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Vol 6, No 1 (2004)
Published online: 2004-03-16

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Combined operative treatment in surgical wards - surgical-gynaecological operations

Dobrosława L. Sikora-Szczęśniak, Wacław Sikora, Andrzej Milczarek, Grzegorz Szczęśniak, Stanisław Kozak
Chirurgia Polska 2004;6(1):37-43.


Background: Gynaecological-surgical operations are performed either for emergency or elective reasons. In cases of concomitant gynaecological and surgical problems, with an adequate model of cooperation between surgeons and gynaecologists, elective surgery is most often performed by a surgicalgynaecological team.
The aim of the study was to evaluate clinical cooperation between surgeons and gynaecologist caried out in a regional hospital.
Material and methods: The analysis included indications for combined surgical-gynaecological treatment in the surgical ward and a range of procedures; in addition to this, preliminary and final diagnoses were compared. The material analysed included surgical documentation, case histories and lab results of histopathological postoperative investigations in the patients operated on for gynaecological problems in the surgical ward over a period of 15 years.
Results: In 1985-1999 the total number of operations at the Department of General Surgery was 9529, of which 195 patients also underwent gynaecological operations. It constituted 2% of all surgeries performed in the surgical ward. In the subsequent 5-year periods the respective values were: 1.9% (70/3634), 2.6% (96/3634) and 1.3% (29/2261). Lack of proper diagnostic tools (ultrasonography) was an important factor influencing results of surgery during first years of the observation period 144 patients underwent emergency surgery (73.8%) and 51 (26.2%) elective gynaecological-surgical procedures. In 13 patients (6.7%) no surgical problems were found in addition to gynaecological ones. The most common indications for surgery in the patients with concomitant gynaecological problems were: diseases of the appendix - 118 (60.5%), cholecistitis - 33 (16.9%), neoplasms - 11 (5.6%). The most common gynaecological problems found during surgical intervention included: ovarian (or peri-ovarian) cysts - 73 (37.4%), ovarian haemorrhage into the peritoneal cavity - 55 (28.2%), diseases of the Fallopian tubes, ectopic pregnancies (graviditas tuberia) and other diseases of the adnexa (including inflammations) - 36 (18.5%) cases.
Conclusions: 1. Operations on the adnexa in women aged up to 30 predominate among emergency combined surgical-gynaecological procedures. 2. The introduction of modern diagnostic methods, the imaging of abdominal organs and adequate models of gynaecological-surgical co-operation have resulted in a significantly decreased percentage of gynaecological operations handled by the surgical ward.

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