Acute abdomen in gynaecology: current trends

ABSTRACT

Objective. This study aimed to assess the efficacy and safety of laparoscopic versus laparotomic approaches for treating acute abdominal syndrome in both pregnant and non-pregnant women, based on data from the Samarkand branch of the Republican Scientific and Practical Centre for Emergency Medical Care.
Materials and Methods. The study used diagnostic methods (history taking, clinical examination, ultrasound, laboratory tests), surgical interventions (laparoscopy, laparotomy), postoperative monitoring (monitoring of patients’ condition, control of laboratory parameters, ultrasound), and statistical analysis of data using Student’s t-test.
Results. The findings highlighted several benefits of laparoscopy, such as minimal invasiveness, shorter hospital stays, and a lower postoperative complication rate (5% compared to 18% for laparotomy). Additionally, laparoscopy was more effective in preserving fertility, with 89% of patients maintaining reproductive function without complications, versus 72% following laparotomy. However, laparotomy was still necessary in critical situations like large neoplasms or severe trauma. The study also indicated that bipolar coagulation reduced complications more effectively than monopolar coagulation, though haemostasis control issues arose in cases of ovarian rupture and tubal pregnancy. Early rehabilitation was crucial in minimizing complications, with standardized protocols proving essential. Regional anaesthesia, particularly epidural, was shown to reduce postoperative pain and promote quicker recovery, reinforcing previous research.
Conclusions. Laparoscopy demonstrated high efficacy and safety, underscoring the need for a multidisciplinary approach to reduce complications. Future research should focus on optimizing postoperative care and refining guidelines for selecting between laparoscopic and laparotomic methods based on specific clinical situations.