Clinical significance of adaptational reactions of female organism undergoing laparoscopic operations on uterus and adnexa

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Conclusions. These parameters were directly connected to the stress caused by hospitalization with urgent surgical diagnosis. We have found that usage of laparoscopic surgery decreases level of anxiety of patients with ectopic pregnancy.

Introduction. Laparoscopic operations on adnexa have become the “golden standard” now and those on uterus start to compete to traditional approach. But adaptational reactions of female organism and their clinical significance are not studied enough.

Material and methods. Clinical and laboratory study of 116 cases of laparoscopic operations on uterus and adnexa was performed. 86 (74%) of them were cases of benign adnexal tumors and 30 (26%) - cases of myomas. 78 (67,2%) cases were operated conservatively and 38 (32,8%) were treated radically. Type of adaptational reaction was evaluated according to L.H. Garkavy’s method (1978, 1999) by correlations in WBC, which reflect the force of side influence. Statistic and discriminant analyses were held using p-criteria and Fisher’s F-criteria.

Results. The most powerful influence was mentioned in radical operations on uterus, the less - in conservative operations on adnexa. In first postoperative day laparoscopic operation and its after-effects became powerful influence for 96% (25 cases) of patients operated on uterus and for 73% (66 cases) of patients operated on adnexae (p<0,05). The most powerful influence among the operations on adnexae proved to be operations due to theratomas and endometriomas with their contence getting into abdominal cavity after their walls injuries or raptures. The less powerful influence was fixed in cases of conservative operations for paraovarial cysts, even more then 20 cm in diameter. By the fifth postoperative day performed laparoscopic operation and its effects stayed powerful influence for 35,4% (41) of patients, influence of middle and low power was fixed in 64,6% (75) of patients. Discriminant analyses of significance of factors of influence showed the main role of mode of influence on tissues during the operation, volume of operation and kind of postoperative treatment. Considerable meaning was mentioned for postoperative pain levels, body temperature, intoxication indexs and WBC adaptational changings.

Conclusion. The results of this research served the pathogenetical basement for correction of using of various types of instruments, special operation techniques and adequate postoperative medicamentous treatment. Usage of received results showed the reduce of quota of patients with reactions on powerful influence in 5th postoperative day more then 4 times - to 8,6% (5 of 58 patients) in group of control.

作者简介

A. Shaparnyov

编辑信件的主要联系方式.
Email: info@eco-vector.com
俄罗斯联邦, Saint Petersburg

М. Kobiashvili

Email: info@eco-vector.com
俄罗斯联邦, Saint Petersburg

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