Summary. The aim of the work was to compare the results of surgical treatment of patients for postoperative abdominal abscesses using different tactics. Materials and methods. The study included data from 63 patients with postoperative abdominal abscesses. Laparotomy access and use of percutaneous puncture / drainage were compared. Kaplan-Meier survival analysis was used to compare hospitalization duration. Results. Laparotomic access was performed according to classical methods. After the application of general anesthesia and treatment of the surgical field was performed opening the anterior abdominal wall. The abscess was opened and the contents were aspirated, after treatment of the cavity site with aqueous solutions of antiseptics, the wound was closed and the drainage system was established. Further stages of treatment of intra-abdominal abscess after routine surgery were: aspiration of abscess in the postoperative period through established drainage; diagnostic control of abscess resolution; effective antimicrobial and detoxification therapy. Percutaneous puncture / abscess drainage was performed under ultrasound control using special puncture needles of size F8 - F12. The needle or drainage stlet-catheter was inserted into the abscess cavity, followed by aspiration of the abscess contents and leaving the drainage system. Kaplan-Maier has reduced hospitalizations in patients who have used mini-invasive technologies. Conclusions. Treatment of postoperative abdominal abscesses involves a surgical approach. Patients with postoperative abscesses who underwent laparotomy access were likely to have an increased total hospitalization duration of 5 days compared with the use of mini-invasive technologies.

Summary. The aim of the study is to develop a method of immunocorrection, which improves the results of treatment of patients with developed peritonitis against the background of the small intestine anastomosis leakege by stopping the cascade of SIRS and MOF. Materials and methods. The work was clinical in nature, was performed in the clinic of the SI «ZIGUS NAMSU» in the period from 2016 to 2019. We examined 58 patients with various diseases of the abdominal organs complicated by peritonitis, in which sections of the small intestine were resected. The Comparison Group included patients who received traditional therapy, patients of the Main Group, the complex of drug therapy included recombinant interleukin-2, galavit and α-lipoic acid. The results of surgical treatment were evaluated according to the classification of D. Dindo, N. Demartinesta, P.-A. Clavien (2004). Statistical analysis was removed from the Statistica 6.0 software (StatSoft, Inc. 2001) and SPSS 7.5 on Apple PC. Results and Discussion. Thus, the results of the use of a comprehensive immunomodulation scheme using IL-2, galavit and α-lipoic acid in the complex treatment of patients with widespread peritonitis against the background of intestinal anastomosis failure suggest that the developed scheme has a targeted immunoregulatory effect and prevents the excess production of inflammatory mediators in the early postoperative the period of the disease, helps to eliminate the cytokine imbalance and prevents the development of secondary immune deficiency. A comparative analysis of the incidence of complications revealed that in patients of the Main Group the average number of complications per patient was 0.53, while in the Comparison Group this indicator was 1.36. Conclusions. The use of a combination of IL-2, galavit and α-lipoic acid in the complex of treatment of common peritonitis helps to reduce the level of systemic and local postoperative complications, as well as the level of postoperative mortality.

Objective. Elaboration of effective and informative method of the small intestine viability determination for improvement of the surgical treatment results in pathologies, which need performance of resection of its segments. Materials and methods. The work is considered as experimentally-clinic one. Its experimental part was conducted on the rats; temporary ischemia was simulated, using application of tourniquet on the intestinal loop, taken from abdominal cavity after doing laparotomy; the animals were distributed on the groups, depending on the ischemia duration applied. Clinical part of the investigation was performed on 68 patients, including a control group of 50 patients, in whom intestinal resection was done, taking into account subjective estimation of the gut viability, and the main group, consisted of 18 patients, in whom intestinal resection was performed, basing on the gut viability estimation data, obtained using the method elaborated. Results. In the animals, on which temporary noncritical ischemia (up to 10 min) was simulated, the ischemia zone did not differed visually from other intestinal segments, while after persistence of ischemia up to 20- and 25-min the changes have had appeared necrotic with presence of peritonitis. Studying of intestinal specimen in the animals, in whom an acute ischemia was simulated, have shown the mostly expressed changes in endotheliocytes of microcirculatory bed, depending on duration of the ischemia dystrophic changes have been enhanced up to destructive. Total electric resistance (іmpedance) was measured on various frequencies. On all the frequencies, the raising of total electric resistance with more durable ischemia period was observed. Conclusion. Changes of total electric resistance are reflecting the degree of the blood flow disorder in intestinal wall and may be exploited as a criterion of determination of its viability (capacity of the anastomosis to heal). Objectivization of estimation of the intestinal wall state reduces the quantity of resection of injured intestinal segment and the morbidity.