PATHOPHY SIOLOGICAL MECHANISMS OF CONNECTIVE TISSUE REMODELI NG AND PROTEIN METABOLI SM IN ANIMALS SUBJECTED TO GAMMA IRRADI ATION

Abstract

Stopping intraoperative bleeding from the prostate bed during prostatectomy in patients with benign prostatic hyperplasia (BPH) is the main stage of this complex surgical intervention. The number of postoperative complications, the outcome of prostatectomy, and the patient's fate depend on the success of hemostasis of the prostate bed. Intraoperative blood loss indicators and the frequency of blood transfusions in patients are the criteria for assessing the type of prostatectomy. Assessment of intraoperative blood loss is important for the anesthesiologist in order to start blood transfusion therapy in a timely manner. Objective. The purpose of the work is to determine intraoperative blood loss by weight method during open and laparoscopic prostatectomy in patients with benign prostatic hyperplasia. Materials and Methods. During 2021–2025, 100 single-stage laparoscopic extraperitoneal ventricular (transcapsular) prostatectomies, 100 single-stage open ventricular prostatectomies and 100 single-stage open transvesical prostatectomies were performed in patients with large benign prostatic hyperplasia (more than 80 cm3). Preoperative assessment of the physical condition of patients was performed according to the classification system of the American Society of Anesthesiologists (ASA) and the Charlson comorbidity index. Uroflowmetry after surgery (upon discharge from the hospital) was performed on a proprietary uroflowmeter “Potik – K” (Dnipro). Intraoperative blood loss was determined by the weight method. Assessment of intra- and postoperative complications after surgery was performed according to the Clavien-Dindo classification. Results. Laparoscopic prostatectomy was characterized by the longest operation time (120.3±12.7 minutes), but the lowest intraoperative blood loss (112.7±23.2 ml), no blood transfusions, the lowest number of postoperative complications (4%), and postoperative bed rest (6.3±1.9). Both laparoscopic and open prostatectomy allow for equally effective restoration of urination in patients after surgery. Conclusions. Laparoscopic prostatectomy is characterised by the longest operation time, but the least intraoperative blood loss, no blood transfusions, the shortest postoperative bed-day, and the fewest postoperative complications.