Background. Parathyroidectomy is the only effective method to improve the clinical and laboratory manifestations of the primary hyperparathyroidism (PHPT) and reduce the risk of urinary calculi formation. However, there are controversies about the existence of renal form of PHPT and about the effectiveness of surgery with regard to the risk of stone formation. Aims. To evaluate the effectiveness of PHPT surgical treatment in relation to clinical, laboratory parameters, as well as the risk of stone formation. Materials and methods. In a prospective single-arm observation one-center nonrandomized study we included patients with PHPT in whom parathyroidectomy was performed in 2012–2015. We analyzed clinical and laboratory parameters before and after surgery in a period from 1 to 3 years. Results. The study included 105 patients, of whom 35 (33.3%) had urolithiasis. Blood calcium after the surgery decreased from 2.72 mmol/l [2,56; 2,97] to 2,3 mmol/l [2,2; 2,35], p < 0.001. Blood calcium concentration decreased to normal values in all patients. Parathyroid hormone level decreased from 206 pg/ml [123; 347] to 72,8 pg/ml [30; 113], p < 0.001. Clinical symptoms questionnaire estmation decreased from 4 points [3; 6] to 2 points [1; 4], p < 0.001. In patients with urolithiasis clinical symptoms before treatment were more pronounced – 5 points [3; 7] vs. 4 points [3; 5] (p = 0.015) and decreased more significantly – by 3 points [2; 4] vs 2 points [1; 3]. The daily calcium urine excretion decreased from 11.4 mmol/day [8.9; 13.9] to 5.4 mmol/day [4.1; 6.8], p < 0.001. In 2 cases (5.7%; CI, 0.7–19.2%) we observed the progression of urolithiasis after surgery. The age of patients correlated with daily calcium urine excretion after surgery (r = 0.69; p = 0.028). Conclusions. Parathyroidectomy normalizes blood calcium and parathyroid hormone, improves clinical symptoms and reduces the risk of stone formation.

Relevance. Baker's cyst is the formation in the popliteal region, resulting from the accumulation of synovial fluid in the semimembranous bursa due to anastomosis between the joint cavity and the synovial bursa of the popliteal region. Trauma and/or some inflammatory diseases of the joints are the main causes of these cysts. Despite the success of endoscopic methods of treatment of this category of patients, the frequency of postoperative complications is 3-10%. The aim is to conduct a comparative analysis of the Baker's cysts treatment results using intracavitary laser obliteration and traditional cyst excision. Materials and methods. The treatment results of 39 patients with Baker cysts, who entered the clinic for the period from 2012 to 2017, are analyzed. Patients were divided into 2 representative groups. Ultrasound-guided intracavitary laser obliteration of Baker's cyst was performed in 24 (62%) patients of the main group. Traditional radical excision of all cyst elements with application of the primary suture was performed for 15 (38%) patients of the control group. A russian single-wave programmable three-mode laser scalpel LSP - "IRE-Polyus" was used in the work. Results. The patients of the main group had almost no pain syndrome, the duration of hospital treatment and rehabilitation were 4 times shorter than in the group of traditional operations (p≤0,05). Satisfaction with the laser treatment results of the patients from this group was 83.3%, while in the traditional treatment group - only 66.6%. Conclusion. The minimum number of the disease recurrences after ultrasonic-controlled intracavitary laser obliteration of Baker's cysts, the simplicity and low-traumatism of manipulation, the low level of complications, coupled with the high patient satisfaction with the treatment results, set apart this technology from traditional one, which allows recommending this method for wide application.

Aim. To carry out the comparative analysis of the results of ambulatory treatment of patients with chronic hemorrhoid using “Step-by-Step” technology and surgeries in hospital conditions. Materials and methods. The results of treatment were analyzed in 4 representative groups: 31 patients of the main group underwent a staged “Step-by-Step” hemorrhoidectomy in ambulatory conditions, 29 patients of the first group of comparison – Longo operation, 32 patients of the second group of comparison – laser hemorrhoidectomy, 29 patients of the third group of comparison – Milligan-Morgan operation. Results. In the main group, the rate of complications was noted in 1.4 %, after Longo operation – 9.8 %, after laser hemorrhoidectomy – 6.6 %, after Milligan-Morgan – 11.2 %. Relapse of disease was registered in 0.6 % of patients of the main group, 6.1 % – first group of comparison, 3.8 % – second group and 3.5 % – third groups. Conclusions. The best treatment results were obtained in patients after using the technology “Step-by-Step” at the expense of a minimum rate of complications and less number of relapses that permits to recommend this technique for a wide clinical application.