Kalogiannidis I, Xiromeritis P, Prapas N, Prapas Y
IAKENTRO, Advanced Medical Center, Thessaloniki, Greece.
Clin Exp Obstet Gynecol. 2011;38(1):46-9.
We performed a randomized clinical trial to estimate whether preoperative use of misoprostol may reduce intraoperative blood loss of patients treated by minimally invasive surgery (MIS), such as laparoscopic (LM) or laparoscopically assisted myomectomy (LAM).
Sixty-seven menstruating patients with three or less myomas of a maximum diameter of 90 mm, scheduled for MIS, were randomly allocated to receive a preoperative single dose of intravaginal misoprostol or placebo. Sixty-four patients remained in the final analysis: 30 in the misoprostol (I) and 34 in the placebo group (II). Estimated blood loss (EBL), decline of postoperative hemoglobin (Hb) and side-effects of administered agent were the outcomes of main interest.
The EBL was significantly higher in the placebo versus misoprostol group (217 +/- 74 vs 126 +/- 41, respectively). Similarly, the decline of postoperative Hb was significantly higher in group II (1.6 +/- 0.43) compared to group I (1 +/- 0.33). The operative time was comparable in both groups, while the rate of side-effects was similar between groups.
The preoperative use of misoprostol in patients with uterine fibroids managed by minimally invasive surgery significantly reduces intraoperative blood loss. Misoprostol might be useful for the prevention of postoperative anemia in more extended minimal invasive interventions, such as myomectomy of large fibroids or laparoscopic hysterectomy.
我们进行了一项随机临床试验，以评估术前使用米索前列醇是否可减少接受微创手术（MIS）治疗的患者的术中失血，如腹腔镜手术（LM）或腹腔镜辅助子宫肌瘤切除术（LAM）。
67例计划接受MIS治疗、最大直径90mm及以下肌瘤数量为3个或更少的月经周期患者，被随机分配接受术前单剂量阴道内米索前列醇或安慰剂。最终分析纳入64例患者：米索前列醇组（I组）30例，安慰剂组（II组）34例。主要观察指标为估计失血量（EBL）、术后血红蛋白（Hb）下降情况及所用药物的副作用。
安慰剂组的EBL显著高于米索前列醇组（分别为217±74与126±41）。同样，II组术后Hb下降幅度显著高于I组（1.6±0.43与1±0.33）。两组手术时间相当，而两组副作用发生率相似。
在接受微创手术治疗的子宫肌瘤患者中，术前使用米索前列醇可显著减少术中失血。在更广泛的微创手术中，如大肌瘤切除术或腹腔镜子宫切除术，米索前列醇可能有助于预防术后贫血。
