The article is devoted to the description of own observations and treatment of patients with hiatal hernias. It was noted that approaches to the surgical treatment of patients with hiatal hernias require an increase in efficiency and safety, which makes this issue relevant, despite the accumulated experience of treatment. Attention is focused on endosurgical technologies in the form of laparoscopic fundoplication and laparoscopic chiatoplasty. It has been established that the main indications for surgical treatment of hiatal hernias are: severe reflux esophagitis, development of extraesophageal complications, lack of the effect from pharmacological therapy. Laparoscopic Nissen antireflux surgery in combination with crurorrhaphy meets the requirements for surgical correction of this pathology. It is effective, well tolerated by patients, has a low percentage of complications, which allows us to consider it the "gold standard".

The article presents description of our own observation of a clinical case of severe viral infection caused by SARS- CoV-2 complicated by bilateral polysegmental pneumonia, complete bronchocutaneous fistula in a patient born in 1961. Brief information about the features of pathogenesis, clinical presentation, differential diagnosis and surgical treatment of pulmonary complications of this pathology according to modern literary data is presented. The study of the given clinical case indicates that the most important component of differential diagnosis of lung lesions with SARS-CoV-2 virus is laboratory diagnosis and high-resolution multispiral computed tomography. Pneumothorax and pyopnevothorax are a severe complication of COVID-19. However, in persistent bronchopleural fistula, it is necessary to continue active surgical treatment when it is clinically possible, performing minimally traumatic interventions.

Все пациенты выписаны в удовлетворительном состоянии. При наблюдении за пациентами сроком до 10 лет рецидива, трансформации карциноида в мелкоклеточный рак не наблюдалось. У всех пациентов метастазирования в регионарные лимфатические узлы и органы-мишени не выявлено. Выводы. В лечении карциноида бронха центральной локализации предпочтительны видеоассистированные анатомические резекции лёгкого или эндобронхиальные малоинвазивные вмешательства. При периферической локализации процесса предпочтительны органосохраняющие резекции с применением хирургического лазера. Неблагоприятный прогноз при карциноидах лёгких связан с такими показателями, как размер опухолевого узла более 3см, высокая пролиферативная активность опухолевых клеток. Ключевые слова: карциноид лёгкого, бронхоскопия с аргоноплазменной коагуляцией, компьютерная многосрезовая томография, видеоторакоскопия.

The article is devoted to the description of our own observations and treatment of complications of a viral infection caused by SARS-CoV-2. It is noted that spontaneous pneumomediastinum and pneumohydrothorax can lead to worsening of the course of the disease. Special attention is focused on spontaneous intermuscular emphysema of the neck and surgical treatment of SARS-CoV-2 complications according to current literature data. It has been established that isolated subcutaneous and intermuscular emphysema of the neck, which occurs as a complication in patients with viral lung disease in COVID-19, does not require surgical intervention. Spontaneous mediastinal emphysema as a complication of COVID-19 requires emergency cervical mediastinotomy in cases of increasing gas syndrome. In patients with COVID-19 complicated by pneumohydrothorax, early diagnosis of this formidable complication and timely transthoracic drainage of the pleural cavity are important. With the formation of a persistent bronchopleural fistula, active treatment in a low-traumatic way using videothoracoscopy is advisable in those cases where it is clinically possible.