MISGAV LADACH SURGICAL TECHNIQUE OF CESAREAN SECTION Our experience at Pula General Hospital

Cilj istraživanja. Utvrditi prednosti tehnike carskog reza »Misgav Ladach« u usporedbi s konvencionalnom metodom po Dörffler-u. Ispitanice i metode. U Općoj bolnici u Puli obuhvaćeno je randomiziranim prospektivnim pokusom 104 pacijentica. U 49 pacijentica je izvršen carski rez konvencionalnom metodom, a u 55 izvršena je »Misgav Ladach« operacijska tehnika. Rezultati. U »Misgav Ladach« operacijskoj tehnici u usporedbi s konvencionalnom metodom doka-zali smo da je trajanje ekstrakcije novorođenčeta kraće (p=0,0009), kraće je ukupno trajanje operacijskog zahvata (p=0,0009), smanjena je postoperacijska bol nakon prvog postoperacijskog dana (p=0,021), ranije je ustajanje iz kreveta i hodanje (p=0,013), smanjena je postoperacijska potrošnja analgetika (p=0,0009), vremenski je kraća primjena analgetika (p=0,0009) i raniji je oporavak peristaltike crijeva (p=0,001). Zaključak. »Misgav Ladach« operacijska tehnika u usporedbi s konven-cionalnom metodom značajno skraćuje trajanje operacije, bolji su rezultati s obzirom na postoperacijsku bol, manja je potrošnja analgetika te brža je uspostava osnovnih fizioloških funkcija. Intraoperacijsko krvarenje, morbiditet majke, nalaz na rani, involucija maternice te procjena upalnog odgovora na operacijski pristup nisu se razlikovali u istraženim skupinama pacijentica.Objective. To evaluate the advantages of the »Misgav Ladach« surgical technique compared to the tradi-tional technique of caesarean section. Population and methods. A prospective randomized trial of 111 women undergoing caesarean section was carried out in the Pula General Hospital. 49 operations were performed by the traditional technique of caesarean section, 55 by the »Misgav Ladach« method. Results. It was proved that the cases where the »Misgav Ladach« method was implemented, compared to the traditional method, showed a significantly shorter delivery/extraction and operative time (p=0.0009), the incision pain in the second postoperative day was significantly lower (0.021), we recorded a quicker stand up and walking (p=0.013), significantly less analgesic injections and a shorter duration of analgesia were required (p=0.0009) and the bowel function was sooner recovered (p=0.001). Conclusion. The »Misgav Ladach« method of caesarean section has advantages over the traditional method by being significantly quicker to perform, with diminished postoperative pain and less use of postoperative analgesics. The recovery of physiologic functions is faster. No differences were found in intraoperative bleeding, mother morbidity, scar appearance, uterus postoperative involution and the assessment of the inflammation response to the operative technique