Akbaba Eren, Sezgin Burak, Sivaslıoğlu Ahmet Akın
Department of Obstetrics and Gynecology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
J Turk Ger Gynecol Assoc. 2022 Jun 1;23(2):111-116. doi: 10.4274/jtgga.galenos.2021.2020-0242. Epub 2021 Jun 8.
Uterine fibroids are common, benign uterine tumours. The three most common surgical treatment approaches for uterine fibroids are laparoscopic, robotic and abdominal myomectomies. Bleeding is a risk with all three approaches. The present study compared post-operative and pregnancy outcomes in patients with bilateral uterine artery occlusion who underwent an abdominal myomectomy, with or without a temporary uterine tourniquet.
This retrospective study included patients with intra-mural fibroids (≥5 cm) who underwent an abdominal myomectomy. The patients were divided into two groups according to the use or non-use of a temporary uterine tourniquet. Post-operative and pregnancy outcomes in the tourniquet use and non-use groups were compared. The association of the number of uterine fibroids removed (≤3 vs >3) with laboratory parameters was also evaluated.
A total of 84 patients were included, divided into use (n=36) and non-use (n=48) of the temporary tourniquet. There was a statistically significant difference between the groups with >3 myomas removed and with a uterine tourniquet applied and not applied in terms of reduction in hemoglobin and hematocrit, transfusion amounts, operation times and lengths of hospitalization in favour of the uterine tourniquet use group (p=0.019, p=0.023, p=0.012, p=0.044 and p=0.036, respectively). Bilateral uterine arterial occlusion using a temporary uterine tourniquet had no negative effects on pregnancy outcomes.
A temporary uterine tourniquet may be an effective method for reducing the amount of perioperative bleeding in patients with multiple, large-sized myomas located close to vascular structures.
子宫肌瘤是常见的良性子宫肿瘤。子宫肌瘤最常见的三种手术治疗方法是腹腔镜、机器人辅助和开腹肌瘤切除术。这三种方法都存在出血风险。本研究比较了接受开腹肌瘤切除术的双侧子宫动脉闭塞患者在使用或不使用临时子宫止血带情况下的术后及妊娠结局。
这项回顾性研究纳入了接受开腹肌瘤切除术的肌壁间肌瘤（≥5 cm）患者。根据是否使用临时子宫止血带将患者分为两组。比较了使用和不使用止血带组的术后及妊娠结局。还评估了切除的子宫肌瘤数量（≤3个与>3个）与实验室参数之间的关联。
共纳入84例患者，分为使用临时止血带组（n = 36）和不使用临时止血带组（n = 48）。在切除肌瘤>3个且应用和未应用子宫止血带的组之间，在血红蛋白和血细胞比容降低、输血量、手术时间和住院时间方面存在统计学显著差异，有利于使用子宫止血带组（分别为p = 0.019、p = 0.023、p = 0.012、p = 0.044和p = 0.036）。使用临时子宫止血带进行双侧子宫动脉闭塞对妊娠结局无负面影响。
临时子宫止血带可能是减少靠近血管结构的多个大肌瘤患者围手术期出血量的有效方法。
