Analysis of surgical care delivery to gynecological patients

Aim. To analyze surgical care delivery to patients with urgent gynecological diseases in Kazan hospitals for the period of 2010-2014. Methods. The data on incidence, its structure, performed interventions, types of surgical approaches, obtained from eight Kazan hospitals, serving the urban population over the last 5 years (2010-2014) were analyzed. Results. During this period, 86 165 women were treated in gynecological departments, 13 863 (16%) of them were provided with surgical care. During the analyzed period, the number of gynecological patients increased by 7000: from 12 374 to 19 548 people. Abdominal surgical interventions prevailed. When analyzing the surgical approaches types ratio in elective abdominal interventions, the prevalence of abdominal laparoscopic approach was revealed. The increase in the use of endoscopy at urgent conditions from 73% in 2010 to 83.7% in 2014 was observed. The downward trend of the laparoscopic approach use during elective surgery, observed in recent years, to some extent may be due to reprofiling of departments and hospitals. The tendency to increase the ectopic pregnancy frequency - from 48.1 to 55.2%, ovarian apoplexy - from 20.8 to 31.7% in 2010 and 2014 respectively, was revealed. The laparoscopy use increase by almost 20% both in ectopic pregnancy and in ovarian apoplexy was observed. Conclusion. Adequate provision of city gynecological departments with endoscopic equipment, the possibility of its round-the-clock use, increase in the number of gynecologists mastered laparoscopic technology allow to increase the proportion of mini-invasive methods of surgical treatment.