Is There a High Risk for GI Bleeding Complications in Patients Undergoing Abdominal Surgery?

INTRODUCTION: Gastrointestinal bleeding (GIB) can cause life-threatening situations. Here, endoscopy is the first-line diagnostic and therapeutic mode in patients with GIB among further therapeutic approaches such as embolization or medical treatment. Although GIB is considered the most common indication for emergency endoscopy in clinical practice, data on GIB in abdominal surgical patients are still scarce. PATIENTS AND METHODS: For the present study, all emergency endoscopies performed on hospitalized abdominal surgical patients over a 2-year period (1 July 2017-30 June2019) were retrospectively analyzed. Primary endpoint was 30-day mortality. Secondary endpoints were length of hospital stay, cause of bleeding, and therapeutic success of endoscopic intervention. RESULTS: During the study period, bleeding events with an indication for emergency endoscopy occurred in 2.0% (129/6455) of all surgical inhouse patients, of whom 83.7% (n = 108) underwent a surgical procedure. In relation to the total number of respective surgical procedures during the study period, the bleeding incidence was 8.9% after hepatobiliary surgery, 7.7% after resections in the upper gastrointestinal tract, and 1.1% after colonic resections. Signs of active or past bleeding in the anastomosis area were detected in ten patients (6.9%). The overall 30-day mortality was 7.75%. CONCLUSIONS: The incidence of relevant gastrointestinal bleeding events in visceral surgical inpatients was overall rare. However, our data call for critical peri-operative vigilance for bleeding events and underscore the importance of interdisciplinary emergency algorithms.

ASSISTED REPRODUCTIVE TECHNOLOGY EFFICIENCY IMPROVEMENT OF TUBAL-PERITONEAL INFERTILITY.

OBJECTIVE: The aim: This study aims to develop and implement a complex of pregravid preparation based on endogenous melatonin level, development of oxidative stress and violation of apoptosis regulation in women with tubal-peritoneal infertility. PATIENTS AND METHODS: Materials and methods: We have examined 100 women of reproductive age, including 65 women with tubal-peritoneal infertility treated by ART. All studied women were defined levels of endogenous melatonin, oxidative status and level of apoptosis in the endometrium and in follicular fluid (infertile women only). As a powerful free radical neutralizer, we used melatonin to improve the microenvironment of maturing oocytes and create favourable conditions for implantation in the endometrium. RESULTS: Results: Treatment by exogenous melatonin showed better results than standard therapy without antioxidants: the quality of oocytes and embryos, the level of ongoing pregnancies and childbirth was significantly higher. CONCLUSION: Conclusions: We achieved such results due to restoring the balance in pro / antioxidant system and apoptosis in female reproductive tract.