Background. The relevance of the study is due to the need to improve the quality of pain relief in the early postoperative period within the framework of the concept of early recovery after surgical treatment (ERAS). The study and optimization of a multimodal approach to pain management, including transversus abdominis plane blockade (TAP block), is essential to improve surgical outcomes and expedite patient recovery.

Aim. To evaluate the effectiveness and safety of using TAP block for postoperative analgesia during laparoscopic nephrectomy.

Materials and methods. The study involved 44 patients divided into two groups: 20 patients with TAP block (group 1) and 24 patients without block (group 2, control). The primary endpoint was the intensity of pain syndrome according to the visual analog scale, the secondary ones were the need for analgesics, restoration of peristalsis, the presence of nausea and vomiting, and the time of patient activation.

Results. The analysis showed a statistically significant superiority of the TAP-block group in terms of pain syndrome at all time-points of follow-up (1, 3, 6, 12 and 24 hours after surgery). The average time to the first use of analgesics was 42 ± 4 hours in the blockage group versus 19.0 ± 1.9 hours in the control group. The frequency of postoperative nausea and vomiting was significantly lower in the group with TAP block (19.4 % vs. 47.4 %, p = 0.003).

Conclusion. TAP block demonstrated a pronounced analgesic effect in absence of complications. The method made it possible to provide longer-lasting analgesia, reduce the need for additional analgesics and the frequency of postoperative nausea and vomiting compared with the traditional method of anesthesia.

Aim.  To study the effect of volume infusion on the first 24 hours after Lewis esophageal resection with gastric esophagoplasty (combined laparotomy and thoracotomy access on the right) on the immediate results and outcomes in cancer patients.

Materials and methods. The study retrospectively included patients who underwent Lewis resections of the esophagus with gastric esophagoplasty (combined laparotomy and thoracotomy access on the right) for malignant neoplasms of esophagus, as well as cardioesophageal cancer at the N.N. Blokhin National Medical Research Center of Oncology in 2023.

Results. Forty patients were included in the study. The patients were divided into 2 groups based on the median rate of daily infusion therapy: in patients of group 1 (n = 21) on the 1^st day of surgery, the intravenous infusion rate was ≥4 ml/kg/day, in patients of group 2 (n = 19) – <4 ml/kg/day. The complication rate was 47.7 % (n = 10) in group 1 and 84.2 % (n = 16) – in group 2 (p = 0.021). The incidence of complications ≥III grade according to Clavien–Dindo classification did not differ in both groups (p = 1.000). The incidence of postoperative deep vein thrombosis was 4.8 % (n = 1) in group 1 and 31.6 % (n = 6) in group 2 (p = 0.039). Ninety-day postoperative mortality was not observed in any of the groups. The length of hospital stay for patients in group 1 was 17 (15–18) days, in group 2 –16 (14–20) days (p = 0.707).

Conclusion. The results of the study revealed that the number of common complications and the frequency of postoperative deep vein thrombosis in patients of the group 2, who received a daily infusion volume of <4 ml/kg/day, was higher than in patients of the group 1. 

The data from this study should be taken into account when planning infusion therapy in patients with esophageal malignancies and cardioesophageal cancer during Lewis esophageal resections with gastric esophagoplasty (combined laparotomy and thoracotomy access on the right).

Low-energy laser radiation, having anti-inflammatory, biostimulating and analgesic effects, can be used for the prevention and treatment of radiation erythema of the skin and post-radiation mucositis.

We analyzed publications devoted to the use of laser therapy in patients with head and neck tumors undergoing radiation and chemoradiation therapy.

To date, there are no standardized parameters for the technique of using laser radiation for preventive and therapeutic purposes in case of radiation damage to the skin and mucous membrane. All this requires further study of the parameters of using low-energy laser therapy, both for the treatment of radiation complications in patients with head and neck tumors, and for the prevention of the frequency and severity of early and late radiation injuries.

Hepatotoxicity is damage to liver cells (hepatocytes) caused by toxic substances, including drugs, chemical compounds and other xenobiotics. Symptoms range from mild discomfort to serious disorders such as fulminant liver failure.

The review examines the types and mechanisms of hepatotoxicity, diagnostic aspects and methods of hepatoprotection against the background of antitumor drug therapy.

The rise of antimicrobial resistance is a pressing problem worldwide. Oncology patients are at risk of developing infections caused by multidrug-resistant bacteria. This is associated with frequent visits of patients to hospitals for chemotherapy courses, long periods of neutropenia in oncohematologic patients and after hematopoietic stem cell transplantation, repeated courses of antibiotic therapy, surgical interventions, etc.

Aim of this work – to familiarize physicians with the mechanisms of antimicrobial resistance of Pseudomonas aeruginosa (P. aeruginosa), the possibilities and limitations of new antibiotics with antipseudomonal activity, and to help with the choice of antibiotic therapy for infections caused by multidrug-resistant P. aeruginosa and infections difficult to treat due to P. aeruginosa resistance.

The summarized data of the Russian online antimicrobial resistance research platform AMRmap on the sensitivity and resistance of P. aeruginosa in Russia for the period 2020–2022 is presented. Recommendations on treatment of infections caused by multidrug-resistant P. aeruginosa and infections difficult to treat due to P. aeruginosa resistance of the Infectious Diseases Society of America (2024), the European Society of Clinical Microbiology and Infectious Diseases (2022) and Russian guidelines on diagnosis and antimicrobial therapy of infections caused by multidrug-resistant microorganisms (2024) were analyzed. The possibilities of overcoming the mechanisms of P. aeruginosa resistance in new beta-lactams and selected antibiotics with antipseudomonal activity are considered.