Kharkiv Surgical School最新文献

{"title":"CYTOLOGICAL CHARACTERISTICS OF EXPERIMENTAL PURULENT NON-HEALING WOUNDS IN THE TREATMENT OF SILVER NANOPARTICLES","authors":"P. Myronov, V. Bugaiov, I. Medvedieva, M. M. Myronova, A. Gift","doi":"10.37699/2308-7005.4-5.2022.04","DOIUrl":"https://doi.org/10.37699/2308-7005.4-5.2022.04","url":null,"abstract":"Summary. The purpose of the work is to conduct a cytological examination of swabs-imprints of experimental purulent wounds that have not healed for a long time, when treated with silver nanoparticles in comparison with 0.05 % Chlorhexidine solution. \u0000Research materials and methods. The study of the features of the cytological picture of skin regeneration was carried out on 60 white non-linear laboratory rats. \u0000Research results. The obtained results of the cytological examination of purulent wounds that did not heal for a long time indicate faster wound healing processes in the group using nanostructured silver compared to the control group: there was a faster decrease in the number of leukocytes in the field of view and the percentage of their destruction, faster activation of monocyte-macrophage cells series, the appearance of fibroblasts and epithelial cells and, as a result, a faster change in the types of cytograms from necrotic to regenerative. \u0000Conclusions. It was established that the presented method of using nanostructured silver contributes to a better elimination of microbial insemination, leads to a significant decrease in the number of neutrophil leukocytes and leukocytes in the stage of destruction, an increase in the percentage of phagocytic leukocytes, fibrocytes, fibroblasts, endotheliocytes and epithelial cells, which indicates a better antibacterial and anti-inflammatory effect and indicates much faster processes of cleaning and regeneration of purulent wounds. The use of silver nanoparticles has significant advantages compared to traditional treatment with a 0.05 % solution of Chlorhexidine and is promising for use in the practice of purulent surgery.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125652832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DIFFERENT ANATOMY OF EXTRAHEPATIC BILE DUCT IN PATIENTS WITH CALCULOUS CHOLECYSTITIS: CLINICAL OBSERVATIONS","authors":"V. Y. Vansovich, Yu. M. Kotik, V. I. Pshenichnyi, R. Vastyanov","doi":"10.37699/2308-7005.4-5.2022.28","DOIUrl":"https://doi.org/10.37699/2308-7005.4-5.2022.28","url":null,"abstract":"Summary. The aim of investigation – to get acquainted with the possibilities of variant anatomy of the extrahepatic bile ducts location. \u0000Results and their discussion. In our own practice, we observed two patients with the extrahepatic bile ducts atypical anatomy. \u0000Patient G. was operated because of chronic calculous cholecystitis. During laparoscopic cholecystectomy, we encountered the following situation: it was found that the gallbladder has a very short duct directly in the region of the portal of the liver. After dissection it was found that d. cysticus flows into the right hepatic duct. Timely establishment of this variant anatomy, which was achieved by careful dissection of the junction area d. cysticus and d. hepaticus dexter, allowed to prevent (in this case) wrong clipping of the right hepatic duct. In this example the possibility of timely establishing the presence of anatomical features of the extrahepatic bile ducts made it possible to prevent their damage. \u0000Patient K. was operated because of calculous cholecystitis, choledocholithiasis (without clinical and laboratory signs of mechanical jaundice). During laparoscopic cholecystectomy, it was established that the patient has variant anatomy of the extrahepatic bile ducts, when the right hepatic duct drains directly into the gallbladder. This anomaly was discovered after the separation of the gallbladder from its bed, as a result of which this duct was damaged. The access conversion was performed, the place of exit from the liver in the area of the gallbladder of the anomalous right hepatic duct was established. In order to restore the outflow of bile, a right-sided hepaticojejunostomy was performed on a Roux loop, external drainage of the choledoch according to Ker, drainage of the abdominal cavity. \u0000Conclusions. Although laparoscopic cholecystectomy is a standard routine operation, the variability of extrahepatic bile duct location should be considered. \u0000We consider it expedient during dissection in the area of the transition of the vesical duct to the hepaticocholedoch to carefully isolate all anatomical structures until their absolute identification.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132297075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DIAGNOSTIC AND THERAPEUTIC MANAGEMENT FOR LEIOMYOMA OF THE UPPER GASTROINTESTINAL TRACT","authors":"V. Shaprynskyi, Y. V. Babii","doi":"10.37699/2308-7005.4-5.2022.10","DOIUrl":"https://doi.org/10.37699/2308-7005.4-5.2022.10","url":null,"abstract":"Summary. Leiomyoma is the most common type of mesenchymal tumor in the esophagus (70-80 %) and the second most common type of mesenchymal tumor (about 45 %) in the stomach. But in the last 20 years, we can find only a small number of publications devoted to them. And in it the leiomyoma mainly became the subject of differential-diagnostic comparison when evaluating other subepithelial neoplasms. \u0000Aim. Based on our own experience of treating patients with leiomyoma of the upper gastrointestinal tract, as well as being guided by current clinical recommendations related to the diagnosis and treatment of SEP, we will develop a diagnostic and therapeutic algorithm that will help to optimize the management tactics of patients with leiomyoma of the upper gastrointestinal tract. \u0000Materials and methods. After the analysis of the results of the treatment of 36 patients with confirmed leiomyoma of the esophagus, stomach and duodenum, a diagnostic and treatment algorithm was proposed, and it is a synthesis of our own experience and current global recommendations of such organizations as ESGE, ESMO, NCCN, JGCA, CSCO. \u0000Results. The management of leiomyoma will depend of the size of the neoplasm at the time of initial diagnosis. Taking into account the specifics of the clinical situation, an active or passive treatment strategy can be used in each individual case. The most effective methods of diagnosis and methods of surveillance are EGDS and EUSG. When choosing the surgical intervention, preference is given to endoscopic resection or laparoscopic resection. Postoperative determination of the etiology of the SEL is carried out by performing pathomorphological and immunohistochemical diagnostics. Within their histological type, leiomyoma may be characterized by a certain pathohistological pleomorphism, and are divided into leiomyoma of simple and proliferating clinical - morphological variants. Leiomyoma of the proliferating clinical-morphological variant have significantly higher indicators of such immunohistochemical markers as Ki-67 and CD31 in comparison with leiomyoma of a simple clinical-morphological variant. Therefore, leiomyoma of the proliferating clinical and morphological variant can reach much larger sizes. The size of the leiomyoma, in turn, has a direct proportional effect on the likelihood of complications. \u0000Conclusions. Leiomyoma are the common and heterogeneous type of subepithelial lesions that require a deep and detailed study.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127098596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE ROLE OF ENDOSCOPIC ULTRASONOGRAPHY IN THE DIAGNOSIS OF CYSTIC FORMULATIONS OF THE PANTACRATIC GLAND","authors":"A. Нoncharov, N. Нoncharova, S. Teslenko","doi":"10.37699/2308-7005.4-5.2022.14","DOIUrl":"https://doi.org/10.37699/2308-7005.4-5.2022.14","url":null,"abstract":"Summary. Differential diagnosis of cystic lesions of the pancreas remains one of the most problematic sections of abdominal surgery. Endoscopic ultrasonography is gaining more and more importance in the diagnosis and determination of treatment tactics of cystic lesions. \u0000The goal is to determine the place of endoscopic ultrasonography in the diagnosis of patients with cystic lesions of the pancreas. \u0000Materials and methods. Analyzed literary sources that were devoted to the use of endoscopic ultrasonography for the diagnosis of cystic lesions of the pancreas. \u0000Results and their discussion. Endoscopic ultrasonography, thanks to its high resolution and the absence of interposition of air-containing organs, allows you to visualize both the characteristic features of the structure of the cystic tumor itself and the ductal system of the pancreas, as well as to evaluate the thickness of the cyst wall, the presence of intracystic membranes and a solid component, the nature of the contents, the number of cystic cavities in the lesions. \u0000Conclusions. Endoscopic ultrasonography is a clarifying method of diagnosis, which should be used in all patients at the stages of examination, planning treatment tactics and choosing a surgical intervention method.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132064806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE RELATIONSHIP BETWEEN CENTRAL BLOOD FLOW AND MICROCIRCULATION WITH THE AMOUNT OF ELASTIC COMPRESSION IN POST-THROMBOPHLEBOTIC SYNDROME IN THE STAGE OF DECOMPENSATION","authors":"V. Rusyn, F. M. Pavuk, V. Y. Fedusyak","doi":"10.37699/2308-7005.4-5.2022.18","DOIUrl":"https://doi.org/10.37699/2308-7005.4-5.2022.18","url":null,"abstract":"Summary. Aim. To determine the influence of elastic compression on the venous and arterial velocity of the main blood flow of the lower limb and the skin microcirculation of the anterior part of the foot in patients with a decompensated form of postthrombophlebotic syndrome. \u0000Materials and methods. 21 patient with post-thrombophlebotic syndrome in the stage of decompensation participated in the study. Among them were 12 (57 %) women and 9 (43 %) men. The average age of the patients was (58.5±6.4) years. All subjects of the study were measured for the ankle-brachial pressure index, deep femoral-popliteal index, regional perfusion index, tcpO2, tcpCO2, arterial blood flow velocity in the femoral artery, and venous blood flow velocity distal to the saphenofemoral junction. After the measurements, the following measurements were performed after using elastic medical knitwear of different compression classes. \u0000Research results. With I class compression, the venous blood flow rate was (0.064±0.007) (p=0.0001). The venous velocity of the femoral blood flow significantly decreased, on average, by 7.4 times compared to the initial conditions when using class IV compression (p=0.0001). values of tcpCO2 increased significantly already at the 1st compression class. (p=0.0001) and continued to increase until the end of the study. Analyzing the changes in tcpO2 and tcpCO2, it was established that at the 3rd compression class, there was a cross between the oxygen and carbon dioxide tension indicators, which was accompanied by the predominance of tcpCO2 pressure over tcpO2 at the next increase in the compression class. \u0000Conclusions. The arterial blood flow rate decreased by 8.5 times compared to the input data at the maximum pressure of the fourth compression class (p=0.0001). Venous velocity of blood flow in the femoral vein at the maximum pressure of elastic compression decreased venous velocity by 7.4 times compared to the initial normal (p=0.0001). tcpCO2 significantly increases at compression of 15 mmHg (p=0.0001).","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"200 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114192536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SURGICAL TREATMENT OF CHRONIC HEMORRHOIDS (LITERATURE REVIEW)","authors":"S. Vasyliuk, A. Gutculiak, V. І. Gudyvok, O. Dmytruk, V. S. Osadetc, I. R. Labyak","doi":"10.37699/2308-7005.4-5.2022.26","DOIUrl":"https://doi.org/10.37699/2308-7005.4-5.2022.26","url":null,"abstract":"Summary. An analysis of clinical guidelines and literary articles on the treatment of patients with chronic hemorrhoids was carried out. Clinical recommendations do not differ in different countries regarding the approaches in terms of choosing options for conservative or operative therapy and methods of surgical treatment. Changing the diet, which allows you to eliminate constipation, normalize intestinal motility and obtain soft and voluminous stools, is an important stage of treatment. Pharmacological therapy has a low evidence base. Studies on the effectiveness of flavonoids for the treatment of chronic hemorrhoids are very heterogeneous, which does not allow for unequivocal conclusions. Rubber band ligation is the most effective procedure for the rapid elimination of chronic hemorrhoid symptoms, but it cannot effectively eliminate hemorrhoidal prolapse. Injection sclerotherapy has severe specific complications, which is why it is predicted to decrease in frequency for the treatment of chronic hemorrhoids. The only surgical approaches that experts recommend are open and closed hemorrhoidectomy. Stapler hemorrhoidopexy has a high frequency of specific complications, so it is necessary to approach its choice for the treatment of chronic hemorrhoids with caution. Doppler-guided hemorrhoid artery ligation is a physiological method of treatment, but it has a very high cost and is not economically viable. \u0000Conclusions. In patients with chronic hemorrhoids Goligher-1, Goligher-2, and in some cases - Goligher-3, “office procedures” can be chosen, but the patient should be informed about questionable results in the remote period. The operation of choice for patients with chronic Goligher-3 and Goligher-4 hemorrhoids remains open hemorrhoidectomy, the current modifications of which mainly include various technological approaches to cutting out nodes. Techniques in which a slightly different principle was proposed can be used as an alternative approach due to worse results when observing in distant terms.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"321 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115865832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INFLUENCE OF HIGH INTENSITY LASER THERAPY ON THE POSTOPERATIVE DYNAMICS OF PATIENTS WITH CHRONIC VENOUS DISEASE","authors":"V. Mishura, Y. Melekhovets","doi":"10.37699/2308-7005.4-5.2022.21","DOIUrl":"https://doi.org/10.37699/2308-7005.4-5.2022.21","url":null,"abstract":"Summary. Purpose: improvement of postoperative dynamics in patients after endovenous laser ablation (EVLA) using high-intensity laser therapy (HILT). \u0000Materials and methods. The study included 54 patients who noted a moderately painful stretch on the thigh along the course of the coagulated great saphenous vein after EVLA. Patients were divided into 2 groups: the first group (n=28) used HILT, the second group (n=26) was a control group. The effectiveness of the treatment was evaluated by the patient’s subjective assessment of his condition, objective examination of the local status, visual analog scale of pain (VAS) and ultrasound monitoring of changes in the coagulated vein. \u0000Research results. After 2 weeks, pain decreased by 62.2% in patients of the first group, by 28.6% in the second group (p <0.05). Compared to the results at the time of application, the vein diameter decreased by 29.9% in the first group, and by 19.4% in the second group. \u0000Conclusions. The use of HILT in patients of the first group in the post-operative period of EVLA allows to reduce the severity of pain by 33.6%, and also to speed up the lysis of coagulated great saphenous vein on the thigh by 10.5%, compared to the second group. The results of this study can be used in clinical practice to add HILT as another non-invasive option to improve postoperative dynamics in patients after EVLА.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"31 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123697869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANTI-RECURRENCE PLASTIC FOR ANTERIOR ABDOMINAL WALL HERNIAS","authors":"V. Pak, T. V. Bereznyi, O. Sytnik, Y. Melekhovets, O. Pererva","doi":"10.37699/2308-7005.4-5.2022.08","DOIUrl":"https://doi.org/10.37699/2308-7005.4-5.2022.08","url":null,"abstract":"Summary. The purpose of the study is to find new methods of surgical treatment of hernias, aimed at reducing the frequency of recurrences. \u0000Research materials and methods. The paper analyzes the results of examination and surgical treatment of abdominal hernias in 39 patients. \u0000Research results. An analysis of the surgical treatment of patients with abdominal hernia using the author’s technique of anti-recurrence plastic surgery by applying a semi-purse suture to the terminal areas of the line of sutures on the aponeurosis was carried out. \u0000Conclusions. The use of our method of antirelapse plastic surgery is pathogenetically justified and does not have a negative effect on the course of the postoperative period in operated patients.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123932113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANALYSIS OF POSTOPERATIVE COMPLICATIONS IN THE TREATMENT OF PATIENTS WITH LUNG CANCER","authors":"G. V. Trunov, A. Havrylov, S. R. Petrychenko","doi":"10.37699/2308-7005.4-5.2022.22","DOIUrl":"https://doi.org/10.37699/2308-7005.4-5.2022.22","url":null,"abstract":"Summary. The aim of the study. Based on the analysis of the nature and course of postoperative complications in the treatment of patients with lung cancer, to improve the results of surgical treatment of this category of patients. \u0000Materials and methods. The results of the analysis of postoperative complications of 363 patients with lung cancer who were treated in the oncological department of the thoracic cavity of the clinic of the Communal Non-Commercial Enterprise «Regional Center of Oncology» in Kharkiv for the period from 2017 to 2021 are presented. There were 234 men (64.6 %) , women - 128 (35.4 %), the age of patients ranged from 43 to 84 years, the average age was (59.8±2.4 years). All patients underwent radical surgery for primary lung cancer. Lobectomies were performed most often. In this volume, 296 patients were operated on, which was 81.5 %. Pneumonectomy was performed on 51 patients, which was 14.1 %. Anatomical segmentectomy was performed in 16 patients (4.4 %). Postoperative complications and factors causing them were analyzed. \u0000Research results and their discussion. The main complications typical for the postoperative period of lung cancer patients are highlighted. Complications in the postoperative period occurred in 10.5 % of patients. Complications related to failure of bronchus stump sutures and tracheobronchial tree anastomoses occurred in 8 patients (2.2 %). In two patients, this led to the development of pleural empyema and death.Thanks to early diagnosis, 4 patients underwent rethoracotomy, bronchus stump suturing, resection or final pneumonectomy. \u0000Cardiovascular complications (acute myocardial infarction, acute cardiovascular failure, stroke, pulmonary embolism) were found in 5 patients (1.4 %). 3 patients died of stroke, acute myocardial infarction and acute cardiovascular failure. Two patients survived, and one of them was diagnosed with Pulmonary embolism (PE), COVID-19 and bilateral pneumonia. \u0000Postoperative mortality was 2.5 % (9 patients died). Two patients (0.6 %) died from failure of the bronchus stump sutures, which led to empyema of the pleura. Two patients (0.6 %) died from the consequences of intrapleural bleeding. Another 2 (0.6 %) patients died of acute myocardial infarction. One patient each (0.3 %) died of stroke, postoperative pneumonia, and pericux abscess, which led to empyema of the pleura. \u0000Conclusions. The surgical method of treating patients with lung cancer remains the main one despite the number of postoperative complications, the majority of which are «non-surgical». Analysis of the nature and course of postoperative complications in the treatment of patients with lung cancer, and the improvement of the method of determining functional operability, made it possible to reduce the frequency of complications and form a concept for improving the results of surgical treatment of this category of patients.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131936114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DIAGNOSTIC MONITORING OF TRAUMATIC LIVERIN JURIES","authors":"O. V. Kapshitar, P. Y. Tantsura, O. O. Kapshitar","doi":"10.37699/2308-7005.4-5.2022.12","DOIUrl":"https://doi.org/10.37699/2308-7005.4-5.2022.12","url":null,"abstract":"Summary. Goal. Develop tactics for diagnostic monitoring of traumatic liver injuries. \u0000Materials and methods of research.The study is based on an analysis of 56 victims with liver damage. A set of studies, including clinical, laboratory, and instrumental methods, was used to examine victims with abdominal injuries. \u0000Research results and their discussion.The tactics of treatment for patients were primarily determined by the results of ultrasound and CT scans. Diagnostic monitoring was carried out in several stages: the first immediately after hospitalization in the admission department or intensive care unit, then, as is, taking into account the data found during the initial examination. The decision to choose conservative tactics was made within the first 3 hours after admission to the clinic. In the future, the patient’s management tactics will be determined depending on the severity of his condition, volume of hydroperitoneum, the intensity of blood loss, and hemodynamic parameters. In the case of hematomas of the liver, in the absence of signs of hydroperitoneum and stable hemodynamics, conservative therapy was performed with dynamic instrumental control over the condition of the hematoma. \u0000Conclusions. Predicting the outcome of liver damage largely depends on the correct choice of methods of instrumental diagnosis and consistency in the analysis of information obtained from dynamic monitoring. This makes it possible to predict the severity of the condition and tactics of the patient, expanding the indications for conservative therapy. Conservative tactics are allowed only with repeated instrumental monitoring.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"47 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134345695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}