Proceedings of the International scientific and practical conference ―Synergy of Modern Science and Education‖ (February 2-4, 2026) / Publisher website: www.naukainfo.com. – New York, USA, 2026. - 324 p.

112 and significantly reduce the number of idiopathic pericarditis from 20.0% to 5.56% (χ2=4.11, at ν = 1, α = 5%). Traditional approaches to the pericardium through anterolateral thoracotomy and median sternotomy have almost lost their relevance today. But in our opinion, they still have indications for use. They are justified in the case of the presence or suspicion of trauma to the chest organs, including the heart, and the need to perform large-scale simultaneous interventions. Median sternotomy allows you to perform the most radical volume of surgical intervention on the pericardium - subtotal pericardectomy in the case of the development of constrictive changes with the threat of compression of the heart or recurrent pericarditis, if the previous surgical intervention was unsuccessful. In our study, subtotal pericardectomy was performed in 4.09% of cases. Based on the analysis of cases of postoperative pericarditis that occurred after heart surgery or with opening the pericardium, its partial removal without manipulation on the heart, a method for preventing postpericardiotomy syndrome using transpericardial drainage of the right pleural cavity ("Method for intraoperative prevention of postpericardiotomy syndrome" patent for utility model No. 131606) was developed, which ensures full drainage of the pericardial space during active wound drainage and for a long time after removal of the drainage. So, The most universal intervention for exudative pericarditis is subxiphoid extrapleural pericardiotomy with pericardioscopy. It can be performed regardless of the patient's condition and the severity of the process. The introduction of minimally invasive interventions and a differential approach to them allowed to reduce the number of cases of acute right ventricular failure in the postoperative period from 5.32% in the comparison group to 1.30% in the main group (significance of the difference χ2=3.25, at ν = 1, α = 5%). A comprehensive approach to the organization of the diagnostic and treatment process by determining the stages, invasiveness and volume of surgical intervention in patients with exudative pericarditis of various etiologies allowed to significantly reduce mortality by 7.21% (χ2=4.42 at ν = 1, α = 5%).