Emergency treatment in gynecology using different methods of surgery
Abstract
The aim. Improving surgical treatment of urgent genital pathology based on comparing the effectiveness of different methods of surgery.
Materials and methods. 170 women were selected and divided into three groups. Group 1 included women with acute pelvic inflammatory disease (aPID); to 2nd group – 60 women with intra-abdominal bleeding (IAB); to 3rd group - 50 women with impaired blood supply to tumors of the internal genitalia (uterus and ovaries) (IBSTIG). Each group was divided into two equivalent subgroups depending on the method of treatment: laparoscopic or laparotomy.
During the study, all examined patients had a medical history, gynecological examination, ultrasound examination, surgical treatment by laparoscopy or laparotomy.
Results. The average duration of laparoscopic operations in patients in subgroup 1.1 was 50.4±7.2 minutes and 80.3±10.1 minutes in subgroup 1.2 – with laparotomy method. Intraoperative blood loss was significantly lower in subgroup 1.1 compared with subgroup 1.2 (210.7±31.4 ml and 375.9±44.5 ml) (p <0.01). In the postoperative period in subgroup 1.1, which included women with emergencies due to aPID and in which operations were performed laparoscopically, the maximum temperature rise after surgery was 37.6±0.04 °C, which was significantly lower than in subgroup 1.2, which included women with emergencies due to aPID and in which operations were performed by laparotomy, this figure was 38.0±0.08 °C (p <0.001). The mean duration of the postoperative period in patients of subgroup 1.1 was significantly shorter compared to subgroup 1.2 (7.2±0.6 and 10.2±1.0 days) (p <0.05).
The average duration of operations in subgroup 2.1 was significantly shorter than in subgroup 2.1 (39.8±2.1 and 59.1±2.5 minutes, respectively) (p <0.001). Intraoperative blood loss was on average significantly lower in subgroup 2.1 (189.1±19.8 and 388.5±37.2 ml, respectively) (p <0.05).
In subgroup 3.1, which included women with IBSTIG and underwent surgical treatment by laparoscopy, the average duration of operations was significantly shorter than in subgroup 3.2, where such women with such pathology received surgical treatment by laparotomy (62.1±4.9 and 89.6±7.8 minutes, respectively) (p <0.01). Blood loss was significantly lower in subgroup 3.1 in contrast to subgroup 3.2 (101.7±10.1 ml and 283.3±12.9 ml, respectively) (p <0.001).
Conclusions. The use of laparoscopy for the treatment of urgent genital pathology could increase the effectiveness of surgical treatment. In addition, this method reduces the duration of surgery and surgical blood loss. As a result, it makes it possible to improve the postoperative period.
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