The aim — to develop an integrated therapeutic algorithm and to evaluate its effectiveness for surgical treatment optimizing in patients with оrоstomas and pharyngostomas.Materials and methods. The treatment results of 90 (3 (3.33 %) women and 87 (96.77 %) men, mean age 56.98 ± 0.42 years) with orostomas and pharyngostomas that occurred in the postoperative period of radical treatment for malignant extracranial tumors of the head and neck. The localization of the primary tumor was as follows: 37 (41.11 %) had oral tumors, 29 (32.22 %) — different parts of the pharynx, 24 (26.67 %) had recurrent and residual tumors of the larynx after radical course of radiotherapy. Patients were treated with conservative and surgical methods. The quality of life was assessed using a specialized scale (Performance status scale for head and neck patients).Results and discussions. It is established that the application of the developed algorithm allows to optimize the medical process and statistically significantly improve the quality of life of patients in terms of «habitual diet completeness « and «the possibility of public food intake» in 1.8 and 2.5 times respectively (p < 0.05).Conclusions. The integrated algorithm with application of both conservative and surgical methods, in particular, plastic closure, allows to achieve stable healing of the orostomas and pharyngostomas and to improve the social adaptation of this category of patients.

Objective. To determine efficacy of various kinds of local plasty in surgical treatment of orostomas (ОS) and pharyngostomas (PHS). Маterials and methods. The results of surgical treatment of OS and PHS, using local tissues, in 52 patients were analyzed. Comparative estimation of efficacy of the surgical interventions applied was conduction. Results. Stable result of treatment without doing restomy intervention in 75% at average, using local flaps for closure of OS and PHS, were achieved. Conclusion. Plasty, using local tissues, constitutes a simple and effective method, which is expedient to apply as a first line surgical treatment for OS and PHS.

This study aims to analyze how access to care influences patient mortality rates after liver transplants in adults by analyzing the relationships between insurance coverage, income, geographic location, and mortality rates post-transplantation. It was hypothesized that a sociodemographic variable, such as insurance type, geographical location, and income level would impact mortality rates post-liver transplant. Results showed that unknown insurance coverage increased the likelihood of mortality post-transplant, income level was not found to be a significant indicator, and patients living in the Northeast region of the United States were more likely to die post-liver transplant.