Bosilah Almandouh H, Hussein Mohamed, Alboghdady Mahmoud Abdelwahed, Zaky Ahmed, Almorsy Ahmed Shafik, Taha Wael Soliman, El Azeem Mohammed Farouk Abd, Sholkamy Amr Mohamed, Khafagy Wael Abd Elatief, Abdelmoaty Muhamed Ahmed, Eldahab Ibrahim Mohamed Abo, Mohamed Bahaa Eldin Elmohamady, Diab Yasser Mohamed Said, Mohammed Ahmed Hashim, Shaaban Ahmed Samir Hamid, Taha Elsayed Mohammad, Elboghdady Adel Aly, Sileem Sileem Ahmed, Essawy Hany Gaber, Elshahat Elmetwally Farouk, Soror Ghada Ibrahim Elsaid, Mohamed Hamza Mohamed Abdelmohsen
Obstetrics and Gynecology Department, Faculty of Medicine Damietta University, Damietta, Egypt.
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Prz Menopauzalny. 2024 Mar;23(1):21-24. doi: 10.5114/pm.2024.136954. Epub 2024 Mar 28.
The aim was to assess the hemostatic impact of B-Lynch sutures following an open myomectomy for efficacy.
In this prospective clinical research, performed in Alazhar university hospitals (Al-Hussain, Damietta, Assiut) and Minia University Maternity Hospital, 250 women scheduled for open myomectomy between January 2021 and January 2023 had multiple fibroid uteri with uterine sizes corresponding to 12-22 weeks. There were two groups of women. Group I (125) underwent standard open myomectomy surgery, whereas Group II (125) underwent normal open laparotomy surgery followed by B-Lynch sutures. Certain inclusion and exclusion criteria were applied to every patient. We recorded vital data, length of the procedure, complications (bleeding during the procedure, bleeding from multiple bites, bladder injury, fever, wound infection), complete blood count before and after surgery, need for blood transfusion, postoperative vital data, time until ambulation, passing flatus, and ability to eat and drink, as well as the amount of blood lost during and after the procedure.
There was no statistically significant difference between the two groups in age, parity, weight, number of fibroids, or uterine size as measured by ultrasonography. Between groups I and II, there was a significant difference in the average intraoperative blood loss (Group I lost 562.6 ml, whereas Group II lost 411.3 ml) as well as the mean blood loss following surgery (205 ±82 ml in Group I and 117 ±41 ml in Group II). No significant difference was observed in the mean length of hospital stay between groups I and II (2 ±0.3 days and 2 ±0.6 days, respectively).
Using a B-Lynch suture can help minimize blood loss during and after an open myomectomy. Therefore, if the uterus is large and has a lot of fibroids, it is recommended to be done frequently.
目的是评估B-Lynch缝合术在开放性子宫肌瘤切除术后的止血效果。
本前瞻性临床研究在爱资哈尔大学医院（侯赛因医院、达米埃塔医院、艾斯尤特医院）和米尼亚大学妇产医院进行，2021年1月至2023年1月期间计划进行开放性子宫肌瘤切除术的250名女性患有多发性子宫肌瘤，子宫大小相当于12 - 22周妊娠。女性分为两组。第一组（125名）接受标准开放性子宫肌瘤切除手术，而第二组（125名）接受常规开放性剖腹手术，随后进行B-Lynch缝合术。对每位患者应用了特定的纳入和排除标准。我们记录了生命数据、手术时长、并发症（术中出血、多处咬伤出血、膀胱损伤、发热、伤口感染）、手术前后的全血细胞计数、输血需求、术后生命数据、直至下床活动的时间、排气时间、进食和饮水能力，以及术中及术后的失血量。
两组在年龄、产次、体重、肌瘤数量或超声测量的子宫大小方面无统计学显著差异。第一组和第二组之间，平均术中失血量存在显著差异（第一组失血562.6毫升，而第二组失血411.3毫升）以及术后平均失血量也有差异（第一组为205±82毫升，第二组为117±41毫升）。第一组和第二组之间的平均住院时长无显著差异（分别为2±0.3天和2±0.6天）。
使用B-Lynch缝合术有助于在开放性子宫肌瘤切除术中及术后减少失血。因此，如果子宫较大且肌瘤较多，建议经常采用该方法。
