[Synchronous left atrial myxoma and gastric cancer: a case report]. / Sinkhronnye miksoma levogo predserdiya i rak zheludka. Klinicheskii sluchai.

The authors present a 57-year-old patient with synchronous left atrial myxoma and gastric cancer undergoing staged treatment. Distal gastrectomy with gastroduodenostomy at the first stage was followed by resection of the left atrial myxoma after 22 days. Postoperative period was uneventful after both interventions. The follow-up examination revealed favorable clinical status and no cancer progression.

[External-internal sigmoid-vesical fistula following sigmoid diverticulum perforation into the patent urachus]. / Naruzhno-vnutrennii sigmovidno-mochepuzyrnyi svishch kak oslozhnenie perforatsii divertikula sigmovidnoi kishki v nezarashchennyi urakhus.

A patient with external-internal sigmoid-vesical fistula is presented. The authors describe surgical intervention (urachus excision, removal of infiltrate with resection of bladder bottom and fistula-related segment of sigmoid). Surgical challenges due to localization of fistula and appropriate literature data are discussed.

[Surgical treatment of enterocutaneous fistulas in patients with ventral incisional hernia]. / Khirurgicheskoe lechenie naruzhnykh kishechnykh svishchei v posleoperatsionnykh gryzhakh.

OBJECTIVE: To determine the optimal surgical treatment in patients with enterocutaneous fistulas combined with ventral incisional hernia. MATERIAL AND METHODS: There were 24 patients with enterocutaneous fistulas combined with ventral incisional hernia. Enterocutaneous fistula was noted in 19 cases, enteroatmospheric fistula - in 5 patients. RESULTS: Simultaneous fistula closure and abdominal wall repair were performed in 14 patients (mesh repair in 5 cases and local approximation of tissues in 9 cases). Postoperative complications occurred in 8 patients, hernia recurrence in long-term period developed in 7 people. Two-stage closure of abdominal wall defect was carried out in 10 patients. Fistula closure was followed by edge-to-edge anterior abdominal wall repair in 5 cases, skin edges were approximated by interrupted sutures or open wound management was performed. There were no postoperative complications and hernia recurrence in this group. CONCLUSION: Surgical treatment of patients with enterocutaneous fistulas combined with hernia should be performed in two stages, i.e. enterocutaneous fistula closure with subsequent hernia repair.

[Management of patients with enterocutaneous fistulae]. / Konservativnyi etap lecheniya bol'nykh s tonkokishechnymi svishchami.

Enterocutaneous fistula (ECF) is the most serious postoperative life-threating complication of various abdominal surgical interventions. Treatment of patients with ECF is associated with life-threatening complications including sepsis and septic shock, intestinal failure and severe water-electrolyte disorders that causes high mortality rates (35-75% according to national authors and 6-33% according to foreign colleagues). This issue is especially relevant in the cases of enteroatmospheric fistulae and high ECF with loss of intestinal contents of more than 500 ml per day. In the absence of correct conservative therapy, this quickly results progression of sepsis and development of multiple organ failure. Surgery without complex preoperative preparation in this period may be fatal and lead to clinical aggravation and death of patient in early postoperative period. Each patient requires an individual approach. However, there are general principles of treatment too. This literature review describes the main aspects of conservative treatment of patients with enteric fistulae.

[Surgical treatment of neurofibromatosis type I followed by retroperitoneal tumor (in Russian only)]. / Khirurgicheskoe lechenie neirofibromatoza I tipa, assotsiirovannogo s opukholevym porazheniem zabriushinnogo prostranstva.

AIM: To determine the optimal surgical approach in patients with abdominal and retroperitoneal manifestations of Recklinghausen's disease. MATERIAL AND METHODS: There were 4 patients (3 women and 1 man) with neurofibromatosis type I who were treated at Vishnevsky National Medical Research Center of Surgery. RESULTS: There were 3 robot-assisted procedures: excision of retroperitoneal tumors (plexiform neurofibroma and schwannoma) in 2 cases and right adrenal pheochromocytoma in 1 patient. We also included 1 clinical case of conventional surgery for neurofibromatosis type I followed by multiple gastrointestinal stromal duodenal and intestinal tumors. In one case, postoperative period was complicated by fluid accumulation in the bed of previously removed tumor that required US-assisted drainage. Postoperative period was uneventful in other cases. CONCLUSION: Robot-assisted surgery is safe and effective in patients with Recklinghausen's disease followed by single abdominal and retroperitoneal tumors. It is more expedient to choose conventional technique for multiple tumors located in different parts of retroperitoneal space or abdominal cavity.