The study investigates the stages and features of privatisation in Ukraine. it describes the impact and consequences of privatisation on the economic potential of the country. The main features and problems of the privatisation process in Ukraine are identified. Theoretical and practical analysis of the consequences of privatisation of state property on the innovative development of Ukraine's economy has been carried out. It was established that the withdrawal from state ownership by means of privatising enterprises is a challenge that negatively affects innovation activity, because it is mainly associated not with the creation of "know-how" to ensure economic development, but with encroachment on material resources states with the motive of enrichment, which leads to the cessation of development and introduction of existing (often imported) technologies and, as a consequence, threatens the internal innovation potential and national security of the country. The proposed ways to reform the privatisation process are aimed at mitigating the consequences of unfair privatisation to strengthen the competitiveness of the national economy, its innovative development and improve the social situation of citizens of Ukraine.
Modern technologies in surgery lead to an increase in the number of surgical interventions, which in turn increases the number of patients with peritoneal adhesions disease. Patients with acute adhesive small intestinal obstruction make up to 70 %. Acute adhesion small intestinal obstruction takes the leading place among mechanical forms of intestinal obstruction and reaches 63–80 %, and the mortality rate is 5.1–8.4 %. The aim. Improvement of minimally invasive technologies in the treatment of patients with adhesive small intestinal obstruction. Materials and methods. The main group – 99 (58.6 %) patients with adhesions of the small intestine, who underwent minimally invasive treatment technologies. The comparison group included 70 (41.4 %) patients with acute adhesion small intestinal obstruction, who were treated with traditional methods. Results. Based on clinical laboratory and instrumental research results, 21 (12.4 %) patients out of 169 patients underwent emergency surgery: 7 (10.0 %) patients of the comparison group and 14 (14.1 %) patients of the main group. Minimally invasive surgical intervention was performed in 45 (45.5 %) patients of the main group with viscerolysis in 29 (29.3 %) patients and conversion was performed in 16 (16.2 %) patients. Median laparotomy was performed in 54 (54.5 %) patients of the main group and in 70 (100.0 %) patients of the comparison group. The complications of acute adhesive small intestinal obstruction and the complications of the postoperative period in the comparative analysis of the results of the treatment of patients were taken into account. The grading of postoperative complications was carried out in accordance with the classification of P. A. Clavien and D. Dindo (2009), according to which a statistically significant difference is noted in the studied groups: 14 (14.1 %) of the main group and 23 (32.8 %) of the comparison group, III, IV and V degrees of complications were preferred. Relaparotomy was performed in 5 (7.1 %) patients of the comparison group and in 2 (2.0 %) patients of the main group. Mortality decreased from 6 (8.5 %) in the comparison group to 2 (2.0 %) in the main group. Conclusions. The use of an improved approach in diagnostics and treatment of patients with acute adhesion small intestinal obstruction ensured improved results of surgical treatment. The use of mini-invasive technologies in diagnosis and treatment made it possible to reduce the frequency of postoperative complications from 32.8 % to 14.1 %, the mortality rate from 8.5 % to 2.0 %, which confirms the effectiveness of the use of mini-invasive technologies in the treatment of patients with acute adhesion small intestinal obstruction.
The aim of the work is to improve the results of surgical treatment of mediogastric malignant tumors complicated by bleeding, perforation and stenosis. During the period 2006–2020, the clinic treated 766 patients with malignant stomach tumors complicated by gastrointestinal bleeding and perforation. Malignant mediogastric tumors were diagnosed in 227 (29.6%) patients, in particular complicated by bleeding – in 212 (93.4%), perforation – in 9 (4.0%), perforation and bleeding – in 6 (2.6%) patients. In total, 106 (46.7%) among 227 patients were operated on, in particular, 13 (12.3%) patients underwent emergency surgery for tumor perforation, and in the group with newly detected cancer operative activity was 48.7% (56 out of 115). Radical operations were performed in 75 (70.8%) patients, palliative and symptomatic – in 31 (29.2%) patients. The total postoperative mortality was 6.6% (7 patients). After radical surgical interventions, 2 (1.9%) patients died, and after palliative and symptomatic operations – 5 (4.7%) (2 (40.0%) of them were operated on for tumor perforation, diffuse peritonitis). It was established that the mortality after emergency operations (22.2%) at the height of ongoing and recurrent bleeding is 4.0 times higher than after operations performed in the early delayed period (5.6%), which are performed after adequate preparation and comprehensive follow-up examination of patients. Therefore operations at the height of bleeding in patients with acutely bleeding malignant mediogastric tumors to be too dangerous, which is associated with high postoperative mortality. In the case of perforation of the tumor, it is advisable to perform palliative or symptomatic surgical interventions at the first stage in order to save the patient's life, followed by delayed (1.5–2 months) radical surgical intervention with lymphodissection D2. Keywords: malignant stomach’s tumors, endoscopic hemostasis, radical operations, palliative operations, symptomatic operations.
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