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The aim of the study of the study is to evaluate the current diagnostic capabilities and improve the method of surgical treatment of patients with NET of the small intestine. Materials and methods: The results of treatment of 68 patients with NET of the small intestine (SI) were studied. Localized tumors were diagnosed in 5,9% of patients, locally spread – 22%, generalized – in 72,1%. Diagnostics of SI-NET included: assessment of clinical manifestations of the disease; laboratory diagnostics (CgA, serotonin, 5-HIAA), instrumental examination (US, CT, MRI, PET-CT 68Ga-DOTA-TATE); morphological examination (histological, immunohistochemical) of the tumor. Results: Late diagnosis of SI-NET is due to an asymptomatic course of the disease in 27,9% of patients, and non-specific clinical manifestations in 29,4%. The sensitivity of CgA, serotonin, 5-HIAA in the diagnosis of localized and locally distributed tumors is 11,1%, 45,5%, 20%, generalized – 59,3%, 86,2% and 50% respectively. The main method for diagnosing neo of the small intestine is CT, which is informative in detecting a tumor of 20%, and mesentery conglomerate – 94.5%. Surgical treatment was performed in 75% of patients. Cytoreduction or removal of the primary tumor increases the life expectancy of patients with generalized NET by 2 times. The developed method of surgical treatment of patients with SI-NET with extensive local distribution, which provides radical surgical intervention. Conclusion: Difficulties in diagnosing SI-NET are due to the peculiarities of the clinical course of the disease. The surgical method is the main one in the treatment of patients at all stages of the oncological process. The proposed techniques of surgery allow performing resection of the small intestine and removing the tumor conglomerate of the mesentery without compromising the functional and oncological results of treatment of patients.

The morphological study of the resected sections of the colon obtained at the S.P. Fedorov Department of Faculty Surgery of S.M. Kirov Military Medical Academy, as a result of surgical treatment of patients with severe chronic slow-transit constipation, included an assessment of the changes in the structures of ganglion plexuses. Three cases were considered (women, aged 3740 years). Various degrees of pathological changes were detected in the ganglion plexuses (Auerbach and Meissner) of the sigmoid colon from patients with chronic slow-transit constipation using Nissls toluidine blue staining. In all cases, reactive, dystrophic, severe degenerative-necrotic changes of ganglion cells, as well as the details of their death, were described in detail. Along with pathological changes in nerve cells in the myenteric nerve plexus and gliosis, features of neuronglial relationships were described, and the death of ganglion cells in the human colon with the active participation of specialized astrocyte-like glial cells was also established for the first time. In the third case, a pattern of pronounced dysplasia and dysgangliogenesis was revealed in the myenteric ganglion plexus of the sigmoid colon, and the presence of diffuse lymphmonocytic infiltrates was noted in the circular muscle layer. Pathological changes in the enteral nervous system in chronic slow-transit constipation reflect neuropathy, which can serve as the main cause of impaired intestinal functions and of some symptoms.

This study presents the main historical aspects of the formation and subsequent development of the department and clinic of the faculty surgery of S.P. Fedorov, which is one of the leading surgical institutions in Russia. The main achievements of the multifaceted activities of the department and clinical teams over a 180-year period of fruitful work are analyzed. The paper also highlighted the role of N.I. Pirogov as a brilliant surgeon and the first head of the department in the formation of the basic principles of the development of surgery as a clinical and scientific discipline, which formed the basis for the subsequent work of the department team. The implementation of his innovative idea at that time of combining the department and clinic made it possible to implement the concept of surgery at the patients bedside; as a result, its theoretical and practical foundations were harmoniously combined in the educational process. This contributed to the formation of clinical thinking and significantly increased the level of professional training of doctors. Students of N.I. Pirogov have rich scientific, clinical, and pedagogical potential, which was accompanied by loyalty to traditions. Professor S.P. Fedorov made a huge contribution to the development of the scientific department school. For more than 30 years of his brilliant leadership, the department has become a real cradle of several scientific and practical areas, including urology, oncology, transfusiology, neurosurgery, hepatobiliary, and endocrine surgery. Compliance with the continuity between subsequent generations of surgeons, together with the talent and outstanding abilities of the department heads, such as V.N. Shamov, V.M. Sitenko, and N.A. Maistrenko, made it possible not only to implement the ideas of N.I. Pirogov but also to create a unique scientific school, whose representatives have made a great contribution to the development of several surgical disciplines.

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