The article presents the main stages of the life and social and scientific activities of Nikolay Aleksandrovich Velyaminov, an outstanding military field surgeon, health care organizer, and head of the Military Medical Academy. Nikolay Aleksandrovich Velyaminov was born on November 15, 1855, in St. Petersburg. After graduating from the Medical Faculty of Moscow University in 1877, he was assigned to the active army and took part in the Russo-Turkish War of 1877–1878 and the military campaign in Central Asia in 1880–1881, where he acquired extensive experience in military field surgery. N. A. Velyaminov constantly combined his military service with clinical and administrative activities in civilian medical institutions. Velyaminov served as the chief physician of the Holy Cross Community of Sisters of Mercy, director of the St. Petersburg Maximilian Hospital, head of the educational department of the Christmas courses for medical assistants and paramedics, and in other medical institutions. N. A. Velyaminov’s military medical career at the court developed rapidly. At the age of 42, he was granted the rank of court surgeon to His Imperial Majesty. N. A. Velyaminov devoted much attention to scientific and journalistic work and from 1885 published a regular surgical journal, which was published for 33 years. In 1989, N. A. Velyaminov defended his dissertation for the degree of Doctor of Medicine, in June 1895, he was appointed extraordinary, and in April 1897, he was approved as an ordinary Professor of the academic surgical clinic of the Military Medical Academy. From 1910 to 1912, N. A. Velyaminov was the head of the Military Medical Academy. As a representative of the Russian Red Cross, he took part in the medical support of Russian troops in all armed conflicts and wars that Russia waged at the beginning of the 20th century. N. A. Velyaminov summarized his experience as a military field surgeon in the manuscript «Essays on the military sanitary affairs of the Russian army in 1914–1917».

The objective of the study was to evaluate the quality of life of patients with DCD after several episodes of exacerbations of the disease.

Methods abd materials. A study was conducted with the participation of 110 patients treated at the State Clinical Hospital in Vladimir from 2019–2024 with DCD. There were 48 men (43.6 %) and 62 women (56.3 %). All patients were divided into 3 groups. Group 1 (n=38) (34.5 %) consisted of patients with one exacerbation during a year. Group 2 (n=24) (21.8 %) consisted of patients with two exacerbations during a Group 3 (n=48) (43.6 %) consisted of patients who had three exacerbations of DCD during a year. The results were evaluated within a period of at least a year from the last episode of the AD attack. The MOS-SF 36 questionnaire, the GIQLI – Gastrointestinal Quality of Life Index and the EQ-5D questionnaire were used to assess QOL.

Results. In patients of group 1 (n=38) (34.5 %), we recorded the best clinical results after the treatment. According to the results of the QOL study using the SF-36 questionnaire: PF-28, RP-8, BP-2, GH-21, VT-15, SF-9, RE-6, MH-21. When analyzing the results on the GIQLI, a GI of 128± was recorded. When analyzing the results of the EQ-5D questionnaire, the best results were obtained. According to the visual analog scale (YOUR), health status level was 92± 3.5. In patients of group 2 (n=24) (21.8 %), we recorded changes in clinical results after treatment. According to the results of the QOL study using the SF-36 questionnaire, the following results were recorded: PF-19, RP-4, BP-7, GH-16, VT-12, SF-6, RE-3, MH-17. When analyzing the results on the GIQLI, the GI was 98±4. When analyzing the results of the EQ-5D questionnaire, 18 (16.3 %) patients experienced some difficulty walking. According to the visual analog scale, the level of health status was 84 ± 3.5. The patients of group 3 (n=48) (43.6 %) had the worst clinical results. According to the results of the study, using the SF-36 questionnaire, the following results were recorded: PF-15, RP-5, BP-7, GH-16, VT-16, SF-7, RE-3, MH-19. When analyzing the results on the GIQLI, the GI was 82±4. When analyzing the results of the EQ-5D questionnaire, the worst results were recorded. According to the visual analog scale, the level of health status was 75±1.2.

Conclusion. The decision on the surgical treatment of patients with DCD must be justified in each case individually, taking into account the study of the quality of life, the clinical picture of the progressive development of the disease and the assessment of the risk of possible severe complications.

The objective of this study was to investigate the use of the procalcitonin test as a marker for the severity of acute biliary pancreatitis.

Methods and materials. A retrospective study was conducted to assess the severity of acute biliary pancreatitis in 45 patients. The severity was determined by the presence and duration of organ failure, the severity of acute cholangitis, and pancreatic necrosis. CT scans were performed in 30 patients and markers of inflammation (procalcitonin, C-reactive protein, and leukocyte levels) were studied. Procalcitonin was assessed by chemiluminescence enzyme immunoassay, and the level above 0.5 ng/ml was considered positive.

Results. Organ failure was present in 22 of 45 patients and absent in the remaining 23. Among those with organ failure, 10 patients had severe acute cholangitis, 3 had pancreatic necrosis, and 9 had both acute cholangitis and necrosis. Three patients died. Without organ dysfunction, all 18 from 30 patients had interstitial pancreatitis, with 6 having no acute cholangitis, 10 having mild cholangitis, and 7 having moderate severity. ROC analysis data: area under the curve (AUC) for procalcitonin was 0.788, cut-off point was 0.6 ng/mL, sensitivity and specificity were 79 % and 76 % respectively, p-value was 0.001. For CRP, AUC was 0.524, cut-off point was 40 mg/L, sensitivity was 58 % and specificity was 61 %, p-value was 0.785. Leukocytes had an AUC of 0.594, with a cut-off of 10´10⁹/L, sensitivity was 58 % and specificity was 66 %, p-value was 0.265.

Conclusion. The procalcitonin test with a level of 0.6 ng/mL or higher has good diagnostic value in predicting organ failure in acute biliary pancreatitis patients, with greater sensitivity compared to CRP and leukocytes.

Introduction. Stenting for recurrent esophageal and gastric cancer to resolve dysphagia is a relatively rare intervention. Scientific publications devoted to this issue are very rare.

The objective was to analyze the effectiveness, complications and life expectancy after esophageal stenting in patients with recurrent esophageal and gastric cancer after surgery.

Methods and materials. Self-expanding metal esophageal stents were installed under videoendoscopic control in 45 patients with dysphagia due to esophageal and gastric cancer, for the period from 2013 to 2023, at the Republican Clinical Oncology Dispensary of the Ministry of Health of the Republic of Tatarstan named after M. Z. Sigal. RESULTS. There were no complications directly during the intervention. Dysphagia indicators decreased by an average of 2 points. In the early and late periods, complications arose in 16 cases (36 %), including stent migration, continued tumor tissue growth, granulation stricture, stent deformation, and pain syndrome. Ineffectiveness of stenting due to the impossibility of endoscopic resolution of the complications that arose was noted in three cases (19 % of the total number of complications). The average survival time was 128 days.

Conclusion. Stenting in this category of patients is a fairly effective way to resolve dysphagia in a short time, but complications are quite common and not all of them can be resolved by endoscopic methods.

The objective was to evaluate the results of surgical treatment in patients with Taylor’s deformity using various types of open osteotomies, including both widely used techniques (Wilson, Weil) and those rarely applied to the fifth metatarsal bone (slide down).

Methods and materials. The authors conducted a retrospective single-center research based on archive data from 2021 to 2024. A total of 71 patients were included, among them 3 (4.2 %) men and 68 (95.8 %) women. Patients were divided into three groups according to the type of osteotomy performed on the fifth metatarsal bone during surgery. In each group, we assessed the correction of deformation by radiographic methods, postoperative complications, changes in pain intensity, and functional outcomes of surgical treatment six months after surgery.

Results. After surgeries, all analyzed groups showed a significant reduction in pain severity as measured by the VAS, averaging 3.71±1.10, 3.60±1.10, and 3.41±1.86 points respectively, along with an improvement in functional status as measured by the AO FAS scale, averaging 35.82±11.82, 28.79±10.34, and 32.00±13.70 points. Similar radiological results were observed across groups regarding changes in the M4–M5 intermetatarsal angle, varus deviation correction of the fifth toe, and lateral deviation angle of the fifth metatarsal. The third group demonstrated a trend toward fewer non-unions at the osteotomy site, although further research is needed to statistically confirm any potential advantages of the slide-down osteotomy over classical techniques.

Conclusion. The considered open osteotomies are reproducible and safe for clinical use and do not require specialized instruments or consumables. The improved slide-down osteotomy technique proposed by the authors for the fifth ray of the foot yields comparable results to traditional techniques used for this location. This method can be safely employed and serve as an additional tool in the arsenal of surgeons performing reconstructive procedures on the forefoot.

Introduction. The problem of maintaining the patency of the permanent vascular access (PVA) for renal replacement therapy (RRT) is extremely relevant due to the high incidence of its thrombosis and the need for repeated surgical interventions to reconstruct or form a new access.

The objective was to evaluate the efficacy of different approaches to surgical reconstructions of the PVA formed by a vascular access graft in its thrombosis.

Methods and materials. We performed a retrospective analysis of medical records of 46 patients operated on from 2018 to 2022 and who were diagnosed with PVA thrombosis. As for the revealed hemodynamically significant stenosis of the prosthetic venous anastomosis, a successful reconstruction of the PVA was performed.

Results. The median time for primary graft patency was 21±13.7 months, and secondary one was 19±15, 6 months. The median time for secondary patency after thrombectomy was 9±7.5 months, thrombectomy combined with plasty of the anastomosis area was 10.3±9.1 months, thrombectomy with reprosthetics was 14±12.9 months, thrombectomy with autovenous replantation was 18±9.0 months. The median time for the cumulative graft patency was 41±27.3 months.

Conclusion. Reconstructive surgery for PVA thrombosis allows not only to restore the patency of the latter, but also significantly prolong its function.

Introduction. The success of treatment of patients with acute intestinal obstruction is determined by many factors, including the correction of intra-abdominal hypertension and endotoxicosis through intraoperative decompression of the small intestine. The absence of a convincing evidence base in domestic practice in favor of choosing a specific method of probe decompression of the intestine in patients with acute intestinal obstruction served as the basis for this comparative study.

The objective was to evaluate the effectiveness and safety of small intestinal decompression methods in patients with benign forms of intestinal obstruction.

Methods and materials. This work was carried out in the format of a multicenter cohort retrospective study, which included an analysis of the treatment results in 315 patients operated with benign forms of intestinal obstruction, who underwent one of 3 intestinal decompression methods. Comparison groups were formed using an optimal matching procedure to avoid the influence of selected confounders on the outcome. The immediate results of treatment were assessed.

Results. The choice between simple nasogastric drainage and insertion of a tube through the ligament of Treitz does not affect rather the rate of adequate peristalsis restoration in the postoperative period, nor the frequency and structure of postoperative complications and deaths. On the contrary, the installation of a long intestinal tube does not accelerate the recovery of peristalsis, since in patients with a nasogastric tube, adequate intestinal activity was recorded on average a day earlier. No effect of nasointestinal intubation on the frequency and structure of non-lethal complications was found, which couldn’t be said about postoperative mortality, which was the highest in the group of patients with long intestinal tubes. At the same time, the most common cause of death was associated with the development of an intra-abdominal complication, while such a trend was not observed among patients with short tubes.

Conclusion. The installation of long intestinal tubes for intestinal decompression in patients with acute intestinal obstruction was associated with the highest mortality due to an increase in the number of intra-abdominal complications. It is impossible to make a clear choice between drainage of the initial parts of the small intestine or isolated installation of a tube in the stomach based on the data obtained.

In order to improve the long–term results of treatment of ductal cancer of the pancreatic head in stage IB–IIA, cryotherapy was performed during gastropancreatoduodenal resections involving the entire pancreatic head tissue in the cold zone. At the same time, freezing was performed twice: 1) before mobilizing the head of the pancreas; 2) after removing the drug on the bed of its removed part. Intraoperative cryotherapy was used in 27 patients with stage IB–IIA ductal cancer. The control group consisted of 31 patients who underwent standard operations without cryoablation. The results of the examination of patients within 7 years of the postoperative period showed the effectiveness of intraoperative cryotherapy on the tumor. Thus, among 10 patients operated on with stage IB of the disease using cryotherapy, tumor recurrence was detected in one patient after five years. While among 12 patients with the same stage, but without cryotherapy, a relapse occurred in 5 patients. The same trend was found in patients operated on during stage IIA of the disease.

The objective was to analyze different methods of anesthesia for endoscopic rhinosinus surgical interventions and to identify the optimal one.

Methods and materials. In a single-center retrospective-prospective study (967 patients), three variants of local anesthesia were evaluated in the form of application + infiltration anesthesia of the nasal cavity with the addition of: 1) intranasal blockade of the pterygopalatine ganglion, n=20; 2) intramuscular administration of benzodiazepines and narcotic analgesics, n=60; 3) intravenous administration of propofol and dexmedetomidine, n=60, as well as the option of total intravenous (n=60) and general combined anesthesia with mechanical ventilation (n=767). Evaluation criteria: hemodynamic and gas exchange (MAP, systolic BP, perfusion index (PI), PetCO2), wound bleeding intensity, patient’s qualitative assessment of anesthesia using the QoR-15 scale. The concentration of IL-6, IL-10, IL-18, alpha1-antitrypsin, and ferritin in the blood was studied in 26 patients.

Results. Local anesthesia methods were rated negatively by patients and surgeons in more than half of cases. Almost 40 % of patients considered the quality of general anesthesia as excellent, the rest considered good or satisfactory, and only 1.6 % considered it as poor. MAP, systolic BP, MAC of the anesthetic, PetCO2 affect bleeding in the surgical area. Optimal values of PI, as an integral criterion of the perfusion state, are in the range from 6.1 to 8.83 %. Exceeding these values is fraught with the development of significant bleeding. The use of a laryngeal mask is safe, moreover, its use instead of tracheal intubation helps to reduce bleeding in the wound.

Conclusion. Endoscopic interventions lasting longer than 60 min are preferably performed under general combined anesthesia with artificial ventilation and maintenance of airway patency using a laryngeal mask. Such anesthesia ensures hemodynamic stability and gas exchange, and allows for the control of the degree of bleeding by selecting the values of the factors influencing it.

The objective was to improve the results of treatment of surgical patients in the perioperative period with concomitant erosive and ulcerative lesions of the gastroduodenal zone.

Methods abd materials. 41 patients receiving inpatient care were observed from March to December 2024. The results of the study were registered for the following stages: 1 – the control before prescribing the drug, 2 – after 3–5 days of therapy with Omeprazole/Lanson-AF. All patients included in the study were assessed at stages 1 and 2 according to the dynamics of the main general clinical and biochemical laboratory parameters and the results of fibrogastroduodenoscopy (FGDS). Statistical data processing was performed using the IBM SPSS Statistics 20 program.

Results. According to FGDS data, defects of the gastroduodenal mucosa of varying severity were detected in patients at the 1st stage of the study. After the 1st stage, patients were divided into 2 groups: control and comparison. Antisecretory therapy with Omeprazole was performed in the control group, and Lanson-AF was performed for 3–4 days in the comparison group. In the control FGDS, there was a decrease in hyperemia, edema, and the absence of a visible defect in the gastric and/or duodenal mucosa. With Omeprazole, ulcerative defect repair was achieved by 3–4 days in 40 % of patients, with Lanson-AF in 92 % of cases.

Conclusion. The appointment of the drug Lanson-AF is more effective than Omeprazole for the purpose of preoperative preparation of patients with defects of the gastric and/ or duodenal mucosa for elective surgery. No adverse events have been reported with the use of Lanson-AF.

A clinical case of successful surgical treatment of a patient with a rare disease – cavernous hemangioma of the thymus is presented.

Lymphangiomas are vascular malformations that occur mainly in childhood. Their etiology is still unknown. In most cases, children arrive with a clinical picture of benign tumor, but there is also an asymptomatic course. The article describes a clinical case of a 5-year-old boy who was admitted to the surgical department of the Children’s Republican Clinical Hospital with a diagnosis of «Volumetric abdominal cavity formation», based on the results of ultrasound examination during periodic health examination. The child was indicated a diagnostic laparoscopy, during which multiple thin-walled cystic formations filled with hemorrhagic fluid were revealed. Due to the difficulties in determining the source of the formations, a decision was made to convert. A transverse laparotomy was performed, followed by total resection of the large omentum. Based on the obtained macropreparation, cytological and general clinical studies, the diagnosis of «Cystic hemlimphangioma of the large omentum» was made. However, the histological picture showed the presence of cystic multicameral lymphangioma. The postoperative period was uneventful. This article describes a rare clinical case of lymphangioma in the large omentum without clinical manifestations, which became an accidental finding during periodic health examination.

An outstanding surgeon and scientist, recognized in European countries, one of the founders of domestic hemotransfusiology, founder and director of the Research Institute of Blood Transfusion in Leningrad, creator of a large school of surgeons and transfusiologists in the USSR, editor-in-chief of the journal «Bulletin of Surgery named after I. I. Grekov» (1934–1937), Professor Eric Romanovich Hesse was born on July 28 (old style) 1883 in the city of Vyborg in a German family of a priest. Eric Hesse received an excellent secondary education at the Annenschule Gymnasium No. 1 in St. Petersburg. In 1902, he entered the Imperial University of Dorpat, a year later, he continued his education at the Imperial Military Medical Academy (1903–1905), and then, studied at the University of Kцnigsberg and the University of Tьbingen. After graduating from the latter in 1907, he received a medical degree and returned to St. Petersburg. For many years, Erik Romanovich worked at the Obukhov Hospital under the supervision of professors G. F. Zeidler and I. I. Grekov. In 1918, he was appointed chief physician of the Holy Trinity Community of Sisters of Mercy Hospital and simultaneously head of the surgical department. In 1920, he defended his doctoral dissertation «Clinic of the saphenofemoral anastomosis in varicose veins of the lower extremities and the remote results of this operation». In 1925, E. R. Hesse was elected head of the general surgery department at the State Institute of Medical Knowledge (GIMZ, now the North-Western State Medical University named after I. I. Mechnikov) and received the academic title of Professor. Concurrently, for 9 years, he provided scientific leadership to the neurosurgery department at the V. M. Bekhterev Psychoneurological Institute. In 1934, Erik Romanovich was elected head of the 1st surgery department at GIMZ and also began to serve as editor-in-chief of the journal «Bulletin of Surgery and Border Regions». Professor E. R. Hesse made a huge contribution to the development of domestic surgery and transfusiology, to the improvement of training of students of medical institutes and postgraduate education of surgeons. He was the author and editor of the first two-volume manual in the country «General Surgery» (1928), the first Soviet three-volume manual «Special Surgery» (1937), the editor of the four-volume manual «Errors, dangers and unforeseen complications in the treatment of surgical diseases» (1936–1937). In 1931, E. R. Hesse organized the first blood transfusion station in Leningrad. In 1932, it was reorganized into the Leningrad Institute of Blood Transfusion, headed by Erik Romanovich. He made a very large contribution to the organization of the network of blood service institutions in Russia, the substantiation of the principles of blood donation, the introduction of component transfusion therapy, the development of preventive measures and approaches to the treatment of post-transfusion complications. Eric Romanovich was the author and co-author of 210 scientific and practical works on 11 surgical disciplines and transfusiology in domestic and foreign publications. Professor E. R. Hesse died tragically on November 26, 1938 in Leningrad.