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Документ The problem of the surgical treatment of non-specific chronic pleural empyema: literature review(ДУ "Інститут загальної та невідкладної хірургії імені В. Т. Зайцева НАМН України", 2020) Sochnieva, Anastasiia LvovnaDespite the rapid development of thoracic surgery, the problem of the surgical treatment of non-specific chronic pleural empyema remains relevant. The variability of the proposed treatment methods: puncture and drainage interventions aimed at pleural cavity sanitation, minimally invasive videothoracoscopic surgeries and traditional lung decortication, dictates the need for case-by-case surgical tactics and determining the stages and duration of the above methods. Treatment outcomes are significantly worsened by the presence of bronchial fistulas, which either cause the development of chronic pleural empyema or develop as a result of its presence and late treatment. Some answers to these key questions are provided in this paper, which aims to identify them in the Ukrainian and foreign literature.Документ Comparison of the intensity of pain in patients with acute cholecystitis with different types of surgical accesses(KRPOCH Publishing House, 2021) Hordiienko, Polina Oleksiivna; Sochnieva, Anastasiia LvovnaBackground: Topicality is related to the widespread prevalence of acute cholecystitis as one of the surgical pathologies. There are 3 types of surgical access for cholecystectomy: laparotomy, laparoscopic and mini-laparotomy in the right hypochondrium. At the postoperative period, patients complain of the pain that occurs at the site of the surgical wound. Intensity of pain depends on the type of surgery. The aim of the study: To analyze and compare the intensity of postoperative pain in different types of surgical accesses in patients with acute cholecystitis. Methods: The study was performed at the State Institution “V. T. Zaitsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine” on the treatment of acute cholecystitis from 2019 to 2021. 30 case histories of patients with acute cholecystitis were analyzed. Patients were divided into 3 groups: Group I - 24 (80.00%) patients underwent laparoscopic cholecystectomy, Group II – 5 (16.67%) – with mini-access and Group III – 1 (3.33%) – laparotomy due to the pronounced adhesion process of the abdominal organs. The intensity of pain was assessed by using a Visual Analog scale. Results: According to the results of the assessment of pain intensity by Visual Analog scale: patients of Group I on the 2nd day after surgery noted pain at the level 50±8.75 mm, on the 5th day – 0 mm, patients of the II Group on the 2nd day – 70±9.32 mm, on the 5th day – 20±5.88 mm. Group III on 2nd day – 90±8.85 mm, on 5th day – 40±2.87 mm. Conclusions: The use of laparoscopic access in the surgical treatment of acute cholecystitis improves the quality of life of patient in the postoperative period and reduces pain.Документ Biliary decompression in patients with obstructive jaundice(KRPOCH Publishing House, 2021) Boyko, Valeriy Volodymyrovych; Avdosyev, Yuriy Vladimirovich; Sochnieva, Anastasiia Lvovna; Yevtushenko, Denys Oleksandrovych; Minukhin, Dmytro Valeriiovych; Shevchenko, Oleksandr MykolaiovychBackground: Benign and malignant diseases of bile ducts usually cause mechanical jaundice. The aim of the study: To determine the optimal duration of percutaneous transhepatic biliary drainage (PTBD) depending on the duration of mechanical jaundice and the initial level of total bilirubin in the serum. Methods: This paper presents the experience of using PTBD in 88 patients with benign and malignant diseases of bile ducts complicated by mechanical jaundice, who were hospitalized at the State Institution “V. T. Zaitsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine” from 2011 to 2017 years. Patients were divided into three groups. The first group consisted of 15 (17.1%) patients with benign diseases of the biliary tract. The second group consisted of 11 (12.5%) patients with resectable cholangiocarcinomas. The third group – 62 (70.4%) patients with unresectable cholangiocarcinomas. Results: For patients of group 1, the process is somewhat slower, but the end result is also quite strongly influenced by the initial level of total bilirubin. The duration of biliary decompression in this category of patients averages 10-12 days. For patients in group 2, biliary decompression requires at least 12 days, but the result is not significantly affected by the initial level of total bilirubin and the duration of obstructive jaundice. Conclusions: Using the Poisson process, or more precisely the quasi-Poisson distribution, it was possible to determine the optimal duration of biliary decompression by using PTBD depending on the duration of obstructive jaundice and the initial level of total serum bilirubin.Документ Treatment of bronchial fistula associated with non-specific chronic pleural empyema (review)(Харківський національний медичний університет, 2021) Boyko, Valeriy Vladimirovich; Krasnoyaruzhsky, A. G.; Sochnieva, Anastasiia LvovnaThe purpose of the study was to identify the prevalence of allergic rhinitis (AR) symptoms in children of Kharkiv and to establish the dynamics of symptoms since 1998. The study conducted in 2015–2017 is phase IV of the international ISAAC program. 5735 children were interviewed, including 3238 children aged 6–7 years and 2197 children aged 13–14 years. The incidence of non-cold-related sneezing was found in 14.7 % and 16.1 %, respectively; during the past 12 months similar problems with nose breathing were noted in 9.1 % and 9.9 %; accompanied by conjunctivitis – in 3.4 % and 4.8 % of children of 6–7 and 13–14 years, respectively. Most patients had seasonal exacerbations and mild/moderate rhinitis. AR diagnosis was verified in 12.2 % and 11.3 % of children, respectively. Decreasing of AR symptoms prevalence was found in children of all ages. The dynamics of AR symptoms prevalence, "eye" symptoms over the past 20 years show a probable decrease in all indicators, which can be explained by the widespread introduction in medical practice of screening methods for the disease diagnosing, activation of primary and secondary prevention.Документ The problem of the surgical treatment of non-specific chronic pleural empyema: literature review(ДУ "Інститут загальної та невідкладної хірургії імені В. Т. Зайцева НАМН України", 2020) Sochnieva, Anastasiia LvovnaDespite the rapid development of thoracic surgery, the problem of the surgical treatment of non-specific chronic pleural empyema remains relevant. The variability of the proposed treat-ment methods: puncture and drainage interventions aimed at pleural cavity sanitation, minimally invasive videothoracoscopic surgeries and traditional lung decortication, dictates the need for case-by-case surgical tactics and determining the stages and duration of the above methods. Treatment outcomes are significantly worsened by the presence of bronchial fistulas, which either cause the development of chronic pleural empyema or develop as a result of its presence and late treatment. Some answers to these key questions are provided in this paper, which aims to identify them in the Ukrainian and foreign literature.Документ Outcomes of surgical reconstruction of the superior vena cava syndrome in patients with locally advanced thymomas(Scientific Route OÜ, Estonia, 2021) Boyko, Valeriy; Krasnoyaruzhskyi, Andriy; Minukhin, Dmytro; Dubovyk, Dmytro; Ponomarova, Kateryna; Sochnieva, Anastasiia Lvovna; Kritsak, VasilThe aim of the study: to study and demonstrate the potential and technical aspects of the surgical treatment of locally advanced thymus tumours with the tumour infiltrate affecting superior vena cava and its branches. Methods. 56 patients with locally advanced thymomas complicated by SVCS were study. The control group included 30 patients with SVCS were treated with conventional techniques, while the experimental group included 26 patients who underwent a novel bypass surgery developed by us. Results. Based on our observations, patients tolerated these surgeries much better. The venous bypass was mandatorily complemented with cytoreduction. Auriculo-jugular (left and right) and auriculo-subclavian (left and right) bypasses were used in our observations Complications in the post-operative period were reported from the experimental group and included auriculo-subclavian bypass thrombosis, post-operative complications were reported in the control group including haemorrhage from the sternotomy wound in 1 (3.3 %) case, superior vena cava thrombosis in 2 (6.6 %) cases, pneumonia in 2 (6.6 %) cases and thromboembolism of small pulmonary arteries in 2 (6.6 %) cases. Post-operative lethality in the study groups was reported in the control and in the experimental group. Total lethality rate was 8.9 % (5 patients). The relative risk of complications and lethal outcome was calculated for patients from both groups. It was found that the risk of complications was twice as high in the control group as in the experimental group (standard error of relative risk equals 0.64), whereas the risk of lethal outcome increased by a factor of 3.5 in the control group (standard error of relative risk equals 1.09). Conclusion. It has been established that the superior vena cava syndrome in patients with locally advanced thymoma is an emergency condition whose surgical correction must be personalised depending on the anatomic and topographic classification of SVC lesion types. It is known that an obligatory pre-condition of the perioperative period in this category of patients is an adequate. Original Research Article: full paper vascular approach to the superior vena cava system. The first mandatory step of the radical surgery in patients with locally advanced thymomas with SVC invasion should be the auriculo-jugular and auriculo-subclavian bypasses, which can reduce the relative risk of post-operative complications by a factor of the risk of lethal by a factor of 3.5.Документ Assessment of ultrasound effectiveness for the diagnostics of common bile duct diseases complicated by obstructive jaundice(Харківська обласна громадська організація "Культура здоров'я", 2019) Boyko, Valeriy Vladimirovich; Avdosyev, Yuriy Vladimirovich; Sochnieva, Anastasiia Lvovna; Yevtushenko, Denys OleksandrovychUltrasound is the first-priority screening test in the diagnostics of common bile duct diseases that enables the differentiation of jaundice genesis and determination of indications and contraindications for further non-invasive and invasive tests. The aim of research is to determine the effectiveness of ultrasound for the diagnostics of common bile duct diseases complicated by obstructive jaundice (OJ).Документ Combined antegrade and retrograde approaches for the treatment of "endoscopically complex" forms of choledocholithiasis: clinical cases(Харківська обласна громадська організація "Культура здоров'я", 2018) Boyko, Valeriy; Avdosyev, Yuriy; Makarov, Vitaliy; Hroma, Vasil; Sochnieva, Anastasiia LvovnaДокумент Treatment of common bile duct diseases complicated by obstructive jaundice (review)(Харківський національний медичний університет, 2018) Sochnieva, Anastasiia LvovnaThe article presents the up-to-date data concerning the treatment of common bile duct diseases complicated by obstructive jaundice. Nowadays, specialized clinics widely use mini-invasive interventions to treat this complicated pathology. Biliary tree decompression is the main objective of operative treatment. It is reasonable to perform antegrade and retrograde endobiliary interventions as preparatory and final stages of surgical treatment and in order to improve the patients' life quality and avoid hepatic impairment progression. Reconstructive-reparative operations following prior biliary decompression yield significantly better results as compared to surgical interventions without it.Документ Results of radical surgical treatment of cholangiocarcinomas(Scientific Route OÜ, Estonia, 2017) Boyko, Valeriy; Avdosyev, Yuriy; Sochnieva, Anastasiia LvovnaRadical operations of cholangiocarcinomas are connected with the great number of post-operative complications, and lethality reaches 15−30 %. The most debatable questions remain the choice of the operation type depending on localization and spreading of a tumor and also the expedience of using mini-invasive technologies as a preoperational preparation to the radical surgical treatment. We would like to share the little experience of the radical surgical treatment of cholangiocarcinomas. The research aimis to analyze results of radical surgical treatment of patients with cholangiocarcinoma. Matherials and methods. We have analyzed the outcomes of surgical treatment in 18 patients with cholangiocarcinomas. Tumor localization was determined according to the Bismuth-Corlett classification. Type 1 tumors were found in 2 (11.1 %), type 2 in 4 (22.2 %), type 3А in 5 (27.8 %), type 3B in 4 (22.2 %), type 4 in 1 (5.6 %), and distal localization in 2 (11.1 %) patients. As biliary decompression, 9 (50 %) patients underwent percutaneous transhepatic biliary duct drainage (PTBD), and another 9 (50 %) patients were operated without preoperative biliary decompression Pre-operative embolization of portal vein branches with the aim to in-crease the low volume of liver after anticipated resection was performed in 4 (22.2 %) patients. Results. After the embolization of portal vein branches, the estimated residual volume of hepatic parenchyma increased from 33.4 % to 45.7 %. Patients with cholagiocarcinomas of different localization performed the radical operations: isolated hepaticocho-ledochus resection in 5 (27.8 %) patients, hepaticocholedochus resection combined with Taj Mahal hepatic resection in 1 (5.6 %), right hemihepatectomy in 5 (27.8 %), left hemihepatectomy in 4 (22.2 %), extended right hemihepatectomy in 1 (5.6 %), and pancreoduodenal resection in 2 (11.1 %) patients. Complications of radical surgeries were observed in 4 (22.2 %) patients. Lethal outcomes occurred in 3 (16.7 %) patients. Conclusions. Radical operations are attended with complications in 22.2 % and lethality in 16.7 %. As a preoperative prepa-ration it is possible to use mini-invasive interventions for the biliary decompression and increase of hepatic parenchyma volume.