Возможности применения рентгеноэндохирургического гемостаза в комплексной терапии миомы матки у пациенток с тяжелой анемией

Abstract

Uterine fibroids is one of the most common benign tumors of the pelvic organs in women. Up to 20% of women over 35 and up to 40% of women over 50 have this disease. The socio-medical significance of uterine fibroids is due to: rejuvenation of the disease, late diagnosis and treatment, which lead to complications resulting in emergency surgical interventions, the likelihood of tumor recurrence after primary surgery, which leads to a violation of generative function and reduce the quality of life of women. In planned gynecological hospitals, surgery for uterine fibroids is performed in more than 50% of patients. Of the total number of gynecological medical services in the emergency room, urgent gynecological care accounts for between 26% and 40%. Uterine bleeding remains one of the urgent problems in emergency gynecology, and in the structure of causes of mortality is 18-23%. Bleeding is one of the main symptoms of uterine fibroids. In urgent situations, the main task is to quickly and effectively stop bleeding and its prevention. Conservative methods to stop bleeding, hormone therapy and a minimal-ly invasive method - hysteroscopy followed by curettage of the uterine mucosa does not always lead to the desired result with large sizes of myoma nodes, as well as with multiple uterine myoma. Conservative myomectomy belongs to the category of reconstructive plastic surgery and is associated with higher risks of peri- and postoperative complications than radical interventions. Naturally, in an emergency situation, in a serious condition of the patient, severe anemia, hysterectomy is performed more often than myomectomy. In the available foreign and domestic literature there are very few works devoted to a comprehensive assessment of the possibility of organ-preserving surgical treatment of uterine fibroids in urgent gynecology. The lack of consensus about the tactics of management of patients of reproductive age with uterine myoma when providing emergency gynecological care, analyzing the results of surgical treatment for reproductive function does not allow to develop a single algorithm for managing patients, both in the operative and postoperative periods, putting this problem among the current.