Abstract
An: 2015, Nr.2, Articol Nr. 26
Title: 

PERITONEAL ADHESIONS DOES NOT REPRESENT A CONTRAINDICATION FOR MINIMALLY INVASIVE APPROACH IN GYNECOLOGICAL EMERGENCIES

Authors: 

      I. Negoi, S. Paun, M. Beuran - University of Medicine and Pharmacy “Carol Davila” Bucharest; Emergency Hospital of Bucharest
      F.M. Filipoiu, G. Lupu, Ruxandra Irina Negoi - University of Medicine and Pharmacy “Carol Davila” Bucharest
      B. Stoica, I. Tanase - Emergency Hospital of Bucharest
      C. Holeab - Executive Agency for Higher Education, Research, Development and Innovation Funding (UEFISCDI)
      PERITONEAL ADHESIONS DOES NOT REPRESENT A CONTRAINDICATION FOR MINIMALLY INVASIVE APPROACH IN GYNECOLOGICAL EMERGENCIES (Abstract): The laparoscopic approach offers many diagnostic and terapheutic advantages in emergency setting for gynecological pathologies. In patients with previous abdominal surgeries laparoscopic approach can be very challenging. To define of peritoneal adhesions due to previous abdominal surgeries increase the morbidity and mortality of minimally invasive approach in gynecologic emergencies.Retrospective study of patients admitted in Emergency Hospital of Bucharest between during 24 months. Selection criteria were: (1) acute abdominal pain of suspected gynecologic origin, (2) laparoscopic approach. For statistical analysis the patients were divided into two groups: PAS – patients with previous abdominal surgery and WPAS – without previous abdominal surgery. There were 29 patients with mean age of 27.7±6 years. 12 (41.4%) have had previous abdominal surgeries (PAS=12, WPAS=17 patients). We found 22 (75.9%) ruptured ovarian cysts and 7 (24.1%) ectopic pregnancies. All patients presented hemoperitoneum: <500 ml – 14 (48.3%), 500-1500 ml – 12 (41%), >1500ml – 3 (10.3%) patients (p=0.729). The previous abdominal surgery was represented by : appendectomy-7, gynecological diseases-3, other-1 patient. The median postoperative decrease in hemoglobin level was 2 g/dl (PAS) and 1.45 (WPAS) (p>0.05). There was no statistical significant difference regarding need for antibiotics, analgesics, in-hospital stay and postoperative morbidity (p>0.05).Laparoscopic approach is safe in patients with acute abdomen of gynecological origin and previous abdominal surgeries.
Key words: GYNECOLOGICAL EMERGENCIES, LAPAROSCOPIC APPROACH, PERITONEAL ADHESIONS
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