of citicoline, cytoflavin, Actovegin. The algorithm of surgical tactics in acute ischemic stroke, as well as criteria to determine preoperatively the possibility of endarterectomy of the internal carotid artery at its occlusion were developed. Good results in the surgical treatment were obtained in 75.3 % of patients with a stable neurological status, conservative — in 48.3 %. Established that surgical revascularization of the brain for hemodynamically significant stenosis of the carotid arteries is an effective treatment and prevention of acute ischemic stroke.

Conclusions. Eversion endarterectomy is an optimal method for short stenosis — less than 2.0 cm. Use of this technique for large lesions increase the incidence of early postoperative blood clots. Classical endarterectomy is indicated for vascular lesions 3.0— 5.0 cm in length. Application of this technique allows for visual monitoring of the distal area endarterectomy and avoid uncontrolled detachment of the intima. Using open endarterectomy with stenosis larger than 5.0 cm accompanied by an increase in the frequency of restenosis remote postoperative period. Indication for prosthetic ICA are hitting at which the length of stenosis greater than 5 cm, or the presence of a circular calcification in the area of reconstruction. Greatest neuroprotective effect has citicoline in combination with Actovegin that reduces the incidence of recurrent stroke and improve the operational period. Carotid endarterectomy — an effective method of revascularization of the brain in acute ischemic stroke. Surgical approach is carried out in view of hemodynamically significant stenosis. With a stable neurological status of the patient, surgical treatment can be performed within 3 — 5 days, and if a progressive course of stroke — in the first 24 hours. Acute occlusion of the carotid arteries, which arose in the early postoperative period, is an indication for urgent revascularization, which should be held in the next 3 hours.

Keywords: acute ischemic stroke, surgical tactics, extracranial arteries.

The aim — to increase the reconstructive surgery effectiveness for deep soft tissue hand defects with propeller- shape perforating flap from ulnar artery region.

Materials and methods. Seven patients for skin and soft tissues hand defects closing with skin-fascia flap on the back ulnar artery perforanti were operated in clinic for the period from 2011 to 2014.

Results and discussion. All transplanted pieces survived, and patients were discharged with recovery. Performed plastic allowed removing post-burning scar contracture in two cases, wound defects in the hand back area — in two, wound defects in the area of palmar surface — in two, wound defect on amputation stumps -in one case. Critical complications accompanied by complete loss of transplanted tissue was not fixed. Non-critical complications were noted: venous stasis — in four cases, partial marginal necrosis — in two cases. These ones were treated in time.

Conclusions. Тhe described method has several advantages Compared with other methods of deep soft tissue defects plastic in the area of hand and wrist joint. Priority use of the dorso-ulnar perforating flap with distal base provides to improve the effectiveness of reconstructive surgery of deep soft tissue defects in the hand area.

Keywords: hand, wound defect perforating flap, the dorso-ulnar perforating flap.

The aim — to study the antioxidant’s effect on the rate on donor’s limb wounds healing in the burns surgery.

Materials and methods. Under a supervision, there were 50 patients that were divided into two groups: control, where traditional treatment of donor wounds of extremities was used, and study, where traditional treatment was complemented by lymphotropic introduction of antioxidant drug Меxidol. Medication was introduced during 3 days, since the day of operative intervention. Basic parameters of groups were identical.

Results and discussion. It has been established that by using, the proposed method for treating donor wound healing occurred faster than the control group; in particular, epithelialization of donor sites occurred at 28.8 % faster. Not fixed any local wounds complications.

Conclusions. The offered method of donor’s extremity wounds treatment allows to accelerate wounds cicatrization on 28.8 % (4.2 days), to decrease the amount of local wounds complications on 6 %, thus to reduce the terms of renewal of the skin.

Keywords: burn, operative treatment, antioxidant system, donor wounds, antioxidants.

The aim — to study the pro-inflammatory and anti-inflammatory cytokines level in patients with colon diverticular disease (CDD) complications and the possibility to use ones as a prognostic factor for the disease course.

Materials and methods. The study of 111 patients with CDD has been carried out, the patients were divided into 4 groups depending upon the type and severity of complications: I group (28 people) — with intestinal hemorrhage, II group (23) — hemorrhage with the pain syndrome, III group (36) — with acute diverticulitis, IV group (24) — with CDD, complicated by pericolic abscesses (local peritonitis) or diffuse peritonitis. The study was carried out on the 1st and 4th day since addmition at the hospital. 10 people were the comparison group. For defining cytokines (TNF-α, IL-6, IL-10) blood serum level was immunoenzymometric assay method with diagnostic test produced by CJSC «Vector-Best» (The Russian Federation) were used in accordance with manufacturer’s guidance

Results and discussion. It has defined that indices of TNF-α, IL-6, IL-10 and cytokine imbalance in patients with CDD vary significantly at initial stages of complications development and tend to normalization after hemorrhage arrest and inflammation subsidence. The presence of inflammation, hemorrhage and purulent complications in patients has correlation with age (r = 0.44; p < 0.05); level of pro-inflammatory cytokines in blood serum: TNF-α (r = 0.5; p < 0.05), IL-6 (r = 0.37; p < 0.05); level of anti-inflammatory IL-10 in blood serum (r = –0.4; p < 0.05), and cytokines imbalance index (r = 0.59; p < 0.05). The proved relation between complications and gender has not been determined.

Conclusions. In patients with CDD complicated by purulent inflammation and bleeding the elevated levels of pro-inflammatory cytokines TNF-α and IL-6 more than 2.5 times, and reduced anti-inflammatory cytokine IL-10 1.1 — 5.3 times were found. During treatment on 4th day there was a tendency to pro-inflammatory cytokines level normalization: TNF-α reduction on 23.6 — 31.2 % and IL-6 on 23.98 — 35.18 %. Cytokine imbalance index TNF-α/IL-10 which increases substantially during the development of DDC complications, is a disease course marker.

Keywords: colon, diverticular disease, complications, cytokines, dynamics of changes.

The aim — to analyze the complications of laparoscopic cholecystectomy and options for their surgical correction.

Materials and methods. An analysis of 95 patients with various biliary tract injuries during laparoscopic cholecystectomy in the period from 2005 until 2014 is presented. According to the classification of Neuhaus P. et al type A injury were revealed in 34 patients, type B — in 12, type C — in 13, type D — in 12, type E — in 24 cases. 24 patients, which underwent laparoscopic cholecystectomy in General and urgent surgery institute consist first group, and 71 patients firstly operated at other hospitals — second. Нepatico-jejuno anastomosis was performed only in 25 % first group patients, and the rest surgery had restoring or draining character. In the patients of the second group the Roux hepatico-jejunostomy was performed in 55.5 % patients in most cases, in 15.5 % — the distal common bile duct patency correction, in one case right hemi-hepatectomy was done.

Results and discussion. Six patients died, four — in the early postoperative period, 2 — due to cholangitis and liver abscesses on the background of previously performed anastomosis strictures.

Conclusions. Among the negative factors affecting the treatment outcome the biliary fistula, high injuries, common bile duct injuries combined with vascular lesions, primary correction in a medical facility that has no experience of such interventions, long-term disease nature, leading to the development of liver irreversible changes.

Keywords: laparoscopic cholecystectomy, common bile duct injury, jaundice, bile leakage.

The aim — to improve the diagnostic results in patients with mini-choledocholithiasis (MCL).

Materials and methods. The examination and treatment results of the 152 patients with cholelithiasis were analyzed. Study group comprised 102 patients with MCL; the control group consisted of 50 patients without concrements.

Results and discussion. Among patients with cholelithiasis complicated by MCL the most often clinical symptoms were dull, aching or acute pain in the right upper quadrant (60.78 %), digestion disorders, jaundice. In the most patients of both groups the increase of total bilirubin (especially its direct fraction), alanine aminotransferase, aspartate aminotransferase, alpha-amylase and cholestasis markers (alkaline phosphatase, glutamate, and γ-glutamyl trans-peptidase) were observed. By ultrasound data the MCL signs were detected in 65.69 % of patients, the diameter of the common bile duct was 9.70 ± 0.86 mm. Among the 62 patients the stones were identified in 60 (96.77 %) with endoscopic retrograde cholangiopancreatography. Six (9.67 %) patients had complications (acute pancreatitis — 4, bleeding — 2). Magnetic resonance cholangio-pancreatography in 61 (96.82 %) of 63 patients managed to diagnose MCL.

Conclusions. The most informative biochemical blood studies indices for MCL are elevated alkaline phosphatase (77.45 % of cases), glutamate-dehydrogenase (67.64 %), and gamma-glutamyl-trans peptidase (82.35 %), which indicates the presence of cholestasis. Diagnostic value of endoscopic retrograde cholangiopancreatography and magnetic resonance cholangio-pancreatography is almost the same (96.77 % and 96.82 %), but the last one is a non-invasive method and assumes no radiation exposure.

Keywords: choledocholithiasis, endoscopic retrograde cholangio-pancreatography, magnetic resonance cholangio-pancreatography.

The aim — to study an efficiency of diosmin — gesperidin contained drug of flavonoid group in complex treatment of acute necrotized pancreatitis (ANP).

Materials and methods. An efficiency of diosmin — gesperidin contained medication as compound of complex therapy was studied in 38 patients with APN (main group) in comparison with traditional treatment in comparative group (46 persons). Drug аdministration was carried out according to original treatment. efficiency evaluation was done on clinical course analysis evidence, of laboratory study indexes, ultrasonography monitoring, on the tissues hydrophilicity tests by Mac-Klury — Oldrich, that were determined on 1, 3, 7 days of treatment.

Results and discussion. It was confirmed that in the main patients group a local clinical signs of disease and laboratory data had more presented tendency to normalizing. The real decreasing of the pancreas in all parts and sizes (upper — low and frontal — back) parapancreatic and paracolar edemas were observed by ultrasonography data. In patients of comparative group the same tendency were not revealed. Mac-Klury — Oldrich test results has determining the increased hydrophilicity of the lumbar area tissues in both patients groups; nevertheless, the test evident normalization becomes in the main group only. Appearance of purulent — necrotic affections of retro-abdominal spaces confirmed in 21 % and 56 % cases accordingly.

Conclusions. Тhe new proposed method of the APN treatment promotes elimination of parapancreatic and paracolar edemas and, together with other compounds, provides positive result of conservative therapy in 78 % cases.

Keywords: acute necrotic pancreatitis, drug therapy.

The aim — to examine the treatment efficiency of decamethoxin in patients with abdominal liquid formations, who underwent minimally invasive puncture-draining surgery.

Materials and methods. The treatment results in 44 patients with abdominal infected liquid formations (36 patients with postnecrotic pancreatic cysts, 8 — with liver abscess) have been analyzed. Patients underwent minimally invasive percutaneous puncturedraining interventions under ultrasound control (Honda Electronics sensor 3.5 Hz) and following cavity sanitation with Decasan daily twice a day (administered into the abscess cavity drainage 0.02% drug solution in a volume of 1/3 cavity content with exposure of 10 — 15 minutes). The control group included 18 patients in which chlorhexidine solutions and betadine have been used for purulent foci sanitation.

Results and discussion. Treatment of infected postnecrotic pancreatic cysts started with minimally invasive techniques, taking into account the infection degree by the microbiological culturing results. Cyst elimination was up to 90 %. Efficiency absence was associated with more severe pancreas damage. In patients with liver abscesses in order to select tactics, it is necessary to establish the cause of abscess formation. Percutaneous techniques have been showed high efficiency, especially after the primary focus of infection removal.

Conclusions. Decasan as an antiseptic for topical administration has a pronounced antibacterial effect in patients with liver abscess and postnecrotic pancreatic cysts. Thus, it allows achieving complete elimination of microorganisms in the cyst’s contents within 11 — 14 days, and most effective sanitation of liver abscess cavity compared to other antiseptics. In contrast, comparable elimination of microorganisms in cases of using other antiseptics has not reached 70 %, and the timing of their treatment was more prolonged.

Keywords: liver abscesses, abdominal liquid formations, minimally surgery.

The aim — to compare the pain intensity in the early postoperative period after the umbilical hernia hernioplasty with IPOM and sub-lay methodology.

Materials and methods. The analysis of surgical treatment results for umbilical hernias in 66 patients who were from August 2011 to January 2014 in general surgery department. Hernioplasty was performed by the IPOM method (study group, n = 31) and sub-lay (comparison group, n = 35) technic.

Results and discussion. VAS index in patients of the main group was 3.34 ± 0.17, in the comparison group — 6.12 ± 0.18 (p < 0.05). On 2nd postoperative day the TNF-α concentration in patients from comparison group, operated by the sub-lay method was 1.7 (p < 0.05) times higher than in patients of the main group, operated by IPOM technique, and the IL-1 concentration — 1.5 times (p < 0.05), ceruloplasmin concentration—1.4 and GAG — 2. Patients of the main group did not require narcotic analgesics in the early postoperative period. Postoperative in-patient period was 1 — 2 days after IPOM hernioplasty, after sub-lay method — 3 —4 days.

Conclusions. After IPOM hernioplasty, a significant reduction in peripheral blood pain mediator’s rate on the second day after the surgery is observed, compared with the hernioplasty sub-lay method ones. Using the IPOM hernioplasty method in the umbilical hernias surgical treatment can reduce patients’ stay in hospital and their social rehabilitation duration.

Keywords: umbilical hernia, hernioplasty, pain.

The aim — to determine the effective preventive approaches to reduce the incidence of venous thrombotic complications (VTC) in patients with acute bleeding colorectal cancer.

Materials and methods. From 2002 to 2013 in Kyiv city center for patients with gastrointestinal bleeding 114 patients with clinical intestinal bleeding were hospitalized. Patients with acute bleeding colorectal cancer (ACRC) were 21.6 %, with bleeding hemorrhoids — 38.1 % and colon diverticulosis — 23.3 %. 811 patients with complicated colorectal cancer were hospitalized during this period. There were 126 men (52.3 %) aged 41 to 94 years (mean age — 66.9 ± 11.8 years), women — 115 (47.7 %) aged 50 to 89 years (mean age — 69.0 ± 8.4 years). Dominated by elderly and senile age — 81.3 %. All patients had concomitant diseases of different organs and systems, which is typical for this age group of patients (polymorbidity — 100 %). Polymorbidity index (PI) was 4.7 for men and 5.3 for women. Surgical treatment was performed in 105 (43.6 %) patients: radical surgery was performed in 90 (85.7 %), palliative and symptomatic — 15 (14.3 %). Resectability was 95.2 %. Conservative therapy was applied in 136 (56.4 %) patients. Treatment results retrospective analysis was performed in patients who were divided into two groups. Group 1 — 69 (65.7 %) patients operated during 2002 — 2010 with VTC prevention in the postoperative period by 1st generation’s low molecular weight heparin or without ones, group 2 — 36 (34.3 %) patients operated during 2011 — 2013 with bemiparin (Zibor) at the recommended dose of 3500 IU/day application against VTC.

Results and discussion. VTC occurred in1 (2.8 %) 2d group patients compared with 8 (11.6 %) 1st group patients (PE — in the 3 patients, deep vein thrombosis — in 2, thrombosis of peripheral veins — in 3). Mortality from VTC was 1.4 % (1 case) in 1st group (fatal pulmonary embolism), in second group was no deaths. Situations that required discontinuation of therapy due to the hemorrhagic complications development was not.

Conclusions. Use of anticoagulant therapy based on bemiparin enabled to reduce the TVC frequency 4.1 times. Postoperative thromboprophylaxis with bemiparin is as efficiently and safely as preoperative one, the operation performed in the «dry box» that allows to do extended and highly technical radical surgical interventions. If surgery is performed for acute bleeding colorectal cancer, the anticoagulants administration for TVC prophylaxis is contraindicated until bleeding tumor is not dissected. In acute bleeding colorectal cancer surgery, the only one low molecular weight heparin bemiparin sodium by the first dose in the postoperative period is allowed to carry out postoperative TVC prevention.

Keywords: acute bleeding colorectal cancer, venous thromboembolic complications, preventive measures.

The aim — to assess the function of the external respiration in patients with deformed anterior abdominal wall and the influence of abdominoplastia on the function of the external respiration during the early and late postoperational periods.

Materials and methods. The patients were divided into 3 groups depending on the nature of changes of muscular aponeurosis carcass and presence or absence of obesity. A spirometry had been performed for all patients to assess the external respiration function preoprationally and postoperationally (early and late).

Results and discussion. The analysis of the received data had shown that preoperational increasing of the abdominal pressure does prevent the drop in readings of the external respiration function for obese patients, while the correction of the muscular aponeurosis carcass improves the external respiration function during the late postoperational period.

Conclusions. The obese patients require to consider the levels of the external respiration function readings, which usually are decreased due to a predicted drop of the function during the early postoperational period after an abdominoplastia with muscular aponeurosis carcass correction (VC to 8.97 ± 1.60 % (p < 0.05) and FVC at 15.85 ± 2.00 % (p < 0.05)). Preoperational increasing of the abdominal pressure of the obese patients by compression of the anterior abdominal wall adapts the respiration system for the conditions which are to be created after an abdominoplastia with muscular aponeurosis carcass correction, which constitutes a prophylaxis of the external respiration function drop during the early postoperational period.

Keywords: abdominoplasty, respiratory function, muscular aponeurotic skeleton, anterior abdominal wall, intra-abdominal pressure.

The aim — to evaluate the wound complications incidence and treatment long-term results in patients with locally advanced cancer of the oral cavity mucous and oropharynx depending on the radiation therapy sequence.

Materials and methods. It was analyzed the treatment results in 184 patients with the oral cavity and oropharynx cancer III — IV stages, divided into two groups: the first group included 79 patients, where the first stage of treatment was surgery followed by adjuvant radiation therapy, the second group consisted of 105 patients who received neoadjuvante radiation before surgery.

Results and discussion. The postoperative complications rate in patients of the first group was less, than in patients of the second group in stage III on 20.0 % (p = 0.01), and in IV stage — on 19.6 % (р = 0.23). No statistically significant difference of one-, three- and five-year survival rates of patients in the two groups were revealed, regardless of the process stage (p > 0.05).

Conclusions. The changes in sequence of the combined treatment main stages, when radiation therapy was transferred to the postoperative period, decreases wound complications on 18.5 % (p = 0.01) without affecting the long-term treatment results.

Keywords: сancer of the oral cavity and oropharynx, the treatment results.

The aim — to study morphological changes in the internal organs and rat’s tail vein after foam-form sclerosing agent administration.

Materials and methods. Study was carried out on 80 white outbred rats weighing 0.22 — 0.27 kg at the age of 3 — 4 months. The sclerosing action of 0.5 %, 2.0 %, 3.0 % polidocanol solution in a micro-foam-form was compared. The test material was taken at 10th minute and 30 days after the injection of 0.5 cm³ drug in rat’s lateral tail vein. Histological examination of internal organs (heart, lungs, kidneys, liver, and brain) in order to identify the direct impact of foam-form polidocanol on the vascular wall was conducted. In the control group the physiological solution in the same amount was used.

Results and discussion. Changes in internal organs of animals in all experimental groups and the comparison group manifested by vessels’ congestion that can be considered a feature of tanatogenesis. The impact of foam-form polidocanol after 10 minutes manifested by the endothelium and venous wall alteration, the changes severity grew with the drug increasing concentration. On the 30th day was managed to achieve vessels fibrous transformation after intravenous injection of sclerosing foam 2 % and 3 % concentration in all test animals. After the introduction of 0.5 %, polidocanol solution the obliteration was observed in 91 % but with no injury for paravasal tissues.

Conclusions. Polidocanol causes the development of fibrotic process in vein, but has no systemic influence upon the body, nor causes any changes in internal organs if recommended drug doses and concentrations are exceeded.

Keywords: foam-form scleroobliteration, vein morphology, morphology of internal organs.

The aim — the improvement of approach for lumbar sympathetic blockade with the spread of local anesthetic on sympathetic ganglia on L3—L4, aortic plexus and plexus hypogastricus superior.

Materials and methods. The new approach for lumbar sympathetic blockade was developed experimentally in 20 unembalmed cadavers with the investigation of injected dye (methylen blue) spread.

Results and discussion. In cadavers there was found the following spread of dye: sympathetic ganglia on L3—L4 and plexus aorticus abdominalis and plexus hypogastricus superior were stained in all cadavers; dye was spread around inguinal artery on injection site in 14 cadavers; genitofemoral nerve was stained in 5 cadavers.

Conclusions. The method allows complete block of all structures, which supply with sympathetic innervations lower limb arteries. The method allows avoiding the potential complications as puncture of kidneys, intestine, aorta and vena cava inferior.

Keywords: lumbar sympathetic blockage, aortic plexus, plexus hypogastricus superior, sympathetic ganglion.

The problems of the modern treatment of acute appendicitis in the world, analyzed the capabilities of existing methods and the main directions of surgical treatment, which is promising in the future. Confirmed that the use of laparoscopy allows most reliably diagnose acute appendicitis and spend minimally traumatic highly safe surgery. However, insufficient equipment surgical hospitals with modern facilities, the lack of highly qualified specialists and proven techniques of laparoscopic appendectomy limit widespread adoption of the method.

Keywords: acute appendicitis, treatment, appendectomy, laparoscopy.

Number of patients with gallstone disease in the world increases. Jaundice — the most common and dangerous complication of it. The main cause of death in patients with jaundice is liver failure because of delayed diagnosis and treatment. Questions about the timing and methods of its resolution is far from a final decision. Most debated is the choice of priorities and methods of resolving. According to large range of modern technical capabilities and complexity of the standard assessment of patients, an individual approach to the choice of tactics with maximum use of benign methods of surgery is required.

Keywords: mechanical non-neoplastic obstructive jaundice, medical tactic, stage treatment, minimally invasive intervention.

The clinical observation of a rare congenital intestinal malformation — malrotation, which is clinically manifested by acute, recurrent or chronic intestinal obstruction is done. After stabilization of the patient and the clinical and laboratory parameters normalization the surgery — a middle laparotomy was performed. The postoperative period was uneventful. On the 20th day after the operation the patient was discharged in satisfactory condition. Control examination carried out in 3 months after surgery revealed no complications. Clinical observation suggests that intestinal malrotation can simulate the chronic duodenal obstruction clinic. The method of treatment should be chosen individually.

Keywords: malrotation, Laddin syndrome, digestive tract X-ray study, chronic intestinal obstruction.

Acute mesenteric ischemia belongs to one of the unpredictable and difficult to diagnose and treat urgent surgical abdominal pathology with high mortality. This article describes a case of successful surgical treatment of 74 years old patients with acute mesenteric ischemia. After performing indirect clot embolectomy of the superior mesenteric artery its satisfactory pulsation has renewed. Due to the lack of clear necrosis boundaries in thin and the right half of the colon bowel the resection as the second stage was decided to perform. The delayed programmable relaparotomy was done, allowing resection of the small bowel in length of 130 cm after the demarcation of necrotic changes zone with the imposition of fine-enteric anastomosis end-to-end. The patient was discharged in satisfactory condition at home on 10th day.

Keywords: acute mesenteric ischemia, thromb-embolectomy, delayed programmable relaparotomy.

Clinical surveillance the patient is given, in whom accidentally during gastroscopy a polyp of the stomach was found, and after endosonography and polyp, biopsy diagnosed gastric carcinoid, removed by endoscopy. For three years after surgery, the continuous clinical observation was carried out in patient. The levels of histamine and serotonin in blood plasma was studied (values were within normal limits). Gastrin levels in the last year increased by 10 pg/ml. According ultrasonography, abdominal metastases were not detected, and according fibrogastrocopy endosonography pathological changes were absent in the stomach. In the fourth year after the operation during fibrogastrocopy with biopsy of tumor-like formations in the stomach and computed tomography multiple carcinoids were diagnosed. Gastrectomy was performed. Patient was discharged from the hospital in satisfactory condition.

Keywords: stomach, carcinoid, chromogranin A, Ki-67.