Aim. To conduct a detailed analysis of the causes of development of late stomal complications, to determine the indications for surgical correction, to evaluate the effectiveness of new methods of surgical treatment. Methods. Conducted was an analysis of the causes of late stomal complications in 141 patients with a stoma of the colon. Results. A parastomal hernia was diagnosed in 44 (31.2%), prolapse - in 29 (20.6%), stricture - in 9 (6.4%) patients. Introduced into practice were new methods of surgical correction of complicated stomas. Parastomal hernia was detected in 44 (31.2%) patients - 26 (59.1%) females and 18 (40.9%) males, all patients with this complication were older than 50 years, the age group 71-80 years included 43.5% of patients. Since 2005 performed were 17 reconstructive operations for parastomal hernias (Russian Federation patent №2406454 and №2395238). Stoma prolapse was observed in 29 (20.6%) patients, 10 cases - in patients aged 71 to 80 years. Most often this complication developed in patients with double-barreled transverse stomas - in 10 (76.9%) of 13 patients. 4 patients underwent surgery due to prolapse. Stoma stricture was diagnosed in 9 (6.4%) patients. In 7 patients with a stoma stricture in the early postoperative period registered was festering of the parastomal wound (4 cases), marginal necrosis of the stoma (2 cases), and stoma retraction (1 case). Correction with the use of stents for the prevention of recurrence (Russian Federation patent №2357681) was conducted in all cases. The so-called «lock-stoma» was diagnosed in 16.3% of cases (23 patients). Although this condition does not belong to stomal complications in its pure form, however in most cases it causes the inability to use the incontinence bag, reducing the quality of life. Conclusion. Despite the inevitability of the development of parastomal complications, provided proper surgical techniques can either prevent or delay their appearance; reconstructive operations for complicated stomas, conducted by moving the stoma to a new place with retroperitoneal conduction makes it possible to obtain satisfactory results, significantly improve the quality of life that promotes full social adaptation of stomal patients.

The aim of the study was to examine the effectiveness of the adherence to the WHO surgical safety checklist.Material and methods. A comparative analysis of the performance of the surgical departments in two clinics was carried out: in the first clinic the WHO checklist was applied to control the performance of the surgical department; in the second clinic these recommendations were not used. The results of 3012 (first clinic) and 3527 surgical interventions (second clinic) were analyzed. The authors studied the frequency of postoperative complications, the effectiveness when using all the points of the recommendations.Results. The frequency of antibiotic prophylaxis during general surgical operations in clinic I was 89.3%, in clinic II - 63.7%, the frequency of infection in the area of ​​surgical intervention was by 13.2% and up to two times higher in clinic II, mortality rates after surgery were also significantly higher in clinic II; consequently, the duration of inpatient treatment was 8.7 in clinic I versus 16.4 days in clinic II.Conclusion. The adherence to the surgical safety checklist can effectively reduce the number of postoperative complications, mortality, and reduce the time of inpatient treatment.