TRANSVESICAL ADENOMECTOMY COMPLICATIONS AFTER USE OF VARIOUS TECHNIQUES FOR GLAND BED HEMOSTASIS

Objective. To study the frequency of complications arising after transvesical adenomectomy by intraoperative hemostasis various methods using the Clavien — Dindo scale.

Materials and methods. A prospective randomized clinical trial was conducted, including 177 patients who had undergone open adenomectomy. Depending on the method of intraoperative hemostasis, the patients were divided into
2 groups. In the first group (90 patients) hemostasis was performed using a swab impregnated with the GAMASTAT and installed in the bed of the removed adenoma. In the second group (87 patients) hemostasis was performed by standard stitching of the bladder neck and tamponing the bed with a swab soaked in 3% hydrogen peroxide solution.

Results. The postoperative period was uneventful in 61 patients (67.4%) in the first group and in 27 patients (31%) in the second group. Complications of the inflammatory nature occurred in 7 patients (7.7%) and 17 in patients (21.9%) in the first and second groups respectively. Red blood cell transfusions were needed in 2 patients (2.2%) of the first group and in 11 patients (12.6%) of the second group. The total blood loss were 242.3±130.4 ml and 505.2±186.6 ml respectively. The differences in the complications number and the blood loss in the groups were statistically significant (p <0.05).

Conclusion. Inflammatory and hemorrhagic complications after an adenomectomy occur most often after open adenomectomies. However, complications of the 1st degree in the second group were 2.7 times more frequent and the blood transfusion frequency was 5.5 times higher than in the first group indicating at the Gamastat antimicrobial and hemostatic effect.

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Автор(ы): V. G. Adaschik, A. V. Strotsky