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Objective: To analyze the efficacy of intraductal radiofrequency ablation (RFA) for neoplasms of the major duodenal papilla with intraductal spread.

Material and methods: Eleven patients with adenomas of the major duodenal papilla and intraductal spread underwent intraductal RFA between 2022 and 2023. Spread to the common bile duct ranged from 10 to 30 mm, to the main pancreatic duct - from 5 to 11 mm.

Results: Technical success was achieved in all cases. Complications after intraductal RFA occurred in 4 cases (post-manipulation pancreatitis - 2 cases, repeated intraductal RFA for residual adenomatous growths - 2 cases). Technical success of stenting of the main pancreatic and common bile ducts was achieved in all cases.

Conclusion: Intraductal radiofrequency ablation for neoplasms of the major duodenal papilla with intraductal spread ensured complete destruction of intraductal tumor with adequate clinical effect and no need for highly traumatic surgery.

Objective: The purpose of the study was to evaluate the results of using fluoropolymer-coated mesh during intraperitoneal onlay mesh hernia repair in patients with primary ventral hernias.

Material and methods: The multicenter, non-randomized, controlled clinical study included 88 patients of both sexes who were operated on using a laparoscopic approach using the IPOM technique for a primary ventral hernia. The duration of observation ranged from 3 to 12 months. In the main group, 48 patients received fluoropolymer-coated meshes (Ftorex). A comparison was made with a retrospective group of 40 patients who were treated with anti-adhesive collagen-coated meshes (Parietene composite, Parietex Composite, Symbotex).

Results: The number of early and late postoperative complications in the groups did not have significant differences, at the same time, their number was lower in the group of patients in whom fluoropolymer-coated meshes were used. Most of the complications corresponded to Clavien-Dindo class I and II and did not pose a significant threat to health. There were no recurrences of hernias observed in patients included in the study. There were slightly more adhesions in the fluoropolymer-coated mesh group (35.4% vs. 25.0% in the collagen-coated mesh group). The quality of life of patients in the study groups did not differ.

Conclusion: In laparoscopic IPOM hernia repair fluoropolymer-coated meshes are not inferior in effectiveness and safety to traditionally used collagen-coated meshes and can be recommended for use in patients with primary ventral hernias.

Today, the issue of atrial fibrillation recurrence after ablation is increasingly discussed in the literature. Many authors analyze the factors predicting success or failure of cryo-maze procedure. This review is devoted to predictors of atrial fibrillation recurrence in long-term period after biatrial cryo-maze procedure. Primary screening identified 48 studies. There were 27 articles after removing duplicate articles, case reports and articles with unavailable full-text versions. Two independent researchers reviewed the full-text articles and enrolled 11 and 14 articles, respectively. After collegial discussion and involving the third researcher, we selected 13 articles for final analysis. It was established that atrial enlargement and duration of atrial fibrillation are the main independent predictors of recurrence in long-term period.

The review is devoted to transcatheter aortic valve implantation (TAVI). Aortic stenosis (AS) is one of the most common valve diseases in the world and cause of premature death. TAVI is an important advance in the treatment of patients with severe aortic stenosis, particularly in those with moderate and high surgical risk. However, this method has some complications. Stroke prevention and development of strategies reducing the incidence of this event are not only important therapeutic goals for patients undergoing TAVI, but also have significant economic implications.

The review is devoted to modern treatment technologies for wound infection. The majority of studies are devoted to pharmacological and surgical methods. A few reports describe non-drug methods including photo and laser therapy. We analyze the main types of phototherapy for complicated wound infection, mechanisms of action and therapeutic effects.

The review is devoted to history of anti-embolic protection system, in particular protection against cerebral embolism, in cardiac surgery and endovascular surgery. Cerebral embolism is a common and dangerous complication in cardiovascular surgery, leading to disability of patients and significantly impairing treatment outcomes. Prevention of embolic complications is an urgent task in correction of heart valve disease in cardiac and endovascular surgery.

Objective: To evaluate clinical efficacy of preoperative carbohydrate loading as a component of ERAS in esophageal reconstructive surgery.

Material and methods: Post hoc analysis included 162 patients who underwent esophageal reconstructive interventions with ERAS principles between 2014 and 2024. The main group (n=61, CHO+) included patients who were metabolically loaded with carbohydrates in preoperative period with 12.5% maltodextrin solution 800 mL the day before and 400 mL 2 hours before surgery per os or enterally. The control group consisted of patients without carbohydrate load (n=101, CHO-). Primary endpoint was length of hospital-stay, secondary control points - postoperative glycemia and complication rate.

Results: Both groups were comparable in sex, age, character of the main and comorbid diseases, body mass index. Patients with CHO had significant lower incidence of respiratory complications (p=0.034). Both groups did not differ in the incidence of anastomosis failure, morbidity and mortality.

Conclusion: Preoperative carbohydrate loading in esophageal reconstructive surgery positively affects metabolic status and reduces the incidence of respiratory complications without effect on length of hospital-stay.

Hiatal hernia may be accompanied by chronic bleeding from erosions and subsequent iron deficiency anemia. This anemia is drug-resistant in 5-10% of patients with hiatal hernia. In this case, the only approach is antireflux surgery for hiatal hernia repair.

Material and methods: A prospective examination of 42 patients with hiatal hernia and concomitant iron deficiency anemia was conducted between 2023 and 2024. To identify latent iron deficiency anemia, patients underwent in-depth laboratory tests. All patients underwent original fundoplication. The results were assessed in 6 and 12 months after surgery.

Results: Favorable functional results with disappearance of reflux esophagitis symptoms were obtained in 39 patients (92.8%). The follow-up laboratory tests after 6 months revealed higher hemoglobin and normal serum iron in 35 (94.5%) out of 37 available patients. Patients did not take iron supplements during the second half of the year, but hemoglobin and serum iron were normal.

Conclusion: Original fundoplication demonstrates high efficiency in patients with hiatal hernia and concomitant chronic iron deficiency anemia.

Traditional surgical treatment of widespread purulent peritonitis has some disadvantages that emphasizes the need for new approaches to postoperative care. The authors present successful treatment of diffuse purulent peritonitis using a combination of 'open abdomen' technology and VAC therapy. This approach reduces abdominal inflammation and intra-abdominal pressure. Combination of 'open abdomen' technology and VAC therapy provides effective control of inflammation and stabilization of patients with purulent peritonitis.

Tetralogy of Fallot is the most common «blue type» heart defect. The goals of surgical correction are closure of ventricular septal defect and reconstruction of right ventricular outflow tract. The results of reconstructions depend on several factors: age, material, management and size of conduit. Some patients may require redo surgery due to dysfunction after primary correction.