Background. Optimization of the process and improved efficiency of the prolonged compulsory enteroalimentation in the patients who require it for more than 4 weeks.

Materials and Methods. We analyzed the first experience of percutaneous endoscopically assisted gastrostomy in 32 patients. Patients were treated in the neurosurgical and neurologic department of Research Scientific Institute – Ochapovsky Regional Clinical Hospital no. 1 in Krasnodar.

Results. Application efficiency of percutaneous endoscopically assisted gastrostomy for prolonged enteral feeding in patients with combined trauma and neurological deficiency was shown. The greatest number of complications 3 (33.3%) was observed in the group of patients with cranio-cereberal traumas.

In this article the most widespread hereditary trombophilia in the setting of ischemic stroke etiology in young patients is considered. Own data on prevalence of various options of hereditary trombophilia in 188 patients who were treated in neurologic department for patients with acute disorders of cerebral blood circulation in Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1 are provided.

The clinical case of treatment in a patient with extensive defects of hairy part skin of the head and face is presented. The autoplasty with split skin with one-stage closing of wound defects with a big auto-omentum was performed. For the best adaptation of biological transplants the autologous platelet enriched plasma, and the allogenic frozen dermal fibroblasts were applied. The good esthetic and functional result was received.

In 80% cases, craniofacial injury is followed by the cerebrospinal liquid leak from natural ways. The leading lifethreatening states at the same time are infectious complications. Approaches for treating such patients are ambiguous and first of all depend on severity of a patient condition. Results of mini-invasive surgical interventions for penetrating craniocereberal trauma are studied insufficiently. In this article we discuss a clinical example of successful staged surgical treatment in a patient with the open severe craniofascial injury.This clinical case includes two hospital stays: the first has been connected to the severity of craniofascial injury itself, the second – with its complication (rhinoliquorrhea). Following the offered algorithm of managing patients with this pathology, at primary admission we performed a dynamic assessment of the patient and then conservative treatment was carried out, at the repeated admission surgical treatment was performed: lumboperitoneal shunting. Primary severity of this injury and staged approach to treatment have allowed to achieve positive clinical dynamics at the stage of mini-invasive surgery and also considerably reduce risks for the patient’s life and carry out full rehabilitation at the shortest possible time.

Diagnosis of parasitic diseases, in a type of their rarity and diversity, always presents considerable difficulties. Clinical observation of an alveococcosis with invasion in the retroperitoneal space with distribution on mediastinal fat proceeding with progressing retroperitoneal fibrosis with ureteral obstruction and hydronephrosis development, with an aorta lumen stenosis, with formation of SVC syndrome in the absence of changes in other parts of the body, first of all in the liver, in the absence of eosinophilia in the peripheral blood throughout all disease and lack of antibodies to echinococci in the blood serum, twice during observation determined by an immunofermental method is presented in this article.

In the present article we report a clinical case of successful two-stage treatment for juvenile aortic coarctation with aortic arch dysplasia in a newborn. We demonstrated possible application of balloon angioplasty, as a palliative procedure in children with severe health condition.

In this article a clinical case of surgical treatment for false aneurysm of extracranial department of an internal carotid artery in a 69-year-old patient after numerous surgical treatment for stenosis atherosclerosis of an internal carotid is described. The diagnostic algorithm consisted of triplex scanning of brachiocephalic arteries, a cerebral angiography and a multispiral computer tomography with intravenous contrast enhancement. This patient underwent carotid endarterectomy in combination with reconstruction of an internal carotid and removal of earlier implanted stent and a synthetic patch were performed. The postoperative period was uneventful. Histological assessment proved that extension of an internal carotid was caused by a false aneurysm. Previous surgery and atherosclerosis were the reasons of aneurysm formation.

True coronary and pulmonary fistulas occur quite seldom. Most often this defect is a casual finding at diagnosis of other cardiac diseases. Hemodynamics of this defect is caused by the affected coronary artery shunt into the cardiac chamber or the great vessel. Before introduction in modern diagnosis methods of high-precision ultrasonic devices and cardiac treatment to verify such anomaly as a coronary artery fistula, it was impossible. In our study we present a clinical case with right and left coronary artery fistulas into a pulmonary artery and a left atrium.

Bland-White-Garland syndrome (BWFS) is an abnormal arising of the left coronary artery (LCA) from the pulmonary artery trunk (PA), (in English-speaking literature ALCAPA – anomalous left coronary artery arising from the pulmonary artery) and it is rather rare pathology, 0,24-0,45% of cases of all congenital heart diseases. There are infantile and adult types described. In most cases, this anatomic anomaly is found at children or teenage age. We present the observations of patients with the BWGS adult type in this article and analyze possibilities of ECG while diagnosing this rare condition.

Endoscopic ultrasound diagnosis occupies an important role in neuroendocrine tumor diagnosis. Key indicators for diagnostic efficiency of this method regarding a tumor nosology are presented in the present article. We described results of the authors; investigations on ultrasonography for neuroendocrine tumor differentiated diagnosis. Possible mistakes in diagnosis of existing neuroendocrine tumors and a study algorithm are analyzed during endoscopic ultrasound investigation.

Background. Generalize modern data on the current opportunities and the perspective application directions of stem/stromal cells of fat tissue in regenerative surgery.

Results. Preclinical and clinical developments of cellular transplantology techniques and tissue engineering with use of the cultivated multipotent mesenchymal stromal cells of fat tissue and freshly isolated stromal vascular fraction of fat tissue in plastic surgery, maxillofacial surgery, orthopedics, neurosurgery, coloproctology, urology, thoracic surgery, cardiac surgery are presented.

Conclusion. Transplantation of stromal vascular fraction of fat tissue for which releasing we do not perform cultivation of cells out of a human body is a safe and effective regenerative technology with an application potential in the wide range of surgical areas.