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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Gynecology</journal-id><journal-title-group><journal-title xml:lang="en">Gynecology</journal-title><trans-title-group xml:lang="ru"><trans-title>Гинекология</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2079-5696</issn><issn publication-format="electronic">2079-5831</issn><publisher><publisher-name xml:lang="en">Consilium Medicum</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">115071</article-id><article-id pub-id-type="doi">10.26442/20795696.2022.6.202027</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>CLINICAL CASE</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЙ СЛУЧАЙ</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Principles of fast-track surgery in the treatment of giant uterine fibroids: а clinical case</article-title><trans-title-group xml:lang="ru"><trans-title>Принципы «Fast-track хирургии» в лечении миомы матки гигантских размеров. Клинический случай</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2875-6307</contrib-id><name-alternatives><name xml:lang="en"><surname>Lapina</surname><given-names>Irina A.</given-names></name><name xml:lang="ru"><surname>Лапина</surname><given-names>Ирина Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>D. Sci. (Med.), Pirogov Russian National Research Medical University</p></bio><bio xml:lang="ru"><p>д-р мед. наук, доц. каф. акушерства и гинекологии лечебного фак-та ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»</p></bio><email>doclapina@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1659-4256</contrib-id><name-alternatives><name xml:lang="en"><surname>Tyan</surname><given-names>Anatoly G.</given-names></name><name xml:lang="ru"><surname>Тян</surname><given-names>Анатолий Геннадьевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Med.), Medsi Clinical Diagnostic Center on Krasnaya Presnya</p></bio><bio xml:lang="ru"><p>канд. мед. наук, рук. Центра женского здоровья АО ГК «Медси», КДЦ на Красной Пресне</p></bio><email>doctortyan@yandex.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7830-2290</contrib-id><name-alternatives><name xml:lang="en"><surname>Dobrokhotovа</surname><given-names>Yulia  Е.</given-names></name><name xml:lang="ru"><surname>Доброхотова</surname><given-names>Юлия Эдуардовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>D. Sci. (Med.), Prof., Pirogov Russian National Research Medical University</p></bio><bio xml:lang="ru"><p>д-р мед. наук, проф., зав. каф. акушерства и гинекологии лечебного фак-та ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»</p></bio><email>pr.dobrohotova@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6297-8811</contrib-id><name-alternatives><name xml:lang="en"><surname>Gomzikova</surname><given-names>Valeriia M.</given-names></name><name xml:lang="ru"><surname>Гомзикова</surname><given-names>Валерия Михайловна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Graduate Student, Pirogov Russian National Research Medical University</p></bio><bio xml:lang="ru"><p>аспирант каф. акушерства и гинекологии лечебного фак-та ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»</p></bio><email>gomzval1402@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9305-323X</contrib-id><name-alternatives><name xml:lang="en"><surname>Sorokin</surname><given-names>Yury  А.</given-names></name><name xml:lang="ru"><surname>Сорокин</surname><given-names>Юрий Александрович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Head, Medsi Clinical Diagnostic Center on Solyanka</p></bio><bio xml:lang="ru"><p>рук. Центра репродуктивного здоровья АО ГК «Медси», КДЦ на Солянке</p></bio><email>sorokin_y@mail.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2338-2884</contrib-id><name-alternatives><name xml:lang="en"><surname>Taranov</surname><given-names>Vladislav V.</given-names></name><name xml:lang="ru"><surname>Таранов</surname><given-names>Владислав Витальевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Graduate Student, Pirogov Russian National Research Medical University</p></bio><bio xml:lang="ru"><p>аспирант каф. акушерства и гинекологии лечебного фак-та ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»</p></bio><email>vlastaranov@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2140-8000</contrib-id><name-alternatives><name xml:lang="en"><surname>Malakhova</surname><given-names>Anastasia А.</given-names></name><name xml:lang="ru"><surname>Mалахова</surname><given-names>Анастасия Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Graduate Student, Pirogov Russian National Research Medical University</p></bio><bio xml:lang="ru"><p>аспирант каф. акушерства и гинекологии лечебного фак-та ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»</p></bio><email>anastasimed@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8302-7510</contrib-id><name-alternatives><name xml:lang="en"><surname>Chirvon</surname><given-names>Tatiana G.</given-names></name><name xml:lang="ru"><surname>Чирвон</surname><given-names>Татьяна Геннадьевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Assistant, Pirogov Russian National Research Medical University</p></bio><bio xml:lang="ru"><p>ассистент каф. акушерства и гинекологии лечебного фак-та ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»</p></bio><email>tkoltinova@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Gudebsckaia</surname><given-names>Viktoria А.</given-names></name><name xml:lang="ru"><surname>Гудебская</surname><given-names>Виктория Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Med.), Medsi Clinical Diagnostic Center on Krasnaya Presnya</p></bio><bio xml:lang="ru"><p>канд. мед. наук, врач – акушер-гинеколог отд-ния женского здоровья АО ГК «Медси», КДЦ на Красной Пресне</p></bio><email>gudebskaia.va@medsigroup.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Firstova</surname><given-names>Svetlana V.</given-names></name><name xml:lang="ru"><surname>Фирстова</surname><given-names>Светлана Витальевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Department Head, Medsi Clinical Diagnostic Center on Krasnaya Presnya</p></bio><bio xml:lang="ru"><p>зав. отд-нием женского здоровья, врач – акушер-гинеколог АО ГК «Медси», КДЦ на Красной Пресне</p></bio><email>firstova.sv@medsigroup.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0189-0845</contrib-id><name-alternatives><name xml:lang="en"><surname>Zateeva</surname><given-names>Anastasia А.</given-names></name><name xml:lang="ru"><surname>Затеева</surname><given-names>Анастасия Андреевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Graduate Student, Pirogov Russian National Research Medical University</p></bio><bio xml:lang="ru"><p>аспирант каф. акушерства и гинекологии лечебного фак-та ФГАОУ ВО «РНИМУ им. Н.И. Пирогова»</p></bio><email>ashirenina@inbox.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Pirogov Russian National Research Medical University</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Medsi Clinical Diagnostic Center on Krasnaya Presnya</institution></aff><aff><institution xml:lang="ru">ОА ГК «Медси» Клинико-диагностический центр на Красной Пресне</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Medsi Clinical Diagnostic Center on Solyanka</institution></aff><aff><institution xml:lang="ru">ОА ГК «Медси» Клинико-диагностический центр на Солянке</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2022-12-21" publication-format="electronic"><day>21</day><month>12</month><year>2022</year></pub-date><volume>24</volume><issue>6</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>543</fpage><lpage>548</lpage><history><date date-type="received" iso-8601-date="2022-12-06"><day>06</day><month>12</month><year>2022</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2022, Consilium Medicum</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2022, ООО "Консилиум Медикум"</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="en">Consilium Medicum</copyright-holder><copyright-holder xml:lang="ru">ООО "Консилиум Медикум"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-sa/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://gynecology.orscience.ru/2079-5831/article/view/115071">https://gynecology.orscience.ru/2079-5831/article/view/115071</self-uri><abstract xml:lang="en"><p>The article addresses the treatment of uterine fibroids, which is still relevant. According to numerous studies, about 70% of females under 50 have uterine fibroids, the most common condition among perimenopausal women. The prevalence of giant forms is not high and accounts for less than 5% of all cases, especially at early diagnosis. The surgical strategy in such cases is individual and depends on many factors: size, location of nodes, and women's reproduction plans. In these clinical cases, the management of patients with giant uterine fibroids is presented according to the multimodal principles of fast-track surgery in a modern gynecological hospital. We described the main approaches in diagnosis, preoperative preparation, surgery features, and subsequent recovery to reduce the complication rate, the duration of inpatient treatment, and postoperative rehabilitation in the treatment of giant uterine fibroids.</p></abstract><trans-abstract xml:lang="ru"><p>В статье поднимается вопрос лечения миомы матки, который продолжает оставаться актуальным в настоящее время. По данным многочисленных исследований, около 70% женщин в возрасте до 50 лет имеют миому матки, которая является наиболее распространенной патологией среди женщин перименопаузального периода. Распространенность гигантских форм не так высока и составляет менее 5% всех случаев, особенно в условиях ранней диагностики заболевания. Объем и тактика хирургического вмешательства в таких случаях индивидуальны и зависят от различных факторов: размер, локализация узлов, репродуктивные планы женщины. В приведенных клинических случаях представлены принципы ведения пациенток с миомой матки гигантских размеров согласно мультимодальным принципам «fast-track хирургии» в современном гинекологическом стационаре. Нами описаны основные подходы в диагностике, предоперационной подготовке, особенности оперативного вмешательства и последующего восстановления с целью снижения частоты осложнений, длительности стационарного лечения и послеоперационной реабилитации при лечении миомы матки гигантских размеров.</p></trans-abstract><kwd-group xml:lang="en"><kwd>giant uterine fibroids</kwd><kwd>fast-track surgery principles</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>миома матки гигантских размеров</kwd><kwd>принципы fast-track</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Santana PT, Estepa PJL, Martyn EJF. Giant uterine fibromyoma. A case report. Medisur. 2013;11(6):701-6.</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. 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