Comparative aspects of different methods of surgical treatment of the combined pathology of uterus

Abstract

DOI: 10.52705/2788-6190-2024-03.1-12
УДК 618.14-006+618.14-007.415]-089

The objective: to learn the comparative aspects of different methods of surgical treatment of the
combined pathology of uterus.
Materials and methods. 362 women which have signs of adenomyosis and uterine fibroids are
plugged in research. To the operation the followings symptoms served certificates: subjective
complaints of patient about a pain syndrome, irregular bloody protracted excretions (bleeding)
from sexual ways, abdominal discomfort, related to disfunction of nearby with an uterus organs.
At laboratory control to the basic certificates the presence of protracted chronic anemization
served to operative interference, to the uncomplying pharmacological correction. In an obligatory
order to all patients ultrasonic research of organs of small pelvis was conducted with coloured
Doppler mapping of uterine vessels.
Results. As a result of research of postoperative complications it is possible to draw conclusion
for the patients of basic group, that in most cases at the use of transabdominal access there are
not reliable differences between the middle indexes of the compared parameters in groups for patients
with complications and without complications (р>0,05). A difference found out in one case:
increase of volume of organ, which retires, for certain increases complication in a postoperative
period from the side of operating wound (р<0,05) at transabdominal access.
All complications at conducted laparotomy are related to greater traumatic, by limitation of mobility
of patient in an early postoperative period, conditioned by the expressed pain syndrome. In
the basic group of patients with arising up complications with the use of laparoscopic and vaginal
accesses, middle sizes of organ, time of operation, eyelids was exceeded by the middle sizes of
those indexes for patients without complications, but at statistical treatment of these differences
discovered it was (р>0,05) not in most sub-groups of comparison.
It is discovered for certain, that increase of volume of organ which retires, the risk of damage of
urinoexcretory ways increases time of leadthrough of operation laparoscopic access (р<0,05).
The use of vaginal access is increased by the risk of forming of dyspaurenia for patients with the
large size of organ which retires, and at the increase of time of operation (р<0,05) which can be
constrained from traumatic tissue at the oncotomy of large size and greater blood loss at increase
of time of operation.
Conclusions. The results of the conducted researches testify to the necessity of the use of the
differentiated going near the use of different methods of surgical treatment (abdominal, laparoscopic
and vaginal) for patients with combination of uterine fibroids and endometriosis.
Rational use of modern methods of operative treatment taking into account age of patients, sizes
of tumour, presence of concomitant extragenital pathology and others like that will allow to reduce
frequency of early and late postoperative complications, and also instrumental in more rapid renewal
of patients.