bluuebunny/crossref_metadata_2025_split huggingface dataset:
DIFFERENTIAL DIAGNOSIS OF STERILE AND I NFECTED PANCREONECROSIS
Authors: Boyko V. V. , Lykhman V. M. , Merkulov A. O. , Myroshnychenko D. O. , Tkach S. V. , Batsman N. V. , Bilodid E. O. , Moskalenko A. V. 
Published: October 2021

Summary. Introduction. The search for objective methods for diagnosing the form and severity of acute pancreatitis, accurate prediction and timely prevention of infectious complications in this surgical pathology is of great practical importance for modern medicine.
Materials and methods. According to clinical, morphological and bacteriological data, groups of patients were selected. The first group included 33 patients with sterile pancreatic necrosis (SP), the second group consisted of 29 patients with infected pancreatic necrosis (IP).
Results and discussion. The program of differential diagnosis of sterile and infected pancreatic necrosis with calculation of the index of differential diagnosis (IDD) for each clinical-laboratory and instrumental indicator used in this system is developed. The development and evaluation of diagnostic possibilities of the method of verification of purulent-septic complications of acute pancreatitis and the transition of a sterile form of pancreatic necrosis to an infected one was carried out.
Conclusions. The use of the developed method of diagnosis of sterile and infected pancreatic necrosis with the calculation of the index of differential diagnosis allowed in 93% of cases to distinguish sterile pancreatic necrosis from infected and timely determine the scope and tactics of treatment.
MULTIMODAL REHABILITATION OF PATIENTS OPERATED ON FOR PANCREATIC NECROSIS
Authors: Kryvoruchko I. A. , Parkhomenko K. Yu. , Drozdova A. G. , Vovk V. A. , Payunov K. E. , Diahiliev S. M. 
Published: October 2021

Summary. The aim of the study — to improve the results of surgical treatment of patients operated on for pancreatic necrosis.
Matherials and Methods of the study. The results of treatment of 56 patients operated on for pancreatic necrosis who were treated in the surgical department of the Municipal non-commercial enterprise of the Kharkov regional council «Regional Clinical Hospital» from 2018 to 2020, aged 22 to 69, were analyzed. In the treatment of all patients, a “step-up approach” tacktics was used and the principles of the concept of “fast-track surgery” or multimodal rehabilitation of patients after surgery were implemented.
Results of the study. Along with the performed surgical interventions (mostly minimally invasive), a “staged” method of managing the postoperative period in patients operated on for pancreatic necrosis is proposed and implemented. As a result, there is a decrease in the incidence of postoperative complications and a decrease in the length of stay in the surgical department (14.6 bed-days). Conclusions. This example confirms the appropriateness of applying the principles of “fast-track surgery” in everyday surgical practice in the complex treatment of patients with pancreatic necrosis, as the results of surgical treatment of this category of patients are improved and financial costs for treatment are reduced.
RADIAL DIGNOSTICS OF LIQUID FOCAL LIVER FORMATIONS WITH THEIR IDENTIFICATION OF A COMMUNICATIONS WITH THE INTRAHEPATIC BILIARY DUCTS
Authors: Vakulenko I. P. , Khatsko V. V. , Kuzmenko O. Ye. , Voytyuk V. N. , Fominov V. M. , Polulyaсh-Chornovol I. F. , Parkhomenko A. V. 
Published: October 2021

Summary. The aim of the study is to improve radiological diagnosis and differential diagnosis of fluid focal formations of the liver and their communication with the intrahepatic bile ducts.
Materials and methods. The article presents the results of radial diagnostics of drained liquid focal liver formations (non-parasitic cyst, hydatid cyst, abscess) in 182 patients over the past 8 years. Clinical laboratory methods, sonography, computer tomography, magnetic resonance imaging, laparoscopy, cytological and bacteriological examination of liquid from a cyst or liver abscess (in various combinations), statistical methods were used for the diagnostics.
Results and discussion. 5 modified diagnostic methods have been applied, which made it possible to improve its accuracy and, at an early stage, to identify the communication of liquid formation with the intrahepatic biliary ducts. The characteristic radial criteria that correspond to various liquid focal liver formations are given.
Conclusions. The use of a combination of imaging methods (MSCT, MRT, et al.) is necessary in difficult cases for the detection and differential diagnosis of fluid focal formations of the liver.
CLINICAL AND STATISTICAL ASPECTS OF THE DEVELOPMENT AND COURSE OF BLEEDING FROM VARICOSE VEINS OF THE ESOPHAGUS IN PATIENTS WITH PORTAL HYPERTENSION
Authors: Trofimov M. V. , Korpusenko V. G. , Muntyan S. O. , Kuznetsov G. E. , Gromov V. V. 
Published: October 2021

Summary. The aim of the study was to identify the main etiological factors that led to the development of portal hypertension — the leading cause of varicose bleeding, to analyze the clinical aspects of the course and methods of treatment of bleeding from varicose veins of the esophagus (EVV).
Materials and methods. We collected, processed and analyzed the results of treatment of 95 patients with bleeding from varicose veins of the esophagus hospitalized in the Dnipro Clinical Emergency Hospital, DGS “for 2017. The leading factor was established liver cir-rhosis — 92 cases (96.8 %). Moreover, in 42 cases (44.2 %), cirrhosis of the liver developed against the background of chronic viral hepatitis C. The endoscopic picture of this category of patients and the degree of blood loss were also assessed.
Results and its discussion. It was found that the most frequently detected VRV II–III st. — in 42 (44.2 %), III st. — in 27 (28.4 %), while 52 (54.7 %) patients showed dilatation of the venous trunks in all parts of the esophagus, in 29 (30.5 %) — in the mid-lower parts. Analysis of concomitant pathology helped to establish against the background of which diseases portal hypertension most often develops: viral hepatitis C was detected in 46 cases (48.4 %), coronary artery disease (diffuse cardiosclerosis) — in 29 (30.5 %), ischemic heart disease (atherosclerotic cardiosclerosis) — in 15 (15.8 %), hypertension II Art. — 26 (27.4 %), diabetes mellitus — 10 (10.6 %). All patients received conservative therapy, which was combined with mechanical methods of hemostasis (Sengstaken – Blakemore probe) in 24 cases (25.3 %), endoscopic hemostasis (ligation with latex rings) — in 3 cases (3.2 %), partial embolization of the splenic artery — in 3 cases (3.2 %), suturing of veins — in 1 (1.1 %). In 70 cases (73.7 %) a favorable outcome was noted, 25 cases (26.3 %) were fatal.
Conclusions. The main cause of bleeding from varicose veins of the esophagus is liver cirrhosis developed against the background of viral hepatitis C. Despite the widespread use of local endoscopic hemostasis techniques, recurrent bleeding occurs in 9.5 % of cases. The mortality rate for bleeding from varicose veins of the esophagus is 26.3 %, which corresponds to the world average trend.
APPLICATION OF MODERN METHODS OF ENDOSCOPIC HАEMOSTASIS IN THE TREATMENT OF GASTRODUODENAL ULCER BLEEDING
Authors: Honcharova N. M. , Svirepo P. V. , Honcharov A. S. 
Published: October 2021

Summary. The aim of the study is to improve the results of treatment of patients with ulcerative gastroduodenal bleeding by using the methods of endoscopic hаemostasis.
Materials and research methods. The results of endoscopic hаemostasis of 153 patients who were treated in the surgical department of the “Regional Clinical Hospital” were analyzed. Patients were examined clinically, laboratory and instrumental.
Results and its discussion. For Forrest 1a, b bleeding, endoscopic clipping was used in 16 (10.4 %) patients with a visualized vessel in the bottom of the ulcer. In the studied patients of this group, there were no relapses of bleeding. Diathermy coagulation was used in 42 (27.5 %) patients. Recurrent bleeding was observed in 6 patients. Submucosal infiltration was performed in 37 (24.2 %) patients with ulcerative bleeding. Repeated bleeding was recorded in 9 patients within the next 3 hours after the intervention and in 7 patients during the first days after endoscopic hаemostasis. Combinations of endoscopic methods of hаemostasis were used in 58 (37.9 %) patients.
Conclusions. The use of modern methods of endoscopic hаemostasis followed by adequate pharmacotherapy in most cases allows achieving a final stop of bleeding. Patients with a high risk of recurrent bleeding and a low surgical and anesthetic risk after successful endoscopic hаemostasis are shown surgical intervention before the development of recurrent bleeding.
THE EFFECT OF ENTEROSORPTION AND INTRATISSULAR ELECTROFORESIS OF ANTIBACTERIAL DRUGS ON PROGRESS OF BURN DISEASE
Authors: Petryuk B. V. , Petryuk T. A. , Khomko L. P. , Khomko O. Yо. , Semenyuk I. E. 
Published: October 2021

Summary. The purpose of the research was to explore the appropriateness of combined usage of enterosorption amplification and intratissular electrophoresis (ITE) of antibiotics in injured with the substantial thermal burns. Clinical effect of the enterosorbtion and ITE antibacterial drugs in burn disease cases was studied in 26 patients with superficial and deep dermal burns (IIb-III deg.) from 27 to 60 % of their body surface. Enterosgel was prescribed from 3rd day after injury for 15–20 g 3–4 times a day for 7–14 days. ITE of antibiotics conducted from the 3–4 day by the «Поток-1» device, applying the direct current with density 0,03-0,05 mAh/cm2 for 60 min.
Materials and methods. The authors studied the leukocyte reaction by a general blood test. The degree of intoxication was determined by the level of molecules of average mass and blood plasma electrical conductivity. They evaluated the dynamics of the wound process, conducted bacteriological and cytological researches of the burn wounds in dynamics on 1–3, 6–7, 13–14, and 19-21 days after traumatization.
Results and discussion. This treatment tactic allows to reduce the level of endogenous intoxication, to optimize the course of the wound process in the area of thermal damage, to intensify demarcation-cleansing processes and reparative regeneration, which increases the clinical effectiveness of treatment. Conclusions. As a result of the research, it was found that the combined usage of enterosorption detoxification by enterosgel and ITE of antibacterial drugs in the complex treatment of victims with widespread burns is appropriate and justified.
SURGICAL ANATOMY OF VENOUS BLOOD FLOW OF THE I NFERIOR VENA CAVA SYSTEM
Authors: Rusin V. I. , Boyko S. O. , Rusin V. V. , Boyko S. Sh. S. 
Published: October 2021

Summary. Purpose. Conduct an anatomical examination of the inferior vena cava (IVC) and its branches and determine the paths of collateral venous blood flow.
Materials and methods. An anatomical examination of the IVC and its branches was performed on 27 corpses as a result of autopsy. The bodies of the corpses were hypostenic-normosthenic type. The organ complex was eviscerated by the Shore method. The degree of IVC coverage by the liver in relation to the circumference of the IVC was determined. Measurements of the total length of the IVC and for each of the individual 6 segments of the IVC were performed. The hepatic and lumbar veins were studied and the paths of collateral venous blood flow were analyzed.
Results and discussion. The average length of IVC in the infrarenal segment was 107.6 mm, in the retrohepatic — 59.3 mm, in the suprarenal — 26.2 mm, in the interrenal — 23.4 mm, in the infradiaphragm — 15.2 mm, in the supradiaphragm — 12.0 mm, along the entire subdiaphragm segment — 197.8 mm. The coverage of IVC by the liver by 1/2 of its circumference was detected in 13 (48.1 %), by 2/3 — in 11 (40.7 %), by 1/3 — in 2 (7.4 %), by the whole length – in 1 (3.7 %) cases. Up to 23 venous trunks flow into the retrohepatic part of the IVC. The avascular area is located under the main hepatic veins with an average length of 13.1 mm and under the right renal vein with an average length of 17.8 mm. In 92.6 % of cases, the lumbar veins had an odd nature of confluence with the IVC – one common trunk.
Conclusions: The anatomical study presented new knowledge of the clinical anatomy of IVС branches.
TREATMENT OF PATIENTS WITH GASTRIC CANCER COMPLICATED BY PERFORATION
Authors: Boyko V. V. , Krivorotko I. V. , Lazirskiy V. A. 
Published: October 2021

Abstract. Introduction. Despite the declining incidence of gastric cancer, the problem of treatment of complicated forms of the disease remains one of the most complex and relevant. The aim of the study was to improve the results of treatment of patients with complicated gastric cancer.
Materials and methods. The study is based on the analysis of the results of treatment of 19 patients with gastric cancer complicated by perforation, who were treated at the “State Institution «Zaitsev V.T. Institute of General and Urgent Surgery of National Academy of Medical Sciences of Ukraine” from 2011 to 2020 aged 18 to 85. All patients were divided into two groups: comparison — 9 (47.3 %) patients (were treated from 2011 to 2015), the main — 10 (52.7 %) patients (treatment period from 2016 to 2020).
Results and discussion. In the comparison group, conventional surgical tactics and operations were used. The main group used active-individualized two-stage surgical tactics, which involve suturing a perforation hole in the first stage and combined and reconstructive surgery in the second. Radical operations were performed in 10 (52.6 %) patients; in 9 (47.4 %) — palliative and symptomatic. Postoperative complications occurred in 5 patients (26.3 %), postoperative mortality was 26.3 % (5 patients).
Conclusions. In patients with gastric cancer complicated by perforation, in a serious condition of the patient and the presence of diffuse peritonitis, we consider it appropriate to use two-stage surgical tactics. The introduction of the proposed surgical tactics and new surgical interventions helped to increase the number of radical operations from 4 (21.0 %) in the comparison group to 6 (31.6 %) in the main group and reduce postoperative mortality from 15.8 % to 10.5 %, respectively.
THE ROLE OF SOME CYTOKINES IN THE FORMATION OF CRYPTOGLANDULAR ANAL FISTULA
Authors: Kryvoruchko I. A. , Sorokina I. V. , Parhomenko K. Yu. , Firsyk T. M. , Bozhko O. P. 
Published: October 2021

Abstract. Aim. Modern surgical approaches to the treatment of anal fistulas involve operations that least damage the sphincter complex of the rectum. The essence of the operation is a complete excision of the anal fistula, which is often accompanied by a significant number of recurrences depending on the chosen method of operation. Failure is likely the result of inflammation that persists after surgery, and cytokines play an important role in these processes.
The aim of the study: evaluate local production and determine the role of IL-6 and TNFα in the formation of rectal fistulas.
Materials and methods. The tissue of the fistula tract was obtained in 90 patients of both sexes with transsphincteric fistula of cryptoglandular origin in the period from September 2018 to February 2020, who underwent surgery (fistulotomy, modified technique LIFT, use of biowelding technique of the fistula tract).
Results. The frequency of IL-6 producing cells was highest (32.0±4,0) specimens in the field of view not only in inflammatory infiltrate, but also in granulation tissue and immature connective tissue of the fistula tract. The lowest rates of IL-6 producing cells were (23.0±3,0) specimens in the field of view. The frequency of TNFα receptor-producing cells ranged from (17.0±1,0) specimens in the field of view to (24.0±3,0) specimens in the field of view.
Conclusions. A large number of IL-6 and TNFα-producing cells has been identified not only in inflammatory infiltration but also in granulation and immatureconnective tissue, indicating the active role of these cytokines in the formation of rectal fistulas.
EXPERIENCE OF STAGED SURGICAL TREATMENT OF ACUTE OBSTRUCTIVE INTESTINAL OBSTRUCTION OF TUMOR ORIGIN
Authors: Kashtalyan M. A. , Shapovalov V. Y. , Yenin R. V. , Koshicov M. О. , Pasternachenko S. O. 
Published: October 2021

Summary. Objective: to improve the results of surgical treatment of patients with acute intestinal obstruction of tumor origin.
Materials and methods of research. During the period from 2014 to 2020 in the surgical clinics of the Military Medical Clinical Center of the Southern Region (Odessa) 186 patients were treated with acute obstructive colonic obstruction of tumor origin.
Research results and their discussion. In 34 (18.3 %) patients with GOKN during the applied conservative measures positive dynamics was observed, which allowed to examine patients in detail and prepare for surgery. In 6 (3.2 %) elderly patients with severe comorbidities, tumor recanalization and stent placement were performed. In 146 (78.5 %) patients, conservative measures were unsuccessful and were operated on according to vital signs, the first stage of which was intestinal fatigue.
Conclusions. Step-by-step tactics of surgical treatment of acute intestinal obstruction of tumor origin with the use of laparoscopic colostomy in the first stage were used in 60.3 % of patients, which allowed final verification of the diagnosis, safe compensation of electrolyte and nutritional disorders in the patient and further treatment and correction.
PATHOHISTOLOGICAL PRERECONDITIONS FOR DEVELOPMENT OF COMPLICATIONS AND R ECURRENCES I N INGUINAL HERNIOPLASTY
Authors: Knut R. P. , Khomko O. Y. , Kyfyak P. V. , Sydorchuk R. I. , Hrodetskyy V. K. , Hrebenyuk V. I. , Plehutsa O. M. 
Published: October 2021

Summary. Inguinal hernioplasty is the most frequently performed surgical operation in the world, but the level of complications still reaches 11 % and of recurrences — 5 %. According to some authors, the reason may be in chronic inflammatory changes of the hernia sac and perihernial tissues.
Aim. To study the pathohistological changes of the hernia sac and perihernial tissues of patients with inguinal hernias for development of adequate methods of complications prophylactics.
Material and methods. The pathohistological examination of fragments of hernial sac and perihernial tissues of 24 patients with groin hernias was performed.
Results and discussion. The investigation detected the signs of chronic inflammation in fragments of tissue of hernial sac in all patients. In 8 (33,3 %) patients the signs of inflammation were found only in fragments of hernial sac, and in 16 (66,7 %) – they were combined with the inflammation of perihernial tissues. Among them, the pronounced signs of chronic inflammation were found in 6 (25,0 %) patients with recurrent groin hernias, they were combined with the pronounced scarring changes of hernial sac and perihernial tissues.
Conclusions. 1. Chronic inflammatory changes of the hernia sac and perihernial tissues are among the reasons for the development of postoperative complications and recurrences. 2. An important component of prevention of complications can be use of antibacterial and anti-inflammatory drugs.
IMMUNOLOGICAL CRITERIA FOR EFFECTIVE SYSTEMIC USE OF MURAMYL PEPTIDE IMMUNOMODULATOR IN THE TREATMENT OF PATIENTS WITH BURN INJURIES
Authors: Nagaichuk V. I. , Chornopyshchuk R. М. , Khimich S. D. , Nazarchuk О. А. , Burkovskyi М. І. , Bobelo А. S. 
Published: October 2021

Abstract. Introduction. The problem of providing effective care to patients with burn injuries remains far from being finally solved. Due to significant immune disorders that occur against the background of thermal damage, the use of immunomodulatory drugs remains promising. Therefore, the aim of this study was to analyze the effectiveness of systemic use of the immunomodulatory drug Liastenum® in the complex treatment of patients with burn injuries.
Materials and methods: The study involved 35 patients with burn injuries with the index of damage severity ranging from 30 to 60 units. Patients in the main group (n = 15) in addition to the usual treatment received an immunomodulator Liastenum®, which was administered intramuscularly at a dose of 2 mg once every 3 days (course dose — 10 mg). Treatment of patients in the comparison group (n = 20) did not involve the use of drugs with targeted immunocorrective action. Examination of patients included laboratory immunological examination of venous blood with assessment of various parts of the immune system and determination of the “Neutrophilic granulocytes form factor” indicator, which was performed on the 3rd, 14th, 21st day after the injury.
The results of the study and their discussion. The obtained results allowed to confirm the ability of Liastenum® to stimulate the functional activity of neutrophilic granulocytes, restoring the phagocytic reserves of these cells, to normalize the level of lymphocytes and their individual subpopulation forms. In general, the action of the immunomodulatory drug was characterized by a balanced effect on the cellular, humoral parts of the immune system, phagocytosis.
Conclusions. The effectiveness of systemic use of immunomodulatory drug Liastenum® in a comprehensive program of care for patients with burn injuries by balanced correction of immune disorders was laboratory established.
SURGICAL TACTICS FOR PURULENT-SEPTIC COMPLICATIONS OF COMBAT BELLY INJURIES
Authors: Gerasimenko O. S. , Gaida Y. I. , Okolets A. V. , Muradian K. R. 
Published: October 2021

Summary. Combat injury of the abdomen, according to the ATO / OOS is from 6.7 to 9 %. The specificity of gunshot wounds to the abdomen causes the development of functional disorders and complications (51–81 %) and, as a consequence, a high mortality rate (12–31 %).
Objective: To improve the effectiveness of surgical treatment of purulent-septic complications in the wounded with combat trauma to the abdomen (BTC).
Materials and methods. The Military Medical Clinical Center of the Southern Region (VMKC PR) analyzed the treatment of 86 wounded who were hospitalized with purulent-septic complications of BTZ from 2014 to 2020, taking into account the location, clinical manifestations and severity of injury, used modern treatment methods , namely: puncture and drainage interventions under the control of ultrasonography and installation of NPWT systems. Comprehensive treatment was supplemented with antibacterial therapy and oxygen barotherapy.
First of all, the wounded underwent puncture and drainage interventions under ultrasonic navigation and gradual rehabilitation for diagnostic and therapeutic purposes. NPWT therapy was used in 11 patients with extensive wounds and purulent-septic complications of the soft tissues of the anterior abdominal wall.
Thus, the use of interventional sonography, as the primary diagnostic and treatment method for the treatment of purulent-inflammatory complications of combat trauma to the abdomen, has improved the quality of diagnosis and reduced traumatic interventions, which has reduced postoperative complications and inpatient treatment.
Results and discussion. Eleven (14.2 %) cases of puncture and drainage interventions were ineffective, in connection with which we had to resort to traditional methods of treatment — opening and drainage of purulent-inflammatory foci and the use of NPWT-therapy. Vacuum therapy is an effective method of treatment of purulent-septic complications of gunshot wounds of the soft tissues of the abdomen, which in combination with puncture-drainage interventions, can reduce by 2.5 times the number of repeated operations (mainly multi-stage surgical treatments), thereby reducing 1.8 times the length of stay of patients in the hospital.
Conclusions. Thanks to the use of modern methods it was possible to improve the results of surgical treatment of purulent-septic complications in the wounded with purulent-septic complications of combat trauma to the abdomen.
The use of the latest techniques has helped reduce the number of invasive treatments, accelerate recovery, reduce bed rest, reduce intoxication, and increase the rate of return of servicemen.