EFFECTIVENESS OF HORMONAL MONOTHERAPY BEFORE SURGICAL TREATMENT IN PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS.

OBJECTIVE: The aim: Evaluation of the effectiveness of hormone therapy before and after surgical treatment in patients with external genital endometriosis (HRT). PATIENTS AND METHODS: Materials and methods: Bibliographic, information-analytical, clinical-instrumental, laboratory, histomorphological methods were used in the work. The sources of information were data from the scientific literature on the topic of the study, modern guidelines, a review of randomized controlled studies. RESULTS: Results: All women involved in the study received hormone therapy before and after surgery for 3-6-9 months: 45.0% - only COCs, 25.0% - courses of a-GnRH drugs; 30.0% - only progestogens. Comparative evaluation of the function of the relapse-free course of UHD using the Kaplan-Meier method showed that when using a-GnRH in patients with UHD, the duration of the relapse-free period is higher than for other groups of drugs: the indicator of the function of maintaining remission before surgical treatment decreases from 100% to 0% during the first 6 months in 89.0%, and during 9 months - in 66.0% of patients. Progression of the disease, after surgery and withdrawal of a-GnRH, with a 3-month course occurred - after 3 months - in 45.0%, with a 6-month course - after 9 months - in 33.0%, with a 9-month course - after 12 months - in 12.0% of people. Thus, the average median of the recurrence-free course was ±11.6 months. CONCLUSION: Conclusions: The most effective hormone therapy in patients with HRT before and after surgical treatment is therapy with drugs of the α-¬HnRH group, courses of at least 6 months.

POSTOPERATIVE INFECTIONS AFTER GYNECOLOGICAL SURGERIES IN UKRAINE.

OBJECTIVE: Aim: To determine the current prevalence of surgical site infections (SSIs) after gynecological surgeries and antimicrobial resistance of causing pathogens in Ukraine. PATIENTS AND METHODS: Materials and Methods: Multicenter prospective observational cohort study was conducted from January 2020 to December 2022 in nine hospitals from eight regions of Ukraine. Definitions of HAIs were adapted from the Centers for Disease Control and Prevention's National Healthcare Safety Network. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST. RESULTS: Results: A total 12.2% (420/3450) patients who undergoing gynecological surgeries were found to have SSIs. The difference in SSI rates between the three subgroups by route of surgery was not statistically significant, being 12.0% for the abdominal group,11.1% for the vaginal group, and 12.5% for the combined group. The most common causing pathogens of SSIs was Escherichia coli, Pseudomonas aeruginosa, Enterobacter spp., Streptococcus spp., and Klebsiella pneumoniae. Many Gram-negative pathogens isolated from SSI cases were found to be multidrug resistant. CONCLUSION: Conclusions: This study showed that SSIs remains the common complication after gynecological procedures in Ukraine. Best practices should be established and followed to reduce the risk of SSIs associated with gynecologic surgery. Optimizing the antibiotic prophylaxis and empirical antimicrobial therapy may reduce the burden of SSIs in gynecological surgeries, but prevention is the key element.