Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

Objective. Improvement of quality of the patients’ treatment, who suffer chronic hemorrhoids Stages III-IV, applying ultrasound energy intraoperatively. Materials and metods. The results of treatment are presented of 129 patients, suffering chronic hemorrhoids Stages III-IV: in 58 of them ultrasound energy was applied (Group I - the main), and in 71 - a standard procedure was performed (Group II - a control one). Results. Average duration of the operation have constituted in patients of Group I - (15.8 ± 1.7) min, and in Group II - (38.6 ± 1.5) min (p < 0.05). Postoperatively the patients of Group I have complained of pain during (3.4 ± 0.2) days, while in the Group II - during (7.5 ± 0.5) days (p < 0.05). In the patients of Group I only nonnarcotic analgetics during (3.4 ± 0.2) days; while in the Group II narcotic preparations were needed (2.1 ± 0.2) days, and nonnarcotic - (5.4 ± 0.3) days. Postoperatively in the Group II patients the pain syndrome level on the first day have constituted (9.1 ± 0.4) points, what is in 2.4 times higher, than in Group I (p < 0.05). Average stationary stay have constituted in the operated patients of Group I (2.8 ± 0.2) days, and in the Group II - (4.3 ± 0.4) days (p < 0.05). Conclusion. Application of the ultrasound energy permits to shorten the operation duration, average duration of stationary stay of the patients, and to reduce the pain syndrome level. Also, while application of ultrasound, the necessity to use narcotic analgetics postoperatively is eliminated. The quality of life indices during 6 mo postoperatively were better in the patients, who were operated, using ultrasound, than in those, to whom classic hemorrhoidectomy was performed.

Мета. Дослідити якість життя (ЯЖ) хворих похилого та старечого віку після виконаних мініінвазивних оперативних втручань. Матеріали і методи. Проаналізовані показники фізичного та психологічного компонентів ЯЖ, оцінені за опитувальником Outcomes Study Short Fait (SF-36) у 255 хворих похилого та старечого віку із гострим холециститом (ГХ) у поєднанні з холедохолітіазом після мініінвазивного хірургічного лікування. Вибір способу корекції патології жовчовивідних шляхів залежав від клініко-морфологічної форми захворювання та вихідного соматичного статусу хворих. Результати. Показники фізичного компонента ЯЖ пацієнтів основної групи через 3 міс після операції були достовірно вищі порівняно з аналогічними показниками пацієнтів контрольної групи (р < 0,05). Показники психологічного компонента ЯЖ були вищі також у хворих основної групи (р > 0,05). Показники фізичного та психологічного компонентів ЯЖ у хворих основної та контрольної груп через 6 міс після оперативного втручання достовірно не відрізнялися. Висновки. Після застосування мініінвазивних лапароскопічних методик показники фізичного та психологічного компонентів ЯЖ, оцінені за опитувальником SF-36, кращі. ЯЖ хворих зі збереженою функцією великого сосочка дванадцятипалої кишки (ВСДПК) вища.

The purpose ofthe work — to study the epidemiological factors in the development of primary and secondary intra-abdominal infiltrates, abscesses and fluid formations in patients with concomitant diseases and diabetes. Material and methods. In the clinic of the Department of Surgical Diseases No. 1, on the basis of the Center of Surgery of the Kiev City Clinical Hospital No. 1 from 2006 to 2019,218patients with primary and secondary intra-abdominal infiltrates, abscesses and fluid formations were treated. The patients’ age ranged from 16 to 85 years. There were 107 male patients (49.08 %), 111 female patients (50.92 %). X-ray examination was performed in 112 (51.38 %) patients, computed tomography (CT) in 25 (11.48 %),ultrasound examination of the abdominal organs for 105 (4816 %) patients. Anterior abdominal wall thermometry was performed in 76 (34.86 %) patients. Resultsand discussion. Depending on the cause of the development of intra-abdominal infiltrates, abscesses and fluid formations, the patients were divided into 4 groups. Patients of the first, second and third groups had primary intra-abdominal complications, and in the fourth group patients had secondary postoperative complications. The first group included 74 (33.94 %) patients suffering from a complicated course of destructive appendicitis. The second group included 48 (22.02 %) patients suffering from perforated gastric ulcer and 12 duodenal ulcer. The third group included 69 (31.65 %) patients suffering from cholecystitis and various types of complications. The fourth group included 27 (12.39 %) patients who underwent urgent surgery due to strangulated hernias, adhesive obstruction. The study of the scales showed that: in 87 (39.91 %) the weight was within normal limits, and in 131 (60.09 %) patients were overweight and obese. It was found that 126 (57.80 %) patients wore glasses. Diseases of the cardiovascular system and arterial pressure disorders according to the data of case histories and anamnesis had 123 (56.42 %) patients. Diabetes was diagnosed in 38 (17.43 %) patients. Diseases of the musculoskeletal system were diagnosed in 27 (12.38 %) patients, and 48 (22.02 %) patients suffered from flat feet of various stages. Primary intra-abdominal complications(infiltrates and abscesses) were diagnosed in 191 (3.48 %) patients out of 5483 urgent hospitalizations and operations, of which 74 (1.35 %) with appendicitis, 69 (1.26 %), perforated gastric ulcer and 12 duodenal ulcer in 48 (0.87 %) patients. Secondary postoperative infiltrates, abscesses and fluid formations were found in 27 (18.12 %) of 149 patients who had undergone urgent abdominal surgery (adhesive obstruction, incarcerated and postoperative hernias, etc.), and in 29 (15.18 %) of 191 patients who underwent surgery for primary intra-abdominal complications of the underlying disease and urgent surgery. Diabetes mellitus was diagnosed in 38 (17.4 3%) patients, and therefore all patients who are hospitalized in an urgent and planned manner must undergo a comprehensive clinical and laboratory examination with the determination of blood sugar. The presence of established diabetes mellitus requires the consultation of an endocrinologist, and during the operation it is advisable and necessary to correct glycemic and volemic disorders, which continues until the restoration of vital functions and stabilization of the general condition of the patient. Intra-abdominal complications occurred on the background of concomitant diseases: overweight in 28.44 %, visual impairment in 57.80 %, diseases of the cardiovascular system and arterial pressure disorders in 56.42 %, diseases of the musculoskeletal system in 12.38 %, which indicates the need for an individual approach in the treatment of each patient.

Purpose – to improve the results of surgical treatment of patients with intra-abdominal infiltrates and abscesses through the introduction of the latest imaging methods and surgical technologies. Materials and methods. In the clinic of the Department of Surgical Diseases No 1, on the basis of the Surgery Center of the Kyiv City Clinical Hospital No. 1 from 2006 to 2019 218 patients with primary and secondary intra-abdominal infiltrates, abscesses and fluid formations were treated. The patients’ age ranged from 16 to 85 years. There were 107 (49.08%) male patients, 111 (50.92%) female patients. Depending on the time of hospitalization (by years), the patients were divided into two groups: the control group (CG) (2006–2012) 117 (53.67%) patients and the study group (SG) (2013–2019) 101 (46.33%) patients. The SG used the latest imaging technologies and improved methods of surgical treatment. Results. The patients were divided into two groups: primary in 191 (87.61%) and secondary postoperative infiltrates and abscesses in 27 (12.39%). The causes of primary infiltrates and abscesses were: complicated forms of appendicitis in 74 (33.94%), perforated stomach and duodenal ulcer in 48 (22.02%), complicated forms of cholecystitis in 69 (31.65%). Postoperative infiltrates and abscesses were observed in 27 (12.39%) patients who underwent urgent surgery: adgeolysis of adhesive ileus in 14 (6.42%) and complicated hernias of various localization in 13 (5.97%). Postoperative complications were diagnosed in 43 (19.72%) patients, of whom 34 (15.59%) from the surgical wound and 29 (15.18%) of the abdominal cavity, who required relaparotomy or laparoscopy, with destructive appendicitis in 10 (13.51%), perforated gastric ulcer and 12 duodenal ulcer in 6 (12.5%), destructive cholecystitis in 9 (13.04%), adhesive intestinal obstruction in 13 (19.12%) and with strangulated and complicated hernias in 14 (17.28%) of the examined patients. During relaparotomy, incompetence of the intestinal wall and intestinal sutures was established in 11 out of 32 patients, an ileostomy was imposed in 7, and cecostomy in 1 patient. Actually, in the control group, 8 (6.84%) patients died on the background of ongoing peritonitis, thrombosis of mesenteric vessels and multiple organ failure and concomitant ailments and in the study group 4 (3.96%) patients died. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis of 69 (36.13%) patients, 48 (25.13%) had laparotomy and 21 (11.00%) had laparoscopic examination. The use of the latest imaging and treatment technologies: Doppler ultrasonography, hydrojet scalpel and laparoscopy in 64 (33.51%), allowed to have better near and long-term results and to reduce postoperative mortality from 6.84% to 3.96%, with an average of 5.5%. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: destructive appendicitis, cholecystitis, perforated gastric ulcer and 12-duodenal ulcer, adhesive leakage, strangulated hernias, diagnosis and treatment.