Vol 15, No 3 (2022)

Introduction. Modern options of plastic surgery tend to improve clinical outcomes, introduce minimally invasive methods, increase the quality of the cosmetic effect, provide long-term preservation of the effect, and use the most efficient and safe procedures. In this paper, the authors reviewed the main options for performing liposuction as a stage of abdominoplasty. The aim of research was to study the clinical outcomes of abdominoplasties combined with liposuction performed in plastic clinics in Krasnoyarsk, and systematize their approaches.
Materials and methods. This prospective and retrospective study involved 172 patients who underwent abdominoplasty with liposuction or liposuction in the Center for Plastic Surgery and Outpatient Healthcare and the Department of Plastic and Reconstructive Surgery of the Clinical Hospital "RZD-Medicine", Krasnoyarsk. The average age of women was 38 years.
Results and discussions. The ways of combining liposuction and abdominoplasty are extremely diverse due to effect of liposuction on the clinical outcomes of abdominoplasty. The volume of liposuction, the terms of liposuction, the area and access of surgical intervention are the most important issues for providing an aesthetic result. According to our findings, 30 women (24%) were performed solely liposuction of the anterior abdominal wall, 10 (8%) women were performed mini-abdominoplasty combined with liposuction, 31 women underwent mini-abdominoplasty or abdominoplasty without liposuction (29%), abdominoplasty combined with liposuction was performed in 54 (42%), which was the largest proportion compared to other types of interventions.
Systematization of liposuction options used in plastic clinics in Krasnoyarsk allows developing a scheme for the major, most commonly used approaches to combine these types of operations. Local complications are more common in women with BMI=30-40. In the postoperative period, local complications were observed in 5.8% of cases; systemic complications were not detected in this study.
Conclusion. Effectiveness analysis of the results obtained demonstrated that the most effective way of the intervention is to perform liposuction during abdominoplasty. Liposuction as a stage of abdominoplasty with a competent and personalized approach improves the effectiveness of abdominoplasty and allows achieving an ideal aesthetic result.

The aim of research was to study parameters of homeostasis and conditions for stable operation of the autoperfused heart-lung complex ex vivo.
Materials and methods. A series of acute experiments (n-3) was carried out to create a functioning heart-lung complex and study parameters of homeostasis ex vivo. A large mammal (mini-pig weighed 20-30 kg) was used as an experimental model. During the experiment, invasive blood pressure in the aortic root, pulmonary artery, central venous pressure, temperature of the left ventricle of the heart, gas composition of arterial blood (in the aortic root) and venous blood flowing from the coronary sinus was monitored.
Results. The series of experiments evidenced the fundamental possibility of an isolated heart-lung complex ex vivo stable functioning. During 4-hours autoperfusion of the "heart-lung" complex, the parameters of hemodynamics, gas and biochemical blood composition remained within the reference values.
Conclusion. The analysis of literature data and the results of experiments on laboratory animals allow us to state that the autoperfusion can be successfully used as an option of safe and long-term conditioning of a donor heart. This technique can be used to improve the results of heart transplantation with prolonged ischemia of the donor organ. Extending the survival of a donor heart ex vivo functioning will significantly expand the geography of donor bases, reducing the ischemic period to a minimum.

Introduction. Treatment of hilar cholangiocarcinoma remains one of the most complicated issues of surgical hepatology. As known, hilar cholangiocarcinoma is resistant to chemotherapy and radiation therapy, and only a surgical option is an effective way to improve patient survival.
The aim of the study was to improve clinical outcomes of patients with cholangiocarcinoma by evaluating the efficiency of various options for resection and reconstructive and restorative stages of surgical treatment.
Methods. The study involved clinical findings and outcomes of 68 patients with hilar cholangiocarcinoma. Biliary decompression was performed in 61 (89.7%) cases. Radical surgical interventions were performed in 35 (51.4%) cases, and palliative surgical interventions were performed in 33 (48.6%) cases.
Results. Specific complications at the stage of biliary decompression were noted in 4 (6.5%) cases, inadequate drainage of the biliary tract occurred in 5 (8.2%) cases. The syndrome of "rapid decompression of the biliary tract" was recorded in 14 (23.0%) cases, cholangitis - in 12 (19.7%). Intraoperative complications were noted in 2 (15.3%) cases, postoperative - in 6 (17.1%) cases. Mortality rate was 8.5%. In the long-term period, stenosis of the biliodigistic anastomosis was recorded in 11.4% of cases, tumor recurrence occurred in 28.6% of cases. The five-year survival rate was 17.0%.
Conclusion. Resection of the bile ducts combined with hemihepatectomy is an operation accompanied by high risks, especially at the height of jaundice and in the elderly patients. Performing a sparing hiatal resection of the liver and bile ducts provides an acceptable survival rate. The proposed method to form a biliodigistic anastomosis is effective in terms of preventing insolvency and stenosis of the anastomosis.

Minimally invasive percutaneous techniques, staged as part of the combined treatment of high stricture complications of the biliary tract, demonstrated high efficiency in the short term. On the other hand, the use of self-expanding nitinol stents as a definitive treatment for non-tumor stricture of the biliary tract in long-term life prognosis cannot be recommended as a routine intervention. The use of stents in these cases can only be justified in the absence of alternative treatment options, subject to frequent monitoring of the biliary tract.

Introduction. Until now, the treatment of postoperative ventral hernias and their complications remains a difficult task of abdominal surgery. Patients with extensive wound defects of the abdominal wall complicated by a purulent-inflammatory process of soft tissues are of particular difficulty for treatment; an attempt to stitch these tissues together in the II phase of the wound process using conventional options results in unnecessary trauma and makes it much more difficult, and sometimes impossible, to accurately match homogeneous layers.
The aim of the study was to demonstrate the potential of successful use of the developed adaptive instruments for mechanical treatment of the wound surface and closure of a large defect in the soft tissues of the anterior abdominal wall, formed during suppuration of the surgical wound and rejection of the endoprosthesis after prosthetic repair of the hernia ring.
Results. Two clinical cases of successful use of the developed adaptive instruments for mechanical treatment of the wound surface and hardware decompression suturing of wounds in the treatment of deep wound infection in postoperative ventral hernias prosthetic repair were presented. Healing of wound defects after wound suppuration and implant rejection was achieved in both cases.
Conclusion. The data obtained demonstrated the safety and clinical efficacy of a staged surgical treatment with mechanical debridement of the wound, followed by vacuum therapy and the implementation of a hardware decompression technique for closing the wound defect; this creating optimal conditions for wound healing according to the type of primary intention.

Cystic echinococcosis is a chronically severe parasitic disease of humans and animals caused by parasitism of the larval stage of Echinococcus unicameral.
Ultrasound (ultrasound) being the most widely used option of visual diagnostics is the leading method of radiological diagnosis of echinococcosis of the liver and other organs. The technique is generally available and allows diagnosing echinococcosis at a stage when parasitic cysts are still small in size, starting from 1.5-2 cm. However, with the high accuracy and specificity of ultrasound in the differential diagnosis of echinococcosis cysts, there are certain disadvantages of the approach.
Due to constant study and, accordingly, changes in knowledge about the course of the disease, methods for its diagnosis and treatment, there is no unified and stable ultrasound classification of liver echinococcosis. The paper analyzes the criteria that justify various classifications of echinococcus, substantiates forming trends. The standardized ultrasound classification of hydatid echinococcosis of the liver, which was adopted by the World Health Organization in 2003 and revised in 2010, is discussed.
The potential and advantages of dynamic ultrasound monitoring of echinococcal cysts and postoperative characteristics of the residual cavity after echinococcectomy are demonstrated.

Introduction. To date, according to WHO, liver failure (LF) is one of the ten leading causes of death in the elderly in developing countries. In developed countries, LF occurs in 0.03% of the population, but mortality and complication rate remain high. WHO predicts that in the next 10-20 years, mortality from liver diseases will increase by 2 times. In this regard, prevention and treatment of liver failure is of great medical and social significance, remains relevant and requires in-depth study on biological models.
The aim of the study was to systematize the data on modern approaches to study liver failure on biological models.
Material and methods. The authors reviewed data in PubMed, Cochrane Library, ScienceDirect, eLIBRARY. The search was conducted on the keywords "liver failure", biological model, "liver surgery", "liver failure", "modeling of liver failure", "biological model" and limited to the period 2010-2021. In addition, a manual search of papers in the peer-reviewed journals was carried out. Criteria for exclusion were: description of individual clinical cases, data from books and documents, comparison of clinical outcomes. Out of 109 initially identified sources, 40 sources were included in the final analysis.
Results. To date, there are several ways to simulate acute liver failure: surgical, toxic and combined. Chronic liver failure is also simulated diversely: toxically (tetrachloromethane, thioacetamide, dipin, sovtol-1, etc.); surgically (ligation of the bile ducts); dietarily (choline-deficient, etc.); genetically (introduction of exogenous genes into the germ line, combination of hepatotoxins with hepatocarcinogens). As stated, LF simulation has features associated with a high rate of regenerative processes in the liver; the fact allowing it to compensate for damage relatively quickly.
Conclusion. There are many techniques to simulate hepatic pathology, differing in damaging factors, the degree of damage and the reversibility of the process, different manifestations of biochemical and morphological changes. When choosing an option to reproduce liver failure, the researcher should take into account the advantages and disadvantages of the model, the conditions for conducting and the expected result of the experiment, and also choose the model that most accurately illustrates the clinical picture of this pathological condition.

The fate of Professor Israil Moiseevich Perelman (1892-1954) is inextricably linked with the history of the Minsk Medical University and the Minsk Provincial Hospital, the Borisov Regional Hospital and the surgical service in Gorki, Gomel and Mogilev. He stood at the origins of the formation of medical universities in Vitebsk, Ordzhonikidze, Novosibirsk and Yaroslavl. It all started with the fact that among the many settlers who came to the promised land of White Russia was Moses Perelman. He was the same Jewish poor who were not allowed to cross the limits of the "Pale of Settlement". Without any preferences for choosing a place of permanent residence, Perelman chose the factory outskirts of Minsk – Lyakhovka. This place is unattractive, but here, along with many thousands of the same "new settlers", starting from zero, it was possible to make plans for the future and vigorously implement them. An artistic and documentary review of the origins of this settlement, its description of everyday life allows us to imagine the atmosphere of the daily life of those who settled there, took root and gave birth to a new generation. It is this close relationship between the past and the future that makes it possible to understand that in any conditions there is a potential for the formation of good abilities and talents, which, in particular, Israil Perelman possessed. Undoubtedly, the parents were the determining factor in this. They, being guardian angels, provided everything possible and impossible for the upbringing of a purposeful personality in the son, and the difficulties only helped to maintain a sense of gratitude for everything that made the childhood of one of the many boys of the Minsk outskirts carefree - that same factory outback, his small homeland – Lyakhovka.

Viktor Ivanovich Bulynin was born on October 12, 1932 in Leningrad, now St. Petersburg, into a family of doctors. After graduation, he entered the Kuban Medical Institute. Red Army, and two years later, in connection with the move of the family, transferred to the Stavropol Medical Institute. After graduating from the medical faculty of a medical university in 1957, he worked as the head of the surgical department of the Gofitsky district hospital of the Stavropol Territory. At this time, Viktor Ivanovich performed various surgical interventions, including cholecyst-, nephrectomy and gastric resection. Information about his work was also reflected in regional newspapers, which wrote about his reimplantation to a collective farmer who was torn off during agricultural work. In 1959, on the advice of his surgeon father, he travels to Moscow to present the vasoconstrictor he created. After meeting with academician A.A. Vishnevsky, he was admitted "to the workplace" to the Department of Vascular Surgery, and in 1960 he was enrolled in the clinical residency of the Institute of Surgery named after A.V. Vishnevsky Academy of Medical Sciences of the USSR. The study of the effectiveness of the use of the vasoconstrictor he developed allowed V.I. Bulynin in 1963 to defend, under the guidance of professors N.K. Galankin and I.I. Khozhainov, his dissertation work for the degree of candidate of medical sciences on the topic: "Circular aortic suture with a minimum period of cessation of blood flow." Further, for family reasons, unable to accept the offer of Academician A.A. Vishnevsky to stay to work at the Institute of Surgery. A.V. Vishnevsky Academy of Medical Sciences of the USSR, Viktor Ivanovich goes to Karaganda, where he works as an assistant (1962-1964), and then as an assistant professor at the Department of Hospital Surgery of the Medical Institute (1964-1971). In 1971, V.I. Bulynin defended his doctoral dissertation on the topic: "Clinical forms of pulmonary hypertension in patients with mitral stenosis." The scientific consultants during this study were well-known professors I.K. Galankin, L.D. Krymsky and F.L. Hectin. In the same year, he was elected head of the Department of Hospital Surgery of the Karaganda Medical Institute (1971-1975), and a year later he was awarded the title of professor. At this time, he operates a lot, including performing surgical interventions on the heart, blood vessels, introducing endovascular interventions such as probing the cavities of the heart and angiocardiography. The first students of Viktor Ivanovich were subsequently known doctors: prof. KGMI D.I. Bogomolov, personal doctor of the President of Kazakhstan N.A. Nazarbayeva S.E. Tokpanov, professor of the Department of General Surgery of Moscow Medical University named after I.M. Sechenov A.N. Afanasyev and others. At the same time, Viktor Ivanovich also works as dean of the medical faculty of the Karaganda Medical Institute. In 1975, V.I. Bulynin was elected head of the Department of Hospital Surgery of the Voronezh Medical University. In 1976, the department under his leadership moved to the newly commissioned building of the largest health care institution in the Chernozem region - the Voronezh Regional Clinical Hospital. On the basis of the hospital there were 19 diagnostic and auxiliary, 34 hospital units, including departments of cardio-, gastro-, endosurgery, thoracic and vascular surgery, neurotraumatological, orthopedic, coloproctological and burn. Later, endoscopic, X-ray surgical and oncourological departments were opened. The hospital had a two thousandth bed fund, which together made it possible to provide qualified medical care to about thirty thousand patients annually. During this period, Viktor Ivanovich introduces into clinical practice about sixty new surgical interventions for Voronezh and the Voronezh region.For the first time in the region, he carried out such cardiac surgery as radical corrections of complex congenital defects and post-traumatic damage to intracardiac structures, multi-valve prosthetics, removal of heart tumors, coronary artery bypass grafting, including in conditions of artificial circulation. In 1976, Viktor Ivanovich performed operations on the "open heart" for the first time in Voronezh. He performed pancreatoduodenal resection in pancreatic cancer for the first time in the region; formation of porto-caval anastomoses in vasorenal hypertension; resections of the thoracic and abdominal aorta; numerous operations on the esophagus, bronchi, adrenal glands, etc. The organization of transplantation and microsurgical care, the manufacture of xenografts for cardiac surgery is associated with the name of Viktor Ivanovich. Viktor Ivanovich was a versatile person, his friends were sculptor I.P. Dikunov, writer G.N. Troepolsky, engineers, Lenin Prize laureates I.I. Poyarkov and G.V. Sukhodolsky, composer M.I. Nosarev, architect P.P. Danilenko, editor R.A. Khodeev, professor-chemist E.G. Goncharov and many others. Communication with these creative people, high-level professionals allowed him to keep up with the times, to create innovative developments at the "junction of specialties." V.I. Bulynin published more than 300 publications, including such fundamental monographs as "Clinical forms of mitral stenosis" (1977), "Wound of the heart" (1989), "Liver resection" (1995), "Wound treatment" (1998), "Treatment of benign prostatic hyperplasia" (1998). He is the author of more than 30 patents of the Russian Federation, including those devoted to methods of treating lung abscesses, endoscopic bleeding arrest, the use of hydropressive flows, HBO and ozone therapy, a device for blood reinfusion, etc. He prepared 26 candidates and 4 doctors of medical sciences, he is the founder of cardiovascular, thoracic and abdominal surgical schools, his pupils head key posts in practical health care and medical education. For fruitful work, Viktor Ivanovich was awarded the Order of Friendship of Peoples (1981) and various medals. In 1994, Professor V.I. Bulynin was elected Honorary Citizen of Voronezh, and in 1995 he was awarded the title - Honored Scientist of the Russian Federation. Viktor Ivanovich was a member of the Presidium of the All-Russian Society of Surgeons, chairman of the Regional Scientific and Practical Society of Surgeons, a member of the International Society of Surgeons, Associations of European and Hepato-Pancreatic Surgeons. He was a member of the Higher Attestation Commission of Russia, dissertation councils of Voronezh and Rostov medical universities, the editorial board of the Great Medical Encyclopedia, and the editorial board of the scientific and practical journal Breast and Cardiovascular Surgery. In 1997, the Cambridge Society "International Biographical Center" named after V.I. Bulynin was included in the encyclopedia of famous doctors "Who is Who." On March 25, 1998, Viktor Ivanovich suddenly died and was buried at the Kominternovsky cemetery in Voronezh. His name is immortalized in the name of the street of the city of Voronezh, his bust is installed in the administrative building of the Voronezh Regional Hospital. In our memory, Viktor Ivanovich remains a charming, intelligent, athletic, cheerful and wise person, a wonderful professional who gave all his strength to people and his beloved profession.

It is the 80th anniversary of the birth of the head of the Department of Dentistry and Maxillofacial Surgery of the Orenburg State Medical University, Doctor of Medical Sciences, Professor Matchin Alexander Artemievich. Alexander Artemievich was born on January 1, 1942 in the village of Alekseevka, Orenburg Region, in the family of a teacher. After completing his studies at the Faculty of Medicine at the Orenburg State Medical Institute, he was enrolled in the clinical residency of the Department of General Surgery. At the end of his residency, he continued his postgraduate studies at the Department of Hospital Surgery and in 1971 successfully defended his thesis. All further scientific and practical activities of A.A. Matchin - a talented surgeon, scientist, skillful organizer - were associated with the Orenburg State Medical Institute (since 1994 - the Academy, and since 2014 - the University), where he worked as an assistant, and then an assistant professor of the Department of Hospital Surgery in the course of dentistry. After the opening of the Faculty of Dentistry, the course was reorganized into the Department of Dentistry and Maxillofacial Surgery, and Associate Professor A.A. Matchin became the head of this department. As the head of the department, A.A. Matchin organized and supervised the educational process for the study of dentistry and maxillofacial surgery at all faculties of the university, gave the main course of lectures, supervised the training of students and clinical residents of the department. He not only supervised the medical work of the clinic of maxillofacial surgery, but also performed the most complex surgical interventions. Under the scientific advice of the Honored Scientist, member of the RAMS correspondent, Doctor of Medical Sciences Professor V.A. Kozlov in 2007, Alexander Artemievich successfully defended his doctoral dissertation and received the title of professor. For a series of scientific works on the use of new medical technologies in maxillofacial surgery and dentistry, Professor A.A. Matchin was twice (2011, 2017) awarded the title of laureate of the Governor of the Orenburg Region Prize in the field of science and technology. Professor A.A. Matchin wrote three chapters for the textbook "Topographic Anatomy and Operative Surgery," published in 2009 by the GEOTAR-Media publishing house, which was reprinted several times. He is also a co-author of a textbook on operative maxillofacial surgery and dentistry edited by V.A. Kozlov and I.I. Kagan, released in 2014 and with an additional circulation in 2019. The main areas of multifaceted medical and scientific activity of Professor A.A. Matchin are such undoubtedly important problems as restorative surgery of the maxillofacial region, treatment of inflammatory diseases and injuries, issues of oncological dentistry and organization of care for specialized patients. He embodied his knowledge and invaluable practical experience in publications of more than 350 scientific and educational works, seven copyright certificates and patents for inventions, prepared five candidates of medical sciences. For many years, Professor A.A. Matchin headed the Dental Association of the Orenburg Region, was a member of the Council of the Dental Association of Russia. Currently, he is a member of the dissertation council D 208.066.04 at the Orenburg State Medical University, a member of the profile commission for maxillofacial surgery of the Ministry of Health of the Russian Federation. For merits in the field of health care and many years of conscientious work, by Decree of the President of the Russian Federation V.V. Putin No. 824 of May 6, 2000, Professor A.A. Matchin was awarded the honorary title "Honored Doctor of the Russian Federation." By a resolution of the StAR Council of 23.04.19, he was awarded the honorary title "Honored Maxillofacial Surgeon." Among colleagues A.A. Matchin is known not only as a high-class specialist, but also as a person of a big soul and a good heart. Happy anniversary, dear friend and reliable comrade!