Anatoly Alekseevich Kurygin was born on September 10, 1932 in the village of Zaborye, Solotchinsky District (now Ryazansky District), Ryazan Region, into a peasant family. In 1950, Anatoly Kurygin graduated from the Solotchinsk complete secondary school with excellent and good marks and applied for admission to the Ryazan Medical Institute. A. Kurygin decided to become a surgeon already at the beginning of his studies at the Institute and persistently went to achieve this goal. After graduating from the 4th year, Anatoly Alekseevich, along with other most successful students, received an offer to continue the study at the Military Medical Faculty at the Kuibyshev Medical Institute named after D. I. Ulyanov, agreed and joined the ranks of the Soviet Army. In July 1956, having received a diploma with honors, lieutenant of the medical service A. A. Kurygin, together with his wife Lyudmila Nikiforovna, departed for the Belarusian Military District. In April 1961, having got the highest grades (five) in the entrance exams, Anatoly Alekseevich was enrolled in the postgraduate course at the Department of Faculty Surgery named after S. P. Fedorov. As a dissertation research, Anatoly Alekseevich was instructed to study the state of lavsan prostheses and a new vascular bed at different times after arterial alloplasty. Soon after defending his dissertation, V. M. Sitenko suggested Anatoly Alekseevich to take up the issue of chronic pancreatitis, which was little studied at that time. During the year, A. A. Kurygin studied the literature on this topic and came to the convincing conclusion that it was impossible as a doctoral dissertation. Anatoly Alekseevich reported his thoughts to the head of the department, substantiated the futility of this topic and expressed a desire to study the physiological and surgical aspects of vagotomy as a new and alternative method of gastric resection for the treatment of chronic duodenal ulcers and its complications. In June 1978, the deputy head of the department, associate professor A. A. Kurygin, successfully defended the first doctoral dissertation in the USSR on the treatment of duodenal ulcers by vagotomy in combination with pyloroplasty. Five years later, in November 1987, professors of the Military Medical Academy V. M. Sitenko, A. A. Kurygin and A. I. Nechay, as part of a group of surgeons from Moscow, Kyiv and Tallinn, were awarded the title of Laureate of the USSR State Prize «For the development and implementation of new methods of treatment of peptic ulcer». In 1985, Professor A. A. Kurygin was appointed head of the Department of Surgery № 2 (for advanced medical training) of the Military Medical Academy. Anatoly Alekseevich was the author and co-author of more than 300 scientific papers, including 39 monographs and manuals, more than 25 teaching aids, 14 inventions, as well as the editor of the Abdominal Surgery section of the Small Medical Encyclopedia. Also, A.A. Kurygin published three collections of poetry. On November 12, 2011, after a severe and prolonged illness, the doctor Anatoly Alekseevich Kurygin was no longer with us. Major-General of the Medical Service A. A. Kurygin was buried on November 15 at the Serafimovsky cemetery in St. Petersburg. 

The OBJECTIVE was to study the dependence of the results of neurosurgical treatment of elderly patients with severe TBI on the organizational transformations of the neurotraumatology care system on the metropolis – Saint Petersburg scale.

METHODS AND MATERIALS. 1228 victims aged 60 to 75 years with severe TBI (men – 982 (80.0 %) people, women – 246 (20.0 %) people) who were treated in the neurotraumatology centers of St. Petersburg in the period before (2007–2009) and after (2010–2020) organizational transformations.

RESULTS. The measures implemented on a megalopolis scale have made it possible to improve the system of neurotraumatology care in St. Petersburg due to optimal routing and rapid delivery of elderly victims with severe TBI to neurotraumatology centers, performing brain SCT scans around the clock during the first 6 hours from the moment of their delivery to the hospital, conducting minimally invasive including neuroendoscopic brain surgery, performing early rehabilitation treatment in the conditions of neurotraumatology centers with further continuation in inpatient centers and medical rehabilitation departments.

CONCLUSION. Modernization of the system of neurotraumatology care for elderly patients with severe TBI on the metropolis – St. Petersburg scale allowed to reduce the frequency of functional disorders, infectious and inflammatory complications, the rate of temporary disability, disability and mortality of victims.

The OBJECTIVE of this study was to evaluate the short-term outcomes of bronchoplastic lobectomies performed from video-assisted thoracoscopic (VATS) and thoracotomic approaches and to identify factors affecting the course of the early postoperative period.

METHODS AND MATERIALS. Out of 398 patients underwent surgical resection in the Center for Intensive Pulmonology and Thoracic Surgery of the SPbSBHI «City multidisciplinary hospital № 2» from 2014 to 2021 for malignant lung neoplasms, 27 patients with bronchoplastic lobectomy were included in the retrospective study. Patients were divided into two groups depending on surgical approach: group I (n=17) included patients operated via thoracotomic approach; group II (n=10) included patients who underwent VATS surgeries. The groups were similar in gender, age, smoking history, Body Mass Index, concomitant pathology, functional status and stage of the disease. Surgical intervention included ipsilateral systematic lymph dissection and bronchoplastic lobectomy.

RESULTS. There were no significant differences in time of operation, blood loss, duration of drainage of the pleural cavity, incidence of postoperative complications, length of hospital stay, number of dissected lymph nodes between the groups. Factor analysis of the influence of pre- and intraoperative factors on the development of postoperative complications showed that the risk of a complicated course of the postoperative period significantly decreased at normal values of FEV1 and FVC (OR=0.942, p<0.05; OR=0.932, p><0.05) and increased in the presence of adhesions (obliteration of the pleural cavity more than 50%), requiring total pneumolysis, and the absence of interlobar fissures (OR=5.5, p><0.05; OR=6.5, p><0.05). In multivariate analysis, strong adhesions in the pleural cavity turned out to be an independent unfavorable prognostic factor for the development of postoperative complications (OR=8.567, p><0.05). CONCLUSION. The use of VATS approach does not increase the incidence of complications after bronchoplastic lobectomies. In patients with FEV1>84.9 %)

CONCLUSION. The use of VATS approach does not increase the incidence of complications after bronchoplastic lobectomies. In patients with FEV1>84.9 % and FVC>101.2 %, the risk of complications after bronchoplastic lobectomies is confirmed lower. Adhesions in pleural cavity requiring total pneumolysis is an independent unfavorable factor in the development of postoperative complications.

The article describes social and economic aspects of the treatment of patients with medium and large postoperative ventral hernias. The study was based on the results of treatment of 181 patients operated by endovideosurgical and open methods for postoperative ventral hernias. The stratification of patients was carried out on the basis of the mod ern classification of postoperative hernias of the EHS approved in the national clinical guidelines. The first main group of patients who underwent laparoscopic hernioplasty using the IPOM+ technique (intraperitoneal onlay mesh) consisted of 47 people. The second main group included 12 patients operated using the preperitoneal eTEP technique (extended total extraperitoneal plasty). The control group consisted of 122 patients with postoperative ventral hernias who underwent traditional (open) hernioplasty: using the techniques of onlay – 35 patients, inlay – 12, sublay– 75. Preoperative examination before planned minimally invasive hernioplasty included routine laboratory and instrumental examinations. The exceptions were patients with stage II and III obesity, as well as large postoperative ventral hernias, patients who underwent computed tomography with abdominometry. The economic efficiency of the treated patients was calculated using standardized formulas. It has been established that the complete e- TEP operation statistically reliably allows to get a significant economic effect compared to the laparoscopic IPOM surgery. IPOM endovideohernioplasty can be used in patients with a combined surgical disease of the abdominal organs in the case of simultaneous intervention. Traditional hernioplasty in patients with large and giant hernias with reduction of abdominal volume are the operations of choice and significantly increase the economic efficiency of the medical hospital. A modern surgical hospital should be able to perform any variants of both traditional and endovideosurgical hernioplasty in order to provide effective medical care and achieve optimal economic performance in any of the existing health insurance systems. 

The OBJECTIVE was to study the process of wound healing after surgical interventions in patients with urgent surgical diseases in combination with a new coronavirus infection.

METHODS AND MATERIALS. We observed for 80 patients with urgent abdominal diseases. Group I – 48 patients with various urgent diseases of the abdominal organs, group II – 32 patients with similar diseases occurring against the background of coronavirus infection. Stages of postoperative examination: 2, 4 and 7 days after surgery. The nature and rate of wound regeneration was assessed by cytological examination of wound exudate. In the tissues along the suture line, trophic indicators and microcirculation were recorded.

RESULTS. The number of neutrophilic leukocytes in the wound exudate in group II exceeded the values of group I by 38.7–116.8 % with a slowed down dynamics of recovery. In the II group of patients, the number of tissue polyblasts was reduced at all stages of observation in comparison with the control group by 34.2–41.9 %. The number of lymphoid polyblasts in the main group was increased in comparison with the control group on days 2, 4, 7 of observation by 33.1 %, 63.2 %, 354.9 %, respectively. The indices of microcirculation in the tissues of the laparotomic wound in the group II of patients changed to a greater extent. The redox potential and oxygen diffusion coefficient in the group II were lower than the control figures by 9.8 – 37.2 % and 35.3 – 38.1 %, respectively. The number of complications according to the Clavien – Dindo classification in the group II of patients compared to the group I was more than 6 times higher.

CONCLUSION. In patients with urgent diseases of the abdominal organs with concomitant coronavirus infection, the process of incomplete reparative tissue regeneration of the wound area slows down, which increases the risk of complications. The main factors that reduce the rate of tissue healing are disorders of microcirculation and bioenergetics.

The OBJECTIVE was to trace the long-term results of the operation of a dosed narrowing of the femoral vein in the lower third of the thigh proposed by Professor P. G. Shvalb.

METHODS AND MATERIALS. The study included 30 patients (20 men and 10 women) with post-thrombotic disease of the veins of the lower extremities of the recanalized form, C4–C6, who underwent surgical correction of deep reflux in the period from 2012 to 2013. In 23 patients, additional phlebectomy of superficial and perforating veins was performed. The research method was duplex scanning (DS). The ratio of antegrade and retrograde blood velocities was used to quantitatively characterize deep reflux. Additionally, the state of the popliteal-tibial segment of the deep veins was determined using the Psatakis reflux index.

RESULTS. The positive effect of the operation was noted in 96.7 % of patients at a follow-up period of 4 years. During follow-up periods of up to 8 years, the numbers decreased to 60.7 %. Relapse of trophic ulcers occurred in 39.3 % of patients. However, all patients noted that ulcers were much smaller in size than before surgery. According to DS data, incompetent perforator veins were detected in 16 patients: in all nine patients with recurrent ulcers and in seven patients without worsening. Vein diameter, maximum and average velocities of retrograde blood flow were greater in patients with worsening: diameter – 4.2±0.5 mm, υ (m) 91.2±19.8 cm/s, υ (average) 90.5±18.5 cm/s versus a diameter of 2.9±0.5 mm, υ (m) 39±15.6 cm/s, υ (average) 35±9 cm/s (p<0.05).

CONCLUSIONS. Operation of dosed narrowing of the femoral vein had good clinical results in 96.7 % of follow-up periods up to 4 years, 60.7 % – after 8 years. Isolated correction of deep reflux with the preservation of insufficient perforator veins can lead to recurrence of trophic ulcers.

The report is about 4 clinical observations that demonstrate advanced capabilities of surgical treatment of leiomyosarcoma of the inferior vena cava and its main tributaries (gonadal, common iliac, and renal veins). The clinical examples present variants of vascular reconstructions in stages, namely, alloprosthesis of the infrarenal segment of the inferior vena cava and the bifurcated aortoiliac alloprosthetics. The article also considers the technique of «kidney-preserving» operations for the leiomyosarcoma of the left renal vein: tumornephrectomy without ureter intersection using the reversible pharmaco-cold ischemia, extracorporeal resection of the renal vein with a tumor and the kidney orthotopic replantation with alloprosthetics of the left renal vein. The article includes features of the postoperative period, the immediate and long-term results of specialized antineoplastic treatment.

INTRODUCTION. The issues of treating patients with acute fluid collections and postnecrotic cysts are still relevant at the present time. Optimization of the tactics of treatment of patients at the early stages of the formation of postnecrotic cysts makes it possible to reduce the percentage of complications.

The OBJECTIVE was to develop diagnostic criteria for the formation of a cyst capsule at the early stages of acute pancreatitis, to determine the optimal timing and options for transgastric drainage of cysts.

METHODS AND MATERIALS. The results of treatment of 62 patients were analyzed. All patients underwent computed tomography with bolus contrast and endoscopic ultrasonography. There were 2 groups of patients who underwent surgical treatment in the early and late periods. The results of endoscopic transgastric drainage of postnecrotic pancreatic cysts were analyzed.

RESULTS. Based on the analysis of the results of treatment of patients with postnecrotic pancreatic cysts and acute peripancreatic fluid collections, the data of multispiral computed tomography and endoscopic ultrasonography at the stages of cyst formation, options and optimal timing of endoscopic transgastric drainage were determined. Causes of complications accompanying this method were identified and analyzed. The technique of transgastric drainage has been improved, methods for the prevention of complications have been proposed.

CONCLUSION. The obtained results make it possible to recommend diagnostic criteria and a treatment algorithm for use in clinical practice.

This article presents a rare clinical observation of a bone form of primary hyperparathyroidism in a 16-year-old adolescent complicated by a pathological fracture of the right femur. The features of the given case are: late diagnosis of primary hyperparathyroidism in an adolescent with clinical manifestations; complication of the disease with a pathological fracture, which required two-stage treatment, open repositioning and metal plate osteosynthesis; difficulties in the organization of the examination and treatment of the patient, related to the detection of covid-19 and his stay in an infectious department; the need for tactical decision on the sequence of surgical treatment of the fracture and its cause - primary hyperparathyroidism.

Cardiac surgery of the aortic valve in pediatric patients is an urgent problem. Performing an open aortic commissurotomy and planar resection of the valves during the newborn period allows to obtain suboptimal results and postpone subsequent interventions indefinitely. With an unsatisfactory result of open aortic commissurotomy in children of the first years of life, the need to search for optimal surgical tactics arises. The presented article describes the technique of replacing the aortic root with a decellularized valve-containing allograft in a child of 14 months of life. A good immediate result of the operation is associated with the ability of the allograft to provide physiological hemodynamics in the aortic position. The advantages of the described technique are the reduction in the time and complexity of surgical intervention, the possibility of preserving own pulmonary valve, the probability of recellularization and the possibility of graft growth with the growth of the child. That is precisely why the presented technique should be considered as an alternative to Ross surgery, especially if there are anatomical contraindications to it.

The article deals with the case of intestinal obstruction due to the formation of a giant fecal stone in the sigmoid colon. Coprolites occur in individuals suffering from severe chronic constipation. In most cases, fecal stones can be removed with the help of conservative measures, however, in this case, there were absolute indications for urgent surgery for acute intestinal obstruction. 

With the successes achieved in the treatment of gastric cancer, the problem of combined neoadjuvant therapy for stenosing tumors remains unresolved. To find the optimal method of treatment, we carried out the analysis of modern domestic and foreign literature. The standard methods are the implantation of a self- expandable stent, argon-plasma coagulation, the implantation of a nasointestinal feeding tube, the formation of gastroenteroanastomoses, gastro/enterostomy. However, there is no evidence base about the effectiveness and safety of the above methods when applying them as part of the combined treatment of potentially operable gastric cancer. The method of endoscopic photodynamic therapy seems promising. 

INTRODUCTION. The development of laparoscopic and robotic surgery in medicine is happening rapidly, but their role and place in the surgery of blunt abdominal trauma are not yet fully defined, the range of diagnostic capabilities and performed operations is constantly expanding, contraindications are decreasing.

The OBJECTIVE was to conduct systematic review based on modern data from Russian and foreign literature to determine the role and place of laparoscopic and robotic technologies in the diagnosis and treatment of patients with blunt abdominal trauma. The systematic literature search was conducted from January 2015 to August 23, 2021.

Laparoscopy reduces the duration of inpatient treatment, the percentage of postoperative complications and mortality in hemodynamically stable patients with blunt abdominal trauma compared to laparotomy.

CONCLUSION. To obtain data of a higher Level of Evidence and Grade of Recommendations, it is necessary to further conduct systematic reviews and meta-analyses based on randomized clinical trials.

A literature review of studies on the problem of providing surgical care to patients with hemorrhoids is presented. The article discusses modern approaches to the use of high-energy devices for dissection of hemorrhoids characterizes these techniques, and indicates their advantages and disadvantages. Based on the analysis of immediate and long-term results of treatment, a comparative assessment of the effectiveness and safety of hemorrhoidectomy performed using various electrosurgical instruments, plasma, laser and ultrasonic scalpels was made. It has been demonstrated that their use provides rapid hemostasis and precise tissue dissection, which leads to a decrease in the intensity of pain syndrome and the incidence of complications in the postoperative period, and also reduces the time of rehabilitation of patients. Despite the obvious positive potential of the devices presented above, their use is fraught with certain risks associated with overestimation of the hemostatic effect and, on the contrary, underestimation of the damaging effect on tissues adjacent to the dissection zone. Thus, the current level of development of biomedical technologies opens up great opportunities for improving the results of surgical treatment of patients with hemorrhoids. However, the key to their implementation is the observance of a reasonable approach to the use of certain high-energy devices, which should be based on a critical analysis of their advantages and disadvantages. 

Professor, Corresponding Member of the Russian Academy of Sciences Arian Pavlovich Kalinin is a prominent domestic surgeon and scientist, founder and leader of the large school of endocrinologists, founder of the Kalinin Readings tradition of regular all-Russian symposiums.