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Video-assisted thoracoscopic esophagectomy for oesophageal cancer involving the thoracic region has certain advantages. However, thoracoscopic instrument manipulations performed in the narrow confines of the posterior mediastinum carry the risk of intraoperative injury to other vital structures.Purpose of the studyTo improve surgical treatment outcomes of thoracic oesophageal cancer patients using topographic anatomical navigation.Materials and methodsThe study included 23 patients with stages II-III middle and lower thoracic oesophageal cancer (TOC), according to TNM-8. All of them underwent thoracoscopic oesophagectomy in the semi-prone position. While the 1st group of patients (n=15) underwent conventional surgery, in the 2nd group of patients (n= 8), our algorithm of sequential visual navigation based on topographic and anatomical landmarks was employed.ResultsIn the 1st group,4 patients (26.7%) developed intraoperative complications. Out of these four, in 3 patients, injury of the thoracic lymphatic duct complicated with chylothorax development was diagnosed, requiring reoperations; in one patient, the surgery caused damage to the thoracic aorta. Unfortunately, two patients out of these four died.In contrast, there were no intraoperative complications or deaths in the 2nd group. In addition, the algorithm allowed the removal of 18% more lymph nodes, reduction in the incidence of postoperative pneumonia by 25%, the operation time by 25±15 minutes, and the length of stays by 3±2 days, compared with the 1st group of patients. ConclusionTopographic anatomical navigation can reduce the incidence of intra- and postoperative complications, effectively guide lymph node dissection, and shorten hospital stay.

The interaction of the blood flow with the aorta is a complex dynamic event described in biomechanics as the Fluid-structure interaction. In this study we’ve developed a method for creation of a personalized 3D dynamic model of the aortic bulb and arch for the prediction of its mechanical behavior using FSI-analysis. We found that the accuracy of predicting geometric aortic deformities based on FSI modeling is on average 92%.

Working in intensive care units (ICUs) is stressful and potentially leads to various psycho-emotional disorders. Today, this issue represents a serious concern to the healthcare sector and affects the quality of healthcare provided. This study aimed to assess and compare the psycho-emotional state in COVID-19 and non-COVID-19 hospitals’ ICU healthcare workers (HCWs). From January to July 2021, we conducted an anonymous cross-sectional web survey of ICU physicians and nurses (N = 1259) of various hospitals in a metropolis with a population of over 10 million people. The statistical distributions of non-COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 14.6%, average 30.8%, and high 54.6%); depersonalization levels (low 11.6%, average 16.5%, and high 71.9%); and reduced personal accomplishment levels (low 23.5%, average 40.3%, and high 36.2%). The statistical distributions of COVID-19 ICU HCWs showed the following results: emotional exhaustion levels (low 16.5%, average 31.5%, and high 52%); depersonalization levels (low 7.4%, average 9.4%, and high 83.1%); and reduced personal accomplishment levels (low 25.4%, average 45.4%, and high 29.1%). This study found a strong correlation between emotional exhaustion, aggression, and depersonalization in non-COVID-19 ICU HCWs and also found a correlation between their age, aggression, emotional exhaustion, and occupational stress.

the world studies showed the interest in measurement of the buccal or anterior cortical plate thickness. Data indicate a significant superiority of the spongy substance over the compact one in the distal part of the jaw, which makes it possible to think about a higher effectiveness of transcortical injections. The empirical "rule of 10″ provides for the choice of a method of anesthesia in children for primary teeth but demonstrates difficulties with high-quality anesthesia accompanied for permanent teeth. Therefore, the importance of clinical examination and anatomical investigation of the jaw cortical plate in children for competent planning of transcortical interventions has been determined.To study the features of the clinical and X-ray anatomy of the cortical layer in distal alveolar part of the mandible in children.The assessment of the X-ray anatomical characteristics of the mandible was carried out according to 150 anonymized cone-beam computed tomograms of patients aged 6-12 years, performed for the treatment of major diseases. Qualitative assessment and examination of the cortical plate of the distal alveolar part of the mandible were carried out on the skeletonized certified preparations of aged 6-12 in the amount of 50.The age characteristics of the cortical plate in the area of the chewing group of teeth in the mandible were determined according to macro anatomical studies, which confirms with the X-ray results. Therefore, the obtained images serve as actual confirmation of X-ray studies, which are ranked by age. The thickness of the cortical plate in the second primary molar of the mandible in subgroups 6, 7 and 8 years has a proportional increase from the cervical region to the apical projection. The average thickness of the cortical plate is 1.57 mm at 6 years, 1.52 mm at 7 years, 1.6 mm at 8 years and 1.84 at 9 years. The cortical plate thickness in the first primary molar of the mandible in subgroups 6 and 7 years has a proportional decrease from the cervical region to the apical projection as well as an inverse proportion to age. The average thickness of the cortical plate is 1.33 mm. In the first molar of the mandible at the age limit of 6-12 years the attention is drawn to the linear increase in tissue volume from the cervical region to the apical projection up to 8 years. At 6-8 years the average thickness of the cortical plate in this age group is 1.74 ± 0.2 mm, at 9 years - 2.03 mm, at 10 - average value in the cervical region it is 1.53 ± 0.23 mm, in the root middle it is 2.19 ± 0.13 mm and in the apical projection it is 1.98 ± 0.16 mm, at 11-2.22 mm and at 12-2.35 mm. For the second primary molar the average thickness of the buccal cortical plate of the second primary molar is 1.4 mm in cervical part, 1.68 mm in the root middle and 1.81 mm in the apical projection. Finally, thickness of the buccal cortical plate in the cervical region of the first permanent molar is 2 mm in groups.The study makes it possible to determinate with noninvasive way the age limit for the least pronounced zone of the buccal cortical plate.

Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia.