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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 Петрович
The 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 %.
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 Борисович
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, Юрій
The 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.
Current principles of diagnosis and treatment of bone lesions in patients with diabetic foot syndrome
(Полтавський державний медичний університет, 2024) Прихідько, Роман Анатолійович; Краснов, Олег Георгійович; Дудченко, Максим Олександрович; Кравців, Микола Ігорович; Заєць, Сергій Миколайович; Іващенко, Дмитро Миколайович; Краснова, Оксана Іванівна; Prykhidko, R. A.; Krasnov, O. H.; Dudchenko, M. O.; Kravtsiv, M. I.; Zaiets, S. M.; Ivashchenko, D. M.; Krasnova, O. I.
One of the most unresolved issues in patients with diabetic foot syndrome is the diagnosis and treatment of bone tissue lesion. The aim was to compare the results of treatment of bone tissue lesions in patients with diabetic foot syndrome and to highlight the factors of prevention of limb amputation. We have carried out treatment of 658 patients with diabetic foot syndrome. High amputation of lower limb in the control group were performed more often. Mortality was higher in the control group. At the same time, the supporting function of the foot in patients was preserved more often in the main group. Radical surgical treatment of osteomyelitis leads to a reduction in the duration of treatment of patients with diabetic foot syndrome and an increase in the number of surgical interventions. However, conservative therapy of osteomyelitis reduces the risk of impaired foot support function and high amputation of the lower limb. Одним із найбільш невирішених питань у пацієнтів із синдромом діабетичної стопи є діагностика та лікування ураження кісткової тканини. Метою було порівняти результати лікування уражень кісткової тканини у хворих на синдром діабетичної стопи та висвітлити чинники профілактики ампутації кінцівки. Проведено лікування 658 хворих на синдром діабетичної стопи. Високі ампутації нижньої кінцівки в контрольній групі проводили частіше. Смертність була вищою в контрольній групі. При цьому опорна функція стопи у пацієнтів зберігалася частіше в основній групі. Радикальне хірургічне лікування остеомієліту призводить до скорочення термінів лікування хворих на синдром діабетичної стопи та збільшення кількості оперативних втручань. Проте консервативна терапія остеомієліту знижує ризик порушення опорної функції стопи та високої ампутації нижньої кінцівки.
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 Володимирович
The 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.
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 Іванівна
Aim: 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.
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 Володимирович
A 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.
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 Олегівна
The 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.
Role of diagnostic laparoscopy in abdominal disorders with uncertain diagnosis: a rare case report
(Полтавський державний медичний університет, 2025) Kravtsiv, M. I.; Dudchenko, M. O.; Ivashchenko, D. M.; Shevchuk, M. P.; Krasnov, O. H.; Horodova-Andrieieva, T. V.; Liulka, O.M.; Кравців, Микола Ігорович; Дудченко, Максим Олександрович; Іващенко, Дмитро Миколайович; Шевчук, Микола Петрович; Краснов, Олег Георгійович; Городова-Андрєєва, Тамара Валер'янівна; Люлька, Олександр Миколайович
Female patient was hospitalized in the surgical of the Municipal Enterprise “2nd City Clinical Hospital of Poltava City Council” (Poltava, Ukraine) in 2023. The patient underwent a complete general clinical examination, a plain radiograph of the abdominal cavity, fibrogastroduodenoscopy, colonoscopy, ultrasound of the abdominal organs, CT scan of the abdominal organs. Diagnostic laparoscopy was performed to make a final diagnosis. A plain radiography of the abdominal cavity revealed no pathology. Ultrasound of the abdominal organs revealed a pelvic mass. A computed tomography scan revealed damage to the pelvic organs in the form of a neoplasm and an enlargement of the left ovary. The preliminary diagnosis was a pelvic tumor, tumor of the left ovary. Diagnostic laparoscopy was performed to make the diagnosis. A rounded formation was defined in Douglas space. The capsule of the formation was opened and pus was released. The abscess wall was opened, and a foreign body (gauze pad) was removed from the cavity. The patient was discharged from the hospital in satisfactory condition on the fifth day after surgery. The case we examined emphasizes that when assessing the nature of an intra-abdominal neoplasm, it is necessary to remember about foreign bodies, especially in patients after surgical interventions. Diagnostic laparoscopy is a technically advanced and minimally invasive procedure for the diagnosis and treatment of intra-abdominal gossypiboma.
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 Георгійович
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 Анатолійович
Meckel'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.
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 Олегович
During 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.
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 Олегівна
Haemorrhoids 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.
The effect of the use of vacuum therapy and instillation of L-arginine in the treatment of purulent wounds on the activity of nitric oxide cycle enzymes
(ДУ «Інститут загальної та невідкладної хірургії НАМН України», Заславський О. Ю., 2025) Horodova-Andrieieva, T. V.; Akimov, O. Ye.; Kostenko, V. O.; Krasnov, O. H.; Lyakhovskyi, O. H.; Kravtsiv, M. I.; Городова-Андрєєва, Тамара Валер'янівна; Акімов, Олег Євгенович; Костенко, Віталій Олександрович; Краснов, Олег Георгійович; Ляховський, Віталій Іванович; Кравців, Микола Ігорович
Background. The problem of treating purulent wounds remains one of the most urgent throughout the history of surgery. Nowadays, despite many years of experience and constant scientific research, the problem of diagnosis and treatment of purulent wounds does not lose its relevance. The purpose is to evaluate the effect of vacuum therapy and instillation of L-arginine in the treatment of a purulent wound on the production of nitric oxide by different isoforms of NO-synthase and the activity of the arginase pathway of L-arginine metabolism. Materials and methods. The experiment was conducted in 20 patients who were randomly divided into 2 groups: vacuum therapy (GR-1, n = 10) and vacuum therapy with instillations of L-arginine solution (GR-2, n = 10). In the blood plasma, the following parameters were investigated: total activity of NO-synthase, activity of the inducible and constitutive isoforms of NO-synthase, activity of arginases and nitrite concentration. Results. When comparing the results obtained after the treatment of a purulent wound in patients from GR-1 and GR-2, a statistically significant difference was found in the concentration of nitrites and the activity of arginases. Thus, the concentration of nitrites in the venous blood of GR-2 patients after treatment of a purulent wound was 45.59 % lower than in GR-1. The activity of arginase in the blood plasma taken from the venous bed closest to a purulent wound was 25.23 % higher in patients with GR-2 compared to the indicators in GR-1. Conclusions. Vacuum therapy with L-arginine instillation, in addition to the effects of therapy itself, limits the accumulation of nitrites in the blood of the venous bed closest to a purulent wound and enhances the metabolism of L-arginine by the arginase pathway. Актуальність. Проблема лікування гнійних ран за-лишається однією з найактуальніших за всю історію хірургії. У наш час, незважаючи на багаторічний досвід і постійні на-укові дослідження, проблема діагностики й лікування гнійних ран не втрачає своєї актуальності. Мета: оцінити вплив ваку-ум-терапії та інстиляції L-аргініну при лікуванні гнійної рани на продукцію оксиду азоту різними ізоформами NO-синтази та активність аргіназного шляху метаболізму L-аргініну. Матеріали та методи. В експерименті взяли участь 20 пацієн-тів, які були рандомізовано розподілені на 2 групи: вакуумної терапії (GR-1, n = 10) та вакуумної терапії з інстиляціями роз-чину L-аргініну (GR-2, n = 10). У плазмі крові досліджували на-ступні параметри: загальну активність NO-синтази, активність індуцибельної та конститутивної ізоформ NO-синтази, актив-ність аргіназ і концентрацію нітритів. Результати. При порів-нянні результатів, отриманих після лікування гнійної рани в пацієнтів GR-1 і GR-2, виявлено статистично значущу різницю в концентрації нітритів і активності аргіназ. Так, концентрація нітритів у венозній крові хворих GR-2 була на 45,59 % нижчою, ніж у пацієнтів GR-1. Активність аргінази в плазмі крові, взятій із найближчого до гнійної рани венозного русла, у GR-2 була на 25,23 % вищою порівняно з показниками GR-1. Висновки.Вакуумна терапія з інстиляцією L-аргініну, крім ефектів власне такої терапії, обмежує накопичення нітритів у крові венозного русла, найближчого до місця гнійної рани, та посилює утиліза-цію L-аргініну аргіназним шляхом.
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 Борисович
This 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.
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 Іванівна
The 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.
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'янівна
The 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 results
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 Миколайович
The 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.
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 Іванович
Background: 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.
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 Миколайович
The 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.

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