Randomized clinical trial comparing cold knife conization of the cervix with and without lateral hemostatic sutures.

OBJECTIVE

Compare blood loss during cold knife conization of the cervix with and without lateral hemostatic sutures in the cervical branches of the uterine arteries.

DESIGN

Randomized clinical trial.

SETTING

Hospital de Clínicas de Porto Alegre (HCPA).

POPULATION

102 patients that underwent cold knife conization.

METHODS

Women that underwent cold knife conization of the cervix were randomized to undergo the procedure with or without lateral hemostatic sutures.

PRIMARY OUTCOME MEASURE

blood loss measured in grams.

SECONDARY OUTCOME MEASURES

operative time and postoperative intervention. Only the participants were blinded to group assignment.

RESULTS

From March 2009 to August 2012, patients were randomly assigned to one of the study groups. There were no differences in amount of blood loss between patients that underwent the procedure with and without sutures (p = 0.39). Operative time was shorter in the group without suture (p = 0.020). There were no differences in intervention due to bleeding (p = 0.20). Blood loss was greater among menstruating women than for menopausal women (p = 0.011). There were no differences in amount of blood lost between smoking and nonsmoking patients (p = 0.082).

CONCLUSIONS

Lateral hemostatic sutures do not affect the amount of intraoperative bleeding or the number of postoperative interventions. Their use is not necessary because they result in longer operative time, have a higher cost due to the use of suture material and pose the risk of ureter lesion in case the sutures are not placed at a lower position in the cervix. ClinicalTrials. gov identifier: NCT02184975.