Onyshchenko Y. Enhancing the effectiveness of surgical treatment of stage I-II laryngeal cancer of median localization by using electrothermoadhesion in performing cordectomy

This dissertation is dedicated to the topical problem of oncootolaryngology, which consists in enhancing the effectiveness of surgical treatment of patients with stage I-II laryngeal cancer of median localization by using electric welding technologies in performing cordectomy. This paper presents the results of the experimentally developed surgical technique with electrothermoadhesion, which is applied at early stages of laryngeal cancer of median localization, and its advantages over the traditional intervention are proven. Based on the surgical technique with electrothermoadhesion, the tactics of patients' treatment in the early postoperative period was developed, including the use of the integrated clinical and educational approach, which allowed improving the quality of life and the indicators of the vocal function in patients after cordectomy. The ablastics of surgery using electrothermoadhesion and the immunomodulating effect of electrothermoadhesion are proven. The original experimental system for studying the structural units of the model system of connective tissue is proposed, and the mechanism of structural changes in tissues under electrothermoadhesion is described. The results obtained indicate the minimization of the number of postoperative complications in the study group (1.92% of cases) and in the comparison group (5.45% of cases); a decreased amount of intraoperative blood loss by 1.57 times, a decreased duration of surgery by 1.2 times; a decreased length of the patient's stay in hospital by 28.74%. The use of surgical intervention with electrothermoadhesion facilitated more rapid and complete recovery of the immune resistance compared to using standard techniques, as evidenced by the possibly faster recovery of the migration ability of immune cells, normalization of functional activity of natural cytotoxic cells (NCC), phagocytic activity of polymorphonuclear neutrophils, normalization of the concentration of IgA, reduced levels of tumor markers (CEA and SCC), and pro-inflammatory cytokines (IL-6 - 8.0, TNF- 24.0) in the serum of patients. Patients of the study group and comparison group revealed a significant decrease in the signal intensity and peak values of formant F1 of vowels "I' and "E", compared with healthy people, the difference between the original data in the two groups was not reliable р?0.05. While studying postoperative results of patients, we determined significantly higher rates of formant characteristics in the study group than in the comparison group, p <0.05.