ОЦЕНКА РЕЗУЛЬТАТОВ ВЫПОЛНЕНИЯ ЛАПАРОСКОПИЧЕСКИХ ТАЗОВЫХ ЭВИСЦЕРАЦИЙ У ЖЕНЩИН В ТЕЧЕНИЕ ВОСЬМИ ЛЕТ

Abstract

Abstract : traditionally, evisceration is performed only through a complete median laparotomy, however, the rapid development of modern medical technologies, especially in the last ten years, allows for a fundamentally new level of surgical intervention. The aim of research : evaluation of the effectiveness of laparoscopic pelvic evisceration in women. Materials and methods : in the period 2011 to 2018, 19 laparoscopic eviscerations were performed in women aged 50-78 years due to locally advanced cancers of the pelvic organs. After the compulsory examinations - computed tomography (CT), magnetic resonance imaging (MRI), ultrasound of pelvic organs and abdominal cavity, colonoscopy, cystoscopy, excretory urography, rectal examination, oncomarkers, laboratory study (hemoglobin, residual nitrogen Blood serum), scintigraphy, positron emission tomography (PET CT), the presence of locally advanced lesions was confirmed, and the patients were sent for surgery. Results : 6 of total, 7 front and 6 rear evisceration was performed. For the purpose of urine diversion was performed a Bricker operation, for the derivation of feces was formed a primary anastomosis with a circular stapler with an additional preventive stoma, or a terminal colostomy. Perioperative results of pelvic excretion are given. Conclusion : When compared with the results of other works on open traditional pelvis exenteration, we can judge that with laparoscopic access there is significantly less blood loss, patients spend less time in intensive care, separation, and less the frequency of early postoperative complications. Such operations should be carried out by competent specialists and in specialized centers, which will reduce the number of complications, relapses, and also will allow to accumulate experience of multi-organizational interventions, for their subsequent introduction into general practice.