An outstanding urological surgeon and nephrologist, a talented scientist and teacher, a major healthcare organizer, the founder of the largest domestic school of urologists and nephrologists, Hero of Socialist Labor (1978), Academician of the USSR Academy of Medical Sciences (1974) and the Russian Academy of Medical Sciences (1992), Honored Scientist of the Russian Federation (1998), three-time laureate of the USSR State Prize (1971, 1984, 1990), laureate of the USSR Council of Ministers Prize (1981), chief urologist of the USSR and Russian Ministry of Health, Chairman of the All-Union and Russian Societies of Urologists (1972–2012), Professor Nikolai Alekseevich Lopatkin was born on February 18, 1924 in Moscow into a doctor’s family. In 1941, he entered the 1st Moscow Medical Institute named after I. M. Sechenov, from which in 1943 he was transferred to the 2nd Moscow Medical Institute named after N. I. Pirogov. In 1947, he graduated from the Faculty of Medicine and was enrolled in residency at the Department of Faculty Surgery of the 2nd Moscow Medical Institute, which he successfully completed in 1950 and was elected to the position of assistant of the Department. In 1953, he defended his candidate’s dissertation and in the same year was transferred to the Department of Urology of the 2nd MMI, where under the supervision of the Professor A. Ya. Pytel, he worked as the assistant, Associate Professor and Professor of the Department, and in 1967, he was elected the head of the Department of Urology and Surgical Nephrology. In 1959, he defended his doctoral dissertation “Renal Angiography”. He introduced general anesthesia with tracheal intubation and artificial ventilation into urological practice, as well as numerous cutting-edge methods of diagnosing and treating urological diseases. In 1958, together with A. Ya. Pytel, he was the first in our country to use the “artificial kidney” apparatus, and later took direct part in organizing hemodialysis departments in urological clinics in the USSR. In 1972, Nikolai Alekseevich organized the All-Union Society of Urologists of the USSR, which he headed until 1991, and was the chairman of the Russian Society of Urologists until 2012. For many years, he served as the chief urologist of the USSR Ministry of Health. On the initiative of N. A. Lopatkin, the Research Institute of Urology of the USSR Ministry of Health was created in Moscow, which he headed from 1979 to 2007. Nikolai Alekseevich was the author and co-author of more than 800 scientific and scientific-practical works, including 40 monographs, manuals and textbooks. Under his supervision, 25 doctoral and about 50 candidate dissertations were defended. Academician N.A. Lopatkin died on September 16, 2013 and was buried at the Vagankovo Cemetery in Moscow.

INTRODUCTION. One of the important problems in cardiovascular surgery is the multilevel lesions of the lower extremity arteries. We presented the results of treatment of multilevel arterial lesion.

METHODS AND MATERIALS. We analyzed the treatment results of 90 patients with combined lesions of the aortofemoral and femoral-popliteal segment of type TASC C and D. The patients were divided into 2 groups and 2 subgroups. Group 1 consisted of patients who underwent combined multilevel interventions, in turn, group 1 was divided into 2 subgroups according to the type of interventions. Group 1A – closed remote endarterectomy (RE) from the iliac arteries + femoral-popliteal (tibial) bypass surgery. Group 1B – aorto (iliac) – femoral bypass + RE from the arteries of the femoral-popliteal segment. Group 2 consisted of patients who underwent combined aorto (iliac) femoral + femoral-popliteal (tibial) bypass surgery.

RESULTS. There were no registered cases of shunt thrombosis in the early postoperative period in group 1, whereas in group 2, both aorto-femoral and femoral-popliteal shunt thrombosis occurred in three cases (12%) in the early postoperative period. In group 1, 1 episode of bleeding was registered that required revision, in group 2, no bleeding was registered. In groups 1 and 2, 1 case of myocardial infarction (MI) was registered in the early postoperative period (p=0.301), one patient in group 2 had a stroke with regression of symptoms in the postoperative period. There were no deaths or amputations in the early postoperative period in group 1. In group 2, two patients (8%) underwent amputation in the early postoperative period, one patient died in the postoperative period. The primary patency in group 1A by 12, 24 and 60 months was 95 %, 76 % and 63 % respectively, in group 1B by 12, 24 and 60 months was 86 %, 86 % and 81 %, respectively, in group 2 by 12, 24 and 60 months was 100 %, 100 % and 85 %, respectively (p=0.368). Secondary patency in group 1A by 12 months was 77 %, by 24 months was 77 % and by 60 months was 52 %. In group 1B – by 12 months – 100 %, by 24 months – 67 %. In group 2 – by 12 months and 24 months – 50 % (p =0.983).

CONCLUSIONS. Thus, if it is impossible to perform hybrid procedures, combined interventions for multi-level lesions of lower extremity arteries is an acceptable alternative to multi-level bypass. There was no difference in long-term patency between the compared methods of interventions, but the presence of fatal complications in the group of multilevel bypass indicates the advantage of a less invasive approach.

The OBJECTIVE was to compare the immediate and long-term results of surgical treatment of patients with De Bakey type I versus De Bakey type II acute aortic dissection.

METHODS AND MATERIALS. We analyzed the immediate and long-term (5 years) results of surgical treatment of 136 patients with acute aortic dissection, operated on at the Samara Regional Clinical Cardiology Dispensary named after V. P. Poliakov from 2014 to 2022. Patients were divided into two groups: 1 (116 patients) – De Bakey type 1 dissection, 2 (20 patients) – De Bakey type 2 dissection.

RESULTS. Hospital mortality was significantly higher in group 1 (24.1 % and 5 % in groups 1 and 2, respectively, p–0.05). Independent risk factors for hospital mortality in patients with acute aortic dissection were: De Bakey type I dissection, body mass index>30.2 kg/m2, arterial hypertension, critical preoperative condition, acute renal failure, history of aortic surgery, duration of artificial circulation and circulatory arrest. The five-year survival rate of patients discharged from the hospital did not differ significantly (88 % and 74 % in groups 1 and 2, respectively, p-0.26). Five-year freedom from reoperations in group 1 – 89 %, in group 2 – 100 %, p = 0.3. Negative remodeling of the descending aorta in the long-term period occurred in 73 % of group 1; in group 2, remodeling of the descending aorta was positive or stable (p < 0.001).

CONCLUSIONS. De Bakey type 1 aortic dissection is associated with a higher risk of hospital mortality in patients after surgical treatment, compared with patients with De Bakey type 2 aortic dissection. Five-year survival rate, as well as freedom from reoperation on the aorta in patients discharged from the hospital, does not depend on the type of dissection.

The OBJECTIVE of the study was to improve the results of surgical treatment of patients with acute obturation intestinal obstruction of tumor and non-tumor origin by improving the algorithm for perioperative diagnosis and treatment of complications.

METHODS AND MATERIALS. A single-center retrospective-prospective study of the results of treatment of patients with acute obturation intestinal obstruction (n=249) was conducted. The comparison group (n=125) was represented by a retrospective sample of patients whose examination and surgical treatment were carried out in accordance with the established procedure for providing medical care. Observation group (n=124): patients whose examination and surgical treatment were supplemented by assessment of the degree of compensation for acute obturation intestinal obstruction, the use of specialized scales, computer monitoring of intra-abdominal pressure and intraoperative assessment of microcirculation in the wall of the colon in patients with acute obturation intestinal obstruction (AOIO) using original methods.

RESULTS. In the observation group, the time from admission to the hospital to surgical treatment was less than in the comparison group and amounted to 6.00 (Q1–Q3: 4.00–8.00) hours and 10.00 (Q1– Q3: 6.00–12.00) hours, respectively, (p <0.0001), mainly due to patients with a subcompensated form. Mortality in patients with acute obturation intestinal obstruction of tumor origin in the observation group was 11 (12.94 %) patients, in the comparison group – 16 (18.18 %) patients; non-tumor origin in the observation group – 8 (20.51 %), comparison – 10 (27.03 %) patients. Based on the conducted studies, an algorithm for perioperative diagnosis and treatment of complications was proposed.

CONCLUSION. The differentiated choice of surgical tactics for acute obturation intestinal obstruction makes it possible to optimize the timing of surgical intervention, reduce the number of postoperative complications, as well as mortality in patients with acute obturation intestinal obstruction of tumor and non-tumor origin.

The article is devoted to the diagnosis of the anastomotic failure of the initial sections of the gastrointestinal tract. A diagnostic method is proposed that allows to objectively determine the presence of components of the contents of the gastrointestinal tract outside its lumen.

The OBJECTIVE was to study the effect of obesity on the severity of acute pancreatitis (AP), its outcome and complications.

METHODS AND MATERIALS. The study included 212 patients with AP. Among the patients, 58 % (n=123) were men, and 42 % (n=89) were women. The severity of AP was mild in 63.2 %, moderate in 21.7 % and severe (SAP) in 15.1 % of cases. The average age of the patients was 52 years. Organ failure (both transient and persistent) was present in 20.3 % of all cases of AP, in 52.3 % of patients with moderate AP and in 59.4 % with SAP. The total mortality rate was 6.6 %, with mild and moderate AP, no deaths were noted, whereas with severe AP, the mortality rate was 43.8 %. The method of calculating body mass index (BMI) was used to diagnose obesity. The presence of obesity was noted at BMI of≥30 kg/m2. The number of obese patients was 39.6 % of all patients with AP. The Mann – Whitney U-test was used to compare patient groups. The criterion χ2 was used to compare the proportions of patients in different groups.

RESULTS. When studying the average BMI and the proportion of obese patients, there were no significant differences in their values depending on the severity of AP. There were also no significant differences in the value of the average BMI and the proportion of obese patients in survivors and deceased patients with AP, as well as in survivors and deceased patients with SAP. Whereas, the surviving patients showed significant differences in the value of the average BMI and in the proportion of obese patients. There were no significant differences in the values of the average BMI and the proportion of obese patients in the groups of patients with OP without and with complications.

CONCLUSION. Obesity does not significantly influence on the severity and frequency of complications in patients with AP.

The presented clinical case demonstrates the possibility of open surgical treatment of high intermittent claudication syndrome in a patient with chronic occlusion of the internal iliac artery by performing profundogluteal autogenous venous bypass grafting.

INTRODUCTION. Significant mitral regurgitation is currently a widespread acquired valvular heart disease and is associated with a significant decrease in survival and deterioration in quality of life. One of the new, unclearly studied, minimally invasive method for correcting significant mitral regurgitation is transapical neochord mitral valve repair, where echocardiography is the key imaging tool.

The OBJECTIVE was to analyze the data of world studies devoted to the problem of echocardiographic navigation in transapical neochord mitral valve repair, to determine the echocardiographic criteria applicable to neochord implantation surgery.

 METHODS AND MATHERIALS. The analysis of studies about using echocardiography in the transapical neochord mitral valve repair has been carried out. Databases searched in this review included PubMed, ResearchGate, and Hindawi.

RESULTS. During the analysis, we figured out that 2D and 3D transesophageal echocardiography is the main method for mitral valve imaging during transapical neochord mitral valve repair. Specific parameters which can be useful in addition for standard echocardiographic protocol of mitral valve evaluation have been identified.

CONCLUSION. The results of the analysis showed that it is necessary to summarize the experience of present studies and standardize the approach to echocardiographic evaluation of the mitral valve during transapical neochord mitral valve repair.

Acute ischemic stroke is one of the leading causes of death and long-term disability. For a long time, intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) has been the only method of treating patients with acute ischemic stroke. However, at present, endovascular treatment allows to achieve better revascularization and good functional outcomes compared with intravenous rt-PA in patients with ischemic stroke due to large vessel occlusion. This article provides an update and discusses the role of endovascular therapy in management of acute ischemic stroke.

December 20 marks the 70th anniversary of the birth of an outstanding Russian scientist, head of the Department of Hospital Surgery of the St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation, laureate of the Russian Government Prize in Science and Technology, Honored Scientist of the Russian Federation, Honored Doctor of the Russian Federation, who made a significant personal contribution to the development of surgery and oncology, Mikhail Dmitrievich Khanevich.