- Features of the course of postoperative period during surgical treatment laparotomic and laparoscopic access to gynecological diseases in women with extragenital pathology
Features of the course of postoperative period during surgical treatment laparotomic and laparoscopic access to gynecological diseases in women with extragenital pathology
HEALTH OF WOMAN. 2017.7(123):111–115; doi 10.15574/HW.2017.123.111
Kostikov V. V.
National Medical Academy of Postgraduate Education P. L. Shupyk, Kiev
The objective: tactics definition postoperative period at surgical treatment of gynecologic patients with extragenital pathology.
Patients and methods. Research included 240 patients who stayed on treatment in a hospital and were operative concerning diseases of internal genitals laparotomical and laparoscopic accesses. All patients had an extragenital pathology. Depending on operation access all patients were divided into two groups. The main group was made by 120 patients who were operated by laparoscopic access. The group of comparison was made by 120 patients whom was operative laparotomical access. Everything patients carried out a clinical-laboratory assessment of a current of the postoperative period.
Results. Results of the conducted researches testify that at the compensated accompanying cardiovascular and pulmonary diseases, a diabetes mellitus and an obesity at gynecologic patients at identical gynecologic and extragenital pathology laparoscopic access is more preferable since takes less time, is less travmatical and morbid, is accompanied by a smaller hemorrhage in comparison with the laparotomical. Aftertreatment after laparoscopic operations takes less time that is bound to existence of less expressed pain syndrome, lack of disturbance of function of an intestine, faster restoration of a physical activity and thereof in the smaller postoperative afternoon. At the same time rising of intra abdominal pressure and the provision of Trendelenburg negatively affect hemodynamic indicators at patients with cardiovascular diseases though it doesn’t lead to a decompensation of activity of cardiovascular system.
Conclusion. Tactics of maintaining the postoperative period at gynecologic patients with extragenital pathology depends on character of a somatic case rate, option quick to access, a hemorrhage and results of clinical-laboratory inspection.
Key words: gynecologic operations, laparotomy, laparoscopy, postpoerative period.
1. Adamyan LV, Kulakov VI, Askolskaya SI. 2009. Quality of life of women after various types of the hysterectomies executed by laparoscopic, laparotomic and vaginal by accesses. Endoscopy in gynecology: 135–148.
2. Breusenko VG, Kravchuk OS, Evseev AA. 2010. Features of maintaining patients after laparoscopic operations on a uterus. Messenger of the Russian association of obstetricians – gynecologists 2:44–49.
3. Vdovichenko YuP, Gorbunova OV, Voloshin AA. 2015. Complex preoperative preparation and postoperative prophylaxis at laparoscopic operations in gynecology. Health of the woman 4(24):157–158.
4. Ventskovsky BM, Zhegulovich VG, Yarotsky NE. 2012. Modern aspects of laparoscopic surgery in gynecology. International medical magazine 1-2:112–115.
5. Zaporozhan VN, Gladchuk IZ, Rozhkovskaya NN. 2008. Endoscopic surgery in gynecologic clinic. Hospital surgery 4:32–40.
6. Kozub NI. 2011. A laparoscopy in diagnostics and treatment of purulent inflammatory diseases of appendages of a uterus. International medical magazine 3:53–56.
7. Bartos P, Zelenka Z. 2015. Total laparoscopic hysterectomy: current role in gynecology surgery. Ceska Gynekol. 64;4:224–227.
8. Chapron CM, Dubuisson JB, Ansquer Y. 2015. Is total laparoscopic hysterectomy a safe surgical procedure? Human Reproduction. l:2422–2424.