Профилактика повышения внутрибрюшного давления как значимый фактор уменьшения интраоперационной кровопотери в хирургии сколиоза

Objective. Quantitative estimation of intraoperative blood loss volume in surgical correction of idiopathic scoliosis with patient’s positioning ensuring complete decompression of the anterior abdominal wall. Material and Methods. Results of surgical correction of idiopathic scoliosis in 122 patients who underwent surgery involving skeletal traction and posterior correction with hybrid instrumentation in the prone position were analyzed. Posterior correction in 60 patients from Group I was performed on a standard orthopedic table, and in 62 patients from Group II - on a modular operating table for spinal surgery providing complete decompression of the anterior abdominal wall. Results. The studied parameters in groups were as follows: deformity magnitude - 54.7° ± 16,3° in Group I vs 61.5° ± 19.4° in Group II, the length of the posterior spinal fusion - 12.5 ± 1.1 vs 12.8 ± 0.9 segments, the number of levels in transpedicular fixation - 4.1 ± 1.1 vs 4.2 ± 1.8, and surgery duration - 169.4 ± 30.3 min vs 159.0 ± 31.6 min, respectively. The volume of intraoperative blood loss showed significant difference between groups: 1024.9 ± 409.2 ml (28.6 ± 12.3 % of circulating blood) in Group I, and 595.2 ± 208.6 ml (16.7 ± 6.2 % of circulating blood) in Group II. Conclusion. Complete decompression of the anterior abdominal wall during surgical correction of idiopathic scoliosis allowed reducing intraoperative blood loss by 41.6 % and ensuring the absence of indications for blood transfusion in 48.4 % of operated patients. Hir. Pozvonoc. 2014; (1): 94-99.