Introduction. Purpose of this work: analysis of the main issues related to cyanoacrylate obliteration of varicose veins.

Materials and methods. A keyword search and analysis of literary sources in the international abstract database PubMed. as well as the Russian system of the Russian Science Citation Center during the last 20 years. The article describes the work related to the occlusion of failed major subcutaneous veins with medical glue – cyanacrylate. More than 60 scientific publications were studied.

Conclusion. The use of thermal obliteration techniques increases the number of outpatient surgical treatment procedures for patients with VVLL without hospitalization, while improving the quality of life. The synthesis and further application of new formulas of cyanoacrylate composites based on laboratoryexperimental and clinical studies will further determine the place of CAO in the treatment of CPV. There is a need to create a modern safe domestically produced cyanoacrylate compound for endovenous treatment of patients with CVC. There is a need to conduct randomized clinical trials with CAO to show how demanded this method of treatment of patients with IBSCs is and to identify all advantages of this NTNT technology for wider implementation in clinical practice.

One of the important and discussed topics in modern medicine, according to research results, are diseases of the pancreas – their diagnosis and treatment. If we look at the global dynamics of the increase in the number of diagnosed cases of pancreatic diseases, then at the moment the increase in the frequency of detection of such diseases is from 8.2 to 10 cases per 100,000 population. At the moment, from 27 to 50 cases of diseases per 100,000 population are detected in Russia, in Europe the indicator is slightly lower, and ranges from 25 to 27 people per 100,000. This frequency is directly related to the constantly deteriorating environmental situation, the growing use of alcoholic beverages, poor food quality due to the transition to semi-finished products and an increase in the composition of the products of the results of the chemical industry, a decrease in the standard of living in general.

Also, in the last ten years, there has been an almost fourfold increase in the detected cases of acute and chronic pancreatitis in the young population, including those who have not reached the 18th birthday. This gives particular importance to the problem under study, since these segments of the population have a very high risk of complications, as a result of which mortality is observed in almost 6 percent of cases, and in the case of severe acute pancreatitis, it can reach 70 percent.

Introduction. Currently, there are no historical medical studies aimed at studying the role of female surgeons in practical healthcare and science.

The purpose of the study. On the basis of literature data, documentary sources and biographies of typical representatives, to form a periodization approach to the development of women's work in surgical specialties. Determine common and particular features within individual periods.

Materials and methods. Narrative, historical-genetic, comparative and structural methods were used in the study.

Results. We have identified three periods of entry of women into surgical specialties. The first period refers to the end of the 19th - beginning of the 20th century and is characterized by single individuals who became surgeons not because of, but in spite of circumstances. The second period can be divided into two stages: the first stage is the mass, directed by the state, training of women in medical universities, which formed a vast contingent of highly educated specialists, most of whom worked as general practitioners (in modern terms, a general practitioner). The second stage of the second period is associated with the beginning of the Great Patriotic War, when female general practitioners were called up to the positions of front-line and hospital surgeons. After the end of the war, many of them continued to work in peacetime surgery. The third period - post-war enrollment in medical universities was characterized by a demographically determined large number of female students who consciously chose surgery as their specialty.

Conclusion. During the years 1890—1940. there is a steady increase in the number of women in surgical specialties, caused by the state policy of the Soviet state.

Introduction. We have performed a comparative morphological analysis of the state of the choledochal wall when plastic and nitinol stent are implanted at different stages after stenting.

Materials and methods. The study included 91 patients who underwent pancreatogastroduodenal resection for periampullary carcinoma at the Department of Hepatopancreatobiliary Surgery, Botkin Hospital from 2014 to 2020. Of these, 56 patients were previously stented using a plastic stent and 35 were stented using a nitinol stent. The histological structure of the choledochal wall was studied depending on the type of stent (plastic or nitinol) and the timing of its implantation (14-30 days, 31-60 days, 61 days and more).

Results. When both types of stents are used, irreversible morphological changes develop in the ductus wall, but their nature is different. When plastic stents are used the changes occur in all layers of the wall and are characterized by mucosal atrophy and ductal fibrosis. With metal stents hyperplastic processes develop in the mucosa, the severity of which is proportional to the duration of the stent placement in the ductus lumen. Hyperplastic mucosa of the duct infiltrates the stent, narrows or completely obstructs the ductal lumen, creating additional opportunities for biofilm formation, while the muscular layer of the duct retains its structure.

Conclusion. The functioning time of plastic stents is shorter than that of nitinol stents, the developing fibrotic-atrophic changes of the ductus wall when they are implanted have less influence on the ductus lumen and bile outflow than hyperplastic processes in nitinol stents, which makes reasonable the use of plastic stents preferable.

Introduction. A rational system for the use of diapeutic measures in the early stages after thyroid surgery has not yet been developed.

The purpose of the study. To substantiate the necessity and effectiveness of diapeutic interventions in the early period after thyroid surgery.

Materials and method. We carried out a retrospective analysis and a prospective study of the results of surgical treatment of 172 patients operated on for thyroid disease. Ultrasound of the area of surgical intervention on the 2nd - 4th day after the operation was performed in 99 patients in order to identify possible complications. The comparison group consisted of 73 patients who did not undergo ultrasound of the operation area during the hospital period.

Results. Ultrasound examination revealed complications in the surgical wound in 14 (14,1 %) of 99 patients, including two cases of a violation of the mobility of the vocal fold on the side of the fluid accumulation in the bed of the removed thyroid lobe. Among 73 patients of the comparison group, complications diagnosed in 3 patients in the post-hospital period in the stage of suppuration required repeated hospitalizations and more traumatic medical manipulations.

Conclusion. Routine use of ultrasound in the early postoperative period after thyroid surgery makes it possible to identify complications and perform their correction using a minimally invasive puncture technique properly. Ultrasound-guided interventions should be performed by a diapeutist – a surgeon who has undergone special training in ultrasound diagnostics.

Introduction. To date, there are many methods for diagnosing choledocholithiasis, but the problem of identifying small stones of the common bile duct remains relevant.

Materials and methods. The work is based on the results of a survey of 65 patients with suspected microcholedocholithiasis, who are being treated at the GKB named after. S.P. Botkin in the period 2020–2022. To analyze the results, all patients were divided into two groups. The first group included 38 (70 %) patients with cholelithiasis, in patients according to the biochemical blood test and transabdominal ultrasound, there were signs of hepaticocholedochus expansion, but the presence of calculi is doubtful. The second group included 16 (30 %) patients with clinical manifestations of cholelithiasis, but there was no pathology according to the results of a biochemical blood test and transabdominal ultrasound.

Results. In the first group of patients, according to MRCP data, in 8 (21 %) cases, filling defects with a diameter of 3–4 mm were found, and in 30 (79 %) cases, calculi were not suspected.

In the second group of patients in 3 out of 18 (17 %) patients, according to the results of MRCP, filling defects with a diameter of up to 4 mm were detected, in 8 (44 %), according to the results of EUS, calculi were detected in the lumen of the choledochus, and in the remaining 7 (9 %) patients, calculi were not identified by either MRCP or EUS.

Conclusion. In most cases, EUS plays an important key role in the diagnosis of microcholedocholithiasis in patients with cholelithiasis, which improves the results of treatment in this category of patients.

Introduction. The Aim. Improving the results of surgical treatment of patients with infection of the aortobedreno-bifurcation prosthesis.

Materials and methods. In the V.V. Veresaev City Clinical Hospital from 2002 to 2022, 70 patients were re-operated on the aorto-iliac-femoral zone due to infection of aorto-femoral bifurcation prostheses (68 patients) and endografts (2 patients). 15 (21.4%) patients underwent primary surgery for aneurysms of the infrarenal aorta, the rest due to occlusive stenotic lesions of the abdominal aorta and iliac arteries. In 37 (84%) patients, primary operations were performed for occlusive-stenotic lesions of the aorto-iliac zone. 38 (69%) of 55 patients with occlusive-stenotic lesions of the abdominal aorta and limb arteries were operated due to chronic ischemia of the 3rd and 4th degree.

Results. In the immediate postoperative period, 7 (10%) patients died. The main cause of death was sepsis with multiple organ failure – 6. In one observation, a patient with sepsis on the 4th day after surgery developed a clinical picture of peritonitis, which was caused by acute ulcers of the jejunum with perforation. Thrombosis of one of the branches of the prosthesis developed in 3 (4.2%) cases. In all observations, blood circulation in the extremities was restored.

Conclusion. The method of choice for infection of synthetic prostheses and endoprostheses in the aorto-iliac-femoral position is the use of the principles of active surgical treatment, with complete removal of the infected synthetic prosthesis with simultaneous in-situ replacement with autovenous shunts from the superficial femoral veins, active pre- and postoperative antibiotic therapy.

The diabetic foot syndrome combines pathological changes in the peripheral nervous system, arterial and microcirculatory channels, and the osteoarticular apparatus of the foot, which pose a direct threat to the development of ulcerative necrotic processes and foot gangrene. Endovascular interventions are the preferred surgery choice for the patients with the diabetic foot syndrome, due to their low invasiveness and the possibility of repeated implementation. Angioplasty performed in the timely manner allows maintaining the supporting function of the foot and avoiding disability. The article presents a clinical example of multiple repeated balloon angioplasty in a patient with critical ischemia of a single lower limb. The aim of the research was to evaluate the results of multiple endovascular treatments of a patient with diabetic foot syndrome. The perioperative period and the course of endovascular intervention were analyzed. The necessity of a team approach in the treatment of this category of patients is substantiated. The effectiveness of interventional procedures in severe damage to the arteries of the lower leg has been proven. It has been confirmed that revascularization operations allow avoiding severe disability for the patients with critical ischemia of the lower extremities. The advantages of endovascular operations compared with open interventions for the patients with diabetic foot syndrome and severe damage to the arteries of the leg are presented. Determining the sequence and timing of surgical treatment of the diabetic foot syndrome and revascularization of the limb, assessing the associated cardiovascular risks and complications of the disease, prescribing complex conservative therapy, individual unloading of the limb, are important components of the overall treatment strategy.