These proceedings present an analysis of own experience and of world-famous literary materials that is dedicated to the issue of transmyocardial laser revasculization and its combination with aortocoronary shunting. On the grounds of 230 own observations the authors showed a high performance of the new treatment mode of ischémie heart disease especially in combination with «gold standard» of cardiosurgery, i.e. aortocoronary shunting. The part of combined operations was 64,3%. Besides, the scientists used their own technique of planning of intervention and evaluation of the treatment results based on zonal mapping of myocardium perfusion. They concluded that laser vascularization of myocardium is safe and effective procedure, which improves quality of life of patients.

Among paroxysmal atria tachycardias, preexcita-tion syndrome occurred in 25 % of cases. This kind of cardiac rate disturbance is related to life-threatening arrhythmia and is one of the reasons for sudden death. The principal aspects of WPW anatomical substratum, the diagnostic opportunities of localization of extra realization ways, the methods and the results of treatment of WPW-syndrome are reflected in present report. The materials showed in this lecture are based on modern methods of noninvasive and invasive diagnostics, treatment of this syndrome and show an interest for cardiologists and therapeutists.

The problems of diagnostics and treatment of ventricular arrhythmia are of vital importance in modern medicine. In 80% of cases the cause of the sudden death is ventricular tachycardia, ventricular fibrillation. The modern methods of diagnostics, electrophysiological mechanisms of the beginnings and the principles of treatment of ventricular tachycardia are reflected in presented lecture. The lecture material is based on the advanced breakthroughs of Russian and world practice in the field of clinic and interventional arrhythmology. The present report can be useful for cardiologists, therapeutists and specialist in other lines of clinic medicine.

In this research there are summarized the international experience and native data on surgical cure of pulmonary artery atresia with the defect of interventricular septum. There are examined the questions of embryogeny, anatomy, hemody-namics, clinic and diagnostics of this congenital heart disease. Sources of collateral blood supply of lungs are also classified there. It is noted that the open surgical operations are very traumatic and are characterized by frequent complications and require multiple-stage treatment. With the purpose of reduction in respect to the number of open operations, it is proposed to use endovascular methods, which do not cause much harm to patient.

This is a literary survey dedicated to comparative analysis of different methods of diagnostics and treatment under abdomen-closed injuries. It's pointed out at leading position of this pathology by quantity of diagnostical errors in emergency surgery. The authors emphasize the role of modern videolap-aroscopic methods, which are especially effective under indistinct clinical picture, combined trauma and loss of consciousness. They consider it's necessary to centralize the urgent lap-aroscopic aid, to define the staff service structure and to solve a range of methodic-organizational questions.

The purpose of the article was to present the concept and definition of microsurgery and elucidate the questions of its history. The authors traced and analyzed the basic data regarding the stages of its development in our country and abroad. Presenting basic dates of different forums, which contributed to reach decisions and adopt resolutions of definite significance they outlined some prospects in different lines of surgery in the view of the authors.

In cardiosurgical department of Primorsky regional clinical hospital No. 1 (Vladivostok) on the strength of check-up and treatment of 546 patients with implanted pacemakers there has been studied a possibility of using a method of metering the stimulation thresholds in order to make diagnostics of latent myocarditis. As a result, there have been selected a group of 17 patients; their results of stimulation thresholds measuring have exceeded the «critical marks» of chronic thresholds of stimulation that were theoretically calculated. To 4 patients were given a diagnosis «myocarditis» within further check-up. Prescribed treatment was effective under 3 medical observations, 1 patient died. Thus, the measuring of stimulation thresholds of patients with implanted pacemakers can be used as screening method for diagnostics of latent forms of myocarditis.

On the grounds of literary data of 52 own observations, there has been held a comparison of method of crystalloid and blood hypothermie cardioplegia for intraoperative protection of myocardium under manipulations upon «dry heart». It has been shown that the necessity of defibrillation and application of temporary electrocardiostimulation, for certain and more often, comes into existence under crystalloid cardioplegia. The method of blood cardioplegia has the best indices of recovery of heart sinus rhythm in postoperative period and the less necessity in cardiotonic agent. Nevertheless, the using of pharmacohypothermic cardioplegia, on the authors' opinion, is admissible with large volumes of operative interferences of patients with high indices from myocardium contractile.

Here are presented clinical experimental researches of coagulant, anticoagulative and fibrinolytic systems as well as functional activity of platelets while performing endovid-eosurgical operations. The heterogeneity of visceral and subcutaneous fat has been determined by influence on local he-mostasis. In these researches there have been shown some differences of indices of hemocoagulation at local and system levels, dependence of existent changes upon the intensity of stress-reaction as well.

In this research the group of cardiosurgeons presented the treatment results of 33 patients who underwent the reconstruction of ischémie mitral insufficiency and aorto-coronary shunting. For correction of mitral insufficiency physicians used valvuloplasty «edge-to-edge» (48,4%), posterior cusp resection and non-implantation annuloplasty (33,3%), annuloplasty with supporting ring (18,1 %), chordae prosthet-ics (3%). The coronary arteries of 94% of patients were shunted with autoarterial transplants. Hospital lethality was 6,1%. The most frequent postoperative complication was acute cardiac insufficiency.

In Primorsky region the mortality due to congenital heart diseases of children under sixteen was 0,1% in 2001. The physicians carried out the analysis of diagnostics and treatment of 177 congenital heart diseases on the mate rial of cardiology department of Regional Clinical Center of Maternity and Childhood Protection during the years 1997-2002. The authors noted an improvement of possibilities for diagnostics, including intrauterine one, and treatment of men tioned diseases under conditions of the region.

The authors describe the principal causes of injuries of extra hepatic bile-duct and consider that it is possible to minimize such kind of complications if the techniques of operation and individual approach to the methods of surgical intervention are thoroughly kept. The timely fulfilled conversion is a prophylactic measure of possible iatrogenic damages. On own material (428 chole-cystectomies, 198 of them were laparoscopic operations), the conversion has been performed in 4,5 % of cases. The damages of extrahepatic bile-duct occurred at 0,2 % of patients.

There was generalized the experience of 16 videothoracoscopic atypical economical resections of the lung under the bounded forms of pulmonary tuberculosis. It is marked that the most complicated thing while carrying-out these operations is to determine the limits of resection. It was proposed to use minithoracotomic access. The authors conclude that the videothoracoscopic resections are advanced directions on treating the bounded forms of pulmonary tuberculosis that is clear of shortcomings of open thoracotomy.

There has been presented an experience of surgical treatment of 1096 patients with non-small cell cancer of lung. Immediate results and ways of prophylaxis of postoperative complications have been also analysed. The authors have specified the indications for choice of operation volume: both dilated and combined, bronchoplastic and economical ones. They estimated some remote results of treatment with defining of prognosis factors. There have been shown the possibilities of improvement of 5-year treatment results of the third stage of disease by 9-13% when the operation is combined with polychemotherapy.

This part will present the results of examination and treatment of 477 patients with cholelithiasis complicated by choledocholithiasis. Within these researches five clinical forms of choledocholithiasis: cholecystitic, pancreatic, cholangitic, obturative and asymptomatic ones have been noted. Taking into account clinical form of the disease and application of the new technique of little inva-siveness it is shown that the choice of efficient surgical approach for the persons of elderly and senile age allows reducing lethality and improving the results of the treatment two times as much.

In this work the analysis of the endoscopie treatment results of 188 morbid events of duodenal ulcer complicated by bleeding is presented. As is shown in this research, under the weak intensity of bleeding it is recommended more effective irrigation of ulcerous defects by denaturing solutions. Under bleedings, which continue at the moment of examination, it is expedient to use combined methods like peri-ulcerous introduction of hemostatic solutions and elec-trocoagulation of vessels.

This research seeks to generalize the experience of endovideosurgery under the conditions of military operations in Chechen Republic. As stated, endoscopie operations are of high-performance for diagnostics and treatment of gunshot wounds of chest, abdomen and lower extremities. It is recommended to use them early in the medical evacuation owing to their ability to reduce a number of complications and period of rehabilitation of victims.

The authors shows an experience of radical surgical treatment of 111 patients with cancer of esophagus and pars cardiaca ventriculi. Their opinion is expounded in the context of indications for the choice of access, volume and kind of surgical operations: multiple and single-stage ones, with forming of intrapleural or out-of-cavity esophageal anastomosis. Scientists have estimated the immediate results. The complications and perspectives of fight with them have been characterized, too. In the course of the work aforementioned physicians show diverse ways of transplant's conducting upon the neck and some variants of esophageal anastomosis with their comparative appraisal.

According to the material of 130 observations the doctors studied diagnostic value of endoscopie methods of examination of patients with perforated stomach and duodenal ulcer. As noted, fibrogastroduodenoscopy is an effective method of diagnostics of perforated ulcers whereas in case of lack of effect under repeated survey radiography of abdominal cavity it facilitates discovering some air incoming through perforated orifice at the moment of insufflation. Furthermore fibrogastroduodenoscopy allows showing any concomitant pathology of esophagus, stomach and duodenum as well as multiple ulcers and bleeding from them. The usage of laparoscopy for the diagnostics of perforation enables to give an opportunity to specify diagnosis, to carry out differential diagnostics, to ascertain the availability of peritonitis, volume and character of exudates.

In these researches there can be find five-year microbiological monitoring data of hospital infections in surgical in-patient departments of Vladivostok. The authors showed that the year 1999 was the worst with regard to the degree of microbe-semination fullness of air, the contamination of environmental objects as well as the sterilization reliability. Later on the microbe-semination level has decreased. The causes of the hospital infections were mostly pathogenic and epidermal sta-phylococcus, colon bacillus, blue pus bacillus. The problem of development of necessary measures to apply microbiological provision standard in the prophylactic system of nosocomial infections is also presented in this investigation.

Micturating disorders of women of different age groups are insufficiently explored problem. The examination carried out to 180 patients at the age from 21 to 80 years shows that the frequency of urination disorders increases with old age being at the maximum by 50 - 60 years. These findings are evidence of the necessity of prophylaxis of dysu-ric disorders of women of thirty and more years.

The authors present the results of electrocauter-izing conization within the treatment of hyperplastic processes of cervix uteri of 70 women of childbearing age. There are advantages of this method in combination with the correction biocenosis of vagina by preparation « Acilactum».

The examination of physician's profession is one of the most complex ones amidst the forensic medical examinations. The materials of 214 forensic medical examinations combined with the complaints about erroneous actions of medical personnel were investigated. The complaints about surgeons received by law machinery were 25,2 % of total quantity of the complaints about doctors.

These scientists had held experimental research of wound process after use of polypropylene implant to 30 white rats. It was shown that implant was indifferent for organism and course of inflammation with its availability almost did not differ from aseptic wound process. 147 operations with using of reticular implant SurgyPRO MESH (USSC) were performed in the clinic: 79 operations were laparoscopic hernioplasty, 17 operations were laparoscopical-ly assisted hernioplasty and 51 operations were hernioplasty according to Liechtenstein. The authors diagnosed the indications to the methods of plasty of hernial gates and analyzed their findings.

There has been given an analysis of 147 cases of drug abortion with using of medication «Mifegyn» («Mifepris-ton») and «Cytotec». The high effectiveness of this method, its safety, considerable reduction of complications' risk in comparison with mini-abortion have been shown in this research.

In present article the authors deal with historical moments according to operation' s fulfillment under anterior resection of rectum,concentrate attention on arguable question about name of operation. On the grounds of own experience and literary survey, they offer a new clinical classification of anterior resections, which, on their opinion, should help in working-out of optimal surgery tactics. It is offered to classify such operations according to location place of anastomosis with dividing them into high, anterior, low and ultra-low resections. The last ones are divided, on their turn, into open and closed (with forming of anastomosis by machine stitch). The ultra-low interferences are additionally divided into «low shave off» and inter sphincteric resections.

The authors having the experience of 15 laparo-scopic splenectomies describe the operative technique of this kind of intervention during the pregnancy. The doctors considered two clinical cases. The indications for the operation were blood diseases. In both cases the act of delivery was natural and on term, children are healthy.

This section describes a technique of making neo-sphincter with artificial neuromuscular stimulation under severe forms of fecal incontinence of diverse aetiology and after removal of natural sphincter on the occasion of tumour. 12 patients had been operated on the basis of colorectal surgery department of SGH. The authors registered the high effectiveness of this method during the treatment of incontinence, and its good effectiveness in respect to the patients with anal duct carcinoma, for which the forming of artificial sphincter had been effected along with the procedure of rectum extirpation, as single stage operation. Neo-sphincter had been formed by transplantation m. gracilis. The effectiveness of neo-sphincter constriction and enfeeblement were controlled with the aid of neuromuscular stimulation system of the firm «Medtronic», which consisted of stimulator that had been implanted under the skin of iliac area, flexible electrodes and programmer as well.

In this study the authors propose the experience of usage of modified technique of intramedullary os-teosynthesis with titanic nails of rectangular cross section and blocking with screws, acquired from 18 patients with diaphyseal crus fractures. The indications for the operation were nonfunctioning fractures of shinbone. In the remote period of time the treatment results of 17 patients out of 18 ones were estimated as good and satisfactory ones.