A prominent Soviet surgeon, scientist and teacher, one of the pioneers of esophageal and diaphragmatic surgery in the USSR, founder of the famous Moscow school of thoracoabdominal surgeons, Corresponding Member of the USSR Academy of Medical Sciences (1975), laureate of the USSR State Prize, Doctor of Medical Sciences (1964), Professor (1965) Eduard Nikitich Vantsyan was born on September 13, 1921 in Tbilisi to a doctor’s family. In 1939, he entered the 1^st Moscow Medical Institute, then transferred to the Tbilisi Medical Institute, from which he graduated in the summer of 1943. After receiving his diploma, he served in various medical positions in the Ministry of Internal Affairs hospital, and after demobilization in 1946, he worked as a surgeon in the emergency hospital, then as a resident in the surgical department of the Transcaucasian District Military Hospital. In 1951, E. N. Vantsyan entered graduate school at the Department of Faculty Surgery of the Pediatric Faculty of the 2nd MMI and in 1954, defended his candidate’s dissertation, «Bilateral Operative Pneumothorax». In 1958, he transferred to the position of assistant Professor at the Department of Hospital Surgery at the 1^st MMI. In 1963, he was appointed head of the esophagus and stomach surgery department at the All-Union Research Institute of Clinical and Experimental Surgery, and from 1969, he served as deputy Director for research at the same Institute. In 1964, he defended his doctoral dissertation «Clinical and Surgical Treatment of Esophageal Diverticula». Eduard Nikitich’s primary research interests included neuromuscular diseases of the esophagus, esophageal hernias, gastroesophageal reflux disease, esophageal diverticula, esophageal tracheal fistulas, benign tumors and esophageal cancer, chemical burn strictures of the esophagus, and diseases of the operated and artificial esophagus. E. N. Vantsyan founded a significant Moscow school of thoracoabdominal surgeons; under his supervision, 26 candidate’s and 9 doctoral dissertations were defended. He was the author and co-author of approximately 170 scientific and practical works, including nine monographs and manuals. Eduard Nikitich was a member of the Presidium of the Scientific Medical Council of the USSR Ministry of Health, was elected to the Board of the All-Union Scientific Society of Surgeons, served as Deputy Chairman of the Surgical Society of Moscow and the Moscow Region, was Deputy Editor-in-Chief of the journal «Surgery», was elected a member of the International Society of Surgeons, and was an honorary member of the surgical societies of the GDR and Cuba. Professor E. N. Vantsyan died tragically in a car accident on February 17, 1989, and was buried at the Babushkinskoye Cemetery in Moscow

INTRODUCTION. Bronchial suture ischemia and necrosis is a serious complication following lung resection. Traditional treatments are often ineffective. Hyperbaric oxygen therapy may be useful as an adjuvant therapy for bronchial suture ischemia following lung resection.

The OBJECTIVE was to study the potential of hyperbaric oxygenation in patients with ischemic changes in the bronchial suture after oncothoracic surgery with systematic mediastinal lymph node dissection.

METHODS AND MATERIALS. A study was conducted involving 174 patients with bronchial raphe ischemia/necrosis following oncothoracic surgery with systematic mediastinal lymph node dissection. All patients underwent HBO sessions. The clinical course of each patient, treatment outcomes, and any adverse effects were analyzed. Treatment outcomes were compared between groups, including those with ischemic and necrotic changes in the bronchial raphe zone.

RESULTS. Ischemia/necrosis was detected after surgery on day 6 [4–7], and HBO was started on day 8 [6–10]. The median duration of HBO was 8 [6–10] sessions. In 127 (93.4 %) patients, HBO allowed to significantly improve the endoscopic picture with subsequent healing of the bronchial suture, in 9 (6.6 %) patients, there was worsening of ischemic changes, which required further surgical intervention. Mortality was higher in the group of necrotic changes of the bronchial suture and amounted to 9 people (23.7 %), than in the ischemia group – 7 patients (5.1 %) (p<0.001). The cumulative 100-day survival probability (according to the Kaplan – Meier curve) in patients with ischemic changes was 94.9 %, and in patients with necrotic changes of the bronchial suture – 76.3 %.

CONCLUSIONS. The obtained clinical data confirm the effectiveness and demonstrate the potential of using HBO to improve bronchial suture healing after lung resection, particularly in cases of tissue ischemia.

The OBJECTIVE was to estimate the incidence and risk factors of seroma following hernioplasty of ventral hernias and to present a clinically applicable prognostic model (nomogram).

METHODS AND MATERIALS. From 01, Feb 2024 to 01, May 2025, 214 hernioplasties of ventral hernias were per formed at the State Healthcare Institution Ulyanovsk Regional Clinical Center for Specialized types of Medical Care named after E.M. Chuchkalov at the Surgical Department № 5 inUlyanovsk. We identified statistically significant variables associated with postoperative fluid accumulation at the mesh implantation site.

RESULTS. In multivariable logistic regression, independent risk factors were coronary artery disease (OR 5.57; 95 % CI 1.98–15.64; p<0.001), preoperative neutrophil-to-lymphocyte ratio (per 1 unit: OR 1.46; 95 % CI 1.19–1.79; p<0.001), and hernia defect diameter (per 1 cm: OR 1.15; 95 % CI 1.06–1.25; p<0.001). The integrated model showed good discrimination: AUC 0.87 (95 % CI 0.78–0.97), sensitivity 82.6%, specificity 81.7%. Median length of hospital stay was longer with seroma – 16 [14–20] vs 6 [4–9] days (p<0.001). Using artificial intelligence (AI) and machine-learning techniques, we developed a nomogram to predict this complication after hernioplasty.

CONCLUSION. Seroma occurred in 10.7 % (23/214). Independent predictors after hernioplasty of ventral hernias were coronary artery disease, higher preoperative neutrophil-to-lymphocyte ratio, and larger hernia defect diameter. The prognostic model and nomogram were developed to estimate individual risk.

INTRODUCTION. The laparoscopic IPOM hernioplasty technique using the domestic composite prolenic mushroom shaped prosthesis with polytetrafluoroethylene coating technology has been developed for the correction of ventral hernias with orifices up to 4 cm. However, publications on the use of this technique in patients with morbid obesity are limited.

The OBJECTIVE was the comparative evaluation of the results of using the domestic composite prolenic mushroom-shaped prosthesis with polytetrafluoroethylene coating alone and in combination with bariatric intervention in patients with ventral hernias and morbid obesity.

METHODS AND MATERIALS. The comparative study included 64 subjects with ventral hernias <4 cm and abdominal obesity. The body mass index (BMI) in the sample was ≥35 kg/m2. The patients were divided into 2 groups: group 1 (n=35) consisted of patients who underwent laparoscopic hernioplasty using the domestic composite prolenic mushroom-shaped prosthesis with polytetrafluoroethylene coating (LLC «Icon Lab GmbH», Russia) composite endoprosthesis, and group 2 (n=29) consisted of patients whose hernioplasty was supplemented by bariatric intervention.

RESULTS. Of the early postoperative complications: in 1 case, a hematoma was observed (in a patient of group 1), 1 case in each group – the appearance of seromas. Recurrence of hernia occurred in 1 case in a patient of group 2. Weight loss over 12 months of observation in group 2 of patients was noted to be up to 28 kg/m2, while in patients in group 1, on the contrary, an increase in body weight of 8–12 kg was recorded (p<0.05).

CONCLUSIONS. Performing bariatric intervention does not increase the time of hernioplasty surgery, does not increase the percentage of postoperative complications, while contributing to a 25 % reduction in patients’ weight over a 12-month observation period. In the case of a combination of a small (W1) ventral hernia with morbid obesity, in our opinion, it is advisable to perform hernioplasty using the domestic composite prolenic mushroom-shaped prosthesis with polytetrafluoroethylene coating, simultaneously with bariatric intervention.

The OBJECTIVE was to analyze the results of open and endovascular reconstructive operations in the internal iliac arteries pool in the treatment of patients with buttock claudication.

METHODS AND MATERIALS. The retrospective study included 53 patients aged from 40 to 77 years (mean age 63.9±7.7 years) with chronic lower limb ischemia of stage IIb (according to Fontaine – Pokrovsky), who underwent open or endovascular reconstructive surgery on one or both of the internal iliac and/or gluteal arteries in the Department of Vascular Surgery at the Pavlov Moscow State Medical University in the period from 2020 to 2025 for occlusive stenotic lesions in order to treat buttock claudication.

RESULTS. 66 operations (56 endovascular and 10 open) were performed in 53 patients. The patency of stented arteries after endovascular reconstructions by the time of discharge from the hospital was 100%, and that of open implanted vascular conduits was 50%. Among 30 (68%) of patients surveyed in the late period after surgery, 21 (70%) patients reported a positive treatment result in the form of relief or reduction of buttock claudication with an increase in pain-free walking distance. The reasons for the unsatisfactory result according to the computed tomography data were thrombosis of reconstruction zone, residual occlusion or stenosis of the gluteal artery or atherosclerotic changes progression of the lower extremities arteries. We established that the 1- and 3-year patency of the operated internal iliac artery bed is 91 % and 61%, respectively. Transcutaneous oximetry among patients, most of whom had a positive treatment result, showed a statistically significant increase in their exercise tolerance test and transcutaneous oxygen pressure of the gluteal regions.

CONCLUSION. Achieving a positive clinical result in 70 % of the surveyed patients indicates both the need for further study of diagnostic methods and treatment tactics for buttock claudication, and the possibility of wider application in clinical practice of reconstructive surgery in patients with occlusive-stenotic lesions of the internal iliac arteries and their branches.

INTRODUCTION. Non-healing wounds do not pose an immediate threat to the patient’s life, but they can become a portal for infection penetration. Surgical methods have demonstrated high efficacy in the treatment of such wounds. However, modern medicine strives to shift its focus from the treatment of complicated wound processes to the prevention and minimally invasive techniques. One of the potential methods for stimulating tissue regeneration is the use of autologous platelet-rich plasma (PRP). However, data on its effectiveness in the treatment of chronic non-healing wounds are mixed, the main reason is the lack of standardized protocols for obtaining and using PRP.

METHODS AND MATERIALS. The study included 40 cases of pressure ulcer treatment. There were 35.0 % men and 65.0 % women among the patients. All treatment cases were divided into two comparison groups. The first group consisted of 20 (50%) cases of pressure ulcer treatment with PRP. The second group consisted of 20 (50%) cases of pressure ulcer treatment serving as a control group. The study included stage 2 and 3 pressure ulcers. Statistical analysis was performed using SPSS 26.

RESULTS. PRP therapy significantly accelerated healing: the average healing time was 35.4±14.8 days versus 23.4±5.6 days in the control group (p=0.03). After the first PRP injection, 100 % of patients (p=0.001) experienced accelerated pressure ulcer epithelialization, with a reduction in ulcer area and peak epithelialization induction by day seven. The most pronounced effect was observed in patients with a normal BMI, whereas patients with an elevated body mass index (BMI>35) demonstrated a less pronounced response to conservative therapy due to a greater mechanical load.

CONCLUSIONS. The study demonstrated the high clinical efficacy of platelet-rich plasma (PRP) therapy compared to standard treatment. Complete healing was achieved in 65.0 % patients in the study group compared to 50.0 % in the control group (p=0.03). The average healing time in the PRP group was 35,4±14.8 days, while in the control group it was 23.4±5.6 days (p=0.03), demonstrating both qualitative improvements and a temporal advantage of PRP therapy.

The OBJECTIVE was to conduct a comparative analysis of short- and long-term outcomes following extended versus standard mesenteric resection in patients with stricturing Crohn’s disease.

METHODS AND MATERIALS. This study was conducted at the Department of Coloproctology of the Loginov Moscow Clinical Scientific Center (2015–2023). The study included 120 patients with confirmed diagnosis “Crohn’s disease” (stricturing phenotype). The main group included 60 patients (prospective group) who underwent extended mesenteric resection. The comparison group included 60 patients (retrospective group) who underwent standard mesenteric resection.

RESULTS. Multivariate regression analysis incorporating gender, age at diagnosis, surgical history, postoperative medical prophylaxis, smoking status, extent of mesenteric resection (standard vs extended), intestinal continuity restoration method (primary anastomosis vs stoma formation), disease phenotype, and perianal manifestations revealed that standard mesenteric resection was the only independent risk factor for postoperative Crohn’s disease recurrence (HR 2.83; 95 % CI 1.01–7.96; p=0.048).

CONCLUSION. Extended mesenteric resection represents a promising surgical approach for Crohn’s disease that may reduce postoperative recurrence rates through complete removal of inflammation-sustaining mesenteric tissues.

The OBJECTIVE was to reconsider the strategy of perioperative antibiotic prophylaxis in patients after pancreaticoduodenectomy (PD) against the background of preoperative biliary drainage to reduce the incidence of surgical site infection (SSI).

METHODS AND MATERIALS. The pilot study was conducted on the effect of personalized perioperative antibiotic prophylaxis in PD on the incidence of acute respiratory viral infections in patients with percutaneous preoperative biliary drainage. The control retrospective group received standard perioperative antibiotic prophylaxis. The main prospective group received perioperative antibiotic prophylaxis based on preoperative bile culture from biliary drainagea. The primary control endpoint was the incidence of SSI.

RESULTS. The control and main groups included 46 and 11 patients, respectively. The susceptibility of pathogens during preoperative bile culture to cephalosporins of the 1st-2nd generation was 21.2%. The highest susceptibility rates were to inhibitor-protected β-lactams of a narrow spectrum: amoxicillin/clavulonate, ampicillin/sulbactam – up to 83.4%. There wasn’t statistical difference in SSI rate between groups: 76.1 % (n=35) vs 81.8 % (n=9), while it’s severity by Clavien – Dindo did not exceed 1-2 degrees of severity in most cases (63.0 % vs 54.5 %). The match between the bile microbiome from the biliary drain and the SSI microbiome was 45.5 %. SSI pathogens were represented by extended-spectrum β-lactamase producers, carbapenem-resistant Enterobacterales.

CONCLUSIONS. The bile microbiome, as well as SSIs following PD, are resistant to cephalosporins of the 1st-2nd generation.The bile microbiome from preoperative biliary drainage does not reflect the features of pathogens involved in SSI, the components of which are both bile pathogens and gastrointestinal pathogens with the properties of extended-spectrum β-lactamases. Further refinement of SSI prevention methods in this patient cohort is required, along with the implementation of perioperative therapy for possible subclinical cholangitis.

Based on a retrospective analysis, the OBJECTIVE was to develop an algorithm for predicting the risk of complications of abdominoplasty in overweight patients (BMI 25-29.9 kg/m²) using laboratory markers of carbohydrate metabolism and cytokine status, as well as to evaluate the efficacy of a modified surgical technique in high-risk patients.

METHODS AND MATERIALS. The study was conducted in two stages: 1) a retrospective analysis of 49 patients (2016-2018) who underwent standard abdominoplasty to identify predictors of complicated wound healing; 2) a prospective cohort study of 30 patients (2022-2023) with a BMI of 25-29.9 kg/m² and identified risk predictors (HOMA-IR≥3.1, insulin level>14.0 µIU/mL, interleukin-1β level (IL-1β)≥45.0 pg/ml), who underwent modified abdominoplasty with limited dissection, preservation of suprapubic tissue, Scarpa’s fascia and flap fixation. The main evaluation criteria were the duration of the operation, the frequency of seromas, hematomas, and ligature fistulas.

RESULTS. The retrospective analysis revealed three independent predictors of the development of local wound complications: HOMA-IR≥3.1, insulin level≥14.0 µIU/mL and lL-1β level≥45.0 pg/ml. The use of the modified technique in female patients with these predictors led to a statistically significant decrease in the incidence of complications compared with the retrospective group of similar risk: the incidence of seromas decreased from 43% to 3% (p=0.001), hematomas from 10% to 0% (p=0.04). The average surgery time was reduced by 40%.

CONCLUSION. The proposed algorithm, combining preoperative detection of markers of insulin resistance, carbohydrate metabolism disorders and systemic inflammation with the use of a gentle modified abdominoplasty technique, makes it possible to objectify the risk and significantly reduce the frequency of postoperative local wound complications in overweight patients, which can serve as a basis for individualizing surgical tactics.

INTRODUCTION. Shrapnel wounds during combat may damage peripheral arteries. In some cases, a false aneurysm is formed. Surgical reconstruction of the vessel after its removal is reduced to two surgical techniques – autovenous saphenous prosthetics and end-to-end anastomosis.

The OBJECTIVE was to analyze the results of various surgical treatment techniques for removing a false peripheral arterial aneurysm in a military field hospital in a special military operation zone.

METHODS AND MATERIALS. During the period from 01.02.2025 to 01.08.2025, 22 reconstructive interventions were performed in the military field hospital in the special military operation zone for the development of a false peripheral arterial aneurysm after a shrapnel wound to the limb. Depending on the chosen surgical technique, all patients were divided into two groups: Group 1 – autovenous saphenous prosthetics with a reversed great saphenous vein (GSV), n=11; Group 2 – end-to-end anastomosis between arterial stumps, n=11.

RESULTS. Acute arterial thrombosis was observed in 3 (20 %) patients in Group 1 and 1 (6.7 %) patient in Group 2. Arteriovenous fistula was detected in 2 (13.3 %) patients and 1 (6.7 %) patients, respectively. In the vast majority of cases, the false aneurysm diameter was 3–5 cm. In all cases, mural thrombotic masses were visualized. The localization sites of pathology in the total sample (n=30) were: n=4 (13.3 %) – axillary artery; n=4 (13.3 %) – brachial artery; n=4 (13.3 %) – posterior tibial artery; n=3 (10.0 %) – popliteal artery; n=2 (6.7 %) – superficial femoral artery; 1 case each (3.3 %) – ulnar artery, radial artery, common femoral artery, deep femoral artery, peroneal artery. The average operation time in the first group was 226.5±24.8 minutes, in the second – 115.7±31.4 minutes (p=0.03). Autovenous grafting of the reversed GSV was performed only in patients with damage to the axillary artery (n=4, 26.7 %), brachial artery (n=4, 26.7 %) and popliteal artery (n=4, 20 %). End-to-end anastomosis was performed in cases of damage to the posterior tibial artery (n=4, 26.7 %), superficial femoral artery (n=2, 13.3 %), common femoral artery (n=1, 6.7 %), deep femoral artery (n=1, 6.7 %), peroneal artery (n=1, 6.7 %), ulnar artery (n=1, 6.7 %), radial artery (n=1, 6.7 %). During 30 days of postoperative observation, no deaths, thrombosis of the reconstruction zone, or infectious complications were recorded. Symptoms of acute ischemia and limb edema completely regressed in all cases.

CONCLUSION. The implementation of autovenous grafting and end-to-end anastomosis after removal of a false peripheral arterial aneurysm is an effective and safe treatment method.

INTRODUCTION. Hypospadias is a common congenital anomaly of the external genitalia in boys, characterized by the external urethral opening located on the ventral surface of the penis, scrotum, or perineum. Surgical treatment aims to restore normal anatomy and urinary function, correct penile curvature, and achieve an aesthetically pleasing result. This article analyzes current hypospadias correction methods, optimal surgical timing, the incidence and types of complications, and short- and long-term treatment outcomes. Based on international and domestic research, it is concluded that the choice of method should be based on the severity of hypospadias, the characteristics of the urethral repair, the surgeon’s experience, and postoperative management options.

The OBJECTIVE of this study was to improve the outcome of surgical treatment for distal hypospadias in children.

METHODS AND MATERIALS. The study included 85 children with distal hypospadias, aged 1 to 16 years, between 2021 and 2025. 

RESULTS. Complications during surgical interventions occurred in 14.2 % of cases, with a success rate of 84.2 %. 

CONCLUSION. Successful hypospadias treatment depends not only on the correct choice of surgery but also on many aspects of postoperative care, including optimal urinary diversion and dressing application techniques. The use of modern atraumatic suture material and microsurgical instrumentation significantly improves surgical outcomes.

INTRODUCTION. Injuries to the median nerve are among the most functionally disabling upper limb traumas, often resulting in sensory deficits, loss of fine motor skills, and impaired quality of life. When nerve gaps exceed 3 cm, complex reconstruction with autologous nerve grafts is the required treatment. The sural nerve remains the most commonly used donor nerve due to its length and expendability.

The OBJECTIVE was to present a clinical case involving the successful reconstruction of a 5 cm median nerve defect using a double-strand sural nerve autograft and to evaluate the functional outcome achieved through microsurgical repair.

METHODS AND MATERIALS. A 42-year-old male patient sustained a deep penetrating forearm injury with sensory loss and impaired flexion of digits I–III. After confirming the diagnosis, nerve reconstruction was performed using a 12 cm sural nerve autograft, prepared in a looped configuration. Microsurgical epineural suturing was done using 8/0 monofilament. Postoperative care included physical therapy, kinesitherapy, neuroprotective and neurotropic medication support.

RESULTS. At 6-month follow-up, the patient regained full finger flexion and sensory recovery in the median nerve distribution. Thumb opposition was preserved. Mild thenar hypotrophy was noted without significant functional limitation.

CONCLUSION. This case demonstrates successful functional restoration in extensive median nerve defects using sural nerve autografts, highlighting the importance of microsurgical precision and structured rehabilitation.

The treatment of patients with Crohn’s disease with total colon inflammation and persistent refractoriness to pathogenetic therapy poses a significant challenge for surgeons and resuscitation specialists. The issues of preoperative preparation, timing of surgical intervention, and surgical tactics are highly relevant. The described clinical case demonstrates the importance of an interdisciplinary approach and provides an example of effective preoperative preparation, as well as successful colectomy in a patient with Crohn’s disease, total inflammatory-necrotic colitis that was resistant to pathogenetic therapy and was accompanied by severe intoxication with systemic inflammatory response syndrome.

The treatment of duodenal ulcer bleeding has evolved over the years from open surgical interventions to the application of minimally invasive technologies, thanks to advancements in medical technologies and the pharmaceutical industry. Despite this progress, ulcer bleeding remains one of the leading issues in modern surgery due to the high morbidity of patients, difficulties in choosing treatment tactics, and the persistence of high mortality rates associated with this condition.

The mainstay of rectal cancer treatment is surgery, which includes rectal resection with the creation of a primary or delayed colorectal anastomosis or rectal extirpation. The most severe complication of rectal resection with primary anastomosis is its failure. One of the approaches to reducing the rate of anastomotic failure is the formation of a preventive intestinal stoma, such as an ileostomy or colostomy. To date, there is no consensus on the optimal type of preventive stoma. This study analyzed 12 national and international studies published over the past 5 years. It was found that the existing data on this issue are contradictory and cannot be interpreted unambiguously. Some authors point to the advantages of ileostomy, justifying this choice by a lower incidence of purulent-septic complications, parastomal hernias, and the availability of modern tools for managing peristomal dermatitis, dehydration, and renal insufficiency. Other authors emphasize the significant disruptions in water-electrolyte balance, an inevitable component of postoperative complications associated with ileostomy. Certain studies highlight the clear advantages of transverse colostomy in terms of fewer postoperative complications compared to ileostomy, while others find no differences. These contradictory findings underscore the relevance of this issue and the importance of further research to determine the optimal type of preventive stoma for low anterior rectal resection to achieve satisfactory outcomes in the surgical treatment of rectal cancer patients.