Background. The first day-care hospital (DCH) in the Russian Federation with 30 beds was established in the departments of general surgery, urology, and gynecology of the Botkin Hospital in 2016 in Moscow. Aim. To analyze the six-year experience of the gynecological DCH based on the Botkin Hospital. Materials and methods. The six-year experience (20162021) of the gynecological DCH based on the Botkin Hospital was analyzed. Results. The number of patients treated in the DCH increased progressively from 2016 to 2019. Due to the gain in the experience of DCH, patients with a broader spectrum of diseases can receive care in DCH settings, the number of hospitalized patients with a higher anesthetic risk has increased, and the proportion of patients over 65 years of age has also increased. Conclusion. Analysis of the activities of the DCH based on the Botkin Hospital showed that the pilot project can be considered successful due to good clinical and economic indicators. This activity format can be widely implemented, and it is optimal to establish such hospitals in multidisciplinary clinics.
Objective. To study the efficacy of interfascial transversus abdominis plane (TAP) block in elderly and senile patients as an element of complex perioperative anesthesia in a gynecology clinic. Patients and methods. The study enrolled 72 patients aged 61–78 years with benign ovarian tumors classified as anesthesia risk groups 2 and 3 according to the grading system of the American Society of Anesthesiologists (1991). The study group randomly included 35 women and the comparison group included 37 women. In the study group, after induction of anesthesia prior to skin incision, an interfascial injection of 2% ropivacaine solution into the rectus sheath under ultrasound control was performed simultaneously with bilateral subcostal TAP block. A total of 140–180 mg of ropivacaine was used. The abovementioned anesthesia was not administered in the comparison group. Results. Within 2 hours after surgery, the pain score on the visual analogue scale was 1.9 (0.2; 2.7) in the study group and 4.9 (3.3; 5.7) in the comparison group. The situation remained unchanged after 6 hours. In none of the observations in the study group was there an indication for opiates to relieve pain. In the comparison group, 14 patients required opiates once or twice during the first day. Conclusion. The use of interfascial plain block in gynecological practice is a promising element of complex anesthesia in the perioperative period. Key words: interfascial transversus abdominis plane block, enhanced recovery, perioperative anesthesia, Fast Track
Aim. To optimize preoperative diagnosis of infiltrative forms of genital endometriosis. Materials and methods. We analyzed the results of the preoperative examination and surgical treatment of 667 patients from 22 to 49 years old (31.4 [27.3; 34.2]) with external endometriosis presented with pelvic pain, dysmenorrhea, dyspareunia (n=580), and primary or secondary infertility (n=215). The duration of the disease ranged from 1 to 16 years. Seventy-eight (11.69%) patients had a history of surgery for external endometriosis. The serum concentration of the CA-125 tumor marker was measured by immunochemiluminescence assay. Colonoscopy was performed in 655 cases, and cystoscopy in 66 cases. In addition, pelvic ultrasound was performed for all patients. Pelvic magnetic resonance imaging (MRI) was performed with an intravenous bolus injection of a contrast agent. Results. Patients with endometrioid ovarian cysts (n=564) and "minor" forms of endometriosis (n=44) predominated. Endometrioid infiltrates occurred in 59 (8.84%) patients. In the group of patients with infiltrates, 18.64% had a history of surgery for endometriosis; 5.7% had a recurrence. Patients with retrocervical endometriosis and endometriosis of uterosacral ligaments predominated among females with infiltrative forms. No statistically significant differences in CA-125 concentration between patients with and without infiltrates were observed. The infiltrate was revealed, and its topography was described in 49 (83.05%) patients using ultrasound and 56 (94.81%) patients using MRI. All patients with dysuria had ultrasound, MRI, colonoscopy and cystoscopy. Conclusion. The combined use of pelvic ultrasound and MRI provides high accuracy in diagnosing infiltrative endometriosis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.