Andrii Formanchuk - Academia.edu (original) (raw)
Papers by Andrii Formanchuk
PubMed, 2022
Objective: The aim: To analyze the frequency of complications of echinococcal cysts of the liver,... more 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.
Acta Facultatis Medicae Naissensis, 2022
Introduction: Neutrophil-lymphocyte ratio (NLR) is one of the laboratory biomarkers used in clini... more Introduction: Neutrophil-lymphocyte ratio (NLR) is one of the laboratory biomarkers used in clinical practice to predict severity and mortality of acute pancreatitis (AP), however, there is currently insufficient information about the changes of NLR in the dynamics in relationship with other clinical and laboratory data. Aims: To assess the relationship between NLR values and other demographics, clinical and simple laboratory data in patients with acute pancreatitis. Methods: The data of two hundred twenty-nine patients with AP were analyzed. All patients were divided into two groups: the group with a positive outcome and the group with a fatal outcome. NLR was counted on the 1 st , 3 rd and 5 th day after admission in each group. The dynamics of NLR index by groups and days, as well as its correlation with other 18 simple laboratory parameters were evaluated. Results: The level of NLR rate itself was significantly higher on the 1 st , 3 rd and 5 th day in the group with the fatal result compared with the group with the positive result (p < 0.05). In patients with AP with the positive result of treatment, there was a gradual decrease in the rate between the 1 st and the 3 rd day (-21.8%) (p < 0.05). The overall dynamics of the indicator between the 1 st and the 5 th day was-21.5%. In contrast to the group of patients with the fatal outcome, despite the infusion therapy, there was an increase in NLR rate between the 1 st and 3 rd day of +15.7%. The overall dynamics between the 1 st and 5 th day was-34.0%. A significant negative relationship of the Spearman's rank correlation coefficient between NLR on the 1 st and 3 rd day with the fatal outcome was revealed. The highest reliability of this indicator was found on the 3 rd day after admission (p < 0.0001). In the group of patients with a positive result, a correlation between NLR on the 1 st day and stabs on the 1 st day, segmental forms on the 1 st day, serum amylase on the 1 st day was found. A very high correlation was found with the level of lymphocytes on the 1 st day (rs =-0.98, p < 0001). In the group of patients with the fatal outcome, a statistically significant correlation (p < 0.05) of moderate strength was found between the value of NLR and the following indicators: glucose level on the 1 st day, total protein on the 5 th day, prothrombin index on the 5 th day. A high correlation was found with the level of segmental forms on the 1 st day (rs = 0.7) and a very high correlation with the level of lymphocytes on the 1 st day (rs =-0.99). Conclusions: There was a significant increase in NLR on the 1 st , 3 rd , and 5 th day in the group of patients with AP with the fatal outcome compared with the group of patients with AP with the positive result. Elevated NLR levels on the 1 st and 3 rd day seem to be associated with hospital mortality in patients with AP. No correlation was found between NLR rate and clinical data in the group with fatal outcome. The main indicators among simple laboratory parameters for determining the predictors of lethal outcome in AP in different periods after hospitalization were: the level of blood glucose, lymphocytes, total protein, serum amylase, prothrombin index.
Клінічна анатомія та оперативна хірургія, Aug 29, 2019
Кафедра загальної хірургії (зав.-проф. С.Д. Хіміч) Вінницького національного медичного університе... more Кафедра загальної хірургії (зав.-проф. С.Д. Хіміч) Вінницького національного медичного університету імені М.І. Пирогова АНАЛІЗ ОСОБЛИВОСТЕЙ ДІАГНОСТИКИ ТА ЛІКУВАННЯ УСКЛАДНЕНИХ ФОРМ ХОЛЕЦИСТИТУ Резюме. Метою дослідження стало проведення аналізу результатів обстеження і лікування хворих на біліарну патологію та виявлення особливостей діагностики і лікувальної тактики у хворих з ускладненими формами холециститу. Аналіз результатів обстеження і хірургічного лікування основано на 704 хворих, що страждали на холецистит, які знаходилися на лікуванні в клініках загальної хірургії Вінницького національного медичного університету імені М.І. Пирогова в період з 2014 по 2018 рр. Виявлено, що на якість діагностики та хірургічної тактики впливає наявність супутньої патології (ожиріння, асцит), анатомо-топографічні особливості органів та рівень знання лікарями УЗД хірургічної патології. Ключові слова: холецистит, холецистектомія, лапароскопічна холецистектомія у людей зі зворотнім розташуванням внутрішніх органів. Надійшла 14.05.2019 р. Рецензент-проф. Полянський І.Ю. (Чернівці)
Acta Facultatis Medicae Naissensis, 2022
The aim of the study was to evaluate the assoсiation of mortality in acute pancreatitis with clin... more The aim of the study was to evaluate the assoсiation of mortality in acute pancreatitis with clinical and simple laboratory data received on the day of admission. Patients and methods. In our retrospective study, the clinical and laboratory parameters of 99 patients with moderate and severe acute pancreatitis were analyzed. All patients were divided into two groups: deceased and survivors. Results. We did not find a significant difference in age and gender distribution between the comparison groups. However, a significant predominance of alcoholic etiology of acute pancreatitis, early hospitalization (up to 6 hours from the onset of the disease) of patients, and the number of necrotizing infected type in the deceased group were found. Concomitant pathology did not significantly differ in comparison groups. In patients from the deceased group, the total number of all complications was significantly higher than in the group of survivors-21 (100%) and 42 (53.8%) (p = 0.0001), respecting. Among the laboratory parameters determined on the day of admission, in the deceased group, there was a significant increase in stabs to 19.8 ± 9.8 and ESR, AST to 225.3 ± 47.5 U/L, urea to 11.2 ± 7.7 mmol/L, and creatinine to 173.6 ± 26.1 mmol/L. Conclusion. The alcoholic genesis of acute pancreatitis, necrotizing infected type of inflammation of the pancreas, presence of late complications, and comorbidities were significantly higher in the deceased group. The levels of stabs, ESR, AST, urea, and creatinine determined on the admission significantly dominated in the deceased group, which requires further study for the prediction of mortality of acute pancreatitis.
Харківська хірургічна школа, Mar 20, 2021
дослідження-проаналізувати результати лікування хворих з ехінококозом печінки. Матеріали та метод... more дослідження-проаналізувати результати лікування хворих з ехінококозом печінки. Матеріали та методи. Проаналізовано результати лікування 76 хворих з ехінококозом печінки: жінок-66 (86,8%), чоловіків-10 (13,2%). Первинний ехінококоз був виявлений у 73 (96,1%) хворих, вторинний-у 3 (3,9%). Серед інструментальних методів дослідження діагностичне значення мали ультразвукове та комп'ютерно-томографічне обстеження. Поодинокі кісти печінки виявлені у 66 (86,8%) хворих, множинні-у 10 (13,2%). Серед хворих з солітарними кістами права доля печінки вражалась частіше ніж ліва-56 (73,7%) хворих проти 20 (26,3%). Ускладнення ехінококозу відзначено у 16 (21,1%) пацієнтів. Серед них найчастішими були: нагноєння кісти-у 13 (17,1%); прорив кісти у вільну черевну порожнину-у 1 (1,3%), у плевральну порожнину-у 1 (1,3%), в біліарний тракт-у 1 (1,3%) випадку. У 20 (26,3%) хворих операцію виконували з верхньо-серединного доступу, у 46 (60,5%)-з косих підреберних доступів за Кохером або за Федоровим. Періцистектомія була виконана у 52 (68,4 %) хворих, у 8 (10,5 %) пацієнтів були виконані резекції сегментів печінки з ехінококовою кістою, у 4 (5,3 %)-розкриття кісти з видаленням вмісту й обробкою її порожнини. Лапароскопічну ехінококектомію застосували у 12 (15,8 %) хворих. У післяопераційному періоді у 16 (21,1 %) хворих виявлені ускладнення. Використання зварювального електрокоагулятора ЕК-300М «Свармед» при термічній санації стінок залишкової порожнини після ехінококектомії дозволило зменшити крововтрату з (2200,0 ± 210,0) до (250,0 ± 50,0) мл, а кількість рецидивівз 2,8 до 0,0 %. До і після операції проводили протирецидивну антипаразитарну терапію альбендазолом (Ворміл) у два цикли по 28 днів, розділених 14-денною перервою. Доза при масі тіла більше 60 кг становила 400 мг 2 рази/добу, а при вазі менше 60 кг препарат призначали із розрахунку 15 мг/кг/добу. Результати та обговорення. При застосуванні лапароскопічної ехінококектомії вдалося зменшити інтраопераційну крововтрату у 9 разів (р=0,0001); тривалість операції-у 2 рази (р> 0,05), перебування у стаціонарі-у 3,3 разу (р = 0,002). Летальних випадків не було. Висновки. Перицистектомія є ефективною операцією щодо повного одужання та не дає рецидивів захворювання. Застосування зварювального електрокоагулятора та лапароскопічна ехінококектомія суттєво покращують результати лікування хворих із паразитарними кістами печінки.
Wiadomości lekarskie (Warsaw Poland), 2021
The aim: Improve the treatment outcomes of patients with fluid collections following acute pancre... more The aim: Improve the treatment outcomes of patients with fluid collections following acute pancreatitis using an ultrasound-guided puncture and catheter drainage methods. Materials and methods: 67 patients with acute pancreatitis complicated by fluid collections were divided into two groups. The first group (comparison group) consisted of 32 patients who underwent percutaneous ultrasound-guided puncture and catheter drainage interventions in addition to conservative therapy. The second group (control group) consisted of 35 patients receiving conservative therapy. The age of patients was from 18 to 77 years. In the comparison group among 32 patients there were 19 women and 13 men, the average age consisted 48.2 ± 2.2 years. In the control group among 35 patients there were 21 women and 14 men, the average age of patients consisted 47.1 ± 2.3 years. Results: The mortality rate in the comparison group was 2 (6.2%) cases, in the control group-4 (11.4%) cases (p <0.05). Infection of fluid collections developed in 2 (6.2%) patients of the comparison group and in 5 (14.3%) patients of the control group. The average length of stay in the hospital of patients in the comparison group was 24.13 ± 2.17 days, in the control group 28.11 ± 1.05 days (p <0.05). Also in the comparison group there was a faster normalization of clinical and laboratory indicators (level of leukocytes, serum amylase, C-reactive protein) (p <0,05). Conclusions: the use of percutaneous ultrasound-guided puncture and catheter drainage methods has reduced mortality and improved treatment outcomes in patients with acute pancreatitis complicated by fluid collections
Wiadomości lekarskie (Warsaw Poland), 2022
The aim: To identify the association of clinical and simple laboratory data determined during hos... more The aim: To identify the association of clinical and simple laboratory data determined during hospitalization of the patient with severity of acute pancreatitis. Materials and methods: Clinical and laboratory parameters of 229 patients with acute pancreatitis were analyzed. All patients were divided into two groups depending on the severity of acute pancreatitis: in the group with mild AP were 130 (56.8%) patients and the group, which included moderately severe and severe degree of AP consisted of 99 (43.2%) patients. Results: The association of the age group of 61-70 years with the severity of acute pancreatitis was revealed (p 0.05). We did not find an association between the causes of acute pancreatitis and its severity. In the group with moderate-severe acute pancreatitis, the frequency of concomitant pathology was significantly higher than in the group with mild acute pancreatitis – 92.9% (92) and 78.5% (102) cases (p<0.05). The association between the severity of acute pancreatitis and the following laboratory parameters: blood sugar, leukocyte levels, the level of stabs, lymphocytes, total protein, serum amylase, urinary diastase, creatinine, ALT, AST, prothrombin index, neutrophil-lymphocyte ratio was revealed (p<0.05). Conclusions: The study did not reveal a significant difference between compared groups in the time of hospitalization; found no association between the causes of acute pancreatitis and its severity. Instead, the association between female sex, the presence of concomitant pathology and some routine laboratory findings with the severity of acute pancreatitis was proved.
Klinichna khirurhiia, 2017
The comparative analysis data were presented, concerning the results of complex treatment of 28 p... more The comparative analysis data were presented, concerning the results of complex treatment of 28 patients, suffering ischemic-gangrenous form of the diabetic foot syndrome, developing on background of chronic ischemia of the lower extremities stage IV. In 14 patients (main group) a routine complex of the treatment measures was added by application of an active pressure (negative pressure wound therapy - NPWT) and a capicor preparation; 14 patients (the comparison group) were treated in accordance to routine scheme. In accordance to the comparative analysis data, in patients of the main group the wound surface sarea have kept reducing in twice more rapid, than in a comparison group, the wounds healing was achieved in 94% patients, duration of the patients’ stationary stay have reduced by (5.2 ± 1.4) days.
Wiadomości lekarskie (Warsaw Poland), 2023
The aim: To evaluate efficacy of the tissue defect closure techniques in combination with VAC in ... more The aim: To evaluate efficacy of the tissue defect closure techniques in combination with VAC in the treatment of battle casualities of the lower extremities. Materials and methods: The results of wound healing until complete wound closure, of 62 patients with shrapnel defects of the lower extremities where assessed. Results: Treatment of patients with soft tissue defects of the lower extremities using rotational flaps on the vascular pedicle and VAC significantly reduces the incidence of infectious complications (18.75% in the main group vs. 30% in the control group (p<0.05)), reduces the intensity of pain according to the VAS scale during the first week of treatment in the main group to 5±0.5 versus 7±0.8 in the control group (p<0.05) and reduces the length of hospital stay by 7 days. Conclusions: The use of rotational flaps on the vascular pedicle and local tissue closure techniques in combination with VAC is an effective method of treating patients with combat gunshot wounds of the soft tissues of the lower extremities
Acta Facultatis Medicae Naissensis
Introduction: Neutrophil-lymphocyte ratio (NLR) is one of the laboratory biomarkers used in clini... more Introduction: Neutrophil-lymphocyte ratio (NLR) is one of the laboratory biomarkers used in clinical practice to predict severity and mortality of acute pancreatitis (AP), however, there is currently insufficient information about the changes of NLR in the dynamics in relationship with other clinical and laboratory data. Aims: To assess the relationship between NLR values and other demographics, clinical and simple laboratory data in patients with acute pancreatitis. Methods: The data of two hundred twenty-nine patients with AP were analyzed. All patients were divided into two groups: the group with a positive outcome and the group with a fatal outcome. NLR was counted on the 1st, 3rd and 5th day after admission in each group. The dynamics of NLR index by groups and days, as well as its correlation with other 18 simple laboratory parameters were evaluated. Results: The level of NLR rate itself was significantly higher on the 1st, 3rd and 5th day in the group with the fatal result co...
Acta Facultatis Medicae Naissensis
Aims. The aim of the study was to evaluate the association of mortality in acute pancreatitis wit... more Aims. The aim of the study was to evaluate the association of mortality in acute pancreatitis with clinical and simple laboratory data received on the day of admission. Patients and methods. In our retrospective study, the clinical and laboratory parameters of 99 patients with moderate and severe acute pancreatitis were analyzed. All patients were divided into two groups: deceased and survivors. Results. We did not find a significant difference in age and gender distribution between the comparison groups. However, a significant predominance of alcoholic etiology of acute pancreatitis, early hospitalization (up to 6 hours from the onset of the disease) of patients, and the number of necrotizing infected type in the deceased group were found. Concomitant pathology did not significantly differ in comparison groups. In patients from the deceased group, the total number of all complications was significantly higher than in the group of survivors-21 (100%) and 42 (53.8%) (p = 0.0001), res...
Wiadomości Lekarskie, 2022
The aim: To identify the association of clinical and simple laboratory data determined during hos... more The aim: To identify the association of clinical and simple laboratory data determined during hospitalization of the patient with severity of acute pancreatitis. Materials and methods: Clinical and laboratory parameters of 229 patients with acute pancreatitis were analyzed. All patients were divided into two groups depending on the severity of acute pancreatitis: in the group with mild AP were 130 (56.8%) patients and the group, which included moderately severe and severe degree of AP consisted of 99 (43.2%) patients. Results: The association of the age group of 61-70 years with the severity of acute pancreatitis was revealed (p 0.05). We did not find an association between the causes of acute pancreatitis and its severity. In the group with moderate-severe acute pancreatitis, the frequency of concomitant pathology was significantly higher than in the group with mild acute pancreatitis – 92.9% (92) and 78.5% (102) cases (p<0.05). The association between the severity of acute panc...
Wiadomości Lekarskie
The aim: To evaluate efficacy of the tissue defect closure techniques in combination with VAC in ... more The aim: To evaluate efficacy of the tissue defect closure techniques in combination with VAC in the treatment of battle casualities of the lower extremities. Materials and methods: The results of wound healing until complete wound closure, of 62 patients with shrapnel defects of the lower extremities where assessed. Results: Treatment of patients with soft tissue defects of the lower extremities using rotational flaps on the vascular pedicle and VAC significantly reduces the incidence of infectious complications (18.75% in the main group vs. 30% in the control group (p<0.05)), reduces the intensity of pain according to the VAS scale during the first week of treatment in the main group to 5±0.5 versus 7±0.8 in the control group (p<0.05) and reduces the length of hospital stay by 7 days. Conclusions: The use of rotational flaps on the vascular pedicle and local tissue closure techniques in combination with VAC is an effective method of treating patients with combat gunshot woun...
Reports of Vinnytsia National Medical University, Jun 27, 2019
Анотація. Мета роботи-проаналізувати результати хірургічного лікування гриж з використанням різни... more Анотація. Мета роботи-проаналізувати результати хірургічного лікування гриж з використанням різних способів герніопластики. Проаналізовано результати лікування 176 хворих з грижами живота, які були під спостереженням з 1995 по 2008 роки. Хворих було розподілено на 2 групи. У першу групу (85 хворих) увійшли пацієнти, яким хірургічне лікування проводили з аутодермальною пластикою. Другу групу (91 хворий) становили пацієнти, яким проводили герніопластику з використанням сітчастих алотрасплантатів. Усіх хворих комплексно обстежували. У пацієнтів з ожирінням використовували антимікробну плівку для заклеювання шкіри під молочними залозами та "складками живота" з метою профілактики мікробного забруднення рани. У всіх оперованих хворих відмічли звичний післяопераційний стан, а післяопераційний період в обох групах був практично однаковим. Ускладнень зі сторони післяопераційної рани у хворих 1-ї групи ми не спостерігали. Рани заживали первинним натягом. Усі хворі були виписані на 8-10 добу в задовільному стані. Відмічено 2 рецидиви: у однієї хворої через 1 місяць після операції, у другої-через 10 років. У 2-й групі, у пацієнтки з ІІ ступенем ожиріння спостерігали нагноєння післяопераційної рани. Середня кількість ліжко-днів у 2-й групі був приблизно таким же як і в 1-й групі. Статистично достовірно збільшувався ліжко-день з ростом ступеня ожиріння у даних пацієнтів. Таким чином, застосування сітчастих алотрансплантатів є ефективним методом лікування гриж і вони повинні використовуватись строго за показами. Аутодермальна пластика із застосуванням шкіряного клаптя є також надійним хірургічним методом лікування гриж. Достовірної різниці в показниках при лікуванні хворих обох груп (за вийнятком вартості сітчастих алотрансплантатів) не виявлено.
Wiadomości Lekarskie
The aim: Improve the treatment outcomes of patients with fluid collections following acute pancre... more The aim: Improve the treatment outcomes of patients with fluid collections following acute pancreatitis using an ultrasound-guided puncture and catheter drainage methods. Materials and methods: 67 patients with acute pancreatitis complicated by fluid collections were divided into two groups. The first group (comparison group) consisted of 32 patients who underwent percutaneous ultrasound-guided puncture and catheter drainage interventions in addition to conservative therapy. The second group (control group) consisted of 35 patients receiving conservative therapy. The age of patients was from 18 to 77 years. In the comparison group among 32 patients there were 19 women and 13 men, the average age consisted 48.2 ± 2.2 years. In the control group among 35 patients there were 21 women and 14 men, the average age of patients consisted 47.1 ± 2.3 years. Results: The mortality rate in the comparison group was 2 (6.2%) cases, in the control group – 4 (11.4%) cases (p <0.05). Infection of...
PubMed, 2022
Objective: The aim: To analyze the frequency of complications of echinococcal cysts of the liver,... more 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.
Acta Facultatis Medicae Naissensis, 2022
Introduction: Neutrophil-lymphocyte ratio (NLR) is one of the laboratory biomarkers used in clini... more Introduction: Neutrophil-lymphocyte ratio (NLR) is one of the laboratory biomarkers used in clinical practice to predict severity and mortality of acute pancreatitis (AP), however, there is currently insufficient information about the changes of NLR in the dynamics in relationship with other clinical and laboratory data. Aims: To assess the relationship between NLR values and other demographics, clinical and simple laboratory data in patients with acute pancreatitis. Methods: The data of two hundred twenty-nine patients with AP were analyzed. All patients were divided into two groups: the group with a positive outcome and the group with a fatal outcome. NLR was counted on the 1 st , 3 rd and 5 th day after admission in each group. The dynamics of NLR index by groups and days, as well as its correlation with other 18 simple laboratory parameters were evaluated. Results: The level of NLR rate itself was significantly higher on the 1 st , 3 rd and 5 th day in the group with the fatal result compared with the group with the positive result (p < 0.05). In patients with AP with the positive result of treatment, there was a gradual decrease in the rate between the 1 st and the 3 rd day (-21.8%) (p < 0.05). The overall dynamics of the indicator between the 1 st and the 5 th day was-21.5%. In contrast to the group of patients with the fatal outcome, despite the infusion therapy, there was an increase in NLR rate between the 1 st and 3 rd day of +15.7%. The overall dynamics between the 1 st and 5 th day was-34.0%. A significant negative relationship of the Spearman's rank correlation coefficient between NLR on the 1 st and 3 rd day with the fatal outcome was revealed. The highest reliability of this indicator was found on the 3 rd day after admission (p < 0.0001). In the group of patients with a positive result, a correlation between NLR on the 1 st day and stabs on the 1 st day, segmental forms on the 1 st day, serum amylase on the 1 st day was found. A very high correlation was found with the level of lymphocytes on the 1 st day (rs =-0.98, p < 0001). In the group of patients with the fatal outcome, a statistically significant correlation (p < 0.05) of moderate strength was found between the value of NLR and the following indicators: glucose level on the 1 st day, total protein on the 5 th day, prothrombin index on the 5 th day. A high correlation was found with the level of segmental forms on the 1 st day (rs = 0.7) and a very high correlation with the level of lymphocytes on the 1 st day (rs =-0.99). Conclusions: There was a significant increase in NLR on the 1 st , 3 rd , and 5 th day in the group of patients with AP with the fatal outcome compared with the group of patients with AP with the positive result. Elevated NLR levels on the 1 st and 3 rd day seem to be associated with hospital mortality in patients with AP. No correlation was found between NLR rate and clinical data in the group with fatal outcome. The main indicators among simple laboratory parameters for determining the predictors of lethal outcome in AP in different periods after hospitalization were: the level of blood glucose, lymphocytes, total protein, serum amylase, prothrombin index.
Клінічна анатомія та оперативна хірургія, Aug 29, 2019
Кафедра загальної хірургії (зав.-проф. С.Д. Хіміч) Вінницького національного медичного університе... more Кафедра загальної хірургії (зав.-проф. С.Д. Хіміч) Вінницького національного медичного університету імені М.І. Пирогова АНАЛІЗ ОСОБЛИВОСТЕЙ ДІАГНОСТИКИ ТА ЛІКУВАННЯ УСКЛАДНЕНИХ ФОРМ ХОЛЕЦИСТИТУ Резюме. Метою дослідження стало проведення аналізу результатів обстеження і лікування хворих на біліарну патологію та виявлення особливостей діагностики і лікувальної тактики у хворих з ускладненими формами холециститу. Аналіз результатів обстеження і хірургічного лікування основано на 704 хворих, що страждали на холецистит, які знаходилися на лікуванні в клініках загальної хірургії Вінницького національного медичного університету імені М.І. Пирогова в період з 2014 по 2018 рр. Виявлено, що на якість діагностики та хірургічної тактики впливає наявність супутньої патології (ожиріння, асцит), анатомо-топографічні особливості органів та рівень знання лікарями УЗД хірургічної патології. Ключові слова: холецистит, холецистектомія, лапароскопічна холецистектомія у людей зі зворотнім розташуванням внутрішніх органів. Надійшла 14.05.2019 р. Рецензент-проф. Полянський І.Ю. (Чернівці)
Acta Facultatis Medicae Naissensis, 2022
The aim of the study was to evaluate the assoсiation of mortality in acute pancreatitis with clin... more The aim of the study was to evaluate the assoсiation of mortality in acute pancreatitis with clinical and simple laboratory data received on the day of admission. Patients and methods. In our retrospective study, the clinical and laboratory parameters of 99 patients with moderate and severe acute pancreatitis were analyzed. All patients were divided into two groups: deceased and survivors. Results. We did not find a significant difference in age and gender distribution between the comparison groups. However, a significant predominance of alcoholic etiology of acute pancreatitis, early hospitalization (up to 6 hours from the onset of the disease) of patients, and the number of necrotizing infected type in the deceased group were found. Concomitant pathology did not significantly differ in comparison groups. In patients from the deceased group, the total number of all complications was significantly higher than in the group of survivors-21 (100%) and 42 (53.8%) (p = 0.0001), respecting. Among the laboratory parameters determined on the day of admission, in the deceased group, there was a significant increase in stabs to 19.8 ± 9.8 and ESR, AST to 225.3 ± 47.5 U/L, urea to 11.2 ± 7.7 mmol/L, and creatinine to 173.6 ± 26.1 mmol/L. Conclusion. The alcoholic genesis of acute pancreatitis, necrotizing infected type of inflammation of the pancreas, presence of late complications, and comorbidities were significantly higher in the deceased group. The levels of stabs, ESR, AST, urea, and creatinine determined on the admission significantly dominated in the deceased group, which requires further study for the prediction of mortality of acute pancreatitis.
Харківська хірургічна школа, Mar 20, 2021
дослідження-проаналізувати результати лікування хворих з ехінококозом печінки. Матеріали та метод... more дослідження-проаналізувати результати лікування хворих з ехінококозом печінки. Матеріали та методи. Проаналізовано результати лікування 76 хворих з ехінококозом печінки: жінок-66 (86,8%), чоловіків-10 (13,2%). Первинний ехінококоз був виявлений у 73 (96,1%) хворих, вторинний-у 3 (3,9%). Серед інструментальних методів дослідження діагностичне значення мали ультразвукове та комп'ютерно-томографічне обстеження. Поодинокі кісти печінки виявлені у 66 (86,8%) хворих, множинні-у 10 (13,2%). Серед хворих з солітарними кістами права доля печінки вражалась частіше ніж ліва-56 (73,7%) хворих проти 20 (26,3%). Ускладнення ехінококозу відзначено у 16 (21,1%) пацієнтів. Серед них найчастішими були: нагноєння кісти-у 13 (17,1%); прорив кісти у вільну черевну порожнину-у 1 (1,3%), у плевральну порожнину-у 1 (1,3%), в біліарний тракт-у 1 (1,3%) випадку. У 20 (26,3%) хворих операцію виконували з верхньо-серединного доступу, у 46 (60,5%)-з косих підреберних доступів за Кохером або за Федоровим. Періцистектомія була виконана у 52 (68,4 %) хворих, у 8 (10,5 %) пацієнтів були виконані резекції сегментів печінки з ехінококовою кістою, у 4 (5,3 %)-розкриття кісти з видаленням вмісту й обробкою її порожнини. Лапароскопічну ехінококектомію застосували у 12 (15,8 %) хворих. У післяопераційному періоді у 16 (21,1 %) хворих виявлені ускладнення. Використання зварювального електрокоагулятора ЕК-300М «Свармед» при термічній санації стінок залишкової порожнини після ехінококектомії дозволило зменшити крововтрату з (2200,0 ± 210,0) до (250,0 ± 50,0) мл, а кількість рецидивівз 2,8 до 0,0 %. До і після операції проводили протирецидивну антипаразитарну терапію альбендазолом (Ворміл) у два цикли по 28 днів, розділених 14-денною перервою. Доза при масі тіла більше 60 кг становила 400 мг 2 рази/добу, а при вазі менше 60 кг препарат призначали із розрахунку 15 мг/кг/добу. Результати та обговорення. При застосуванні лапароскопічної ехінококектомії вдалося зменшити інтраопераційну крововтрату у 9 разів (р=0,0001); тривалість операції-у 2 рази (р> 0,05), перебування у стаціонарі-у 3,3 разу (р = 0,002). Летальних випадків не було. Висновки. Перицистектомія є ефективною операцією щодо повного одужання та не дає рецидивів захворювання. Застосування зварювального електрокоагулятора та лапароскопічна ехінококектомія суттєво покращують результати лікування хворих із паразитарними кістами печінки.
Wiadomości lekarskie (Warsaw Poland), 2021
The aim: Improve the treatment outcomes of patients with fluid collections following acute pancre... more The aim: Improve the treatment outcomes of patients with fluid collections following acute pancreatitis using an ultrasound-guided puncture and catheter drainage methods. Materials and methods: 67 patients with acute pancreatitis complicated by fluid collections were divided into two groups. The first group (comparison group) consisted of 32 patients who underwent percutaneous ultrasound-guided puncture and catheter drainage interventions in addition to conservative therapy. The second group (control group) consisted of 35 patients receiving conservative therapy. The age of patients was from 18 to 77 years. In the comparison group among 32 patients there were 19 women and 13 men, the average age consisted 48.2 ± 2.2 years. In the control group among 35 patients there were 21 women and 14 men, the average age of patients consisted 47.1 ± 2.3 years. Results: The mortality rate in the comparison group was 2 (6.2%) cases, in the control group-4 (11.4%) cases (p <0.05). Infection of fluid collections developed in 2 (6.2%) patients of the comparison group and in 5 (14.3%) patients of the control group. The average length of stay in the hospital of patients in the comparison group was 24.13 ± 2.17 days, in the control group 28.11 ± 1.05 days (p <0.05). Also in the comparison group there was a faster normalization of clinical and laboratory indicators (level of leukocytes, serum amylase, C-reactive protein) (p <0,05). Conclusions: the use of percutaneous ultrasound-guided puncture and catheter drainage methods has reduced mortality and improved treatment outcomes in patients with acute pancreatitis complicated by fluid collections
Wiadomości lekarskie (Warsaw Poland), 2022
The aim: To identify the association of clinical and simple laboratory data determined during hos... more The aim: To identify the association of clinical and simple laboratory data determined during hospitalization of the patient with severity of acute pancreatitis. Materials and methods: Clinical and laboratory parameters of 229 patients with acute pancreatitis were analyzed. All patients were divided into two groups depending on the severity of acute pancreatitis: in the group with mild AP were 130 (56.8%) patients and the group, which included moderately severe and severe degree of AP consisted of 99 (43.2%) patients. Results: The association of the age group of 61-70 years with the severity of acute pancreatitis was revealed (p 0.05). We did not find an association between the causes of acute pancreatitis and its severity. In the group with moderate-severe acute pancreatitis, the frequency of concomitant pathology was significantly higher than in the group with mild acute pancreatitis – 92.9% (92) and 78.5% (102) cases (p<0.05). The association between the severity of acute pancreatitis and the following laboratory parameters: blood sugar, leukocyte levels, the level of stabs, lymphocytes, total protein, serum amylase, urinary diastase, creatinine, ALT, AST, prothrombin index, neutrophil-lymphocyte ratio was revealed (p<0.05). Conclusions: The study did not reveal a significant difference between compared groups in the time of hospitalization; found no association between the causes of acute pancreatitis and its severity. Instead, the association between female sex, the presence of concomitant pathology and some routine laboratory findings with the severity of acute pancreatitis was proved.
Klinichna khirurhiia, 2017
The comparative analysis data were presented, concerning the results of complex treatment of 28 p... more The comparative analysis data were presented, concerning the results of complex treatment of 28 patients, suffering ischemic-gangrenous form of the diabetic foot syndrome, developing on background of chronic ischemia of the lower extremities stage IV. In 14 patients (main group) a routine complex of the treatment measures was added by application of an active pressure (negative pressure wound therapy - NPWT) and a capicor preparation; 14 patients (the comparison group) were treated in accordance to routine scheme. In accordance to the comparative analysis data, in patients of the main group the wound surface sarea have kept reducing in twice more rapid, than in a comparison group, the wounds healing was achieved in 94% patients, duration of the patients’ stationary stay have reduced by (5.2 ± 1.4) days.
Wiadomości lekarskie (Warsaw Poland), 2023
The aim: To evaluate efficacy of the tissue defect closure techniques in combination with VAC in ... more The aim: To evaluate efficacy of the tissue defect closure techniques in combination with VAC in the treatment of battle casualities of the lower extremities. Materials and methods: The results of wound healing until complete wound closure, of 62 patients with shrapnel defects of the lower extremities where assessed. Results: Treatment of patients with soft tissue defects of the lower extremities using rotational flaps on the vascular pedicle and VAC significantly reduces the incidence of infectious complications (18.75% in the main group vs. 30% in the control group (p<0.05)), reduces the intensity of pain according to the VAS scale during the first week of treatment in the main group to 5±0.5 versus 7±0.8 in the control group (p<0.05) and reduces the length of hospital stay by 7 days. Conclusions: The use of rotational flaps on the vascular pedicle and local tissue closure techniques in combination with VAC is an effective method of treating patients with combat gunshot wounds of the soft tissues of the lower extremities
Acta Facultatis Medicae Naissensis
Introduction: Neutrophil-lymphocyte ratio (NLR) is one of the laboratory biomarkers used in clini... more Introduction: Neutrophil-lymphocyte ratio (NLR) is one of the laboratory biomarkers used in clinical practice to predict severity and mortality of acute pancreatitis (AP), however, there is currently insufficient information about the changes of NLR in the dynamics in relationship with other clinical and laboratory data. Aims: To assess the relationship between NLR values and other demographics, clinical and simple laboratory data in patients with acute pancreatitis. Methods: The data of two hundred twenty-nine patients with AP were analyzed. All patients were divided into two groups: the group with a positive outcome and the group with a fatal outcome. NLR was counted on the 1st, 3rd and 5th day after admission in each group. The dynamics of NLR index by groups and days, as well as its correlation with other 18 simple laboratory parameters were evaluated. Results: The level of NLR rate itself was significantly higher on the 1st, 3rd and 5th day in the group with the fatal result co...
Acta Facultatis Medicae Naissensis
Aims. The aim of the study was to evaluate the association of mortality in acute pancreatitis wit... more Aims. The aim of the study was to evaluate the association of mortality in acute pancreatitis with clinical and simple laboratory data received on the day of admission. Patients and methods. In our retrospective study, the clinical and laboratory parameters of 99 patients with moderate and severe acute pancreatitis were analyzed. All patients were divided into two groups: deceased and survivors. Results. We did not find a significant difference in age and gender distribution between the comparison groups. However, a significant predominance of alcoholic etiology of acute pancreatitis, early hospitalization (up to 6 hours from the onset of the disease) of patients, and the number of necrotizing infected type in the deceased group were found. Concomitant pathology did not significantly differ in comparison groups. In patients from the deceased group, the total number of all complications was significantly higher than in the group of survivors-21 (100%) and 42 (53.8%) (p = 0.0001), res...
Wiadomości Lekarskie, 2022
The aim: To identify the association of clinical and simple laboratory data determined during hos... more The aim: To identify the association of clinical and simple laboratory data determined during hospitalization of the patient with severity of acute pancreatitis. Materials and methods: Clinical and laboratory parameters of 229 patients with acute pancreatitis were analyzed. All patients were divided into two groups depending on the severity of acute pancreatitis: in the group with mild AP were 130 (56.8%) patients and the group, which included moderately severe and severe degree of AP consisted of 99 (43.2%) patients. Results: The association of the age group of 61-70 years with the severity of acute pancreatitis was revealed (p 0.05). We did not find an association between the causes of acute pancreatitis and its severity. In the group with moderate-severe acute pancreatitis, the frequency of concomitant pathology was significantly higher than in the group with mild acute pancreatitis – 92.9% (92) and 78.5% (102) cases (p<0.05). The association between the severity of acute panc...
Wiadomości Lekarskie
The aim: To evaluate efficacy of the tissue defect closure techniques in combination with VAC in ... more The aim: To evaluate efficacy of the tissue defect closure techniques in combination with VAC in the treatment of battle casualities of the lower extremities. Materials and methods: The results of wound healing until complete wound closure, of 62 patients with shrapnel defects of the lower extremities where assessed. Results: Treatment of patients with soft tissue defects of the lower extremities using rotational flaps on the vascular pedicle and VAC significantly reduces the incidence of infectious complications (18.75% in the main group vs. 30% in the control group (p<0.05)), reduces the intensity of pain according to the VAS scale during the first week of treatment in the main group to 5±0.5 versus 7±0.8 in the control group (p<0.05) and reduces the length of hospital stay by 7 days. Conclusions: The use of rotational flaps on the vascular pedicle and local tissue closure techniques in combination with VAC is an effective method of treating patients with combat gunshot woun...
Reports of Vinnytsia National Medical University, Jun 27, 2019
Анотація. Мета роботи-проаналізувати результати хірургічного лікування гриж з використанням різни... more Анотація. Мета роботи-проаналізувати результати хірургічного лікування гриж з використанням різних способів герніопластики. Проаналізовано результати лікування 176 хворих з грижами живота, які були під спостереженням з 1995 по 2008 роки. Хворих було розподілено на 2 групи. У першу групу (85 хворих) увійшли пацієнти, яким хірургічне лікування проводили з аутодермальною пластикою. Другу групу (91 хворий) становили пацієнти, яким проводили герніопластику з використанням сітчастих алотрасплантатів. Усіх хворих комплексно обстежували. У пацієнтів з ожирінням використовували антимікробну плівку для заклеювання шкіри під молочними залозами та "складками живота" з метою профілактики мікробного забруднення рани. У всіх оперованих хворих відмічли звичний післяопераційний стан, а післяопераційний період в обох групах був практично однаковим. Ускладнень зі сторони післяопераційної рани у хворих 1-ї групи ми не спостерігали. Рани заживали первинним натягом. Усі хворі були виписані на 8-10 добу в задовільному стані. Відмічено 2 рецидиви: у однієї хворої через 1 місяць після операції, у другої-через 10 років. У 2-й групі, у пацієнтки з ІІ ступенем ожиріння спостерігали нагноєння післяопераційної рани. Середня кількість ліжко-днів у 2-й групі був приблизно таким же як і в 1-й групі. Статистично достовірно збільшувався ліжко-день з ростом ступеня ожиріння у даних пацієнтів. Таким чином, застосування сітчастих алотрансплантатів є ефективним методом лікування гриж і вони повинні використовуватись строго за показами. Аутодермальна пластика із застосуванням шкіряного клаптя є також надійним хірургічним методом лікування гриж. Достовірної різниці в показниках при лікуванні хворих обох груп (за вийнятком вартості сітчастих алотрансплантатів) не виявлено.
Wiadomości Lekarskie
The aim: Improve the treatment outcomes of patients with fluid collections following acute pancre... more The aim: Improve the treatment outcomes of patients with fluid collections following acute pancreatitis using an ultrasound-guided puncture and catheter drainage methods. Materials and methods: 67 patients with acute pancreatitis complicated by fluid collections were divided into two groups. The first group (comparison group) consisted of 32 patients who underwent percutaneous ultrasound-guided puncture and catheter drainage interventions in addition to conservative therapy. The second group (control group) consisted of 35 patients receiving conservative therapy. The age of patients was from 18 to 77 years. In the comparison group among 32 patients there were 19 women and 13 men, the average age consisted 48.2 ± 2.2 years. In the control group among 35 patients there were 21 women and 14 men, the average age of patients consisted 47.1 ± 2.3 years. Results: The mortality rate in the comparison group was 2 (6.2%) cases, in the control group – 4 (11.4%) cases (p <0.05). Infection of...