[Results of the first All-Russian consensus conference on bariatric surgery]. / Rezul'taty pervoi vserossiiskoi konsensus-konferentsii po bariatricheskoi khirurgii.

Until now, there has not been organized consensus for standardization in bariatric surgery In Russia. We present the results of the first Bariatric Surgery Consensus Conference conducted in Barnaul (March, 2023). A list of questions was proposed within 6 blocks: 1) general issues of bariatric surgery, 2) sleeve gastrectomy, 3) one-anastomosis gastric bypass («mini-gastric bypass¼), 4) Roux-en-Y Gastric Bypass, 5) Single Anastomosis Duodenal Switch and other options for biliopancreatic bypass, 6) rare procedures. Consensus (>70% agreement) was reached for 51 out of 96 statements. Stratification by the level of expertise was carried out, and responses of the expert group were compared with responses of all participants.

[Differential diagnostics of gastric cancer and precancerous changes of the gastric mucosa using analysis of expression of six microRNAS.]

The lack of specific symptoms for the early detection of gastric cancer leads to the fact that it is often diagnosed at a late stage, when the prognosis is unfavorable. The analysis of molecular markers in addition to standard diagnostic procedures is a promising approach for improving the preoperative diagnosis of both gastric cancer and precancerous changes in the mucosa. Therefore, the aim of our study was to analyze the diagnostic significance of using miRNA expression to diagnosis gastric cancer and precancerous conditions (dysplasia) in histological material. In this work, 122 samples of archival histological material in the form of paraffin blocks were used: 34 samples of gastric adenocarcinoma, 54 samples of gastric ulcers with dysplasia and 34 samples of normal gastric mucosa obtained from patients after bariatric surgery. The expression level of miRNA-145-5p, -150-5p, -20a-5p, -21-5p, -31-5p, -34a-5p, -375 was determined using real-time RT-PCR. Samples were stratified into different groups using the C-RT decision tree algorithm. All miRNAs, except miRNA-20a, were included in the decision tree, which allows stratification of samples for normal mucosa, dysplasia, and gastric cancer. Normal mucosa can be distinguished from gastric cancer only by miRNA-34a, -21, -375. Diagnostic characteristics for the detection of dysplasia: specificity - 97%, sensitivity - 87%; for the detection of gastric cancer: specificity - 91%, sensitivity - 93%. The sufficiently high values of the diagnostic characteristics for detecting dysplasia of the gastric mucosa and gastric cancer obtained in our study indicate the possibility of using expression data of a small amount of miRNAs for the effective separation of samples with tumor and precancerous changes in the stomach tissue.

THE USE OF DEXMEDETOMIDINE IN COMBINATION NEFOPAM FOR POSTOPERATIVE ANALGESIA AFTER LAPAROSCOPIC CORRECTION OF MORBID OBESITY.

AIM: To study the possibility of using a combination of dexmedetomidine with nefopam for postoperative analgesia in patients with morbid obesity after bariatric surgery in anesthesia quality aspects and theimpact of the study on the combination during the inflammatory response to surgical trauma. SUBJECTS AND METHODS: A prospective cohort study of 48 patients with obesity. RESULTS: Based on the analysis of hemodynamic parameters, evaluation of pain using a numeric rating scale pain concluded that selective agonist of o-2 adrenergic dexmedetomidine in combination with nefopam provides effective postoperative pain relief in patients who underwent bariatric surgery, and is not a factor for suppression of postoperative inflammatory response Unlike the effects of ketorolac tromethamine, do not always provide a sufficient level of analgesia and reduce the rate of growth in the level of IL-6. CONCLUSION: The combination of dexmedetomidine with nefopam provides sufficient analgesic effect after bariatric surgery, with noted a more rapid onset of analgesia than with ketorolac. Postoperative analgesia and dexmedetomidine nefopam, unlike the use of ketorolac tromethamine, are not violated ratio of interleukins 1 and 6 was not a factor and suppression of postoperative acute phase inflammatory response.

[The peculiarities of rat tissue reactions to intraperitoneal implants made out of biodegradable polyhydroxyalkanoates].

The reaction of rat tissues to intraperitoneal placement of implants made out of biodegradable polyhydroxyalkanoates (PHA), was studied at different time points after the operation by the methods of light microscopy. It was found that after intraperitoneal PHA implant placement, the active adhesive process started leading to formation of fibrous adhesions between PHA implants and intestinal loops. When PHA implants were used in the form of films, they became surrounded by a thick fibrous capsule. As a result of PHA implant placement in the form of ultrathin fibers, the extensive foreign body granulomas with perifocal inflammation and sclerosis of surrounding tissues were formed. In these granulomas the polymer fragmentation and phagocytosis by macrophages with formation of giant cells of foreign body occured. It is concluded that PHA implants are not biodegradable and induce tissue reactions similar to those caused by other foreign bodies.