Zaporožskij Medicinskij Žurnal (Jun 2017)
The tactics of choice of surgical intervention in the diagnosis of space-occupying process of the fallopian tubes in women of reproductive age
Abstract
The aim. Analysis of the use of modern methods of surgical treatment of space-occupying process of the fallopian tubes in women of reproductive age based on the study of anamnestic, clinical and instrumental methods of diagnosis. Material and methods. In an open prospective study included 155 patients who were hospitalized in the gynecological department with a diagnosis of chronic salpingitis and oophoritis and who were divided into two clinical groups. The first clinical group consisted of 89 women in whom chronic salpingitis was diagnosed according to clinical and laboratory examination; the second group included 66 women with chronic inflammation of the uterine appendages that have been diagnosed of space-occupying process of the fallopian tubes (hydrosalpinks) and who underwent surgery laparoscopic access. Results. It was found that 66 patients with formation of space-occupying process of the fallopian tubes were operated by laparoscopic access routinely. In 28 patients (42.42%) of the clinical group clinically reasonable amount of intraoperative surgery of space-occupying process of the fallopian tubes was bilateral tubal removal of the fallopian tubes or deletion of a single fallopian tube. 12 women (18.18%), who had parity (8 patients - 66.67%) and 4 patients who planed future pregnancies (33.33%) were recommended postoperative consultation with specialized reproductive center. Taking into account the woman's age, reproductive history (parity absent in 32 patients - 84.21%), in 38 patients (57.58%) organ preserving surgery was performed to preserve possibility of conception without the use of reproductive technologies such as in vitro fertilization. Conclusions. When selecting the amount of surgery in women with tubal bulky formations leading role is dedicated to clinical data which can be obtained during intraoperative visual evaluation of the fallopian tubes of the patient based on age and reproductive history.
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