The results of treatment of patients with malignant neoplasms of the biliopancreatoduodenal zone remain unsatisfactory. With this localization, pancreatoduodenal resection (PDR) remains the only radical surgical intervention. It is more advisable to start with non-surgical treatment, in the presence of arterial invasion of magistral vessels. This served as an impetus for the development of approaches to determine the presence of tumor invasion in the superior mesenteric artery at the early stage of the operation. The surgical goal of PDR remains to minimize contact with the tumor prior to mobilization and ligation of the supply vessels, as well as to increase the edge of the resection around the superior mesenteric artery. To achieve this goal, a number of researchers have proposed various approaches to the superior mesenteric artery during pancreatoduodenal resection, combined “artery-first approach”.
An analysis of the existing artery-first techniques for pancreatoduodenal resections, as well as their effect on the treatment results of patients with periampullary malignant neoplasms, is carried out. When conducting literary searches, the databases Pubmed, Сochrane, EMBASE were used using the MESH keywords “Pancreaticoduodenectomy” in combination with the phrase “artery first”. During this search, 157 articles were found. After further analysis, 53 scientific papers were included in the literature review.
Modern studies show a decrease in intraoperative blood loss, a decrease in the frequency of postoperative pancreatic fistulas and gastrostasis, as well as an increase in the frequency of R0 resection when this approach is followed. An unambiguous conclusion about the effectiveness of the artery first accesses when performing pancreatoduodenal resection requires further well-planned randomized clinical trials with a large number of patients.

Abstract: treatment of patients with primary and recurrent locally advanced pelvic tumors represents an extremely complex problem of surgical oncology.
Aim: to evaluate perioperative and long-term postoperative results of laparoscopic pelvic exenteration technique.
Material and methods: in the period from 2011 to 2018, 21 pelvic exenteration was performed with laparoscopic access, (mean age 59.79 ± 8.5), sex distribution: 17 women and 4 men. Nosology distribution: in 6 patients cervical cancer was verified, 7 patients had bladder cancer, 4 patients had rectal cancer, 1 patient had vaginal cancer, 2 patients had recurrence of vaginal cancers after previous uterine extirpation and 1 patient with ovarian neoplasm.
Results: the volume of the exenteration was as follows: 9 total, 7 anterior and 5 posterior. In all cases, it was possible to achieve a negative margin of resection line (R0). The duration of the operation, the volume of blood loss, the frequency and nature of intra- and postoperative complications were evaluated.
Conclusion: laparoscopic access is accompanied by a smaller amount of blood loss, decrease of frequency of early postoperative complications, contributes to more comfortable postoperative period with early activation, less severe pain syndrome and leads to a reduction in the duration of inpatient treatment.

Abstract: ventral hernias remain one of the most frequent reason for scheduled and emergency surgeries. Despite the widespread use of various methods and technologies of hernias repair, including traditional non-invasive and laparoscopic methods popular in recent years, the problem of recurrent hernias remains relevant to this day. At the end of the last century, studies have shown that patients with inguinal hernias, compared with patients operated on for other intraabdominal reasons, have pronounced quantitative and qualitative changes in collagen proteins. This, in turn, led to increased interest in the exchange of connective tissue and the structure of the extracellular matrix in patients with hernia disease and other similar diseases, as well as the biology of wound healing and scar formation to this day. Significant number of experimental and clinical studies of the structure and function of the extracellular matrix in patients with hernia disease have been accumulated. The review is designed to reveal current understanding of relationships of metabolism of connective tissues and structure of extracellular matrix to pathogenesis of ventral hernias in order to identify key points, which will, in the future, develop a personalized approach to treatment of patients with these disorders.

Purpose. To analyze short-term and long-term results of surgical treatment of patients with hiatal hernia complicated by gastroesophageal reflux disease.
Materials and methods. A retrospective analysis of short-term and long-term results of treatment of 98 patients for the period 2009–2016, who underwented surgical treatment of hiatal hernia with a hernia defect size 5 or more cm was performed. The first group included 69 patients underwent suture repair of hernia defect. The second group underwent mesh repair - 29 patients.
Results. Intraoperative complications - 7 (10.1%) versus 2 (6.9%), postoperative complications - 6 (8.7%) versus 3 (10.4%), the duration of surgery - 141 ± 21.1 min versus 179 ± 28.4, duration of hospital stay - 6.7 ± 1.6 days versus 6.9 ± 1.8, postoperative dysphagia - 11 (15.9%) versus 6 (20.7%) were not noted. In 5 years after surgery, reccurence in the suture group were noted in 14 (20.3%) patients, in the mesh group - in 4 (13.8%) patients. The total GERD–HRQL questionnaire score was 6.4 ± 1.8 points in the suture repair group and 5.9 ± 2.1 points in the mesh group. 9 (13%) patients in the suture repair group and 5 (17.2%) in the mesh group evaluated their condition as unsatisfactorily.
Conclusion. The analysis of long-term results in 5 years after the surgery showed the absence of benefit after using mesh reinforcement during laparoscopic repair of large hiatal hernias compared to usual suture cruroraphy both in recurrence rate and in assessing the quality of life.

Abstract. The article is devoted to the experimental study of the effectiveness of AMIC technology in the surgical treatment of full-thickness defects in hyaline cartilage. Purpose of the study - study the biological potential of collagen membranes and their ability to transform into cartilage tissue. The study was conducted on 4 pigs. On the joints of the hind limbs, full-thickness cartilage defects and implantation of 2 different collagen membranes were formed. Animals were removed from the experiment in the period 2,3,4,6 months after surgery. The article presents a morphological analysis of the nature of cartilage tissue regeneration 6 months after surgery. The study showed the high biological potential of collagen membranes and their ability to transform into hyaline cartilage.

Abstract: In recent decades bladder cancer has become one of the most topical problems of modern healthcare due to its widespread distribution. This makes it necessary to investigate new effective methods of surgical treatment.
Objective: Assessment of the effectiveness of en bloc resection of the bladder with tumor by analyzing scientific publications on this matter.
Materials and methods: We have analyzed current articles related to this topic on the databases Pubmed and Google Scholar. The search was performed using the keywords «Bladder Tumor», «En bloc resection of the bladder wall», «non-muscle-invasive bladder cancer».
Results: Most studies confirm the advantages of laser en bloc resection over other methods in terms of such parameters as the frequency of recurrence, macrohematuria, and the quality of morphological material.
Conclusions: Laser en bloc resection of a bladder tumor without invasion of the muscle layer is a safe and effective operation that has a number of advantages over classical transurethral resection, namely: no obturator syndrome, high-quality material for pathomorphological research, low recurrence rate.

Summary. This article substantiates that the timely diagnosis of atopy and adequate treatment of AtD and AR help prevent the development of severe forms of the disease and the progression of the atopic march. It also analyzes the modern possibilities of solving problems related to the complexity of diagnosis, differential diagnosis, false-positive and false-negative results of clinical and laboratory studies of allergic diseases, genetic characteristics of patients and many other parameters; We are considering the possibility of integrating bioinformatics and systemic biomedicine approaches, based, on the one hand, on massive databases of experimental studies, and on the other, on advanced technologies for genotyping and marker identification. It is concluded that further improvement of modern methods for the diagnosis of atopic dermatitis associated with allergic rhinitis is an actual scientific direction at the junction of allergology, genetics and immunology.

Abstract: Nowadays medical society is facing increasing numbers of adnexal masses in women of reproductive age, and especially challenging for the diagnostic workup and management are such cases during the pregnancy. Our study has a primary focus on the specific features of the pregnancy and delivery in patients with benign ovarian neoplasms.
Materials and methods: This is a retrospective study that included 88 pregnant patients with benign ovarian neoplasms that delivered in our facility during the period from 2014 to 2016. The patients were divided into two groups, the 1st group included 45 pregnant women with endometrioid ovarian cysts, the 2nd group consisted of 43 pregnant women with cystadenomas and ovarian teratomas. As a control group, we used cumulative statistical data from our facility and several related organizations, representing the general population.
Results: It was observed, that the odds ratio of the threatened miscarriage and the threat of preterm delivery was significantly higher in patients with endometrioid ovarian cysts compared to the general population. However, the frequency of complications of the preterm period and delivery in patients with cystadenomas and ovarian teratomas showed no significant difference, compared to populational data. There were no significant differences in complications between patients with endometrioid ovarian cysts and cystadenomas / ovarian teratomas.
Conclusion: Our research provides additional data on pregnancies with adnexal masses, which can help in the prevention of complications and choosing the modality of treatment in pregnant patients.