Russian surgical journal

Werner Germanovich Tsege von Manteuffel (Werner Maximilian Friedrich Zoege von Manteuffel) is remembered in the history of medicine as an outstanding surgeon whose professional work had a significant impact on the development of healthcare in Russia and Europe. His multifaceted legacy remains relevant in modern medical practice. The surgeon made fundamental contributions to the advancement of medicine: he was a pioneer in the introduction of aseptic techniques, becoming the first to systematically use rubber gloves sterilized by boiling, which greatly reduced the risk of infection. In clinical practice, he performed the first successful operation to extract a bullet from the heart, developed new methods for vascular suturing and surgeries on the inferior vena cava, and improved techniques for thyroidectomy (strumectomy). In abdominal surgery, he created a classification of intestinal obstruction, advocated for early surgical intervention, and refined gastric resection; the diagnostic syndrome he described is still used today. Tsege von Manteuffel also reformed military field surgery by introducing a triage system for the wounded and optimizing their evacuation, later adapting these principles for civilian medicine. His pedagogical talent was equally significant: he trained a generation of distinguished surgeons, including N.N. Burdenko, the founder of Russian neurosurgery, thereby ensuring the continued development of the traditions of the Dorpat school.

Postoperative specific and nonspecific complications in abdominal surgery remain a significant clinical and organizational problem, associated with increased mortality, prolonged hospital stay, and higher treatment costs. Despite advances in modern surgical technologies, their incidence has not significantly decreased over recent decades, indicating the need to improve approaches to risk assessment and management of complications. To analyze the role of modern diagnostic scales and existing clinical decision support systems in risk assessment and prevention of postoperative complications in abdominal surgery. A review of domestic and international publications was conducted, focusing on postoperative complications, surgical risk assessment scales, outcome registries, surgical safety checklists, and clinical decision support systems, including soft computing methods and machine learning approaches. Traditional clinical and scoring risk scales were shown to have limited predictive accuracy and are generally focused on individual complications or specific nosologies in abdominal surgery. Regression and machine-learning models demonstrate higher predictive accuracy; however, they require large datasets and substantial computational resources. The use of surgical registries and safety checklists potentially reduces complication rates, but their implementation is limited by organizational and methodological factors. Existing methods for predicting postoperative complications are fragmented. A relevant objective is the development of integrated modular clinical decision support systems that account for individual patient factors and improve the effectiveness of complication prevention.

This article presents a clinical case of a delayed complication following a shrapnel wound in a 30-year-old serviceman. The patient was admitted to a field military hospital one day after sustaining a wound to the left lower leg, with satisfactory distal blood flow. However, on the 7th day of hospitalization, profuse arterial hemorrhage developed, necessitating urgent surgical intervention. Ultrasound examination enabled the rapid diagnosis of the cause: the formation of a false aneurysm of the peroneal artery with mural thrombosis. Surgical intervention was performed, which included proximal control of the popliteal artery, exploration of the neurovascular bundle of the leg, opening of the aneurysmal cavity, thrombectomy, and isolation of the damaged vessel. Intraoperatively, a longitudinal rupture of the peroneal artery measuring 2 cm in length was identified, with the artery itself having a small diameter of less than 1 mm. Given the satisfactory pulsation in the main tibial arteries (anterior and posterior tibial), a reasoned decision was made to forgo reconstructive repair in favor of ligating the peroneal artery as a definitive hemostatic measure within the "damage control" concept. The postoperative course was uneventful. The patient was discharged with restored limb function and subsequently returned to active duty. This case clearly illustrates a typical scenario of a delayed, life-threatening complication of combat vascular trauma. It underscores the critical importance of vigilance for secondary hemorrhage, the indispensable role of ultrasound diagnostics at the forward medical echelon, and the rationale for choosing an organ-preserving strategy (ligation) for injuries to non-essential arteries in a field hospital setting.

Wernicke’s encephalopathy remains a clinically significant but often underestimated postoperative complication, particularly in the context of the increasing prevalence of non-alcoholic forms of the disease. This report describes a non-alcoholic form of Wernicke’s encephalopathy in an 84-year-old female patient who underwent surgical treatment for transverse colon cancer with right hemicolectomy, ileostomy creation, and a prolonged course of parenteral nutrition. In the postoperative period, the patient gradually developed oculomotor dysfunction, cerebellar ataxia, and impaired consciousness. The diagnosis was established based on the clinical presentation and findings on magnetic resonance imaging. Concomitant metabolic disturbances, including hypokalemia and metabolic alkalosis, in the absence of marked laboratory-confirmed thiamine deficiency, complicated early diagnosis. Administration of high-dose thiamine therapy led to rapid clinical improvement. This case highlights the need for clinical vigilance regarding non-alcoholic forms of Wernicke’s encephalopathy in surgical patients at risk of malabsorption and nutritional deficiency, as well as the importance of timely prevention and raising awareness of the pathogenesis and clinical features of the disease in modern medical practice.

Despite scientific evidence that the joint is an independent, hollow organ composed primarily of soft tissue, clinical practice in many countries, including Russia, continues to use an outdated definition focused on bone structures. Recognizing the joint as an organ is becoming not only scientifically but also clinically necessary to optimize a multidisciplinary approach to osteoarthritis. During embryogenesis, the knee joint develops as an independent organ, forming before and beyond the bone primordia. The incidence of osteoarthritis is determined by a combination of genetic, demographic, social, and cultural factors in each region of the world. Taking these factors into account will enable the development of effective prevention and treatment strategies at the national level. The diagnosis of knee osteoarthritis is undergoing a qualitative leap – from passive detection of late radiographic changes to an active search for early, reversible signs of the disease. Modern diagnostic tools, including quantitative MRI, ultrasound, and molecular biomarkers, offer a unique opportunity to intervene in the pathological process at a stage when joint preservation is still possible. Implementing this paradigm requires rethinking the role of orthopedists and rheumatologists: from “surgeons of last resort” to “joint preservation specialists”.

The monograph analyzes the prevalence of osteoarthritis and the features of its statistical accounting. The long-term results of knee osteoarthritis treatment were studied using the statistical method of survival analysis. An algorithm for a differentiated approach to multidisciplinary treatment and rehabilitation of patients with knee osteoarthritis has been scientifically substantiated and developed, taking into account conservative and organ-preserving surgical methods and rehabilitation measures. Data on the results of a study of a number of morphological parameters are presented, from the standpoint of the validity of knee arthroplasty. The information presented in the monograph can be useful both for orthopedic traumatologists and outpatient rehabilitologists, as well as for specialists of inpatient medical and preventive institutions. The information presented in this publication may be useful for healthcare organizers, as well as used by students and teachers as reference materials in the preparation and conduct of lectures and practical classes on rehabilitation and traumatology and orthopedics in medical universities.

11 февраля 2026 г. исполнилось 70 лет со дня рождения генерального директора НМИЦ хирургии им. А.В. Вишневского Минздрава России, главного хирурга и эндоскописта РФ, академика РАН Амирана Шотаевича Ревишвили – выдающегося кардиохирурга и ученого с мировым именем, крупного педагога, организатора медицинской науки и здравоохранения, одного из основателей хирургической и интервенционной аритмологии в России.

5 января 2026 г. отметил свой 80-летний юбилей доктор медицинских наук, профессор, заведующий кафедрой организации биомедицинских исследований, главный научный сотрудник отдела экспериментальной хирургии НИИ Клинической хирургии РНИМУ им. Н.И. Пирогова (Пироговский Университет), президент Всероссийского общества герниологов, заместитель главного редактора журнала «Вестник РНИМУ им. Н.И. Пирогова», член редколлегии журналов «Доказательная герниология» «Российский хирургический журнал», «Hernia».

В рамках мероприятий, проводимых Всероссийской общественной организацией «Общество герниологов», 12–13 декабря 2025 г. в Москве прошел VIII Всероссийский съезд герниологов «Новые прогрессивные тенденции и достижения отечественной герниологии». В работе съезда приняло участие более 280 делегатов из 68 городов и 45 регионов Российской Федерации, а также специалисты из-за рубежа.