Aim. To present the experience in performing posterior separation plasty according to Yu. Novitskiy, to evaluate the efficacy and safety of the technique. Methods. The results of treatment of 22 patients with giant middle postoperative ventral hernias, treated in the surgical department №1 of Kazan City clinical hospital №7 in 2013-2016, were analyzed. 9 patients had open posterior separation plasty of the abdominal wall in Yu. Novitskiy’s modification performed (study group). Comparison group included 13 patients who had standard tension-free inlay-plasty. Results. The average duration of surgery in the study group was 143.9±10.7 min, in comparison group - 136.6±12.1 min. In the study group there were no serious complications in the immediate postoperative period. In 3 cases at control ultrasound examination clinically insignificant seromas were found which did not require additional treatment and self-resolved within the period of 3 weeks. In one case there was lymphorrhea from the wound for 9 days. Healing of a surgical wound in all cases was by primary intention. Average hospital stay was 10.2±0.6 days. There were no lethal outcomes. Recurrence of the disease in the observed period was not registered. Conclusion. Posterior separation plasty of the abdominal wall in Yu. Novitskiy’s modification is a safe and effective technique that allows recommending this surgery to the surgeons operating patients with giant postoperative ventral hernias.

The review decribes the radio-endovascular methods in prevention and treatment of arrosive bleedings in destructive pancreatitis. The importance of non-surgical treatment in patients with aseptic forms of destructive pancreatitis is presented. It is stressed that the problem of an optimal surgical treatment choice in patients with pancreatolysis is not solved. Efficiency of minimally invasive surgery for treating destructive pancreatitis is shown. Radio-endovascular treatment methods, including intraarterial drug infusions and pancreatic arteries embolization to prevent and treat pancreatic inflammation and arrosive bleedings from visceral arteries aneurisms, are among such options. Researches of domestic and foreign authors give the clinical basis for selective drug introduction into coeliac artery in destructive pancreatitis treatment. Clinical cases of visceral arteries (lienal, gastroduodenal, left colonic, intrahepatic) embolization are reviewed as a way of hemorrhagic complications prevention and emergency treatment in destructive pancreatitis. The problem of arrosive bleedings in destructive pancreatitis at the present stage can be adequately controlled in the conditions of specialized surgical ward equipped with operational radio-endovascular facilities and multispiral computed tomographic scanner.

Aim. To improve the treatment results of patients with obstructive jaundice using endoscopic methods for restoring biliary tract patency. Methods. A retrospective analysis of treatment results of 636 patients, treated in the surgical departments of City Clinical Hospital №7, Kazan, Russia in 2004-2014 with obstructive jaundice induced by tumors and other diseases was performed. Results. It was revealed that using endoscopic techniques for biliary system decompression allows to improve the treatment results. Our observations of patients 2014 with obstructive jaundice induced by tumors and other diseases suggest that the most important element of a comprehensive treatment of such patients is the earliest possible biliary tract decompression using minimally invasive approach, including endoscopic papillotomy and biliary tract stenting. The liver failure stage is an important criterion that defines patient management in case of obstructive jaundice. In patients with obstructive jaundice, treatment of endogenous toxemia and liver failure, according to the contemporary approaches, is based on drug administration and infusions of the required volume and contents, associated with one of the methods for biliary decompression therapy adequate in its formula and size. Conclusion. Endoscopic surgeries are indicated in the majority of acute, recurrent, and chronic large duodenal papilla obstruction cases. Performing endoscopic retrograde cholangiopancreatography, endoscopic pancreatic sphincterotomy in obstructive jaundice not associated with biliary tumors may refuse the surgical approach or reduce its volume and surgical injury.