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腹腔镜子宫肌瘤剔除术中双侧子宫及卵巢动脉短暂夹闭的手术影响。

Surgical impact of bilateral transient occlusion of uterine and utero-ovarian arteries during laparoscopic myomectomy.

机构信息

Department of Obstetrics and Gynecology, Ramón y Cajal University Hospital, 3428034, Madrid, Spain.

Department of Obstetrics and Gynecology, HM Montepríncipe-Sanchinarro University Hospital, 3428050, Madrid, Spain.

出版信息

Sci Rep. 2024 Mar 25;14(1):7044. doi: 10.1038/s41598-024-57720-9.

Abstract

The objective of this article is to compare the amount of intraoperative blood loss during laparoscopic myomectomy when performing bilateral transient clamping of the uterine and utero-ovarian arteries versus no intervention. It´s a randomized controlled prospective study carried out in the Department of Obstetrics and Gynecology Ramón y Cajal University Hospital and HM Montepríncipe-Sanchinarro University Hospital, Madrid, Spain, in women with fibroid uterus undergoing laparoscopic myomectomy. Eighty women diagnosed with symptomatic fibroid uterus were randomly assigned to undergo laparoscopic myomectomy without additional intervention (Group A) or temporary clamping of bilateral uterine and utero-ovarian arteries prior to laparoscopic myomectomy (Group B). Estimated blood loss, operating time, length of hospital stay, and postoperative hemoglobin values were compared in both groups. The number of fibroids removed was similar in both groups (p = 0.77). Estimated blood loss was lower in the group of patients with prior occlusion of uterine arteries (p = 0.025) without increasing operating time (p = 0.17) nor length of stay (p = 0.17). No patient had either intra or postoperative complications. Only two patients (2.5%) required blood transfusion after surgery. We conclude that temporary clamping of bilateral uterine arteries prior to laparoscopic myomectomy is a safe intervention that reduces blood loss without increasing operative time.

摘要

本文旨在比较腹腔镜子宫肌瘤剔除术中双侧子宫动脉和卵巢动脉临时夹闭与不干预的术中出血量。这是一项在西班牙马德里 Ramón y Cajal 大学医院和 HM Montepríncipe-Sanchinarro 大学医院妇产科进行的随机对照前瞻性研究,纳入了接受腹腔镜子宫肌瘤剔除术的子宫肌瘤妇女。将 80 名诊断为有症状的子宫肌瘤妇女随机分为两组:不进行额外干预的腹腔镜子宫肌瘤剔除术组(A 组)或在腹腔镜子宫肌瘤剔除术前临时夹闭双侧子宫和卵巢动脉组(B 组)。比较两组的估计失血量、手术时间、住院时间和术后血红蛋白值。两组切除的肌瘤数量相似(p=0.77)。动脉闭塞组患者的估计失血量较低(p=0.025),但手术时间(p=0.17)和住院时间(p=0.17)无明显增加。两组患者均无术中或术后并发症。仅 2 例(2.5%)患者术后需要输血。我们得出结论,在腹腔镜子宫肌瘤剔除术前临时夹闭双侧子宫动脉是一种安全的干预措施,可以减少出血量而不增加手术时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8965/10963736/2ff8dfc598c1/41598_2024_57720_Fig1_HTML.jpg

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