Department of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Department of Functional Sciences, Discipline of Public Health, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Medicina (Kaunas). 2023 Nov 10;59(11):1979. doi: 10.3390/medicina59111979.
: The objective of this study was to assess the effectiveness of using a peri-cervical tourniquet in reducing blood loss during a laparoscopic myomectomy. : This prospective study evaluated the impact of performing a concomitant tourniquet placement during a laparoscopic myomectomy (LM). A total of 60 patients were randomly allocated to one of two groups: 30 patients who underwent an LM with a tourniquet placement (the TLM group) and 30 patients who benefited from a standard LM (the SLM group). This study's main objective was to evaluate the impact of tourniquet use on perioperative blood loss, which is quantified as the difference in the pre- and postoperative hemoglobin levels (Delta Hb) and the postoperative blood transfusion rate. : The mean Delta Hb was statistically lower in the TLM group compared to the SLM group: 1.38 g/dL vs. 2.41 g/dL ( < 0.001). The rate of postoperative iron perfusion in the TLM group was significantly lower compared to the SLM group (4 vs. 13 patients; = 0.02). All four patients that required a blood transfusion were from the SLM group. On average, the peri-cervical tourniquet fastening time was 10.62 min (between 7 and 15 min), with no significant impact on the overall operative time: 98.50 min for the TLM group compared to 94.66 min for the SLM group. : Fastening a tourniquet during a laparoscopic myomectomy is a valuable technique to effectively control intraoperative bleeding and enhance surgical outcomes.
: 本研究旨在评估在腹腔镜子宫肌瘤剔除术中使用宫颈周围止血带减少出血的效果。 : 这项前瞻性研究评估了在腹腔镜子宫肌瘤剔除术(LM)中同时使用止血带的影响。共有 60 名患者被随机分为两组:30 名患者接受 LM 联合止血带放置(TLM 组),30 名患者接受标准 LM(SLM 组)。本研究的主要目的是评估止血带使用对围手术期失血的影响,通过术前和术后血红蛋白水平的差异(Delta Hb)和术后输血率来量化。 : TLM 组的平均 Delta Hb 明显低于 SLM 组:1.38 g/dL 与 2.41 g/dL( < 0.001)。TLM 组的术后铁灌注率明显低于 SLM 组(4 对 13 例; = 0.02)。需要输血的所有 4 名患者均来自 SLM 组。平均而言,宫颈周围止血带固定时间为 10.62 分钟(7-15 分钟),对总手术时间无显著影响:TLM 组为 98.50 分钟,SLM 组为 94.66 分钟。 : 在腹腔镜子宫肌瘤剔除术中固定止血带是一种有效控制术中出血和改善手术结果的有价值技术。