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Документ A three-stage therapeutic and diagnostic algorithm in mechanical jaundice of different genesis and the most effective mini-invasive method of its treatment(Полтавський державний медичний університет, 2022) Prykhidko, R. A.; Dudchenko, M. O.; Kravtsiv, M. I.; Zaiets, S. M.; Ivashchenko, D. M.; Chelishvili, A. L.; Shevchuk, M. P.; Прихідько, Роман Анатолійович; Дудченко, Максим Олександрович; Кравців, Микола Ігорович; Заєць, Сергій Миколайович; Іващенко, Дмитро Миколайович; Челішвілі, Анатолій Леонідович; Шевчук, Микола ПетровичThe paper analyzes the experience of treatment of mechanical jaundice with the use of minimally invasive surgical interventions in 176 patients. It has been found that the clinical presentation, laboratory parameters are of secondary importance in determining the etiology and level of biliary obstruction. For the differential diagnosis of etiological factors of obstructive jaundice, we used non-invasive and minimally invasive radiological methods: ultrasound – 203, magnetic resonance cholangiopancreatography – 98, multislice computed tomography – 74, endoscopic retrograde cholangiopancreatography - 138, percutaneous transhepatic cholangiography – 27. In order to determine the informativeness, we evaluated the detection of concretions, strictures of the bile ducts, mass lesions, dilation of intra- and extrahepatic bile ducts. Methods of elimination of biliary hypertension were various types of endoscopic decompression, which were performed in combination with endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography. We compared the following aspects: the possibility of performing these types of decompression of the bile ducts, their effectiveness in eliminating jaundice and complications. Based on our results, we developed a 3-stage diagnostic and treatment algorithm, whose efficiency in the elimination of mechanical jaundice was 96.0 %.Документ Alloplasty of abdominal wall at incisional hernias developed after adrectal incision(Springer-Verlag France SAS, 22, rue de Palestro, 75002 Paris, France, 2015) Lysenko, R. B.; Лисенко, Руслан БорисовичДокумент Clusteroluminogenic polymers: applications in biology and medicine (Review Article)(American Institute of Physics, 2024) Sakhno, Tamara; Ivashchenko, Dmytro; Semenov, Anatolii; Ivashchenko, Olena; Sakhno, Yuriy; Сахно, Тамара Вікторівна; Іващенко, Дмитро Миколайович; Семенов, Анатолій Олексійович; Іващенко, Олена Дмитрівна; Сахно, ЮрійThe current state of research on unconventional luminescence of nonconjugated polymers, which arises as a result of spatial conjugation due to the overlapping of electronic orbitals of atoms in aggregates formed at high concentrations of substances in solutions or in the solid state, is considered. The manifold applications of clusteroluminogenic polymers in the realms of biology and medicine take center stage. This includes the utilization of clusteroluminescence for monitoring and visualizing dynamic reactions, exploring pathways in biomedical research and targeted drug delivery, facilitating real-time monitoring, as well as imaging and tracking. The emphasis is placed on their pivotal role in combination therapy and theranostics.Документ Influence of vacuum instillations with intravenous introduction of nitrogen oxide donators on the healing of purulent soft tissue wounds(Полтавський державний медичний університет, 2022-02) Gorodova-Andreeva, T. V.; Lyakhovskiy, V. I.; Sydorenko, A. V.; Городова-Андрєєва, Тамара Валер'янівна; Ляховський, Віталій Іванович; Сидоренко, Архип ВолодимировичThe efficacy of vacuum therapy with instillations of L-arginine was studied in combination with its intravenous infusion. Results were in 89 patients, treated for purulent-necrotic soft tissue diseases. Patients were emergency operated on. The main group - 44 patients, got the same therapy and intravenous 100 ml of arginine hydrochloride solution daily. 2-3 courses of vacuum therapy, 3 days each were performed. In the main group, signs of intoxication and body temperature returned to normal by an average of 3.1 days. Normalization of the level of leukocytes was observed in 5.4 days. pH-metry from the wound surface, it was found that significant changes in the average pH of patients in the main group were observed for 7-10 days - the beginning of the regeneration phase. The therapy in the main group in comparison with typical local treatment provided accelerated wound cleansing, reduction of microbial contamination and faster transition of purulent-necrotic phase to regeneration.Документ Modern principles of medical rehabilitation of patients with median defects of the abdominal wall(Wydawnictwo Aluna, 2022-09) Lysenko, R. B.; Liakhovskyi, V. I.; Krasnov, О. H.; Krasnova, O. I.; Лисенко, Руслан Борисович; Ляховський, Віталій Іванович; Краснов, Олег Георгійович; Краснова, Оксана ІванівнаAim: Toanalyze rehabilitation and improvement of the quality of life of patients with median abdominal wall defects (MAWD) by increasing the efficiency of alloplasty by determining the general principles of planning and performing surgical interventions. Materials and methods: We carried out an analysis of the treatment results of 346 patients with MAWD, who underwent surgery in the 1st Poltava City Hospital for the period 2005-2019. There were 269 women (77.8%), men – 77 (22.2%). 282 (81.5%) patients underwent reconstructive surgeries, 59 (17.1%) – reconstructive and corrective alloplasty techniques, and 5 (1.4%) – corrective ones. Patients underwent surgery: onlay – in 3 patients (0.9%), sublay – in 289 (83.5%), sublay-inlay – in 38 (11.0%), inlay – in 4 (1.2%), Ramirez modification – in 10 (2.9%), open IPOM – in 2 (0.6%). Results: Local complications were in 25 (7.2%) cases: seroma in 12 (3.5%) patients, infiltrate in 5 (1.5%), necrosis of the edges in 4 (1.2%), hematoma – in 3 (0.9%), wound suppuration – in 1 (0.3%). In the remote period, 14 (4.1%) were registered: recurrence – 7 (2.0%); longterm deep seroma- 3 (0.9%); ligature fistulas with phlegmon – 2 (0.6%); abscess formation – 1 (0.3%), hernial sac infiltration – 1 (0.3%). Conclusions: The results of MAWD alloplasty depend on the correct solution of the planning problem and the choice of the most rational treatment tactics. Adequate abdominoplasty leads to an improvement in the quality of life of patients, medical and social rehabilitation.Документ Problems of diabetic foot syndrome treatment and possible ways of their solution(Art of medicine, 2018-12-11) Kyzymenko, O. O.; Lyakhovskiy, V. I.; Gorodova-Andreeva, T. V.; Liulka, О. М.; Zaporozchenko, O. V.; Кизименко, Олексій Олексійович; Ляховський, Віталій Іванович; Городова-Андрєєва, Тамара Валер'янівна; Люлька, Олександр Миколайович; Запорожченко, Олександр ВолодимировичA number of patients with diabetes mellitus worldwide increases with geometric progression, which means that a number of complications increases as well. Diabetic foot syndrome is the leading cause of early disability of patients. Therefore, the search for new therapeutic tactics is a constant process that motivates surgeons and in turn opens new opportunities in the treatment of various forms of purulent-necrotic processes in patients with diabetes mellitus. Therapy with negative pressure is one of the most promising nowadays. A number of conducted randomized clinical trials have already proved its effectiveness in practice. The use of vacuum therapy as an integral component of the combined treatment of purulent-necrotic lesions in diabetic foot syndrome can significantly accelerate reconvalescence and reduce % of high amputations in the future.Документ Retrograde intrarenal surgery as a method of improving the endoscopic management of occlusive concrements of the upper parts of the ureter(Poltava State Medical University, 2023) Ivashchenko, D. M.; Dudchenko, M. O.; Kravtsiv, M. I.; Shevchuk, M. P.; Ivanova, H. O.; Іващенко, Дмитро Миколайович; Дудченко, Максим Олександрович; Кравців, Микола Ігорович; Шевчук, Микола Петрович; Іванова, Галина ОлегівнаThe paper presents upper ureter stone treatment with use of retrograde intrarenal surgery. This is the latest method, which has advantages in treatment of complex cases of nephrolithiasis, stone translocations and residual cases. We analyzed treatment of patients with ureteral stones. Two representative groups were formed and underwent surgical interventions. Patients of first group underwent contact lithotripsy with semi-rigid ureteroscope, in patients of group 2 used flexible ureteroscope. We compare total operation time, average size and density of stones, presence of residual fragments, surgical and postoperative complications. Performing lithotripsy using a retrograde intrarenal surgery provides higher frequency of achieving “stone-free state”, which is the ultimate goal of intervention. Also, this is a method that has fewer intraoperative complications, but has a slightly longer duration of surgical intervention. The use of combination of retrograde intrarenal surgery and semi-flexible ureteroscopy should facilitate operations, speed up patient recovery and minimize complications.Документ Simulations computer modelling of biomechanics of the anteror abdominal wall(Springer-Verlag France SAS, 22, rue de Palestro, 75002 Paris, France, 2015) Lysenko, R. B.; Kryshchuk, N. G.; Лисенко, Руслан Борисович; Крищук, Микола ГеоргійовичДокумент Strangulated bowel obstruction and torsion of Meckel’s diverticulum: case report(Surgical society of northern greece, 2018) Kravtsiv, M. I.; Dudchenko, M. O.; Ivashchenko, D. M.; Prykhidko, R. A.; Кравців, Микола Ігорович; Дудченко, Максим Олександрович; Іващенко, Дмитро Миколайович; Прихідько, Роман АнатолійовичMeckel's diverticulum is the congenital anomaly of gastrointestinal tract. The frequency of its occurrence is about 1 - 3%. There are various complications associated with diverticulum, including hemorrhage, intestinal obstruction, inflammation and perforation. Intestinal obstruction is the most common complication in adult. The Aim of the work is demonstration of the case of strangulated bowel obstruction combined with the torsion of Meckel's diverticulum. The female 27 years old was admitted to the surgical department urgently with nausea, vomiting, cramping abdominal pain. The obtained results of the examination were evaluated as acute small bowel obstruction. An emergency surgery was performed - exploratory laparotomy. It was detected: axial torsion of Meckel's diverticulum followed by gangrene, its topside was attached to the dorsal peritoneum by retained fibrous vitelline band. This diverticulum also formed a loop which caused strangulation of the small intestine. The correct diagnosis of Meckel's diverticulum before surgery is generally impossible, because complicated diverticulum imitates many other abdominal pathologies. The torsion of the Meckel's diverticulum is one of the rare complications. In our case, one patient encountered two complications of the Meckel's diverticulum: its torsion with gangrene and acute intestinal obstruction. Exploratory laparotomy is a mandatory procedure for the detection of complicated Meckel's diverticulum and correct treatment.Документ Substantiation of the application of gasless laparoscopic cholecystectomy in patients with a background of Covid-19 respiratory infection(Полтавський державний медичний університет, 2023) Zaiets, S. M.; Prikhidko, R. A.; Kravtsiv, M. I.; Ivashchenko, D. M.; Shevchuk, M. P.; Dudchenko, M. O.; Zezekalo, Ye. O.; Заєць, Сергій Миколайович; Прихідько, Роман Анатолійович; Кравців, Микола Ігорович; Іващенко, Дмитро Миколайович; Шевчук, Микола Петрович; Дудченко, Максим Олександрович; Зезекало, Єфім ОлеговичDuring the COVID-19 pandemic, calculous cholecystitis is one of the most frequent emergency pathologies requiring immediate surgical intervention. Laparoscopic surgery around the world has successfully replaced open surgery. However, high intra abdominal pressure of carbon dioxide, which is used according to the technology, leads to a high level of standing diaphragm, and can exert an extremely negative influence at the end of the operation in patients with COVID-19 respiratory infection. One of the ways to prevent complications is the further development of the laparolifting gasless laparoscopy technique. The aim of the study was to improve the surgical treatment of patients with acute calculous cholecystitis against the background of COVID-19 infection. We conducted an analysis of the effectiveness of cholecystectomies using the pneumoperitoneum and gasless method with the help of the laparolifting device, which we developed. The study involved the observation of patients who were immediately admitted to the surgical department with acute calculous cholecystitis against a background of COVID-19. The study showed that conducting cholecystectomy with the use of laparolifting in patients with COVID-19 respiratory infection allows us to reduce the risk of perioperative complications from the lungs, overstrain of the cardiovascular system and reduce the need for oxygen after surgery in patients with respiratory disorders, as well as to reduce the risk of increased blood pressure, eliminate the imbalance of the coagulation system in patients with COVID-19 infection much faster and restore the enzymatic activity of the liver in patients after surgery.Документ The choice of a method for surgical treatment of internal chronic hemorrhoids(Полтавський державний медичний університет, 2022) Kravtsiv, M. I.; Dudchenko, M. O.; Ivashchenko, D. M.; Prykhidko, R. A.; Shevchuk, M. P.; Zaiets, S. M.; Ivanova, G. O.; Кравців, Микола Ігорович; Дудченко, Максим Олександрович; Іващенко, Дмитро Миколайович; Прихідько, Роман Анатолійович; Шевчук, Микола Петрович; Заєць, Сергій Миколайович; Іванова, Галина ОлегівнаHaemorrhoids are one of the most common diseases in the anorectal zone. Often this disease requires surgical treatment, so the study of types of operations for treatment of hemorrhoids is very important in our time. The aim of our study was to compare Rafaelo radiofrequency ablation of hemorrhoids and Milligan-Morgan hemorrhoidectomy to determine the best method of surgical treatment of chronic hemorrhoids. Our study included 135 patients divided into two groups. The first group consisted of 75 patients operated on by radiofrequency ablation, the second group consisted of 60 patients who underwent classical Milligan-Morgan hemorrhoidectomy. Obtained results showed that the method of radiofrequency ablation of hemorrhoids using the Rafaelo method is less traumatic, easier to perform for surgeons, has an insignificant level of postoperative pain, low frequency of early and late postoperative complications and recurrence, does not require additional drug therapy and is characterized by a short postoperative period and recovery.Документ The effectiveness of meloxicam in the prevention and treatment of postoperative pain in abdominal wall alloplasty about its defects(“Ottawa University Press”, 2015) Lysenko, R. B.; Лисенко, Руслан БорисовичThis study is devoted to study of dynamics of change in the intensity of pain, activation, and availability of complications in postoperative period in dependence from kind of analgesia in the abdominal wall alloplasty about its defects. Дана стаття присвячена дослідженню динаміки зміни інтенсивності больового синдрому, активізації хворих, наявності і виду ускладнень у післяопераційному періоді в залежності від виду знеболення при алопластиці черевної стінки з приводу її дефектів.Документ The features of emergency surgical care during the covid-19 pandemic(Полтавський державний медичний університет, 2023) Zaiets, Serhii; Dudchenko, Maksym; Horoshko, Viktoriia; Prykhidko, Roman; Kravtsiv, Mykola; Danylchenko, Svitlana; Zaets, S.; Dudçenko, M.; Xoroşko, V.; Prixodko, R.; Kravtsiv, M.; Danilçenko, S.; Заєць, Сергій Миколайович; Дудченко, Максим Олександрович; Хорошко, Вікторія; Прихідько, Роман Анатолійович; Кравців, Микола Ігорович; Данильченко, Світлана ІванівнаThe article presents the results of a study conducted to analyze and determine the characteristics of providing emergency surgical care in the context of the COVID-19 coronavirus infection. A retrospective analysis of case histories of 242 patients with confirmed COVID-19 infection was conducted, who were admitted to the surgical department from February to June 2021 due to the need for emergency surgery. A comparative analysis was carried out with a group of patients who underwent emergency surgery from February to June 2019 (group without COVID-19 infection). Emergency surgical care for patients in an infectious diseases hospital was one of the urgent problems during the pandemic of a new coronavirus infection COVID-19. The analysis showed that during the pandemic period, the number of patients with American Society of Anesthesiologists status 2-3 was significantly higher (< 0.0001), and the mortality rate during the pandemic period in the surgical department was 6.2%. During the pandemic, we detected the prevalence of patients with pathologies related to coagulopathy due to COVID-19 infection in the form of thrombosis of the mesenteric arteries, thrombosis of the arteries of the lower extremities, perianal venous thrombosis, and thrombophlebitis. The tendency for thrombosis and the development of coagulopathy in patients with COVID-19 infection should be taken into account when preparing them for surgery and preventing thrombosis with the help of anticoagulants. Laparoscopic operations are safe for medical personnel, providing the compliance with sanitary and epidemiological requirements.Документ The need for a cycle of thematic improvement in herniology for listeners of surgical profile(Полтавський державний медичний університет, 2022) Liakhovskyi, V. I.; Lysenko, R. B.; Nyemchenko, I. I.; Krasnov, O. H.; Gorodova-Andreeva, T. V.; Ляховський, Віталій Іванович; Лисенко, Руслан Борисович; Нємченко, Іван Іванович; Краснов, Олег Георгійович; Городова-Андрєєва, Тамара Валер'янівнаThe article notes that medicine is developing rapidly worldwide, so there are problems and changes in the established structure of improving the knowledge level related to the medical profession. General surgery is increasingly fragmented into subspecialties. Many pathological conditions used to be treated by general surgeons and are now treated by specialists. Recently, the view of surgical treatment of hernias among most general surgeons has changed. A deeper problem understanding of the abdominal wall at the current level and its restoration, the introduction of a new surgeries variety for abdominal hernias, which has improved the treatment of these patients, has led to a new specialty – herniologist. In recent years, thanks to the introduction of new open, video laparoscopic, endoscopic, and even robotic techniques and many medical devices, abdominal hernia surgery has acquired entirely different technologies. Given the significant positive developments and trends in herniology, the results of abdominal hernias treatment in general in Ukraine are not satisfactory. There are still many urgent herniotomies and, accordingly, high postoperative mortality. Many hernia surgeries in Ukraine are performed using old, traditional methods, and most surgeons are little or unfamiliar with modern techniques. Therefore, for the widespread introduction and promotion of the latest world technologies in the surgical treatment of abdominal hernias, promoting scientific and practical solutions to modern problems of herniology, training of surgeons in the application of modern methods of abdominal hernias treatment in courses of thematic improvement and improvement of surgical care for patients with abdominal hernias of all types the authors proved the urgent need to create a specialized cycle of thematic improvement in herniology for surgeons, especially in the presence of herniologists and a modern clinical base, which deals with abdominal hernia surgery with good resultsДокумент The role of various methods of kidney drainage in obstructive pyelonephritis(Полтавський державний медичний університет, 2021) Ivashchenko, D. M.; Dudchenko, M. O.; Kravtsiv, M. I.; Prykhidko, R. A.; Shevchuk, M. P.; Shchasnyi, D. M.; Іващенко, Дмитро Миколайович; Дудченко, Максим Олександрович; Кравців, Микола Ігорович; Прихідько, Роман Анатолійович; Шевчук, Микола Петрович; Щасний, Дмитро МиколайовичThe study is devoted to the analysis of methods for drainage of the renal pelvis in the presence of a symptom complex of acute purulent obstructive pyelonephritis, comparison of various drainage methods (internal and external), analysis of the severity of inflammatory changes in the blood and urine, dynamics of laboratory parameters. In two groups of patients, the corresponding indicators were analyzed when performing internal (stenting) and external (nephrostomy) drainage of the urinary tract. According to the results, a more rapid decrease in blood and urine leukocytosis in the external drainage group was noted, the hyperthermic reaction of the body was also reduced faster, and there were more positive changes in the ultrasound picture. According to the results of the study, we can say that both methods of drainage are indicated in the presence of obstructive pyelonephritis as one of the components of treatment, and the method of external drainage is more effective than internal stenting.Документ Urgent abdominal surgery(ПП "Астрая", 2020-06-24) Lyakhovskiy, V. I.; Nemchenko, I. I.; Liulka, O. M.; Kovalyov, O. P.; Krasnov, O. G.; Gorodova-Andreeva, T. V.; Sydorenko, A. V.; Сидоренко, Архип Володимирович; Ляховський, Віталій Іванович; Нємченко, Іван Іванович; Люлька, Олександр Миколайович; Ковальов, Олександр Павлович; Краснов, Олег Георгійович; Городова-Андрєєва, Тамара Валер'янівнаРекомендовано Вченою радою Української медичної стоматологічної академії МОЗ України як навчальний посібник для студентів медичних факультетів закладів вищої медичної освіти, які навчаються англійською мовою. Протокол № 11, від 24 червня 2020 р.Документ Use of Bacteriophages in the Treatment of Infected Wounds in Patients who have Allergy to Antibiotics(2016) Ivashchenko, D. M.; Ligonenko, O. V.; Digtyar, I.; Іващенко, Дмитро Миколайович; Лігоненко, Олексій Вікторович; Дігтяр, Ілля ІвановичBackground: In recent years, there has been a tendency of increasing of the number of antibiotic-resistant strains of microorgan-isms as causative agents of surgical wound infections, and increasing of the number of patients who have a multiple allergy to antibiotics. This significantly increases the duration and cost of treatment, and puts some questions on its efficiency. Aim of our research is to study how the bacteriophages act as agents to deal with purulent infection in the presence of allergy to antibiotics. Materials and Methods: We carried out a clinical examination and treatment of 68 patients with purulent-inflammatory soft tissue diseases treated in the Poltava Central District Clinical Hospital in the period from 2013 to 2015. The patient’s age ranged from 18 to 60 years. The patients were divided into three groups. The first group included 25 patients in whom the treatment was performed with the use of antibiotics. The second group included 22 patients in whom both antibiotics and bacteriophages were used in the complex treatment, and the third group - 21 patients who had been identified to have multiple allergy to antibiotics and instead of antibiotics, they were prescribed bacteriophages. We evaluated the following criteria: duration of the pain, local tissue edema, time of appearance of granulation and wound healing, measured leukocyte index of intoxication, microbiological markers of wound contamination. Results: In the analysis of the treatment of 68 patients found that the results of the 1st and 3rd groups did not differ statistically significantly, while the 2nd group of patients who used the bacteriophages and antibiotics, we found a significant reduction of terms in wound healing. Conclusions: The study shows that bacteriophages are effective agents for treatment of purulent infection and are an alternative in case of impossibility of the use of antibiotics. Cooperative use of bacteriophages and antibiotics leads to more effective treatment.Документ Ways of solving the problem of choledocholithiasis in patients with pathology of parapapillary zone and common bile duct(Полтавський державний медичний університет, 2023) Ivashchenko, D. M.; Shevchuk, M. P.; Dudchenko, M. O.; Kravtsiv, M. I.; Prikhidko, R. A.; Zezekalo, E. O.; Zaiets, S. M.; Іващенко, Дмитро Миколайович; Шевчук, Микола Петрович; Дудченко, Максим Олександрович; Кравців, Микола Ігорович; Прихідько, Роман Анатолійович; Зезекало, Єфім Олегович; Заєць, Сергій МиколайовичThe paper presents an analysis of the results of endoscopic treatment of choledocholithiasis in clinically severe cases. A retrospective and prospective analysis of the treatment of 161 patients with choledocholithiasis was conducted. Endoscopic papillosphincterotomy, mechanical lithotripsy, nasobiliary drainage and transpapillary stenting were performed to restore the bile passage and rehabilitate the extrahepatic bile ducts. Then we carry out a comparison of the efficiency of endoscopic lithoextraction in two groups of patients. The 1-st group – patients with large calculi of the common bile duct and normal anatomy of the parapapillary zone and choledochus, the 2-nd group – patients with choledocholithiasis and complicated anatomy – diverticuls of the parapapillary zone, stenosis or strictures of the extrahepatic bile ducts. Endoscopic papillosphincterotomy was performed in 151 patients. In 44 patients with diverticula of the large duodenal papilla, stones were removed by standard lithoextractors, in other 107 cases – mechanical lithotriptor was used. Stones were successfully removed in 98 patients. Lithotripsy was unsuccessful in 7 patients of 1-st group and in 2 patients of 2-nd group, and the reliability of lithotripsy did not differ in both groups. Endoscopic manipulations were equally effective in both groups.Документ Абдомiнопластика при хiрургiчному лiкуваннi хворих iз складними дефектами черевної стiнки(Українська медична стоматологічна академія, 2019) Салiмов, Г. Р.; Лисенко, Руслан Борисович; Салимов, Г. Р.; Лысенко, Руслан Борисович; Salimov, G. R.; Lysenko, R. B.Пацiєнти зi складними дефектами черевної стiнки зазвичай мають деформацiю живота, яка може зберiгатися й пiсля операцiї, та потребують вирiшення цiлого комплексу проблем. Досить часто дефекти черевної стiнки поєднуються з рiзноманiтними естетичними деформацiями, що пов'язанi з патологiчними пiсляоперацiйними рубцями, трофiчними виразками, норицями, стомами. Хоча вiдновлення або покращення функцiональних можливостей черевної стiнки є основною метою алопластики при складних дефектах черевної стiнки, особливу увагу заслуговують й косметичнi аспекти операцiї, що часто бiльш важливi для пацiєнтiв. Від вибору оптимального оперативного доступу значною мiрою залежить yспix операцiї, але бiльшiсть хiрургiв не придiляють йому особливої уваги та переважно використовують обрамляючi розрiзи над дефектом або випинанням. До цього часу такi величини, як вид, величина розрiзу, глибина, межi вiдшарування клаптiв залишаються емпiричними й часто призводять до додаткової деформацiї зони операцiї та розвитку ускладнень. Абдомiнопластика - одна з найбiльш суперечливих операцiй в естетичнiй та пластичнiй хiрургiї, при якiй ускладнення досягають 27,5-30,8 %. Поняття «абдомiнопластика» передбачає методи оперативної корекцiї деформацiй черевної стiнки у виглядi надлишкiв шкiри i пiдшкiрно-жирової клiтковини, патологiчних пiсляоперацiйних рубцiв, а також дефектiв м'язово-апоневротического шару в данiй областi. Вiдомо декiлька способiв абдомiнопластики. Мета роботи - визначення ефективностi виконання абдомiнопластики при хiрургiчному лiкуванні складних дефектiв черевної стiнки. Матерiали i методи. У хiрургiчнiй клiнiцi 1-ї мiської лiкарнi м. Полтави за останнi 10 рокiв прооперовано 360 хворих iз складними дефектами черевної порожнини. Рiзного роду деформацiю черевної стiнки виявлено у 289 пацiєнтiв (80,3%). Локалiзацiя дефекту: M – 306 (85%), L – 31 (8,6%), ML – 23 (6,4%). Розмiри дефекту: W1 – 103 (28,6%), W2 – 188 (52,2%), W3 – 69 (19,2%). Супутнiй дiастаз прямих м'язiв живота 1 ст був виявлений у 179 пацiєнтiв (49,7%), 2 ст – у 114 (31,7%), 3 – у 17 (4,7%). Поєднанi хiрургiчнi захворювання виявленi у 332 хворих (92,2%), у 18,1% iз них – iнтраабдомiнальна патологiя. Результати та обговорення. Види виконаних дерматолiпектомiй: поздовжня – 77 (28,1%), за Бебкоком – 114 (41,6%), за Келлi – 6 (2,2%), за Фернандесом - 63 (22,9%), модифiкована Фернандес – 7 (2,5%), за Берсоном – 3 (1,1%), за Тореком – 2 (0,8%), за Гразером – 2 (0,8%). Види алопластики: «onlay» - 3 (0,8%), «sublay» - 289 (80,3%), «sublay-inlay» - 38 (10,6%), «inlay» - 3 (0,8%), Ramirez – 4 (1,1%), iнтраабдомiнальна - 2 (0,6%), комбiнована – 21 (5,8%). Висновки. Термiн абдомiнопластика має бiльш широке значення, нiж вважається. Диференцiйована хiрургiчна тактика покращує результати лiкування пацiєнтiв iз складними дефектами черевної порожнини.Документ Активізація навчання в інтернатурі як запорука якісної підготовки лікарів-інтернів(ДВНЗ «Тернопільський державний медичний університетімені І. Я. Горбачевського МОЗ України». Майдан Волі, 1, м. Тернопіль, 46001, Україна, 2017-05-18) Малик, Сергій Васильович; Челішвілі, Анатолій Леонідович; Лисенко, Руслан Борисович; Капустянський, Денис Васильович; Безручко, Максим Васильович; Осіпов, Олександр Сергійович; Драбовський, Віталій СергійовичБезперервний процес удосконалення знань і умінь лікарів-інтернів останнім часом в умовах стрімкого прогресу в сучасних медичних технологіях робить вкрай важливими заходи щодо поліпшення післядипломної освіти. Використання методів активізації діяльності лікарів-інтернів – важливий принцип навчання на післядипломному рівні. Завдяки активній роботі інтерни реалізують себе як фахівці та підтверджують, що головними провідниками в життя для тих, хто обрав нелегкий, але почесний шлях лікаря, є доброта і милосердя, людяність і співчуття в поєднанні з високим рівнем професійних знань і умінь.