OBJECTIVE

To improve the results of minimally invasive treatment of patients after gynecological operations complicated by exudative intrapelvic masses by optimizing the tactics of radiosurgical techniques.

MATERIAL AND METHODS

Patients with exudative intravesical complications after gynecological operations (n=97, the main group) were sanitized (from Latin sanato — recuperation) by using puncture-drainage techniques; the control group consisted of patients with the similar complications (n=35), which were sanitized by the traditional open method or by laparoscopy. Apart from the transabdominal approach, the main group patients were treated using alternative approaches (transperineal, presacral, transovaginal). Besides assessing the clinical efficacy and safety of the minimally invasive techniques used in the patients of both groups, the patients’ quality of life was also studied (SF-36 questionnaire). The data were statistically processed using parametric and nonparametric methods.

RESULTS

The duration of hospital treatment in the main group was significantly shorter than that in the control group. There were no «major» complications that required a change in the treatment tactics. «Minor complications were detected in 18 (18.6%) patients. During the quality of life assessment, both physical and mental health parameters were significantly higher in the main group (75.4±3.1 and 69.8±4.5 points versus 66.2±3.2 and 56.4±4.1 points respectively). When comparing the alternative accesses, transperineal approach was characterized by a significantly lower number of postoperative complications and higher quality of life.

CONCLUSION

The transabdominal approach remains the preferred approach for sanation in patients with postoperative exudative intrapelvic masses. If this is not possible, alternative approaches, presacral, perineal, and transperineal, are also effective and safe. It is the task of the interventional radiologist to choose the best one in each case.