[Role of neodymium laser in surgery: stimulation of postoperative surgical wounds healing. Results of clinical studies]. / Rol' neodimovogo lazera v khirurgii: stimulyatsiya zazhivleniya posleoperatsionnykh khirurgicheskikh ran. Rezul'taty klinicheskikh issledovanii.

OBJECTIVE: To prove the effectiveness of the low-intensity laser radiation application in the treatment of wounds of different origin. MATERIAL AND METHODS: The clinical study involved 110 persons, divided into 55 subjects in both the study and control groups. The patients of the study group were exposed to the long-wave short-pulse neodymium laser immediately and within 35 days after interventions with a skin incision using it, in a way that wound treated with laser received low-level laser therapy. The control group patients' wounds were treated with standard methods by the means of topical drugs corresponding to the clinical manifestations of the wound process in each particular case. The study was carried out in the hospital of the department of maxillofacial and plastic surgery of the dental complex of the «Russian University of Medicine¼ from 2019 to 2022, and further conservative treatment was conducted in the department of dermatology and cosmetology of the University Hospital of the Medical Graduate School (Institute) of the RSSU. All wounds were classified into three groups for the convenience of systematization and formation of a generalized treatment protocol for postoperative surgical wounds. RESULTS: The objectivity and optimality of the chosen by us actions were confirmed in the conducted work. The formed scars were visually assessed on the POSAS scale at the end of the treatment by patients and 4 independent doctors, as well as each scar was visually assessed by four independent doctors and patients. At the end of the study we formed and proposed an algorithm for the treatment of surgical wounds of various origins. The parameters of the Aerolase Neo Light Pod neodymium laser for the treatment of patients with different types of skin wounds were clinically determined. Experimentally proven properties of the Aerolase Neo Light Pod neodymium laser on accelerating the healing process of surgical wounds through photobiomodulation mechanism support their regeneration with the formation of negligible normotrophic scars, as well as reduce the length of patients' treatment in surgical hospitals, as compared to patients receiving standard external drugs.

[Optimization of laser exposure parameters during surgical correction of soft palate tissues in patients with ronchopathy and obstructive sleep apnea syndrome]. / Optimizatsiya parametrov lazernogo vozdeistviya pri khirurgicheskoi korrektsii tkanei myagkogo neba u bol'nykh ronkhopatiei i sindromom obstruktivnogo apnoe vo sne.

OBJECTIVE: Substantiation of optimization of laser radiation parameters when performing surgery on the soft palate to improve the results of treatment of patients with ronchopathy and obstructive sleep apnea syndrome. MATERIAL AND METHODS: Based on the experience of performing laser sculptural uvulopalatoplasty in 309 patients with ronchopathy and obstructive sleep apnea syndrome, a rational choice of parameters of laser radiation used during the operation is justified. RESULTS: Optimization of laser radiation parameters during laser sculptural uvulopalatoplasty allowed to improve the positive results of treatment of patients with ronchopathy and obstructive sleep apnea syndrome in 98.4% of cases (304 out of 309 operated patients). CONCLUSION: Optimization of laser radiation parameters when performing laser sculptural uvulopalatoplasty increases the effectiveness of treatment of patients with ronchopathy and obstructive sleep apnea syndrome.

[Combined treatment of colorectal cancer followed by metastatic liver injury]. / Analiz rezul'tatov kombinirovannogo lecheniia bol'nykh kolorektal'nym rakom s metastaticheskim porazheniem pecheni.

AIM: To increase the effectiveness of treatment of colorectal cancer followed by metastatic liver lesion. MATERIAL AND METHODS: This study included 319 patients with colorectal cancer and metastatic liver lesion Gennari grade I, II, and III for the period from 2002 to 2017. All patients received combined treatment. 107 patients underwent liver resections: right-sided hemihepatectomy - 10, advanced right-sided hemihepatectomy - 7, left-sided hemihepatectomy - 9, triple segmentectomy - 33, bisegmentectomy - 29, segmentectomy - 19 cases. Radiofrequency ablation of liver metastases was performed in 105 patients. Cool tip device with a power of 200 W was used for destruction. Fifty-seven patients underwent microwave destruction of liver tumor (AveCure MWG 881, 34 W). Transarterial chemoembolization by doxorubicin and HepaSpheres 150-250 ng was applied in 34 patients. RESULTS: Annual, 2-, 3- and 5-year survival was 83.1%, 73.5%, 60.2% and 24.6%, respectively after liver resection. RFA of liver metastases was followed by annual, 2- and 3-year survival near 73.5%, 53.3% and 32.1%, respectively. In case of MWA of liver metastases annual survival was 78.5%, 2-year - 63.3%, 3-year - 58.3%. CONCLUSION: Chemotherapy combined with targeted therapy, radiofrequency and microwave ablation is able to increase resectability up to 35-40% in patients with colorectal cancer followed by liver metastases. Minimally invasive procedures (RFA, MWA) reduce surgical risk in critically ill patients.

[Antegrade approach for cholangiolithiasis complicated by mechanical jaundice]. / Vozmozhnosti antegradnogo dostupa v lechenii kholangiolitiaza, oslozhnennogo sindromom mekhanicheskoi zheltukhi.

AIM: To improve an efficiency of surgical treatment of patients with cholelithiasis complicated by obstructive jaundice through antegrade interventional approach. MATERIAL AND METHODS: 166 patients aged from 23 to 92 years with cholangiolithiasis complicated by mechanical jaundice were enrolled. Patients were divided into 2 groups: group I (136) - retrograde endoscopic method, group II (30) - antegrade interventional approach. RESULTS: In the first group surgical efficacy was 79.4%. Morbidity and mortality were 13% and 2% respectively. In the second group these values were 96.7%, 10% and 3% respectively. CONCLUSION: Antegrade interventional approach for minimally invasive procedures is technically feasible, has the same effectiveness as the retrograde endoscopic method and also all advantages of minimally invasive techniques.

[Method of surgical treatment of hiatal hernia]. / Sposob khirurgicheskogo lecheniia gryzh pishchevodnogo otverstiia diafragmy.

A method of hiatal hernia surgery providing an opportunity to decrease postoperative complications has been proposed. The method eliminates the development of a pathologic hiatal narrowing during diaphragmocrurorraphy. The method has been used in 65 patients. The advantages of the method are demonstrated.

Surgical management of gastroduodenal ulcer associated with hiatal hernia.

The problem of surgical management of gastric and duodenal ulcers associated with the hiatal esophageal hernias is reported. The authors have summed up the results of simultaneous surgical treatment of 97 patients. Good follow-up results were obtained in 69.2 percent of the patients, satisfactory in 26.9 percent and unsatisfactory in 3.9 percent of the patients. Of the 28 patients with reflux esophagitis who had previously undergone gastric resection, it was noted that nonresection of the associated hiatal hernia during the primary operation for ulcer disease decreased the effect of surgical treatment. A new method of surgical management of reflux esophagitis of the resected stomach is presented. The authors conclude that simultaneous operation for gastroduodenal ulcers associated with hiatal hernia is a promising area of surgical treatment and ensures high medical, social and economic efficiency.

[Kasten's syndrome]. / Sindrom Kastena.

The associated hiatal hernia, chronic cholecystitis and duodenal ulcer disease were diagnosed in 12 patients. Combined surgical operations were performed in 9 patients with a good long-term result.

[Simultaneous surgeries in the treatment of stomach and duodenal diseases]. / Simultannye operatsii pri lechenii zabolevanii zheludka i dvenadtsatiperstnoi kishki.

The results of diagnosis and treatment of diseases of the stomach and intestine associated with diseases of the abdominal organs: hiatal hernia (97 cases), commissural disease of the peritoneum (31), calculous cholecystitis (28), abdominal wall hernia (22) are presented. In 34 patients, 3 and more diseases were revealed. Simultaneous operations were performed in 181 patients. At the long-term period, a good result was noted in 68.6%, a satisfactory one--in 25.5%, and unsatisfactory result--in 5.9%. The substantiated performance of simultaneous operations in patients of the given category is a perspective trend in surgery, it ensures the high medico-social and cost effectiveness of treatment.

[Simultaneous operations in gastric and duodenal ulcer]. / Simul'tannye operatsii pri iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki.

The experience with surgical treatment of 112 patients with gastric and duodenal ulcer disease associated with pathology of the abdominal organs is summarized. Most frequently in ulcer disease, sliding hiatal hernia (34.1% of cases) and adhesive disease (25.7%) were revealed. In all the patients, the simultaneous operations were performed. The incidence of postoperative complications was 13% and didn't exceed that in the control group of patients, who underwent only the operations on the stomach and duodenum.