http://ir.librarynmu.com/handle/123456789/19672 2026-06-02T04:14:30Z http://ir.librarynmu.com/handle/123456789/19685 Название: General Surgery №1 (16) 2026 2026-01-01T00:00:00Z http://ir.librarynmu.com/handle/123456789/19684 Название: Mechanism-oriented three-level classification of treatment methods for chronic hemorrhoidal disease. Review Авторы: Markulan, L.; Bilianskyi, L.; Voloshyn, I. Краткий осмотр (реферат): OBJECTIVE – to synthesize current approaches to the treatment of chronic hemorrhoids and to develop a mechanism-oriented classification of treatment methods that integrates the pathophysiological mechanism of action of interventions, the anatomical target of treatment, the degree of surgical invasiveness, and the organpreserving potential of the procedures. 2026-01-01T00:00:00Z http://ir.librarynmu.com/handle/123456789/19683 Название: Hepatorenal syndrome: historical perspectives on the recognition of the problem. Review Авторы: Tutchenko, M.; Patrakh, D. Краткий осмотр (реферат): Hepatorenal syndrome (HRS) is a severe functional complication of portal hypertension and liver cirrhosis, characterized by profound renal hemodynamic dysfunction in the absence of significant structural kidney damage and associated with high mortality. Recent studies report a 90-day mortality of 40 – 60 %, depending on disease severity and therapeutic interventions. The pathophysiology of HRS is primarily driven by marked splanchnic vasodilation, resulting in reduced effective arterial blood volume, renal vasoconstriction, and a decline in glomerular filtration rate. The association between advanced liver disease and renal dysfunction was first recognized in the 19th century, whereas a clear clinical definition of HRS emerged in the mid-20th century. Subsequent advances led to the classification of HRS into two major types: type I, an acute, rapidly progressive form with a very poor prognosis, and type II, a more indolent form commonly associated with refractory ascites. Therapeutic strategies focus on restoring effective arterial circulation. The most evidence-based pharmacological treatment is the combination of vasoconstrictors, particularly terlipressin, combined with albumin. Invasive approaches, including transjugular intrahepatic portosystemic shunt (TIPS), peritoneovenous shunting, albumin-based extracorporeal liver support systems, and renal replacement therapy, are considered as supportive or bridging options in selected patients, especially those awaiting liver transplantation. Prevention of HRS is based on early infection control, avoidance of nephrotoxic agents, adequate correction of hypovolemia, and routine administration of albumin after large-volume paracentesis. Overall, HRS represents a hallmark of advanced hepatic decompensation and requires early recognition and a multidisciplinary therapeutic approach. 2026-01-01T00:00:00Z http://ir.librarynmu.com/handle/123456789/19682 Название: Endoscopic transluminal interventions in the management of acute infected necrotizing pancreatitis. Literature review Авторы: Puzyr, N.; Tkachenko, A. Краткий осмотр (реферат): Acute necrotizing pancreatitis remains one of the most challenging diseases in general surgery. Infection of necrotic tissue, sepsis, and organ failure are the main determinants of mortality in this pathology. Other lifethreatening complications include intestinal obstruction, biliary obstruction, abdominal compartment syndrome, external fistulas, bleeding, and thrombosis of the splenic and portal veins. The formation of walled-off necrosis after the fourth week of disease creates anatomical conditions for a transluminal endoscopic access to the pathological focus when appropriate indications are present. Current management of acute necrotizing pancreatitis is based on a step-up minimally invasive strategy in which endoscopic interventions occupy a leading role. International clinical guidelines, particularly those of ESGE, AGA, and ASGE, support the endoscopic step-up approach as first-line therapy for infected walled-off necrosis. This strategy focuses on controlling septic manifestations rather than performing immediate necrosectomy. Key factors for success include appropriate timing of intervention, a multidisciplinary approach, and individualization of the treatment strategy. The optimal indications for escalation to more invasive procedures remain unresolved and are subject to ongoing debate, often depending on the experience of a particular specialized center. The complexity of clinical decision-making may also be related to differences in treatment approaches between general surgeons and endoscopists, which necessitates a balanced interdisciplinary collaboration. 2026-01-01T00:00:00Z