HE ROLE OF TELEMEDICINE IN TRAINING OF SCIENTIFIC-PEDAGOGICAL AND PROFESSIONAL MEDICAL STAFF

Nowadays, telemedicine services are widely used throughout the world. Various types of telemedicine services, such as the storage and transmission of real-time information, remote monitoring or self-control can be applied in the fields of education, health and management, disease screening and disaster risk management worldwide. Telemedicine can play a big role in conducting medical research, as well as in the field of training scientific personnel, allowing remotely collaborate with scientific and clinical institutions and gain access to expensive remote equipment. In this context, it is considered appropriate to develop and apply such innovative ideas as online computing models in telehealth applications; simplified software and hardware interfaces, programs for modelling; portable telepresence systems; artificial intelligence applications that are especially relevant in cases where simulated patients cannot replace real ones; and development of a large number of application simulators

CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF PATIENTS WITH UNCOMPLICATED LIVER ECHINOCOCCOSIS

Objective: Analysis of clinical and demographic parameters of patients with uncomplicated liver echinococcosis (LE). Methods: The study included 182 patients who underwent only open surgery for LE. Primary LE was detected in 39.6% of patients, recurrence of the disease – in 40.1%, combined echinococcosis (CE) – in 20.3%. Clinical and demographic parameters such as gender, age, incidence of comorbidities, location of residence, and cyst size were considered. Results: Among the patients enrolled in the study 44.5% were males and 55.5% were females. The average age was 36.0±1.2 years. The average duration of the disease among male and female patients was 5.5±0.7 and 4.9±0.5 years, respectively (p>0.05). The width of the cysts was significantly larger in female patients compared to the male ones (p<0.05; Z=2.04). There were significantly more comorbidities in the female than in the male patients (p<0.05), however, there were no significant difference in the incidence of any concomitant disease. In the majority of patients (47.2%) cysts were <9 cm in size; followed by the cysts 9-15 cm wide (39%), and exceeding 15 cm (13.9%). In female patients’ cysts <9 cm were found significantly more often than of any other size (p<0.001). Cysts <9 cm prevailed in residents of urban areas (p<0.01), while in rural areas predominance of cysts ≥9 cm was observed (p<0.01). CE was diagnosed in 70% of female patients, allowing us to consider female gender as a risk factor for the development of this form of the disease. In male patients with combined cysts their diameter in the liver <9 cm was found significantly more often (p<0.05) than cysts of larger size; while the incidence of the cysts <9 cm and ≥9 cm in diameter did not differ in male and female patients. Patients with recurrent form of LE in 50% of cases applied for surgical treatment of cysts ≥9 cm. In rural areas, the number of patients with recurrent cysts <9 cm prevailed over cysts of ≥9 (p<0.001), while in city dwellers recurrent cysts ≥9 tended to predominate.Conclusion: The study demonstrated that young age is predominantly affected by LE. Frequency of surgical visits of patients with large and giant cysts is high. The female gender may be considered to be a risk factor for CE. Conclusion: The study demonstrated that young age is predominantly affected by LE. Frequency of surgical visits of patients with large and giant cysts is high. The female gender may be considered to be a risk factor for CE

RADICAL SINGLE-STAGE OPERATIONS AT INTESTINAL OBSTRUCTION, CAUSED BY THE TUMOR OF THE LEFT HALF PART OF THE LARGE INTESTINE (CURRENT STATUS OF THE PROBLEMS)

In more than 40% of cases, colon cancer (CС) is diagnosed in stages III-IV, at the same time the resectability reaches 70-80%. The main priority of surgical intervention by obturation of intestinal obstruction at the first stage is the bowel emptying from the contents and the elimination of its obstruction. Intraoperative entero- and colon lavage with subsequent colosorption facilitate single-stage surgical interventions. When treating patients with decompensated intestinal obstruction, preference is given to more sparing and multi-stage surgical interventions. The key point of the operation is the removal of the tumor in full volume R0. Segmental left-sided colectomy can be performed in the presence of adequate edges of R0, as well as the conduct of lymphadenectomy. In the case of the presence of a locally advanced process involving neighboring organs, it is possible to perform a so-called «curative resection», an «an block» resection with complete or partial removal of the involved organs together with the tumor. In patients with compensated and subcompensated intestinal obstruction, it is possible to perform intestinal resection with the formation of a primary anastomosis. In recent years, endosurgical techniques for restoring the passage of intestinal contents, which can be considered as a method of preparing the patient for radical treatment, have become very popular in the treatment of patients with tumour obstruction. The possibility of open treatment of patients suffering from CC largely depends on the presence or absence of metastases in the liver. If their presence, in some cases, it is possible to perform anatomical resections of the affected areas of the liver. Early postoperative results of surgical treatment of patients after removal of large intestine tumours largely depend on the full preparation of the intestine, the presence of concomitant diseases, as well as the ways of protection of the anastomosis and its type