[Methods of anesthesia in obstetric surgery].
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OBJECTIVES: The increase of the radical oncological operations in gynecology and caesarean section in obstetrics constantly produce urinary tracts injuries. DESIGN: The aim of this paper is retrospective study the results surgical treatment of the ureteral lesions after gynecologic and obstetrics operations. MATERIALS AND METHODS: 65 women in average age 44 years old were undergone to analyze. The follow-up was 1-39 years (mean age 7.6 y.) after ureter injury. Anatomical and functional status of the genitourinary tracts was estimated. RESULTS: Good result was obtained in 75.3%, moderate in 10.8% and bed in 13.8% of the operated women. CONCLUSIONS: The best time for the reconstructive surgery are intraoperations period and the time between 5-14 weeks after ureteral lesions. The multiples urinary tract injures and necessity the extravesical urinary diversion give worse results of the late reconstruction urinary tracts. The percutaneous nephrostomy and employment the Psoas Hitch procedure during ureteral reimplantation, significantly improve the late results in reconstructive surgery of ureter. The late results of reconstruction urinary tracts in last lately 20 years are statistically better than obtained 20 years earlier.
Preventing infections at operative sites has long been a goal of gynecologic and obstetric surgeons. These infections constitute the leading cause of morbidity after both elective and emergent surgical procedures. Serious sequelae such as bacteremia, septic shock, phlegmon, pelvic abscess, septic pelvic thrombophlebitis, wound abscess, and fascial dehiscence may complicate primary infections, with devastating results. Early attempts to prevent postoperative infections concentrated on aseptic techniques and the modification of surgical skills. Soon after the introduction of antibiotics into clinical medicine, surgeons began to administer these drugs to clinically uninfected women to prevent operative-site infection; that practice has been documented and assessed in a large volume of literature. This article reviews the chronologic development of prospective data in the areas of benign gynecology, obstetrics, gynecologic oncology, and infertility and makes recommendations regarding antibiotic prophylaxis of infections associated with surgical procedures.
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