Professor Fedor Rodionovich Bogdanov was born on October 2 (15 in the Gregorian calendar), 1900. In 1919, Fedor successfully graduated from the classical men’s gymnasium and then entered the medical faculty of Rostov University. In 1930, F.R. Bogdanov and his wife moved to Sverdlovsk, where he became the head of the scientific and educational sector of the Institute and at the same time the head of the clinical department. There he actively studied the current and unresolved problem of treating intra-articular fractures at that time. In 1937, Fedor Rodionovich defended his doctoral thesis on the topic: «Reparative processes in intra-articular fractures and the principles of treatment of these fractures (experimental and clinical studies)». In 1958, F. R. Bogdanov moved to Kiev, where he was elected the head of the Department of Traumatology and Orthopedics of the Institute for Advanced Medical Studies and at the same time was appointed deputy director of the Kiev Research Institute of Traumatology and Orthopedics for scientific work. For all the time of his practical and scientific activity, F.R. Bogdanov was the academic advisor of 31 doctors and 86 candidates of medical sciences, the author and co-author of more than 200 scientific papers and 7 monographs. Professor Fedor Rodionovich Bogdanov died on March 27, 1973 and was buried at the Baikove Cemetery in Kiev.

The OBJECTIVE was to determine the best option for decompression of the biliary tract in patients with malignant neoplasms of the hepatopancreatobiliary zone to resolve obstructive jaundice before performing radical surgery.
METHODS AND MATERIALS. The study of the results of examination and surgical treatment of 325 patients with mechanical jaundice caused by malignant tumors of the hepatopancreatobiliary zone allowed us to identify 93 (28.6 %) patients who initially underwent drainage operations on the bile ducts, and then radical surgical interventions.
RESULTS. Stage I of the oncological process according to the TnM system (8 reconsideration) was determined in 16 (17.2 %) patients, stage II – in 71 (76.3 %) and stage III – in 6 (6.5 %). According to the ECOG scale, I or II scores were determined in all patients before radical surgery. Tumors of the head of the pancreas, common bile duct and large papilla of the duodenum led to the I level of biliary tract blockage in 81.7 % of patients. Tumors of the common bile duct and head of the pancreas (involving the cystic duct), tumors of the gallbladder and Klatskin (Bismuth–Corlette I) caused the II level of biliary tract blockage in 12.9 % of the examined patients. Klatskin tumor (Bismuth–Corlette II, IIIa, IIIb,) caused bile duct blockage of III level (5.4 % of patients). Pancreatoduodenal resection was performed in 85 patients, endoscopic papillectomy – 3, bile duct resection – 2 and bile duct resection in combination with liver resection – 3. The choice of a rational option for decompression of the biliary tract, taking into account the level of their blockage and the severity of the general somatic condition of patients, provides the possibility of performing radical surgery.
CONCLUSION. Before performing radical surgery, obstructive jaundice in operable patients with malignant tumors of the hepatopancreatobiliary zone at the blockage of I level can be effectively and safely resolved by cholecystostomy, at the blockage of II level – endoscopic stenting, while the blockage of III level – percutaneous-transhepatic cholangiodrainage.

Transcatheter arterial chemoembolization of hepatocellular carcinoma on liver cirrhosis in patients awaiting liver transplantation OBJECTIVE. To evaluate the role of TACE as a method of neoadjuvant antitumor therapy of HCC before LT.
METHODS AND MATERIALS. From January 1998 to April 2020, we performed 245 OLTs in 229 patients, among them in 25 (10.2 %) for HCC associated with LC. We analyzed treatment results of 16 patients who received 49 TACE sessions as neoadjuvant therapy. 10 (62.5 %) patients fell under Milan criteria, 6 (37.5 %) – beyond them. According to the Child – Pugh score of LC, two (12.5 %) patients matched A stage, 12 (75 %) – B stage, two (12.5 %) – C stage. According to the BCLC (Barcelona Clinic Liver Cancer) staging system, 10 patients matched A₁–A₄ stage and 6 – B stage. Totally, we performed 49 TACE sessions, both classical with lipiodol and hemostatic sponge, and with drug-eluting beads from 1 to 7 (on average 3) times. In all cases Doxorubicin was used.
RESULTS. Technical success was 100 %. There were no complications. We performed RFA in three patients as an adjunct, in two patients – laparoscopic RFA-assisted atypical liver resection and in one patient – sequential resection and RFA. According to the m-Recist criteria, a complete response was observed in 6 (37.5 %), partial – in 7 (43.75 %), and stabilization – in 3 (18.75 %) patients. It was possible to achieve a tumor response to the treatment in 4 patients and return them to the Milan criteria. LT was performed in all 16 patients, among them – 14 (87.5 %) within the Milan criteria. The waiting periods for LT from the beginning of TACE were from 2 to 30 (on average 12.5) months. According to the histological studies, in 13 (81 %) patients, total and subtotal necrosis of HCC was revealed in excised organs.
CONCLUSION. The results of the performed study indicate that neoadjuvant TACE delays the growth of HCC masses and prolongs (up to 30 months) a safe waiting period for the donor liver.

INTRODUCTION. A number of studies demonstrate the advantage of bilateral mediastinal lymphadenectomy in surgery of non-small cell lung cancer (nSCLC). For surgical approach to the opposite mediastinum for many years there were proposed sternotomy, video-thoracoscopy, and transcervical video-assisted interventions. In our practice, we use videoassisted mediastinal lymphadenectomy (VAMLA).
The OBJECTIVE was to learn the efficiency and safety of VAMLA in surgery of NSCLC.
METHODS AND MATERIALS. The study included the materials of examination and treatment of 102 patients with NSCLC. 102 patients were divided into 2 groups. In the 1st group (54 patients), VAMLA and lung resection were performed. In the 2nd group (48 patients): anatomical lung resection and systematic ipsilateral lymphadenectomy (SLD) were performed.
RESULTS. The average number of remote lymph node stations in group 1 was (7.8±1.7); in group 2 – (4.5±1.2) (p<0.05). The average number of lymph nodes was 26±8.6 compared to (14.3±6) in both groups, respectively (p<0.05). «Occult» pN2-N3 metastasis was detected in 20 % (7/34) of patients of the group 1 and 6.5 % (2/31) of patients of the group 2 (p<0.05). The level of postoperative complications in both groups was 33.4 vs. 29.2 %, respectively (p>0.05). The duration of the postoperative day ((12.7±4.9) vs. (13.7±6.5)) and the duration of pleural drainage ((5.5±4.2) vs. (5.8±4.4)) did not differ in both groups (p>0.05).
CONCLUSION. VAMLA is an effective and safe method for evaluating the pN stage of NSCLC. Performing VAMLA in left-sided NSCLC allows removing significantly more lymph nodes and stations in comparison with SLD available in VATS and thoracotomy, which increases the accuracy of postoperative N-staging. The use of the VAMLA in minimally invasive surgery of right-sided NSCLC may be promising in cases of high risk of «occult» pN3 lesion, but requires further study of the role of contralateral lymphatic dissection.

The OBJECTIVE was to analyze the developmental trends, possibilities and outcomes of applying minimally invasive technologies in surgical treatment for kidney cancer.
METHODS AnD MATERIALS. The study included 368 surgeries for kidney tumors which were performed from 2012 to 2019. Partial nephrectomy (Pn) was performed in 228 (60.6 %) cases, radical nephrectomy (Rn) – in 148 (39.4 %) cases. Tumors of the stage cT1a detected in 148 (39.4 %), сТ1b – 145 (38.6 %), сT2a – 58 (15.4 %), сТ2b-cTxn1M1 – 25 (6.7 %) patients. Operations were performed using open (3.7 %), laparoscopic (50.3 %), robotic (46.0 %) approaches with assessment of surgical and oncological outcomes of treatment.
RESULTS. The incidence rate of Pn in patients with kidney cancer at the stages cT1a, cT1b and cT2a was 89.9, 57.2 and 20.7 %. Rn was performed in all cases of tumor stage сТ2b-cTxn1M1. The frequency of Pn at the stages cT1a, cT1b and cT2a in 2019 exceeded 80 %. Minimally invasive technologies (MIT) for Pn was used in 98.3 %, for Rn – in 92.2 % of cases. The incidence rate of postoperative complications after Pn and Rn at stages сТ1а, сT1b, сТ2а was 14.3and 6.7, 16.9 and 3.2, 16.7 and 2.2 %, respectively. Complications after Rn at tumors of the stage cT2bcTxn1M1 occurred in 20.0 % of patients. Positive surgical margin (PSM) occurred after Pn for tumors of the stage cT1a in 0.7 % of cases; for cT1b – in 2.4 %; for cT2a and after Rn – was not determined.
CONCLUSION. Our study demonstrates a steady tendency towards an increase in the number of MIT for kidney tumors, including when performing organ-preserving surgeries. Robot-assisted surgery allows to expand the indications to use a minimally MIT even in the most difficult clinical cases. The frequency of complications after RP compared with Rn is higher because the complexity of the operation increases, and these complications did not affect the outcome of treatment, taking into account the functional advantages provided for patients. The development and widespread introduction of minimally MIT into clinical practice is an evident and inevitable way to develop surgical treatment of kidney cancer.

The OBJECTIVE was to perform a comparative cytological analysis of the wound exudate in healing wounds during autodermoplasty on a granulating burn wound with and without vacuum therapy.
METHODS AND MATERIALS. The article presents the results of the cytological study substantiated the use of vacuum therapy in combustiology. The comparative analysis was performed in 2 groups of patients. The first group consisted of patients with granulating burn wounds, who underwent surgical treatment with vacuum therapy. The second group consisted of patients who underwent surgical treatment without vacuum therapy. In both groups, the complex of surgical treatment included autodermoplasty on a granulating burn wound. All the patients were treated in the Burn Department of the «Scientific research institute – Ochapovsky regional clinic hospital № 1».
RESULTS. The application of vacuum-associated dressings in the surgical treatment of patients in burn hospitals helps to reduce the time of graft retention in the plasty of granulating burn wound, decrease the number of dressings and the amount of dressing material, reduce the time of treatment of patients.
CONCLUSION. The obtained cytological results allow us to justify the application of vacuum therapy in the surgical treatment of granulating burn wounds.

The OBJECTIVE was to create a simulator for practicing manual skills of performing percutaneous endoscopic gastrostomy (PEG).
METHODS AND MATERIALS. A patient simulator has been developed. It has a mouth, oropharynx, removable esophagus, stomach, and anterior abdominal wall that allows performing all stages of the operation. To objectify tension force of the gastrostomy tube during fixation and transmitting the proper manual sensations, a measuring device – bezmen was used. Initially, we used a single-use gastrostomy kit Freka PEG, FR 20 for the simulation. It increased the cost of the simulation. Therefore, instead of disposable kits, the Pezzer catheter No. 24 with a developed metal coneshaped tip was used as a gastrostomy tube (patent RU 2669483, 11.10.2018). Simulation was performed with reusable surgical instruments. At the final stage, an additional external pressure plate and a connector with a cover were used.
RESULTS. The developed method of simulation training for PEG imposition allows performing all stages of endoscopic gastrostomy imposition. The simplicity of manufacturing and the possibility of replacing worn elements allows multiple implementation of the method. Using reusable instruments and a Pezzer catheter with a designed reusable tip increases the cost-effectiveness of training. The use of a measuring device allows to convey the necessary sensations of tension of the gastrostomy tube during fixation with an external pressure plate, corresponding to the sensations in real clinical simulation.
CONCLUSION. The developed method of training for PEG imposition with the simulator allows to effectively work out manual skills and reduce the risk of iatrogenic complications during surgery on the patient.

A clinical case of an interdisciplinary approach to the treatment of a 20-year-old patient with acute purulent polysinusitis, complicated firstly by intracranial episubdural empyema, and then by intracerebral and interhemispheric abscesses, is presented. Despite the timely initiation of antibiotic therapy, the patient had intracranial purulent-inflammatory complica tions of acute purulent polysinusitis, which required the participation of a multidisciplinary team of medical specialists, the appointment of reserve antibiotics and repeated surgical interventions. The described clinical observation confirms that the influence on the course and outcome of the disease in patients with EnT-associated intracranial purulentinflammatory complications is exerted by: a multidisciplinary approach involving a neurosurgeon, otorhinolaryngologist, neurologist, radiologist, clinical pharmacologist, and anesthesiologist-resuscitator; early diagnosis, including computed tomography and/or magnetic resonance imaging of the brain and paranasal sinuses; early verification of the pathogen and determination of its sensitivity to antibiotics; timely etiotropic high-dose parenteral antibiotic therapy with drugs that penetrate the blood-brain barrier; radical rehabilitation of EnT-organs and intracranial foci of infection.

RELEVANCE. Pathological tortuosity of the carotid artery and thrombotic occlusion of the intracranial segment of the carotid artery, critical subostial stenosis are the main causes of tandem lesions in patients with intracranial cerebral artery occlusion. Proximal occlusion may prevent intracranial endovascular access to distal tandem occlusion and increase the risk of endovascular complications.
The OBJECTIVE was to evaluate technical and functional results of the hybrid technologies used in treatment of a patient with tandem damage of proximal and distal segments of the carotid basin in the acute period of ischemic stroke.
CLINICAL OBSERVATION. The result of the intervention was a change in stroke severity by comparing scores on the national Institutes of Health Stroke Scale (nIHSS) after a hybrid intervention – primary reconstruction of the left internal carotid artery with pronounced pathological tortuosity in the extracranial segment and thrombectomy from the tandem M1 occlusion of the left medial artery segment in a patient with ischemic stroke in the left carotid pool in the acute period. A rare clinical observation is presented.

The article describes a case of successful treatment of the rupture of aortic aneurysm by the endovascular method. Patient P., 71 years old, was hospitalized in a multidisciplinary hospital with a diagnosis of acute cerebral circulation disorder. The patient was examined in the intensive care unit. Signs of neurological symptoms regressed. Spiral computed tomography of the chest organs was performed with suspected pulmonary embolism, the results of which revealed an aneurysm of the descending thoracic aorta, complicated by a rupture with the formation of a right-sided hemothorax. The patient underwent endoprosthesis of the thoracic aorta with stent graft. After 2 days, thoracoscopic sanitation, drainage of the right pleural cavity was performed. The postoperative period proceeded without peculiarities. The patient was discharged on the 12^th day in satisfactory condition. At control examination in 1, 6, 12 months, the long-term steady positive result was noted. Endovascular methods minimize the risk of postoperative complications, contributing to a favorable outcome of the disease.

An extremely rare case of complete invagination of the vermiform appendix in a 45-year-old female patient caused by endometriosis is presented. Difficulties of preoperative diagnostics and determination of treatment tactics in the absence of specific clinical and instrumental data are demonstrated.

Extramammary Paget’s disease is the infrequently diagnosis in surgical practice, representing a diagnostic challenge. The timely verified diagnosis guarantees successful treatment. We report about a clinical case of the patient with extramammary Paget’s disease of perianal area.

Modern surgery is difficult to imagine without mechanical stapling devices. The objective of the study was to trace the continuity of the development of mechanical stapling technology by European and American surgeons. The main step that led to this technological development was the idea of using a simple paper staple for suturing of human tissue. The first time the mechanical stapling device was used on a human was 9th May, 1908 in Budapest. Subsequently, surgeons and engineers of Europe, primarily Hungary (Austria-Hungary) (H. Hultl, V. Fischer, A. von Petz, etc), Germany (H. Friedrich, etc.) and the USSR (V. Gudov, V. Demikhov, P. Androsov, etc) refined the mechanical principles and practical implications of this new technology. By the mid-1950s, two types of devices were manufactured in the USSR for simple suturing tissues such as the pulmonary parenchyma or bronchus and for the construction of anastomosis. The disadvantages of these devices could be attributed the requirement of delicate manual loading of small metal staples into the cartridge and assembling of sterile parts immediately prior to application. A group of surgeons and engineers led by an American thoracic surgeon, Mark Ravitch, managed to overcome these disadvantages by making devices user-friendly, launched their production in the USA and even organized a training network for surgeons wishing to use the new instruments. The history of mechanical stapling devices illustrates the successful realization of novel ideas that were supported by technological advances and the professional ambitions of surgeons.

Aortic esophageal fistula (AEF) is a rare but extremely life-threatening condition requiring immediate surgical treatment. The mortality rate among such patients may exceed 60 %, including after surgical treatment. Etiological and pathogenetic mechanisms of AEF are complex and various, but in most cases, they are associated with chronic aortic diseases. The second group of etiological factors of AEF includes trauma of esophagus wall by foreign bodies, malignant neoplasms of the esophagus or mediastinum. AEF may also occur as a result of surgical interventions on the aorta and esophagus. The difficulties of early diagnosis are primarily associated with non-specific clinical manifestations of AEF and the lack of unified protocol for the examination of patients with the first-time upper gastrointestinal tract bleeding. The described reasons in some cases can lead to an inaccurate diagnosis, which entails a loss of time. Among the instrumental diagnostic methods, the most informative is the combination of esophagogastroduodenoscopy and computed tomography of the chest with intravenous contrast enhancement. Each of these methods has its advantages and disadvantages, and allows to identify a number of direct and indirect signs of pathological communication between the aorta and the esophagus.

At present, the determination of the severity of patients with complications of acute calculous cholecystitis, manifested in the form of mechanical jaundice (MJ), remains an insufficiently studied issue. This is due to the fact that the main attention in the examination of such patients is paid to the diagnosis and assessment of the severity of liver failure, and the signs of SIRS (Systemic Inflammatory Response Syndrome) are not given due attention. In this regard, this literature review presents data on the systemic inflammatory response syndrome in such patients, describes its etiopathogenetic mechanisms of development, presents clinical signs, stages of this pathological process. The role of biomarkers, which can be used to determine the severity of inflammatory changes in the biliary system in MJ, is estimated on the basis of literature data.

An analytical review of the literature on the pathogenesis of disorders of the motor-evacuation function of the intestine, which underlies the enteral insufficiency syndrome (EIS), which develops in various acute intra-abdominal surgical diseases, is presented. On the basis of a multivariate analysis of literature data, various pathogenetic mechanisms of enteric dysfunctions caused by morphological and structural changes in the wall of the small intestine, violations of its local defense mechanisms are described. The essence of the modern concept of the pathogenesis of enteral insufficiency – enteral distress syndrome (EDS) according to the literature is presented. According to new views, EDS is a combination of various pathogenetic mechanisms that are formed as a result of dysregulation and destabilization of biological membranes of tissue structures of the intestinal wall (especially its mucous membrane) and a violation of the functional and metabolic status of the intestine, developing in acute surgical diseases of the abdominal organs. Recognition of the validity of the concept will allow unifying the terminology and creating more evidence-based and generally accepted teaching about the nature of EIS.

The treatment of ventral hernias in the history of surgery has always been an urgent problem. In the 90s of the XIX century, hernioplasty using metal threads and plates began, but the long-term results of treatment of patients remained unsatisfactory. A particularly urgent problem in herniology during the last century was the treatment of postoperative ventral hernias, and patients with large and even more giant hernias were often recognized as incurable. The great revolution in herniology was the introduction into practice of biologically inert mesh polymer materials. A fundamentally different method of endoprosthesis of the abdominal wall is retromuscular («sublay») hernioplasty, proposed by the French surgeon of Algerian origin Rene Stoppa in 1965. In 1966, a compatriot, colleague and friend R. Stoppa Jean Rives used the principles of this technique when eliminating postoperative median hernia by prosthetics of the anterior abdominal wall retromuscularly through the xiphopubic incision. Decades later, during the rapid development of endovideosurgery, the principle of operation Rives-Stoppa was the foundation for the development of modern minimally invasive and highly effective methods for eliminating inguinal and other ventral hernias. Thus, the method of prosthetics of the anterior abdominal wall proposed 55 years ago by Rives-Stoppa was an ideological breakthrough in herniology and significantly improved the results of operations for external abdominal hernias.