Lashkul O. Modern approaches to perioperative tactics in gynecological patients.

The dissertation is devoted to the improvement of the results of surgical treatment of gynecological patients by introducing a perioperative method of fast track surgery (FTS). On the modern methodological level, based on thorough comprehensive research in the preoperative, intraoperative, early and late postoperative periods, the evaluation of structural components of the multimodal strategy of rapid recovery surgery (FTS) and its efficiency in gynecological patients has been proved. Depending on the type of surgical treatment, patients were divided into six groups: the first - 19 people (vaginal hysterectomy without FTS); the second one - 22 (abdominal hysterectomy without FTS); third - 53 (laparoscopic operations on the appendages of the uterus without FTS); fourth - 20 (vaginal hysterectomy with FTS); fifth - 19 (abdominal hysterectomy with FTS); sixth - 26 (laparoscopic operations on the appendages of the uterus with FTS). Quality of life and sexual function were investigated by questioning 165 patients who underwent planned gynecological operations. The in-depth study of the pathogenetic mechanisms of the effectiveness of the multimodal strategy of rapid recovery surgery by determining the dynamics of proinflammatory and anti-inflammatory cytokines and comparing the response of the organism to the stress and proinflammatory action of perioperative gynecological interventions under the generally accepted and modern multimodal strategy of FTS is conducted. It is proved that the use of the technique of rapid recovery surgery at the present stage of development of domestic gynecology is not only possible, but also advisable as it enables to significantly improve the results of surgical treatment, demonstrates both the effectiveness of medical treatment and the improvement of the quality of life of gynecologic patients.