Risk factors for thromboembolic complications in patients with elevated body mass index during the perioperative period of laparoscopic myomectomy

Background. Uterine fibroid is one of the most common diseases in gynaecological practice accounting from 32 to 70 % according various authors. In 80 cases, fibroids are observed women reproductive age. Laparoscopic myomectomy main methods surgical treatment for uterine A large number advantages this method many cases lead underestimation existing risks such as risk thrombosis with elevated body mass index (BMI). The purpose study detect adequate comprehensive thromboprophylaxis patients BMI perioperative period laparoscopic using an instrumental diagnosis low-frequency piezoelectric blood viscometer. Materials and methods. Patients aged 30–45 years undergoing (n = 60) were examined. They divided into 3 groups depending on method. Group 1 16) included < 30 kg/m2, who did not receive thromboprophylaxis. 2 18) consisted > treated enoxaparin at a dose 2,000 anti-Xa IU/0.2 ml subcutaneously (at 30–40 kg/m2) 4,000 IU/0.4 40 kg/m2). Third group 26) individuals kg/m2 received pentoxifylline Results. viscometry revealed statistically significant (p 0.05) deviations reference values coagulogram towards structural (increased maximum clot density) chronometric hypercoagulation (acceleration time formation fibrin-platelet structure T5, shift clotting T3 left, increase intensity coagulation drive), thrombin activity (an constant activity, decrease T2 time), activation vascular-platelet hemostasis (reduced T1 reaction onset, increased contact coagulation), inhibition lytic (a retraction lysis clot) 3. On first day after surgery 3, there was (compared preoperative indicators) indicators T1, T5; indicator density, well coagulation, which confirms effectiveness antithrombotic therapy. However, reported hemostasis, higher compared shorter time, higher. 5th surgery, normocoagulation trend hemostatic potential all patients. Conclusions. use allows reliably quickly assessing kinetics formation.