Experience in pathogenetically correcting blood coagulative disorders during laparoscopic gynecological operations

Objective: to study a coagulative component of hemostasis in gynecological patients before and after laparoscopic operations, to assess whether it is expedient to correct hemocoagulative changes with selmevit. Setting: Tyumen State Medical Academy; Maternity Hospital 3, Tyumen. Design: a retrospective study. Subjects: 252 women (of whom 232 had undergone laparoscopic interventions: I) into uterine appendages; 2) medical myomectomy; and 3) hysterectomy) were examined. A control group comprised 20 healthy women of reproductive age. Methods: examinations were made 24 hours before and 1, 3-4, anti 5-7 days after surgery. The clinicoanamnestic characteristics of the female patients operated on were studied. The duration of an operation, the mode of anesthesia, and intraoperative blood loss were taken into account. In the postoperative period, the authors estimated the presence and frequency of thrombohemorrhagic complications, the total length of hospital stay, and the number of bed/days at hospital after surgery. The coagulative component of hemostasis was evaluated in all the women, by using the reagents manufactured by Tekhnologiya-Standart (Technology-Standard) (Barnaul). Results: It has been ascertained that laparoscopic surgery in gynecological patients may cause blood coagulative changes and increase the activity of platelets, resulting in the accelerated thrombin -fibrinogen interaction that reaches the point that induces secondary hypocoagulation. Examination of the patients undergone laparoscopic gynecological operations (on the uterine appendages, medical myomectomy or hysterectomy) has revealed that the magnitude of hemostasiological changes may be limited by supplementing routine (traditional) therapeutic measures and by using the complex antioxidant selmevit that diminishes lipid peroxidation activation and facilitates a rapider recovery of hemostasis. Conclusion: The vitamin-antioxidant complex selmevit (one dragee daily before 14 days prior to surgery and within the first 14 postoperative days) is recommended for the prevention of thrombohemorrhagic complications during endosurgical gynecological operations.