An outstanding surgeon, a prominent scientist, a teacher, a talented leader, Academician of the USSR Academy of Medical Sciences (1967), Academician of the Russian Academy of Sciences (1991), Winner of the Lenin Prize (1961), winner of the international prize of the Holy All-Laudable Apostle Andrew the First-Called and the Center of National Glory of Russia «For Faith and Fidelity» with the award of the Order of Andrew the First-Called on a blue moire ribbon (2003), laureate of the Academician A. N. Bakulev Prize (2004), Professor Fyodor Grigorievich Uglov was born on October 5, 1904 in the village of Chuguevo, Kirensky district, Irkutsk region. In 1923, Fyodor Grigorievich entered Irkutsk University, then transferred to Saratov University and graduated with honors in 1929. He studied at the internship at the clinic of Professor V. A. Oppel (1931–1933). In 1937, he entered the postgraduate course of the Department of Surgery of the Leningrad State Institute for Advanced Medical Training named after S. M. Kirov. He defended his PhD thesis in 1939 and his doctoral dissertation in 1949. Fyodor Grigoryevich Uglov worked at the Department of the Academician N. N. Petrov until 1950. The next 58 years of Fyodor Grigoryevich’s working activity was associated with the Medical University named after Academician I. P. Pavlov (1 LMI, Pavlov University). During this period of time, he performed unique operations, developed new methods of surgical treatment of diseases in almost all sections of surgery. Being an excellent teacher, Fyodor Grigoryevich Uglov brought up excellent surgeons. Many of them became doctors of sciences, academicians, and heads of surgical departments. Fyodor Grigoryevich also founded a bright school of thoracic and cardiac surgeons.. Academician F. G. Uglov died on June 22, 2008 and was buried on June 25, 2008 at the Nikolsky Cemetery at the Alexander Nevsky Lavra in St. Petersburg.

The OBJECTIVE was to improve the results of surgical treatment of morbid obesity by reducing the frequency of postoperative complications.

METHODS AND MATERIALS. The research is based on the studying the results of surgical treatment of 149 morbidly obese patients. The patients were divided into retrospective (49 patients) and prospective (100 patients) groups.

RESULTS. Among the patients of the retrospective group (n=49), a statistical analysis of the effectiveness of using various scales and indices for predicting the risk of complications of bariatric interventions was carried out. The analysis revealed the low efficiency of currently available tools for predicting the risk of complications in this category of patients. The totality of prognostically important factors and their ratings were integrated into the original «Individual Risk Assessment Scale for Bariatric Surgery». The results obtained during the study made it possible to integrate the developed tactics of preoperative examination and preparation for surgical intervention in morbidly obese patients into a practical algorithm. Application of the developed tools for predicting the risk of complications in bariatric surgeries allowed to reduce the complication rate from 12.2 % to 2.0 %, and the mortality rate from 2.0 % to 0 %.

CONCLUSION. The use of the developed tools for predicting the risk of complications of bariatric surgery improves results by reducing the frequency of complications in the early postoperative period, which in turn expands the capabilities of using metabolic surgery for patients at high surgical risk, including those over 60 years of old.

INTRODUCTION. Currently, the choice of tactics in the treatment of esophageal cancer remains an urgent problem. Important factors are: the stage of the disease, the functional state of the patient, as well as the morphological type of tumor. An integrated approach is today the standard for this pathology. However, after radical treatment, a significant number of complications are observed, in particular, the development of leakage of esophagogastroanastomosis. Today, according to world literature, it is generally accepted that the development of anastomotic leakage is associated with the detection of the disease in late stages, the consequences of radiation during combined chemoradiotherapy, and extensive surgical intervention for esophageal cancer.

The OBJECTIVE was to improve the results of treatment of patients with malignant neoplasms of the esophagus and esophagogastric junction, through the use of an integrated approach.

METHODS AND MATERIALS. During the period of 1988–2022, treated 2784 patients with cancer of the esophagus and esophagogastric junction were treated at the Republican Clinical Oncology Dispensary named after Prof. M. Z. Sigal. The study group included 1,799 patients who received surgical treatment, combined chemoradiotherapy in combination with surgery, and external beam radiation therapy in combination with surgery.

RESULTS. Due to changes in treatment tactics for patients with cancer of the esophagus and esophagogastric junction, postoperative mortality after surgical complications decreased from 24.3 % to 6.2 %, and anastomotic leakage in the postoperative period decreased from 27.0 % to 8.1 %.

CONCLUSION. Changes in the treatment of patients with cancer of the esophagus and esophagogastric junction made it possible to reduce the development of postoperative complications and increase life expectancy. The molecular genetic approach allows for effective analysis of screening, early diagnosis, treatment and rehabilitation.

The OBJECTIVE was to compare efficiency of the use of various types of conduits during coronary artery bypass grafting (CABG).

METHODS AND MATERIALS. The retrospective study included 282 patients, who underwent CABG, performed with different types of conduits. The average age of the patients was 63.2±8.5 years; the majority of 231 patients (81.9%) were male. Patients were separated in 3groups depending on the use of conduits: the first one included patients after bimammary coronary artery bypass grafting (n=77); the second one involved coronary artery bypass grafting using radial artery(n=87); the third one included patients with venous conduits (n=77). The main endpoint of the study was the development of conduit dysfunctions in the long-term period according to diagnostic coronary artery bypass grafting.

RESULTS. The average follow-up time in the long-term period was 44.9±39 months. During this period, 198 patients underwent diagnostic coronary artery bypass grafting. According to the results of the analysis, the greatest effectiveness was observed in groups using arterial conduits – the left internal thoracic artery and radial artery. For example, the incidence of dysfunction of the left internal thoracic artery in the anterior artery basin was 8.2%; the incidence of dysfunction of radial artery in the right artery basin was 12.5 %, and in the obtuse marginal branch basin – 11.5 %; while the incidence of venous conduits’ dysfunction varied, reaching its maximum of 42.8 %.

CONCLUSIONS. Thus, the greatest efficiency was observed when using the left and the right internal thoracic arteries, thereafter by the radial artery. The results of using venous conduits were lower.

INTRODUCTION. The method of laparoscopic fundoplication for hiatal hernia is today the most common surgical intervention for this pathology. However, there are a significant number of complications, one of the most severe is relapse of the disease. Today, according to the world literature, there is not enough information about the causes of relapse, methods of prevention and long-term postoperative results of reconstructive operations.

The OBJECTIVE was to analyze of reconstructive surgeries in patients who underwent surgery for gastroesophageal reflux disease associated with hiatal hernia.

METHODS AND MATERIALS. The work was performed on the basis of data from two clinics – Oncology Department ¹ 2 of the RCOD of the Ministry of Health of the Republic of Tatarstan and Thoracic Department ¹ 2 of the RCB of the Ministry of Health of the Republic of Tatarstan. 1,661 laparoscopic interventions were performed in patients with hiatal hernia. The basis of the work is the analysis of reconstructive operations in 99 patients.

RESULTS. The most common reasons for reconstructive operations were relapses of diseases in gastroesophageal reflux disease associated with a hiatal hernia: destruction and (or) migration of the fundoplication cuff – 77 (77 %) cases, recurrence of paraesophageal hiatal hernia – 10 (11 %). Reconstructive surgery in patients with relapse of hiatal hernia remains the method of choice and leads to positive results in 83 % of cases.

CONCLUSION. Surgical treatment of hiatal hernia should be carried out in a specialized hospital and experienced surgeons who own both laparoscopic and open methods of treating this pathology.

The OBJECTIVE was to develop a diagnostic algorithm in oncologic patients with pulmonary hemorrhage.

METHODS AND MATERIAL. A retrospective single-center study of the medical records of 258 patients who met the inclusion criteria was conducted. Inclusion criteria: age over 18 years, oncologic disease of the chest organs complicated by pulmonary hemorrhage. Inclusion criteria: age over 18 years, oncologic disease of the chest organs complicated by pulmonary hemorrhage. Exclusion criteria: age under 18 years, pulmonary hemorrhage of non-oncologic etiology. Pulmonary hemorrhage was considered to be the discharge of any volume of fresh blood or clots from the tracheobronchial tree, which was determined on the basis of anamnesis, clinical manifestations in the hospital, endoscopic examination. Routine diagnostic methods of investigation, such as chest radiography, chest computed tomography (including with contrast enhancement), fibrotracheobronchoscopy, bronchial arteriography were evaluated.

RESULTS. The sensitivity for diagnosing the oncologic process in chest radiography, computed tomography, and fibrotracheobronchoscopy, was 84.7 %, 98.4 %, and 94.4 %, respectively. The sensitivity of fibrotracheobronchoscopy to detect the bleeding itself in oncologic patients reached 31.3 %, and the sensitivity of bronchial arteriography to diagnose the source of bleeding was 87.7 %.

CONCLUSION. In pulmonary hemorrhage of oncologic genesis, the combination of fibrotracheobronchoscopy with computed tomography has sensitivity in 100 % of cases in determining the source and localization of the pathological process. Bronchial arteriography allows to perform endovascular hemostasis. It is necessary to conduct multicenter studies in order to develop and implement a unified algorithm assessing all etiopathogenetic features of pulmonary hemorrhage in oncologic patients.

INTRODUCTION. Currently, there are no uniform algorithms for surgical tactics of conversion hip arthroplasty.

The OBJECTIVE was to evaluate the mid-term results of conversion hip arthroplasty in patients with adverse effects of proximal femoral fractures.

METHODS AND MATERIALS. A retrospective study of the treatment results of 58 patients who underwent conversion hip arthroplasty was conducted. All patients underwent bacteriological examination before and during surgery, blood tests for ESR and CRP. Patients were divided into two groups: Group 1 (low risk of infections) – 29 patients in one stage, group 2 (high risk of infections) – 29 patients with a two-stage technique using a cement spacer. Randomization criteria: positive preoperative culture, elevated CRP (>10 mg/L) and ESR (>30 mm/hour). Efficacy was assessed using the visual analogue pain scale and Oxford Hip Score after 6, 12 and 24 months, as well as the frequency and nature of complications.

RESULTS. The average age of patients was 58.7 years. The average follow-up period was 4.5±1.3 years. The average surgery time – 115 minutes in group 1 and 100 minutes in group 2. The average blood loss was 650±123 ml in group 1 and 630±108 ml in group 2. Pain syndrome according to the VAS scale after 6, 12 and 24 months was 2.5–1.2–1.2 points in both groups, respectively (p=0.001). Periprosthetic hip fracture occurred in 7 cases (12 %); dislocation – in 1 case (1.7 %); deep infection – 3 patients (5.1 %); aseptic loosening – in 2 cases (3.4 %). Revision arthroplasty was required in 5 cases (8.6 %).

CONCLUSION. The mid-term results of conversion arthroplasty are significantly lower compared to the results of primary arthroplasty. Conversion is associated with a higher number of intraoperative hip fractures and infections. The use of a two-stage conversion technique with temporary installation of a cemented spacer allows to reduce the number of infectious complications after the final arthroplasty by 3 times.

Bullet wounds to the heart on the battlefield are quite rare. The victims usually die in the near future after being in[1]jured. The injuring agent most often pierces through the heart, thereby causing massive bleeding and cardiac arrest. All rare, unique cases when the wounded remained alive are associated either with the loss of kinetic energy of the injuring agent when the defeat occurs at the limit of flight range, or with a «behind the barrier» defeat when a bullet or fragment initially penetrates the «barrier» (armor, vehicle, ricochet from weapons or other solid objects, etc.). Injuries, when a bullet hits the shoulder, ricochets off the bones of the skeleton or spine and hits the heart, are found in isolated cases.

In the presented clinical observation, the combatant was wounded in the left shoulder. At the stages of medical evacuation, a chest injury with heart damage and the presence of a foreign body was revealed. Initially, the wound proceeded without hemodynamic disorders, and only 36 hours after the injury, the first symptoms of a violation of the cardiovascular system appeared. As a matter of urgency, the wounded man was transferred by the intensive care team to a specialized cardiac surgery department, where emergency surgery was performed in conditions of artificial circulation. The postoperative period was smooth. The victim is currently receiving rehabilitation treatment. Heart injuries in combat conditions are highly relevant and are an extremely serious problem of the medical service at all stages of evacuation, diagnosis and treatment. The difficulties in diagnosing heart wounds are associated with the lack of the necessary hardware and diagnostic base near the line of contact and the extremely rapid development of the terminal condition. High mortality rates are due to acute cardiac disorders (cardiac tamponade, damage to the coronary arteries, massive bleeding). Subjective signs of cardiac injuries are often absent due to the admission of such a category of patients in an unconscious state. In this clinical case, timely diagnosis at the stages of medical care and interdisciplinary interaction made it possible to urgently refer a victim with a brachiothoracic bullet wound to the stage of specialized care.

The OBJECTIVE of this article was to present a clinical demonstration of the successful experience of using minimally invasive surgical treatment of a patient with primary hyperparathyroidism (PHPT) by percutaneous microwave ablation (MWA) of parathyroid adenoma, under ultrasound guidance. This method provides maximum effectiveness with minimal invasiveness, a shorter recovery period after surgery, and a better cosmetic effect. After the minimally invasive intervention, the patient had complaints related to hypocalcemia, which develops practically after any form of radical PHPT treatment. No other complications were observed. Further dynamic observation was carried out by an endocrinologist at the place of residence. The obtained positive results demonstrated a good perspective of PHPT treatment by using MWA.

Acute traumatic pancreatitis is one of the etiological forms of acute pancreatitis, the main cause of the development of which is mechanical trauma to the pancreas. A clinical case of successful treatment of a patient with acute traumatic pancreatitis developed as a result of a shrapnel thoracoabdominal injury with pancreatic damage and its complications using a multidisciplinary approach is presented. The possibilities of implementing the tactics of “damage control” at all stages of medical care are demonstrated.

The single ventricle is a group of congenital heart defects, which even today remains the most difficult for surgical treatment and further patient care. The survival rate of patients with this defect remains relatively low despite a number of staged surgical interventions. A large percentage of mortality is observed in the interstage period due to the development of heart failure, the treatment of which is an urgent problem because standard therapy does not meet expectations. This article reviews the world literature on the application of an innovative method of heart failure correction – stem cell therapy. The main types of stem cells, their sources, mechanism of action, methods of their delivery to myocardium are also considered.

The article provides a review of modern literature on the problem of treatment of cholelithiasis complications and endoscopic transpapillary interventions. The pathogenetic mechanisms of these complications were analyzed. Studies on the impact of the timing of laparoscopic cholecystectomy after endoscopic transpapillary interventions show that the risk of recurrent biliary complications increases significantly in patients when cholecystectomy was delayed, while early performance of this operation after endoscopic transpapillary interventions reduces the risk of developing these complications

A prominent Soviet surgeon, a well-known specialist in the field of topographic anatomy, operative and military surgery, a talented scientist and teacher, academician (1963) and vice-president (1966) of the USSR Academy of Medical Sciences, honored scientist of the RSFSR (1965), laureate of the USSR State Prize, Rector of the 1st MMI named after I. M. Sechenov (1956–1966), Professor Vladimir Vasilievich Kovanov was born on March 13 (February 28, old style) 1909 in St. Petersburg into a working-class family. In 1931, V. V. Kovanov graduated from the 1st Moscow Medical Institute and continued his postgraduate studies at the Department of Pathological Anatomy under the guidance of Professor A. I. Abrikosova. For medical reasons, he changed his specialization and moved to the Department of Surgery, headed by Academician N. N. Burdenko. During the Great Patriotic War, he worked as a surgeon in a triage hospital in Yaroslavl, in an evacuation hospital in Kazan, then served as the head of the surgical department of the field mobile hospital of the 5th shock army, the chief surgeon of the 44th army and the chief surgeon of the 28th army, in whose ranks he reached to Berlin with the rank of lieutenant colonel in the medical service.

In 1946, V. V. Kovanov defended his doctoral dissertation and in 1947, took the position of head of the department of operative surgery and topographic anatomy of the 1st Moscow Medical Institute named after I. M. Sechenov (1947–1988), from 1956 to 1966, was the rector of this institute, since 1988 – consulting professor. Vladimir Vasilievich was the author and co-author of more than 130 scientific works, including 7 monographs and manuals. His main works were devoted to the treatment of chest wounds, anaerobic infection, traumatic shock, the organization of surgical work in the military area, the anatomy of fascia and cellular spaces, surgery of the heart and blood vessels, organ and tissue transplantation.

V. Kovanov was awarded two Orders of Lenin, the Order of the Red Star, the Order of the Red Banner, two Orders of the Patriotic War of the 1st degree, two Orders of the Patriotic War of the 2nd degree, the Order of the October Revolution, the Order of the Red Banner of Labor, six medals, and many badges of honor. Academician of the USSR Academy of Medical Sciences V. V. Kovanov died on February 22, 1994 in Moscow and was buried at the Troekurovskoye cemetery.