Sucu Seyhun, Özcan Hüseyin Çağlayan, Karuserci Özge Kömürcü, Demiroğlu Çağdaş, Tepe Neslihan Bayramoğlu, Bademkıran Muhammed Hanifi
Deparment of Obstetrics and Gynecology, Gaziantep Univercity, Medical Medicine, Turkey.
SANKO University, Gaziantep Gazi Muhtarpaşa Bulvarı, Gaziantep, Turkey.
Ginekol Pol. 2021;92(2):137-142. doi: 10.5603/GP.a2020.0145. Epub 2021 Jan 15.
Our study aims to evaluate the effect of bilateral prophylactic internal iliac artery ligation (IIAL) on bleeding in patients with placenta percreta who undergo cesarean hysterectomy (CH) with the use of blunt dissection technique.
This retrospective cohort study included 96 patients with placenta percreta who underwent planned CH with using the blunt dissection technique to allow better vesico-uterine dissection at the gynecology and obstetrics unit of a university hospital between the years 2017-2019. We carried out bilateral IIAL before CH in the study group (group 1) while we performed only CH in the control group (group 2).
Group 1 and Group 2 consisted of 50 and 46 patients; respectively. There was no statistical difference between the two groups as regards to the mean estimated blood loss, the mean transfused blood products, the mean operation time, and the number of complications. In total, 24 patients (25%) had complications with the finding that the most common one was bladder injury (16/96, 16,66%).
Routine bilateral prophylactic IIAL before CH in placenta percreta cases does not have a beneficial effect on decreasing the amount of bleeding and the amount blood transfusion.
我们的研究旨在评估双侧预防性髂内动脉结扎术（IIAL）对采用钝性分离技术行剖宫产子宫切除术（CH）的胎盘植入患者出血的影响。
这项回顾性队列研究纳入了96例胎盘植入患者，这些患者于2017年至2019年间在一所大学医院的妇产科采用钝性分离技术接受计划性CH，以更好地进行膀胱子宫分离。研究组（第1组）在CH前进行双侧IIAL，而对照组（第2组）仅进行CH。
第1组和第2组分别有50例和46例患者。两组在平均估计失血量、平均输注血液制品量、平均手术时间和并发症数量方面无统计学差异。共有24例患者（25%）出现并发症，其中最常见的是膀胱损伤（16/96，16.66%）。
在胎盘植入病例中，CH前常规进行双侧预防性IIAL对减少出血量和输血量没有有益影响。
