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a problem Urgency

The problem of diagnostics and treatment of tumours and tumorous formations of ovaries is difficult and extremely actual, as tumours of ovaries are often meeting gynecologic pathology (Adamjan L.V., Beloglazova of Century 1999; Sidorova I.S., Guriev Etc., 2003; Serov V.

N, Zvenigorodskij I.N., 2003).

Tumours of ovaries take the second place among all tumours of female genitals. Frequency of tumours of ovaries for last ten has laid down it was enlarged from 6,0-11,0 % to 19,0-25,0 % of all tumours of genitals (Adamjan L.V., Mynbaev O. A, 2000; Savelyev G. M, Breusenko V. G, 2004).

The majority of tumours of ovaries are good-quality, on their share 70,0-80,0 % are necessary. The cancer of ovaries makes 4,0-6,0 % among all malignant tumours (Poljakova V. A, 2001).

Among good-quality formations of ovaries most often there are epithelial formations - tsistadsnomy (serous and mucinous) - 22,86 % and mature teratomas, oljusjashchiesja to group

germinogennyh - 15,7 % (Gus A.I. 1996; Abdullaeva S.A., 2005).

The appreciable part of formations of ovaries is presented tumorous retentsionnymi by formations - 70,9 %. Cysts of ovaries average 17,0 % from all ovarialnyh formations, from them follicular - 85,0-90,0 %, cysts of a yellow body of 2,0-5,0 %, tekaljutennovye cysts of 1,0-2,0 %, endometrioidnye 5,0-10,0 %. In special group of formations about an ovary allocate paraovarialnye cysts (4,9 %) and serozotssls (5,2 %). They nanosecond concern neoplasms of ovaries, but to distinguish them from tumours of ovaries before operation difficultly, therefore them include in group ovarialnyh formations (Serov V. N, 1999; Savelyev G. M, Breusenko V. G, 2004; Torchinov A.M., Umahanova M. M, 2004; Abdullaeva S.A., 2005).

Certain group of tumorous formations of ovaries make tuboovarnalnye formations of an inflammatory genesis. Inflammatory diseases of appendages of a uterus essentially influence health of the woman of genital age. Last years rising of frequency of inflammatory diseases of appendages of a uterus (Strizhsletsky V.V., Zhemchuzhina T.J., 2005) is noted.

According to data of the domestic literature, inflammatory processes of internal genitals make 60,0-65,0 % among out-patient and to 30,0 % among inpatients. At 12,0-25,0 % of women acute inflammatory process proceeds with complications. Development tuboovarpalnyh formations is frequent, formation of abscesses (ppovara and nnosalpnnksa) are a consequence of inadequate therapy ZPPP (Fists of Century I, and co-workers., 2000; Adamjan L.V., and co-workers. 2000; Krasnopolsky Century I, and co-workers. 2001; Sweet R.L., 1994).

Purulent inflammatory diseases of appendages of a uterus can arise at any age, however is more often they are observed at women of genesial age, and case rate "peak" is necessary from 31 till 40 years (Strizhakov A.N., Podzolkova N.M., 1996).

According to the International agency on cancer studying, annually in the world it is registered more than 165000 cases of a cancer of ovaries. In Russia annually the cancer of ovaries is taped more than at 11000 women (10,7 on 100000), taking the seventh place in structure of the general oncologic case rate and the third - among gynecologic tumours after a cancer of a body and a uterus neck. For last 10 years in the country there was a disease gain on 8,5 % (Novikova E.G., Ronina E.A., 1999; Urmanchssva A.F., Kutusheva G. F, 2001; Zaridzs D.G., 2001; Zhordania K.I., 2004).

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In connection with untimely diagnostics at 77,0-80,0 % of women the cancer - of ovaries is taped for the first time in late stages, when radical and

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Effective treatment is impossible. It is bound to absence

patogiomopnchnyh symptoms, characteristic for early stages of disease (Vishnevskaja E.E., Bohman J.V., 1994; Makarov O. V, Borisenko S.A., 1996; Kolosov A.E., 1996; Poljakova V. A, 2001; Savelyev G. M, Solomatina A.L., 2002; Yancic R., 1993).

The majority of tumours of ovaries develop at the age from 31 till 60 years, is is more often more senior 40 years. The given pathology often leads to disturbance of menstrual, genesial, sex functions and is frequent to invalidizatsip women. These changes are the disability reason that causes social and economic aspects of the given pathology (Savelyev G. M, Breusenko V. G, 2004; Torchiiov A.M., Umahanova M. M, 2004).

Differential diagnostics of tumours and tumorous formations of ovaries is extremely important, as defines tactics of conducting patients individual in each concrete case.

In modern conditions one of leading places among methods of diagnostics of tumours of organs of a small basin occupies ultrasonic research which in a combination with dopplsrometrisj and dopplerografiej allows to differentiate more precisely types pridatkovyh formations and to surround features of a blood flow in them (Makarov O. V, 1990; Demidov V. N, 1 990; Savelyev G. M, 2004; Timor - Triscli I.E., Rottem S., 1991;

I., Rubin S.C., 1994; SugiyamaT. S., 1998; Silvija K. Rouzvia 2004).

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Methods have strongly entered into the last desjatiletne in laboratory practice

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immunoanaliza, allowing to define specific fibers,

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Synthesised by tumours of a various genesis, so-called tumoral markers (СА-125, SEA, SA - 50). Most often in practical gynecology it is used onkomarker СА-125 which definition can be used for monitoring of results of treatment (Alekseeva M. P, 1995; Tingulstad S., Hagen V, 1996; Meyer T, Rustin G. J., 2000; Smith R.A., V., 2002).

Now two basic approaches to diagnostics and treatment of tumours and tumorous formations of ovaries take place: laparotomnyj (traditional) and laparoskopichesky. Last years endoscopic methods of research and treatment of tumours of ovaries more widely take root into clinical practice all. Among endoscopic methods special value is given to a laparoscopy, as to the most informative research (Serov V. N, Kudrjavtseva L.I., 1999; Strizhova N.V., Zhordania N.I., 2001).

Despite the successes reached in revealing of tumours of ovaries, dooperatsionnoe the true nature establishment ovarialnogo formations still meets appreciable difficulties that can entail inexpedient tactics of conducting patients. Working out and perfection of methods of visualisation ovarialnyh formations (Murvatov K.D., Adamjan L.V., 2002) proceed.

Thus, in modern conditions diagnostics of tumours and tumorous formations of ovaries of nanosecond can be based on one method of research, and demands the complex approach for revealing ovarialnyh formations at early stages of development, and also carrying out of differential diagnostics dobrokachssgvsnnogo or malignant process and definition of a morphological structure of a tumour.

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A source: FOFONOVA Irina Jurevna. MODERN APPROACHES To DIAGNOSTICS And TREATMENT of TUMOURS And TUMOROUS FORMATIONS of OVARIES At WOMEN of GENESIAL AGE. The DISSERTATION on scientific degree competition kandidati medical sciences. Smolensk - 2007. 2007

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