Aim. To compare the clinical effectiveness of argon plasma coagulation (APC) and radiofrequency ablation (RFA) for the treatment of patients with chronic radiation proctitis (CRP) complicated by recurrent rectal bleeding.
Methods. A prospective, randomized, single-center study conducted in the State Medical University of the Loginov Moscow State Medical Scientifi Centre. The study included 73 patients with 1—2 degrees of CLP on the RTOG/EORTC scale. The indication for endoscopic treatment was recurrent rectal bleeding. Endoscopic treatment was performed: APC (36 patients) and RF (37 patients), depending on randomization.
Results. In 44 patients (60.2 %), of which 18 (50 %) patients in the APC group and 26 (70.2 %) patients in the RF group, a complete regression of the disease was revealed. Telangiectasia was detected in 18 patients (50 %) in the APC group and in 11 patients (29.7 %) in the RF group, which were a continuing source of bleeding. After regression of inflmmatory changes, the patients underwent the second stage of surgery corresponding to the randomization group. After the second stage of surgery in the APC group in 17 patients (94.4 %) and in the RF group in 11 patients (100 %), a complete regression of the disease was revealed. Postoperative pain syndrome occurs in two groups; however, the RF group experiences higher intensity and longer duration of pain.
Conclusion: Radiofrequency ablation and argon plasma coagulation are effective and safe treatments for rectal bleeding in chronic radiation proctitis without erosive or ulcerative lesions.

Aim. To assess the effectiveness of triple-plane structural preservation mammoplasty in correcting grade I—III ptosis with breast implants.

Methods. This study comprised 40 women aged 24 to 46 who underwent breast ptosis correction. The patients were divided into two groups of 20 each: the main group underwent the triple-plane technique, while the comparison group received standard ptosis correction methods (periareolar, vertical, and inverted T-shaped mastopexy).

Results: Employing the triple-plane technique for correcting breast ptosis led to a 1.4-fold reduction in pain intensity to 5 ± 1 points (p ≤ 0.05), a 2.5-fold decrease in exudation duration (drain removal) to 18 ± 2 hours (p ≤ 0.05), a 2-fold reduction in hospitalization time to 23 ± 2 hours (p ≤ 0.05), and allowed for the transition to soft fiatives by the 14th day of the postoperative period.

Conclusion. Triple-plane structural preservation mammoplasty for correcting grade I—III ptosis with breast implants proves highly effective. It preserves the mammary gland’s ligamentous structure, reduces complication rates, and restores glandular shape without requiring incisions on the lower pole and nipple-areolar region skin. This results in improved aesthetic outcomes and enhances patients’ quality of life.

Aim. This study aimed to evaluate the therapeutic effiacy of two laser modalities, namely a 595-nm pulsed dye laser and a 755-nm long-pulse alexandrite laser, in the treatment of hemangiomas in patients with concurrent anemia.
Methods. A total of 194 patients diagnosed with infantile hemangiomas, characterized by a thickness ranging from over 2 mm to under 8 mm, were included in this study. The patients were randomly assigned to two groups: the control group received treatment with the 595-nm pulsed dye laser, while the experimental group underwent sequential therapy, beginning with the 755-nm long-pulse alexandrite laser followed by the 595-nm pulsed dye laser.
Results. In the control group, the overall treatment effiacy was 36.1 %. In contrast, the experimental group exhibited a signifiantly higher effiacy of 76.3 %. Statistical analysis of the abundance data was conducted using the Chi-square (X2) test, with results deemed statistically signifiant at a signifiance level of P < .05.
Conclusion. Sequential therapy, which integrates both the 755-nm pulsed dye laser and the 595-nm pulsed dye laser, demonstrates remarkable effectiveness in treating hemangiomas, particularly in cases complicated by anemia.

Aim. To develop bariatric and antireflx surgery for the treatment of patients with obesity and GERD, and to assess its effectiveness and safety.
Methods. A prospective controlled study included 28 patients who underwent laparoscopic mini-gastric bypass with Nissen fundoplication, and their progress was monitored for three years postoperatively. This study covered the surgical procedure and its technical aspects. Surgical treatment was evaluated using GERD-HRQL, BAROS, and GIQLI questionnaires, as well as instrumental studies (esophagogastroscopy and X-ray of the esophagus and stomach).
Results. According to the GERD-HRQL questionnaire, mini-gastric bypass with Nissen fundoplication demonstrated excellent control over GERD symptoms during all stages of postoperative follow-up. The most signifiant reduction in body weight occurred within the fist year after the operation, with sustained effects throughout the observation period. The maximum percentage of excess body weight loss was observed two years post-operation. The GIQLI questionnaire showed an average score increase of 54 % three years after surgical treatment compared to baseline. Evaluation of the bariatric treatment’s effectiveness using the BAROS system criteria consistently indicated «excellent and very good results» throughout the entire postoperative follow-up period. No signifiant postoperative complications were identifid, both in the early and long-term periods.
Conclusion.The developed mini-gastric bypass with a Nissen fundoplication proves to be a safe and effective surgical treatment method for patients with obesity and GERD. Following further clinical studies and the analysis of long-term results, the proposed operation could be recommended as an alternative to RYGB and MGB-OAGB for patients with obesity and GERD.

Aim. To conduct a comparative analysis of the effectiveness of local anesthetics used for regional anesthesia.
Methods. An open randomized study was conducted to assess the effiacy and safety of Articaine-Binergia 20 mg/ml and Lidocaine as local anaesthetics for anaesthesia at two levels (axillary and wrist) during surgical procedures on the upper limbs of geriatric patients with degenerative-dystrophic hand and forearm conditions.
Results. The results of the study convincingly proved the advantage of Articaine-Binergia 20 mg/ml in terms of effiacy and safety. A notable advantage observed was the shorter latency period, which translates into reduced patient time in the operating room and increased operational effiiency.
Conclusions. Based on the study fidings, Articaine-Binergia is recommended for anaesthesia in traumatology-orthopedics involving upper limb procedures, especially for patient groups at higher risk of systemic toxicity.

The morbidity structure related to degenerative-dystrophic diseases of connective tissue structures in the upper limb includes a distinct category known as stenoses of bone-firous canals. These conditions are polyetiological, meaning they result from various causes and involve the compression of anatomical elements within specifi canals due to a size mismatch between the canal and its contents. One of the most prevalent connective tissue diseases within this category is stenosing ligamentitis, which affects the annular ligaments of the figers.

The analysis of contemporary scientifi literature, clinical recommendations, and the identifiation of challenges in the diagnosis, treatment, and postoperative care of patients encountered by non-oncology physicians are conducted. Gastrointestinal stromal tumors (GISTs) are neoplasms originating from the gastrointestinal tract’s mesenchymal cells, particularly from interstitial Cajal cells. They hold an intermediate position between benign and malignant tumors, occurring at a rarity rate of approximately 1 to 3 %. The description of this pathology in both domestic and foreign literature is infrequent. A clinical case description from personal practice is presented, detailing the assessment of preoperative research methods and surgical tactics, along with the results of histological and immuno-histochemical studies. An important aspect in the postoperative period involves assessing the risk of tumour recurrence and metastasis. Notably, GISTs are characterized by the absence of lymphogenic metastasis and an extremely low frequency of infitrative growth. Thus, it is now a common practice to perform resections without lymph node dissection. The primary method for defiitive diagnosis confimation is an immuno-histochemical study, crucial for determining the indications for targeted therapy. The rare incidence of GISTs in the small intestine in non-oncological medical practice, compounded by the limitations of endoscopic imaging methods for the small intestine, poses challenges in establishing a diagnosis during the outpatient examination.