The monograph is devoted to one of the urgent problems of emergency surgery. The problem of choosing the volume and method of surgical treatment of acute sigmoid colon obstruction is constantly in the field of view of surgical specialists. The monograph critically analyzes the methods of surgical treatment of this pathology and the methods of forming colonic anastomoses, and also indicates the unresolved issues that require further research.The work is based on experimental and clinical studies. In the experimental part we improved the methods of colonic anastomoses with histological study of the healing process and the reaction of the colon tissue to the suture material. In the clinical part we analyzed the application of improved methods of colonic anastomosis formation in surgical treatment of patients with acute sigmoid colon obstruction. The monograph is intended for students, clinical residents, masters and doctors.