History of the institute - Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine

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The history of the gastroenterological service began 55 years ago with the opening of the Research Institute of Gastroenterology in Dnepropetrovsk, on the basis of the Resolution of the Council of Ministers of the Ukrainian SSR of December 19, 1964. The main activity of the institute was formulated by the Ministry of Health of Ukraine – study of the clinic, development of methods for diagnosis, treatment and prevention of diseases of the digestive system.

It was the first institute in the USSR, only 3 years later the All-Union Research Institute of Gastroenterology of the Ministry of Health of the USSR was opened in Moscow, in 5 years – laboratory of gastroenterology in Tartu and a small institute with one clinical department in Душанбе.

Employees of the institute have developed new theories about the occurrence of diseases of the digestive system. They were among the first in the USSR and Ukraine to master and implement endoscopic methods of research and treatment, took a direct part in the development of state-of-the-art surgical interventions, and developed new theories about the occurrence of digestive diseases.

Our Institute, together with other scientific institutions of our country and with foreign countries, gave impetus to the development of cancer prevention through stabilization of precancerous conditions, study of fibrosis of parenchymal organs underlying diseases and often fatal pathological changes, to develop new types of minimally invasive, operative interventions in diseases of the digestive system.

Formation and development of scientific and practical gastroenterology are connected with the name of the first director of the Institute of Gastroenterology and the chief gastroenterologist of the Ministry of Health of Ukraine, candidate of medical sciences – Yevhen Maksymovych Polyakov.

From April 1967 and for 20 years the institute and the specialized gastroenterological service were headed by the honored worker of science of the USSR, doctor of medical sciences, professor Pavel Fedorovich Kryshen.

From 1987 to 2011 the institute was headed by a corresponding member of the National Academy of Medical Sciences of Ukraine, Doctor of Medical Sciences, Honored Worker of Science and Technology of Ukraine, Professor Yuriy Filippov.

Currently, the director of the institute is a corresponding member of the National Academy of Medical Sciences of Ukraine, Doctor of Medicine, Professor, Chief Specialist of the National Academy of Medical Sciences of Ukraine in Gastroenterology and Dietetics, Honored Doctor of Ukraine, Member of the Presidium of the Ukrainian Gastroenterological Association. Ukraine »Yuriy Myronovych Stepanov.

Scientists who have made a significant contribution to domestic theoretical and clinical gastroenterology worked within the Institute. Their works are known not only in Ukraine but also abroad.

Significant contribution to the development of gastroenterological science, the formation of a specialized gastroenterological service and training has been made by such well-known scientists and organizers of health care as: MD. Yu.I. Rafes, MD T.P. Shamshonkova, MD VP Singer, Ph.D. T.V. Smirnova, Ph.D. І.Т. Kruglikov, Ph.D. O.A. Kryvytskyi and others.

Today the Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine is the main research institution on Gastroenterology with a developed research and clinical base, which studies the prevalence, etiology and pathogenesis of digestive diseases, develops methods for their diagnosis, surgical and therapeutic treatment. Highly qualified personnel and material and technical potential of the Institute allow to successfully perform all tasks of research, medical-diagnostic, organizational-methodical and other types of work in accordance with the main activities at the level of the best world standards. Research conducted at the Institute is characterized by in-depth study of the problems of the digestive system at the population, systemic, organ, cellular and subcellular levels.

Scientists of the Institute were the first in the country:

formulated the concept of cholesecretory disorders, introduced the concept of “biliary insufficiency” into clinical nosology and developed methods of its correction on the basis of evidence-based medicine;
developed the direction of endocrine gastroenterology, which allowed to theoretically substantiate the concept of the pathogenetic role of regulatory peptides in the occurrence of chronic pathology of the digestive system, on the basis of which new methods of diagnosis and treatment. The use of gastrointestinal hormones and new drugs created by scientists of the Institute on the basis of products – analogues of natural and animal raw materials was substantiated;
developed and implemented methods of using polyalcohols (sorbitol, xylitol, algurine) for the diagnosis and treatment of patients with gastroduodenal and hepatobiliary pathology;
created a number of medical and biological models based on the violation of information exchange of the gastroduodenal zone and liver;
proposed a number of new ways of functional testing of the state of regulation of gastric secretion;
identified the role of psychotrauma in the development of gastroduodenal diseases and developed a systematic approach to the choice of psychotropic therapy;
substantiated the need for differential psychotropic therapy as a mandatory component of comprehensive treatment of patients with gastroenterological profile;
proved the pathophysiological significance of the intestinal microflora in diseases of the digestive system;
modified already known, developed and implemented new methods of bacteriological diagnosis of dysbiosis, the original method of immunocorrection by autocytokine therapy, which can significantly improve treatment outcomes, increase remission, improve the quality of life of patients;
conducted basic research, achieved significant success in studying the problem of precancerous diseases of the stomach, introduced methods for the prevention of dysplastic changes in the mucous membrane;
the surgical school of the Institute was established, where unique experience in the development and implementation of new methods of surgical treatment, reconstructive operations on the stomach, laparoscopic organ-sparing operations and minimally invasive surgical interventions in pathology of the digestive organs;
methods of diagnosis and treatment of patients with complicated forms of chronic pancreatitis have been developed;
methods of resection of the pancreas are improved while preserving the morpho-functional structure of the duodenum, pancreatoduodenal resection is performed for tumors of the head of the pancreas and large duodenal papilla;
diagnostic criteria for determining fibrotic processes in the liver and pancreas are being developed, new approaches to their inhibition are being implemented.

Today the main directions of scientific activity are:

study of the peculiarities of complicated hernia of the esophageal orifice of the diaphragm, gastroesophageal reflux disease, achalasia of the cardia, stenosis of the gastroduodenal zone of ulcerative origin and improve methods of their surgical correction using endolaparoscopic technologies;
study the features of comorbid status and cytokine balance in patients with precancerous gastric conditions and justify new approaches to diagnostic and treatment tactics;
study of the leading factors influencing the course of non-alcoholic steatosis of the liver in children, development of criteria for predicting the adverse course and a differentiated algorithm of therapeutic measures;
study of factors of humoral immunity and development of a set of criteria for predicting the course of chronic inflammatory bowel disease;
study of clinical, biochemical and structural features of the formation of steatosis and fibrosis in patients with chronic diffuse liver disease.

For the first time, the Institute established a specialized gastroenterological service of Ukraine, defined the principles of organization of specialized medical care, developed new forms and methods of medical examination and rehabilitation for diseases of the digestive system. For the first time, the Institute established a specialized gastroenterological service of Ukraine, defined the principles of organization of specialized medical care, developed new forms and methods of medical examination and rehabilitation for diseases of the digestive system.

An automated hospital system, clinical and statistical classifications of digestive diseases, local clinical protocols and routes for providing highly specialized tertiary care to patients with digestive diseases have been created, implemented and are functioning in the institute’s clinic.

The integration of basic and applied science at the Institute is based on a combination of experimental and clinical data, therapeutic and surgical gastroenterology, which provides a comprehensive solution to current problems in this field of medicine.

Over the past 3 years, in order to increase the level of medical care to the population of Ukraine, the Institute has undergone qualitative and quantitative changes in the material and technical base. The clinical-diagnostic and biochemical laboratories were equipped with the most modern equipment. In the diagnosis of pathological conditions informativeness is 70-93%.

Significantly updated resource base, purchased and put into operation new equipment:

Digital X-ray diagnostic complex “Orera T90cex”;

Digital X-ray diagnostic complex “MSA PLUSS”;
Scalpel surgical “SonoSurg-G-2”;
Monitor of the patient’s condition “UM-600”;
Handheld pulse oximeter “Pearl10”;
Apparatus for artificial respiration and lung ventilation “Monnal T-75”;
Video gastroscope “GIF-HQ 190”;
Rack videolaparoscopic “Karl Storz GMBH & Co KG”;
Fibroduodenoscopes “FD-34V2”;
Colonoscope FC-38LV;
FibroScan;

Ultrasound device Radmir ULTIMA;
Ultrasonic diagnostic complex “SSA-660A Xario”.

The Fibroscan device allows to determine the stages of liver fibrosis and steatosis at the stages when these processes are reversed, improves the quality of diagnosis of liver diseases and provides control over the effectiveness of treatment.

Thanks to the administration under the leadership of the director of the institute, MD, prof. Yu.M. Stepanov, was carried out modern, in accordance with all applicable sanitary requirements, repair of the operating room, laundry room and rooms for staff and patients, with the installation of modern supply and exhaust ventilation system, system of inhalation anesthetics, updated tile, electrical system, insulation and LED -lighting of premises.

Also installed is a modern double-dome shadowless operating lighting system Trilux Aurino Wave, which provides a more organic perception of color temperature of different conditions of the operated organs, the surgeon during surgery, provides full and deep illumination of the operating field and equipped with hygienic nozzles, touch screens and , will allow even more improve the quality of medical services for our dear patients!

The Department of Pediatric Gastroenterology has been providing inpatient care to older children (from 6 years old) with a wide range of gastroenterological diseases since June 2013. The unique opportunity to combine scientific experience, the embodiment of the latest achievements of the pediatric scientific community, backed by professionalism, energy, sincerity and friendliness of the staff creates a favorable environment for restoring the health of children and adolescents.

Children with a variety of pathological conditions from functional to orphan (rare) diseases of the gastrointestinal tract have the opportunity to receive high-quality diagnostic and therapeutic care in the department.

Modern video endoscopic equipment Olympus Evis Exera III provides the ability to perform high-quality visualization of the mucous membrane of different parts of the gastrointestinal tract in different modes, which allows early detection of early signs of pathological changes, thorough differential diagnosis, avoid unwarranted invasive interventions. Pentax FG16V small diameter endoscopic equipment in combination with anesthesia support of diagnostic procedures allow children to conduct complex diagnostic examinations with minimal psychological stress according to world pediatric standards. Targeted selection of material for morphological examination during high-resolution edoscopy can confirm eosinophilic esophagitis, Barrett’s esophagus, neoplasia of the gastroesophageal junction and stomach, Crohn’s disease, celiac disease and other complex diseases.

One of the areas of research of the Department of Pediatric Gastroenterology is the “diseases of civilization” – fatty liver and pancreas, which in recent years is leading among chronic diseases in children due to the high prevalence of sedentary lifestyle, malnutrition, low physical activity and associated obesity. Detection of diseases in the early stages of development with the help of modern imaging technologies carried out in IG – transient elastography, shear wave elastography, steatometry, is the key to effective treatment.

Also among the most promising and rapidly developing areas of activity is the study of the intestinal microbiome and its role in the formation of food intolerance and hypersensitivity, which are a well-founded concern of parents in recent times. Also among the most promising and rapidly developing areas of activity is the study of the intestinal microbiome and its role in the formation of food intolerance and hypersensitivity, which are a well-founded concern of parents in recent times.

The staff of the institute works on the study of pathogenetic mechanisms of precancerous conditions, steatosis and liver fibrosis in adults and children, chronic inflammatory bowel disease, cystic formations of the pancreas and other common diseases of the digestive system. The methods of their diagnosis, treatment and prevention have been improved, the volume and composition of medical care for patients with digestive diseases are substantiated and the sequence of its provision is developed.

Today, a wide front of scientific research has become possible thanks to the team of highly qualified personnel and material and technical potential of the Institute. The level of medical-diagnostic, scientific-organizational, methodical and other areas of work meets the best world standards.

In recent years, the institute has been equipped with the best modern diagnostic equipment of the world level, has the necessary clinical and experimental base, highly qualified human resources, which allows to solve the tasks set before it.

The strengths of the institute include the world’s best modern devices for diagnosis and treatment, which are now widely used in providing medical care to the population of Ukraine:

EVIS EXERA III video endoscopy system with Olympus 190 gastroscope and Olympus 185 colonoscope with NBI function and optical magnification allow to diagnose precancerous changes and early cancer of the gastrointestinal mucosa in the early stages. The use of electrosurgical unit SERING ARCO 3000 with mono-, bipolar and argon-plasma coagulation allows for minimally invasive endoscopic surgery for precancerous conditions and diseases, early gastrointestinal cancer (polypectomy, endoscopic resection and endoscopic resection and dissection dissection and dissection dissection cardia. Stenting of tumor strictures of the gastrointestinal tract is also performed.

The first in Ukraine newest high-quality EUS-device with elastography function for use in surgical and therapeutic purposes was purchased.
Over the last year, a professional electronic (impedancemetry) body composition analyzer Tanita MS-780 MAR, a convex sensor for the SonoScape S60 ultrasonic system, a two-flow oxygen concentrator, and current repairs of medical equipment were purchased.
Considering that more than 10 million people in Ukraine suffer from chronic diffuse liver diseases, early diagnosis by non-invasive, painless determination of liver fibrosis and steatosis using transient elastography using the unique FibroScan-502 device (France) is very important. In addition, we use unique options – shear wave elastography (verification of fibrosis) and the attenuation factor of ultrasound (verification of steatosis) using an ultrasound scanner expert class Soneus P7 (Ukraine-Switzerland);
The Department of Digestive Surgery has a video laparoscopic stand Stotz (Germany), an ultrasonic scalpel Olympus (Japan), an X-ray surgical C-shaped system ISA (Italy) and a digital X-ray machine “Opera”, which significantly expanded the capabilities and quality of surgery. The use of the new ultrasonic scalpel Olympus (Japan), X-ray surgical C-shaped system ISA (Italy) in the Department of Digestive Surgery, has significantly expanded the range and quality of surgical interventions. The level of medical care for patients with gastroenterological profile is increasing due to open, laparoscopic, minimally invasive surgical interventions under ultrasound and radiological control. Staged methods of bile outflow correction with the use of transpapillary and endobiliary interventions have been developed, pancreatoduodenal resections and modern operations for complicated forms of chronic pancreatitis are performed. According to diagnostic and therapeutic indications, ERCP with papillosphincterotomy is performed.

Given the priority of intersectoral areas of work, an agreement was concluded with the Institute of Electric Welding named after E. О. Paton of the National Academy of Sciences of Ukraine on a joint scientific study aimed at developing new methods of treatment using a device for welding tissues during surgery.

Recently, the staff of the institute has been successfully solving problems of developing ways to improve the diagnosis and treatment of pathology of the upper gastrointestinal tract, research of precancerous conditions and opportunities to prevent gastric cancer, establishing relationships between functional and structural disorders in patients with chronic diffuse liver disease. approaches to slowing down the development of fibrosis, the introduction of organ-preserving and minimally invasive methods of surgical treatment of diseases of the digestive system.

Combined endolaparoscopic operations are performed in the treatment of duodenal stenosis of ulcerative etiology, which allows to influence the main mechanisms of ulceration, normalize motor – evacuation disorders and reduce acidity due to the combined action of laparoscopic selective proximal vagotomy in the area of G. Hill – M. B – M. dilatation.

The introduction of laparoendoscopic organ-sparing operations in cholecystolithiasis allows for endoscopic revision of the gallbladder cavity to perform cholecystolitextraction not only of diagnosed stones in the bladder cavity, but also undiagnosed small stones in the mucous membrane. Combined endolaparoscopic operations in the treatment of single and multiple cholecystolithiasis with preservation of the gallbladder organ allowed to perform cholecystolitextraction by endoscopic revision of the gallbladder cavity

The use of inhaled anesthetics together with the LEON device allows to make anesthesia safe and manageable, especially in overweight patients, and therefore with high cardiac and respiratory risks. Balanced anesthesia with sevoflurane, its minimal cost with low gas flow, is the optimal method for patients in bariatric surgery. The key to patient safety during surgery is the Harvard Monitoring Standard, which includes monitoring ventilation, oxygenation, capnography, recording the minimum alveolar concentration of inhaled anesthetics (MAC) and their rapid correction – all in the purchased LEON device. The operation of the device with such capabilities allows to accelerate the rapid awakening of the patient after surgery, avoid postoperative complications, reduce the time of rehabilitation of patients and expand the range of surgical interventions.

In the last 3 years the organizational and scientific-methodical management of gastroenterological assistance to the population has been intensified: field scientific-practical conferences are held in the regions of Ukraine with advisory assistance to doctors and patients, scientific forums with international participation.

The young scientists have repeatedly won the President’s Prize of Ukraine and were awarded a Scholarship of the Cabinet of Ministers of Ukraine.

Organizational and scientific-methodical management of gastroenterological assistance to the population and training of gastroenterologists of Ukraine was significantly intensified. Field scientific and practical conferences are held in the regions of Ukraine with the provision of advisory assistance to doctors and patients, scientific forums with international participation are held.

Since 2013, the scientific sessions of the institute have been resumed, where employees and leading scientists report the results of their own research, highlight new achievements of science and practice.

The international contacts of the Institute are expanding, in particular, cooperation is carried out with the European Gastroenterological Society, the International Association of Science and Higher Education (IAEA), work is underway on agreements on scientific and information cooperation with the Central Research Institute of Gastroenterology. Moscow (Russia), with the laboratory “NL Biotechnology Ltd.” (USA, Arkansas). As part of a long-term cooperation agreement, multicenter randomized trials of the efficacy and safety of drugs for the treatment of intestinal and liver pathology are being conducted. Scientists of the Institute are members of the ESSO, International (IPC) and European (EMC) clubs of pancreatology.

The program of strategic development of the Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine provides for joint research programs, grants and agreements on international cooperation with foreign partners in accordance with the main areas of research. Contacts with foreign partners are deepened and expanded by organizing international conferences, during which leading foreign experts share their experience and achievements in the field of diagnosis, treatment and prevention of gastrointestinal diseases with the medical community of Ukraine.

Employee of the Institute, MD Mosiychuk LM is the chairman of the advisory group for the development of section 3 “Gastroenterology. Medicines ”of the State Form of Medicines of the Central Formulary Committee of the State Expert Center of the Ministry of Health of Ukraine.
Director of the Institute, prof. Stepanov Yu.M. is a member of the section of the Scientific Council of the Ministry of Education and Science of Ukraine in the field of “Biology, Biotechnology and Current Issues of Medical Sciences”. The institute provides training of highly qualified scientific personnel in accordance with the established procedure. For the last 3 years the institute has participated in scientific cooperation with the implementation of targeted programs in gastroenterology with Novartis Institutes for BioMedical Reseach Inc., Cambridge, USA. The results were: the project “small molecules” Nanoparticles, Liver fibrosis, the project “early markers of HBV, response to treatment.”

The research project of the Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine on “Investigating the relationship between intestinal microbiocenosis disorders and functional disorders of the biliary tract in overweight and obese children” received an international grant from Biocodex, Europe (2018).

The institute deepens and expands contacts with foreign partners by organizing international conferences, during which leading foreign experts share their experience and achievements in the field of diagnosis, treatment and prevention of internal diseases with the medical community of Ukraine. For the last 3 years the institute has organized and held 9 international scientific and practical conferences.

Scientists of the institute are active participants in all major international forums on gastroenterology and hepatology and have extensive experience as speakers at major international congresses.

Researchers of the Institute are trained in foreign clinics, regularly participate in international, European and national gastroenterological forums (Italy, Switzerland, Germany, China, Turkey, France, Austria, Japan, etc.).

The achievements of the Institute’s scientists have been awarded diplomas, certificates and prizes at scientific forums of various levels.

Young scientists of the Institute received the Scholarship of the President and the Cabinet of Ministers of Ukraine, many times announced the winners of the annual regional competition of projects “Young Scientists – Dnipropetrovsk region” under the program “Youth of Dnipropetrovsk region”

Senior Research Fellow Zavgorodnya O.Yu. awarded the Medal of St. Panteleimon (national competition) for achievements in scientific activities.

Director of the Institute Corresponding Member of the National Academy of Medical Sciences of Ukraine, Professor Stepanova Yu.M. awarded the State Award – the Order of Merit II and III degree.

Every year the research works of the institute are awarded diplomas of the Presidium of the National Academy of Medical Sciences of Ukraine.

A comprehensive approach to solving problems (from studying the pathogenesis to the creation of new drugs, advanced diagnostic and treatment technologies, new automated systems, organizational and methodological, management programs) allows to bring gastroenterology and specialized care to Ukraine to the best world practices.

The institute is a clinical base of the Department of Therapy, Cardiology and Family Medicine of the Faculty of Postgraduate Education of the Dnieper State Medical University.

Scientists of the Institute have done a lot of work to create the Ukrainian Gastroenterological Association, which has been working fruitfully for more than 15 years.

Since 1969, the Institute has been publishing an interdepartmental collection of scientific papers “Gastroenterology”, which reflects the achievements of gastroenterological science and practice in Ukraine and abroad. The collection is a professional publication of the Ministry of Education and Science of Ukraine, included in the scientometric database ScienceIndex, as well as in the Ukrainian scientific journal “Source”.

The Institute is the main institution of the Problem Commission of the National Academy of Medical Sciences and the Ministry of Health of Ukraine “Gastroenterology”, which coordinates the planning of scientific and dissertations, publication of guidelines and manuals for physicians. The Institute has a Specialized Academic Council for the defense of doctoral and master’s theses in “Gastroenterology”, “Cardiology” and “Pediatrics”. The institute is a base of clinical residency and postgraduate studies in the field of internal medicine, gastroenterology and surgery.

The results of scientific research are widely published in domestic and foreign scientific journals. During these years, the staff of the Institute has published about 6,000 scientific papers, published 28 monographs, 87 textbooks and reference books, more than 200 guidelines and departmental instructions. The Institute has completed 29 doctoral and 112 candidate dissertations.

On the basis of the Institute there are courses of information and internships for physicians, gastroenterologists, surgeons, endoscopists, sonologists, morphologists and other specialties.

The competitiveness of the Institute’s research is ensured by security documents: about 200 new technical solutions are protected by patents and copyright certificates for inventions.

Gastroenterology provides an opportunity to gain new and deepen existing knowledge about the epidemiology, etiology, pathogenesis of digestive diseases, to develop new areas of diagnosis and treatment of such common and socially significant diseases as hepatitis, pancreatitis, peptic ulcer disease, inflammatory bowel disease. young people of working age.

Today the Institute is a scientific and practical center that integrates related branches of medicine such as therapy, gastroenterology and surgery. It is this combination that allows you to educate highly qualified professionals who know their business well. The achievements of the Institute are the result of multifaceted creative activity of its scientists, doctors and all employees.