• Integrating Fast track surgery in the treatment scheme operated patients with acute gynecological pathology 

Integrating Fast track surgery in the treatment scheme operated patients with acute gynecological pathology 

HEALTH OF WOMAN. 2016.4(110):146–149; doi 10.15574/HW.2016.110.146 
 

Integrating Fast track surgery in the treatment scheme operated patients with acute gynecological pathology 
 

Vdovichenko Y. P., Anoshina T. N., Vinarska-Svyrydiuk V. L., Boyko E. N.

National Medical Academy of Postgraduate Education P. L. Shupyk, Kiev

Kyiv city clinical hospital


The article presents the results of treatment of operated patients with acute gynecological pathology after integration of the principles regimen fast track surgery.


Patients and methods. The study included patients from 17 to 55 years with acute gynecological pathology who were treated with surgery and laparoscopic gynecology department in KMKL №6 at the Department of Obstetrics, Gynecology and Perinatology named of P.L. Shupyka. NMAPE in 2013-2015.

All patients (n = 346) were divided into 2 groups. The first group (n = 166) of patients was treated by the traditional method, the second group (n=180) was introduced with FTS program, performing laparoscopic surgery.


Results. It is proved that the using elements of fast track surgery improves outcomes of patients with acute gynecological pathology. It also allows to reduce the feeling of pain on VAS from 2,7 to 1,9, the length of dyspepsia, duration of antibiotic therapy and infusion of 3,4 and 3,2 days to 1,5 and 1,8 days. All this things lead to a reduction in bed days from 4,2 days to 2,9 and can reduce the cost of treatment.


Conclusion. Multimodal FTS program increases the efficiency of the surgical treatment of patients, provides a comfortable postoperative course, contributes to reduce the period of rehabilitation , early hospital discharge and reduce treatment costs, that is of course, the direct economic effect and significantly increases the prestige of the doctor and the medical establishment.


Key words: acute gynecological pathology, laparoscopy, perioperative therapy.


REFERENCES

1. Adamyan LV, Kulakov VI, Myinbaev OA. 2000. Operativnaya ginekologiya – hirurgicheskie energii: Rukovodstvo. M, Meditsina-Antidor:862.

2. Ventskivskyi BM, Zhehulovych BH, Semeniuk LN. 2001. Laparoskopichne likuvannia hostrykh zapalnykh protsesiv prydatkiv matky i pelvioperytonitiv iz zastosuvanniam ozonoterapii. Odes. med. zhurnal 2(64):29–31.

3. Laparoskopiya v ginekologii. Pod red. GM Savelevoy. M, GEOTAR Meditsina. 2000.

4. Schepotin IB. 2010. Rezultatyi ispolzovaniya multimodalnoy programmyi «fast track surgery» u bolnyih rakom tolstoy kishki. Onkologiya 12;2:44–67.

5. Carter J, Philp Sh, Arora V. 2011. Early discharge after major gynaecological surgery: advantages of fast track surgery. Open J. Obstet. Gynec. 1:1–5. http://dx.doi.org/10.4236/ojog.2011.11001

6. Kehlet H. 1997. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 78:606–617. http://dx.doi.org/10.1093/bja/78.5.606; PMid:9175983

7. Kehlet H, Wilmore DW. 2008. Evidence-Based Surgical Care and the Evolution of Fast-Track Surgery. Annals of Surgery. 248;2:189–198. http://dx.doi.org/10.1097/SLA.0b013e31817f2c1a; PMid:18650627

8. Wodlin NB, Nilsson L, Kjolhede P. 2011. Health-related quality of life and postoperative recovery in fast track hysterectomy. Acta Obstet. Gynec. Scand. 90;4:362–368. http://dx.doi.org/10.1111/j.1600-0412.2010.01058.x; PMid:21306322