Kharkiv Surgical School最新文献

{"title":"PSYCHOEMOTIONAL INDICATORS OF PATIENTS WITH PURULONECROTIC COMPLICATIONS OF THE DIABETIC FOOT SYNDROME WHO USED DEVICE FOR OFFLOADING OF FOOT DURING MARTIAL LAW","authors":"D. S. Pryimenko","doi":"10.37699/2308-7005.3.2022.08","DOIUrl":"https://doi.org/10.37699/2308-7005.3.2022.08","url":null,"abstract":"Abstract. Aim. To study the psychoemotional state of patients with purulent-necrotic complications of diabetic foot syndrome (DFS), who used the device for offloading of foot developed by us during the martial law in Ukraine and to compare it with the results of health-related quality of life indicators in peacetime. \u0000Materials and methods. All operated patients had stage 3 or 4 of the pathological process on the foot according to the Meggitt-Wagner classification, a neuroischemic form of DFS. The first group includes 28 patients who received prescribed treatment before the introduction of martial law in the country; the second group – 24 patients who were treated during martial law. The psychoemotional state of patients with purulent-necrotic complications of DFS was studied on the 1st and 20th days using the «Emotions» subscale from the «Illness Impact Profile» questionnaire; index of general (good) well-being/ WHO, version 1999; hospital anxiety and depression scale. \u0000Results and discussion. The indicators of patients of the first group according to the subscale «Emotions» on the 1st day — (85.7±14.3) points, and of the second group — (104.6±16.1) points. In the group of patients who were interviewed before martial law, the result of the general well-being index was (48.4±1.2). Patients of the second group have (43.5±1.1). Anxiety level: (7.5±0.3) points and (8.7±0.4) points; level of depression: (6.4±0.5) points and (7.6±0.4), respectively. Although the indicators remain unsatisfactory on the 20th day, the tendency towards the improvement of the psychoemotional state is already becoming obvious. The difference in indicators between the two groups remains, which is explained by the influence of military events. \u0000Conclusions. In the second group, worse indicators were found for the psychoemotional component of health-related quality of life, both on the 1st and 20th days. The worse dynamics of the improvement of the specified indicators on the 20th day were recorded. In the first group, according to the «Emotions» subscale, there was an improvement of 63.1 %, in the second group — by 36.2 %; the general well-being index increased by 40.1 % and 25.1 %, respectively. If in the first group, the anxiety index decreased by 16 %, and depression by 20.3 %, then in the second group, the anxiety index decreased by 12.6 %, and depression — by 10.6 %.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133055574","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":"COMPARISON OF THE RESULTS OF RADIOFREQUENCY ABLATION AND PHLEBECTOMY OF SUPRAFASCIAL SEGMENTS OF THE GREAT SAPHENOUS VEIN IN PATIENTS WITH VARICOSE DISEASE OF THE LOWER EXTREMITIES","authors":"V. Pertsov, O. V. Mamunchak","doi":"10.37699/2308-7005.3.2022.07","DOIUrl":"https://doi.org/10.37699/2308-7005.3.2022.07","url":null,"abstract":"Summary. Introduction. Over the past two decades, such traditional surgical procedures as crossectomy and stripping have been replaced to a greater or lesser extent by less invasive endovenous methods. Unfortunately, endovenous ablation methods do not allow to completely exclude such complications as: hyperpigmentation, paresthesias, hematomas, thermal damage to the skin. \u0000Purpose.To improve the tactics and improve the cosmetic effect of surgical treatment of superficially located suprafascial segments of the great saphenous vein in patients with varicose veins of the lower extremities. \u0000Materials and methods. An analysis of the treatment of 107 patients with VDLE at the University Clinic of ZDMU in 2019-2021 was carried out. The first (main) group – 65 (60.75 %) patients – received surgical treatment according to the proposed method – RFA, miniphlebectomy of the suprafascially located main trunk, miniphlebectomy of the tributaries along the Varada. The second (comparison) group – 42 (39.25 %) patients – received standard treatment – RFA of the GSV trunk, miniphlebectomy. \u0000Research results. According to the control duplex scan in all patients, the deep vein passage was occluded in 106 (99.1 %) patients. \u0000The overall frequency of postoperative complications in the main group was 18.4 % (12 out of 65 patients), in the comparison group – 35.7 % (15 out of 42 patients, mainly due to hyperpigmentation) and was significantly different (р ˃ 0.05). \u0000According to the data of CIVIQ-2, the proposed method of surgical intervention made it possible to improve the quality of life from (31.72 ± 1.56) points in patients of the comparison group to (27.49 ± 1.45) in patients of the main group. \u0000Conclusions. The proposed tactic of surgical correction of the varicosity of the trunk of the GSV – RFA of the intrafascial area of the GSV plus miniphlebectomy of the suprafascial segment – allows to reduce the probability of the development of hyperpigmentation, which contributes to a better cosmetic effect, subjective satisfaction of patients with the results of the operation, and a better quality of life in patients with VDLE.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133214053","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":"OPTIMIZATION OF SURGICAL TACTICS IN PATIENTS WITH POSTNECROTIC PANCREATIC CYSTS","authors":"V. Boyko, O. Shevchenko, A. Merkulov, Ye. O. Bilodid","doi":"10.37699/2308-7005.3.2022.05","DOIUrl":"https://doi.org/10.37699/2308-7005.3.2022.05","url":null,"abstract":"Summary. The predominance of people of working age (21-60 years) among patients with pancreatic necrosis, the occurrence of permanent disability in a significant part of patients, high overall and postoperative mortality (20-85 %), due to various complications, turns the treatment of pancreatic necrosis into an important social problem. The frequency of formation of false cysts in acute pancreatitis is 5-16 %, and in destructive forms it increases to 60-80 %. \u0000Materials and methods. The scope of endoscopic interventions in the treatment of 16 patients with pancreatic cysts of the pancreas directly depended on the preoperative findings and, first of all, on the presence of the connection of the cyst with the pancreatic ducts. Favorable conditions for endoscopic correction in the treatment of pancreatic pseudocysts were a small (less than 10 mm) distance between their cavity and the lumen of the gastrointestinal tract, minimal thickness of the capsule (no more than 2 mm), large dimensions (over 6 cm), as well as localization in the projection body and isthmus of the pancreas. \u0000Research results. When analyzing the results of the treatment of complications of pancreatic necrosis, we formulated an algorithm for the rational choice of operative interventions. We believe that rational treatment is based on early diagnosis of PN complications, including hemorrhagic ones. \u0000Conclusions. The use of the developed algorithm allowed us to reliably reduce postoperative mortality among patients of this category.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132371964","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 AGE FACTOR IN THE DEVELOPMENT OF PERIOPERATIVE COMPLICATIONS DURING THE SURGICAL TREATMENT OF CALCULOUS CHOLECYSTITIS","authors":"S. Vasyliuk, R. Bondariev, A. S. Vasyliuk, О. О. Bondarieva","doi":"10.37699/2308-7005.3.2022.09","DOIUrl":"https://doi.org/10.37699/2308-7005.3.2022.09","url":null,"abstract":"Summary. Elderly and senile patients in surgery are associated with numerous concomitant diseases, reduced functional reserve and high anesthetic risk. \u0000Aim. To assess the frequency and nature of perioperative complications in elderly and senile patients after laparoscopic cholecystectomy for acute or chronic calculous cholecystitis. \u0000Materials and methods. We analyzed the qualitative and quantitative characteristics of intraoperative and postoperative complications in 180 patients aged 60 to 90 years (elderly and senile) after laparoscopic cholecystectomy for acute or chronic calculous cholecystitis. The comparison group consisted of 200 patients aged 25 to 44 years. The procedure of choice in all patients was laparoscopic cholecystectomy. \u0000Results. In elderly and senile patients, intraoperative complications occurred more often (p<0.05) than in patients under 44 years of age. No significant differences were observed only in the frequency of intraoperative bleeding from the gallbladder artery, in the intrahepatic localization of the gallbladder, in the frequency of local peritonitis and gallbladder hydrops. In 20 (11.1 %) cases, there was a need for conversion (p=0.0002). Complications occurred in 29.4 % of cases, against 10.5 % in young patients (p<0.001). The difference in the number of minor complications: Clavien Dindo-1, Clavien Dindo-2 and Clavien Dindo-2a was improbable. Clavien Dindo-2b (5.0 %) (p<0.05), Clavien Dindo-3 (5.0 %) (p<0.05) and Clavien Dindo-4 (4.4 %) (p<0.05) complications occurred more often. \u0000Conclusions. Patients over 60 years of age are more likely (p<0.05) to have intraoperative problems during laparoscopic cholecystectomy and have a higher (p<0.05) risk of severe complications that require invasive procedures or may cause patient death.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124339800","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":"ACUTE AND CHRONIC CHOLANGITIS: PATHOPHYSIOLOGY, CLINIC, SURGICAL TACTICS","authors":"V. Boyko, R. Smachilo, O. Maloshtan, O. M. Tishchenko, A. O. Neklyudov","doi":"10.37699/2308-7005.3.2022.01","DOIUrl":"https://doi.org/10.37699/2308-7005.3.2022.01","url":null,"abstract":"Summary. Aim of the study: Based on new knowledge about the course of acute and chronic cholangitis in patients with obstructive lesions of the bile ducts to improve the results of diagnosis and treatment, using improved algorithms and new minimally invasive technologies. \u0000Materials and methods. 200 patients with acute and chronic cholangitis were selected. There were 93 men — 107 men, the age of patients ranged from 25 to 79 years, the average age was (61,8 ± 2,4) years. \u0000Results and discussion. Reconstructive surgery for choledochal strictures should be performed if the patient’s condition allows as early as possible (preferably within 3–4 weeks after symptomatic minimally invasive biliary tree decompression) to prevent the development of irreversible cirrhotic changes in the liver parenchyma. \u0000Conclusions. Minimally invasive interventions are effective both in the treatment of cholangitis due to intraductal causes, where they are the ultimate treatment, and as a first-line method of preparation for major radical intervention in severe anatomical changes in the biliary system.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121030603","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":"A CASE OF SUCCESSFUL COMBINED SURGICAL TREATMENT OF A WOUNDED WITH PURULOUS MEDIASTINITIS AFTER CHEST AND NECK INJURY OF FIRE ORIGIN","authors":"V. Boyko, V. Krytsak, P. Zamyatin, O. Shevchenko, D. P. Zamyatin, E. Khoroshun, V. Negoduyko, Yu. M. Bunin","doi":"10.37699/2308-7005.3.2022.12","DOIUrl":"https://doi.org/10.37699/2308-7005.3.2022.12","url":null,"abstract":"Resume. The purpose of the study was to reveal the main features of the development of purulent mediastinitis in a wounded person with penetrating gunshot wounds of the chest and neck in order to further improve the diagnosis and treatment of this difficult complication. \u0000The work reports on the injured K., 29 years old, with acute purulent-necrotic mediastinitis and late bilateral empyema of the pleura caused by a gunshot wound to the chest and neck. \u0000With early diagnosis of suppurative mediastinitis due to penetrating gunshot wounds of the chest and neck, active surgical tactics including wound dressing, drainage, massive antibiotic therapy, and adequate postoperative care with intensive care generally help to save the patient's life.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133463872","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":"PECULIARITIES OF POSTOPERATIVE PERIOD OF PATIENTS WITH ESOPHAGEAL CANCER AND GASTROESOPHAGEAL CANCER","authors":"V. Starikov, A. Hodak","doi":"10.37699/2308-7005.3.2022.02","DOIUrl":"https://doi.org/10.37699/2308-7005.3.2022.02","url":null,"abstract":"Abstract. Introduction. To date, complete cure from esophageal cancer/MS/and gastroesophageal cancer/GER/can only be achieved surgically. At the same time, the five-year survival rate of patients is from 25 to 35 % according to various authors. At the same time, postoperative mortality in MS and GER reaches 15%, and only in leading clinics it is 3–9 %. In the treatment of cancer of these localizations, there are many controversial issues, namely the issue of optimal surgical access in cancer of various anatomical departments of the esophagus and GER, the volume of lymphodissection, the reconstructive stage of surgery, the relation to splenectomy. There is insufficient information on the prevention and treatment of postoperative complications. \u0000Purpose. Establish the nature of postoperative complications in patients with MS and GER and study the possibilities of preventing their development. \u0000Materials and methods. The results of surgical treatment of 219 pa-tients with esophageal cancer/MS/and gastroesophageal cancer/ GER/are presented. The patient underwent surgical interventions according to the method of Lewis/98/and Osava-Garlock/121/. The formation of esophageal-gastric anastomosis was carried out manually without the use of cross-linking devices. Preferred plastic submerged esophageal-gastric anastomosis, which has high reliability and good functional properties. Postoperative complications and factors that cause them were analyzed. The clinical case of diagnosis and treatment of gastric graft rotation is presented. \u0000Research results. Complications in the postoperative period occurred in 34.95 % of patients. The leading place was occupied by somatic complications: cardiovascular 17.1% and pulmonary 12.0 %. Complications from esophageal ventricular anastomosis occurred in only 4 (1.8%) patients, and in no case this led to the death of the patient. Intrapleural bleeding from the chest wall (1.4 %) and gastric cookies (1.0%) were very rare. There are also complications in the form of gastric graft rotation and complete obstruction. This complication was eliminated by the imposition of gastroenteroanastomosis on the abdominal gland of the stomach in laparotomy. \u0000Deaths were caused in 3 (1.4 %) patients with cardiovascular insufficiency and in 1 (0.5 %) patient with TELA. \u0000Conclusions. Prominent in the structure of postoperative complications are therapeutic: cardiovascular and pulmonary, they account for more than 80% of all complications. The most common cardiovascular complication is a heart rhythm disorder. \u0000The method of formation of esophageal anastomosis is a separate independent side of the problem. The search for the optimal method continues. However, in our opinion, the result depends not so on the method used, but how this method corresponds to the principles of optimal healing of anastomosis and the correctness of its technical performance. \u0000For the prevention of transplant rotation during surgery, control of its location, both from ","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132488593","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":"PREDICTORS OF THROMBOGENICITY AND DEVELOPMENT OF ENDOTHELIITIS IN PATIENTS WITH СOVID-19 — ASSOCIATED CARDIAC AND VASCULAR SURGICAL PATHOLOGY IN THE ACUTE AND POST-COVID PERIODS","authors":"O. Klimova, Y. Kalashnikova, O. Lavinska, L. Drozdova, O. Buchneva, O. Tkachuk","doi":"10.37699/2308-7005.3.2022.04","DOIUrl":"https://doi.org/10.37699/2308-7005.3.2022.04","url":null,"abstract":"Summary. Purpose: to identify early immunoinflammatory predictors of the development of disorders of the hemostasis system (coagulation, anticoagulation, and fibrinolysis) in patients with urgent cardiac and vascular surgical pathology in the conditions of joining the SARS-Cov-2 viral infection and in the long term after infection. \u0000The results. For patients with COVID-19, a characteristic excessive long-term activation of the complement system was revealed, which is manifested by an increase in the level of C3 and C4 components (in the acute period of Covid-19, the level of the C3 component of complement was increased by 83 % and 157 %, respectively, for patients with vascular and cardiac pathology, and the level of the C4 component in these groups exceeded the reference level by 96 % and 124 %, respectively). It was shown that the content of C-reactive protein significantly exceeded the reference level in the acute period of Covid-19 in vascular pathology by 22.7 times, in cardiac pathology by 10.6 times, in the post-covid period this ratio was maintained, namely, in vascular pathology in 26.6 times, with cardiac pathology 15.5 times, that is, in vascular pathology, C-reactive protein was always increased significantly more than in cardiac. Thrombocytopenia, detected in all groups, especially in the acute period of SARS-Cov-2 infection, (vascular pathology — a decrease in the number of platelets by 2 times or by 50 %, cardiac pathology — by 15 %), (vascular pathology in the post-covid period — a decrease by 38 %, cardiac pathology — a decrease of 22.7 %), due to the activation of platelets due to increased thrombin formation and subsequent clearance by the reticulo-endothelial system, activation of thrombus formation and consumption coagulopathy, direct viral-platelet interaction, interaction with immune complexes (antigen + antibody + complement), clearance of platelets due to pronounced endotheliitis in main and capillary vessels. Excessive activation of the complement system along with a significant increase in the content of CRP has a prognostic value for the duration and severity of immunoinflammatory reactions and clinically expressed complications in the distant post-covid period against the background of surgical pathology. A significantly increased concentration of IL-6 in vascular pathology was revealed in the acute period of viral infection by 27.7 times, in the post-viral period by 24.4 times. In cardiac pathology, the concentration of IL-6 was significantly increased in the acute period by 2.5 times, and in the post-epidemic period by 3.2 times due to pro-compensatory and adaptive reactions against the background of suppression of the adhesive and absorbing properties of phagocytic neutrophils. A significant increase in the concentration of IL-18 in the blood serum of all examined patients in the acute period was found: in vascular pathology by 24.6 %, in heart pathology by 70 %, indicating long-term activation of macrophages. Diff","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127239432","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":"COMBINATION OF THE MULTIMODAL ALGORITHM AND THE RECONSTRUCTIVE-RESTORATIVE LADDER IN THE TREATMENT OF THE WOUNDED WITH FLAMMABLE DEFECTS SOFT FABRIC","authors":"I. Lurin, I. Khomenko, V. Negoduyko, S. Tertyshnyi","doi":"10.37699/2308-7005.3.2022.10","DOIUrl":"https://doi.org/10.37699/2308-7005.3.2022.10","url":null,"abstract":"Resume. Most wounds formed as a result of a gunshot wound require staged, and in some cases, multistage reconstructive and restorative operations and rehabilitation. \u0000Materials and methods. During treatment at the Military Medical Center of the Republic of Poland for 6 months (from 24.02.22 to 10.09.22), reconstructive and surgical treatment of 54 wounded soldiers was carried out using the principles of reconstructive and plastic surgery. The treatment process was based on a multimodal approach - dynamic screening of gunshot wounds with soft tissue defects, which was used in the pre-, intra- and postoperative periods. \u0000Results and their discussion. A total of 54 wounded people were included in the study. Methods of closure that were used during the recovery process: spontaneous epithelization — 3 (5.6 %) of the injured, secondary sutures — 10 (18.5 %), PHO with the use of a split skin flap - 12 (22.2 %), sliding flaps – 12 (22.2 %), propeller flaps – 17 (31.5 %). When using full-layer flaps (sliding, propeller) in wounded patients, inflammatory complications were not observed in the postoperative period, but the phenomena of venous stasis, marginal necrosis of the distal part of the flap were noted. The average number of postoperative bed days before independent movement or self-care was 7.5 days. The aesthetic component in wounded patients with the use of flaps increased by 1.8 times compared to the RSK technique.The functional component was restored in 35 % during further observation. \u0000Conclusions. As the experience of the VHP in previous military conflicts has shown, primary closure of a gunshot wound is not possible, and in some cases even harmful. Therefore, in our opinion, the preparation of a gunshot defect of soft tissues, based on multimodal monitoring, can be considered as a bright addition to the reconstructive-plastic ladder. Performing reconstructive and plastic closure of gunshot wounds with propeller flaps is an actual method of restoring the damaged anatomical area, which allowed to obtain better aesthetic, as well as anatomical and functional results, in some cases - without additional wound surfaces (places for the collection of RAS).","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127910664","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":"A FEATURE OF LAPAROSCOPIC TREATMENT OF IRREDUCIBLE AND LARGE INGUINAL HERNIAS","authors":"I. Bulyk, V. Shkarban, R. V. Bondaryev","doi":"10.37699/2308-7005.3.2022.06","DOIUrl":"https://doi.org/10.37699/2308-7005.3.2022.06","url":null,"abstract":"Summary. Introduction. The inguinal hernia is one of the most common surgical problems around the world. Patients with large inguinal and inguinal hernias are a certain group. At present, there are no final convincing evidence of the advantage of laparoscopic hernia repair of complex forms of inguinal hernias, indications and contraindications to various methods of this operation, the technology of performing surgical interventions for various types of complex inguinal hernias has not been completed. \u0000Aim. Perform perioperative complications in surgical treatment of unrecognizable and large inguinal hernias with laparoscopic modified TAPP method, classic Laparoscopic TEP laparoscopic technique and inguinal canal plastic according to Lichtenstein. \u0000Materials and methods. Surgical treatment of 42 patients with unrecognizable and large inguinal hernias was performed. All of them were performed incapacitated plastic with the use of a prone grid. In 12 patients, the Lichtenstein (Lichtenstein group) was performed, 18 patients with a modified technique (TAPP group) and 12 — TEP (TEP group). Modification was a high resection of the hernia sac in patients with inguinal-callous hernia, and the techniques of digestion of the peritoneum with a fixed gut in cases where the intestine is tightly fictoned in a large length to the peritoneum in the area of the hernia sac. \u0000Results of the research. Application in the performance of transabdominal preperitoneal hernia repair of the technique of high resection of the hernia sac in patients with inguinal-potassium hernia, and methods Surgery, reduce the frequency of hematoma and inflammatory processes in the TAPP surgery area is likely (p < 0.05), and reduce the number of conversions in the TAPP group. \u0000Conclusions. Diagnostic laparoscopy is a necessary highly informative stage of diagnosis and determination of surgical tactics for complex types of inguinal hernias. Laparoscopic hernia repair of complex forms of inguinal hernias is a method of choice, which provides low trauma, asepticity, good conditions for wound healing. Modified technique of transabdominal preperitoneal hernia repair of complex inguinal hernias, which reduced the trauma of the operation and thus reduce intra and postoperative complications that are manifested by the formation of hematoma and inflammatory processes in the surgery.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128995119","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}