Active Surgical Tactics Research Articles

THE STRUCTURE OF THYROID NODULES IN CHILDREN SUBJECTED TO SURGICAL TREATMENT

The article provides the literary information and the results of our own research on the structure of the thyroid nodules in operated children.The clinical significance of nodular neoplasms of the thyroid gland is determined by the relatively high risk of carcinomas. Along with this, the relevance of this research is due to the increasing of surgical interventions and the fact that the features of nodules in children and tactics of management of patients remain debatable.The aim of the work was to study the structure of thyroid nodules in childrenin various age groups. The case histories of 225 operated childrenfrom 4 to 17 years oldfrom 2007 to 2017 were analyzed. Nodular neoplasms of the thyroid in children were more common. Tumor-like diseases - colloid nodes in childhood were rare, only in 2.2% of cases. The high incidence of thyroid cancer (35.6%) under the mask of nodal goiter determines active surgical tactics in patients with nodal neoplasms in childhood.

Algorithm for the Diagnosis and Treatment of Penile Injury

Injuries of the external genital organs in men are most often found in active age with a predominance of closed injuries and require careful implementation of the entire necessary amount of diagnostic and therapeutic measures, active surgical tactics aimed at preventing distant cavernous blood flow disturbances, the development of fibrotic changes in the cavernous tissue, protein membrane and stricture of the penile urethra.

Necrotizing enterocolitis: escalation of surgical decisions

Purpose of the study was to study the results of treatment of necrotizing enterocolitis in premature infants and to develop measures to improve surgical tactics. Materials and methods . A comparative analysis of the results of the treatment of necrotizing enterocolitis in 2 cohorts of premature infants (total 102 patients) differing in surgical tactics was performed in the Surgut Clinical Perinatal Center for the period from November 1, 2008 to December 31, 2018. Results . The choice of active surgical tactics when advancing intestinal perforation made it possible to carry out the most rational surgical intervention aimed at stopping the main pathological process and creating favorable conditions for further nursing of immature infants. The use of diagnostic laparoscopy facilitates the differential diagnosis and verification of indications for laparotomy. As a result of changes in surgical tactics, a mortality reduction of more than 2 times was achieved; according to the results of observation in the history office – the number of patients suffering from short bowel syndrome decreased by more than 4 times. Conclusions. High mortality in necrotizing enterocolitis among premature infants is due to the severity of abdominal sepsis and loss of intestinal length. Many diagnostic and therapeutic issues of supervision of this disease are pending. Laparotomy after the development of intestinal perforation is a tactically «late» intervention and makes it impossible to choose an adequate surgical strategy. Reasonable surgical intervention prior to intestinal perforation creates better conditions for the implementation of a favorable surgical solution. Improving surgical tactics increases the prospects for survival and nursing. In doubtful clinical cases, laparoscopy is effective in premature babies with suspected abdominal catastrophe. In the future, randomized trials should be conducted so that a primary anastomosis with proximal Santulli ileostomy can be recommended as an alternative to double terminal ileostomy in necrotizing enterocolitis.

Клинические случаи активной хирургической тактики в реабилитации детей с membrana pupillaris perseverans

«Российская офтальмология онлайн» - электронное информационное издание, создается с 1 марта 2010 года под эгидой Российского общества офтальмологов. Основная задача проекта - научно-информационная поддержка специалистов в области офтальмологии.

Dynamics of the Results of the Treatment of Resectable Pancreatic Head Cancer over a 30-Year Period

Objective: to analyze the dynamics of the immediate and long-term results of the treatment of resectable pancreatic head cancer (PHC) for the period from 1989 to 2019. Material and methods. The retrospective analysis of 123 consecutive cases of the treatment of resectable PHC has been performed. During period I (from 1989 to 2000) 11 patients were operated, during period II (from 2001 to 2013) - 72, and period III (from 2014 to 2019) - 40 patients. The structure and frequency rate of postoperative complications, 90-day mortality and the overall survival rate (by the Kaplan-Meier method) have been assessed. Results. The frequency rate of the postoperative complications in I, II, and III periods were 63.6, 48.6, and 52.5%, mortality - 0, 5,6 and 5.0 %, respectively (P > 0.05). The most common complication and cause of death in all the cases were pancreatic fistula. The indicators of the 3-year survival in I, II, and III periods were 10.0 ± 9.5 %, 18.5 ± 4.7 % and 35.3 ± 9.6 %, the median survival - 10, 13, and 22 months, respectively (P = 0.07). Conclusion . A high frequency rate of the postoperative complications with a relatively low rate of the postoperative mortality was observed in all the analyzed periods. Pancreatic fistula prevailed in the structure of the complications and was the cause of death in all the cases. In the last period there was a clear tendency to improve the long-term results of the treatment, which may be due to more active surgical tactics, increased frequency of combined operations with the resection of vessels and proportional decrease in the share of palliative (R2) operations, standardization of the volume of lymph node dissection, an increased proportion of one-stage operations and increasing the number of patients receiving adjuvant chemotherapy.

The impact of glenoid labrum damages on condition of the cartilage of the shoulder joint

The joint labrum is an anatomical structure of the shoulder joint, one of the functions of which is to ensure the stability of the shoulder. It has been proven that instability, direct trauma and surgery of any joint eventually lead to cartilage damage and osteoarthritis. It is still unknown whether and how the damage to the joint labrum affect the condition of the cartilage of the shoulder joint. Aim of study – investigation of impact of glenoid labrum damages on condition of the cartilage of the shoulder joint. For the period from 2006 to 2016, on the basis of State Institution “Institute of Traumatology and Orthopedics of AMS of Ukraine”, MC “Modern Orthopedics”, Kyiv, a study was conducted on an array of 467 patients. Used clinical diagnostics, MRI diagnostics, arthroscopic diagnostics. Fact verification and localization of joint damage was performed during arthroscopic examination. Localization of cartilage damage was divided into separate areas on the articular surfaces of the shoulder scapula and head. The degree of cartilage damage was classified by Outerbridge. Quantitative analysis of the results was performed using Microsoft Excel in the summary tables. It has been found that damage to the shoulder labrum is the cause of cartilage defects in the joint surfaces of the shoulder. The incidence and severity of cartilage defects increase over time since the injury. The worst prognosis for the development of damage to the articular cartilage is characteristic of patients with damage to the posterior part of the labrum. Thus, damage to the joint labrum is a significant factor in the occurrence of defects in the articular cartilage of the shoulder. Early active surgical tactics for the treatment of damage to the joint labrum are necessary to prevent deterioration of the condition of the joint surfaces and the prevention of osteoarthrosis.

Postoperative Lymphatic Leakage in Oncosurgical Patients

Purpose: to evaluate the influence of postoperative lymphatic leakage volume and duration on homokinesis and incidence of postoperative complications in oncosurgury patients underwent different operative interventions.Material and methods. The results of treatment of 310 patients subjected to standard elective surgical intervention for a malignant pathology of different organs with regional lymph node dissection were evaluated. The selection criterion was prolonged (more than 7 days) and prominent (over 50 ml a day) lymphatic leakage during the postoperative period. The fluid discharged during the postoperative period was identified as a lymph by cytology. The diagnosis of a malignant pathology was verified in all patients after histological examination and patients were distributed according to established diagnosis.Results. The duration of lymphatic leakage including the outpatient treatment stage varied from 9 days to 1 year and 2 months depending on the type of surgery. The longest lymphatic leakage occurred in 2 patients after radical mastectomy. During the 1st week of observation in patients with daily lymph losses up to 100 ml, no changes in the blood composition were noted. Prolonged lymphatic leakage (1–2 weeks after operation) in a volume over 100 ml a day resulted in reduced protein content in blood plasma, severe lymphocytopenia, increased platelet count. During the postoperative period, complications were detected in 31 patients; at that, during the 1st week of observation, 27 patients experienced initial lymphatic leakage over 100 ml a day. Analysis of fatal outcomes (7 patients) showed that in all patients the lymphatic leakage exceeded 150 ml a day and lasted 1 to 2 weeks. The longest inpatient time was typical for patients after Wertheim's hysterectomy and cystectomy, whereas the longest outpatient treatment was experienced by patients after radical mastectomy and inguinofemoral lymph node dissection.Conclusion. In case of lymphatic leakage over 100 ml a day in oncosurgury patients, it was necessary to make up protein losses and after 7 days of persistent lymphatic leakage it became necessary to consider use of active surgical tactics aimed at liquidation of lymph losses.

Tactical and technical aspects of complex treatment of patients with acute destructive cholecystitis complicated with peritonitis and billary sepsis

Purpose of the study. To clarify the clinical and diagnostic criteria of BS, caused by complicated acute destructive cholecystitis for the development of optimal treatment tactics.
 Material and methods. 193 patients with acute destructive cholecystitis and choledocholithiasis, complicated by peritonitis, had surgery on the basis of Odessa regional clinical center in the clinic of surgery № 2. All patients with BS were divided into two groups. In the first group, 115 non-invasive laparoscopic surgical interventions were performed. In the second group, 78 patients were performed laparotomy, cholecystectomy, choledochotomy and external drainage of choledoch duct, as well as external drainage of CAL.
 Results. In patients with BS and obstructive jaundice, prior emphasis was placed on active surgical tactics, the use of noninvasive technologies in combination with intensive infusion and antibiotic therapy. Of great importance in the treatment of BS was also given to hemodynamic and respiratory support, detoxification with the use of efferent methods (hemosorption, plasmapheresis), rational antibiotic therapy, immunocorrection, antioxidants, and vitamin therapy.
 Conclusions. Adequately initiated treatment with the use of modern methods of diagnosis and conservative therapy, surgical interventions in the early stages, reduces the percentage of development of severe complications and the number of fatal cases in this pathology. In perspective, it is necessary to determine more precise markers of biliary sepsis at an early stage, to improve methods of endoscopic surgery and detoxification treatment.

A case of successful intensive treatment of a child with a severe burn injury

In this article presented the positive clinical experience of treatment of a child with deep extensive burns up to 85 % of the body surface. It is proved that successful treatment of this patient is possible only in a multidisciplinary clinic with combination of active surgical tactics, balanced infusion-transfusion, adequate antibacterial and immuno-substitutive therapy, control of microbiome of wound secret and biological fluids, usage of the air fluidized bed, personified dressing tactics, suitable nutritional support, a complex of modern rehabilitation measures.

Torsion of morgagni hydatid in «acute scrotum» syndrome

The results of operative treatment of 252 patients aged from 3 months to 20 years (mean age 9,9±2,9 years) hospitalized with acute pain in the scrotum were demonstrated. The structure of the causes of the «acute scrotum» syndrome: the torsion of Morgagni hydatid – 86,5%, acute orcho-epididymitis – 8,7%, testicular torsion – 4,4% and traumatic injuries of the testicle – 0,4%. Although the most informative diagnostic method in the syndrome of the «acute scrotum» is ultrasonography with color Doppler mapping, often the cause of acute pain in the scrotum can be established definitely only during the operation. Active surgical tactics can prevent trophic changes, testicular atrophy and, consequently, copulatory and reproductive disorders. In the long-term period – from 3 months to 1 year after the operation, 186 patients were examined. None of the patients showed atrophic changes in the testicle.

Діагностика та хірургічне лікування поєднаних форм туберкульозу і раку легень

The aim of the work: to raise efficiency of the surgical treatment of patients with combined forms of pulmonary tuberculosis and non-small cell lung cancer.
 Materials and Methods. The retrospective analysis was conducted to 91 patient with combined forms of pulmonary tuberculosis and lung cancer, who were treated in TB hospitals, surgical departments of different regions of Ukraine.
 Results and Discussion. The analysis of the morphological features of combined forms of pulmonary tuberculosis and non-small cell lung cancer was made in comparison groups , that were explored retrospectively.
 Conclusion. The leading effect of pulmonary tuberculosis on the surgical treatment of patients with combined forms of tuberculosis and lung cancer was shown in groups of comparison. The increase of 3 years survival in patients of basic groups is set , demonstrating the advantage of active surgical tactics of sterno-mediastinal access and the appliance of more radical bilateral lymph node dissection.

PS01.067: SHLYAKHOVSKIY I.A., ERMOLOVA I.V., SELINA I. E., P. O., BURCHULADZE/PERFORATED APPENDICITES IN DIAPHRAGMAL HERNIA

Abstract Background We present a clinical case of a patient with acute perforated appendicitis complicated by empyema in a false left-sided diaphragmatic hernia. Methods Patient K. 21 L. taken by ambulance to the intensive care unit. X-ray conclusion—the rupture of the left dome of the diaphragm to the infringement of the colon. The patient urgently operated. The defect of the diaphragm size 10,0х6,5cm. There is a lack in the abdominal cavity of small and large intestine, and spleen. The diagnosis—gangrenous perforated appendicitis in the left pleural cavity, empyema. Performed appendectomy, diaphragm was sutured. 5 days after surgery performed videothoracoscopy Results The patient is in satisfactory condition was discharged from hospital 32 days after admission. Conclusion Polypositional x-ray examination of the chest and abdominal cavity and active surgical tactics has allowed to establish the correct diagnosis and resulted in a favorable outcome. Disclosure All authors have declared no conflicts of interest.

Хірургічне лікування гострого біліарного панкреатиту

Introduction. Despite the widespread of associated damage of the biliary system and the pancreas, a lot of issues of treatment tactics remain unresolved. There is no doubt that an adequate treatment of this pathology should combine the surgical and conservative components which will be determined by the peculiarities of the course of pathological processes in the bile ducts and in the pancreas.Materials and methods. A clinical examination and treatment of 126 patients with acute biliary pancreatitis have been performed. Men were 32 (25.4%), women – 94 (74.6%). There was isolated cholecystolithiasis in 65 patients with acute biliary pancreatitis (group 1). 35 patients were diagnosed small concrements in different parts of the common bile duct, which did not cause obstruction of the common bile duct (group 2). 26 patients were diagnosed obturating concretions of the common bile duct, including – impacted into a large duodenal papilla (third group).Results and their discussion. Clinical symptomatology, biochemical blood count, elevation of α-amylase, lipase, pancreatic α-amylase, and positive ACTIM Pancreatitis test allowed us to establish a preliminary diagnosis of acute pancreatitis. Ultrasound examination evaluated changes in the pancreas, but did not always fully describe the state of extrahepatic bile ducts. Magnetic resonance imaging (MRI) was used to fully characterize the pathology of the common bile duct, which made it possible to clearly identify the genesis of acute biliary pancreatitis. At the first stage of treatment, all diagnostic-therapeutic measures were performed during 24 hours. The absence of pathological inclusions in the common bile duct was determined in 80.0% of patients of group 1 using ultrasound examination. MRI was performed for 20.0% of patients. 25.7% of patients of group 2 needed MRI, and 74.3% – transpacillary endoscopic radiography. The ultrasound examination was effective only in 7.7% of patients of group 3. Other patients in this group to verify the cause of acute biliary pancreatitis required the use of other methods of radiotherapy. During 24 hours, laparoscopic cholecystectomy (LCE) was performed in 49 patients (75.4%) of group 1. Patients of groups 2 and 3 were performed endoscopic diagnostics and revision of extrahepatic biliary ducts, followed by LCE during 24 hours. 12 (9.5%) patients had complications related to the unfavorable course of the inflammatory process in the pancreas and peripanecratic tissue. The formation of false pancreatic cysts was diagnosed in 2 patients of group 1, in 3 patients – group 2 and in 2 patients – group 3. Taking into account their favourable course and the absence of laboratory and clinical data for their infection, these patients were recommended to follow dynamic observation in the outpatient settings. Abscesses of retroperitoneal space developed in 5 patients (group 2 – in 3 patients and group 3 – in 2 patients).Conclusion. Diagnostic tactics in acute biliary pancreatitis should include: determination of the activity of lipase, α- amylase, pancreatic α-amylase, ACTIM Pancreatitis test and MRI. Active surgical tactics involving LCE should be used in patients with acute biliary pancreatitis in cholecystolithiasis, and also endoscopic transpasillary decompression of the common bile duct in choledocholithiasis, within 24 hours of patient’s stay in the surgical department.

RECONSTRUCTION OF PELVIC ORGANS AND ILIAC VESSELS IN THE PATIENT WITH LOCALLY ADVANCED RELAPSE OF OVARIAN CANCER

The possibility of implementing active surgical tactics in patients with locally advanced tumoral process in the small pelvis is demonstrated, despite the invasion of the main iliac vessels. It has been established that the use of a personified approach to the planning of surgical treatment, along with the use of a wide range of reconstructive-plastic techniques, allows achieving good long-term results even in such complex clinical situations.

THE POSSIBILITIES OF SURGICAL TREATMENT OF PATIENTS WITH RECCURENCES OF RECTAL CANCER

OBJECTIVE. The objective of the study is to improve the results of treatment of patients with local recurrences of rectal cancer by implementing active surgical tactics within multidisciplinary approach. MATERIAL AND METHODS. The analysis of results of surgical treatment of 57 patients with the diagnosis: recurrence of a rectal cancer. The morphological structure of the primary tumor and its recurrences was adenocarcinoma of the intestinal type. In most cases, recurrences of rectal cancer were intraintestinal genesis with invasion of neighboring organs and structures. In addition, almost all patients had sufficiently paratumoral complications, significantly worsening their general condition. RESULTS. All recurrences and rerecurrences (repeated recurrences) of rectal cancer led to 73 operations: 9 patients underwent two interventions, 2 patients underwent three operations and 1 patients underwent four operations. The remaining 45 patients were operated on once. Resectability of recurrent tumors was 93 %. The development of complications in the postoperative period was noted in 37 % of patients. Hospital mortality was 1.5 %. The median duration of life reached 30.1 months. The overall three-year survival rate was 47.2 %. CONCLUSION. The following of the comprehensive diagnostic program and subsequent active surgical tactics allows achieving encouraging results of treatment in patients with recurrences of a rectal cancer.

Conservative therapy vs active surgical tactics in the treatment of patients with оrоstomas and pharyngostomas

The aim — to develop an integrated therapeutic algorithm and to evaluate its effectiveness for surgical treatment optimizing in patients with оrоstomas and pharyngostomas.Materials and methods. The treatment results of 90 (3 (3.33 %) women and 87 (96.77 %) men, mean age 56.98 ± 0.42 years) with orostomas and pharyngostomas that occurred in the postoperative period of radical treatment for malignant extracranial tumors of the head and neck. The localization of the primary tumor was as follows: 37 (41.11 %) had oral tumors, 29 (32.22 %) — different parts of the pharynx, 24 (26.67 %) had recurrent and residual tumors of the larynx after radical course of radiotherapy. Patients were treated with conservative and surgical methods. The quality of life was assessed using a specialized scale (Performance status scale for head and neck patients).Results and discussions. It is established that the application of the developed algorithm allows to optimize the medical process and statistically significantly improve the quality of life of patients in terms of «habitual diet completeness « and «the possibility of public food intake» in 1.8 and 2.5 times respectively (p < 0.05).Conclusions. The integrated algorithm with application of both conservative and surgical methods, in particular, plastic closure, allows to achieve stable healing of the orostomas and pharyngostomas and to improve the social adaptation of this category of patients.

Efficiency of the early surgery in acute biliary pancreatitis

Background. The evaluation of the effectiveness of active surgical tactics in patients with acute biliary pancreatitis was the purpose of our study. Materials and methods. A clinical examination and treatment of 126 patients with acute biliary pancreatitis has been performed. Among the examined patients, there were 32 men (25.4 %), and 94 women (74.6 %). Based on the causes of acute biliary pancreatitis, we identified three groups of patients: the first one — 65 individuals with isolated cholecystolithiasis (42 — with acute calculous cholecystitis, 23 — with chronic calculous cholecystitis), the second one — 35 patients with small concrements in different departments of the biliary tract, which did not cause obturation of the common bile duct, and the third one — 26 persons, who had torsion concretions of the common bile duct, including those wedged into major duodenal papilla. Patients in the first group underwent laparoscopic cholecystectomy, in the second and third groups — endoscopic transpapillary decompression of the common bile duct and, if necessary, laparoscopic cholecystectomy. In up to 48 hours, surgeries were performed in 78.6 % of patients in all groups. Results. During the analysis, it was found that the temperature response in patients, who were operated for 48 hours, was normal within 2.2 ± 0.8 days, whereas in patients, who had surgical intervention at a later date, — after 3.0 ± 0.7 days. Early operative intervention in all groups of patients positively influenced the regression of clinical signs of acute biliary pancreatitis and paralytic intestinal obstruction. Active surgical tactics allowed to reliably eliminate respiratory (p = 0.01; odds ratio (OR) = 4.0); hemodynamic (p = 0.02; OR = 5.69); enteral (p = 0.04; OR = 3.50) syndromes, systemic inflammation response syndrome (p = 0.04; OR = 3.50) and an increased level of enzymes in the blood (p = 0.07; OR = 4.79). We had not found significant differences in regression of clinical and laboratory manifestations of peritoneal (p = 0.6; OR = 1.74), metabolic (p = 0.3; OR = 2.29), hemocoagulation (p = 0.8; OR = 1.24) and liver syndrome (p = 0.1; OR = 2.54) and renal (p = 0.3; OR = 2.02) dysfunction, depending on the terms of the operation. Also, these patients noted a lower incidence of specific complications of acute biliary pancreatitis: acute peripancreatic uninfected fluid clusters (p = 0.03; OR = 0.15), peripancreatic abscesses, postnecrotic cysts of the pancreas (p = 0.05; OR = 0.18) and postcholecystectomy syndrome (p = 0.05; OR = 0.27). Conclusions. In patients with acute biliary pancreatitis, surgery on the bile duct system for up to 48 hours can significantly improve the regression of the main clinical manifestations of the disease, is pathogenetically substantiated and should be used more frequently.

The first episode of spontaneous pneumothorax (errors, hazards, complications)

To analyze the errors and complications of surgical care in patients with the first episode of spontaneous pneumothorax at different hospitals. From 2005 to 2015 three hundreds and seventeen patients with the first episode of spontaneous pneumothorax have been treated at the thoracic department of Volgograd State Medical University. Patients were divided into 2 groups: 79 of them underwent thoracotomy while in 238 cases minimally invasive technologies were applied. Faster preoperative management and earlier active surgical tactics were suggested. There were 6 the most typical violations of surgical care in 42% of patients with the first episode of spontaneous pneumothorax. Medical and diagnostic violations at regional centers and central district hospitals were the same, but there were differences in certain types of errors and their incidence. Minimally invasive technologies do not significantly affect the number of violations of thoracic surgery principles. Early procedures against the recurrence by using of thoracoscopic interventions reduce postoperative morbidity from 1.2 to 0.3% and mortality by 8.25 times.

ПАЛЛИАТИВНО-КУРАТИВНЫЕ ХИРУРГИЧЕСКИЕ ВМЕШАТЕЛЬСТВА У БОЛЬНЫХ РАКОМ ЖЕЛУДКА С МЕТАСТАЗАМИ В ПЕЧЕНЬ

Objective: To assess the effectiveness of relatively curative surgical interventions in the treatment of patients with gastric cancer with metastases to the liver and to show the role of active surgical tactics in improving the quality of life of patients. Methods: The study included 28 patients with gastric cancer with metastases to the liver. Patients with type I and type II Borrmann’s tumor growth (17 (85.7%) patients) were prevalent. It was found that in the predominant majority of patients had lesions of regional lymph nodes (91.6%). Detection of ultrasound and CT studies of enlarged retroperitoneal lymph nodes, lymph nodes of the aortocaval space, as well as massive invasion of the serous cover of the stomach with the extra organ component detected by laparoscopy, is a contraindication for performing simultaneous operations on the stomach and liver. In 14 (50%) patients,surgical interventions were carried out against the background of a complicated clinical course of gastric cancer: in the presence of pylorostenosis in 9 (32%) cases and torpid (sluggish) bleeding in 5 (17.85%) cases. Results: Analyzing the primary tumour and metastatic hearth in the liver, we came to the conclusion that gastric cancer with gastric metastases in the liver should be resected in cases of highly or moderately differentiated adenocarcinoma that has exophytic or mixed forms of growth, preferably with the intactness of the serous cover of the stomach. Practically in half of the patients in our series, the metastasis in regional lymph nodes are revealed,however, only in two, the defeat of lymph nodes of the second – order was diagnosed. Thus, “resectable” liver metastases can occur even at the N0 stages. In the studied group, patients with type I and II Borrmann’s prevailed with type I and II, most of them showed the intestinal histological type of a tumour. Conclusion: Liver resection for gastric cancer metastases should be performed under the following conditions: the absence of other distant metastases (peritoneum, non-regional lymph nodes, etc.); performing “radial” gastrectomy with D2-D3 lymphadenectomy; the possibility of carrying out macroscopic radical resection of the liver; functional portability of the operation; physiological operability. Keywords: Gastric cancer with liver metastases, palliative operations, indications, prognosis.

Ten-year results of abdominal aortic and great vessels aneurysms management

To present own 10-year experience of abdominal aortic and great vessels aneurysms management. There were 369 patients with abdominal aortic aneurysms (AAA) for the period 1995-2016 at the Yaroslavl Regional Clinical Hospital. 25% of patients suffered from abdominal aortic and great vessels aneurysms. Mean age was 70.3±7.5. There were 79 (86%) men and 13 (14%) women. 93 patients had 212 aneurysms of other sites besides AAA (from 1 to 6 aneurysms in each case). 63 (68%) patients have been treated and followed-up for the period from 1 to 10 years (mean 105±11.8 months). 1-, 5-, 8- and 10-year survival after AAA repair was 98%, 81%, 54% and 38% respectively. The common complications of great vessels aneurysms are distal thrombosis and embolism (40%). Ruptures of aneurysms are less common (13%). These complications require active surgical tactics that allows to preserve the limbs in 85% of patients. Progressive nature of disease in overwhelming numbers of patients (95%) with aneurysms enlargement and their occurrence in other sites requires regular lifelong clinical examination with mandatory ultrasound 2 times per year.