Nikolai Nikolaevich Petrov was born on December 2 (14), 1876 in St. Petersburg in the family of a famous scientist, professor of mechanics Nikolai Pavlovich Petrov. In 1894, Nikolai graduated from the First Classical Gymnasium and entered the Imperial Military Medical Academy. After graduation in 1898, Nikolai Nikolaevich was left at the Academy for 3 years to prepare for a professorship at the Department of Surgical Pathology, and in 1902 completed his dissertation experimental work for the degree of Doctor of Medicine on the topic: «Tuberculosis of the joints due to injury». After defending his thesis, he was sent for 2 years to further improve in Western Europe, and after returning to St. Petersburg in 1905, N. N. Petrov was elected to the position of privatdozent of the Military Medical Academy. From 1905 to 1912, Nikolai Nikolaevich published about 40 scientific papers, including two fundamental monographs: «The General Doctrine of tumors (pathology and clinic)» (1910) – the first monograph in Russian devoted to oncology, and the monograph «Free Bone plastic Surgery», published in 1912. From 1912 to 1913, he was the Professor of the Hospital Surgical Clinic of the University of Warsaw. From 1913 to 1964, he was the Professor of the Surgical Clinic of the State Institute for Advanced Medical Training. In 1920, N. N. Petrov took an active part in the creation of the first university in the Kuban, especially in the organization of the Faculty of Medicine in Krasnodar. In 1917, N. N. Petrov was elected to the position of the Head of the Department of Hospital Surgery of the Women’s Medical Institute (later the Pavlov First Leningrad Medical Institute, and now the Pavlov First Saint Petersburg State Medical University (Pavlov University)), which he headed until 1927. Due to the duty trips, he began to head the Department only in 1921 after returning from the front. In 1921, N. N. Petrov and his family returned to Petrograd. Thanks to the perseverance and high authority of Nikolai Nikolaevich as a surgeon, scientist and health organizer, he managed to achieve the creation of a specialized practical and research oncological center in Leningrad, and on March 15, 1927, the Institute of Oncology was founded, which in 1966 was named after N. N. Petrov. Nikolay Nikolaevich made a significant contribution to the development of experimental oncology thanks to the organization in 1938 of the laboratory of experimental cancer in Sukhumi on the basis of a nursery for monkeys, which was at that time a branch of All-Union Institute of Experimental Medicine (VIEM). Nikolay Nikolaevich was the author and co-author of more than 300 scientific papers, more than 50 dissertation studies were carried out under his supervision. His most famous student was F.G. Uglov, who headed the Department of Hospital Surgery of the Pavlov First Leningrad Medical Institute in 1950. For outstanding services to Soviet healthcare and great achievements in medical science, N. N. Petrov was awarded three Orders of Lenin and two Orders of the Red Banner of Labor. Academician Nikolai Nikolaevich Petrov died on March 2, 1964 and was buried at the cemetery in the village of Komarovo near Leningrad.

The OBJECTIVE of our study was to research changes in the radial artery in patients with multifocal atherosclerosis and associated risk factors.
METHODS AND MATERIALS. The object of the study was fragments of the human radial artery extracted during coronary bypass surgery. Patients were divided into 2 main groups: group 1 – patients who, in addition to coronary artery disease, had multifocal atherosclerosis. Group 2 – patients who did not have concomitant lesions of the main arteries. The groups did not differ statistically by gender and age. Morphological and histological studies of the preparations of the radial artery wall were carried out.
RESULTS. The analysis revealed such changes as: edema of one layer of the artery or all three, proliferation of the subendothelial layer of the endarterium, intimal fibrosis, overlap of the artery lumen with a massive accumulation of agglutinated red blood cells, as well as occlusions of the radial artery.
CONCLUSION. Statistical analysis of the results revealed that the combination of the above-mentioned histological factors is an early sign of atherosclerotic lesions of the radial artery wall, as well as confirmed that changes in the radial artery wall are not related to the initial wall thickness and diameter.

The OBJECTIVE of the study was to assess the possibility of using laser technologies in the treatment of perianal Crohn’s disease.
METHODS AND MATERIALS. The study included 18 patients with perianal Crohn’s disease who were treated in Surgery Department ¹ 3 of the Clinic of the Research Institute of Surgery and Emergency Medicine of Pavlov University. The study was conducted in 2 stages. The first stage consisted in placing the draining seton (ligature) in the main fistulous canal. The second stage was performed in 3 months. The seton was removed with further laser destruction of the fistulous canal. On the background of surgical treatment, the patients received conservative therapy according to the recommendations of gastroenterologists.
RESULTS. Every stage of surgical treatment lasted no more than 30 minutes, under intravenous anesthesia. Intraoperative blood loss did not exceed 5 ml. Due to the absence of complications, the bed-day of each stage varied from 0 to 2 days. 3 months after surgical treatment, the examination showed the complete closure of the fistula canals. The maximum period of relapse-free course was 24 months. All patients received anti-inflammatory therapy, 63 % of patients continued to receive genetically engineered biological therapy.
CONCLUSION. The use of sphincter-preserving techniques proved to be effective in patients with perianal Crohn’s disease. It improves the quality of life and reduces the risk of patients’ disablement.

The OBJECTIVE was to evaluate the first experience of using bone chips in sternum metallic osteosynthesis in terms of safety and clinical efficacy.
METHODS AND MATERIALS. 20 patients, 10 people in each group (11 men and 9 women; the average age in Group 1 was 74.2±5.3 years; in Group 2 – (72.4±6.7) years) were enrolled in the study. In accordance with the objective of the study, when suturing the sternum, bone-chip grafts were inserted into the spongy substance in Group 1 patients. Group 2 included patients who underwent surgical treatment according to the generally accepted standard protocol: bone wax was applied to the spongy bone tissue of the sternum.
RESULTS. The evaluation of sternum reossification was performed with spiral computed tomography. The initial state of the bone tissue was examined before the operation, in the early postoperative period (12 days) and in the midterm period – 12 months after the operation. The results were evaluated on a point scale: 0 points – sternal diastasis more than 3 mm, 12 points – complete sternal consolidation. In the early postoperative period, the degree of sternum fusion did not differ in both groups. (Group 1 – (3.5±0.7); Group 2 – (3.5±0.8) points). In the mid-term follow-up (12 months after), the degree of sternum fusion in patients of Group 1 was (11±0.7) points, which was almost two times higher than in patients of Group 2 – (5.6±3) points.
CONCLUSION. The use of Xeno-materials for bone grafting in patients at high risk of impaired reossification after median sternotomy is safe and effective. 

The OBJECTIVE was to analyze the accumulated experience of interventions using the iliac branch device (IBD) in patients with common iliac artery aneurysm.
METHODS AND MATERIALS. The article presents short-term results of surgical interventions in two patients with pathology of the infrarenal aorta and bilateral pathology of the iliac arteries. In both cases, in order to preserve blood flow in one of the internal iliac arteries, IBD was used. The branches of the contralateral internal iliac artery were simultaneous embolized with coils.
RESULTS. Technical success was achieved in both interventions. In the postoperative period one of the patients developed high intermittent claudication (from the embolized internal iliac artery), the conservative therapy provided positive effect. Control CT did not reveal endoleaks and thrombosis of the endoprosthesis.
CONCLUSION. The use of IBD allows to preserve pelvic blood flow and can be considered as the main method of endovascular treatment in patients with aneurysm of the common iliac artery, especially in the case of bilateral lesions.

The OBJECTIVE was to show a potential and efficiency of endovascular methods in treatment of patient with portal vein stenosis after pancreatoduodenal resection complicated by the development of varices in the portomesenteric basin and recurrent gastrointestinal bleeding.
METHODS AND MATERIALS. We presented the results of treatment of two patients who previously underwent pancreatoduodenal resection for pancreatic head cancer. 2 patients were admitted to the Clinic of the Research Institute of Surgery and Emergency Medicine of Pavlov University with a clinical picture of recurrent gastrointestinal bleeding.
RESULTS. Both patients had no visible bleeding site with endoscopy, but had recurrent melena and hemoglobin loss. On radiological imaging we found a portal vein stenosis with a significant varicose transformation of the mesenteric basin. Endovascular stent placement for portal vein stenosis was performed in both cases with no recurrence of bleedings and no complications.
CONCLUSION. Portal vein stenosis after pancreatoduodenal resection is a rare complication, which can manifest in recurrent gastrointestinal bleeding with no visible bleeding site on endoscopy. Endovascular methods are feasible and safe in treatment of portal vein stenosis with no relapse. Multidisciplinary approach in diagnostic and treatment of such patients allow to identify and remove the cause of recurrent bleeding.

The OBJECTIVE of the study was to analyze the results of treatment of patients with severe injuries of the elbow joint, who underwent two-stage reconstruction of soft tissues and total elbow arthroplasty (TEA), to assess of the effectiveness of tactics, early and long-term functional state.
METHODS AND MATERIALS. A retrospective analysis of the treatment of 8 patients from 2009 to 2019, who had extensive soft tissue injuries that required complex soft tissue reconstruction and total elbow arthroplasty, was carried out. 6 male and 2 female patients, average age 33.5 years (min. 27, max. 39 years), no concomitant diseases. Injuries in 6 patients were IIIB, in 2 patients – IIIC (classification of R. B. Gustilo and J. T. Anderson (1976). Upon admission as an emergency, all patients underwent primary surgical debridement, then two-stage reconstruction of soft tissues and after wound healing, total elbow arthroplasty.
RESULTS. With a favorable course of the wound process on average for (11.6±6.5) days (min 1 day, max 36 days), soft tissue reconstruction was performed: musculocutaneous (thoracodorsal flap) or fascial skin flaps (medial fascial skin flap thighs 3 cases and scapular flap 4). TEA was performed on average (219.1±22.2) days (min. 158 days and max. 308 days) after wound healing with Coonrad-Morrey prostheses (Zimmer, Warsaw, IN, USA). The average follow-up period after arthroplasty was (8.8±2.1) years (min. 8 years, max. 10 years). After surgery, functional results improved: on the DASH scale from (91±6) to (19.5±2.8), and on the MEPS scale from (33.5±3.3) to (80.6±6.5), hand strength from (23.3±3.8) kg to (42.1±3.7) kg and persisted throughout the observation period. No infectious complications were noted.
CONCLUSION. Severe injuries of the elbow joint area with a defect in bones and soft tissues can be successfully operated with two-stage microsurgical reconstruction of soft tissues and TEA, this tactic allows to obtain a good longterm functional result and does not interfere with revision surgery.

The OBJECTIVE was to evaluate the results of posterior separation plasty in patients with large incisional ventral hernias.
METHODS AND MATERIALS. Results of surgical treatment of 19 patients with large incisional ventral hernias were analyzed, posterior separation plasty with a polypropylene mesh implant was done in all cases. Mean age of the patients was (57.8±2.8) years. Assessment of quality of life of patients was carried out (15.7±1.6) months after the operation using the SF-36 questionnaire, and the anterior abdominal wall and the area of surgical intervention were also examined.
RESULTS. All patients of the study group had comorbidity, the most frequent were diseases of the cardiovascular system – in 14 (73.7 %) patients, pathology of the digestive tract – in 12 (63.2 %) patients, obesity – in 10 (52.7 %) patients. The mean duration of hernia presentation was (44.2±11.3) months. The average width of the hernial defect was (15.2±0.5) cm. Posterior separation plasty by A. M. Carbonell was used in 12 (63.2 %) patients, TAR-plasty – in 7 (36.8 %) patients. Mean hospital stay was (18.7±1.9) days. Postoperative wound complications developed in 5 (26.3 %) patients. Complications like abdominal compartment syndrome, pulmonary embolism, and deaths have not been noticed. Quality of life assessment (15.7±1.6) months after surgery revealed that the physical health (PH) was (48.35±2.63), and the mental health (MH) was 52.42±3.04. In addition, there were 3 (15.8 %) recurrences of hernia after posterior separation plasty by A. M. Carbonell method.
CONCLUSION. The use of posterior separation plasty with mesh prosthesis made it possible to perform reconstruction of the anterior abdominal wall, avoiding the development of intra-abdominal hypertension and death. It is recommended to avoid the posterior separation plasty by A. M. Carbonell method because of the risk of recurrence of incisional ventral hernias, TAR-plasty should be preferred for use.

The OBJECTIVE was to study the informative value of ultrasound examination in patients with paracolar abscess, to evaluate the therapeutic and diagnostic effectiveness of minimally invasive treatment of abdominal and pelvic abscesses in this pathology.
METHODS AND MATERIALS. In the period from 2016 to 2021, 85 patients who underwent minimally invasive drainage of paracolar abscesses were treated under ultrasound and RTV guidance. In 72 (84.7%) patients, the diagnosis was confirmed on MSCT. Transvaginal ultrasound was performed in 12 (14.1%) patients, and transrectal ultrasound was performed in 25 (29.4%) patients. In 18 (21.1%) cases, the diagnosis was determined on pelvic MRI.
RESULTS. Diverticulitis in 65 (76.4 %) patients led to the development of paracolitis, with the formation of intraperitoneal and retroperitoneal inflammatory infiltrates in 40 (47 %) patients and in 25 (29.4 %) patients. Percutaneous drainage was performed in 85 cases. By volume, the abscesses were divided as follows: in 19 (22.3 %) patients, dimensions were 8–10 cm; in 42 (49.4 %) patients, dimensions were 5–8 cm; in 24 (28.2 %) patients, dimensions were up to 5 cm. The most severe group consisted of patients with an abscess volume of 8 to 10 cm. The duration of standing drains in patients with sizes 8–10 cm was 16–18 days, with sizes 5–8 cm–10–14 days, with sizes up to 5 cm – no more than 10 days. Rdical surgical treatment was performed in 15 (17.6 %) patients.
CONCLUSION. A paracolar abscess is an indication for its minimally invasive drainage. We considered the technique of minimally invasive drainage as a possible «bridge» to elective surgery for diverticular disease of the colon. Ultrasound examination has a high sensitivity and specificity in diverticular disease of the colon. This makes it possible to use it not only as a method of primary examination and minimally invasive drainage of the abscess, but also as a way to objectify the dynamics of the affected area of the colon.

INTRODUCTION. The significance of all components of donor plasma on the process of inflammation in patients with COVID-19 is currently a little-studied problem.
The OBJECTIVE was to determine the effect of components of donor plasma on the inflammatory process in COVID-19.
METHODS AND MATERIALS. The study included 50 patients with coronavirus infection (COVID-19), bilateral polysegmental pneumonia, who received standard therapy. Anticovid plasma transfusions were performed in 38 patients. Quarantine fresh frozen plasma was transfused to 12 patients. Before and after transfusion, changes in biochemical, immune, clinical and instrumental parameters of patients were evaluated in dynamics. Separately, the intensity of humoral immunity to SARS-CoV-2 was evaluated in donors of anticovid plasma and in all patients in dynamics. The dynamics of changes in the parameters of components of donor plasma was studied with an assessment of their correlation relationships between biochemical and immune blood parameters before and after transfusion. The most significant component of donor plasma affecting the inflammatory process in COVID-19 was identified.
RESULTS. After transfusion of any type of donor plasma, the parameter of the intensity of humoral immunity to SARS-CoV-2 increased with normalization of clinical and instrumental parameters and a decrease in the parameters of acute phase inflammatory reactants. The value of the alpha2-macroglobulin index was reduced, and it increased after transfusion. Correlations between acute phase inflammatory reactants and donor plasma components before and after transfusion with any type of donor plasma were consistently studied. As a result, the interrelations of varying degrees of severity with the alpha2-macroglobulin index were revealed.
CONCLUSION. After transfusion of any type of donor plasma, there is an increase in the intensity of humoral immunity to SARS-CoV-2 in the form of the appearance of specific antibodies, the parameters of acute phase inflammatory reactants decrease. One of the significant components of donor plasma affecting the inflammatory process in COVID-19 is alpha2-macroglobulin. The study of the possibility of using alpha2-macroglobulin isolated from donor plasma is one of the promising directions in the complex treatment of COVID-19 patients.

The OBJECTIVE was to study the efficiency of transplantation of autologous hematopoietic stem cells in patients with chronic critical lower limb ischemia and compare the results of treatment depending on the number of their transplantations.
METHODS AND MATERIALS. 9 patients with chronic critical lower limb ischemia, recognized as inoperable, received courses of conservative therapy in clinic supplemented with transplantation of autologous hematopoietic stem cells. Patients were divided into 2 groups. The first group included 4 patients who underwent from 2 to 6 transplantations of autologous hematopoietic stem cells at six-month intervals. The second group included 5 patients who underwent only 1 transplantation of autologous hematopoietic stem cells. The effectiveness of treatment was evaluated by objective and subjective signs: an increase in the distance of painless walking, an increase in the ankle-shoulder index. Microcirculation was assessed using three-phase scintigraphy.
RESULTS. Relief of rest pains was noted in all patients. The distance of pain-free walking ranged from 200 to 600 m, the ankle-brachial index increased in 8 out of 9 patients. Scintigraphy data demonstrated the improvement of microcirculation in all patients.
CONCLUSION. The use of autologous hematopoietic stem cells is an effective method in treatment of chronic critical lower limb ischemia. The number of transplantations of autologous hematopoietic stem cells does not affect the clinical effect. Further research is needed in the field of cell therapy for chronic critical lower limb ischemia.

We report the clinical case of esophageal cancer development in the patient who previously underwent bilateral lung transplantation. The oncological disease was characterized by extremely rapid growth; despite the regular post-transplant examination, esophageal cancer was diagnosed in IV stage (liver metastases). The tumor was complicated by recurrent massive bleeding. For that reason, according to vital indications, a subtotal esophagectomy with a plasty by wide gastric tube was performed. The postoperative period was uneventful. The postoperative chemotherapy was carried out and stabilization achieved.

The article describes a rare complication of gallstone disease – vesicoduodenal fistula. This complication is accompanied by the release of a large concrement into the lumen of the duodenum. Subsequently, the migration of the concrement leads to the development of small bowel obstruction. The present clinical observation presents the early diagnosis and successful treatment of an elderly patient with severe concomitant pathology before the development of the clinic of small bowel obstruction.

When examining patients with chronic inflammatory pancreatitis, about 50% of them have pseudocysts. Bilocular pancreatic pseudocysts are rare clinical findings. This article presents a clinical observation that demonstrates the difficulties in the diagnosis and treatment of a 37-year-old patient with inflammatory chronic pancreatitis with a large (giant, more than 10 cm in size) bilocular pseudocyst of the pancreas. The pseudocyst was the outcome of sterile macrofocal pancreatic necrosis with a predominant lesion of the tail of the pancreas. It was diagnosed with computed tomography of the abdomen 1.5 months later after the end of the treatment of acute pancreatitis, the size of the pseudocyst was 4.8×7.3×22.0 cm. A special feature of the case is the occurrence of an internal cysto-colonic fistula. The choice of the method of surgical treatment is discussed taking into account the size of the pseudocyst, the time of its formation, the absence of signs of ductal hypertension of the pancreas and other complications of chronic pancreatitis. The use of external puncture drainage of the pseudocyst and the drug «Sandostatin LAR» made it possible to successfully complete the treatment of the patient using minimally invasive technologies.

To date, there are a large number of terms used in herniology. However, there is a problem with the correct use of these terms in Russian literature. Thus, the resulting terminological inconsistencies make scientific communication difficult and do not allow for an adequate comparative analysis of treatment results.
The article considers options for the correct use of the main terms used to refer to plastic materials, names of surgical interventions and diagnoses.

The article presents a literature review of studies on the use of local destruction methods (photodynamic therapy and radiofrequency ablation) in the treatment of patients with unresectable extrahepatic cholangiocarcinoma. Currently, many studies have been published on the assessment of photodynamic therapy in the treatment of patients of this category. Radiofrequency ablation in tumors of extrahepatic bile ducts has been used relatively recently, but, according to available data, it may represent an alternative to photodynamic therapy. The article discusses the mechanism of action, the method of photodynamic therapy and radiofrequency ablation, and presents the results of the largest studies. It is reported that photodynamic therapy is comparable to R1/R2 resection according to the survival results. There is evidence of its successful use as adjuvant and neoadjuvant treatment, the possibility of using photodynamic therapy as a method of local tumor control in patients with unresectable cholangiocarcinoma awaiting liver transplantation. The use of radiofrequency ablation at the first stage before stenting the biliary tract allows to increase the diameter of the bile ducts, increases the stent patency time, as well as the survival orate f patients. In addition, radiofrequency ablation and photodynamic therapy can be successfully applied to occlude previously inserted stents. The advantage of photodynamic therapy is the possibility of using it in weakened patients with hyper bilirubinemia. The advantages of radiofrequency ablation include the lower cost of the procedure, as well as the absence of the need to keep the light regimen. The prospects of using methods of locoregional destruction as part of combined treatment regimens (in combination with systemic or regional chemotherapy) are being studied, which allows achieving the best results.

In modern scientific literature, the opinion is firmly established: «... a systematic study of burn injury in our country began in the mid-30s of the XX century». How historically accurate is it? This fact determined the relevance of the study of the Russian medical periodicals on the topic «Burns» for the period of the XIX – early XX centuries. The obtained data testify to the active work of Russian specialists not only in the study of the peculiarities of local and general manifestations of burn injury, but also in the development of diagnostic and treatment methods. They collected and analyzed the statistics of burns of various etiologies, under various conditions of human life, and also carried out experimental work. They published the obtained results in various medical publications: newspapers, magazines, manuals, encyclopedias, etc., which were published on the territory of the Russian Empire. Our doctors have formulated a number of fundamental conclusions that are not disputed by anyone in the 21st century. For example: even superficial first-degree burns, manifested only by hyperemia and moderate edema of the skin, with a large lesion area can lead to death, in contrast to skin inflammatory diseases characterized by similar local manifestations and proceeding relatively favorably for the general condition of a person. In addition, it became clear that the pathology under consideration should be treated by a doctor who knows its features and optimal treatment methods. Otherwise, long-term wounds can be fatal at a time when the threat to the victim’s life seemed to have passed. Experimental studies conducted since the middle of the 19th century have not only strengthened the evidence base of research works, contributed to the writing and defense of thematic dissertations, and had a significant impact on the scientifically grounded development of new methods of treatment.

The OBJECTIVE of the work was to study the incidence of general surgical diseases, their structure and individual issues in general surgical care to the population using the example of the region of the Russian Federation – the Republic of Bashkortostan.
METHODS AND MATERIALS. The results of a retrospective analysis of the work of the surgical service of the region, the surgical departments of 54 medical organizations, the statistics of the medical information analytical center of the Ministry of Health of the Republic of Bashkortostan for 2008–2018 are presented. 87 484 inpatient, 71 036 outpatient surgical patients were analyzed.
RESULTS. The incidence of general surgical pathology (incidence) was 2302.1 per 100 000 population, taking into account outpatient surgical patients – 4171.5/100 000, which is higher than the incidence of cancer, HIV infections, tuberculosis and is at the level of diseases of the circulatory system (4121/100 000). The incidence in its structure depends on the demographic indicators: in people over 80 years old, it is 2 times higher than in people of 20–55 years old, and in the structure of morbidity in the elderly and senile age, the leading role belongs to acute cholecystitis, acute mesenteric ischemia, and also to rupture aortic aneurysms. The issues of volume (number) of operations per 1 surgeon, the need to emergency general surgery with qualified personnel, the material base, the correspondence of the indicators of the surgical service to the indicators proposed by Lancet Сommission Global Surgery are considered.
CONCLUSION. Despite the fact that general surgery is not a priority in the healthcare system, insufficient funding, the indicators of this service for 10 years has improved and, in many areas, corresponds to those in developed countries. It is necessary to pay more attention to financing, equipping general surgical departments, training specialists - general surgeons, creating a separate emergency general surgical care service.