Kubrak M. Medical aspects of simultaneous surgical interventions in endocrine surgery.

The aim of this work was to improve the diagnostic of combined surgical pathology and the results of treatment after simultaneous surgery in patients with endocrine diseases by developing an algorithm for examination and justification of indications and contraindications to surgery, taking into account the scale of functional status P-POSSUM. The thesis is based on the results of own observations of surgical treatment, clinical, instrumental and laboratory - biochemical and special methods of research of patients. Observations of both groups were evaluated before surgery, on the first day, 3 - 5 days after the intervention and after 6 months. To identify the combined surgical pathology, based on the Department of General Surgery and Postgraduate Surgical Education of Zaporizhzhya State Medical University, was developed and implemented the algorithm of diagnostics. According to this method, 318 patients with diseases of the endocrine system were examined in the clinic, among which 71 (22.3 %) revealed combined surgical pathology of other organs. In the structure of patients with combined surgical diseases the combination of thyroid pathology (TG) and chronic calculous cholecystitis (СCC) - 32 (45.1 %) was most common. Given the wide variety of diseases involved, 32 patients with TG and CCC pathology were included in the main group for objectification of data and comparative evaluation of patient groups. The comparison group included 35 patients with isolated thyroid pathology (subgroup A) and 35 patients with СCC (subgroup B). The analysis of the main indicators of treatment during simultaneous surgery and two stage interventions (summarizing the results of treatment of patients in each case of hospitalization) was performed in the work. In terms of demographics, the severity of comorbidities was not significantly different between the groups. All patients were operated on a routine basis under general combined anesthesia using inhalation anesthetics (sevoflurane) with artificial lung ventilation.