The article contains an overview of the literature on Mallory-Weiss syndrome. It analyzes numerous etiological factors, provides new insights into the pathogenesis of the disease, gives a description of a previously unknown dependence of discontinuous-hemorrhagic syndrome on the topographic and structural features of the cardioesophageal area of the digestive tract, and gives scientific credence to methods of prediction, prevention, and treatment of the syndrome with complex involvement of granular sorbents.

Relevance. Gastroduodenal ulcer bleeding is one of the most complex problems of emergency abdominal surgery. An endoscopic hemostasis is a crucial importance during the treatment of patients with gastroduodenal bleeding. The using of biologically active draining sorbents in combination with local haemostatic drugs is a promising direction in the endoscopic hemostasis.Objective. The aim of the investigation is to improve the results of treatment of patients with acute ulcerative gastroduodenal hemorrhages by application of biologically active draining of sorbent Asepticob-A in combination with platelet-rich plasma for endoscopic hemostasis as an important component of complex therapy.Materials and methods. The study is based on the results of treatment of 112 patients with peptic ulcer bleeding. They were treated in the specialized city centre for the treatment of patients with gastrointestinal bleeding of Voronezh state hospital of emergency medical care №1. During the treatment of patients of the main group (n=57 persons) was used individual complex approach with the using of biologically active draining of sorbent of new generation – Asepticob-A and platelet-rich plasma in endoscopic treatment of bleeding complications of gastroduodenal ulcers. In the comparison group (n=55 persons) was used the well-known traditional methods of endoscopic hemostasis without the use of granular sorbents and platelet-rich plasma.Results and discussion. The effectiveness of treatment of patients with ulcerative gastroduodenal bleeding was assessed according to the criteria of reliability of hemostasis, assessment of dynamics of reparative processes in ulcerous defects, the frequency of recurrence of bleeding on the background of treatment using endoscopic techniques, prevention, emergency operations and mortality rate. The methods of treatment of gastroduodenal bleeding with the combined use of biologically active draining sorbents and platelet-rich plasma for the reliability of endoscopic haemostasis, that was developed and introduced into clinical practice, reduces the number of emergency operations in 2.6 times, mainly due to the reduction of recurrent bleeding and, as a consequence, leads to lower postoperative mortality.Conclusions. The use of biologically active draining of sorbent Asepticob-A and platelet-rich plasma in complex endoscopic treatment of patients with ulcerative gastroduodenal bleeding allows to reduce the frequency of recurrence of bleeding from 10.9% to 3.5% (3.1 times), to reduce the number of emergency surgical interventions at the height of bleeding from 9.1% to 3.5% (2.6 times), to reduce postoperative mortality from 5.45% to 1.75% (3.1 times) and reduce the duration of inpatient treatment from 9.0 to 6.0 days (p<0.05).

Purpose. To develop a new relaxing incision on the anterior wall of rectus sheath and to compare its efficiency with the classical counterparts in the experiment. Materials and methods. We measured tension nodal seam with the help of a spring dynamometer on 24 cadavers. This seam was overlaid on the inner edge of the rectus abdominis in the region of the umbilical ring before and after relaxing incision. The objects of study were divided into four groups randomly. We studied the proposed wavelike relaxing incision in the first group and classical methods in other groups. Results.  Maximum relaxation nodal seam (56%) was observed when using a wavelike relaxing incision of anterior wall of  rectus sheath. Vertical relaxing incision of aponeurosis of the external oblique abdominal muscles along the lateral edge of the rectus abdominis (by O. M. Ramirez) was close in efficiency to the proposed method. It is possible to reduce tension of the nodal seam at 48%. Relaxing effect arc-shaped relaxing incision of anterior wall of rectus sheath by V.I. Belokonev was 39%. Vertical relaxing incision in a staggered pattern by U.Z. Zagirov showed minimal relaxing effect – 25%. Conclusion. Wavelike relaxing incision of anterior wall of rectus sheath which was proposed allows reducing tissue tension in hernioplasty compared to the classical methods.

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