Object of the study: pathology of the gastrointestinal tract (GIT), which requires surgical treatment. Purpose of the study: solution of the problem of preventing intra- and postoperative complications, improving results of the treatment of patients with some surgical pathology of GIT on the basis of a complex study of peculiarities of the electrosurgical and ultrasonographic effects on tissues for their dissection and coagulation. Methods of the investigation: histological, morphometric, histoimmunological study of parts of GIT organs and vessels, indices of lipid peroxidation after the effect, produced by physical methods of tissue dissection and coagulation. Theoretical and practical results: techniques were suggested for the optimum use of physical methods of tissue dissection and coagulation in order to achieve better results of the treatment. The obtained data make it possible to orientate oneself with confidence in a broad spectrum of the apparatuses designated for dissection and coagulation, but, first of all, in advantages and disadvantages of high-frequency electrosurgical and ultrasonographic units. The described differences in the abilities and efficacy of different techniques make it possible to optimally choose the way of dissection or coagulation in each particular case. Observance of the principles and consideration of peculiar effects on tissues by different kinds of energy ensure a decrease in the number of specific complications, caused by application of physical methods. The use of ultrasonographic dissection and coagulation in GIT surgery is characterized by some advantages over high-frequency electrical ones, such as a bloodless mobilization of the stomach, large and small intestines, a sparing dissection of their walls, therewith ensuring the most favourable conditions for a course of reparative processes, they are more convenient and simple with respect to a technical formation of anastomoses. The use of an ultrasonographic scalpel made it possible to avoid development of complications within the postoperative period, first of all such as leakage of anastomosis stutures and haemorrhage, thereby making it possible to improve indices of the patients’ treatment and rehabilitation in a complex. Novelty: the first complex thorough experimental-clinical study of the clinical application of the electrosurgical and ultrasonographic effects was performed on the basis of a long-term clinical use of different methods of the physical dissection of tissues and coagulation; the study included the main theoretical and practical aspects. For the first time, peculiarities in the effects, produced on tissues of GIT organs by electrosurgical dissection and coagulation, were studied experimentally and in clinical conditions, thereby making it possible to reveal peculiarities in the course of reparative processes in the region of gastro-, entero- and colotomic wounds within different postoperative terms, rather than only the degree of severity and spread of local disorders immediately following the above effects. For the first time, the imunohistochemical processes, which develop in the region of gastro-, entero- and colotomic wounds within different postoperative terms and exert their influence on the conditions of healing and possible development of postoperative complications, were studied experimentally. For the first time, the morphological processes, which ensure haemostasis during electrosurgical and ultrasonographic coagulation, were studied on experimental-clinical material. Advantages and disadvantages of each kind of energy during their action on GIT organs were determined as a result of a complex study of the effects of dissection and coagulation. For the first time, a complex comparative characteristic of the reparative processes when using different kinds of physical dissection and coagulation was suggested. Degree of introduction: theoretical propositions of the thesis and practical recommendations proceeding from the research results were introduced into the practice of work of the Department of the Oesophagus and GIT Diseases of and the Department of Urgent Surgery of the Abdominal Organs of the state establishment “Institute of General and Urgent Surgery of the Academy of Medical Sciences of Ukraine”, surgical departments of A.I. Meshchaninov Kharkiv City Hospital of First and Urgent Aid, surgical departments of the state institution “Railway Hospital of Kharkiv Station” of the Statutory Territorial-Trade Association “Southern Railway”. The main scientific propositions of the thesis are introduced in the educational process at the Department of Surgical Diseases of V.N. Karazin Kharkiv National University. Sphere of application: medicine, surgery.
