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45% of patients at admission. Neck and chest X-ray examination is obligatory before endoscopy. Flexible endoscopy is a gold standard for diagnosis and extraction of foreign bodies. Repeated endoscopy after foreign body extraction should be mandatory. It is necessary to visualize complications associated with foreign body and identify esophageal diseases.

To analyze the early and long-term postoperative outcomes after Collis gastroplasty in the treatment of patients with hiatal hernia complicated by gastroesophageal reflux disease and shortening of the esophagus.

Postoperative outcomes after Collis gastroplasty were analyzed in 22 patients with hiatal hernia and shortening of the esophagus. The control group consisted of 166 patients after simple repair of hiatal hernia without Collis procedure.

In case of Collis gastroplasty, surgery time was 185 (160-250) min. Intraoperative complications were observed in 3 (13.6%) patients, incidence of postoperative complications - 18.2%. There were no lethal outcomes in this group of patients. Mild functional dysphagia was observed in 2 (9.1%) patients. Length of hospital stay was 7.8±2.4 days. Mean follow-up was 34 (6-52) months. There were no anatomical recurrences. A relapse of gastroesophageal reflux was noted in 1 (4.6%) case. GERD-HRQL score was 4.8±2.2 points. Additional Collis gastroplasty did not affect the immediate and long-term results of surgical treatment in comparison with simple cruroraphy and fundoplication.

Unreduced shortening of the esophagus may be followed by high incidence of recurrent hiatal hernia and GERD in long-term period. In case of shortening of the esophagus, surgery should include Collis gastroplasty. This effective and safe procedure does not impair treatment outcomes. Indications and optimal technique of Collis gastroplasty require clarification and further research.

Unreduced shortening of the esophagus may be followed by high incidence of recurrent hiatal hernia and GERD in long-term period. In case of shortening of the esophagus, surgery should include Collis gastroplasty. This effective and safe procedure does not impair treatment outcomes. Indications and optimal technique of Collis gastroplasty require clarification and further research.

To develop an algorithm for surgical treatment of acute destructive cholecystitis in elderly and senile patients and to improve postoperative outcomes in this cohort of patients.

A prospective analysis included 50 patients with acute destructive cholecystitis aged 60-90 years, who admitted to the Topchubashov Research Surgical Center for the period from 2015 to 2019. All patients had diabetes mellitus, obesity or cardiovascular diseases. Ultrasound was performed in all patients, CT - in 60% of patients, MRI - in 36% of cases. Thirty-six (72%) patients underwent laparoscopic cholecystectomy, 14 (28%) patients - open cholecystectomy.

Intra- and postoperative complications were analyzed in both groups. In our opinion, subtotal 'fundus first' cholecystectomy should be preferred for safe cholecystectomy and prevention of iatrogenic lesions. Laparoscopic 'fundus first' cholecystectomy was carried out in 16% of patients (including 10% of subtotal cholecystectomies). Pribram subtotal cholecystectomy was performed in 5 (10%) patients. Iatrogenic damage to the common bile duct was absent.

We have developed an algorithm for the diagnosis and surgical treatment of acute destructive calculous cholecystitis in advanced age patients.

We have developed an algorithm for the diagnosis and surgical treatment of acute destructive calculous cholecystitis in advanced age patients.

To analyze the primary experience of laparoscopic distal gastrectomy in patients with distal gastric cancer.

There were 21 laparoscopic distal gastrectomies in patients with antrum malignancies. Mean age of patients was 63.7±6.3 years. According to TNM staging system, cancer stage I was detected in 90% of patients (

=19), stage IIa - in 10% (

=2) of patients.

Duration of distal gastrectomy was 190.4±51.6 minutes, blood loss - 90.3±51.2 ml. The number of harvested lymph nodes was 21.2±5.1. EN4 clinical trial We were able to reach R0 resection edge in all patients. Length of hospital-stay was 7.6±2.3 days, incidence of postoperative complications - 23.8%. Complications Clavien-Dindo grade IIIb-V were observed in 9.5% of patients (

=2). Overall postoperative mortality was 4.7% (

=1). No progression of the underlying disease has been revealed in any patient throughout the follow-up period (since May 2018). To date, the maximum median follow-up is 25 months of overall and disease-free survival.

Laparoscopic subtotal distal resection is appropriate intervention ensuring R0 resection edge in most cases.

Laparoscopic subtotal distal resection is appropriate intervention ensuring R0 resection edge in most cases.Severe acute pancreatitis is one of the most difficult problems in emergency abdominal surgery. Mortality among patients with this disease ranges from 20 to 80 percent. The use of staged surgical intervention in the treatment of purulent complications of acute severe pancreatitis may affect not only the risk of open surgery, but also the number of post-operative complications.

Improving the results of treatment of patients with infected pancreatic necrosis by applying a step by step surgical approach and comprehensive correction of endotoxicosis.

The study was retrospectively prospective. All patients were divided into two clinical groups. The control group for the period from 2018 to 2019 included 31 patients for whom the standard surgical tactics of treating pancreatic necrosis were used laparotomy, necrsecestrectomy and drainage of parapancreatic fluid accumulations, and, if necessary, repeated sanation. The main group included 26 patients, treated from 2019 to 2020. According to the developed step-by-srelief of endogenous intoxication.

The choice of surgical intervention for pancreonecrosis should be determined taking into account the development phase of the disease, the type of location of the purulent-necrotic sinuses, and its delimitation from surrounding tissues. Phased surgical treatment with the initial application of minimally invasive technologies affects the number and severity of post-operative complications as well as the early start of correction of enteric insufficiency syndrome - the early relief of endogenous intoxication.