ANALYSIS OF THE FUNCTIONING OF PHTISIOSURGICAL SERVICE IN THE SIBERIAN AND FAR EASTERN FEDERAL DISTRICTS OF RUSSIA IN 2020–2022

Introduction. In recent years, the Russian Federation has achieved some improvement in the epidemic situation regarding tuberculosis. However, in the Siberian and Far Eastern Federal Districts of Russia, epidemiological indicators remain above the Russian average. Surgical treatment of pulmonary tuberculosis contributes to the radical elimination of the main source of infection in the tissue and facilitates the therapy tasks. Aim of this study is to analyze the provision of phthisiosurgical care in the “Thoracic Surgery” profile to respiratory tuberculosis inpatients in the tuberculosis pulmonary-surgery departments of regional and local tuberculosis dispensaries of the Siberian and Far Eastern Federal Districts in 2020-2022. Materials and Methods. To assess the general characteristics of the phthisiosurgical service in the above districts, we analyzed the personnel composition, bed capacity, thoracic bed operation, surgical activities, average bed turnover, implementation of the bed-day plan, and the number of operations performed on respiratory tuberculosis patients. The study was basedon materials provided by the statistical departments of regional and local TB dispensaries. Results and Discussion. When comparing the indicators for the years of 2020 and 2022, a worsening personnel shortage was found: The number of surgeons decreased from 30 to 17 in the Far Eastern Federal District and from 35 to 29 in the Siberian Federal District. Over the past 3 years, there has been a significant decrease in the phthisiosurgical bed capacity in the Far East. In the Siberian Federal District and, especially, in the Far Eastern Federal District, beds in phthisiothoracic departments are often used for the purposes other than their intended one. In both the Siberian Federal District and the Far Eastern Federal District, surgical activity rates remain quite high or is recovering after the pandemic, except for Transbaikalia, the Republic of Buryatia, and the Amur Oblast. Conclusions. Analysis of the performance of phthisiosurgical departments in Siberia and the Far East in 2020-2022 shows that it is necessary to increase the number of specialized operations and improve the material and technical base of surgical departments in the above districts, although with the increase in multidrug resistance of Mycobacterium tuberculosis to anti-tuberculosis drugs, the role of surgical treatment methods increases. Today, only federal centers meet all the standards established for providing surgical care to tuberculosis patients