Optimization of surgical treatment of large uterine fibroids

Abstract

DOI: 10.52705/2788-6190-2023-04-5
УДК 618.14-006.36-089

The objective: increase of efficiency of surgical treatment of large uterine fibroids on the basis
of study of clinical-and-echographic and morphological features, and also development and
introduction of the differentiated going near the choice of method of operative interference with
the use of modern endoscopic technologies.
Materials and methods. The results of complex inspection and surgical treatment are analysed
200 patients by the large uterine fibroids (sizes are tumours, proper 12 and more to the weeks of pregnancy
and mass of remote macropreparation a more than 300 g) which was added planned
hysterectomy on the clinical base of department. 50 a patient is execute total laparoscopic
hysterectomy (group 1), 50 – total laparotomy hysterectomy (group 2), 50 - subtotal laparotomy
hysterectomy (group 3) and 50 – total vaginal hysterectomy (group 4).
Results. At to the analysis of the conducted operations it is set by us, that in 76,0% patients in a
group 1, 66,0% – in a group 2, 60,0% in a group 3 and 58,0% – in the group of 4 hysterectomy was
combined with other operations. More than half (54,0%) of patients in groups 2 and 3 operated
with the use of transversal suprapubic laparotomy (type Pfannenstiel) which is less traumatic and
provides more favourable results. Before infero-median transection succeeded in the cases of the
repeated interferences in patients which are before operated with the use of longitudinal cuts of
abdominal wall, sizes of tumour, which exceed 17–18 weeks.
Conclusion. The results of the conducted researches testify that the use of the differentiated
going near surgical treatment of large uterine fibroids is grounded and allows to improve early and
remote consequences for women in the aspect of clinical motion of early postoperative period and
quality of life in a remote period.