Zavgorodniy S. M., Kubrak M. A., Danilyk M. B., Rylov A. I.
Improving the diagnosis of combined pathology, developing indications and contraindications to these operations, assessing and substantiating the benefits of these surgeries are pressing issues in the current world medical literature. Aim of the study. Conduct a comparative analysis of the results of diagnosis and treatment of patients after isolated two-stage and simultaneous surgical interventions for endocrine and combined surgical pathology. Object and methods. According to the developed algorithm of diagnostics 318 patients were examined. 71 (22.3%) revealed 1 to 3 concomitant surgical diseases. 64 (90.1%) patients underwent simultaneous surgery. Results of the study. The overall level of complications in performing simultaneous interventions was 22.9%, and two stage operations – 28.7%, U = 85.0; p = 0.0419. The duration of hospital stay in the main group was 9.6 ± 1.7 days, the confidence interval (9.0; 10.2); in the comparison group – 16.5 ± 1.4 days, interval (15.8; 17.3), U = 8.0; p <0.0001. The time of surgery in the case of simultaneous and sequential isolated operations did not differ: 113.1 ± 23.7 minutes, confidence interval (105.0; 121.3) and 107.2 ± 21.7 minutes, confidence interval (96.4; 116.1) respectively, U = 543.5; p = 0.4196. When comparing the duration of anesthesiology, significant statistical changes were found: 141.7 ± 28.3 minutes, interval (131.9; 151.4) in the main group; 165.6 ± 31.9 minutes, interval (146.7; 178.9) in comparison group, U = 339.5; p = 0.0014. Conclusions. 1. An algorithm for diagnosis of combined surgical pathology in patients with diseases of the endocrine system was developed and put into practice, which allowed to increase the level of detection of concomitant surgical pathology from 7.2% to 22.3%, U = 25.5; p = 0.0016. 2. Performing a simultaneous surgical intervention in comparison with a two-stage operation reduced the length of hospitalization from 16.5 ± 1.4 days, confidence interval (15.8; 17.3) to 9.6 ± 1.7 days, interval (9, 0; 10.2), U = 8.0; p <0.0001; duration of anesthesiologic support from 165.6 ± 31.9 minutes, interval (146.7; 178.9) to 141.7 ± 28.3 minutes, confidence interval (131.9; 151.4), U = 339.5 ; p = 0.0014 and complication rate from 28.7% to 22.9%, U = 85.0; p = 0.0419. 3. Indicators of time of surgery in the case of simultaneous and consecutive isolated operations did not differ: 113.1 ± 23.7 minutes, confidence interval (105.0; 121.3) and 107.2 ± 21.7 minutes, confidence interval (96.4; 116.1), respectively, U = 543.5; p = 0.4196.
«Bulletin of problems biology and medicine» Issue 3 (152), 2019 year, 101-104 pages, index UDK 616-089.8-089.168-042.2
