The work is based on the analysis of literature data devoted to the problem of preserving the functional state of the kidneys with various video endoscopic methods of surgical treatment of large and complex kidney stones. The purpose of the review is to highlight the likelihood of deterioration in the functional state of the kidneys in the postoperative period. A detailed analysis of postoperative outcomes in various minimally invasive methods of treatment of patients with large and complex kidney stones was carried out, with an overview of the possibility of using dynamic nephroscintigraphy as a method of objectively assessing the functional state of the kidneys.

Introduction. The search for effective drug combinations for treating continental disorders in women is still relevant. The interval scale for assessing lower urinary tract symptoms in women is a simple and convenient tool for monitoring pharmacotherapy. Objective: to evaluate the effectiveness of treatment of imperative and mixed urination disorders in women with alpha1-blockers in combination with nootropic drugs using an interval symptom rating scale.
Materials and methods. Under observation there were 31 patients aged 40 to 73 years who applied to the Center “Urination Pathology” with mixed and imperative disorders of the continent and urinary incontinence. Conservative therapy was carried out with the appointment of alpha1-adrenoblockers, nootropic and metabolic drugs for an average of 5.8 months. The therapeutic effect is recorded using the interval symptom score scale.
Results. After discontinuation of drugs, the overall score on the symptom rating scale decreased by 40.2%, imperative symptoms – by 29.5-50%, and quality of life increased by 19%. In the group of women aged 40-49, with comparable dynamics of symptoms with patients older than 50 years, therapy lasted less. The difference averaged 4.1 months and was associated with a higher frequency in the older age group of vascular, metabolic and neurological disorders that slow down the regulatory processes of urination recovery.
Conclusion. Alpha1-blockers and nootropics are pathogenetically substantiated for the treatment of imperative disorders of urination and urinary incontinence. Evaluation using the interval scale reliably demonstrates their high clinical effectiveness, persistence of the therapeutic effect and the feasibility of application at the stage of selection for surgical treatment.

This clinical case represents the experience of surgical treatment of a patient with multiple primary metachronous cancer: 1. Sigmoid cancer рТ4NxM0. Resection of sigmoid colon (16.12.2013). Three courses of adjuvant chemotherapy (XELOX). Recurrence (2015). Laparotomy, Colproctectomy with D3 paraaortic lymph dissection. Ileostomy (2015). One course of chemotherapy (XELOX). 2. Upper tract urothelial carcinoma (right ureter) pT2N0M0R0. Right nephroureterectomy with the resection of the bladder and right testicular cord, cystostomy (19.02.2015). Recurrence. Nephrostomy drainage of the left kidney. Adhesive disease. Rectovesical fistula. Taking into account the history and comorbid status of the patient, it was decided to perform laparoscopic supralevator pelvic exenteration, ureterectomy on the left. The duration of the operation was 280 minutes, intraoperative blood loss was 200 ml. The period of stay in intensive care is 24 hours, the patient was discharged on the 7th day after the operation, the resection margin was negative (R0). After 12 months, there is no data for the disease progressed.

Relevance. Treatment of achalasia of the cardia (AС) is currently palliative, aimed at reducing the manifestation of clinical symptoms of the disease. Together with instrumental methods of examination of esophageal function, the Eckardt scale and the GIGLI questionnaire are convenient and simple tools for evaluating results in the long-term postoperative period.
The aim of the study was to evaluate the long-term results of surgical treatment of patients with 2-4 stages of AС, after laparoscopic Нeller myotomy with anterior hemiesophagofundoplication by Dor to the results of special methods of esophageal examination and patient questionnaires using the Eckardt scale and the GIGLI questionnaire.
Materials and methods. The work included the results of examinations of 103 patients who underwent video laparoscopic Нeller myotomy, with anterior hemiesophagofundoplication by Dor. The period of examination in the postoperative period was from 3 to 7 years. The results of X-ray examination of the esophagus and stomach, manometry of the esophageal and esophageal-gastric junction before and after surgery were studied , and patients were also surveyed according to the Eckardt scale and the GIGLI questionnaire.
Results. The analysis of the results of instrumental methods of studying the function of the esophagus in the pre – and postoperative periods showed that the given manometry of the esophagus and esophageal-gastric junction, X-ray of the esophagus and stomach significantly improved in the postoperative period in patients with all stages of the disease. The results of patients of 4th stage AC compared with the results of 2nd and 3rd stages patients were worse(p<0,05).The leading symptom of AK-dysphagia in the long-term postoperative period decreased in all the studied patients, the results were better in patients with stage 2, worse in patients with stage 4 of AK (p<0,05).The leading symptom of AK-dysphagia in the long-term postoperative period decreased in all the studied patients, the 2nd stage patients results were better, 4th stage patients results were worse (p<0,05).
Conclusions. After video-endoscopic Нeller myotomy with fundoplication by Dor, the indicators of esophageal manometry and esophageal and stomach radiography significantly improve, the results of the Eckardt scale and GIGLI questionnaire survey of patients show a significant decrease in the severity of clinical manifestations of AC in the balls. This method of surgical treatment can be recommended already at the 2nd stage of AC and as an organpreserving operation for 4th stage.

Background. Meckel's diverticulum is an ileal diverticulum, formed as a result of incomplete reduction of the yolk duct, occurs on average in 2% of the population. Up to 25% of cases of this pathology are symptomatic or have complications (up to 16%), while more often it manifests in children under 2 years of age. Destructive diverticulitis is the least common complication of Meckel's diverticulum, requiring urgent surgical intervention.
Clinical case. A 28-year-old patient with a clinical picture of acute appendicitis came to the emergency room. Intraoperatively, destructive diverticulitis and widespread fibrinous-purulent peritonitis were identified. Conversion to a laparotomic approach and expansion of the volume of the main stage of the operation to appendectomy, segmental resection of the ileum were performed. The postoperative period was uneventful. The patient received complex conservative therapy, was discharged on the 10th day in a satisfactory condition.
Conclusion. Destructive diverticulitis requires the surgeon to be vigilant in conducting a diagnostic search in the clinical picture of acute appendicitis in adult patients. If a correct intraoperative diagnosis is established, a radical and least traumatic operation should be selected from a rational approach (if necessary, it should be converted to a laparotomic one). It is necessary to emphasize the importance of an individual approach in choosing intraoperative tactics and planning perioperative complex therapy

The analysis of the results of treatment of 97 patients who were operated from surgical diseases of the cardiac stomach. Proximal gastric resection (PRG) was performed using isoperistaltic jejunogastroplasty (modified by Merendino-Dillard) (50 people – group I) and with direct esophagogastroanastomosis (47 people – group II). 12 and 24 months after the operation, an X-ray and endoscopic examination of the upper digestive tract was performed, assessing the severity of functional disorders (nutritional status, body weight deficiency, reflux esophagitis, anastomosis) Results. After 2 years or more, 5.9% of patients ate more than 6 times a day in group I, while in group II, 23.3% (p <0.05). 67.6% of patients in group I and 36.7% in group II returned to their previous (as before the illness) diet – 3-4 times a day (p <0.05). After 24 months or more, in group II, the average weight of patients did not exceed preoperative indicators (95.9 ± 0.25%), while in group I, there was an increase in the average weight of 109.9 ± 0.13%. (p <0.05). The frequency of reflux esophagitis was observed in 8 (9.3%) cases: in group I – in 2 (4.5%) and in group II-in 6 (14.3%) (p <0.05) According to the authors, the PRG with the reconstruction of the digestive tract according to Meredino-Dilard creates optimal conditions for a faster and better recovery of functional parameters and demonstrates how significant and effective the performed surgical treatment is.

In the structure of the incidence of malignant tumors for a number of years, colorectal cancer occupies one of the leading positions, with a steady tendency to growth. The five-year survival rate of patients with metastatic liver damage in colorectal cancer does not exceed 28%. A significant breakthrough in the study of the biology of colorectal cancer has led to a deep understanding of individual processes of carcinogenesis and a personalized approach to treatment tactics. Despite this, the problem of chemoresistance remains one of the most acute. The high toxicity of systemic chemotherapy limits its use in this group of patients. In this connection, minimally invasive and at the same time effective methods of local treatment of malignant liver tumors have been introduced into clinical practice. These methods include: hepatic artery chemoinfusion, chemoembolization, oil chemoembolization and radioembolization. At present, a large world experience has already been accumulated in the application of the above-described methods of treatment. However, the question of the application of methods of interventional surgery in the treatment of patients with chemoresistant metastases is still open. The presented review reflects the results of the analysis of scientific literature on the treatment of this group of patients. The main stages of development and improvement of X-ray endovascular methods of treatment are presented.