PROPHYLACTICS OF BLOOD LOSS DURING ADENOMECTOMY IN ELDERLY PATIENTS WITH BENIGN HYPERPLASIA OF THE PROSTATE

THE AIM of the investigation was to improve results of surgical treatment of elderly patients with benign hyperplasia of the prostate (BHPP) by means of using complex intraoperative hemostasis during adenomectomy which combined an original removable suture and inhibitors of local fibrinolysis. PATIENTS AND METHODS. The investigations included 885 BHPP patients aged from 74 through 92 years (mean age 79.3±0.5 years) after adenomectomy. The patients were divided into 3 groups. The first group consisted of 214 patients in whom the removable hemostatic suture was put on the bed of the ablated adenomatous nodes by an original method. The second group consisted of 393 patients in whom putting the removable hemostatic suture was combined with temporary tampon of the bed with an inhibitor of fibrinolysis – Gordox and introduction of it into the bed tissueof the ablated nodes. The third group (group of comparison) included 278 patients in whom hemostasis was made by the temporary tampon only. RESULTS. A comparative analysis suggests that the volume of postoperative blood loss was considerably different in the first group patients with the hemostatic suture. It was 2.2 times less than in the group of comparison. In the second group of patients with the hemostatic suture and local application of Gordox it was 4.7 times less. CONCLUSION. The mechanical arrest of bleeding in adenomectomy by putting a removable hemostatic suture with a local application of the fibrinolysis inhibitor Gordox results in a substantially less volume of blood loss and better results of operative treatment in elderly BHPP patients.

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