A prominent Soviet surgeon, scientist, educator, healthcare organizer, and public figure of the Dagestan ASSR, founder of the largest scientific and practical school of surgeons in Dagestan, Corresponding Member of the USSR Academy of Medical Sciences, Honored Scientist of the RSFSR and the Dagestan ASSR, Doctor of Medical Sciences, Professor Rashid Pashaevich Askerkhanov was born on November 13, 1920, in the village of Sultan-Yangiyurt, Kizilyurt District, Dagestan ASSR. In 1943, he graduated with honors from the Dagestan Medical Institute and was enrolled in a clinical residency at the Department of Hospital Surgery. From January 1946, he worked as an assistant in the Department of General Surgery and in 1949, he defended his PhD dissertation «Changes in the Tibia Bones with Varicose Veins of the Lower Extremities». In 1952, R.P. Askerkhanov was elected Associate Professor of the Department of Faculty Surgery, and from September 1953 to 1958, he headed the Department of General Surgery at the Dagestan Medical Institute. In 1955, he defended his doctoral dissertation «Contrast Venography of the Lower Extremities». From 1958, he headed the Department of Faculty Surgery, and in 1985, he took the position of Head of the Department of Surgery at the Faculty of Advanced Medical Studies. R.P. Askerkhanov was the author and co-author of 400 scientific and practical works, including 12 monographs on many surgical topics. Under his supervision, 12 doctoral and 38 candidate dissertations were defended. Rashid Pashaevich was elected a full member of the International Society of Surgeons and the International Society of Vascular and Cardiac Surgeons, and an honorary member of the International Society of Phlebologists. He was awarded the Order of the October Revolution, the Order of the Red Banner of Labor, two Orders of the Badge of Honor, and numerous medals and honorary distinctions. Professor R.P. Askerkhanov died on May 3, 1987, in Makhachkala.

The OBJECTIVE was to evaluate the efficacy of local anesthetic infiltration of trocar sites (LAITS) as a component of multimodal analgesia in patients undergoing elective laparoscopic colorectal resection for colorectal cancer.
METHODS AND MATERIALS. A prospective analysis of 24 patients randomized into two groups was conducted. The study group (n=12) received LAITS in addition to general anesthesia, while the control group (n=12) received general anesthesia combined with thoracic epidural analgesia (TEA). The primary endpoint was the intensity of resting pain assessed using a visual analog scale (VAS) over 2 weeks postoperatively. Secondary endpoints included pain intensity on movement/coughing, length of hospital stay, time to return of bowel function, need for supplemental analgesia, and incidence of surgical complications.
RESULTS. Statistically significant differences were found in resting pain intensity at 4, 6, 8, and 12 hours postoperatively (p=0.01), as well as in pain on movement/coughing at 2 (p=0.03), 4, 6, 8, and 12 hours (p=0.01), favoring the control group. The peak VAS score in the study group was 4.65±2.03 points at 6 hours, compared to 1.91±1.63 points at 2 hours in the control group. No significant differences were observed in secondary endpoints, including pain scores at the remaining time points.
CONCLUSIONS. In this pilot randomized clinical trial, the LAITS method demonstrated comparable efficacy to TEA method in controlling postoperative pain.

INTRODUCTION. The role of surgical treatment of invasive mycoses (IM) of the lungs after hematopoietic stem cell transplantation (HSCT) and antitumor chemotherapy (ACT) in patients with oncohematological profile has not been determined. There are only isolated publications on this topic in the scientific medical literature, the presented results are contradictory, and it is difficult to use them to make decisions.

MATERIALS AND METHODS. A retrospective analysis of immediate and long-term treatment results was conducted for patients who underwent ACT and/or HSCT and underwent lung resections for invasive mycosis since 2013. The indications for surgery were the absence of positive dynamics or progressive inflammatory changes in the lungs despite adequate antifungal therapy.

RESULTS. The study included 13 patients, children (n=3) and adults (n=10), 11 males, with a median age of 25 years (ranging from 10 to 64 years). Diagnoses: acute leukemia in 4 patients (31 %), chronic myeloproliferative diseases in 4 patients (31 %), aplastic anemia in 3 patients (23 %), and lymphoma in 2 patients (15 %). In 11 cases (85 %), IM developed in patients after allogeneic HSCT (allo-HSCT), and in 2 cases (15 %) during ACT, with a median development time of 96 days after treatment initiation (ranging from 20 to 510 days). Neutropenia was observed in 46 % of patients (n=6), and platelet counts below 50х10⁹/L in 10 patients (77 %). Bilateral lung changes were present in 54 % of cases (n=7), unilateral lung changes in 46 % of cases (n=6). 5 pneumonectomies, 4 lower lobectomies, 2 upper bilobectomies, 2 atypical lung resections, and 1 upper lobectomy were performed; 2 out of 13 patients (15 %) underwent chest wall resection. One patient died in the early postoperative period (7.7 %). Eight patients (61.5 %) recovered from pulmonary IM with a median follow-up of 118 days (ranging from 42 to 900 days).

CONCLUSIONS. Surgical treatment of IM in this patient group is possible provided that risk factors are eliminated or, more commonly, their severity is reduced (compensation of concomitant conditions, discontinuation of antitumor chemotherapy, transfusions of erythrocyte mass, and platelets). With proper selection of hematological patients with pulmonary IM, the immediate results of surgical treatment can be considered favorable.

INTRODUCTION. Inguinal masses in women have heterogeneous etiologies and include both surgical and gynecological pathologies, which makes differential diagnosis challenging. Particular focus is placed on distinguishing inguinal extragenital endometriosis from a congenital abnormality – the cyst of the canal of Nuck.

The OBJECTIVE was to analyze the clinical and anamnestic, instrumental, and morphological characteristics of inguinal masses in women of reproductive age.

METHODS AND MATERIALS. The study included six reproductive-age women presenting with inguinal masses. Medical history, clinical symptoms, ultrasound (US) and magnetic resonance imaging (MRI) findings, type of surgical intervention, and histopathological evaluation were analyzed. Quantitative variables are presented as median (Me) and interquartile range [Q1; Q3].

RESULTS. The median age was 43 [39; 44] years, and the median body mass index was 20.4 [19.1; 22.1] kg/m². Catamenial symptoms were observed in 50 % of patients, and the median pain severity score using the Visual Analogue Scale was 0 [0; 8]. Preoperative imaging suggested the cyst of the canal of Nuck in 67 % of cases. Histopathological examination confirmed the cyst of the canal of Nuck in four (67 %) patients, whereas in two (33 %) patients, round ligament endometriosis was identified. All patients underwent surgical treatment, and no postoperative complications occurred.

CONCLUSIONS. The presented clinical observations illustrate the diagnostic complexity of inguinal masses in women. The findings support the necessity of a multidisciplinary approach, the use of high-resolution imaging modalities, and surgical verification for definitive diagnosis.

OBJECTIVE. In patients with atherosclerotic lesions of the aortoiliac segment and arteries of the lower extremities, to evaluate the correlation between the prevalence of occlusive-stenotic lesions of the arteries supplying the penis and the severity of erectile dysfunction.

METHODS AND MATERIALS. The retrospective study included 66 men aged from 45 to 76 years (mean age 61.8±6.5 years) with aneurysmal and/or occlusive-stenotic lesions of the aortoiliac segment, arteries of the lower extremities, who upon admission to the vascular department of the Pavlov University in the period from 2020 to 2025, erectile function was assessed based on a questionnaire of International Index of Erectile Function (IIEF-5) and catheter arteriography of the pelvis was performed in three projections. The patients were divided into three groups: group 1 (n=13) included patients with unilateral hemodynamically significant lesion along of common, internal iliac or internal pudendal arteries; group 2 (n=43) included patients with bilateral lesions along the indicated arteries, as well as of the infrarenal aorta; the 3rd (n=10), control group, consisted of patients without hemodynamically significant lesion of the arteries supplying the penis.

RESULTS. Erectile dysfunction was suffered by 54 (82 %) patients, of which 19 (29 %) had moderate to severe severity. There was no statistically significant correlation between the total score on the IIEF-5 scale and the scores of arterial lesion prevalence; a statistically significant weak inverse correlation with the age of the patients was established.

CONCLUSION. The prevalence of occlusive-stenotic lesions of the arteries supplying the penis does not play a leading role in the severity of erectile dysfunction.

INTRODUCTION. Currently, the usage of esophagocardiomyotomy (POEM) in elderly and senile patients as a first-line treatment remains a subject of discussion.

METHODS AND MATERIALS. Between 2014 and 2023, POEM was performed in 99 patients over the age of 60. The mean age of the patients was 71 years (60–88 y. o.), with a predominance of females (65/34). Immediate postoperative outcomes were evaluated in all patients. Long-term results of the intervention were assessed in 67 patients (67.7 %) who were able to complete questionnaires and follow up.

RESULTS. POEM was successfully performed in all clinical cases. Two adverse events were marked by the features of the perioperative period associated with comorbidities. A positive effect after operation was observed in 63 (94 %) of the 67 patients available for follow-up, characterized by a reduction in dysphagia severity to ≤3 points on the Eckardt scale. In 4 cases out of 67 (5.9 %), a repeat POEM was necessary due to recurrence of complaints and symptoms of the disease.

CONCLUSION. The results of the study demonstrate that age, duration of the disease, comorbidities and previous interventions on the esophagus do not affect the outcomes of POEM.

The OBJECTIVE was to evaluate the effectiveness of modern surgical methods for removing intrathoracic foreign bodies in patients with penetrating gunshot chest wounds.

METHODS AND MATERIALS. The study included 207 patients with intrathoracic foreign bodies (FBs) after penetrating gunshot chest wounds. Depending on the size and location of the FBs, the choice of surgical access and method of their removal was determined.

RESULTS. FBs were large in 35 (17 %), medium – in 113 (54.6 %), small – in 59 (28.4 %) patients. Localization of FBs was noted in: lung parenchyma – 76 (36.7 %), mediastinum – 28 (13.5 %), pleural cavity – 103 (49.7 %) patients. In 197 (95.2 %) cases, the FBs were removed using videothoracoscopic methods, «open» surgical procedures were undertaken only in 3.4 % (n=7) of observations, and intraluminal endoscopic interventions were performed in 3 (1.4 %) cases. Postoperative complications developed in 14 (6.7 %) patients. There were no fatal outcomes.

CONCLUSION. In specialized thoracic surgery departments, minimally invasive video-assisted thoracoscopic surgical procedures are used in most cases to remove FBs from the pleura, lungs and mediastinum. Indications for performing thoracotomy and sternotomy are limited to cases of removing FBs from dangerous locations (heart, main vessels).

The OBJECTIVE was to evaluate the effectiveness of modern diagnostic methods and organ-preserving treatment of girls with cystic formations and adnexal torsion to develop an optimal therapeutic and diagnostic algorithm.

METHODS AND MATERIALS. A retrospective analysis of 81 cases of adnexal torsion in girls aged 8 to 17 years (mean age 13.2±2.4 years) treated from 2017 to 2024 was conducted. Based on the severity of clinical manifestations, three stages of the disease were proposed: stage I – initial manifestations; stage II – severe symptoms; stage III – suspected irreversible ischemic changes in the affected organ.

RESULTS. In 57 (70.4 %) patients, the referral diagnosis was acute appendicitis, and the correct diagnosis at the outpatient stage was established in only 7 (8.6 %) cases. Distribution by severity of clinical manifestations: stage I – 33 (40.7 %), stage II – 28 (34.6 %), stage III – 20 (24.7 %) patients. Ultrasound with color Doppler imaging showed a sensitivity of 75.3%. Intraoperatively, organic causes of torsion were identified in 65 (80.2 %) patients. Laparoscopic approach was used in 61 (75.3 %) patients. Organ-preserving operations were performed in 74 (91.4 %) patients: 100 % in stages I–II and 65 % in stage III. Blood flow restoration after detorsion was observed in 65 % of stage III patients and 86 % of stage II patients.

CONCLUSION. Adnexal torsion in girls is characterized by a high frequency of diagnostic errors. Organ-preserving laparoscopic approach is effective in most cases, including patients with severe ischemic changes. The proposed staging classification allows predicting treatment outcomes.

A neuroma (schwannoma) is a tumor of the peripheral nervous system that originates from Schwann cells of the neural membrane. Esophageal neurinoma is a very rare submucosal tumor. Since the clinical symptoms of esophageal neurinoma are non-specific, its preoperative diagnosis remains a rather difficult task, and treatment issues are not sufficiently described. This article presents a clinical case of removal of cervical esophageal neurinoma against the background of Recklinghausen’s disease, and review of the literature on this issue is also presented.

Dieulafoy’s syndrome (Dieulafoy’s lesion) is an abnormality of vascular development of the submucosal layer of the gastrointestinal tract, with destruction of the covering layers of the epithelium and the absence of a primary ulcer, accompanied by massive bleeding. This paper presents a comprehensive approach in the diagnosis and treatment of Dieulafoy’s syndrome in a young patient. Application of endoscopic, radiological and surgical methods allowed to stabilize the patient’s condition and prevent recurrences. Analysis of literature data shows that in such rare cases of multiple lesions – resection surgery remains the only effective method. The work emphasizes the importance of multidisciplinary approach in the treatment of rare diseases.

An observation from practice is given – a clinical case of treatment of a patient with cholecystoenteric fistula in combination with Mirizzi syndrome type IV. This article demonstrates the complexities of diagnosis and treatment, the complicated course of gallstone disease and its variety of forms. The uniqueness of this clinical case is due to the lack of global statistics and the extremely rare occurrence of a combination of cholecystoenteric fistula with Mirizzi syndrome.

Surgical treatment of diseases of the artificial esophagus is a complex and debatable problem of operative gastroenterology. The modern thematic literature on this issue is extremely scarce and not systematized. Therefore, the demonstration of even single observations is a significant contribution to the overall picture of long-term complications of esophagoplasty, which will eventually allow for a detailed analysis of errors made at the stage of primary reconstruction and the development of effective preventive measures. We present a clinical case of a disease of an artificial esophagus created from the colon.

The incidence of fractures of the femoral components of a hip implants ranges from 0.1 to 3.4 % and is an extremely rare orthopedic complication. In our clinic, a fracture of the Exeter V40 cement stem was diagnosed for the first time 3 years after implantation.

OBJECTIVE – to demonstrate a fracture of the cement femoral component, as well as a scientific analysis of the causes of this complication. The main reasons for the development of this complication were: excess weight (BMI – 39 kg/cm2), increased offset (head 36 mm in diameter, size +10) of the femoral component with a relatively small size (Exeter V40 37.5 N2) and early fretting corrosion.

A review of the literature on the use of transcatheter arterial embolization in the treatment of acute hemorrhages from the upper gastrointestinal tract is presented. It has been shown that this method can be an alternative to surgical operations, especially in patients with severe comorbid pathology and unstable hemodynamics. Due to the fact that, taking into account the occurrence of recurrent bleeding after endoscopic hemostasis, arterial embolization is an effective preventive measure to prevent repeated hemorrhage, when using the method, there is also a low incidence of complications, low mortality and the possibility of repeated use without delay.

Treatment of patients with pancreatic necrosis remains one of the most urgent and complex tasks in emergency surgery. The need for further research in this area is dictated by a high mortality rate (15–70 %). Active surgical approach at the first stage of severe pancreatitis is a necessary measure aimed at aspirating peritoneal exudate and reducing pressure in the abdominal cavity. At the second stage of the disease, infected pancreatic necrosis develops with purulentseptic complications and multiple organ failure. To date, the issue of surgical tactics in infected pancreatic necrosis, especially in relation to its walled-off forms, remains debatable. The problem of choosing an operative approach and strategy remains unresolved. In the article, we analyzed various options for minimally invasive surgery for treating patients with walled-off infected pancreatic necrosis. The timing of surgical treatment and methods of drainage and debridement (percutaneous drainage, endoscopic transluminal stent, video-assisted retroperitoneal necrosequestrectomy or VARD) were analyzed. The article also discusses a «step-up» minimally invasive strategy in terms of treatment effectiveness, complication rate and mortality. Most studies recommend adhering to a “step-up” strategy, which allows reducing the invasiveness of surgery, minimizing the risk of complications and shortening hospital stays. This approach is a promising direction in the treatment of patients with infected pancreatic necrosis.

Life and scientific and practical activities of Talman Israel Moiseevich, Doctor of Medical Sciences, Professor, Colonel of the Medical Service, acting as the head of the Department of Faculty of Surgery named S.P. Fedorov, head of the Department of General Surgery of the S. M. Kirov Military Medical Academy, head of the Department of General Surgery of the 2nd Leningrad Medical Institute.