Effects of pericervical tourniquet on intraoperative bleeding at abdominal myomectomy

42225

Background: Uterine arteries are the major source of blood flow of the uterus. At the lateral isthmic level, uterine artery divides into two branches and enters the uterus. The ascending branch mainly nourishes uterine corpus while the descending branch provides blood supply for the upper vaginal area. Reduction or discontinuation of ascending uterine artery flow will reduce bleeding during surgical procedures. Surgery is the most preferred treatment in symptomatic leiomyomas. The present study aims to compare the efficacy of conventional and pericervical tourniquet assisted techniques in abdominal myomectomy.Method: Fourty-five women who underwent abdominal myomectomy between January 2013 and January 2014 were allocated into two groups: (1) pericervical tourniquet -assisted technique (15 patients) and (2) conventional technique (30 patients). The patients with submucous, subserosal and parasitic fibroids were excluded. For pericervical tourniquet assisted myomectomy, 16F catheter was strapped around the isthmic level on both sides of the uterus so that tourniquet was applied in front of the anterior region.Results: The mean hospital stay was 2.5 days for the pericervical tourniquet -assisted technique and 2.6 days for the conventional technique (p 0.05). The mean operation time was 54.7 minutes for the pericervical tourniquet -assisted technique and 54.6 minutes for the conventional technique (p 0.05). Both groups were statistically similar in aspect of perioperative complications as well as hemoglobin and hematocrit changes (p 0.05 for all).Conclusion: Pericervical tourniquet-assisted technique is a feasible and effective method for performing myomectomy.

89

Pericervical tourniquet , myomectomy , hemoglobin , hematocrit

Kocatepe Medical Journal

93

Kocatepe Medical Journal