[Laparoscopic diagnosis and treatment of early adhesive small bowel obstruction after gynecological surgery].

It is presented the results of diagnostic and curative laparoscopic interventions in 33 patients with acute early adhesive small bowel obstruction. Ileus developed after surgical treatment (laparotomy) of different gynecological diseases. Laparoscopy appeared as the most informative diagnostic method to confirm diagnosis in all patients, to estimate state of abdominal cavity and small pelvis organs what can help to determine method of surgical treatment. Contraindications for laparoscopic surgery were identified in 12 (36.4%) patients and conversion to laparotomy was applied in this group. Postoperative complications were diagnosed in 1 (8.3%) patient. 2 (16.6%) patients died. Early adhesive ileus was resolved laparoscopically in 21 (63.6%) of 33 patients. Recurrent acute early adhesive ileus was detected in 1 (4.7%) patient.

[The prevention of the adhesive process after surgical interventions in gynecological patients in the reproductive period]. / Profilaktiki spaechnogo protsessa posle khirurgicheskikh vmeshatel'stv u ginekologicheskikh bol'nykh v reproduktivnom periode.

Dynamic laparoscopy making use of special tubes was carried out in 149 patients (30 with acute inflammatory diseases of the uterine tubes, 80 following reconstructive surgery on the tubes suffering from tuboperitoneal sterility, 9 operated on the internal genitals). Repeated laparoscopic examinations were carried out in the course of 14 days, every 2-3 days. The course of the postoperative period was assessed by the presence of adhesions, hyperemia, edema, and exudation. Adhesions were separated, during mixtures were delivered including antibiotics, corticosteroids, enzymes, rheopolygluquins; chromohydrotubations was carried out. Dynamic laparoscopy in patients with inflammatory diseases of the internal genitals helped detect positive results 2-3 days after intensive care was started and prevent adhesions. This method appears to be particularly valuable if used after inflammatory processes and interventions on the internal genitals in young, more so in nulliparous women planning to have children in future.

[Ovarian and endometrial status in tubal and peritoneal sterility]. / Sostoianie iaichnikov i éndometriia pri trubnom i peritoneal'nom besplodii.

A total of 97 patients with laparoscopically confirmed tubal and peritoneal sterility were examined. Thirty-six patients presented with a normal biphasic menstrual cycle, the rest 61 with the lutein phase insufficiency. Follicular presence and size were examined by ultrasonography, the dominant follicle and endometrium volumes were estimated. Only in 17 of the 97 examinees all the examined parameters were found normal, in the rest deviations from the normal echographic picture were revealed. More marked changes were detected in the patients with the lutein phase insufficiency. The findings evidenced a direct correlation between ultrasonic data and rectal temperature, adhesion process severity and the results of ovarian biopsy specimen histologic examination. The authors recommend ultrasonic examination for the assessment of ovarian function in patients suffering from tubal and peritoneal sterility.

[Ultrasonic examination of the status of the ovaries and endometrium after the treatment of tubal and peritoneal infertility]. / Sostoianie iaichnikov i éndometriia po dannym UZI v protsesse terapii posle likvidatsii trubnogo i peritoneal'nogo besplodiia.

The authors analyze the usefulness of ultrasonic examination for the assessment of ovarian and endometrial status in 84 patients operated on for tubal and peritoneal sterility. After surgery the patients were recommended nootropic agents and cyclic vitamin therapy for 3 months. In cases with concomitant diseases (endometriosis, small pelvis varicose veins) synthetic estrogen-gestagen drugs, anticoagulants, disaggregants were prescribed. If the treatment did not result in pregnancy in 2 months, ovulation stimulants (clostilbegit, choriogonin) were prescribed. Drug therapy had a favorable effect on ovarian and endometrial function. Ultrasonic examination may be recommended for monitoring ovarian and endometrial status.

[Echography in the examination of postmenopausal patients with endometrial pathology]. / Mesto ékhografii v obsledovanii bol'nykh perioda postmenopauzy s patologiei éndometria.

Small pelvic organs were examined in 61 postmenopausal females suspected for having an intrauterine abnormality and 25 females matched for age who had no clinical signs of endometrial abnormalities. The findings were compared with the results of hysteroscopic and histological examinations of their curettage specimens. There was a 85% agreement of echographic and histological findings in the patients with suspected intrauterine abnormalities. The echography of small pelvic organs is a screening tool for the diagnosis of intrauterine diseases in postmenopausal females. When M-mode echography shows high values, hysteroscopy and separate diagnostic curettage are indicated. M-mode echography is a useful method for checking up the endometrial status in postmenopausal females receiving hormonal therapy for proliferative endometrial processes.

[The estrogen receptors of the endometrial plasma membranes in proliferative processes in the postmenopause]. / Retseptory éstrogenov plazmaticheskikh membran éndometriia pri proliferativnykh protsessakh v postmenopauze.

Estradiol receptors of plasma membranes (PM), PM lipids, the activity of membrane-bound enzymes and plasma levels of hormones have been tested in patients of postmenopausal ages with various endometrial diseases (glandular fibrous and glandular cystic polyps, highly, moderately and poorly differentiated adenocarcinomas). Test findings were similar in patients with the glandular cystic polyps and poorly and moderately differentiated adenocarcinomas. Therefore, the patients with the glandular cystic endometrial polyps are at high risk of endometrial cancer. Since the risk increases with higher estrogen plasma levels, the patients with proliferative endometrial conditions may benefit from intake of antiestrogens.