CURRENT STATE OF LAPAROSCOPIC SURGERY FOR THE WOMEN WITH REPRODUCTIVE PROBLEMS / Шинэ санаа Шинэ нээлт

ABSTRACT

Today, in technologically updated world medicine, laparoscopy is more preferable than the common, open surgery procedures. There is a lack of scientific studies on laparoscopic surgery in gynecology, especially its present state and further tendencies. Therefore it served us as the background of the study.Retrospective study was conducted on 2016 laparoscopic surgery histories, which were performed in 2010-2014, at Mongolian state and private obstetric-gynecological hospitals and clinics. The study was developed by the program SPSS21.In 2010-2014 totally 2016 laparoscopic surgeries was performed 713 – in First Maternity Hospital, 653 – in Bayangol hospital, 429 - inASE hospital, 221 – in National Cancer Center of Mongolia. The patients were classified by their age, education state, and citizenship. Mean age of these patients was 33.03 ±7.6(min 12, max 70). By educations the 72.4% (1460) of them were high educated, 18.2%(367) has the secondary education, 4.7%(95) – college education, 4.5%(91) – 8th grade education, and 0.2%(3) – elementary school education or non-educated. The 81.8 %( 1649) patients were citizens, the 18.15 %( 366) – from rural areas. And only 0.05% (1) was the foreigner. We noted 7 %( 14) cases that shifted from laparoscopic surgery to open procedure. The post surgery average bed day was 2.7 ±1.3 (min 1, max 12), duration of the laparoscopic surgery 58.46 ±31.6 minutes (min 10, max 260). The average amount of blood loses during the surgery was 76.17 ±69.3( min 5, max 700),The relevance of the surgery duration and preoperative bleeding was(r-0.445). Various diagnoses were involved in the study the 25.9% (524) of them had second infertility, ovarian endometriosis cyst- 10.5% (212), ectopic pregnancy- 9.4% (189), hydrosalpinx- 7.5% (152), endometrioma ≥ 4.5 cm - 6.3% (128), ovarian follicularcyst- 6.3% (128), ovarian cancer- 5.7% (115), primary infertility- 5% (101), ovarian dermoids cyst-4.3% (86), endometrioma ≤ 4.5cm- 3.4% (68), others-15.7%. Surgical procedures are classified by their purposes: 29% (584) of surgery for examine the fallopian tube using contrast for medium and divide adhesion, 17.6% (354) – to remove ovarian cyst, 12.8% (259) – to examine fallopiantube using contrast and remove ovarian cyst, 9.4% (189) – to remove fallopian tube, 7% (142)- to remove endometrioma, 6.3% (128) – to examine uterine tube using contrast dye, 6% (121)-ot do hysterectomy, 11.9%- for other reasons. The 76.7% of all surgeries were done within one hour and there was moderate correlation between duration of surgery and bleeding (r-0.445). The secondary infertility was the most common diagnosis. And the laparoscopic manage of adhesion and hystersalpingography were performed more. According to the study, non-cancerous growth of uterus was 9.7 and the 6% of it surgeries was laparoscopic myomectomy.