Biomeditsina va amaliyot jurnali, 2022 №3
Subject of the article
TOTAL GISTEREKTOMIYANING SUBTOTAL GISTEREKTOMIYADAN USTUNVORLIGINI TAHLILLASH (78-84)
Authors
SHAVAZI Nargiza Nuraliyevna, AHADOVA Nigina Jamol qizi ABDULHAKIMOVA Moxinur Nasriddin qizi
Institution
SamDTU
Abstract
Mavzuninig dolzardligi: Biz yashab turgan davrda, ayollar jinsiy a’zolari sistemasi patologiyasini davolashning innovatsion uslublarining rivojlanishi, bachadonni olib tashlash operatsiyalarini bajarish darajasini keskin darajada tushira olmaydi. Ilmiy dunyoda o’tkazilgan ilmiy tadqiqotlarda gisterektomiyaga bo'lgan ilmiy qarashlar har xildir Operatsiyaning qo'lami bo'yicha yagona fikr yo'q: umumiy yoki subtotal, tuxumdonlarni saqlash yoki olib tashlash. Gisterektomiya uchun jarrohlik yondashuv (qorin bo'shlig'i, vaginal yoki laparoskopik) bilan bog'liq savollar hali ham munozarali. Bachadonni olib tashlash operatsiyasining total va subtotal turlari mavjud. Bachadonni noto’liq, bachadon bo’ynini qoldirgan holda olib tashlash subtotal gisterektomiya, to’liq, bachadon bo’yni bilan olib tashlash, tibbiyotda total gisterektomiya deb yuritiladi. Jarrohlikning qulay va kam jarohatli metodlarining jadal kiritilishiga qaramasdan, jarrohlikni qay uslubda olib borish masalasidan ko’ra, bachadonni to’liq yoki noto’liq olib tashlash masalasi aktual bo’lib qolmoqda. Ko’p olimlar izlanishlari natijalari va adabiyotlar dagi ko’rsatkichlarga asoslangan holda, subtotal gisterektomiyadan farqli o’laroq, total gisterektomiyadan keyin bo’ladigan qin devorlari past tashlashi, yoki jinsiy funksiyaning buzilishi isbotsiz qolmoqda. Shundan kelib chiqib, subtotal gisterektomiya faqat bachadon bo’yni sog’lom ayollarda o’tkazilishi kerak deb mulohaza qilsak, mubolag’a bo’lmaydi. Tadqiqot usullari: nazariy ya’ni mavzuga oid bo’lgan ilmiy va uslubiy adabiyotlarni tahlil qilish, shuningdek, unda aynan total gisterektomiyaning subtotal gisterektomiyadan ustunvorligini belgilash. Xulosa. Jarrohlik ishi va uning ko'plab afzalliklari texnik jihatdan murakkab bo’lgan opperatsiyalarda ya’ni miyomatoz tugunlarning atipik lokalizatsiyasi, keng tarqalgan endometrioid infiltratlar holatlarda ko’rsatilgan.Subtotal gisterektomiyani amalga oshirishda jarrohlik texnikadan foydalanish intraoperatif qon yo'qotishni sezilarli darajada kamaytirishi, operatsiya ichidagi va operatsiyadan keyingi asoratlarning chastotasini kamaytirishi mumkin.
Key words
bachadon total va subtotal gisterektomiyasi, jarrohlikdan keying hayot
Literature
1. Высоцкий М.М., Манухин И.Б., Овакимян М.А. Особенности техники лапароскопической гистерэктомии при больших размерах матки. Эндоскопическая хирургия. 2009;4: 37-40. [Vysotskii MM, Manukhin IB, Ovakimyan MA. Osobennosti tekhniki laparoskopicheskoi gisterektomii pri bol'shikh razmerakh matki. Endoskopicheskaya khirurgiya. 2009;4:37-40.] 2. Адамян Л.В., Андреева Е.Н., Артымук Н.В. и др. Миома матки: диагностика, лечение и реабилитация. Клинические рекомендации по ведению больных. М. 2015. [Adamyan LV, Andreeva EN, Artymuk NV. i dr. Mioma matki: diagnostika, lechenie i reabilitatsiya. Klinicheskie rekomendatsii po vedeniyu bol'nykh. M. 2015. (In Russ.)] 3. Беженарь В.Ф., Цыпурдеева А.А., Долинский А.К., Бочоришвили Р.Г. Лапароскопическая гистерэктомия — семилетний опыт. Журнал акушерства и женских болезней. 2011;60(4):12-20. [Bezhenar' VF, Tsypurdeeva AA, Dolinskii AK, Bochorishvili RG. Laparoskopicheskaya gisterektomiya — semiletnii opyt. Zhurnal akusherstva i zhenskikh boleznei. 2011;60(4):12-20. (In Russ.)] 4. Andersen LL, Ottesen B, Alling-Møller LM et al. Subtotal versus total abdominal hysterectomy: randomized clinical trial with 14-year questionnaire follow-up. Am J Obstet Gynecol. 2014. pii: S0002-9378(14)02498-3. doi: 10.1016/j.ajog.2014.12.039 5. Anvar Ibragimovich Kamalov, Larisa Rubenovna Aghababyan, Medical aspects of prevention of massive bleeding after childbirth, Journal of Biomedicine and Practice. 2022, vol. 7,Issue 1, pp.11-16 6. van Evert JS, Smeenk JM, Dijkhuizen FP et al. Laparoscopic subtotal hysterectomy versus laparoscopic total hysterectomy: a decade of experience. Gynecol Surg. 2010;7(1):9-12. 7. Oscarsson U, Poromaa IS, Nussler E, Lofgren M. No difference in length of hospital stay between laparoscopic and abdominal supravaginal hysterectomy — a preliminary 8. Robert M, Soraisham A, Sauve R. Am J Obstet Gynecol. 2008. Postoperative urinary incontinence after total abdominal hysterectomy or supracervical hysterectomy: a metaanalysis 9. Todd R. Jenkins. Laparoscopicsupracervical hysterectomy. American Journal of obstetrics and gynecology. 2004;191:1875-1884. 10. Кулаков В.И., Адамян Л.В., Аскольская С.И. Гистерэктомия и здоровье женщины. М.: Медицина; 1999. [Kulakov VI, Adamyan LV, Askol'skaya SI. Gisterektomiya i zdorov'e zhenshchiny. M.: Meditsina; 1999. (In Russ.)] 11. Паукер В.А. Здоровье женщины после тотальной и субтотальной гистерэктомии, произведенной по поводу миомы матки: Дис. ... канд. мед. наук. М. 1997. [Pauker VA. Zdorov'e zhenshchiny posle total'noi i subtotal'noi gisterektomii, proizvedennoi po povodu miomy matki: Dis. ... kand. med. nauk. M. 1997. (In Russ.)] 12. Scott JR, Sharp HT, Dodson MK, Norton PA, Warner HR. Subtotal hysterectomy in modern gynaecology: a decision analysis. Am J Obstet Gynaecol. 1997;176:1186-1192. 13. Vale DB et al. Usefulness of vaginal cytology tests in women with previous hysterectomy for benign diseases: assessment of 53.891 tests. Gynecologic oncology. 2015;137(2):270-273. 14. Hannoun-Levi J, Peiffert D, Hoffstetter S, Luporsi E, Bey P, Pernot M. Carcinoma of the cervical stump: retrospective analysis of 77 cases. Radiother Oncol. 1997;43(2):147-153. 15. Akintobi A, Bello O, Asaolu OA et al. Laparoscopic supracervical hysterectomy and uterine morcellation: case report from Asokoro District Hospital, Abuja, Nigeria. Nigerian Journal of Clinical Practice. 2015;18:824-827. 16. Erian J, El-Shawarby SA, Hassan M et al. Laparoscopic subtotal hysterectomy using the plasma kinetic and lap loop systems: An alternative approach in the surgical management of women with uterine fibroids. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2008;137(1):84-87. 17. Gimbel H. Total or subtotal hysterectomy for benign uterine diseases? A meta-analysis. Actaobstetricia et gynecologicascandinavica. 2007;86(2):133-144. 18. Hasson HM. Cervical removal at hysterectomy for bening disease. J Reprod Med. 1993;38:781- 790. 19. Van Wijngaarden WJ, Duncan ID. Upper age limit for cervical screening. BMJ. 1993;306(6889):1409-1410. 20. Kikku P, Gronroos M, Rauramo L. Supravaginal uterine amputation with perioperative electrocoagulation of endocervical mucosa. Description of method. Acta Obstet Gynecol Scand. 1985;64(2):175-17 21. Alvarez-Rodas E, Mettler L, Semm K. Histologic features of the CISH procedure. J Am Assoc Gynecol Laparosc. 1994;2(1):37-41. 22. Mettler L. (ed). Endoscopische Abdominalchirurgie in der Gynäkologie. Stuttgart. 2002. 23. Mettler L. (ed). Manual for laparoscopic and hysteroscopic gynecological surgery. Jaypee Brothers, New Delhi. 2006. 24. Mettler L, Ahmed-Ebbiary N et al. Laparoscopic hysterectomy: challenges and limitations. Minim Invasive Ther Allied Technol. 2005;14(3):145-159.