Parkhomenko K. Simultaneous operations for combined diseases of the abdominal cavity, small pelvis and anterior abdominal wall in herniology.

Dissertation for the degree of Doctor of Medical Sciences in the specialty 14.01.03 - Surgery. Kharkiv Medical Academy of Postgraduate Education of Health of Ukraine. Kharkiv, 2021. In the dissertation work, a new scientific direction of modern herniology was created, which allows making a reasonable choice and ensuring the safety of hernia repair and simultaneous operations in for combined pathology of the abdominal wall, pelvic organs and abdominal cavity. Based on the results of the study, the frequency and structure of combined abdominal pathology requiring surgical treatment in abdominal hernias of various localization was established, the range of simultaneous interventions were determined depending on the main access and the optimal sequence of stages of simultaneous operations. The frequency and structure of local and general complications were analyzed depending on the anatomical features of the hernia, the general somatic state of the patients and the characteristics of surgery. The main risk factors for the deve¬lopment of complications have been determined. A substantiated choice of the method of hernia repair for planned operations with simultaneous interventions for concomitant pathology and the concept of stepwise multimodal rehabilitation are proposed. The use of the proposed measures of perioperative maintenance and improvements in the technique of surgical interventions contributed to a decrease in the frequency of local and general complications (from 13.9% to 4.1% and from 5.7% to 1.4%, respectively, p <0.05) and the duration of inpatient treatment after elective hernia repair and simultaneous abdominal operations by 30% (p <0.05). Key words: hernia repair, simultaneous operations, perioperative maintenance, immediate results, risk factors for complications.