The textbook is devoted to the diagnosis of esophageal injuries and treatment of patients. The article describes the surgical anatomy of the organ, causes of esophageal injuries, classification, diagnostic methods, tactics, describes possible treatment options for patients depending on the clinical picture, technique and volume of operations depending on the developing complications. The paper presents original methods of treatment of the esophagus, methods of management of patients in the postoperative period, treatment of possible complications and their prevention. Meets the requirements of the Federal state educational standards of higher education of the latest generation. For doctors-surgeons, clinical residents, postgraduates, undergraduates and teachers of medical universities.

Objectives - to improve the surgical treatment results in patients with injuries of the esophagus after the elimination of deformation of a vertebral column with metal devices. Material and methods. From 2001 to 2018 we treated 17 patients with esophageal injury appeared as a result of cervical vertebras fixation with metal devices - in 12 patients to correct their instability due to the traumatic compression fractures and in 5 patients having the herniated discs with the spinal channel compression. 12 patients underwent the urgent operation, 5 patients - the delayed or planned one. Three mechanisms of esophageal injury were defined: 5 patients had the first type of injury, 8 - the second type, 4 - the third type. The patients were operated on after the diagnosis confirmation. The operation was aimed at the removal of the metal device from the collum and the closure of the esophagus wall defect. Tactics of treatment of the esophageal injuries depended on the alterations in its paries, the size of the defect, the nature of the trauma and the mediastinitis prevalence. In 8 patients the primary suture of the esophagus was applied. In 9 patients with decubituses of the esophagus and the large size of the defect we applied the partial suturing of the defect and the transesophageal drainage of the fistula and mediastinum, strengthening the injured zone with a muscle on the pedicle. Results. First intention healing was achieved in 5 patients of the 8 ones who underwent the esophagus wall suturing without a fistula transesophageal drainage. The partial suture incompetence occurred in 3 cases and it required the transesophageal drainage through the defect in the esophagus wall. The external tubular esophageal fistula formed in 12 patients. After the drainage removal the fistula closed in 10 cases. One of the 17 patients died of the multiple organ failure and sepsis. Conclusion. Injuries of the esophagus caused by the metal devices fixing the unstable vertebras have the clinical features depending on the installation time. The suturing of the esophageal defect and the suture strengthening m. sternocleidomastoideus on the pedicle supplemented by a through lumenal transesophageal drainage have advantage in comparison with the esophageal wall suturing without drainage.

Bilateral lung resections are performed  for various pathologies: pulmonary  emphysema,  parasitic diseases, metastatic  lesions, and bronchiectasis. In clinical practice, sequential or staged interventions  are more common.  Surgical treatment of bronchiectasis is currently carried out only in cases with complications  of localized forms and, as a rule, consists of resection of the affected part of the lung. The percentage of such patients is not large and amounts to about 5%. Taking into account the chronic course of bronchiectasis and certain successes of the conservative treatment, indications for resection operations  may arise at different periods of the patient’s life. Sometimes,  up to several decades can pass between the surgeries. Aim. To demonstrate  a rare clinical case of staged lung resection for bronchiectasis in a patient who had 4 lung lobes removed with an interval of 52 years. Results. History of the disease was described. Indications  for staged surgical interventions  were identified. The main characteristics  of the health status after the surgeries were described. Conclusion. The presented case illustrates the place and role of surgical methods in the treatment of bronchiectasis, as well as the compensatory  capabilities of the lung tissue in the case of staged resection interventions.

Textbook is dedicated to the prevention and treatment of obstruction of the esophagus after chemical burns by corrosive liquids. Presented possible options for the treatment of patients depending on the stage of the disease, prone to recurrence and complications. The main method of treatment of patients with obstruction of the esophagus is probing the efficiency of which depends on the techniques of its implementation. Considered indications for balloon dilatation and stenting of the esophagus. Great attention is paid to the prevention of complications of dilatation of the esophagus and treatment for their development. Meets the requirements of Federal state educational standards of higher education of the last generation. Designed for students of higher educational institutions, clinical interns, postgraduate students, doctors, surgeons and medical teachers.

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