Comparative features of different forms of ovarian apoplexy
Authors: Pavlyk Uliana 
Published: January 2024

The objective: to learn comparative aspects of women with the different forms of apoplexy on the modern stage.

Materials and methods. It was conducted A clinical-and-laboratory inspection of 140 women from which – 65 patients by the anemic form of ovarian apoplexy, which first added to the laparoscopic operations. These patients were plugged into prospective research and were part of two groups depending on the method of hemostasis used during an operation. In 1 group entered 35 patients, hemostasis was carried out by bipolar coagulation, in 2 groups – 30 patients, bleeding from an ovary that was shut down by imposition of guy-sutures. Repeatedly operated women were included in the 3rd and 4th groups – 21 and 19 women, respectively. In that or other group, patients were taken away by a «blind» method. In research, patients joined with the stable indexes of hemodynamics before interference and duration of hospitalization not more than 24 hours. All operations were executed by the same surgical brigade. The criteria of exception from the research were intra-abdominal bleeding as a result of the break of benign tumor or endometrioid ovarian cyst; a presence in anamnesis of operative interferences on ovaries; and also the reception of the combinatorial contraceptives or use of methods of stimulation of superovulation exogenous gonadotropins less than 3 months prior to an operation. The group of comparison was made 35 patients from laparoscopic the confirmed pain form of ovarian apoplexy, that got conservative treatment.

Results. Working it is possible to say out total of analysis of results of the preoperative inspection, that more than any procatarxiss of ovarian apoplexy absented in the halves of patients. The investigated groups did not differ in the character of clinical displays of the anemic form of ovarian apoplexy, frequency of anemia, ultrasonic indexes of volumes of the staggered ovary, and free fluidity in the cavity of the pelvis, to the parameters of preoperative preparation. The group of comparison differed from the investigated groups only the considerably less volume of free fluidity in the cavity of the pelvis, discovered at an echography and structure of certificates to the lead through of diagnostic laparoscopy. After confirmation of the diagnosis of an anemic form of ovarian apoplexy in all patients operative treatment was carried out. In the majority 28 (80%) patients of a group of comparison after confirmation of diagnosis pain form of ovarian apoplexy and in default of in the abdominal region of far of ferrofluid of no subsequent surgical manipulations did not execute. To 7 (20%) patients of this group with a volume of serosal exudate of more than 200 ml evacuation and washing to the cavity of the pelvis was executed solution. All operations were executed fully by laparoscopic access, there was not a single passing to laparotomy. Intraoperative complications were not. The catchment of the abdominal region was carried out only 2 (3,1%)by a patient. In 13 (37,1%) patients of a 1 group and 11 (36,7%) operations of the stop of bleeding from the ovary were combined with other interferences (р>0,05). The most frequent united operation was a division of joints in the cavity of the small pelvis, which was executed 8 (23%) by a patient of 1 group and 6 (20%) by a patient of 2 groups (р>0,05). 3 (8,6%) by the patient of a 1 group and 4 (13,3%) by a patient2 group the executed coagulation of hearths of endometriosis (р>0,05). Two by the patient of a 1 group the delete of shallow (to 2 see is in a diameter) subserosal myomatous node was executed on a leg.

Conclusion. The results of the conducted research testify that the unique meaningful difference between the two investigated groups was an index of the duration of operative interference (р<0,05). 1,5time had operations almost more protracted in 2 groups of patients, hemostasis which carried out the imposition of guy-sutures on an ovary. The analysis of digital records of the operative manual defined that reason for the increase in his duration is the stage of hemostasis which foresaw a 100% husking of the cysts and impositions of one or a few guy-sutures on the wound of the ovary. Duration of the stage grew, as a result of the laparoscopic imposition of guy-sutures, especially with the intracorporal stringing of nodes, is labor intensive enough procedure.No meaningful differences between groups in the middle volume of blood loss, frequency of the United operations, postoperative conduct, the motion of postoperative period and duration of stay in permanent establishment discovered it was not.