CLINIC EXPERIENCE IN PLANNED SURGICAL TREATMENT OF MILITARY

Abstract. Introduction. The epidemic of gunshot wounds and injuries resulting from war continues to grow, and knowledge about gunshot wounds is becoming increasingly relevant. Specialized medical care plays an important role in maintaining the health of military personnel. The article presents the experience of the clinic in the planned surgical treatment of military personnel. The results of treatment of 328 military personnel were analyzed. 188 (57.3%) cases were associated with combat trauma, while 140 (42.7%) patients had general somatic pathology of the respiratory system. The most difficult contingent were military personnel in whom destructive pneumonia was complicated by pleural empyema without/or with bronchial fistula (40 – 12.2% and 31 – 9.5%) cases, respectively). Aim. Introduce doctors of various profiles to the clinic’s experience in elective surgical treatment of military personnel. Materials and methods. During the 3 years of the war, 328 soldiers were treated at the state institution “National Scientific Center for phthisiology, pulmonology and Allergology named after F. G. Yanovsky of the National Academy of Medical Sciences of Ukraine”. 188 (57.3 %) cases were associated with combat trauma, while 140 (42.7%) patients had general somatic pathology of the respiratory system. Research results and their discussion. For comminuted lesions of the lungs and soft tissues of the chest, it was important to determine the feasibility of removing each individual fragment and minimizing surgical trauma. Removing the fragments had a significant positive psychological effect on the military. No complications were observed. In combat THC with the development of destructive pneumonia (including pleural empyema without/or with bronchial fistula), the main method of closing the bronchial fistula was bronchoblock. In 1 (3.2%) patient with a bronchial fistula, a thoracostoma was created, and later staged thoracoplasty with closure of the defect was performed. All patients were discharged with either recovery or improvement. In case of bullous lung disease (with a history of spontaneous pneumothorax), all patients underwent videothoracoscopic operations to reduce the volume of the lung. All patients were discharged with significant improvement with minimal risk of pneumothorax recurrence. Surgical treatment of military personnel with lung neoplasms, tuberculosis processes, pulmonary dissemination syndrome and/or intrathoracic lymphadenopathy (diagnostic interventions were performed) did not have any special features. All patients were discharged with recovery or improvement. Conclusions. The main burden in the treatment of military personnel falls on frontline health care facilities, but highly qualified and specialized medical care also plays an important role in maintaining the health and combat capability of the military.