HighlightsIntraoperative ruptures of trachea during thoracoscopic esophageal resection are very serious complications.A 52-year-old woman had cancer of middle third of esophagus T3N1M0, stage IIIB.The woman underwent thoracoscopic esophageal resection with gastric tube plasty.Successful management of intraoperative tracheal and bronchial rupture with use of the intracorporeal suture.The patient had an uneventful, standard recovery and was discharged 12 days after the surgery.

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AIM: to assess the effectiveness of micronized purified flavonoid fraction (MPFF) in conservative treatment for chronic hemorrhoids according to high-resolution anoscopy (HRA).PATIENTS AND METHODS: the study included 192 patients with chronic hemorrhoids, stage III. The general recommendation for all patients was dietary fibers for soft stools. The main group included 96 patients treated with MPFF for 2 months, 96 controls used dietary fibers only. The treatment effectiveness was evaluated due to high-resolution anoscopy data and clinical manifestation of the disease. The calculation of the drug intake compliance was carried out as well.RESULTS: patients of the main group showed significant clinical improvement after treatment in prolapse correction (66% vs 27%; p=0.001), in pain intensity decrease (5 times vs 1.5 times; p=0.03), in bleeding incidence (4 times vs 1.5 times; p=0.001). HRA showed significant reduction of inflammation (from type 2 to type 1) in main group in 50% and 20% in controls (p=0.02). Compliance with the MPFF in main group 1 was 74%, the total compliance of dietary fiber intake in both groups was 66.3%.CONCLUSIONS: combination of MPFF with dietary fiber intake significantly reduces clinical manifestations of chronic hemorrhoids stage III and HRA shows significant reduction of inflammation in hemorrhoid piles in these cases.