SURGICAL TREATMENT OF ECHINOCOCCOSIS OF THE LIVER AND ITS COMPLICATIONS.

OBJECTIVE: The aim: To analyze the frequency of complications of echinococcal cysts of the liver, the causes of recurrence and the results of surgical treatment of patients with echinococcal liver disease. PATIENTS AND METHODS: Materials and methods: The results of surgical treatment of 79 patients who were hospitalized from January 2011 to JANUARY 2022 with liver echinococcosis and its complications were analyzed. Among them there were 11 men (13,9%) and 68 women (86,1%), with average age 47,5 ± 2,3 years. Complications of echinococcal cysts developed in 17 (21,5%) patients. RESULTS: Results: The choice of surgical intervention method was determined individually, taking into account the location of echinococcal cysts, their size, depth, proximity of important anatomical structures. 53 (67,1%) patients underwent total or subtotal pericystectomy, 8 (10,1%) patients underwent liver segment resection, 5 (6,3%) patients underwent cyst dissection with removal and treatment its cavity, PAIR method was applied in 1 (1,3%) patient. Echinococcectomy was performed laparoscopically in 12 (15,2%) patients. The use of laparoscopic surgery for echinococcosis of the liver reduced intraoperative blood loss, duration of operation, hospital stay. We did not have recurrences of the disease after radical surgery. After palliative surgery, recurrence occurred in 2 (2,63%) patients. CONCLUSION: Conclusions: Surgical interventions for urgent indications in patients with complicated echinococcal cysts of the liver increase the risk of recurrence of the disease. Pericystectomy was performed in 53 (67,1%) patients, is a radical and efficient operation for complete recovery and does not lead to recurrence of the disease. The efficiency of laparoscopic echinococcectomy has been demonstrated.

Complex treatment of purulent wounds with the use of high-pressure aerodisperse mixture.

OBJECTIVE: The aim: To investigate the effectiveness of complex treatment of purulent wounds with the use of high pressure aerodispersed mixture of antibacterial drug using sorbents and correction of hydrogen index. PATIENTS AND METHODS: Materials and methods: In total, 54 patients were treated, out of which there were 26 patients with purulent wounds in the main group and 28 patients in the control group. Patients in the main group were treated according to the developed method, patients in the control group were treated with traditional antiseptics and water soluble ointments. RESULTS: Results: Within patients of the main group, there was a decrease in the duration of inflammatory process, decrease in the quantity of microorganisms in the wound; slight changes in the sensitivity of the microorganisms to antibacterial preparations, compared with the control group, which showed a high percentage of development of resistant strains; decreased edema and secretion from wounds, the early appearance of granulation. CONCLUSION: Conclusions: The use of the proposed approach reduces the microbial burden on the wound, accelerates its purification from purulent-necrotic tissues and reduces the duration of the inflammatory process due to the presence of the microbial factor.