Kosakivska I. Surgical treatment of children with non-neoplastic disease of lymphopharyngeal ring using electric welding technology (experimental and clinical research)

The dissertation presents a theoretical generalization and a new solution to the problem - increasing the effectiveness of surgical treatment of children with non-neoplastic diseases of the pharyngeal lymphoid tissue ring by clinical and experimental justification of new and improving existing surgical interventions using electric welding technology and creating appropriate devices and instruments. It was found that high-frequency current (HFC) (66 and 440 kHz) has a bactericidal action regardless of the type of bacteria and their sensitivity to antibiotics. The normal flora of PT was more resistant to HFC compared to pathogenic and opportunistic flora. In the study of apoptosis in the experiment it was found that the greatest destructive effect has HFC in the mode of "cutting", and the least - in the mode of "welding". It is established that the additional effect on PM HFC (66 kHz) in the mode of "cutting" or "overlapping" at intratissue placement of bipolar electrodes is not accompanied by damage to crypts and does not cause destructive changes in other structures of PT, offering prospects for further use of intratissue ETA in the treatment of HPT in the clinic. The method of high-frequency welding of biological tissues significantly improves the quality of surgical interventions for LPR in children, as evidenced by a decrease in blood loss in adenectomy 4,7 times, at TE – 5,4 times, at tonsillotomy (TТ) – 7,4 , at TP - in 2,8 times (p < 0,001), and also absence of bleeding at ETA PT. This method allows to reduce the duration of surgery with adenectomy and TE - more than twice, with TТ - by 1,6 times, and with ETA PT - 3 times compared with TТ without ETA (p < 0,001); prevent recurrence of adenoid vegetations and restore or improve hearing in the case of chronic secretory otitis media.