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Background: Surgical treatment of massive hepatic formations is an acute problem of operative hepatology, often being the only way to increase the life expectancy of patients. However, even nowadays, liver surgeries are considered to be traumatic, high-risk interventions due to the development of a potent body stress response induced by tissue damage, risk of severe intra- and postoperative complications, and high mortality. High mortality rates, especially after extensive liver resections, are more often associated with bleeding, bile flow from a liver section with the subsequent development of peritonitis, intoxication, and post-hepatectomy liver failure. The aim of this study was to perform intraoperative, post-resection prevention of acute liver failure (ALF) by applying cyanocobalamin in the experiment. Methods and Results: The study included 96 sexually mature male Wistar rats, which were divided into 4 groups, 24 animals in each group. A conventional 70% hepatectomy was performed on animals of all groups. Prevention of post-hepatectomy liver failure (PHLF) was not performed in animals of the control group (CG) 1; animals of CG2 received 1 ml of 0.9% sodium chloride solution that was injected into the preserved hepatic lobes intraoperatively; animals of the experimental group (EG)1 received 10 intrahepatic injections of 0.1 ml of cyanocobalamin (200 μg/ml); animals of EG2 received 1ml of cyanocobalamin (200 μg/ml) intraperitoneally. The general condition of the animals (activity, appetite), healing time of the postoperative wound, and weight of the regenerated liver were assessed after the experiment. Biochemical methods included assessment of the indices of the cytolysis syndrome, cholestatic syndrome, the syndrome of hepatic cell failure, as well as the analysis of oxidative stress parameter and sevaluation of the expression of transforming growth factor beta ( TGF-β). On Day 5 after hepatic resection, a significant improvement in the general condition of the animals (increased appetite and activity) was noted in EG1 and EG2. Intraoperative, intrahepatic administration of cyanocobalamin can increase the TGF-β expression by 2.5-3 times, affecting the proliferative activity of hepatocytes and providing recovery to 96.15±4.31% of the initial liver weight by Day 14 after hepatectomy Conclusion: Intraoperative, intrahepatic administration of cyanocobalamin prevents the development of ALF in the early postoperative period and ensures restoration of the anatomical and functional integrity of the liver.

The preconditions of an original method is described, and the techniques are presented for an intraoperative prevention of lymphatic edema of the upper limb in locally advanced breast cancer patients. The essence of the method is based on a preventive ablation of the clavicular part of the greater pectoral muscle and the clavipectoral fascia in the course of mastectomy with subsequent retro-grade lymph node dissection, which makes it possible to rule out the very possibility of postradiation tissue fibrosis and subclavicular vein compression., Описаны предпосылки и представлен оригинальный метод интраоперационной профилактики лимфатического отека верхней конечности у больных местно-распространенным раком молочной железы. Суть метода основана на превентивном удалении во время мастэктомии ключичной части большой грудной мышцы и грудинно-ключичной фасции с последующей ретроградной региональной лимфодиссекцией, что позволяет исключить возможность постлучевого фиброзирования тканей и сдавление подключичной вены., Описані передумови і наведено оригінальний метод інтраопераційної профілактики лімфатичного набряку верхньої кінцівки у хворих на місцево-поширений рак грудної залози. Суть методу оснований на превентивному видаленні під час мастектомії ключичної частини великого грудного м'яза та груднинно-ключичної фасції з подальшою ретроградною регіональною лімфодисекцією, що дає змогу виключити можливість післяпроменевого фіброзування тканин і стискання підключичної вени.