AIM: A new surgical method of non-tension autoplasty by displaced aponeurotic flap for the treatment of uncomplicated inguinal hernias has been developed. METHODS: Thirty patients were operated on using a new method of autoplasty; the comparison group involved 30 patients which were operated on by Liechtenstein hernioplasty using a partially absorbable mesh implant (UltraPro). The effectiveness of the methods was evaluated by clinical data, instrumental research methods (ultrasound examination, and computed tomography [CT]), and results of life quality. RESULTS: There were no relapse cases in both groups in the early and long-term after surgery. According to ultrasound, inflammatory infiltrate was absent in the group using a new autoplasty method, subclinical seromas resolved earlier after surgery. According to data of compression elastography and CT, the formation of a denser scar in the postoperative area was registered in the comparison group with a statistically significant difference. The feeling of discomfort and pain in the study group was more pronounced in the early post-operative period in comparison with the group using a mesh implant. However, in later terms, the life quality of patients in the group using a new autoplasty method improved with a statistically significant difference. CONCLUSION: The operation method is simple to perform, does not require the use of an endoprosthesis or extensive dissection of tissues and can be a reliable alternative and compete with prosthetic methods of hernioplasty.

BACKGROUND: Numerous methods of eliminating abdominal wall defects developed in the world today do not allow us to talk about solving the problem of hernias. In particular, the causes of chronic postoperative pain associated with the effect of scarring on the spermatic cord have not been fully studied. Testicular flow studies after hernia repair mostly showed different outcomes. AIM: Comparative assessment of blood flow parameters of the testicular, capsular and intratesticular arteries, as well as the diameter of the testicular artery after autoplasty with a displaced aponeurotic flap and Lichtenstein hernioplasty using ultrasound. MATERIALS AND METHODS: A new method of autoplasty was used in 35 patients (Group I). The comparison group (Group II) amounted to 35 patients with Lichtenstein hernioplasty surgery using partially absorbable mesh endoprosthesis (UltraPro). The dynamics of changes in blood flow in the arteries was assessed using color Doppler before surgery, in the early and late postoperative periods. RESULTS: The Wilcoxon paired test showed a significant difference between preoperative and immediately postoperative measurements in both groups. Statistically significant differences between the groups were found in the end-diastolic velocity and resistance index in the testicular, capsular and intratesticular arteries 6 months and 1 year after surgery. The difference in peak systolic velocity was significant in the testicular artery also in the late stages after hernioplasty. The diameter of the testicular artery tended to increase in dynamics, but there was no any statistically significant difference between the groups. CONCLUSIONS: The method of autoplasty in the inguinal canal with a displaced aponeurotic flap does not significantly affect testicular perfusion. In Group II, arterial blood flow indicators 6 months and 1 year after surgery were lower than basal values and had statistically significant differences compared to Group I.

BACKGROUND: Pancreatitis severity is an important death rate indicator that plays a crucial role in deciding on proper handling of patients at their initial admission, when making a decision on patient’s transfer to the intensive care unit. Many studies point out a direct relation between death rate and the number of affected organs. In view of that, looking for new criteria for assessment of multiple organ failure is still useful in clinical practice. Assessment of multiple organ failure with patients undergoing treatment in the intensive care unit is carried out with the use of various integrated indicators based both on clinical laboratory assessment of patient’s condition, and on data obtained with the help of advanced imaging methods. However, many researchers point out that the facilities of diagnostic radiology, including in particular computerized tomography (CT), are not used to the full extent. AIM: We proposed expanding functionality of abdominal CT examination by means of pancreatitis severity assessment that takes into account changes in the pancreas and in addition enables assessing multiple organ failure with examined patients. We identified the organs and systems whose changes need to be monitored through CT imaging to be able to assess multiple organ failure in the patients with pancreatitis. METHODS: Out of 314 patients, 100 patients were selected diagnosed with pancreatitis confirmed by changes demonstrated by the laboratory test results. Of those, 24 patients (24.0%) revealed presence of multiple organ failure (maximum of 5 organ systems), 46 patients revealed a single organ failure. RESULTS: Development of early organ failure accompanied 82% of cases of severe pancreatitis and considerably aggravated predicted outcome and course of severe AP. Among them, 30 patients had pancreatitis without changes of the vital organs and 70 patients had dysfunctions of the vital organs, suffered from organ or multiple organ failure, and received treatment in the surgery unit and the intensive care unit of the Department of Surgical Conditions of Karaganda Medical University. In view of CT results, we assessed a relation between multiple organ failure and specific failure of a single organ and necrosis and death rate. We analyzed a relation between organ failure and degree of the pancreas necrosis. CONCLUSION: Identified changes enabled us to create a CT score for the assessment of pancreatitis severity that can be used not only for identification but also for the prediction of organ failure at an early stage of pancreatitis with high accuracy as compared against conventional CT systems for the assessment of patients’ condition. It can also be used to differentiate extent organ dysfunction and the number of affected organs.

The purpose of the article was to evaluate trends of uterine submucousal myomas after the embolization of uterine arteries. Uterine fibroids are a common disease in women of reproductive age, accounting for 10 to 30 %, according to various authors. The submucous location of the myomatous node is an unfavorable type of localization of fibroids since it almost always requires surgical treatment. In this work, we would like to report on the results of endovascular x-ray occlusion of the uterine arteries in the treatment of submucous myomatous nodes. Percutaneous through catheter occlusion of uterine arteries with submucousal myomatous nodes was performed in 21 patients where 18 of them through the femoral, and 3 of them through beam access. The patients’ age was under 32 up to 47 with average 36,5. Myomatous nodes’ size is from 3,0 till 9,0 centimeters. There were noted self-expulsions of 10 from 21 submucousal myomatous nodes after X-ray endovascular occlusion during the 7 days and until 3 months. In the gynecological department they performed removal of partially born submucosal nodes in 3 out of 21 patients within 3 months. In the remaining 8 of 21 observations (381 %), submucosal nodes underwent myolysis in the following 12 months. After X-ray endovascular occlusion there might be expulsion or myolysis of myoma nodes in different terms during the submucosal myomatous of uterine.