This article contains historical aspects of the life of the great Russian scientist and surgeon – Nikolai Alekseevich Bogoraz. The work is devoted to the scientific discoveries of Nikolai Alekseevich in the field of urology, operative surgery, as well as the main points of the biography of N. A. Bogoraz are described here: the path from a student of the Military Medical Academy to an outstanding Russian surgeon. Nikolai Alekseevich was born on February 1 (13 according to the Julian calendar), 1874 in the city of Taganrog, Donskoy Army region – modern Rostov region. The future famous scientist and surgeon, Nikolai Alekseevich, graduated with a gold medal at first from the Tiflis Gymnasium in 1892, and then from the Military Medical Academy in 1897, graduating with the degree of «doctor with honors». Further, N. A. Bogoraz had a long, multidisciplinary professional path. In 1920, Nikolai Alekseevich lost both lower limbs because of a traffic accident, which gives a halo of heroism to the image of the professor. However, this tragic accident did not hindered the talented surgeon from creating a monumental work that glorified N. A. Bogoraz in the world medical community, – «Reconstructive surgery» in two volumes. N. A. Bogoraz died at the age of 78 on July 15, 1952 from repeated myocardial infarction and was buried at the Vvedenskoye cemetery in Moscow.

The objective was to evaluate the effectiveness and safety of video-assisted thoracoscopic surgery for closed chest trauma and to determine the most favorable terms for performing surgical intervention in case of complicated closed chest injury.

METHODS AND MATERIALS. The study included 95 patients who underwent video-assisted thoracoscopy (VATS) for closed chest trauma. Group I – operated within the first 5 days from the moment of injury; group II – operated within 5–10 days after injury; group III – operated later than 10 days after injury.

RESULTS. Performing thoracoscopic intervention within the first 5 days after the injury significantly reduces the incidence of complications such as pneumonia, pleurisy, empyema. VTS allows safely and effectively performing various surgical procedures in case of complicated closed chest trauma, and diagnosing diaphragm injuries.

CONCLUSION. Indications for video-assisted thoracoscopy should be set as early as possible.

The OBJECTIVE was to study the efficacy and safety of laparoscopic decompression of the celiac trunk.

METHODS AND MATERIALS. A comparative analysis of the results of laparoscopic (30 patients) and conventional decompression of the celiac trunk (50 patients) was carried out. All patients were operated on between September 2018 and July 2021.

RESULTS. Intraoperative bleeding during laparoscopic decompression of the celiac trunk, which required conversion of access to laparotomy and vascular suture, was noted in 2 (6.7 %) cases. With conventional access, there were no such complications. The average duration of laparoscopic decompression of the celiac trunk was 107 minutes, from conventional access – 150 minutes. The average length of hospital stay after laparoscopic intervention was 4 days, after the traditional one – 7 days. Long-term results of treatment over a period of more than 6 months were evaluated in 28 patients who underwent laparoscopic decompression of the celiac trunk and 45 people who underwent conventional decompression. Ultrasound examination in all cases stated the return of linear and velocity parameters of blood flow in the celiac trunk to normal. complete relief of the clinical manifestations of the disease was achieved in 24 (85.7 %) patients after laparoscopic and in 39 (86.7 %) after traditional intervention.

CONCLUSION. Laparoscopic decompression of the celiac trunk is an effective method of surgical treatment of the syndrome of compression of the celiac trunk, but there are risks of vascular damage. The long-term results of laparoscopic and open decompression of the celiac trunk are comparable.

The OBJECTIVE was a comparative assessment of the efficacy and safety of surgical resection and endoscopic submucosal dissection in the treatment of early colorectal cancer.

MATERIALS AND METHODS. We retrospectively evaluated 165 patients after endoscopic submucosal dissection (main group) and 70 patients after surgical resection (control group) with Tis-T1N0M0 stage of colorectal cancer. Median age was 65 and 67. According to the histological structure, the groups consisted mainly of differentiated types of adenocarcinoma.

RESULTS. In the endoscopic group, all tumors were removed in a single block. Radical removal was recognized in 80.7% of cases. No progression was detected during the follow-up period. In the group of surgical resections,  progression was detected in 1 patient Postoperative complications in the endoscopic group were 9%, in the surgical group – 35.7%, class 3a and higher according to clavien–Dindo, 4.2 and 25.7%, respectively. When the tumor was localized in the rectum and rectosigmoid bend, there were significantly fewer complications in the main group than in the comparison group (4.2% vs. 20%). In the surgical group, a coloor ileostomy was formed temporarily in 28.6 % of cases, and in 10 % – for perpetuity. There were no treatment-related deaths in both groups.

CONCLUSION. In this study, endoscopic submucosal dissection showed a technical success in 100% of cases, with a risk of major postoperative complications of 4.2% and radicality in 80.7% of cases. Standard surgical techniques, along with high oncological efficiency, show significant rate of major complications (25.7 %) and in 38.6 % of cases led to a temporary or permanent life-quality recession. Thus, endoscopic submucosal dissection, in the absence of a negative prognosis factors, is the method of choice in the radical treatment of colon cancer Tis-T1N0M0 due to its effectiveness and safety.

The OBJECTIVE was to improve the treatment outcomes of patients with chronic paraproctitis using the combination of minimally invasive techniques.

METHODS AND MATERIALS. The treatment outcomes of 170 patients with transsphincteric anal fistulas of cryptoglandular origin were analyzed. The duration of the disease in both groups varied within 2–34 months. The main group included 85 patients operated with a combined minimally invasive method (laser destruction of the fistulous tract with subsequent ligation and its ligation in the intersphincter space), in the control group, 85 patients underwent LIFT procedure.

RESULTS. Median follow-up for patients in the main group was 13 months, in the control group – 24 months. In the main group, relapses were registered in 10 patients (11.8 %), in the control group – in 22 patients (25.9 %). The average time for the formation of relapses in the main and control groups was 4 months. There was no clinically significant violation of the function of the rectal obturator in both groups.

CONCLUSION. The ability to combine the LIFT procedure and laser destruction of the fistulous tract allows to achieve fewer relapses compared to the isolated use of the LIFT technique in patients with transsphincteric anal fistulas.

Severe septic complications are an important clinical problem. The outcomes of sepsis treatment, not to mention septic shock, are extremely unsatisfactory. To improve outcomes, the complex approach should be used, which, according to modern ideas about management as a science of health management, should extend to the field of human, medical, technological and material resources. The article considers the sticking-points in each of these areas and, based on literature data and own experience, makes suggestions for improving the care of patients with sepsis.

The OBJECTIVE was to improve the results of surgical treatment and to reduce the incidence of postoperative vascular complications in patients after distal radial-cephalic arteriovenous fistula formation using a new method of vascular anastomosis application and cilostazol medication.

MATERIALS AND METHODS. We studied 69 patients. The comparison group included 32 patients who underwent standard treatment with distal radiocephalic fistula formation according to the generally accepted method without additional conservative treatment. The main group consisted of 37 patients in whom the fistula formation was carried out according to the proposed method, and in the postoperative period, cilostazol medication was used at a dosage of 100 mg mg twice a day for more than 2 months.

RESULTS. The main group showed smaller number of vascular complications: 12 (32.4 %) patients versus 15 (46.8 %) patients in the comparison group.

CONCLUSION. The use of the proposed surgical method for arteriovenous fistula formation in combination with the use of cilostazol in the postoperative period leads to a decrease in the incidence of vascular complications, in particular, to a decrease in the frequency of thrombosis and disorders of the arteriovenous fistula formation.

INTRODUCTION. The choice of a treatment method in patients with stages 3–4 of the esophageal achalasia remains an actual topic.

The OBJECTIVE was to evaluate the long-term results of Heller esophagocardiomyotomy with Dor hemiesophagofundoplication at stages 3–4 of the esophageal achalasia by comparing the results of patient survey with data of instrumental methods of diagnosis of esophageal function.

METHODS AND MATERIALS. The results of the operation were analyzed in 67 patients, including 35 patients with stage 3 and 32 patients with stage 4 of the disease. The period of postoperative follow-up was 1–5 years. The results of X-ray examination of the esophagus and stomach, esophageal manometry, 24-hour pH-metry and the data of the Eckardt and GIGLI scale questionnaires were evaluated.

RESULTS. The data of X-ray examination of the esophagus and stomach, in the long-term period, showed a complete restoration of the esophagus evacuation function in all patients (p=0.001), according to manometric data, a significant decrease in the tone of the lower esophageal sphincter in all patients to normal values (p=0,001) was revealed, esophageal atony was noted in three patients with stage 4 of the disease. Pathological gastroesophageal reflux before and after surgery was not registered by pH-metry, the De Meester index was within the normal range in all groups (less than 14.72). Dysphagia in the long-term period decreased in all patients. Long-term results on the Eckardt scale in patients with stage 3 improved by 83.5 %, with stage 4 by 78.3 % (p=0.001), according to the GIGLI questionnaire, patients with stage 3 scored 83.5 %, with stage 4 by 78.3 % more than before surgery.

CONCLUSION. Laparoscopic Heller esophagocardiomyotomy with Dor fundoplication reduces symptoms of the disease in patients with stages 3–4 of the esophageal achalasia, increases the gastrointestinal index of quality of life, which makes it advisable to perform organ-preserving surgery at stage 4 of the disease.

This article presents a rare clinical case of a newly diagnosed carcinoma of the nasal cavity in a young woman. The clinical symptoms of this disease are scarce, complaints are typical for most diseases of the ENT organs. The final verification of the diagnosis is possible on the basis of histological examination of the surgical material.

This article presents a clinical case of a rare pathology in urological practice – idiopathic stricture of the female urethra, considers the tactics of patient management and the method of surgical correction.

Caesarean section (cS) is one of the most common obstetric operations in the world. About 32 % of all births end by caesarean section. Postpartum infection at the surgical site, wound infection and endometritis are the main causes of long stays in maternity hospitals and are a source of additional costs for the healthcare system. In 2–16 % of cases postpartum endometritis develops. Many risk factors for the development of postpartum infections have been described. These include maternal factors (such as tobacco use, inadequate prenatal care, obesity, corticosteroid use; prematurity, multiple gestation, and uterine scar), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged anhydrous period; prolonged labor , especially a long second period; large incision of the anterior abdominal wall; subcutaneous tissue thickness more than 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; rapid labor; massive blood loss during childbirth). Effective measures to reduce the incidence of obstetric infectious complications include prophylactic use of antibiotics (preoperative preparation with first-generation cephalosporins and intravenous azithromycin), preoperative showering with chlorhexidine instead of iodine, shaving immediately before surgery, vaginal sanitation, removal of the placenta by traction of the umbilical cord, suturing of the subcutane-ous tissue, if the depth of the wound is larger than 2 cm and suturing the skin with sutures instead of using staples. Establishing an evidence-based optimal care algorithm for patients after caesarean section can reduce the incidence of serious infectious complications.

The literature data on the role of various microorganisms in the etiology of infectious and inflammatory complications in poststernotomic cardiac surgery are discussed. Their pathogens can be a wide range of gram-positive and gram-negative microorganisms, representatives of various taxa. Gram-positive bacteria dominate, in particular bacteria of the genus Staphylococcus. S. aureus and S. epidermidis cause up to 60–70 % of all infectious and inflammatory complications, and S. aureus strains, as a rule, cause more severe clinical forms of the disease (sternomediastinitis). Enterobacteriaceae and non-fermenting group are the predominant gram-negative bacteria. Among non-fermenting bacteria, P. aeruginosa more often cause the development of sternomediastinitis. In recent years, antibiotic-resistant strains, methicillin-resistant staphylococci and gram-negative bacteria producing betalactamases have increasingly become etiopathogens.

Screening allows detecting not only tumors in the early stages, but also precancerous diseases. Over the past decades, due to the introduction and implementation of screening programs in many Western countries, there has been a gradual decrease in morbidity and mortality. Several screening tests have been developed to detect and prevent colorectal cancer (CRC). These tests differ in technology, cost and object of study. At present, the stool occult blood test and fibrocolonoscopy are mainly used to detect CRC. However, the search for new non-invasive and reliable markers with high sensitivity and specificity and suitable for the early diagnosis of CRC remains an urgent task. Due to the ability of microRNAs to be present outside the formations in various biological fluids of the body and to be determined using the polymerase chain reaction (PCR), the detection of microRNAs has shown significant promise in the diagnosis and prognosis of CRC.

Professor Vladimir Ivanovich Burakovsky was born on August 20, 1922 in Tiflis (Tbilisi). In 1940, Vladimir entered the Tbilisi Medical Institute. In 1947, V. I. Burakovsky was enrolled in a clinical residency at the Department of Faculty Surgery № 2 (since 1955 – Department of Surgery for Advanced Doctors № 1) Military Medical Academy named after S. M. Kirov in Leningrad. In the spring of 1960, Vladimir Ivanovich was accepted as a senior researcher at this Institute and appointed the head of the Department of Surgery of the heart and blood vessels in children. Vladimir Ivanovich was the author and co-author of more than 500 scientific papers, including 15 monographs: on the issues of pathophysiology, clinic, diagnosis and surgical treatment of congenital and acquired heart defects and major vessels, heart diseases in young children, complications after open heart surgery, surgery of complex congenital defects and coronary heart disease, heart defects with pulmonary hypertension, the use of hyperbaric oxygenation in cardiac surgery, surgical treatment of coronary disease, heart transplantation in experiment, history and philosophy of cardiac surgery. In 1970, «for the best scientific work on thoracic surgery», Vladimir Ivanovich was awarded the title of laureate of the S. I. Spasokukotsky Prize of the USSR Academy of Medical Sciences (together with B. A. Konstantinov). Academician Vladimir Ivanovich Burakovsky died on September 22, 1994 in Moscow and was buried at the Kuntsevo cemetery. The Institute of cardiac Surgery of the Federal State Budgetary Institution «A.N. Bakulev National Medical Research center of cardiovascular Surgery» (A. N. Bakulev NMRcVS) of the Ministry of Health of the Russian Federation bears his name, in which a bust of his creator is installed.