ZUR HAMODYNAMIK DER BEINVENEN NACH GYNAKOLOGISCHEN OPERATIONEN

The frequency of phlebothrombosis of the deep veins of the legs in gynaecologic surgery is described in the literature as 11 to 37%. The risk consists in complications as lung embolism and postthrombotic syndrome. The early detection of these complications only considering the clinical symptoms is not possible. In this paper a noninvasive method of measuring, light-reflection-rheography, is used to detect these complications. The reflection of an emission of 940 nm is measured of the cutaneous veins. The reflection is strictly proportional to the blood content of the veins. The parameters measured are venous drainage Δ R (mV) and venous refilling time t₀ (sec). We investigated 74 patients. We distinguished between abdominal or vaginal hysterectomy, surgery of the ovary and fallopian tube and surgery of the breast. Δ R (mV) of both legs significantly decreased in all groups at the 4th postoperative day compared with the results obtained preoperatively. Until the 8th to 12th day after surgery the results measured at the beginning were not reached. The variation of t₀ (sec) in both legs was nearly identical and at the 4th postoperative day high significantly different from the preoperative results. Moreover we found in the group of patients with surgery of malignant breast diseases a reduction of t₀ (sec) of 46.7% compared with 32.6% in benign breast diseases. The relative variation of t₀ (sec) after surgery in the small pelvis was on average 50%, while after surgery of the breast the relative decrease of t₀ (sec) was 35%. The changes were found by using the method of light-reflection-rheography can be compared with previous investigations. There is a good correlation with the results obtained by the invasive method of phlebodynamometry.