Klìnìčna endokrinologìâ ta endokrinna hìrurgìâ最新文献

{"title":"Diagnosis and treatment of metabolic-associated fatty liver disease in patients with type 2 diabetes mellitus. Review","authors":"S. M. Tkach","doi":"10.30978/cees-2023-3-62","DOIUrl":"https://doi.org/10.30978/cees-2023-3-62","url":null,"abstract":"Metabolic‑associated fatty liver disease (MAFLD) is a new clinical definition of fatty liver disease that changes the definition of non‑alcoholic fatty liver disease (NAFLD) from a disease of exclusion to a disease of inclusion, in which the main pathogenic processes originate from metabolic dysfunction, primarily in type 2 diabetes mellitus (T2DM) and obesity. In recent years, MAFLD has become an epidemic and is closely associated with T2DM and a significant synergistic increase in the risk of cardiovascular disease. The presence of MAFLD significantly increases the risk of T2DM development, and the risk of new onset of T2DM in patients with MAFLD doubles. When managing patients with MAFLD and T2DM, the presence of fibrous nonalcoholic steatohepatitis (NASH) should be actively detected, for which non‑invasive indicators should first be used, such as FIB‑4 and FNI, which are available at the level of primary care. Despite evidence of utility in improving diagnosis, the effectiveness of many of the above non‑invasive tests for detecting fibrosis, particularly in unselected populations with advanced fibrosis, is low and generally remains uncertain at the primary care level. Modifications of lifestyle and diet have traditionally been considered the best therapeutic option for MAFLD in T2DM, with weight loss of ≥7% significantly improving steatosis, leading to reductions in NASH activity and glycemia. At the same time, only 40% of patients achieve this goal and reduce the activity of steatohepatitis, emphasizing the difficulty in treating MAFLD only by lifestyle changes. Nevertheless, mandatory dietary and lifestyle modification should still be recommended for patients with MAFLD, along with antidiabetic drugs that can reduce liver enzyme activity, inflammation, and fibrosis, such as PPARγ inhibitors, SGLT‑2i, GLP‑1 RA, as well as dual GIP and GLP‑1 RA agonists.
","PeriodicalId":475695,"journal":{"name":"Klìnìčna endokrinologìâ ta endokrinna hìrurgìâ","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032565","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":"Correction of body weight regain after Roux-en-Y gastric bypass. Clinical case","authors":"O. O. Kalashnikov, O. Y. Usenko, I. M. Todurov, S. V. Kosiukhno","doi":"10.30978/cees-2023-3-70","DOIUrl":"https://doi.org/10.30978/cees-2023-3-70","url":null,"abstract":"Obesity and overweight are health problems that indicate excessive and abnormal accumulation of body fat and lead to adverse health effects. Epidemiological studies have identified obesity and overweight as risk factors for several diseases, including diabetes, various cancers, cardiovascular disease, and hypertension. Roux‑en‑Y gastric bypass is one of the most common operations performed for the patients with morbid obesity. With the long‑term follow‑up of bariatric surgery, insufficient weight loss or weight regain is becoming more frequently encountered after RYGB. Insufficient weight loss or weight regain after proximal Roux‑en‑Y gastric bypass occurs in 35% of cases. As a result, revisional surgery will be more frequently performed. No consensus has been reached on the best revisional operation for these patients. The presented clinical case demonstrates tactical approaches to a comprehensive examination of patients who are scheduled for revision surgery due to insufficient weight loss or weight regain after Roux‑en‑Y gastric bypass. 3D computer gastrovolumetry is an effective method that allows the qualitative and quantitative examination of the state of the proximal gastric pouch after Roux‑en‑Y gastric bypass. The presented clinical case demonstrates the importance of an individualized approach for each patient, according to the recommendations of the multidisciplinary team for diagnosis and correct surgical strategy treatment weight regain after Roux‑en‑Y gastric bypass. Combined reconstruction of the gastric pouch with gastroenteroanastomosis and distalization of the alimentary loop is a safe and effective method of correction of weight regain in patients after Roux‑en‑Y gastric bypass.
","PeriodicalId":475695,"journal":{"name":"Klìnìčna endokrinologìâ ta endokrinna hìrurgìâ","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032049","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":"Age-related peculiarities of the symptom complex of the increased risk of primary hyperparathyroidism development","authors":"O. A. Goncharova, V. M. Dubovik, M. E. Sazonov, L. V. Gerasimenko, K. O. Pobielienskyi","doi":"10.30978/cees-2023-3-35","DOIUrl":"https://doi.org/10.30978/cees-2023-3-35","url":null,"abstract":"Objective — to analyze the peculiarities of the structure of non‑specific complaints in groups aged ≤50 years and >50 years with application of the questionnaire for early detection of individuals at increased risk of the primary hyperparathyroidism (PHPT) development. The questionnaire was developed by specialists of the Danylevsky Institute of Problems of Endocrine Pathology, NAMS of Ukraine.
 Materials and methods. The analysis was performed on the data of questionnaire survey of 50 patients who were examined for PHPT in the years 2020—2021. The control group consisted of patients with thyropathology who applied for medical assistance to the clinical units of the Danylevsky Institute of Problems of Endocrine Pathology. The frequency of each complaint, included in the questionnaire, was determined in the subgroups aged ≤50 years and >50 years. The factors, presented against the PHPT background and associated with the development of this pathology have been established. Statistical processing of the obtained data was carried out by the methods of variational statistics using the standard package of statistical calculations Microsoft Excel and Statistica 6.0. The probability of differences in mean values was determined by the Student’s t test.
 Results. Identifying the features of the symptom complex associated with an increased risk of PHPT development in different age periods, made it possible to determine the set of factors that are the most dangerous for the development of PHPT, including: the presence of relatives with diseases related to calcium metabolism disorders, deterioration of memory, attention, pain in bones and joints, chronic pain in the upper and lower limbs, chronic pancreatitis in people under 50 years of age. The most typical, “classic” symptom complex was revealed in patients of the older age group.
 Conclusions. The presence of only non‑specific symptoms of PHPT in a significant number of patients complicates the diagnosis of the disease at early stages and leads to the development of complications of the disease. The testing of the version of the questionnaire developed by the authors made it possible to determine the list of the most dangerous symptom complex of non‑specific complaints regarding the high risk of PHPT development in the groups ≤50 years and over 50 years. The implementation of this list in the everyday practice of the medical practitioners can increase the effectiveness of efforts for early detection of the disease.
","PeriodicalId":475695,"journal":{"name":"Klìnìčna endokrinologìâ ta endokrinna hìrurgìâ","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032564","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":"Hypoandrogenism and reproductive function — a problem-oriented approach to pregnancy planning. Literature review","authors":"L. S. Chernukha","doi":"10.30978/cees-2023-3-51","DOIUrl":"https://doi.org/10.30978/cees-2023-3-51","url":null,"abstract":"The author considers pre‑pregnancy care program in women with endocrine imbalances as a complex problem that requires involvement of a multidisciplinary team of doctors in the examination process, including endocrinologists, therapists, gastroenterologists, and if needed, immunologists, nutritionists and hematologists. This approach is stipulated by the frequency of accompanying somatic pathology and the burdened obstetric and gynecological history of such women, in particular, menstrual cycle disorders, infertility, miscarriage, spontaneous abortions, a high percentage of hyperplastic diseases and inflammatory processes of the female genitalia. Disorders of hormonal homeostasis in women with endocrinopathies result in the pro‑inflammatory orientation of their immunity, oxidative stress, which disrupts both the folliculogenesis process and leads to metabolic and morphological changes in the receptor organs of both the female genitalia and other organs of the endocrine system (thyroid gland, adrenal glands), forming a vicious cycle of pathological processes in the endocrine balance of female steroids, which, in turn, is accompanied by disturbances in the homeostasis system of the entire organism. Based on the literature data, the authors made conclusions about the stages of examination of women with hypoandrogenism in the pre‑gravid stage. Speaking about natural pregnancy, the first stage, according to the authors, is to determine the main location of the pathology — the central mechanism (disruption of the hypothalamic‑pituitary‑ovarian‑thyroid‑adrenal chain), genetic enzymatic polymorphisms, deficiency/insufficiency of vitamin D and their elimination. At the second stage, there is a need to determine the state of organs — receptors (endometrium, endocervical glands, vaginal epithelium), the state of detoxification organs and their correction. The third stage is to ensure conditions for full‑fledged ovulation and transport of gametes. The fourth stage is early pregnancy support, prevention, early diagnosis and treatment of vaginal infections. The pregnant woman is monitored together with a specialist in the detected comorbid pathology (geneticist, hematologist, gastroenterologist, therapist, endocrinologist, psychotherapist, etc.). Further research is needed to develop a clear algorithm for pre‑pregnancy care program in women with hypoandrogenism depending on reproductive age, obstetrical and gynecological history, methods of overcoming infertility.
","PeriodicalId":475695,"journal":{"name":"Klìnìčna endokrinologìâ ta endokrinna hìrurgìâ","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032402","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":"Evaluation of the effect of preoperative use of pregabalin on pain in patients with metabolic syndrome during knee arthroscopy","authors":"L. M. Zenkina, Y. O. Skobenko, S. О. Osadcha, V. O. Kuprii","doi":"10.30978/cees-2023-3-21","DOIUrl":"https://doi.org/10.30978/cees-2023-3-21","url":null,"abstract":"nee arthroscopy is a common surgical procedure often accompanied by significant postoperative pain syndrome. As pain limits patient mobility and prolongs patients’ hospitalization, the development of optimal pain management with minimal side effects for early activation and full recovery of patients is urgent.
 Objective — to assess the impact of preoperative administration of pregabalin on postoperative pain syndrome in patients with metabolic syndrome after arthroscopic knee surgery.
 Materials and methods. A double‑blind, placebo‑controlled study was conducted, involving 50 patients admitted to the Orthopedic Department of the State Scientific Institution «Center for Innovative Medical Technologies of the National Academy of Sciences of Ukraine» between the years 2020 and 2023. Patients, scheduled for knee arthroscopy, were randomly divided into two equal groups, receiving placebo or pregabalin at a dose of 300 mg 2 hours before surgery, the drug was administered orally 12 hours later.
 Results. The results demonstrated a reduction in static pain intensity within 24 hours and a decrease in dynamic pain intensity after 48 hours among patients who received pregabalin before the surgery. Pregabalin administration prior to knee arthroscopy in patients with metabolic syndrome was associated with lower opioid consumption at 24 hours.
 Conclusions. The effectiveness of the preoperative pregabalin administration in reducing the postoperative pain syndrome in patients who underwent arthroscopic surgery on the knee joint has been established. However, further research is warranted to determine the optimal dosage and timing of pregabalin administration for this specific patient population.
","PeriodicalId":475695,"journal":{"name":"Klìnìčna endokrinologìâ ta endokrinna hìrurgìâ","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032050","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":"Possibilities of immunocytochemical staining for HBME-1 expression in the «diagnostic search» of differentiated thyroid cancer. Own investigation","authors":"O. P. Nechay, N. I. Belemets, V. O. Palamarchuk, D. M. Kvitka, Y. S. Kozachuk, O. A. Tovkai","doi":"10.30978/cees-2023-3-5","DOIUrl":"https://doi.org/10.30978/cees-2023-3-5","url":null,"abstract":"Objective — to investigate HBME-1 expression variants on cytological material classified as doubtful (III, IV, V), according to the Bethesda categories, to evaluate the value of the HBME-1 expression test on the corresponding histological material of nodular goiter, follicular tumor with an uncertain potential for malignancy for the differential diagnosis of thyroid carcinoma (ThC). Materials and methods. The analysis was performed on the data of 14 patients with thyroid nodular lesions and cytological Bethesda categories III, IV, and V (“gray zone“). The HBME-1 expression was determined by the results of immunocytochemical (ICC) and immunohistochemical (IHC) staining with the use of mouse monoclonal antibodies against human HBME-1 (1 : 500; cat № BSB 3459; «Bio SB» «Bioscince for the World» Santa Barbara USA). The HBME-1 expression grade was calculated as the sum of the score for staining intensity and cytoplasmic positive cells square, present in the IHC sample. HBME-1 positive result was considered with an IHC score >6 point. Results. From 14 investigated patients, five were defined as HBME-1 positive. According to the postoperative histological conclusion for the group of HBME-1 positive patients, thyroid carcinoma was diagnosed in four subjects, including three cases of papillary ThC and one follicular ThC; in one patient follicular tumor of uncertain malignant potential (FT-UMP) was reported. Importantly, immunocytochemical and immunohistochemical HBME-1 reactions in the specimens of these patients were of the same intensity. Among 9 HBME-1 preoperative negative patients, none had malignancy according to the final histological study. Nodular goiter was diagnosed in six patients, and tumor of uncertain malignant potential (FT-UMP) was reported for three subjects. Histological specimens of all 9 patients were HBME-1 negative as well. The obtained results demonstrated an increase in cancer detection rates with increasing Bethesda category. Application of statistical software for biomedical research МedCalc revealed that positive predictive value (PPV) of the HBME-1 expression test was 80% (95% confidence interval CI 38.4—96.3%), and diagnostic efficiency was 92.9% (CI 66.1—99.8%). These results suggest the great potential of the test, however, due to the limited observations, the confidence intervals are too wide. Conclusions. HBME-1 can be used as an immuno­cytochemical marker for the differentiation of benign and malignant thyroid nodules, its use will help to reduce the number of unnecessary surgical removals of benign tumors, which will improve the quality of life of patients and reduce the burden on medical services.","PeriodicalId":475695,"journal":{"name":"Klìnìčna endokrinologìâ ta endokrinna hìrurgìâ","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032363","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 the complex treatment of patients with locally disseminated malignant thyroid tumors with invasion or compression of the upper respiratory tract","authors":"I. V. Deineko","doi":"10.30978/cees-2023-3-26","DOIUrl":"https://doi.org/10.30978/cees-2023-3-26","url":null,"abstract":"In recent years, the number of widespread malignant tumors of the thyroid gland with invasion or compression of the upper respiratory tract, most often with medium to low histological differentiation, has been increasing rapidly, which worsens the prognosis for the recovery of patients. The most important prognostic factors in the case of widespread malignant tumors of the thyroid gland are histological differentiation and the extent of tumor invasion. The urgency of the issue of comprehensive treatment of patients with locally disseminated malignant thyroid tumors is due to the lack of a single tactic, the choice of the scope of surgical interventions and resections of the upper respiratory tract is not defined.
 Objective — to determine medical and surgical tactics for improving the complex treatment of patients with locally disseminated malignant thyroid tumors with invasion and compression of the upper respiratory tract (URT), depending on the degree of spread and histological structure of the tumor.
 Materials and methods. In total, 2,300 patients with malignant tumors of the thyroid gland have been treated. The experimental group included 165 patients (7.2%) with T4a‑b category locally disseminated malignant thyroid tumors. The clinical and morphological characteristics of the patients in the general and experimental groups were analyzed and compared. The patients of experimental group demonstrated lower morphological differentiation of tumors, significantly higher number of regional and distant metastases, older patients’ age, that worsened the prognosis for recovery, and prevalence of men over women.
 Results. Most often, the tumor was disseminated in the URT, 55 patients had signs of URT stenosis of the I—III degree. Urgent tracheotomy was performed in 9 patients with pronounced stenosis of the III degree, which turned out to be very difficult, and 3 patients died during the operation or in the early postoperative period. In the case of initially inoperable T4b tumors, we performed neoadjuvant antitumor chemotherapy, the resulting tumor regression allowed for radical surgery in most patients. Various resections of the latter with the application of a tracheostomy or primary anastomosis were performed in patients with invasion of the upper respiratory tract. The effectiveness of various methods was analyzed depending on the prevalence of invasion and morphological differentiation of the tumor. In the experimental group of radically operated patients, the mortality rate was 31.0%, the recurrence rate was 39.3%.
 Conclusions. The prognosis for recovery in the group of locally disseminated malignant thyroid tumors is worse due to the lower morphological differentiation of tumors, older age of patients, and a greater number of regional and distant metastases. In case of URT stenosis, it is advisable to prepare the patient for radical surgery with intraoperative placement of a tracheostomy. In the case of an initially inope","PeriodicalId":475695,"journal":{"name":"Klìnìčna endokrinologìâ ta endokrinna hìrurgìâ","volume":"2014 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032571","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":"Thyroid gland and heart: a cardiologist’s view on an endocrinological pathology. Review","authors":"V. E. Кondratiuk, А. P. Stakhova","doi":"10.30978/cees-2023-3-41","DOIUrl":"https://doi.org/10.30978/cees-2023-3-41","url":null,"abstract":"The review of the literature considered the mechanism of action and the role of thyroid hormones (TH) on cardiovascular hemodynamics and, subsequently, on changes in the myocardial structure. A brief description of the genomic and non‑genomic mechanisms of thyroid hormones is provided. The mechanisms of thyroid hormones’ effects on the development of arterial and pulmonary hypertension, atrial fibrillation are highlighted. Attention is focused on the fact that congestive heart failure of the dilatation type develops against the background of hyperthyroidism. A possible connection between thyroid hyperfunction and Takotsubo stress‑induced cardiomyopathy was investigated. The impact of subclinical hyperthyroidism on the development and progression of cardiac pathology is illustrated. The mechanism of influence of hypothyroidism on the parameters of the lipid spectrum, acute phase proteins, insulin sensitivity, but not only the contractile function of the myocardium was considered. Changes in the electrical activity of the heart and its structural and functional changes were determined. Attention is focused on the importance of achieving euthyroidism in both hyperthyroidism and hypothyroidism. Stress‑induced Takotsubo cardiomyopathy is closely related to the hyperthyroid state and is often accompanied by the development of cardiogenic shock. Hyperthyroidism is associated with an increased risk of permanent atrial fibrillation and hypercoagulability. The achievement of euthyroid state can result in the reversal of left ventricular hypertrophy and decrease in the heart chamber dilatation. Even subclinical hyperthyroidism increases the risks of overall mortality and cardiovascular events, especially in the elderly persons. Patients with hypothyroidism are characterized by the development of anemia, dyslipidemia, decreased sensitivity to insulin, which is associated with endothelial dysfunction. In hypothyroidism, in contrast to hyperthyroidism, the risk of atrial fibrillation development is lower due to an increase in the arrhythmogenic threshold, but more typical disorders include sinus bradycardia, atrioventricular blocks of various degrees and prolongation of the QT interval, which are associated with the early development of impaired myocardial relaxation. For patients with thyroid pathology, the achievement of euthyroidism is mandatory to ensure cardio‑ and vasoprotection.
","PeriodicalId":475695,"journal":{"name":"Klìnìčna endokrinologìâ ta endokrinna hìrurgìâ","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032365","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":"Single-incision sleeve gastrectomy in the treatment of patients with type 2 diabetes mellitus associated with obesity","authors":"S. V. Kosiukhno, O. Y. Usenko, I. M. Todurov, A. V. Trots","doi":"10.30978/cees-2023-3-12","DOIUrl":"https://doi.org/10.30978/cees-2023-3-12","url":null,"abstract":"Background. Single‑incision laparoscopic sleeve gastrectomy (LSG) allows the most comfortable conditions for patients in the perioperative period and achieve better cosmetic results, providing the same advantages in terms of metabolic effects as in multiport surgery. Its application requires appropriate skills and a specific material and technical base, therefore, currently there is a limited number of publications on the results of treatment of patients using this technique.&#x0D; Objective — to evaluate the results of treatment of patients with obesity‑associated type 2 diabetes mellitus (T2DM) after single‑incision LSG in comparison with multiport LSG.&#x0D; Materials and methods. This study included 41 patients with prediabetes or T2DM, who were divided into 2 groups: single port (15 patients) and multiport (26 patients). The following assessments have been performed: body weight and body mass index (BMI); surgery duration; volume of intraoperative blood loss; pain syndrome according to VAS scale on postoperative days 0, 1, 2, and 3; postoperative hospital stay; patient satisfaction with the cosmetic results of surgery according to POSAS scale after 1 month, and T2DM remission according to the level of glycated hemoglobin (HbA1c) one, two, three and five years after surgery.&#x0D; Results. There was no significant difference in the volume of intraoperative blood loss (p=0.076) and surgery duration (р=0.59) between the groups. In the single‑incision LSG group, less pronounced pain syndrome was observed with a significant difference starting from the 1 postoperative day (p <0.05), however, the severity of the pain syndrome between two groups on postoperative day 0 did not reach a significant difference (p=0.48). Average postoperative hospital stay in the single‑incision LSG group was significantly lower (p=0.035). At the same time, the cosmetic results of the operation were significantly better in the group of single‑incision LSG (p=0.001). The average level of glycated hemoglobin (HbA1c) in the groups was: for single‑incision group — 6.3±0.7%, and for multiport group — 7.4±1.7% (р=0.02). Normalization of carbohydrate metabolism was observed in the majority of patients involved in the study with a follow‑up period up to 5 years (p <0.01), and only 1 patient (3.8%) in the multiport LSG group had a recurrence of type 2 diabetes after 5 years.&#x0D; Conclusions. Single‑incision LSG is an effective and safe operation in patients with obesity‑associated type 2 diabetes. Single‑incision LSG is an acceptable alternative to multiport LSG, if provided by a surgeon who has an experience in performing such operation and after careful selection of patients. Performance of a single‑incision LSG allowed implementation of some aspects of international protocol (intraoperative bilateral subcostal interfascial block, absence of abdominal cavity drainages) into clinical practice, which in turn shortened patient’s hospital stay. Single‑incision LSG allows patient","PeriodicalId":475695,"journal":{"name":"Klìnìčna endokrinologìâ ta endokrinna hìrurgìâ","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135032567","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}