Introduction. Intracurrent papilloma is a benign neoplasm that develops in the duct of the breast, consists of glandular epithelium, stromal and fibrovascular elements. 'This article presents the experience of treating and monitoring patients with intracurrent breast formation after VAB.

The purpose of the work: to compare the traditional method of treatment of intracurrent formations sectoral breast resection, with the method proposed by us vacuum aspiration biopsy (VAB).

Materials and methods. The clinical observations of two patients who underwent VAB with a control examination after 6 months are presented.

Discussion. The article discusses the advantages of performing VAB in patients with this disease, as well as the advantages of VAB in comparison with other known methods of treatment. Unlike sectoral resection, VAB has a number of advantages in the surgical treatment of ductal formations.

Conclusions. In our opinion, vacuum aspiration biopsy of intracurrent breast formations is the highest quality minimally invasive and atraumatic method of treatment with obtaining complete high-quality postoperative histological material

Introduction. In modern herniology, all operations are performed using mesh implants. Many factors depend on the method and reliability of fixation: the severity of pain, the number of early and late postoperative complications, the frequency of relapses, the speed of surgery and cost-effectiveness. Currently, many methods of fixing meshes have been proposed, but each of these methods has disadvantages, complications and selection criteria. We analyzed the method of fixation using a glue, and its effectiveness and feasibility of use were proven.

Purpose of the study. To analyze the technique of fixing mesh implants using a glue.

Materials and methods. The study included patients with inguinal, umbilical, postoperative ventral hernias of sizes W1-2. In the main group, fixation of the mesh implant was performed using glue. In the comparison group, fixation of the mesh was performed with separate sutures or a herniostapler.

Results. Analysis of different mesh fixation techniques has proven the effectiveness of using glue to fix mesh implants. A decrease the risk of developing intraoperative complications, a decrease in pain syndrome, and a decrease in the risk of developing chronic pain syndrome were noted. A decrease the time of surgical intervention and the economic efficiency of the adhesive fixation method were noted.

Conclusions. When using glue, a decrease in the risk of developing intraoperative complications, a decrease in pain syndrome, and a decrease in the risk of developing chronic pain syndrome, as well as a decrease the time of surgical intervention were noted. The fixation method has economic efficiency.

Introduction. Due to the small number of scientific studies on alloplasty techniques for postoperative anterior abdominal wall hernias, there is still an urgent need to search for new techniques of anterior abdominal wall alloplasty, as well as the development and implementation of surgical mesh implants.

The purpose of the study. Study of the dependence of biomechanical and morphological properties of prosthetic alloplasty on the mesh implant suturing technique.

Materials and methods of research. 36 laboratory rats of Standard breed, weighing 400±50 g, were used as biological models in the experiment. In the conditions of acute experiment, the laboratory animals under general anesthesia in aseptic conditions underwent alloplasty with a mesh implant (Esfil, RF) according to the sublay technology. Two observation groups were formed (18 operated rats in each group) depending on the performed method of alloplasty. In the 1st group alloplasty with fixation of the implant with through U-shaped sutures was performed, whereas in Group 2 the implant was not fixed. On the 21-st day, material was collected for biomechanical and morphologic studies. The digital data obtained from the INSTRON-5944 bursting machine were processed by methods of variational mathematical analysis.

Results. It was found that the difference in biomechanical indices after modeling prosthetic alloplasty with two different techniques (with and without fixation) was not statistically significant in the area of elastic-plastic deformations.

Conclusion. In the course of biomechanical and morphological studies, it was proved that the strength of the abdominal wall in modeling posterior separation alloplasty does not depend on the method of fixation of the implant to the abdominal muscles.

Introduction. Goal. To study the nature and degree of morphological changes in the gastric mucosa when comparing various forms of acute pancreatitis.

Materials and methods. 48 acts of pathomorphological conclusions and medical records (case histories) of patients who died from pancreatic necrosis for the period 2019-2023 were analyzed. All medical histories were analyzed together with the maps of pathoanatomical studies, while the stratification of changes was carried out according to the risk scale for changes in the mucous membrane of the digestive tract.

Results. In 2 cases, erosive and ulcerative lesions were represented by single small-point erosions (4,2 %). In other cases, there were multiple mucosal lesions, which corresponded to a group of 4-7 points in 33,3 %. The remaining 62,5 % had 100 % predicted risks of erosive and ulcerative lesions, all had severe acute pancreatitis, equally sterile and infected forms. During the morphological study of gastrobiopaths obtained from patients with sterile forms of pancreatic necrosis, we registered a significant increase in all processes of vascularization and blood flow in tunica mucosa, multiple leukocyte-macrophage complexes were visualized. The analysis ofpatients in the group of infected pancreatic necrosis revealed the progression of circulatory disorders in gastric tunica misosa, and consequently, with the dominant ischemic component in the blood supply disorder.

Conclusion. The study of the issues of ulcerogenesis in acute pancreatitis should become a springboard for the formation of effective prevention programs for the latter, and consequently, reduce the proportion of complications and the risk of death. The results obtained by us allow us to prove one of the leading roles in the formation of erosive and ulcerative lesions of the gastric mucosa in severe acute pancreatitis an ischemic factor. The use of perfusion restoration methods in a comprehensive program of gastric mucosa protection will improve the results of treatment of patients with pancreatic necrosis in general.

Introduction. The implementation of prosthetic variants of inguinal hernioplasty has led to a decrease in the frequency of hernia recurrences and the simultaneous occurrence of specific complications associated with the installation of implants. This dictates the need for a comprehensive assessment of the results of using implants from various materials in patients with inguinal hernias.

The aim of the study. Was to compare the results of treatment of patients with inguinal hernias using titanium and polypropylene implants, to evaluate the reparative processes in the implant installation area.

Material and methods. The study included 89 patients with inguinal hernia: 50 of them were operated on using a titanium mesh implant (group 1), 39 polypropylene implant (group 2). The duration of surgery, the frequency of complications, the duration of postoperative treatment, quality of life, and the quality of peri-implantation scar were compared.

Results. The duration ofthe operation was significantly longer in group 1 (78 minutes versus 64, p0,05). After 6 months, the frequency of chronic groin pain was significantly lower in group 1 (6 % vs. 15,4 %, p0,05), especially in young and middle-aged patients. 12 months after surgery, 28,6 % of group 2 patients showed signs of an ongoing reparative process in the peri-implantation scar. There were no differences in the quality of life between the groups.

Conclusion. In the treatment of patients with inguinal hernias, the use of mesh implants made of titanium is preferred.

Introduction. The relevance of the problem of pancreatic necrosis is that currently the number of diseases, including severe forms, is steadily increasing.

Purpose. To improve the results of early diagnosis of pancreatic necrosis by studying the membranes of red blood cells.

Materials and methods. The erythrocyte membrane was examined using atomic electron microscopy. Additionally, neutrophilic erythrocytes were studied using this method. The study included 17 patients with pancreatic necrosis.

Results. The study conducted by atomic electron microscopy in patients with pancreatic necrosis revealed changes in the membrane of erythrocytes and the shape of the nucleus and the state of the cytoplasm of neutrophilic leukocytes.

Conclusions. The study of the erythrocyte membrane and the state of neutrophilic leukocytes by atomic electron microscopy in patients with pancreatic necrosis makes it possible to identify early changes in the absence of clinical manifestations and predict the possibility of purulent septic complications.

Introduction. Purpose: this study aimed to develop a machine learning-based approach for identifying key CT abdominometry features to assist in the preoperative planning of patients with large and giant postoperative ventral hernias.

Materials and methods of research. A retrospective analysis was conducted on 90 patients examined between 2020 and 2024. Patients were divided into three groups: those without postoperative ventral hernias (n=30), patients with W2 hernias (n=30), and patients with large or giant hernias who underwent preoperative botulinum therapy (n=30). CT scans of the abdomen, retroperitoneum, and pelvis were performed, and parameters such as anterior abdominal wall muscle characteristics, abdominal circumference, hernia gate width, defect ratio, and component separation index were measured. Statistical analyses included ANOVA, the Kruskal-Wallis test, Student’s t-test, and the Mann-Whitney U test. Feature selection was performed using a random forest algorithm, logistic regression was utilized for predicting the need for botulinum therapy, and clustering methods (K-Means, DBSCAN) were applied to identify distinct patient subgroups.

Treatment results. Logistic regression achieved an accuracy of 86 % (AUC-ROC = 0,95). 'The defect ratio, component separation index, and right muscle area were identified as significant predictors for botulinum therapy. K-Means clustering delineated a subgroup in which 83 % of patients underwent botulinum therapy, underscoring the objective differentiation based on CT features. An optimal predictive threshold of 0.6 was established to minimize false negatives.

Conclusion. The application of machine learning techniques facilitates objective and personalized preoperative planning, thereby enhancing surgical decision-making in the management of postoperative ventral hernias.

The aim of the study. To develop the optimal surgical technique of the endoscopic colorectal stenting. To analyze the results of the endoscopic colorectal stenting in patients with stenosis unresectable colon tumors.

Material and methods. In the period from 2016 to 2022, we studied the results of the endoscopic colorectal stenting of various parts of the the colon with metal stents in 86 patients with stenosing unresectable colon tumors.

Results. In 14 patients (16,3 %) with difficult-to-reach localization of stenosing tumor and complex anatomy of the colon, we applied the transparent plastic cap at the distal end of the colonoscope. There were no intraoperative complications. Technical and clinical success was achieved in 98,8 % of cases. The pain syndrome persisted in 19 patients (22,1 %) during the period of hospitalization; the chronic pain syndrome was recorded in 3 (3,5 %) patients in the postoperative period. 3 months after surgery, colorectal stent-to-stent restenting was performed in 13 patients (15,1 %) with the repeated tumor obstruction. No cases of the stent migration were recorded 3 months after surgery.

Conclusion. Endoscopic colorectal stenting is a highly effective and safe intervention that allows to achieve for rapid relief of clinical symptoms of intestinal obstruction and demonstrates a low incidence of postoperative complications. In presence of the complex intestinal anatomy, as well as a difficult-to-reach localization of a stenosing tumor, we consider it advisable to use a distal transparent plastic cap, which is justified by more adequate visual positioning of the intestinal lumen, which allows better endoscopic intestinal stenting.

Introduction. The acute form of mesenteric ischemia remains an urgent and serious problem in modern medicine. Unfortunately, the use of CT angiography and selective mesentericography in modern conditions of urgent surgery is difficult to implement in most district and rural hospitals. Due to the need to minimize the diagnostic time, research is underway aimed at creating and evaluating the effectiveness of new diagnostic markers. Similar characteristics are the intestinal form of the fatty acid binding protein (Intestinal Fatty Acid Banding Protein, (I-FABP).

Goal. To evaluate the diagnostic effectiveness and significance of I-FABP as an important parameter for the differential diagnosis of intestinal wall necrosis.

Materials and methods. The single-center clinical and laboratory comparative study included 162 patients enrolled in the period from 2022 to 2023 at the State Medical University named after V.V. Veresaev DZM in Moscow. In addition to a set of examinations in accordance with the standards of medical care, the subjects were assessed for the concentration of the I-FABP protein.

Results. Significant differences were found between the median concentrations of I-FABP in the main group of patients and comparison group I and the main group and comparison group II. The concentration of I-FABP in the blood serum of more than 308,42 pg/ml in patients with suspected OMI may indicate the onset of necrosis of the small intestine.

Conclusion. Laboratory determination of the intestinal form of fatty acid binding protein in blood serum is a promising method for early differential diagnosis of acute mesenteric circulatory disorders, it has a chance to become part of the algorithm for diagnosing patients with suspected ONMpC.

Introduction. Endovenous laser ablation is the most widely used method for treating lower extremity varicose veins. One primary cause of disease recurrence is pathological reflux persistence in the sapheno-femoral junction. Identifying factors affecting occlusion stability in the great saphenous vein's proximal segment may optimize surgical techniques and improve outcomes.

Aim. To identify clinical and tactical-technical factors influencing the effectiveness of endovenous laser ablation in achieving stable occlusion of the great saphenous vein's proximal segment in the sapheno-femoral junction.

Materials and methods. 'This prospective study involved 546 patients (692 limbs) with varicose veins treated by endovenous laser ablation. A novel method assessed occlusion effectiveness in the great saphenous vein's proximal segment. Twenty-one factors were analyzed, including 8 quantitative and 13 qualitative variables. Data were processed using descriptive statistics and gamma correlation analysis.

Results. High effectiveness (90,9 %) was achieved within 30 days post-procedure. Moderate correlations were observed with factors like manual traction technique for the laser fiber (y=0,495564), linear energy density >100 J/cm (y=0,459682), and specific energy density >40 J/cm² (y=0,41604). Mid-term results showed that in 35,6 % of cases, pathophysiological conditions promoting varicose vein progression persisted in the sapheno-femoral junction.

Conclusion. Endovenous laser ablation is highly effective for achieving stable occlusion of the great saphenous vein's sapheno-femoral junction. Several controllable factors significantly impact the procedure's success, offering opportunities for improved outcomes.

Introduction. In recent years, endovascular laser ablation (EVLO) technology has become the leading method for treating varicose veins. However, the effect of the volume of modern surgical interventions on the incidence of complications has not been studied.

Aim of the study. To assess the effect of EVLO volume on the incidence of complications

Materials and methods. The study was conducted on 967 patients from 2018 to 2021. All underwent combined operations in the volume of EVLO of saphenous veins in combination with an individual volume of miniphlebectomy. The age in the sample ranged from 29 to 80 years, the average age 51.5 years. A total of 381 EVLO of the main trunks of the saphenous veins were performed. Patients were divided into three groups depending on the volume of intervention. The treatment results were assessed on the 1st day, 7th day and during the first month after surgery.

Results. Unreasonable expansion of the minimally invasive treatment due to simultaneous combined interventions on both lower extremities significantly increases the trauma of endovascular thermal procedures, contributes to longer rehabilitation of patients and an increase in the number of adverse events in the early postoperative period. A significant increase in the number of complications with an increase in the scope of the operation was revealed.

Conclusion. Optimization of the scope of the operation can help reduce complications and improve rehabilitation.

Introduction. Purulent diseases of the soft tissues of the extremities are one of the common pathologies in the structure of surgical departments, and can reach 30-35% of cases. In everyday practice, surgeons regularly encounter advanced clinical cases that are caused by late seeking medical care.

Purpose of the study. To study the reasons for late seeking medical care by patients, the reliability of subjective signs of compartment syndrome in patients with intermuscular phlegmon of the upper limb, taking into account age characteristics.

Materials and methods of research. The work was carried out in the purulent surgery department of the Rostov Regional State Emergency Medical Service in Rostov-on-Don. The work is based on the results of an examination of 134 patients with phlegmon ofthe upper limb (segments of the shoulder and forearm).

Results and discussion. During the survey, it was found that the key reason for late seeking medical care was the hope for self-medication. The second place among the reasons was due to the fear oflearning the truth about the disease, fear of "going on sick leave", and missing classes at an educational institution. It was found that the most vivid clinical picture of the disease was in patients of adolescence, which is easily explained by the anatomical features of the fascial compartments, in particular their biomechanical parameters such as tensile strength and elastic modulus.

Conclusions: A study of the reasons for late seeking medical help by patients with intermuscular phlegmon of the upper limb depending on the age period showed that most of them are afraid of losing their job due to disability, learning the current state of their health, and have hopes for self-treatment.

Introduction. The issues of substantiation of decompressive fasciotomy in patients with thigh phlegmon, against the background of compartment syndrome, remain insufficiently disclosed.

Purpose of the study. To improve the results of surgical treatment of intermuscular phlegmon of the thigh by using technology for diagnostics and treatment of acute tissue hypertension (compartment syndrome).

Materials and methods. The experimental, pathomorphological study included 24 preparations of fascial structures of the thigh, as well as preparations from patients with intermuscular phlegmon of the thigh (IMF), taken during surgery. Biomechanical studies were conducted according to the method of Tatyanchenko VK. (patent of the Russian Federation № 2271740). The promising stage of the work was carried out in the form of a comparative cohort study, which included 65 patients with IMF.

Results and discussion. In the treatment of patients with hip phlegmon at normal tissue pressure values (8-10 mm Hg), early postoperative complications significantly (by 1,9 times) decreased and pain syndrome was completely relieved (according to the Khabirov A.F. scale) on the 14th day. In the control group, pain syndrome persisted in 56,3 % 6 months after surgery, which was associated with the formation of pain trigger zones.

Conclusions. The developed treatment algorithm allowed to exclude unsatisfactory treatment results in patients of group I (n=33) by 100 %, to achieve good results in 91,7 % compared to 54,8 %, which indicates the importance of the developed technology of the treatment and diagnostic algorithm (RU Patent № 2826879).

Introduction. In the daily practice of surgical departments, purulent-inflammatory processes of the soft tissues of the upper limb occupy one of the leading places, both in terms of incidence and duration of patient disability. As a rule, this pathology occurs in young patients, which makes the problem socially significant.

Purpose of the study. To conduct a comprehensive analysis of the causes and structure of purulent diseases of the upper limb in 184 patients treated at the State Budgetary Institution of the Rostov Region "Central City Hospital" in Bataysk.

Materials and methods of the study. The study included 184 patients with purulent-inflammatory processes of the soft tissues of the upper limb (phlegmon and abscesses) who were treated at the State Budgetary Institution of the Rostov Region "Central City Hospital" in Bataysk. In the period from 2018 to 2024. The age composition of patients was within 18-75 years.

Results and discussion. The main causes of the disease have been established, among which the first position is occupied by direct infection, seasonality (46,8 % of cases were recorded in the summer). The terms of the disease before hospitalization have been determined, the structure of diseases has been clarified most purulent processes occur in the shoulder area (62,5 %, of which abscesses 28,9 %). Purulent-inflammatory processes of the soft tissues of the upper limb have their own characteristics, which should be taken into account when organizing medical care.

Conclusions. Purulent-inflammatory processes of the soft tissues of the upper limb have their own characteristics, which should be taken into account when organizing medical care.

Introduction. This article presents the first experience of treatment and observation of nodular/multinodular nontoxic goiter. In addition to presenting the clinical observation, the article discusses the advantages of laser ablation, as well as the advantages of LA compared to other known treatment methods.

The purpose of the study. To evaluate the effectiveness of laser ablation for the treatment of nodular/multi-nodular non-toxic goiter

Materials and methods of research. The study was conducted on the basis of the Russian University Clinic. The Elesta Echolaser X4 device was used to evaluate the effectiveness of laser ablation. A clinical case of the method was analyzed. The assessment included changes in nodule volume, vascularization, and recovery dynamics in patients.

Treatment results. Patient F., 66 years old, with a 1,7 x 1,5 mm node after laser ablation showed a 61,8 % decrease in node volume after 6 months, with no vascularization according to dopplerography.

Conclusion. Laser ablation is an effective and safe method of treating nodular and multi-nodular non-toxic goiter. Its advantages include minimal injury, reduced recovery time, and the absence of significant cosmetic defects. This method may be the preferred choice for patients seeking to avoid radical surgical interventions.

Introduction. Over the past 50 years, bariatric surgery methods have been increasingly used to treat obesity. However, a marked decrease in body weight leads to a sharp loss of subcutaneous fat and the formation of hanging skin folds, the so-called "aprons", which forces patients to seek help from plastic surgeons in order to correct this pathology.

The purpose of this study is to identify the frequency of patients seeking help from plastic surgeons and to evaluate the results two years after performing plastic surgery.

Materials and methods. In the course of a retrospective study, 154 patient medical records were analyzed and clinical observation was performed.

Research results and discussion. To optimize the study, all patients were distributed according to the degree of obesity before bariatric surgery, by age and group affiliation. The analysis of postoperative complications in the immediate postoperative period, long-term results of scar condition and patient satisfaction with aesthetic operations performed was carried out.

Conclusion. Performing aesthetic correction after bariatric surgery is the method of choice for restoring the patient's mental and physical comfort.

Introduction. Plastic surgery for endoprosthetics is one of the most popular after radical operations on the mammary gland. They allow you to increase the volume of the gland and give it the desired shape. At the same time, the emergence of expanders and breast implants made a separate contribution to the development of reconstructive breast surgery. The variety of breast implants in terms of volume, shape and coating creates flexibility in choice and allows you to achieve a certain aesthetic result after surgery.

The aim of the study: to study the immediate and long-term results of the use of endoprostheses after surgical treatment of breast cancer.

Materials and methods. The study involved 44 patients aged 28 to 65 years who underwent mammary gland removal due to a malignant tumor in the 1st oncology department of the MMCC Kommunarka, in the period from 2022 to 2024.

Treatment results. The article examines complications after surgical interventions and the results of self-assessment of quality of life after mastectomy for breast cancer with endoprosthetics at different periods after surgery.

Conclusion. The obtained data indicate that endoprosthetics is quite simple to perform, satisfaction with the results of the operation is higher in the early postoperative period than in the late period, and the postoperative complications that can be treated do not affect the late aesthetic results of the treatment.

Introduction. The treatment of soft tissue wounds remains one of the urgent problems of modern surgery. Despite the wide variety of methods of their treatment and medications used to accelerate the course of regeneration processes, this problem remains unresolved.

The purpose of the study. To study the effect of crushed maral antler slices on the course of the wound process in the treatment of aseptic soft tissue wounds in an experiment.

Materials and methods of research. The study was conducted on the basis of the Burdenko Scientific Research Institute of Experimental Biology and Medicine on 90 Wistar rats in 3 groups. The effectiveness of the use was studied using objective, histological and histochemical, metric, including planimetric and morphometric techniques.

Results. Swelling and hyperemia of soft tissues were significantly relieved by 17,5 % and 14,8 % faster in the experimental group compared with the 2nd control group. The highest rate of reduction of the wound surface area is noted when using the proposed technique: on the 1st day, the area of the wound defect decreased by 40,54 %, by the 3rd day 70,97 %, by the 5th day 82,84 %, by the 7th day 90,84 %, on the 14th day of the study 99,41 %.

Conclusion. Analysis of the data from objective and morphological research methods has shown that the use of crushed slices of maral antlers leads to a complete restoration of the dermis of rat skin in the treatment of soft tissue wounds, activation of cellular elements, early cleansing and restoration of histoarchitectonics of the skin.

Introduction. Currently, the number of patients with the solid abdominal organ trauma does not tend to decrease. Liver and spleen trauma continues to occupy the second place in the structure of blunt abdominal trauma.

The purpose of the study. To improve the results of treatment of patients with blunt liver trauma using hybrid surgical interventions.

Materials and methods of research. The article presents a clinical observation of a 38-year-old patient with a diagnosis of isolated blunt liver trauma of the II degree according to AAST, posttraumatic aneurysm of the S6 segment of the liver, hemoperitoneum 1050 ml.

Results. The patient with a liver injury with difficult localization underwent hybrid surgery superselective endovascular embolization of the arterial branch containing an pseudoaneurysm, and diagnostic video laparoscopy with lavage and drainage of the abdominal cavity. There were no postoperative complications. The length of hospital stay was 5 days.

Conclusion. The use of hybrid surgical access for liver injury made it possible to reduce the level of surgical aggression and speed up social and labor rehabilitation.

Introduction. At the end of the 20th century and especially in the last decade, interest in the use of the local negative pressure (MLNP) method in the treatment of wounds, including surgical wounds of various locations, has increased enormously, and the areas of application with different options for its implementation have expanded. 'The purpose of our study was to conduct a systematic review of the literature to obtain information regarding the effectiveness of the use of (MLNP) in the prevention of complications of surgical wounds after high amputations of the lower extremities at the hip level, considering the chosen strategy and technique for performing surgical interventions, and complications in the postoperative period that worsen the process of subsequent rehabilitation patients.

Results. The literary sources of domestic authors and available foreign ones dedicated to the method of treating wounds with negative pressure were analyzed. Despite sufficient experience in the use of this technique, and many areas of surgery in which this method is used, there remains enough unsolved problems, one of them is the use of this method in the prevention of wounds after high amputations of the lower extremities.

Conclusion. The conducted analysis of literature data demonstrated that this area of surgery is in demand and requires further research and development of new modern improved surgical ideas for the management of postoperative wounds.

Introduction. A critical aspect of the surgical treatment of gastroesophageal reflux disease (GERD) and hiatal hernias is the selection of the antireflux surgical technique, which determines the success and long-term outcomes of the intervention. The utilization of manometry for assessing esophageal motility has become increasingly relevant, as it provides crucial data regarding peristaltic activity.

The purpose of the study. To analyze existing methods of antireflux reconstruction, evaluate their advantages and disadvantages, and determine the feasibility of applying different approaches based on the individual characteristics of patients, thereby improving the outcomes of surgical treatment for gastroesophageal reflux and enhancing patients' quality of life.

Materials and methods of research. Review of articles published in scientific databases such as PubMed, Web of Science, Scopus, and eLIBRARY.

Results of research. The study discusses the advantages and disadvantages of the Nissen, Chernousov, and Toupet techniques, as well as the importance of a personalized approach tailored to each patient, considering individual characteristics and the severity of the disease.

Conclusion. An individualized approach to the treatment of GERD and hiatal hernias, based on patients’ individual characteristics and disease severity, is critical for achieving optimal clinical outcomes and minimizing complications. It is essential to consider not only the effectiveness of treatment methods but also potential complications and long-term consequences for patients.

Introduction. Avascular necrosis of the femoral head (ANFH) is a common problem that occurs in 10-18 % of patients with a trauma profile. Extensive research has recently explored the potential of treating ANFH using mesenchymal stem cells and has shown results convincing of the effectiveness and safety of the method.

The purpose of the study. To study the clinical efficacy of mesenchymal stem cells in the treatment of patients with avascular necrosis of the femoral head.

Materials and methods. The data is reviewed in PubMed, CochraneLibrary, ScienceDirect, eLibrary. A clinical case of treatment of a patient with avascular necrosis of the femoral head using mesenchymal stem cells is described.

Results. MSCs are best suited for early therapy of ANFH, as a stage of conservative treatment of patients in order to improve the results of complex treatment and to obtain the possibility of stabilization and regression of necrotic changes in bone tissue. If patients have advanced stages, the use of MSCs can reduce pain and increase limb functionality, improve quality of life, and delay the need for total hip replacement.

Conclusion. Extensive research over the past decade has explored the potential of the MSC and shown promising results. Despite the existing controversies, it seems that the overall results of using MSC for the treatment of avascular necrosis of the femoral head are positive not only in terms of efficacy, but also safety. However, for reliable interpretation of the results, they need to be determined over time.

As long as scientific research has existed since ancient times, there have been deliberate attempts to substitute and imitate research results. The desire and temptation to quickly achieve the desired results, and then the long-awaited fame, can lead to the temptation to show results and scientific achievements, which, in fact, are "adjusted" to the expected outcome. Errors often accompany any study, objectively or subjectively caused by methodological, statistical or simply elementary errors, especially in multicenter studies, which combine data from hundreds and thousands ofpatients from clinics of various therapeutic and scientific potential. Theoretically, it is always possible to embellish the research results to a certain extent, "without getting too carried away." In this case, the scrupulousness and basic honesty of the authors of the work is crucial. Another thing is the desire to achieve the desired result, which seems logical to you, but still does not line up in numbers and graphs, to get a result that paves the way to a well-known and respected magazine. In the end, all this "creativity" comes at a high price to society, where the brilliance and radiance of awards and titles multiply, neatly draped in success, and unresolved problems.

The article examines the changed approach of the courts when considering claims filed by citizens against medical organizations for compensation of moral damage due to the provision of defective medical care.

Introduction. The author shows the special importance of the fact that doctors comply with clinical recommendations, standards and procedures when proving in court the absence of defects in the medical care provided. The changed approach of the courts to assessing the causal relationship between defects in medical care and the deterioration of the patient's health or death is noted. The author analyzes the current practice, according to which the courts began to satisfy citizens' claims for compensation of moral damage in cases when the results of a forensic medical examination established the fact of a possible impact of a defect in medical care on the deterioration of health or death of the patient. The contradictory approach of the courts in assessing the conclusion of an examination of the quality of medical care conducted by an insurance company based on patient complaints as evidence of poor-quality medical care is shown.

Conclusion. Based on the results of the analysis, taking into account the social significance and narrow specialization, a conclusion is made about the possibility of creating specialized courts or judicial panels for medical disputes.