An outstanding anatomist and surgeon, scientist and teacher, talented artist, Privy Councilor, Honored Professor and Academician of the Imperial Medical-Surgical Academy, Honorary Member of the Medical Council of the Ministry of Internal Affairs, Academician of the Imperial Academy of Arts, Doctor of Medicine and Surgery, Professor Ilya Vasilyevich Buyalsky was born on July 26 (August 6, new style), 1789 in the village of Vorobyovka, Novgorod-Seversky district, Chernigov province, in a family of noble origin. After graduating from the Imperial Medical-Surgical Academy in 1814, I. V. Buyalsky received the position of prosector at the Department of Anatomy under the direction of Professor P. A. Zagorsky. In 1817, he was appointed associate Professor of Anatomy. In 1823, he presented a treatise «Some Circumstances Determining the Pathology and Therapy of Aneurysms» at the Academy conference and, after a public defense, he was awarded the academic degree of Doctor of Medicine. At the same time, the detailed description and corresponding report at the conference on 210 complex surgical interventions he performed served as the basis for receiving the degree of Doctor of Surgery. In 1825, I. V. Buyalsky was elected extraordinary, and in 1831, ordinary Professor of the department of Anatomy of the Imperial Medical-Surgical Academy (he headed the department from 1833 to 1844) and consultant of the Mariinsky Hospital (1831–1864). From 1833, he served as surgeon of the Tsarskoye Selo Lyceum, and from 1835 – chief doctor of all cadet corps. Since 1829, I. V. Buyalsky was the head of the St. Petersburg Surgical Instrumental Plant, which produced various instruments for doctors. In 1828, I. V. Buyalsky published an outstanding work «Anatomical and surgical tables explaining the operations of ligation of large arteries», which became the first domestic atlas on topographic anatomy and operative surgery, combining educational and practical manuals. Later, two more volumes of the atlas were published, devoted to other topics of topographic anatomy and surgery (1835 and 1852). I. V. Buyalsky stood at the origins of teaching plastic anatomy in our country. Having a natural inclination towards fine arts, Ilya Vasilyevich became a Professor of Anatomy at the Imperial Academy of Arts in 1831, and in 1842, he was the first Russian physician to be elected its Academician. In 1837, he published a lithographic manual «Anatomy for Painters and Sculptors». I. V. Buyalsky is one of the founders of forensic medicine. Professor Ilya Vasilyevich Buyalsky died on December 8 (20 according to the new style), 1866 and was buried at the Bolsheohtinskoe Cemetery in St. Petersburg.

INTRODUCTION. The frequency of parastomal hernias reaches 58 % and occurs with any type of stoma.

The OBJECTIVE was to analyze the results of open retromuscular prosthetic repair of the abdominal wall with posterior separation of components in the treatment of parastomal hernias.

METHODS AND MATERIALS. Between 2019 and 2023, 11 patients with end colostomies and parastomal hernias were operated on. The median age of patients was 72 years. There were 10 women, 1 man. According to the classification of the European Society of Herniology (2014), the distribution was as follows: type I – there were no patients, type II – 1 patient, type III – 5 patients, type IV – 5 patients. One patient had a recurrent parastomal hernia. All patients underwent open retromuscular prosthetic repair of the abdominal wall with posterior separation of components and formation of a colostomy in the same place.

RESULTS. The treatment results were studied in 10 patients. There was fatal outcome in 1 patient with a type IV parastomal hernia due to infection with the development of necrotizing fasciitis and cellulitis of the abdominal wall. In one case, necrosis of the colostomy occurred, which required laparoscopic mobilization and re-formation of the colostomy. Long-term results were monitored in 9 patients over a period of 1 to 4 years. Recurrence occurred in 4 patients: 1 patient with type III parastomal hernia and 5 patients with type IV (two patients had 2 relapses). With repeated relapses, in one case, there was a pinching of the section of the small intestine in the paracolostomy opening

CONCLUSION. The results of treatment of parastomal hernias in our clinic were largely disappointing. Some success can be noted only in the treatment of type III parastomal hernias.

The OBJECTIVE was to identify risk factors for anastomotic leakage following McKeown esophagectomy.

METHODS AND MATERIALS. From January 1, 2016 to December 31, 2022, in our clinic, a total of 69 patients with stage I–III esophageal cancer were operated with McKeown esophagectomy performed in a fully open approach (thoracotomy, laparotomy, cervicotomy). The characteristics of the studied patients were evaluated according to a standardized protocol. Statistically significant factors influencing the development of anastomotic failure were determined.

RESULTS. The frequency of anastomotic leakage was 13/69 (18.4 %). Mortality due to anastomotic failure occurred in 3 (23 %) patients; while in the non-failure group, there were 4 (7.1 %) fatalities. The average postoperative hospital stay was 11.57±3.71 days in the non-leakage group and increased to 25.42±8.12 days in the leakage group (p=0.001). Univariate analysis revealed that the presence of diabetes mellitus, postoperative blood transfusions, and higher than Grade III chronic kidney disease significantly influenced anastomotic integrity. These factors were selected for multiple logistic regression analysis. In multivariable logistic regression only chronic kidney disease and diabetes mellitus were confirmed as significant risk factors for anastomotic failure; Type III and IV failures occurred in 5/13 (38.5 %) patients resulting in death for three individuals (23 %).

CONCLUSIONS. In univariate analysis, diabetes mellitus, chronic kidney disease and perioperative blood transfusion were recognized as statistically significant risk factors associated with anastomotic leakage following McKeown esophagectomy. Unsatisfactory outcomes occurred with leakage type III and IV.

The OBJECTIVE was to study the short-term results of surgical treatment of patients with brachial artery injury in peacetime upper limb injury.

METHODS AND MATERIALS. This study presents the short-term results of surgical treatment of 61 patients with brachial artery injury in peacetime upper limb injury. The study included 33 patients who were admitted to the City Hospital of St. Martyr Elizabeth in St. Petersburg from 2011 to 2022 and 28 patients who were admitted to Hospitals in the Leningrad Region from 2017 to 2022.

RESULTS. All 61 patients underwent emergency surgery: autovenous prosthetics of the brachial artery was performed in 46 patients, an end-to-end anastomosis was formed in 10 patients, and a lateral suture was applied to 5 patients. In the early postoperative period, there were 3 thrombosis of the reconstruction zone, 1 amputation of a limb, 1 fatal outcome from severe blood loss.

CONCLUSION. Upper limb injury with brachial artery injury without specialized assistance can lead to disability and even death of a patient, therefore requires emergency intervention by a vascular surgeon to stop bleeding, restore the main blood flow and stop limb ischemia.

The OBJECTIVE was to evaluate the effectiveness of the use of preoperative transthoracic insertion of an «anchor mark» as a marker of a small intra-pulmonary pathological site for performing atypical videothoracoscopic resection (biopsy).

MATERIALS AND METHODS. The study included 15 patients with solitary peripheral lung neoplasms of small diameter (8 [6; 10] mm). All neoplasms were located in the intermediate zone of the pulmonary parenchyma.

RESULTS. In 9 (60 %) patients, according to cito-biopsy data, tumor cells were detected in the studied preparation, which served as a reason for performing endovideosurgical anatomical lung resection – lobectomy, in 2 (13.3 %) patients, hamartoma was detected and, thus, atypical lung resection proved to be a sufficient volume of surgical intervention, in 4 (26.7 %) patients, areas of local pneumofibrosis were verified, which made it possible to complete surgery at the diagnostic stage. The average duration of marking of the pathological focus was 25 minutes, atypical videothoracoscopic lung resection was 30 minutes. There were no access conversions.

CONCLUSION. Preoperative transthoracic marking by means of the «anchor marks» system is a safe and highly effective navigation method for atypical resection (videothoracoscopic biopsy) of small-diameter lung neoplasms.

Urinary bladder leiomyoma is an extremely rare type of benign urinary bladder formation. So according to the literature, only 250 cases of pathology are known. The article presents a clinical case of a rare clinical observation of a benign tumor originating from the urinary bladder smooth muscle. Successful treatment is described.

Esophageal cancer is an oncological disease with a poor prognosis due to late diagnosis and detection of the tumor at a late stage. At present, the combined method of treatment is generally accepted for this pathology, starting from stage IIA. Preoperative chemoradiation therapy in this approach helps to achieve not only partial but also complete regression of the tumor. The question of the necessity of surgical tactics in this group of patients, due to the lack of clear recommendations, remains controversial at present. The article presents a successful case of neoadjuvant chemoradiation therapy, which made it possible to achieve not only clinical, but also complete pathomorphological regression of the tumor. This tumor response to chemoradiation therapy occurs in less than a third of all patients with esophageal cancer. Despite this, complete regression of the tumor does not mean recovery.

The OBJECTIVE of this study was to demonstrate and original clinical case of an appendiceal mucocele, complicated by intussusception in a 45-year-old female patient.

METHODS AND MATERIALS. We present a rare clinical case of appendiceal mucocele in a female patient, complicated by partial intussusception into the caecum. Diagnostic laparoscopy was performed, followed by laparotomy with reduction of the intussusception and an atypical appendectomy.

RESULTS. In this article we present a review of the literature and analyze our clinical case. Treatment result was positive, postoperative period was uncomplicated. This patient was followed up for year postoperatively.

INTRODUCTION. The issue of a relapse-free treatment in herniology has not yet been resolved. Over the past few years due to the development and wider use of modern technologies, there has been an improvement in the quality of surgical care for patients with inguinal hernias. Approaches to preparation for surgical interventions, redistribution of surgical options and postoperative management of patients have also changed significantly.

The OBJECTIVE of this work was to determine modern aspects of the treatment of patients with inguinal hernias and the effectiveness of various methods of surgical treatment in herniology, as well as to identify differences due to statistical heterogeneity in research results.

METHODS AND MATERIALS. More than 2,000 domestic and foreign publications on the surgical treatment of inguinal hernias were subjected to preliminary analysis. Taking into account the inclusion and exclusion criteria, the review included 10 scientific studies published in domestic and foreign scientific journals from 2014 to 2022. We analyzed 2649 cases of surgical treatment of patients with inguinal hernias, assessing the results of treatment and the clinical effectiveness of various methods.

RESULTS. When comparing methods of operations, the best results in terms of the frequency of relapses and the frequency of specific complications were obtained with transabdominal preperitoneal plastic surgery of inguinal hernias. The worst results in terms of the frequency of relapses were demonstrated by total extraperitoneal plastic surgery, in terms of the frequency of specific complications, the highest percentage belongs to Liechtenstein hernia repair. Taking into account the heterogeneity of patients in the studies, we can conclude that the use of transabdominal preperitoneal plastic surgery is a priority.

CONCLUSION. The overall effectiveness of treatment of patients with inguinal hernias has significantly improved using modern principles of evidence-based medicine, standardized approaches to the management of surgical patients and the prevention of possible complications. Endovideosurgical operations widely introduced into practice all over the world have shown the best results in assessing the risk of relapses and specific postoperative complications. However, compared to other methods, the share of endovideosurgical operations is a smaller percentage.

The OBJECTIVE of the study was to analyze specialized publications concerning the tactics of rehabilitation treatment of patients after total knee and hip replacement based on the Fast-track protocol.

METHODS AND MATERIALS. We presented a systematic review of current literature, including 80 publications with a search depth of up to 45 years.

RESULTS. Components of the enhanced recovery program for large joint replacement are as follows: Preoperative stage: patient education, extremity joint exercises with a rehabilitation specialist, breathing exercises, avoidance of premedication with opioid analgesics, oral multimodal analgesia, preoperative oral carbohydrate load, absence of fluids in the oral cavity 2–3 hours before surgery, avoidance of preoperative fasting. Intraoperative stage: spinal or combined anesthesia, the use of regional anesthesia, intravenous dexamethasone, the use of tranexamic acid, intraoperative avoidance of excessive intravenous administration of colloid and crystalloid solutions, active intraoperative warming. Postoperative stage: multimodal oral analgesia, early mobilization (6–12–24 hours after surgery), passive-active exercises for 12–24 hours after surgery, preparation for verticalization.

CONCLUSION. The most popular hardware methods are mechanotherapy, cryotherapy, laser therapy, magnetic therapy and electrical neuromyostimulation. The introduction of computer technology into the postoperative rehabilitation program after large joints replacement makes it possible to restore an individual gait stereotype. A potentially promising direction is the introduction of artificial intelligence into early rehabilitation methods.