The work presents an analysis of the results of thyroid surgery in 3758 patients. The majority of interventions were performed within 1975-1985 and amounted to 2863 (76.18%) cases, of which 72 (1.92%) were for giant benign neoplasms. Diagnosis verification was carried out in 2613 (69.53%) patients using scintigraphy, and in 1145 (30.47%) - echography. The median age was 52.7±15.8 years. The distribution by sex is 713 (18.97%) male and 3045 (81.03%) female. Most 2572 (68.44%) surgical interventions were performed under local anesthesia. Damage to the return nerve after surgery occurred in 127 (3.38%) patients, and in giant neoplasms in 31. In 18 (0.48%) patients, clinical manifestations of return nerve injury occurred on the opposite side. Positive dynamics from the treatment complex were observed in 113 (88.97%) patients, at the same time, 14 (11.02%) had persistent damage to the return nerve. In the early postoperative period there were phenomena of hypocalcemia during the first day in 384 (10.22%) patients, by the end of the second day - in 292 (7.77%), by the end of the third day - in 12 (0.33%), of which 248 (6.59%) are elderly. 112 (2.98%) cases involved intraoperative bleeding. The source of hemorrhage in 103 (2.74%) cases was neoplasm capsule vessels. It has been established that the mismatch between the size of surgical access and pathological mass (giant thyrotoxic goiter), disruption of the stages of intervention (except early planned cases), intimate fusion with the capsule, its thin wall, disregard of video monitoring data are risk factors for intraoperative complications in benign thyroid diseases. The use of nonstandard techniques («making Novocain cushion,» change of intervention algorithm) allows to visualize clearly nearby anatomical structures, and therefore, in the future - atraumatic operation.

Purpose. To analyze short-term and long-term outcomes of surgical treatment of the patients with hiatal hernia complicated by gastroesophageal reflux disease, depending on the choice of fundoplication method.Materials and methods. A retrospective analysis of the short and long-term outcomes of the treatment of 171 patients suffering hiatal hernia complicated by gastroesophageal reflux disease was performed. All patients were underwent laparoscopic hiatal hernia repair supplemented by Nissen fundoplication - 109 patients or Toupet fundoplication – 62 patients.Results. In the Nissen fundoplication group the incidence of intraoperative complications was 9.2% (11 patients), postoperative complications – 8.3% (9 patients), dysphagia in the early postoperative period was noted in 24 (22%) patients. In 5 years after surgery, gastroesophageal reflux was observed in 6 (5.5%) patients, anatomical recurrence in 13 (11.9%) patients. Dysphagia in the late postoperative period was noted in 7.3% (8 patients). In the Toupet fun doplication group the incidence of intraoperative complications was 11.3% (7 patients), the incidence of postoperative complications was 6.5% (4 patients), functional dysphagia in the early postoperative period was noted in 8 (12.9%) patients. In 5 years after surgery, gastroesophageal reflux was observed in 8 (12.9%) patients, anatomical relapse in 13 (11.9%) patients. Persistent long-term dysphagia in the late postoperative period was noted in 2(3.2%) patients.Findings. The choice of fundoplication method did not significantly affect on the duration of surgery, the frequency of intraoperative and postoperative complications, duration hospital stay, the incidence of early functional postoperative dysphagia, the number of unsatisfactory results in the long term period, including recurrence and dysphagia.

Purpose: to compare the effectiveness of laser therapy and traditional methods for managing diabetic patients with purulent-necrotic lesions in their lower extremities.Material and methods. The article presents a retrospective analysis of outcomes after treatment of 76 patients with diabetes mellitus having purulent-necrotic lesions in their lower extremities. Patients were divided into two groups. The first (main) group consisted of 34 patients in whom traditional treatment was accompanied by intravenous laser blood irradiation and local laser therapy; the second (control) group consisted of 42 patients who received only traditional treatment.Results. Laser therapy contributed to more rapid reduction of wound defect (17.4 %) compared to patients after traditional treatment (11.1 %); it reduced the period of transition to inflammatory-regenerative changes, promoted a smaller number of high amputations of lower limbs from 14 to 6 % as well as shortened the length of hospital stay by 11.2 days.Conclusion. Laser light therapy in patients with diabetic foot accelerates cleansing and reduction of the wound area, allows to reduce or eliminate inflammatory process in shorter time than with traditional treatment.

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Цель исследования — анализ непосредственных и отдаленных результатов оперативного лечения больных с грыжами пищеводного отверстия диафрагмы, осложненными гастроэзофагеальной рефлюксной болезнью.Материалы и методы. Проведен ретроспективный анализ непосредственных результатов лечения 171 пациентов, страдающих грыжей пищеводного отверстия диафрагмы, осложненной гастроэзофагеальной рефлюксной болезнью. Все пациенты оперированы в объеме лапароскопической крурорафии с фундопликацией по Ниссену либо по Тупе.Результаты исследования. Длительность пребывания в стационаре в среднем составила 7,1±1,9 дней. Послеоперационные осложнения отмечены у 13(7,6%) пациентов. Функциональная дисфагия легкой степени отмечена у 30(17,5%). Стойкая длительная дисфагия при приеме плотной пищи в позднем послеоперационном периоде отмечена у 10(5,8%) пациентов. Через 5 лет после оперативного вмешательства рецидивы результаты отмечены у 32(18,7%) пациентов. Суммарный балл по шкале-опроснику GERD — HRQL через 5 лет после операции составил 6,9±3,1.Выводы. Лапароскопические вмешательства являются безопасными, малотравматичными, обеспечивают возможность ранней реабилитации больных, позволяет достичь положительные функциональные результаты у 85% пациентов и должны быть операцией выбора в лечении пациентов, страдающих ГПОД, осложненной ГЭРБ.